Lily’s Room in the Cancer Hotel

My train­er and good friend Janet called me one after­noon in July. “Mari­no says Lily is bleed­ing.” Her voice was tight, strained. “He says there’s a lot of blood.” Lily is a gray Azteca mare. Mari­no is the man who feeds my hors­es and mucks out the stalls.

“I’ll go over there now,” I said.

“Call me when you get there. I’ll come in if it’s as bad as he says.”

When I arrived at the barn, Lily stood at her stall door. She looked alert, her ears pricked up, her eyes clear.

Inside her stall, I found blood smeared on the wall and crim­son stains in the wood shav­ings of her bed­ding. Lily’s lush white tail was soaked red, and blood stained her back legs.

I lift­ed her tail. On its under­side near the top, a black tumor the size of a crab-apple had burst and gushed blood.

Look­ing at the blood in the stall and on Lily, I pieced togeth­er what hap­pened. The huge tumor caused Lily dis­com­fort. She backed up against the wall and rubbed the tumor against it, push­ing so hard it ruptured.

Lily is 16. I bought her when she was 8. Her pre­vi­ous own­er abused her. When we brought her home, she was afraid of men – me, the vet, Mari­no. Janet was able to work with her, but when I approached, she ran to the oth­er side of her cor­ral and stared at me fearfully.

I vis­it­ed her every day, talked soft­ly to her, and plied her with treats. About two weeks into it, she final­ly allowed me to touch her. See Lily’s Song for the full story.

Short­ly after that, I found two small hard knots on her shoul­der. Years ear­li­er I’d seen growths like that on my dog. I knew what they were.

I called the vet. In addi­tion to the knots, he found a string of mar­ble-sized black lumps on the under­side of Lily’s tail. He con­firmed my fears. “Lily has melanoma,” he said.

Equine melanoma is com­mon among gray hors­es. About 80 per­cent of them become afflict­ed with it at some point in their lives. The can­cer­ous tumors are usu­al­ly locat­ed on the lips, around the eyes, along the neck, or on the under­side of the tail. Over time, the tumors often mul­ti­ply and grow larger.

There is no cure, but if the tumors don’t attack vital organs or impede bod­i­ly func­tions, a horse with melanoma may live to old age with­out sig­nif­i­cant adverse effects.

“Is there any­thing we can do to improve Lily’s chances?” I asked the vet.

“There’s a vac­cine for dogs,” he said. “Some dog vets will pre­scribe it off-label for hors­es. It doesn’t elim­i­nate the tumors in hors­es, but it some­times slows their growth. It’s expen­sive, and it often doesn’t work. Most own­ers let the can­cer take its course and hope it doesn’t kill the horse.”

At my vet’s request, a dog vet pre­scribed the vac­cine for Lily. We gave her shots every six months for the next six years. It seemed to work. The tumors didn’t grow much and remained con­fined to the under­side of her tail.

Two years ago, pro­duc­tion prob­lems severe­ly cur­tailed the sup­ply of the drug. All off-label pre­scrip­tions for hors­es were ter­mi­nat­ed. The dog vet cut Lily off. We couldn’t get the drug anywhere.

With­out the vac­cine, Lily’s tumors grew rapid­ly, bal­loon­ing to the size of ping-pong balls, and spread over the entire under­side of her tail in one con­joined mass.

In July, sev­er­al large tumors erupt­ed, ooz­ing a brown pus that ran down Lily’s tail. The vet said there was noth­ing we could do oth­er than clean her wounds, try to con­trol the infec­tions, and hope they heal.

They did not. Foul-smelling pus drained from them almost con­tin­u­ous­ly. Wear­ing plas­tic gloves and face­masks, Janet and I washed and dis­in­fect­ed them every day. Then, the biggest tumor rup­tured and bled.

She stood per­fect­ly still at the wash rack while I bathed the bloody tumor in warm water. It stopped bleed­ing, and I coat­ed the wound with an anti­sep­tic cream. Although the sores on her tumors had to be painful to the touch, Lily hadn’t flinched through all our efforts to treat them, and she didn’t flinch that day. She seemed to know we were try­ing to help her.

In bed that night try­ing to find sleep, I couldn’t stop think­ing about Lily. Life dealt her a cru­el hand. Her pre­vi­ous owner’s abuse caused injuries to her shoul­ders and legs that nev­er ful­ly healed and con­tributed to the ear­ly onset of arthri­tis. Her gait is irreg­u­lar, and she strug­gles on down­hill grades. We give her med­ica­tion dai­ly to ease the pain.

Her psy­cho­log­i­cal dam­age runs even deep­er. We can’t erase entire­ly her mem­o­ries of the abuse, but Janet and I have earned her trust. We groom her and pet her every day. I spend extra time with her when­ev­er I can, stroking her gen­tly and speak­ing to her soft­ly. “Good girl. Pret­ty girl. I’m so proud of you.”

