Thursday, November 29, 2007

Lo siento

About a year and a half ago, I met this very interesting client. She was a little defensive, since her previous vet had apparently seriously insulted her, suggesting she was stupid. She's also from Spain, and I think the cultural difference was too much for them.

She had a beautiful older golden retriever and an old husky who had canine cognitive dysfunction (doggie alzheimer's). I noticed a black mass in the corner of the retriever's lip and recommended removal. It came back melanoma.

There are two really bad places for dogs to get melanoma. By the toenail, or in the mouth.

A couple of months later, the melanoma was in the submandibular lymph node. She let me remove that last December, joking that she was going to send a picture of the dog to all her relatives for Christmas, since she spent all her present money on the dog. In February we found another deeper lump, and she told me to remove it, too. "What am I gonna do, watch it grow?" she asked.

After February, things got quiet for this dog. On several rechecks and chest Xrays, everything looked clear.

In September, I had to euthanize her old husky. He was a shell of his former self, and had lost nearly half his body weight because he spent all his time pacing, pacing, pacing. Losing that dog took a huge emotional toll on my client.

Today, she brought the retriever in. He had another lump in his neck. "Just tell me it's nothing," she pleaded. The mass was firm, and this time it was DEEP. An aspirate of the mass confirmed it was melanoma again. I gave her the bad news, then sent the dog to get chest Xrays to look for metastasis (spreading tumors).

I sat in front of the computer and was looking for a time to do his surgery when the films came up. I nearly fell of my stool, and I cussed fiercely. There were at least 6 big mets in his lungs.

My staff knows this flamboyant lady who loves her dogs so much. They were all upset to see the films, too. They did not envy me having to deliver the grave prognosis.

I've really gotten attatched to my funny Spanish client. I took a deep breath, and told her plainly and honestly that it was bad, that I wouldn't do surgery on the neck if it were my dog since I couldn't get the tumors out of the lungs. Also, I had been worried that a I couldn't even remove the neck mass anyway, it was so deep.

Her emotions were all over the place. First she was asking me to do the surgery anyway, then asking me if she should just have me euthanize him now. That way she wouldn't have to see him, a "dead man walking," dreading what was to come. She cried some more. "Of course I can't do that," she said, and picked up his leash to go home.

I would much rather have spent the afternoon, cramming in his surgery...


Laura said...

I'm sure that she'll appreciate the fact that you were able to communicate with her honestly, even though the news was dire.

Also having been to a vet who insulted me, I really appreciate one who shoots from the hip!

Dana said...

Poor Mrs. V. She does love her dogs. I saw her leave today and I knew she was upset, but I didn't know what was going on since I was dealing with other things. Too wouldn't be too hard to "cram" in these days.

peevish said...

Sometimes there just isn't alot you can do. But I know it is hard for you, and harder for her.

get2eric said...

One more post tomorrow then you can take a day off, OK?

Anonymous said...

You do have your share of heart aches, don't you, and you are the kind hearted vet always delivering the bad news. So sorry about this part of your work but I know your clients are appreciative in the end.
Love you, M

Anonymous said...

What a brave lady!! I mean you too,Jennifer..that would kill me!! oh,my,what a heartbreaking story..

A.Norma said...

this above is from me! why on earth have you changed your format..??? Aunty Norma.x