Saturday, October 29, 2011

The curse of being a veterinarian

It's kind of a joke in my field (and probably every field has their variation of this) - but veterinarians ALWAYS get the animals with the rare diseases, the congenital abnormalities, or the undiagnosable illnesses. Apparently, this extends to family members, as well.

A day or 2 after Evaline was born, my aunt called me about her 10+ year old Labrador/Great Dane mix. He was severely lethargic to the point where he would not rise. His breathing was labored, his gums were pale, he had severe bruising on his abdomen, and his extremities were cold. My aunt also noticed that his abdomen looked distended.

Any other Labrador with these symptoms would have a ruptured splenic or liver mass. It's as common as grass! I see at least 3 rupture splenic or liver tumors a month at work, and they are almost all Labradors or Golden retrievers. I recommended she get him to her veterinarian ASAP.

Dr W did a thorough exam on Flip and could not find evidence of a splenic or other abdominal mass. Flip's clotting times were abnormal, though. Given that Flip is an outdoor dog and because of the way the clotting times were elevated, the vet suspected rat poison and started treating accordingly. Initially, Flip responded and seemed to do well.

Then he started to deteriorate again and became severely, severely anemic. The veterinarian ordered packed red blood cells to give him a transfusion. When he rechecked the anemia a couple of days later, it had resolved! Flip seemed to be improving. He was discharged home, and he became lethargic again.

Further, he was now having trouble walking - as his back end was weak. He was almost walking on his elbow in one rear leg. The muscles were wasting away (atrophied), and he had developed a fever.

Last weekend, my aunt brought him to me to ultrasound his abdomen, looking for a culprit. I found nothing to explain his symptoms. He was still feverish. With no answers, I started him back on doxycycline (an antibiotic used to treat tick-borne disease such as Rocky Mountain spotted fever, Lyme, and Ehrlichia) and prednisone (a steroid).

His condition has not improved, and his atrophy has worsened in the rear limbs. I am going to euthanize him tomorrow at my aunt's house.

And still, I have no answers. I highly suspect some sort of cancer, but this could be tick-borne disease, autoimmune disease, or anything else. I am highly frustrated! I am a good veterinarian, and usually I at least have a handle on what is causing a patient's illness. In this case, I am left baffled.

Unfortunately, the veterinarian's curse strikes again - making me feel rather like a failure.


Brittney said...

We had a dog with a ruptured splenic mass in the ICU at school this week so that is what I thought when I started reading your post. Then rodenticide (we had one of those as well). I'm sorry it turned out to be something different and that you can't figure it out. :(

The curse of the veterinarian also extends to the vet/vet student. I'm always being told my medical problems are 'complex.' We might have figured it out, but then again we might not have. I started IVIG on Thursday and am crossing my fingers.

rgcarr said...

You did a good job on Flip. Not every illness is solvable. You helped a lot:)

Anonymous said...

was studying for one of my animal science classes and came across phosphorus poisoning...which sounded remarkably similar...not sure if that is still used as a rodenticide in your even mentioned recovery followed by death within 48 hours due to liver failure...not exactly helpful i know...but i thought i would share just in case