Anyone who has visited our home, even if only to deliver a pizza, has met Bob. Bob is quite possibly the coolest cat ever. Without a doubt he is the sluttiest . He loves everyone. Bob also has a mass in his chest. Right in front of his heart. Right cranioventral lung lobe about the level of T3 to T5 for the other medical nerds out there. I discoverd this about 2 weeks ago when I was running preanesthetic tests so that I could remove a tumor on his leg. On a whim, I took chest rads. I am so glad that I did because much as this sucks it would have sucked that much worse to have him die on my surgical table.
So, what do you do when you are a veterinarian and your sweet boyo has a mass in his chest? Well, you show the rads to your boss, just in case maybe your eyes are on the fritz (I think that this would count as denial in the stages of grief). You discuss performing a thoracotomy at your practice to remove the mass. You realize that a) you don't have a ventilator so someone will have to breathe for your pet the entire time and b) there's that ugly dying on your table fact rearing its ugly ugly head. So, you e-mail your husband and ask him to meet you at work to go over the films.
What happens next? Oddly enough, with Tony there I went into discussion-with-client-mode. I showed him the rads, explained what I was seeing and what the options were and realized what I offer a client. Not surgery by me without a ventilator. Not kitty hospice. No. I would recommend my client go to see an oncologist. I broached the topic, along with an estimated price tag that I will not repeat here and Tony, bless him, simply replied, "But it's Bob."
Tomorrow morning Bob and I will be up at 5:00 so that we can leave at 6:00 (hopefully with him well-sedated). Our appointment at Michigan State is for 9:00. What happens next? I don't know. If it's not surgical then I guess we'll consider chemo or kitty hospice. If it is surgical, then we'll give it a chance. I guess worst case we lose him on the table of a specialist where everything can be done. Best case we get our happy Bob for a little while longer.
4 comments:
So what did they find? Can they do anything for Bob?
At this point, there's still no true diagnosis. The lump on his back leg is a sarcoma (the pending biopsy will tell us what kind). The lump in the chest just keeps giving us necrotic debris (dead tissue for those who don't speak medical-ese). And a new lump was found in the intestines via ultrasound. This one has lots of reactive lymphocytes, but the clinical pathologist feels that it's not lymphoma (nasty bad white blood cell tumor treatable with chemotherapy). Oh, and he's borderline for hypertrophic cardiomyopathy (very thick heart muscle). That means that anesthesia is OK, but IV fluids are risky. He's going to get a dose of L-asparaginase tonight, along with IV fluids running
v-e-r-y slowly. I'm going to pick him up on Sunday morning and repeat the chest rads on Monday. If the chest mass is lymphoma, it should be much reduced if not gone completely. If it's still there, then we head back up to M.S.U. and they crack the chest. I'm really glad that I took him up there 'cause you know it's bad when you're stumping the oncologists :(.
Oh, I did learn that Bob is a magnificent traveler when given just a hint of acepromazine. No pee, poop or puke.
Was the drive back on Sunday okay?
/me on pins and needles about chest rads... tries to be patient.
although i've been travelling a lot, i wanted to say i read your updates on bob and we're saying little kitty prayers for him up here as well.
Post a Comment