Lamenting the passing of a puppy
Published 5:04 am Monday, February 14, 2022
Life is not fair!
Maybe I was sensitized by the deaths in Charleston, but there was too much death this week.
Bane was a happy dog. Double dewclaws on the back told me that he wasn’t a pure yellow lab. He was in the larger exam room because he had been losing weight for three weeks.
His back-right leg was swollen. He had been diagnosed at the referring vet with whipworms and treated with a couple of pills. He was not eating then, but doing better now. He liked my treats, but wouldn’t come to me for them.
Bane also had a time of shortness of breath a few weeks ago. Certainly an unusual history for a year-old dog, but not sure exactly what the owner saw.
The physical exam showed a very thin, alert, active dog. His abdomen was a little tense, but not painful. His left testicle was soft and the right one was enlarged. Bane’s right back leg had some swelling and edema, but not severe edema. He had some tarter on his teeth.
The testicles could have been venereal disease (STD), but that didn’t account for the weight loss. The whipworms could have accounted for the weight loss, but not the feeling bad. None of these would really account for the breathing episode that the owner described.
I discussed the need for a work up with the owner. She understood and we proceeded to start.
A CBC (Complete Blood Count), Chemistry (liver, kidney, glucose, pancreas, etc.), blood parasites and radiographs were started.
The CBC immediately showed a high white blood cell count. There was severe infection somewhere in the body.
The testicles or prostrate could account for the high count, but Bane was very young to have such a severe reproductive infection. Bane also had a mild anemia, but his platelets were fine. Still he was sick enough that I knew he needed IV fluids and antibiotics if he was going to do well.
The owners okayed treatment and Bane responded well to the fluids and antibiotics.
The next results were his chemistry. This wasn’t very helpful to me.
The amylase (a pancreatic enzyme) was slightly high, but not enough to be the problem.
His total protein and globulin were high, so his anemia was worse than it would appear because of the concurrent dehydration.
His albumin, ALP, ALT, total Bilirubin, Blood Urea Nitrate, Calcium, Phosphorus, creatinine, glucose, sodium, potassium and lipids were normal. Likewise, his blood parasite profile was normal: no heartworms, Lyme, ehrlichia, or anaplasmosis.
His radiographs were a little more interesting. The heart and lungs were normal. But there was a “thoracic spondylosis deformans. The T4-5 intervertebral disc space appears irregular, and the caudal endplate of T4 and cranial endplate of T5 appear to exhibit irregular lucencies.” However, another image did not appear as severe.
And there was just a little bit of the abdomen on the radiograph.
“There is a round soft tissue opacity within the mid-abdomen predominantly right sided on the VD view which causes leftward displacement of the gastric axis on the VD view and appears caudal to the stomach on the lateral view. There is poor serosal detail.”
Hard to see because of the lack of fat in the abdomen to cause edges to be seen, but there was a mass.
The radiologist said it was a “large opacity within the cranial mid-abdomen predominantly right sided, differentials for etiology include a pedunculated liver mass, pancreatic mass, gastrointestinal mass, right kidney, or spleen (considered less likely given the leftward displacement of the stomach). An abdominal ultrasound would be helpful to determine the organ of origin of the mass.” The spinal mass was probably “discopsondylitis, or overestimated by rotation, but no definitive evidence of pulmonary metastasis.”
On a busy surgery morning, I talked with the owner about the ultrasound or surgery.
Ultrasound was less dangerous, but could not fix anything.
Surgery had a chance to fix whatever was wrong.
She first said that she wanted an ultrasound, but then called back to ask what I would do if it were my dog. We talked again about options and costs. I still hoped that I could fix the mass.
Bane was so young a tumor would be highly unlikely.
We decided on the surgery and Bane was prepped.
Right before I induced his anesthesia, I told him that his mom loved him and petted him on the muzzle.
Under anesthesia, on the table, I could better feel that there was something there.
I did so a quick ultrasound (at no charge to the owner), but it didn’t make sense because the echo pattern showed a tumor like pattern everywhere.
But I did have a sick feeling, because I could not feel something, also.
Quickly cutting into the abdomen, I found a very large mass. Most probably a lymphosarcoma, it was almost the size of a soccer ball.
If the size wasn’t bad enough, the mass had incorporated the left kidney, some of the stomach, several feet of intestines and major blood vessels.
There was also a ping pong ball-sized mass in the pancreas.
I try my best to do what owners want me to do.
I know that at times, I have had seven dogs and two cats and would have made different decisions at different times.
I feel that it is my job to present facts and teach owners to understand them.
But in this case, there was nothing that could be done.
Removal was not an option. Debulking the tumor and chemotherapy would have resulted in Bane bleeding to death.
Waking him up was just pain and starvation as the tumor ate more and more of Bane.
Soon the metatasitis to the spine would break the spine and Bane would be paralyzed and in extreme pain.
Ultimately surgery was cheaper than the ultrasound, but putting him to sleep permanently without ever waking him up was the best option.
Bane’s mom didn’t like that option, but she understood and she bravely decided what was best for Bane.
She cried when giving permission and again when I called her after he was gone and I had sewn him up. I think we did, too.
Sometimes it is not fair that life is unfair!
One-year-old dogs should not die of cancer any more than worshipers should die in church.
Strange that I shed tears for the dog and not the people, although, let there be no doubt — these nine human lives cut short has affected me.
It is time to change.
I will be watching. And working.
MJ Wixsom, DVM MS is a best-selling Amazon author who practices at Guardian Animal Medical Center in Flatwoods, Ky. GuardianAnimal.com 606-928-6566