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The amuputation of Quinta’s front left leg was the immediate result of a biopsy that confirmed the presence of histiocytic sarcoma, an aggressive cancer with a grave prognosis. We have since learned that the tumor has metastasized to Quinta’s lymph nodes. Here in Japan, possible chemotherapy treatment involves either lomustine (CCNU) or doxorubicin (adriamycin), but the efficacy of such treatment is not clear. Even if the treatment were effective, in most cases it is short-term. Serious adverse effects include bone marrow depression, a condition from which Quinta already suffers.

I have been struggling with whether to put Quinta through chemotherapy under these circumstances, trying to figure out what is “best” for Quinta. He has been home for the past week and regaining his health; he is hopping around and enjoying the company of our three cats and our friends who visit him. Just being home and being relaxed have done wonders for him. Quinta seems very happy today.

I decided not to put Quinta through chemotherapy that may be of limited efficacy and that involves risks that would likely create discomfort for Quinta. I do not think that is what Quinta wants and I think what is important to him (and to me) now is to be able to spend every minute in the comfort of our home and with the cats and our friends whom we love.

A part of me wonders whether, by deciding not to proceed with chemo, I am failing to pursue all available options for Quinta, and therefore failing to fight cancer and giving up. I keep reading about how we should not give up without a fight, and wonder if I am not even trying to fight the cancer. Have I failed as Quinta’s guardian? What does it mean to fight cancer? Is there any correct way to do so?

However much I wish for a miracle cure, I realize that no amount of chemotherapy agent injected into Quinta’s bloodstream will be able to sustain the lethal attack of histiocytic sarcoma. The chemotherapy tools available to help Quinta today seem like 19th century gunboats trying to fight the onsalught of a nuclear arsenal. I cannot fight cancer on its terms.

Quinta and I will therefore fight cancer on our own terms — love and compassion. We have a great team of doctors, dog sitters and friends who have rallied around Quinta to provide him with the best care in order to ensure that his quality of life does not suffer and he can continue to live the rest of his remaining life in as much comfort as possible, surrounded by love and in a way that respects his personality and what is important in his life. I want Quinta to have as normal a life as possible, so we have started a rehab program to support his new life as a tripawd, as well as a program of supplements and Eastern medicine. I want him to continue to live a healthy life as a dog, being able to walk/hop and enjoying his meals and treats and playing with the cats and his friends. None of this may prevent what histiocytic sarcoma will ultimately bring, but we will not allow it to take over Quinta’s life and dictate how he lives.

Quinta is alive and happy today.

Even before the surgery, Quinta had been receiving acupuncture treatment from a vet who is trained in Eastern medicine. She comes to our house and spends about an hour with the treatment, which has helped enormously with Quinta’s legs. Today was the first treatment post-operation.

Our vet was pleasantly surprised by how strong Quinta seemed — she said that she expected his back and his neck to be more tense, and his legs to be more strained. She had taught me how to give Quinta a massage, so I have been doing so every morning. This seems to have helped in lessening the strain on his legs and back.

To help boost his immune system, Quinta has started taking Wei Qi booster, a Chinese herbal medicine associated with immune functions. He is also taking maitake mushroom supplements that are supposed to have a similar effect. Our vet trained in Eastern medicine coordinates closely with the doctors at the animal hospital where Quinta had his surgery, so we are trying to come up with a comprehensive treatment plan that incorporates both Western and Eastern medicine.

Here in Japan, it is common custom to send a friend or relative a present when he or she goes home after a period of hospitalization. The gift is intended to covey both a “get well” message as well as a message of support and encouragement.

Today, Quinta received such a present — a box full of beautiful fresh peaches and watermelons!

The gift was from Jam (one of my cats)’s foster mother (the person who found Jam as an abandoned kitten and rescued her, and then brought her all the way from Osaka to Tokyo to be part of our family). She met Quinta last summer when she brought Jam to our home, and has been delighted by how much care Quinta gives to little Jam. She says that he is like a mother to Jam even though he is a boy.

Quinta’s last fentanyl patch came off today but he does not seem to be bothered by pain any more. He is walking more energetically, although not for any long distance. He is still panting occasionally but not so much as to disturb his sleep.

Thank you to everyone for your messages of support and encouragement. I will find out where Quinta’s gauze T-shirt comes from, as it seems that this is not typical in the US. The T-shirt was particularly useful when the surgery wound was still wet and healing. It also stays on more reliably than a bandage, so no reason why it should not be used outside of Japan.

Quinta’s fever went down and he is able to sleep better. Last night his temperature was 39.4 degrees C., but this morning it was down to 38.6 degrees. The hospital instructed me to take Quinta’s temperature three times a day and to notify them if it goes above 39.5 degrees. This morning, Quinta was even playing a bit with his “little sister”, Jam the cat.

