Gabe had his MRI this morning at the WSU veterinary teaching hospital, and I took the photo of our oncologist, Dr. Janean Fidel, showing me the images. His tumor is very large and fills the entire right side of his nasal passage. Here's a close-up of the image, which is reversed, so you really are looking at the right side:
The vertical orange line is marking one edge of the tumor — it's that area in bright white that extends from the orange line at the right end all the way to his nose on the left end. It fills the entire space from immediately above his teeth to the top of his snout. At the lower right edge, the tumor actually extends past the orange line a bit.
At the upper end of the orange line where it sticks out above his skull, you can see a change in color, or density, from the white of the tumor to a light gray mass that fills his forehead area. Dr. Fidel thinks this is most likely fluid from his nasal passages that hasn't been able to drain out, so it's backed up inside his head. (Can you imagine what that must feel like?) When I saw that I just winced.
If you click on the image for a larger version, you'll be able to see a cursor arrow indicating roughly the center of the tumor.
It turns out that the tumor has not grown into the left side of his nose, but the reason both his nasal passages are blocked is because at the back end — where that orange line is — the tumor wraps around in a curve and effectively blocked the left side, too.
Dr. Fidel said the image looks to her like a fibrosarcoma, which would be consistent with the initial biopsy we did in Helena.
One of the surgeons confirmed to Dr. Fidel today that they would be able to remove the tumor surgically, and Gabe is tentatively scheduled for surgery for tomorrow (Thursday) afternoon. The surgeon will be calling me on Thursday morning to review the procedure and to let us know what to expect in terms of post-operative care.
At some point after he recovers from the operation — it might be a week or two — Dr. Fidel will begin the radiation treatment. Gabe will have essentially the same 3-week, 18-dose regimen that blind Callie had back in April.
The good news in all this is that Dr. Fidel believes the combination of surgery and radiation will give Gabe at least another two to three years of life. The cost is steep — we're looking at roughly $6,000 for everything — but Alayne and I feel we owe it to this blind boy to give him those extra years. Gabe is already blind, nearly deaf, and has been living with this hideous tumor for Lord knows how long. And if that's not bad enough, here the poor guy was turned out and left to fend for himself as a stray. He's been dealt some really bad cards in life, and we think he certainly deserves another chance. Because of the support we get from so many amazing, compassionate people, we're blessed to be able to give it to him.
When I wrote out the check for $1,000 today at the hospital as a deposit for his treatment, I felt so incredibly grateful for the gifts that make it possible for us to do something like this for a dog like Gabe.
Before I left to head back to Montana, the 4th-year vet student who is Gabe's case manager — Al D., who is from Missoula and who got his undergraduate degree at Montana State University — brought Gabe out so I could say goodbye. Gabe had just recently come out of the MRI and was still groggy from the anesthesia, so Al wheeled him into the lobby on a cart:
Please keep Gabe in your thoughts for a successful surgery on Thursday.
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In Teddy news: Dr. Jennifer Rockwell called me while I was en route back to Montana to tell me our internist, Dr. Britt Culver, found no abnormalities during his ultrasound of Teddy this morning. Britt did detect mitral valve insufficiency, which is causing Teddy's heart murmur, but he's definitely not in heart failure and it's so minor there's no need for medication. In effect, a clean bill of health from radiographs, bloodwork, urinalysis, and ultrasound … meaning we still have no idea why Teddy had his crisis episode Sunday night. All I know is medicine is three parts science and one part stuff-you-just-can't-explain. Jennifer will do his dental on Friday and he should be coming back to the ranch this weekend.
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