Thursday, March 15, 2012


I hate how good owners always seem to have pets with terrible diseases. It's such a cliche in veterinary medicine. Probably in human medicine as well.

Last week, I was presented with a nice, small breed dog late at night. His owner was concerned because he'd suddenly developed very, very bloody urine, as well as lethargy. As I examined the dog, my heart sank. He was dehydrated, depressed, and his gums were yellow-tinted, as were his eyes and inner ear pinna. Jaundice coupled with bloody urine usually means that the body is hemolyzing its own red blood cells (IMHA - see sidebar).

My testing confirmed this terrible disease, and I delivered the news to his owner. IMHA carries a fairly grim prognosis. Partly because it's a really bad disease and partly because it can be very, very expensive to treat. Owners often end up euthanizing because the cost is too great.

In this case, the owner wanted to try, so we started with a blood transfusion. Unfortunately, my patient rapidly hemolyzed it, leaving him more anemic than when we started. He also developed evidence of disseminated intravascular coagulation.

After much soul-searching, his owner elected to euthanize him. I can't say it was the wrong decision, given the rapid deterioration, but it was still such a downer. His owner loved him very much and cared for him very well.

Life is not fair.


Karen Whiddon said...

AH, over the years I've lost two dogs to IMHA. The first, a mixed breed (poodle-shelty) and the second eight years later a purebred mini-Schnauzer. Both were exactly eight years old. The first dog was treated with prednisone only. She should have been euthanized but instead she died a painful, horrible death. The second dog (male), we tried everything. Blood transfusion, prednisone, but I couldn't save him. I loved him very much and held him as he was euthanized. It's a horrible, horrible disease and I wouldn't wish it on any animal or owner. Sigh.

foffmom said...

In medicine, the truism is "Nice guys have the worst diagnosis." So bemoaning the fact that a patient was was a nice guy and the biopsy was cancer, I would always hear "You said he was a nice guy, what did you expect?" Made me want to be a jerk in self-defense. Wonder if that thought pattern explains some surgeons?