This afternoon my friend Midori — herself a cancer survivor — came to visit Quinta. Quinta adores Midori, and when she came into the house, he immediately got up and hopped over to greet her. Midori was in tears seeing Quinta act so strong and happy only one week after his surgery. Quinta was back to being his old self during Midori’s visit, wagging his tail and licking her hand. Towards the end of the visit, however, his temperature had shot up to 39 degrees, so we let him rest a bit, but he is fine now. I think these visits with the people he loves are doing more for Quinta’s health and spirit than any drug or medication.

You will see that Quinta is wearing a light blue-green shirt. This is a special gauze shirt that the hospital gave us for Quinta to wear until next week (I change the shirt daily). This is intended to keep the surgery wound covered, although it seems to be healing steadily. I don’t know if they use these shirts in the US, but they are quite handy and help to keep the wound area clean.

Last night, the first night home for Quinta, he did not sleep very well. Several times during the night, Quita woke up panting. Worried that he was feeling too hot, I turned on the air conditioner and he went back to sleep. This morning, we tried to follow our usual routine as much as possible. We went outside just for a few minutes (as it was apparent that Quinta did not want to go far) for Quinta to pee, came back into the house and went to the kitchen to fix everyone (Quinta & cats)’s breakfast. He waited in my bedroom while I showered and dressed, and we went back up to the living room. We had some visitors this morning and this seemed to brighten up Quinta’s spirits. He is now sleeping quietly on his favorite bed by the window.

Ever since Quinta became family, we would look forward to March/April of each year when the cherry blossoms are in full bloom. It is perhaps the most beautiful time of the year in Japan, when it is not too cool/cold or too warm/hot. On our usual walks, Quinta and I would stop and admire the cherry blossoms. I do not think Quinta can walk that far any more, so I got him a buggy. It is too hot in Tokyo now to go out on buggy excursions, but when it gets cooler, I want to take him around the neighborhood so that he can visit his friends. Our goal is at least to make it until next March/April so that I can take him to see the cherry blossoms again. Having this one goal — however small — helps to keep focused and positive and look forward to so many more wonderful days that Quinta and I plan to spend together.

The animal hospital called this morning to say that Quinta can come home. Sadly, the otherwise happy news came with some bad news: the tests on Quinta’s lymph glands (removed during surgery) revealed that the cancer has metastasized. While chemotherapy (lomustine) is an option, Quinta already has anemia and low white blood cell count, which will likely worsen with chemo.

For now, Quinta is safely home and relaxing in his favorite bed. He still has a slight fever and we need to monitor his temperature several times a day. His appetite is healthy but his back legs are a bit weak from having spent a week in the hospital. A friend came to visit, and when she entered the room, Quinta immediately got up, wagged his tail and walked over to her to say hello.

Today I am just thankful that Quinta is home with me.

Tuesday — we thought Quinta would be able to come home today, but the site of his surgery wound is still a bit swollen and he continues to be anemic, although he is eating well. The doctor wants to keep Quinta in the animal hospital for a couple more days, so we now hope to bring Quinta home around Thursday. If we do, Quinta will have been in the hospital for exactly one week, which is what the doctor told us would be likely when Quinta went in for surgery. Quinta seems to be getting stronger by the day and his expressions are livlier (no more grogginess from pain medication).

When Quinta sits up or stands, he balances his front leg towards the center of his body to steady himself. He seems to be getting slowly used to being a “tripawd”.

Now, if only Quinta can come home!

Sunday in Japan (big election day here). After casting my vote, I went to the animal hospital to visit Quinta. When I came into the room, he smiled and wagged his tail. He did not get up, but when I took out today’s snack (sliced apples), he immediately stood up and hopped over for his treat. The doctor says that Quinta slowly seems to be getting used to being on three legs. We expect Quinta to come home either Tuesday or Wednesday. The cats, especially the little one, seem to be looking for Quinta around the house and wondering where he is. They (and I) will be delighted to welcome him home soon.

Quinta seems to be doing much better today (Saturday). He is no longer in a crate with the other animals and is getting VIP treatment by being allowed to roam around in a small air-conditioned room all for himself. He is still on pain medication but a lot less groggy than he was yesterday. He can stand up and hop around. When I came into the room, he was all smiles. For his snack today, I brought some blueberries (another favorite treat) from the blueberry tree at our house. The vet thinks that we need a few more days in the hospital for monitoring, but I hope he can come home early next week.

A heartfelt thanks to everyone who sent Quinta and me much love and words of support and encouragement. Although we are far away, they were duly received and helped us get through the surgery on Thursday.

Quinta is a strong and resilient boy. He is still recovering in the hospital, but getting stronger by the day. Yesterday, when I visited him, he immediately stood up and licked my hand as if to say, “I am so happy!” Like all good Labs, he has not lost his appetite (!!) and is getting straight-As in the “voracious eater” department. I brought over some cherry tomatoes (Quinta’s favorite snack) that my father grew this summer for Quinta, and Quinta ate them with gusto.

I realize that there will be ups and downs in the recovery process, but I am grateful that Quinta is doing well, thanks to all the support we have received from everyone around the world.