Friday, July 06, 2007
First Friday at the Emergency Vet Clinic
I got home tonight and as has been my habit, quickly grabbed Fire's collar before he could leap out of the kennel and spin around to play-bow at me in his typical inside-out-with-joy greeting. With his bad leg, I wanted NO leaping or spinning!
As it was, he didn't do more than hop excitedly. I saw immedately that he was worse. I took him outside right away, and he didn't waste any time...walking was clearly way to painful for him. Fire was not himself.
I took him back in, took the Shepherd out, I fed them, watching Fire out of the corner of my eye. He was still interested in food. Good sign. But he was limping badly, majorly favoring his leg. He was anxious, restless...not good signs.
I went up to change out of my work clothes, anticipating going to Mass, and when I came down, the dogs were done eating and Fire was circling his dog bed. Well, maybe "hovering" is a more correct term - he was trying to figure out how to lie down. He was panting heavily, more so than what the stuffy 78 - degree house would cause.
Clearly, Fire was in some pretty major pain; he's going downhill FAST and very suddenly. Worried, I called my vet clinic. They were closing, but referred me to the emergency animal hospital they use. I called them and described the problem as well as my concern in getting him there; I have a small car, might I hurt him more in transport? They said to bring him in anyway as if he was that bad off, meds would be warranted to make the risk worth it. I agreed. They quoted the cost to come in. I have already written off a few fingers from my left hand.
I called a neighbor to see if she could "dog-sit" my Shepherd. Because she is quite attuned to everything, history has taught me that when I have to take one dog and leave suddenly, she goes nuts trying to follow. The last time she almost ate the inside doorknob and tore the trim off the doorway. Well, my neighbors weren't home, so I opted to just take her with us. I didn't have time to prepare a "special treat" that would keep her busy and calm, especially as we were all already riled up. I hoped she wouldn't be too much of a problem but sensed her presence was needed more for me than for anything else, anyway.
Fire was very excited to be going somewhere, and hobbled along, holding his leg up, still in pain but interested in life. Again, good sign, but I knew that left to its own, this suddenly-worsening injury was not going to clear up.
I feared the worst on my way down and had to constantly shift my thoughts. Being in a panic over the unknown cost, the unknown diagnoses, one of which I didn't want to think about, and which had NOT been suggested in the prior post - bone cancer. I've known several people with Greyhounds who have lost dogs to this disease. I was wondering "what if"? Will I be bringing Fire back home tonight, or saying goodbye? I had to immediately slam the door on that thought process. Way too early to think of that.
There was one dog ahead of us, and they gave us the large examining room. Fire sounded like a freight train, he was panting so heavily in his pain and anxiety, and I'd never seem him drool so excessively or shudder so much! He couldn't lie down, he was tired standing up with all of his rear weight on one leg, and I think they had to put out sandbags to keep the dog drool out of the waiting room.
They took him away to give him a shot of Hydromorphon, a painkiller, at 6:30 tonight. By then, I knew I was not going to make it to the first First Friday Mass I've missed in about a year, maybe more. I said my apologies to Jesus and asked for a "pass". I began to wonder if I should have gone to Mass first so I could have prayed better, etc. I was not thinking clearly, because obviously, I was worried. It was obvious we needed to be right where we were. In the emergency vet clinic. Drooling in anxiety.
Then a tech brought him back to me and told me what some effects of the drug might be, told me they would come back in about 10 when the drug should have worked so they could examine his knee. They returned and couldn't really find anything but what I'd already observed; some very, very light swelling right around the knee (can be palpated but not seen - very minor), and some heat. I confirmed to the Vet that I'd noticed heat earlier on this week and had iced the area, when he indicated that the heat may have more to do with the hot weather and his high temp.
Yes, Fire was running a temp, indicating possible inflammation somewhere.
