Tess got to visit the vet this morning whom she adores. The cancer is aggressive now and her elbow is being affected. She is dead lame. It probably dissolved most of the radius (head of the elbow). She has been licking her leg this week so she is in pain. Her heart sounds fine but still is very enlarged and pressing on her trachea. We increased her Lasix for the heart issue about 10 days to help with her coughing and it had reduced it some, but she still wakes me up at 2ish with her coughing. I get up and rub her sides and cuddle her for an hour, until she settles down, then nap for a couple hrs before I go to work. As for the cancer, it is a day by day situation. We thought the heart would get her first but when cancer decides to be aggressive, there is no stopping it. The Tramadol has been increased to one every 5/6 hrs and she is still lame. She has been on Metacam since mid week when this all came about but it hasn't helped much. So needless to say, per the vet, when she quits eating or we see pain in her eyes when the pain pills are no longer effective, she will cross the bridge. Thanks to everyone who has been supportive in the last couple of weeks. We've been totally distraught the last week.