A Family Pet & Goodbyes

There are many things that make being a veterinarian a unique experience.  One of the more profound for me is this: that on occasion I have the opportunity to care for a pet from its earliest weeks of puppy- or kitten-hood through it’s geriatric years. You won’t find this in the human medical professions, for better or worse. In my practice, being in both a tourist location and close to two large military complexes, there are clients that come, go, and move away. There are pets that I see one or two times, maybe already in their twilight years, or for a second opinion, soon to return to their regular veterinarian. So, it’s a special occurrence when I have the benefit of following a pet from its first weeks of life  into its last days.

Having been in practice for more than 17 years, I’ve seen some of these pets in recent years. Such was the case with Sadie .  She came to me as a young yellow lab puppy.  She was typical for the breed – wild, stubborn, happy, and energetic.  For most her her life, her visits were for routine services – vaccinations, examinations, her spay surgery, an occasional ear infection, GI upset, etc. From the first visit, her family was like many others, consisting of a mother, father, 2 young children of elementary school age.

Over the years, I rarely saw the children, who I’m sure had their own activities and the commitments of childhood and adolescence. But I did get to know her mother and father rather well – as well as one gets to know the family of the pet you care for. Sadie’s visits were most commonly characterized by exhaustion for me and the staff, given her unbounded energy, excitability, and what might have been interpreted as ADHD.

In her 10th year, she developed type 1 diabetes.  She lost substantial weight during a prolonged stay in a nearby boarding facility. The diagnosis, once I examined her and we performed a few tests, was simple and straightforward.  Every visit she had at our office (her longevity as a patient of ours means she was with us in our original location and our new office) had been replete with jumping, panting, kissing, licking, and at least 2 staff members needed to control her for whatever was being done.  When she can into the office after having lost over 20 lbs, not only was she emaciated, but she was lethargic and depressed.  The first words out of my mouth – “that can’t be Sadie. No way.  Are you positive?”

Insulin therapy and diet change were instituted, and she soon returned to a healthy weight.  Months later, she developed cataracts in both eyes and lost her vision.  Fortunately for her, her parents were devoted and loved her dearly. She visited a veterinary ophthalmologist, and surgery to remove her cataractic lenses successfully restored her vision.  More recently she developed a nasty skin infection, the canine equivalent of MRSA (known as MRSP).  Therapy was intense but she made substantial progress within several weeks.

At one of her rechecks for the skin infection, I noticed (inadvertently glancing at her gums) that she was likely quite anemic.  After a simple blood test, anemia (a low red blood cell count) was confirmed.  On examination and palpation of her abdomen, I suspected the presence of a mass within the abdominal cavity. An ultrasound  scan of her abdomen revealed a large irregular mass on the spleen.  Most likely, this was a malignancy of the spleen called hemangiosarcoma.

Hemangiosarcoma is, in my opinion, the worst type of cancer a dog can have.  By the time we diagnose these tumors, most dogs have very little time remaining, with or without surgery, with or without chemotherapy. After some discussion with Sadie’s parents, we decided against aggressive therapies.  We would focus on keeping her comfortable, supporting her appetite, and enjoying the remaining time her family had with her.  At the time of the diagnosis, the now college-aged children had just gone back to their respective schools, the youngest just starting her freshman year.  I knew that some difficult decisions would need to be made in the near future.  A short time later she would return to the office, demonstrating jaundice, likely resulting from damage to her red blood cells, or possibly resulting from concurrent liver failure. Her disease was advancing.

Soon thereafter , Sadie’s mom called our office. Sadie had started vomiting, had stopped eating, and had developed bloody diarrhea.  She couldn’t get upon her own.  She came to the office in the afternoon, thin and tired. Sadie’s dad was out of town.  The children were away at school, so this task fell on mom, accompanied by a few caring neighbors.

After examining Sadie, I tried not to mince my words. I’ve found it’s best to be direct when the path and choices are clear.  It was time for Sadie to let go and stop fighting.  It was time for her mother to let go of her.  She knew this was the right decision.  Often, the pet owners know before they walk in the door. Such was the case that afternoon. Sadie’s mom called her husband, and with the phone to Sadie’s ear he said his goodbyes via speakerphone.

There she lay on the exam room floor, being ravaged by the effects of cancer, insisting on giving me as many kisses as I would allow, wagging her tail throughout.  It was then that I was hit by the proverbial brick. Not that euthanasia was anything new – not by a long shot.  It is a nearly daily occurrence in our office. I manage to stay fairly composed in most cases. Not uncaring, but professional.  But, as I thought of Sadie, having provided her family with 12 years of companionship, helping “raise” and mold two children, and having had a positive, lasting impact on those of us that were fortunate enough to be with her for only a few minutes each year, I lost my composure.