They wrote up an estimate for an X-Ray, Lyme's disease test, heartworm test, blood test, and to pull fluid from the swollen area. I signed the permission; they are tests needed for diagnosis. As I have a certain amount of medical training myself and have other life exposure to reasonable medical things, well, I knew that what they suggested was all reasonable. I put it in God's hands and signed the permission. $375.00 for the tests/ visit, excluding the painkiller already given.
The Vet suspected Lyme's disease both because it's the season and, in spite of the fact we use Frontline religiously, the symptoms match. I had considered that as well earlier this week so wasn't surprised to hear that come up. Truth be told, I would have inquired about it if he hadn't mentioned it.
The vet came back and said Lymes' was negative, platelets were low, they got nothing from the fluid around the knee at all, no indication of soft-tissue injury. So he put the X-Ray film up and I saw what might be the problem before he even pointed to it.
I remained silent, hoping he would say something else as he pointed to the dark area at the superior portion of the proximal tibia. He pointed out that the knee looked normal, no sign of a tear or other injury. But there was a dark spot, a couple of them, and a "moth-eaten", as he called it, appearance on the lateral aspect of the tibia. (The tibia is one of the bones of the lower leg - dogs and humans have a very similar bone structure to our legs. The tibia is the larger of two lower leg bones; the other is the fibula.) As he described what he was seeing in the film, I didn't wait for his possible diagnosis.
"Are you thinking bone cancer?" Sometimes it's best to be direct and to the point. Get it over with; if it's bad news, say it, call it what it is, be honest, be truthful, even if the truth is brutal and heartbreaking.
Yes, he was thinking it was bone cancer. He didn't want me to worry; no, of course not. But Fire is at the right age, and the Vet was really just recommending I take the films to a radiologist for a consult, at the cost of "less than $100.00"), and he's right here in town. The alternative is to take it to my vet, have him review it for another opinion. Get a bone biopsy if it seems indicated, or maybe the radiologist/ other vet would recommend not really worrying, but rather, re-take the pictures in another month. Or get a biopsy right away.
I asked the Vet if he thought that the joint pain was related to what might-be-cancer, or, whether it is or is not, is it possibly a part of something else or just a tweak that lead us to discover this other possible issue?
He told me that the symptoms of inflammation - the fever, low platelets, and lameness - could all be related to the cancer, if that's what it is.
I inquired about the acute appearance of the symptoms....limping less than a week, suddenly bad today. Are those symptoms of cancer, being so suddn?
Yes. That's what happened to his dog. He looked at me sympathetically, if stoically. This vet was more reserved than most I have known, but likely because he is all business; it's easier that way. I was actually surprised he mentioned his own pet - he didn't seem the type to bring his own experience into the conversation.
He clearly felt that I should take the films to a specialist versus my own vet, and be aggressive about it, but told me it was at my discretion, and in any case, said a second opinion is never a bad thing. I asked him about just waiting a month. What would happen then?
He told me that it all depended on how aggressive I wanted to be. He didn't look me in the eye. That said more than anything else.
From the way the conversation went, I'm certain this vet does believe it is bone cancer, and I have to concur, albeit in my very inexperienced and uneducated way. But I saw the spots, too. I know people who have lost their Greys to this cancer, and it started in the knee/ hip. They discovered it suddenly, and lost their pets not long after.
A heartbreaking story...one friend came home to find her female Grey lying at the base of the stairs, panting. She had broken her leg. They took her to the vet, completely mystified as to how this had happened - and that's how they found the cancer. They put her in a cast, kept her comfortable, and let her go. Some people removed the offending cancer, meaning the entire leg, paid for chemo - and then let the dog go.
I don't have an official diagnosis, but now I'm faced with a very real decision, and one that needs to be made aggressively. They can't ID cancer without a bone biopsy, and it's logical to have a radiological consult before doing something so invasive. I can't afford a myriad of tests at hundreds a pop, just to diagnose or rule out. I can't make a decision without the information. Clearly, I will have to pay for a test here, but I think I will look to my own vet first. He is a greyhound expert, which is why I go there, and this is th clinic where I adopted my Grey. Dr. Barr is wonderful, and they are not in the habit of ordering unnecessary tests. Nor will they mince words. I need them not to mince words.
