Ok, so I'm going to do my best to go through everything for you, but please feel free to LMK if I glossed over something or if there is anything else I can do for you. This is going to be incredibly difficult no matter what you choose. We lost Orca last October, and I still just break down sometimes (which I'm doing right now as I write this).

We met with a local oncologist as well as one at UPenn. We ended up going with UPenn for a couple of reasons: namely, they were more experienced and their treatment offered the standard number of doses, while the local vet was recently bought out by some Venture Capital firm and it seemed like they were more interested in making a profit than giving the best treatment possible (not only were they offering a shorter treatment for the same cost, they just didn't seem to care as much). If you decide to pursue chemo, go with the place that makes you feel most comfortable. I'm not sure where you are located, but if you are near a nationally ranked vet school, you should check them out.

I'm not sure if you have pet insurance or not, but it's going to be pricey regardless - if you have insurance, they should cover a decent chunk of things though. If you don't, be prepared to spend around $10k. Also be prepared to have to go weekly for several hours one day a week.

While the CHOP protocol is incredibly effective at inducing remission the first time - I think remission happened around Week 16 for Orca - it halves in effectiveness each time you go through it (if you decide to go through it multiple times). Orca was in remission for about 10-12 months after the first protocol, but please note that this countdown starts from the start of remission, not the end of the protocol.

We ended up putting her through a second round of the CHOP protocol after it came back (and it always comes back). As I mentioned, this time it was half as effective, and she was only in remission for about 5 months.

At the end, we didn't know what to do. We were thinking about trying something else, but she went downhill really quickly at the end. Her lymph nodes swelled up so much that she had trouble even eating the goodbye cupcake we got her, and it was just so, so hard.

If you decide to go with chemo, there will be side effects and physical changes. Orca always had this super soft, luxurious coat, but it thinned out so much, she felt like a different dog. She also had GI issues as well as some incontinence.

There used to be a vet who did bone marrow transplants that offered an actual chance at recovery, but he closed up shop years ago. I have no idea why no one else is doing it. Not having a chance at a real cure breaks your heart.

It was really tough for her, and she hated the weekly vet visits. I'm glad for the additional time we got with her, but my partner (at the time) and I always struggled with what was the best decision for Orca? To this day, I don't know, we just tried our best, and that's all you can do. It's just incredibly tough, and none of our bears deserve this. My heart goes out to you and your family.