One of my readers asked if I read the book "How Doctors Think." I have and that is how I recognized these thought processes and the mistakes I am prone to making. It was an enormously helpful and insightful book. I might read it again soon.
It seems to be divided 50/50 as to whether people would want to know or not. For what it's worth, the final radiologist decision was aspiration pneumonia. After reviewing the rads again, I had come to this conclusion, but I sent the xrays for professional review just to be sure. So, aspiration pneumonia and an abdominal mass. This was coupled with a pretty serious anemia. All told, in a dog that old, it wasn't good.
After much soul-searching and discussing the situation with fellow, scrupulous veterinarians, I have decided there is nothing to be gained from telling the owner. I do not want to make her question her final decision, as I still think it was the right thing. She was anguished when euthanizing the dog, and I think introducing any uncertainty into her decision would be selfish of me. I don't want to unburden my guilt onto her - relieving myself but hurting her further.
It's not an easy decision, but I hope it is the right one.
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