I can't let my dog suffer because I quit my job. And in reality, I'm not sure my employment status would make a difference. I have looked at this question before, when considering my friends' experiences. What would I do in their shoes? What makes sense? What can I afford? What SHOULD be done? After all, he is a dog. I love him, but he is a dog, not a human. Where do I draw the line as to what is appropriate, and when I should make that call?
Suddenly, I am in their shoes, and they are even more uncomfortable than I had imagined. Not only is my heart breaking, but I'm out of kleenex and I sound like a coldhearted bitch while I speak of a beloved pet in sterile medical terms.
In my heart, I do believe it's cancer, and I'm not surprised, because bone cancer is very common in Greyhouns. Maybe I'm jumping the gun, but in this case, I need to; I can't face this without considering all angles, especially those I don't want to see. I don't want to consider cancer and possibly putting him down, thus I HAVE to consider it, and taking it all within cotext, seeing the X-Ray, knowing the Vet has seen this up close and personal...well, time to face reality.
I may not have much time left with my Fire. Tomorrow I'll bring the film to my own Vet, and then, when he has reviewed them, we can talk about the options, the possible outcomes, the costs, and what it will take for me to keep my boy comfortable and see him out of this world. And what his life expectancy is.
Tonight, I missed Mass. I made a Spiritual Communion around the time real Communion would have been offered tonight, and I had my Magnificat, so while I waited for Fire's tests to be completed and petted my German Shepherd,happy I had my own form of "pet therapy", I read the readings, finding the Gospel for tonight to be especially comforting.
"I desire mercy, not sacrifice."
I came back to that line over and over again. Until that moment, I had been feeling guilty for not being at Mass, even understanding that it was God's will that I be at the Vet clinic tonight. "I desire Mercy, not Sacrifice."
Tonight I was faced with a decision; offer an imperfect sacrifice of my own by overcoming my own will and attending Mass (sometimes I don't want to go), attending the Holy Sacrifice....or....making a sacrifice of mercy and justice for one of God's creatures?
Fire is now on anti-inflammatories, pain meds, and antibiotics. He is finally lying down. He has stopped panting, and I will be sleeping downstairs tonight so as to keep an eye on him in order to respond to any problems.
All I wanted to do when leaving the clinic was to go to Adoration, to kneel at Jesus' feet and take my tears straighit to him, pray about the next step. But I'm home tonight; I have to watch for drug reactions or other complications, and this is where I belong.
I don't understand why, but I've noticed that when we face our greatest trials, all too often we do not have recourse to the True Presence and have to make our own offerings from afar, suffering without any direct consolations. I think this is a form of spiritual darkness meant for our purification, but I really wish God didn't order things this way! Yet here I am, and this is where God wants me to be. So be it.
I don't know what's going to happen, and I'm terrified. I fear that there's a decision coming that I don't want to make, but tonight, as I sat in the clinic waiting, reading Magnificat, I knew that I was not alone, not by any means. I knew, thanks to all the comments of the previous post, that people are praying, and that no suffering exists without notice. I do not believe that it was insignificant that this happened on a First Friday, and I offered this evening to the Sacred Heart. What else can I do? I could barely pray because any conversation with God brought me to tears, which would not have been helpful for anyone there. Thank God I had brought my Shepherd with me. As it turns out, pet therapy works! At least, it kept me focuses on helping her shed and not on my wandering thoughts. My apologies to the vet clinic for all the hair left behind. And for the dog drool.
For now, Fire seems to be ok, but I am glad he doesn't know what's coming next. I wish I could live in such trust.
Sacred Heart of Jesus, I place all my trust in thee!