“Ranjana, how long can Fifi live with liver cancer?”

An unexpected aspect of being an oncologist (for humans) is being approached for advice about pets (usually dogs) with cancer. Bruno, Marco, Maisie, Ziggy, Chloe, Tiger, Muppet, Jessie, Bella, Buddy, Johnny, Wilfred. Apart from my own Odie, the dogs of my friends form the backdrop of my life. Not all of them develop cancer but when there is a diagnosis, I know.

I had recently qualified as an oncologist when a neighbour told me about his cancer-afflicted dog, and the options for treatment being surgery or “let him die”. My first alarmed instinct was to beg that I knew precious little about human illness let alone canine oncology, but as he talked about his choices, I realised that I was merely a vessel for the anticipatory grief of losing his “top person”. This, I was comfortable with.

There have been many conversations since: whether to do the biopsy, remove the kidney, resect the bowel, detach the leg, accept chemotherapy, when and where to palliate.

Now, it’s Fifi’s turn. Fifi, who has lost her senses but navigates her surroundings with determination and behaves with unobtrusive gentleness, never one to bark at guests or nose her way into their laps. Fifi’s liver is heaving with cancer and the bloods are dire. Decisions weigh on her owners. To treat or palliate. How to gauge pain and define suffering. What is the right thing to do by a beloved........

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