Tuesday, May 1, 2007

Receiving Some Bad News

Yesterday I made an appointment with a veterinarian rehab clinic that offers aquatic therapy, general physical therapy, massage, monitored exercise therapy, etc...just for dogs.

After a fellow Aussie rescue volunteer suggested I try swim therapy for Cody, I decided it would be a good idea to check it out. Cody is skin and bones and when my vet of twenty years saw him, he implied that his loss of muscle mass and fat was because we had not given him sufficient exercise, even though his exercise routine has never changed in the thirteen years we’ve owned him.

Blood tests and urinalyses were taken on Cody, and nothing unusual showed up. The vet seemed stumped. He said we’d have to have further diagnostic tests done if we wanted to pinpoint the exact diagnosis of Cody’s problems, but a hands-on physical exam indicated that he was a pretty “normal” dog.

At his most recent exam several weeks ago, he said cheerfully, "I can live with him at fifity pounds, as long as he doesn't lose more."

Cody is a very large-framed dog who weighed close to seventy pounds all his life. The vet can live with twenty fewer pounds and a back bone and hip bones like sharp blades? My son was aghast at this, but I was Ms. Trusting...I've had this vet for twenty years and through the care of numerous pets, and I wanted to believe him.

The exams at the vet’s office had always seemed rather perfunctory to me…a quick once-over while the vet talked non-stop and I had few moments to squeeze in a question of my own. The vet mentioned an ultra-sound or an MRI as the only means of indicating what was going on with Cody, but I knew them to be extremely costly, and - besides - the vet had indicated that every time he did a physical hands-on exam, Cody seemed fine to him. I didn't want to take the expensive test road unless it was desperately needed. It was a no-brainer that my small fixed income would not support such a large outlay of money. So I reluctantly said no.

For a year we’ve been struggling with Cody’s continual weight loss, trying every trick in the book to put some meat on his poor frail bones, to no avail. After my friend suggested the swim therapy, I saw it as a last chance to help my beautiful Aussie dog. He had just had his annual check-up exam a few weeks ago, so I called my vet to ask if he thought some water exercise might help rehabilitate Cody. He relayed a message to his receptionist that he thought it would be excellent therapy.

When I arrived at the clinic I was impressed with the cleanliness, the efficiency, the thorough exam and the expertise of the vets and technicians there. An animal physical therapist and a young, friendly vet checked Cody out. After all the questions had been answered, the vet carefully examined Cody. Suddenly, while palpating his underbelly she paused at a certain point near his ribs. She glanced up at the physical therapist and their eyes met in an unspoken message. She asked me if I could wait for a couple of minutes while she consulted with the Director of the clinic. I said sure. She and he returned a few minutes later and he knelt on the floor next to Cody. Cody immediately took a liking to him, licking him in the face, at which he laughed. He repeated the young vet’s exam and nodded and then excused himself.

The young vet told me she definitely had felt the tip of a “mass” in his belly, perhaps near his spleen or liver. I was dumbfounded. A mass? But Doctor Z. had just examined him recently.

“When was that?" she asked. “Sometimes it doesn’t show up in a way that you can feel, specially if a year has passed.”

I said, my voice rising, “My God, it was only a couple of weeks ago that he had his annual exam. Why didn’t he detect it then?” I was pissed and didn’t try to hide it. She said, “Well, maybe it has just become noticeable”, she said in an obvious attempt to make me feel better about Dr. Z’s sub-par diagnostic abilities. Oh, yeah…in three weeks it has just become noticeable….to a very experienced vet who is a grad of U. of Penn. Vet School, supposedly one of the premier universities for the study of veterinary sciences?

“Listen”, she said, “This very well may be a benign growth. I’d like to hope that is what it is. But the only way we’ll know whether it’s a growth is with an ultra-sound, and then if the ultra-sound does find a mass, the only way we’ll know whether it is benign or not is with a biopsy of some tissue. Let’s start with the ultra-sound to get a definite diagnosis first.”

I took a deep breath and asked how much it would cost. “About $300.”, she said. I was a bit relieved; I had envisioned about $1,000, but she laughed and said that was closer to what an MRI would be, and that they didn’t need to resort to that…it would be unnecessary because she felt they would know the immediate diagnosis simply with the ultra-sound.

So I made an appointment to bring Cody in this morning between 8:00 AM and 8:30 AM to wait until the ultra-sound specialist comes in for her regular Tuesday ultra-sound exams. As I dropped him off, I hugged him and said sadly, “Be a good boy, Cody.” He ignored me, and trotted gaily away from me with one of the helpers, stopping to sniff a few interesting scents along the way.

I’m waiting for a call to pick him up. They tell me it might not be until this evening because of the heavy schedule lined up for the ultra-sound. I’m crossing my fingers that the diagnosis will be one that’ll have me bringing him home with me in a happy mood, but I don’t kid myself that at thirteen years old, this beloved guy just might not be on his last paw.