[Jan 24 Tue]To tell the truth, it was scheduled on Jan. 24 but the TC-scan machine broke down and I came back empty handed. On that day, I was feeling ill because I got IV (Intravenous) shots on my front and hind legs in preparation for my anesthesia and left waiting in vein for many hours. When I came back to my master and mistress, I had no appetite and they let me rest at home without dinner. Late at night, I regained my appetite, took the late dinner and I was completely normal next morning and walked with my master in the Tallman Mountain. [Jan 26 Thu]Two days later today, again at 7am in the morning, I was sadly lying on the floor of the main waiting room on the second floor of AMC, with my hind legs trembling. In the room, there were only three dogs and three couples including myself and my master couple. I saw a big golden retriever vehemently resisting not to be pulled away by a hospital staff but eventually being pushed by his master couple into the treatment quarter. Next on my turn, when a hospital staff came to pull me away, I was quite obedient. After a deep sleep, I woke up gradually and I was taken back to my master and mistress who were eagerly waiting for me. Unlike the last time, I was feeling very well and came back home.
When I finished eating dinner as usual, the daughter of my master came to embrace me and started crying. I realized that the whole family is in deep distress. As for myself, I feel quite good and happy to be at home with the whole family. I may have to ask my master to disclose to you three messages he has been sending and receiving. [My master’s message to his son in Tokyo]: As a result of the CT-scan, unfortunately the cancer has spread extensively in the upper jawbone (maxilla). The surgeon pointed out that the excision from the dogtooth up to the first molar would be required at the minimum. He could not say for sure whether the cancer can be taken out completely or not unless he actually executes the surgery. As we were very surprised and hesitating to make a decision, the surgeon proposed the three alternatives and said: "Let's stop the surgery for now. I can do the surgery even tomorrow if you should decide." We waited until Coty waked out of anesthesia and took him back without the surgery.
[Message from the surgeon]: There are 3 alternatives to attempt to control local disease for Coty: 1) the best chance at local control is for an aggressive surgery and only if the resection is not complete, then follow-up radiation therapy. If the excision is complete, then radiation therapy is not necessary. 2) A marginal (or smaller) surgery, and followed by radiation therapy is the next best option for local control, although from first principles this may be less effective than the first option. 3) The third option is radiation alone, which is better for local control than doing nothing, but radiation does not work as well when you can actually see tumor present (i.e. with gross disease).[Response message from Dr. Soeda]:Indeed, if you do, you do it very aggressively, otherwise, it may be meaningless. Realistically speaking, the appearance of Coty would change considerably and look miserable. If that is the most effective means to improve the current situation, please consider carefully the treatment of Coty and his quality of life after the surgery as well as the feeling of the family members and make a decision. Of course, I will also think with you.