This morning when I woke up, I noticed Alec had vomited a little in the night, or maybe that morning. I had given him a CET chew (dental rawhide chewy thingy) the night before, which I have given him many times. There was a chunk of this along with some food in the vomit. I thought maybe he had an upset tummy because he ate the whole thing before bed (sometimes he chews them over the course of a few days, but not always). When we got up he went right to his water bowl and started drinking…and drinking…and drinking. Finally I called him away before he could drain the whole (big) bowl and took him outside where he urinated and defecated like normal, but he did not want to walk – not normal – and just stood there obviously wanting to come back inside. He seemed weak and was acting strange. I brought him inside, thinking again maybe just a little upset tummy. He went straight into his “little house” (his kennel) and showed no interest in breakfast – very unusual. It crossed my mind he might have some of the chewy hung up inside but I (mistakenly, it turns out) thought he could not be blocked if he had peed and pooped. I called his regular vet and they were booked of course, but Daniella at the front desk (who is wonderful) told me if it was a blockage I would not want to wait; she recommended I take him to the emergency clinic. Even though it turned out not to be a blockage, this was very good advice.
As luck would have it, my annual performance review at work was scheduled for that morning. I was going to take Alec in as soon as it was over. When my boss called at 9:30 am, however, she could tell immediately something was wrong (I have neither poker face, nor poker voice, nor poker anything) and she suggested we reschedule and thank god she did. I took him in right after that and he was so weak by the time we got to the emergency clinic. There were dogs in the lobby and he did not even respond (again, highly unusual) and he laid down while I was at the front desk checking in…also unusual for this normally anxious boy. He was weak and lethargic and clearly did not want to walk. What was wrong with him?
After the front desk called for triage, a tech came out to the lobby. He asked me some questions about things Alec might have gotten into. I assured him Alec was rarely out of my sight, and he was not the scavenger type dog anyway – never has been (that was my dear Kobi – totally different story). I asked, but was not allowed to come back with him. I waited. Someone came and told me they were doing an ultrasound to see if he was blocked. An hour or so later the doctor came out to the lobby to call me back. She did not have a poker face either. My heart sank as the panic rose.
She said Alec was bleeding internally – a lot. There was a mass on his spleen, and it had ruptured. There was no blockage; it wasn’t the rawhide chewy I gave him. She said I could not have known ahead of time (as I pleaded, “what signs did I miss?? I watch him so closely!”). She told me there are usually no clinical signs for splenic masses until they rupture. She said cancer of the spleen is common in German shepherds but there is a chance it could be a benign hematoma. As remote as this chance may be, it is what I am hoping for.
The only option was surgery to remove the spleen. They recommended x-rays first to be sure there were no tumors on his lungs, in which case surgery might be futile. They brought him to me in the exam room and I said good-bye to him before the x-rays (he was alert but weak…although he walked in on his own, we had to drag him back across the slippery floor on the blanket because he did not want to walk) and waited another hour. The doctor came out to tell me his chest x-rays were clear. Hurdle one. Then he went into surgery. I came back home as there was nothing I could do and waited by the phone. Three hours later the surgeon called to tell me he had come out of surgery okay and was stable. Hurdle two. She had removed his spleen, which had a grapefruit sized mass on it. They sent his whole spleen out to the lab, and I won’t know until next Wednesday or Thursday if it is definitely cancer. Again, if you are reading this, BENIGN HEMATOMA is what we are hoping for!!! Alec has beaten the odds before. He has been through so much. I know life isn’t fair, but he deserves a break. The estimate for today was $6,300. If it is cancer, chemotherapy will be an option. And of course, one I will take. The prognosis is only 2-6 months without chemo.
Of course I asked, if it IS cancer (please no!!!!), is there a possibility it was all removed when his spleen was taken out? The surgeon told me no; because of the vascular nature of the spleen, with so much blood passing through (unlike some random leg muscle for example) there is the potential that the rest of his cells have been “showered.” He would require chemo.
He came out of surgery three hours ago. The surgeon said I could visit in five. I will be heading to the hospital soon. I am writing this to take my mind off things, to keep from drinking too much whiskey. I just poured myself a finger when I learned he made it through surgery okay. I don’t know what to do with myself. I am trying so hard to think good thoughts, but my brain is crazy with worry and anxiety. I don’t want to let the bad thoughts in. Whiskey helps. But I can’t drink too much because I need to drive to the hospital later.
He will be monitored overnight, his heart, his blood levels, etc. If everything looks good tomorrow I can bring him home. Or it may not be until Sunday. As luck would have it, I am traveling to the east coast for work next weekend. I don’t think I will be able to stick to the original plan of having friends watch him now. The emergency clinic does medical boarding. I got a quote: $630 for 72 hours. This might be my only option. I was nervous enough leaving him before this…I can’t imagine leaving now without him being monitored 24/7.
In keeping with my previous post about bedside manner, the ER doctor who first spoke to us, Maree Doolan, was wonderful. She was so compassionate and really caring and spent time talking with me until I was out of questions. I did not feel rushed. This is a special skill; its easy for busy vets to inadvertently make you feel hurried. This is also what I love about Kristin Sulis, our regular vet at Mt Tabor Veterinary Care (and her wonderful staff). Our neurologist back in California, Lisa Tieber, shared this quality. I have had lots of experiences with vets and if they could all be like this, it would be great. Dr. Doolan even called to check in after the surgeon had already called with an update. Those of you who have been in similar situations know how much that means…not a perfunctory call, but genuine. One can tell the difference, and it made a difference to me.
Quick note about my previous posts: the laser and VOM therapies I wrote about last time had no effect; Alec did not show any improvements. I was holding off writing that update, for obvious reasons I guess. But I am glad I tried. If only it hadn’t been so expensive for nothing to come of it. The doctor was so hopeful at the outset; she was really disappointed he had not improved. Oh well. All of that matters little now. I just need him to get better. Benign hematoma, benign hematoma…and no complications. Please say it with me. Please let him be okay.