Per­haps because of her dark his­to­ry, Lily responds to affec­tion with more sen­si­tiv­i­ty and love than oth­er hors­es. Janet says she’s the most soul­ful horse she’s ever worked with. I feel that, too.

I felt it most last sum­mer. The doc­tors found an extreme­ly aggres­sive form of der­mal melanoma in my shoul­der beneath the skin. They were wor­ried it had spread to oth­er parts of my body. I was scared. I went to Lily’s stall the morn­ing after my diag­no­sis. I stood beside her, my arm over her back, my fore­head pressed against her neck. I don’t know if she under­stood, but it felt like she knew. I vis­it­ed her sev­er­al times dur­ing the tests and treat­ment. Although I don’t under­stand how or why, those vis­its gave me courage and hope. See The Can­cer Club for that story.

As I lay awake the night after Lily’s tumor burst, I couldn’t shake the feel­ing I was let­ting her down. I was can­cer-free, but she was still trapped in its con­strict­ing grip.

In the morn­ing, I called the vet and asked him to pull out all the stops to find the vac­cine. I told him I didn’t care where he had to go or what he had to do. I’d pay to fly it in from any­where in the world; I’d buy it on the black mar­ket; I’d do any­thing to get that drug. My emo­tions over­whelmed me, and I broke down.

The vet’s a good guy. He called the dog vet and begged her for the drug. Maybe he cried, too. I don’t know, but what­ev­er he did, it worked.

The dog vet gave us the vac­cine, and we resumed the shots in July. My vet also added an antibi­ot­ic to Lily’s dai­ly feed, hop­ing it might heal the drain­ing sores, and Janet tried a new dis­in­fec­tant spray on the wounds.

The infec­tions cleared. Lily’s con­di­tion sta­bi­lized. Her ener­gy lev­el returned to nor­mal. Things looked good.

For a lit­tle while.

In August, Janet called me over to Lily’s stall. “Something’s wrong,” she said.

Lily loves car­rots. Janet had giv­en her one. It lay at her feet. She picked it up gin­ger­ly with her lips, dropped it, retrieved it, and dropped it again. She couldn’t chew it.

Most hors­es won’t let you probe inside their mouths and Lily is less trust­ing than oth­ers, but I was able to sep­a­rate her lips long enough to glimpse a small black lump. My heart sank.

I called the vet. After giv­ing her a tran­quil­iz­er, he exam­ined her mouth. “She has tumors inside her jaws on both sides,” he said. “They’re small but there are a lot of them.”

This is the end of the line, I thought. The tumors only imped­ed her chew­ing of hard food so far, but I assumed it was just a mat­ter of time until they metas­ta­sized and pre­vent­ed her from eat­ing any­thing. She would slow­ly starve, and I would have to con­front a heart­break­ing deci­sion to end her suffering.

While I strug­gled to hold my emo­tions togeth­er, the vet con­tin­ued to probe inside Lily’s mouth.

“Her low­er molars are long and sharp,” he said, sound­ing excit­ed. “Remind me, have we ever float­ed her teeth?”

“No.”

“How old is she?”

“16.”

We stared at each oth­er hopefully.

As hors­es age, their molars grow and some­times devel­op sharp points that make chew­ing uncom­fort­able. This usu­al­ly occurs at about age 15. “Float­ing” is a den­tal pro­ce­dure where the vet uses a pow­er tool, a spin­ning wafer-sized rasp mount­ed on the end of a long met­al col­umn, to file down the sharp points. Lily was 16, and we had nev­er float­ed her teeth.

The vet got his rasp, and I held Lily’s head while he float­ed her back molars.

When the tran­quil­iz­er wore off, Lily attacked a batch of car­rots with her usu­al enthusiasm.

“It wasn’t the tumors,” the vet said. “It was her teeth. If we’re lucky and the vac­cine works, the tumors in her mouth won’t grow large enough to become a problem.”

So, Lily lives on. But I’m a real­ist. Her room in the Can­cer Hotel grows dark­er every day. We’re fight­ing hard – Lily, Janet, the vet, and I – but can­cer is relent­less. That dark day I dread so much still lurks out there somewhere.

Mean­while, I’m try­ing hard to fol­low Janet’s advice to live in the present, like Lily does. Lily’s hap­py and con­tent. She’s eat­ing well and hold­ing her weight. We pony her off Jack­son, her favorite bud­dy, and lunge her in the cor­ral. I groom her every day, stroke her neck and face gen­tly, and speak soft­ly to her. “Good girl. Pret­ty girl. I’m so proud of you.”

And I tell myself we still have time. We still have time.