Saturday, November 07, 2009

Old age is not a disease

At work today I saw a 15 year old golden retriever that I've been seeing for a few years. About 18 months ago I told the owner that her spleen was enlarged. This usually means a tumor, could be benign or not. I recommended an ultrasound to further evaluate the spleen, then a big surgery to remove the spleen. I spent a long time explaining this to the owner in person and later on the phone. Eventually she called me and said she was going to try a treatment a friend recommended to her, cottage cheese and flax seed oil.

Seriously? For a tumor in the spleen? I know my plan was expensive, and if you can't afford it that is really okay. But don't fool yourself with this treatment.

Fast forward to today. Apparently the tumor is not malignant, because the patient is still alive and happy. Only now the tumor is enormous. The dog has a pot-bellied appearance and his back is hunched to accomodate the tumor. "He may be uncomfortable, but I don't think he is in pain," I said. "Of course, the tumor could burst at any time, and that would be an emergency." Probably it would kill him.

"Well, I'm really just relying on you to guide me here," the owner told me.

Inside I think, "Are you joking?!?" but in reality I say, "I still recommend an ultrasound and full bloodwork to evaluate him, then removing the spleen if we don't find anything else."

She looked at me, shocked, and said, "But I thought you said he was too old for the surgery."

I said, "No, I said we'd do an ultrasound first to see if he was a good candidate. We do surgery all the time on older patients." She then requested estimates, and I gave them to her.

I hope that she will consider my plan. I think she loves her dog, but she is not very savvy when it comes to making medical decisions for him. Sometimes I think people like this don't deserve golden retrievers that live to be 15.


Laura said...

You know, it's interesting. Sometimes I WISH the young vets in our clinic would provide a clear treatment recommendation for me to follow, but they often don't, even when we're specific about a request. Must be a difference in philosophy or training. That's why I like the vet who owns the clinic so much. He's very clear about what he thinks is best. Too bad we can't come see you!

EdamameMommy said...

I think the owner needs to have her hearing tested.

Emily said...

Sometimes it's hard to hear things you don't want to accept. But cottage cheese & flax seed oil? Please!

peevish said...

Treating the animals is easy, right?
But the people, not so much.