My work week started off with terrible news from my last practice. One of my techs there very unexpectedly and tragically lost their young cat on Monday. Obviously, I wasn’t there, but from what I understand, the cat was in for routine labwork. One of my other techs collected blood and urine, and the cat went into respiratory distress immediately following the procedure and did not recover. No one did anything wrong; it’s just one of those events that can only be classified under “complete, unfair bullshit” that happens sometimes with no justifiable explanation. What I can say is that, although this cat’s life ended far too early, she led one of the most full, beautiful and adventurous lives of any cat I know, and she died having known more love than many. RIP Frankie.
Wednesday, I saw a patient for a recheck appointment and some sedated radiographs of his back leg. When I first saw him a couple of weeks prior, he was quite painful. Combining that with the fact that Magic and I had had a little disagreement earlier that morning about whether or not she needed help getting a treat unstuck from her teeth (we both made poor life choices in the moment) and had my left index finger bandaged with the inability to put pressure on it, I couldn’t get the best orthopedic exam done. We elected to rest him and start pain medications. The family went back and forth a little about whether or not he was improving and ultimately scheduled the follow-up. When he was dropped off, it was reported that he had been significantly better in the previous two days, but they still wanted him at least checked out.
On his exam, I could still appreciate him favoring the leg, and he reacted painfully when I extended the leg back from his hip a couple of times. His owners elected to move forward with the radiographs, which were suspicious for a lesion on his femur near his hip. His owners agreed to chest films, which also looked concerning. Our radiologist confirmed our suspicions with her report on Thursday morning. I could tell his owner was fighting tears as I talked to her on the phone those couple of times over two days.
There are some cases that put a bigger pit in your stomach than others. In the case of this dog, he’s just about Rookie’s age. You can tell he’s a spirited guy, and the way his owner talks about him is very similar to how we often talk about Rookster: he’s a little wild and can be a lot, but he’s mine, and I love him to pieces. After Rook’s lameness in the fall and cancer being my biggest (although I deep-down felt unlikely) fear, this one hurts a little more. I’m so sad for this dog and his family. At least he is much more comfortable now, and his family is committed to keeping him that way for as long as they can. I very much hope he gets the six months his family wants with him.
Shortly after delivering the news from that dog’s radiology report, my second appointment of the day turned out to be a cat owned by someone I had crossed paths with very early in my career. She was a cat that this owner came across through her job and hadn’t really intended to keep, but anyone who works in the pet world knows that’s exactly how it goes sometimes. Just over two years ago, this cat had a mammary tumor removed that was a confirmed mammary carcinoma. She was presenting for a couple week history of coughing. As soon as I read that, I knew it wasn’t going to be good news. My gut feeling got stronger when I learned that she also had a relatively new mammary mass.
I did my exam, discussed my concerns (which the owner shared) and recommended chest x-rays. Sure enough, this cat’s lung fields looked like a classic “snow on wet pavement” appearance we learned about in school, indicating likely metastatic disease. This owner shared with me before we took the films that if that was the case, she was most likely going to euthanize her cat. Her reason was not because this patient was currently suffering. We probably could have bought her some decent time with steroids. However, the owner has her own ongoing medical situation, and she said, although she felt terrible making this decision, she worried that if the cat declined rapidly in the coming weeks that she would not be able to attend to her needs appropriately. I couldn’t argue with that, and so together, we said, “goodbye,” to her little cat, who took a nice swipe at me while I tried to unwrap to extension set on her IV catheter to give me a little more space to work.
Already feeling pretty glum, I had Elliott at work for the second week in a row for my colleague to scan her belly. I had brought her to see her vet 10 days prior because she hasn’t eaten on her own in about 6 months. (She did go see her vet back in July as well. It was determined that she had eggs, which could’ve explained her lack of appetite, bloated appearance and discomfort that I presented her for back then.) In addition to that, I had found her stuck in a couple of off spots within the preceding couple of weeks, and I just wanted her checked out. Blood work was perfect, other than being loaded with a parasite called coccidia. I also approved radiographs, which showed one concerning area, suspected to be associated with her GI tract. We didn’t know what it might be and started off treating with a dewormer and plans to soak her twice a week to see if it would pass.
At work last Tuesday, I mentioned her appointment and the weird finding to our tech that helps with ultrasounds and asked if she thought our colleague would scan her. Last Thursday, I brought her in, images were collected and submitted for someone that reads exotic scans to look over and generate a report. They saw the same area of concern and felt it could possibly be an abscess or early neoplasia and recommended some repeat imaging.
Fast forward back to this Thursday, and my colleague gets some additional images. Turns out, this unknown structure is vascular. An abscess shouldn’t be vascular. Desiccated egg remnants shouldn’t be vascular. Cancer can absolutely be vascular. Obviously, this has not been confirmed yet. Elliott’s vet has all of the images and is likely going to discuss them with her radiologist next week. Pending their review, Elliott may go have another scan with her vet’s radiologist, or maybe they’ll feel a CT scan would be more appropriate. I don’t know if they will feel that they could attempt to aspirate it and get a sample, or if they’ll feel that could be a bad idea. I don’t know if an exploratory surgery and biopsy could be an option. I don’t know how risky that might be or what recovery is like for a Bearded Dragon from abdominal surgery. I am NOT an exotics vet. Hopefully next week, I’ll know what my next steps could or should be.
She’s only about 9. Some would say that’s the within the expected lifespan for a Bearded Dragon. Others would say it’s nowhere close for one in captivity. Either way, I was expecting another 5-6 years with her, at least. Hopefully, next week lays off on the heavy feeling that this week left in me.
“If you change the way you look at things, the things you look at change.” ~ Dr. Wayne Dyer
