Help Kodiak keep going in the face of hemangiosarcoma

For those who don't know me, I'm Lil. I'm a veterinarian completing a residency in Emergency and Critical Care. I'm hyper-independent to a fault and hate asking for help in my personal life. For multiple reasons, I am moving across the country from LA to Boston, MA at the end of April. After years of moving further and further away from home, I'll finally be going back to New England, back to my old hiking spots, back to my family, and back to my friends. But this isn't just about me. I am choosing to be vulnerable in asking for help to cover the costs of my dog Kodiak's emergency surgery, recent chemo costs, and costs of the clinical trial he is in for hemangiosarcoma, a terminal cancer. Despite having really good (and expensive) insurance for him which has literally been a lifesaver, they don't cover 100% and a few thousand dollars here and there is just not doable for me right now while also paying to move my life across the country.

Kodiak is my heart and soul outside of myself in a fuzzy brown body with a wet nose. He has kept me alive, without exaggeration. I wouldn't be here without him. Since adopting him in 2015 from a rescue in Rhode Island, he's been with me through our move to Philly for vet school, then Pittsburgh for internship, and Los Angeles for residency. We've hiked, explored, sunbathed, shared ice cream, and napped, among so many other things. He recently turned 9 years old.

I know we never get enough time with our pets, but it feels so unfair to have so little time with him when I was able to provide him with the best medical care throughout his life. I am privileged to be a veterinarian, but cancer doesn't care about privilege.

Unfortunately, I diagnosed him with hemangiosarcoma in Aug 2024. Even with surgery and chemotherapy, we struggle to get dogs with this cancer to live longer than 6 months post-diagnosis. We found a small mass on his spleen when looking for causes of GI upset. I took him to surgery the next day, removed his spleen, and submitted it for biopsy. About 70% of incidentally found splenic masses are benign, but unfortunately Kodiak fell into the 30%. He had a rough recovery from surgery for a few weeks and his injectable chemotherapy made him feel sick for a few days after each injection. We submitted his mass to a special gene sequencing company to find specific targets for additional chemotherapy, which he takes orally daily. He is on all of the supplements and since completing his injectable chemo, has been feeling really good for the past 7 months! We recently started a clinical trial for the Yale Vaccine, which attempts to teach the immune system to target the HER2 protein, a protein over-expressed in certain types of cancers, including hemangiosarcoma. The day prior to his first vaccine, we found a new small ~1.5cm mass in his left liver lobe. I knew this would happen eventually. I knew more masses would come, but that doesn't mean I was ready for it. We hoped that with ongoing chemo and the Yale Vaccine, we could slow the growth of the tumor.

On March 23, about 2 weeks after finding the new tumor, Kodiak suddenly became wobbly on his feet, wouldn't eat breakfast, and had pale gums. I immediately knew his tumor had started bleeding. For those who don't know, hemangiosarcoma kills because of bleeding. They generally feel really good, until they don't. I took him in and scanned his belly. His liver tumor had grown to ~5cm and he had free fluid in his abdomen - internal bleeding from the tumor, as I suspected. The tumor more than tripled in size in less than 2 weeks. Kodiak's vitals were stable, so I suspected he clotted the bleed on his own, but once they bleed, they will bleed again. In general, most people don't take their pets to surgery again to remove tumors because it is considered metastatic disease and removing one tumor only helps until the next grows and ruptures. It's like playing whack-a-mole and the time between tumors popping up gets shorter and shorter. So I knew what this bleeding event meant for Kodiak. Time was almost up.

I took him to the beach and he was so tired that I had to carry him most of the way to the water's edge. I sobbed and watched the sunset with him. I told him it was ok to be tired and that I wouldn't let him suffer. I was devastated that he wouldn't make it home to Rhode Island to see all of his old friends, see his grandma, and hike his old haunts. We only had a month before moving, but I knew that even if he didn't bleed again in that time, it was too risky to put him on a plane in cargo, unmonitored, for a 9 hour flight. If he suffered a bleed on the plane, I would never forgive myself. Even if he felt great and was his normal bouncy self, the right thing to do would be to put him to sleep before moving. For the next few days and nights, I gave him some supportive care treatments at home, but I was barely sleeping. I was up late in the evenings looking for my lost cat, I was struggling to fall asleep from anxiety, and even when I managed to finally fall asleep, I would jolt awake sometimes as often as every hour and check Kodiak's gums and his breathing rate to make sure he was still stable.

The alternative, of course, was to go to surgery and remove the bleeding tumor. One of the most common questions I get as a vet is "what would you do?" My answer is usually that I can't truly answer that question because I don't think anyone knows what they'd do unless they were in the exact same situation with the exact same life circumstances. Still, I asked so many trusted people whether I was crazy for considering surgery. I asked some of the best vets I know for guidance. I didn't know what the "right" answer was, but I knew some other factors made the decision even harder for me. Only 1 week prior to his bleed, my cat Noodles went missing and still hasn't returned despite all of my efforts to find her. I suspect she was unfortunately eaten by a coyote or similar, so I have been grieving her. My dad passed away in January, which is complex, but still painful. And I've been dealing with a lot of other life changes that have felt insurmountable. My anxiety has gotten so bad from repeated traumas that I've developed a body-focused repetitive behavior called trichotillomania, a compulsive condition that causes you to pull out your own hair (not sure why I shared that, but these types of compulsions aren't talked about enough and carry a lot of stigma, so whatever). I didn't want to be selfish and keep Kodiak alive for me, but I would be lying if I said I was in a healthy enough place to let him go. And I knew that he had the chance to be back to himself once he recovered from surgery.

The left lateral liver lobe is the easiest to remove surgically. He had no other evidence of spread or new tumors (though often we just can't see the spread yet in hemangiosarcoma). He still had one more Yale Vaccine to get for the clinical trial and didn't even have a chance for it to potentially help. It wasn't healthy for me to be getting so little sleep from how anxious I was that he was going to bleed again at any moment. And ultimately, even if it only bought him a month or two of good time, I would do anything for an extra month with my boy. So, on March 27, Kodiak underwent surgery to remove the tumor and has recovered SO well since then. I took his stitches out today, the day I'm writing this April 9th, and he's bouncing around playing like his normal happy self. He's currently staring at me not-so-subtly from across the room waiting for me to acknowledge that it's time for dinner.

I don't know how much longer he has, but I am committed to give him as much good time as possible. That being said, the timing of all of this is the worst it could be for me and his insurance is covering less than I expected them to. I don't have the extra funds to cover the surgery, submission of the new tumor for gene sequencing to see if there are other chemo drugs we could be using, and the costs of his Yale Vaccine (which is not covered by insurance because it's a clinical trial). So here I am, asking for help because we all need a little help sometimes, even if it is uncomfy to ask for it.

I appreciate anyone who has made it this far, even if you are unable to donate. It feels good to talk about the things I've been struggling with. I'm so grateful Kodiak has recovered smoothly from his recent surgery and is feeling like himself. I'm trying to memorize the feeling of his nose nudging me in the mornings for breakfast, the sound of his tail thumping on the furniture, the way his ears flap when he's walking, and the feeling of his entire weight sitting on me when I'm not getting up fast enough or he just wants attention. I cherish every second I have left with him.