This was goodbye for Sadie, goodbye for her family (those present and those far away), and it was goodbye for me. It takes a special pet to deeply touch those with whom she has limited contact, including her veterinary care caregivers.  Sadie was such a dog, such a pet, and such a wonderful spirit.  She will be sorely missed, not the least by her former veterinarian.


by Todd Worrell, DVM

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Your Pet’s Health radio program

Your Pet’s Health Radio program July 24th 2014

We are pleased to announce that we will be archiving audio from our weekly radio program on WTKF 107.1 FM every Thursday morning, which airs live at 7:15pm from Morehead City, NC. Attached you should find the mp3 audio from today’s show. Thanks for listening

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These 7 People Just Threw Their Dog a Birthday Party…

See on Scoop.itPet Humor

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The 10 Stages of Cat Surgery

See on Scoop.itIn Your Pet’s Best Interest

Cat health: We explain the 10 stages of surgery for cats.

PetDocks Veterinary Hospital‘s insight:

An excellent overview of the process of anesthesia and surgery – not just for cats, but dogs too. The exact details may change from patient to patient, but the general process outlined in this article is the same for patients at our hospital. 

See on www.catster.com

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Type 1 diabetes cured in dogs for the first time, paving the way for humans

See on Scoop.itIn Your Pet’s Best Interest

Researchers from the Universität Autònoma de Barcelona (UAB) have cured type 1 diabetes in dogs for the first time. The finding is significant becau…

See on www.emaxhealth.com

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Deconstructing Dental Chews and Tartar-Control Treats for Pets

See on Scoop.itIn Your Pet’s Best Interest

Dr. Patty Khuly shares five misconceptions about dental chews.

PetDocks Veterinary Hospital‘s insight:

Another excellent post by Dr. Patty Khuly. A worthy read for pet owenrs interested in dental chews/treats as part of their plan for their pets’ dental health program

See on www.vetstreet.com

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Curbing Sexual Aggression in Neutered Cats

See on Scoop.itIn Your Pet’s Best Interest

By not smelling like a male, a female cat could be viewed as a target for the unwanted sexual advances of a neutered super-male Romeo.

See on www.veterinarypracticenews.com

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Do We Really Know That Cats Kill By The Billions? Not So Fast : NPR

See on Scoop.itIn Your Pet’s Best Interest

Murderous cats are in the headlines this week. Commentator and cat-rescuer Barbara J. King questions the reliability of the new, extreme cat-killer statistics, which appear in a “meta-study” that she says makes some questionable assumptions.

See on www.npr.org

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Things Every Pet Owner Should Ask their Veterinarian, or Things Your Vet Should be Telling You

A veterinary visit can be a hectic time, from the unruly patient, to a crowded waiting room. As a pet-owner, you may not be on your “A” game when your vet is examining your pet, or going over test results, medication that have been prescribed, etc. Here are a few things you should feel comfortable asking your vet, especially if he/she hasn’t offered the information by the end of the appointment

1. What did you find on physical exam? This is basic, but probably most important. The physical exam is the lynchpin of preventive care as well as the starting point for diagnosing disease. Hopefully, your vet is verbalizing their exam findings, normal or otherwise. If not, ask them to summarize their exam findings.

2. What were the test testing and what were the results? While you may not understand the specifics or subtleties of the tests and what the results mean, your vet should be able to give you an overview of what tests were performed and what the results mean in a larger context.

3. What are these medications being prescribed for? Simple, yes. However, many pet owners walk out of the vet’s office with a mobile pharmacy without the slightest clue what they are giving or applying, much less what each medication is aimed at achieving. It shouldn’t take long to explain, so ask your veterinarian what each medication does.

4. Will I need to continue these medications and for how long? Will I be able to refill without another visit and if so for how long? This is a subset of the question above. Be sure to give the entire course, as prescribed. If the medication is a long-term medication (as in anti-inflammatories for arthritis), ask about refills and if changes in dosing need to be made over time. This is also a good time to ask if any monitoring tests should be performed (e.g. to check for changes in liver or kidney values, which may occur with certain types of drugs) and at what intervals those tests are needed.

5. Are there side effects to medicine that we should be looking for? Part 3 of the medication interrogation – be sure to ask about side effects before they happen. There is no need for you to be guessing if what you see at home is a result of the medication(s) your pet has been prescribed, or due to some other issue.

6. What should I expect with this treatment? When should I contact you again? When and under what circumstances should we recheck? Some conditions will respond to the proper prescription(s) within hours or days. Others may require weeks before outward change or improvement is noted

7. What will we do if things get worse? Be sure that you leave your vet’s office knowing what will need to be done if your pet’s symptoms worsen, or at a minimum, what the plan is if the symptoms do not resolve with the planned course of treatment

8. Should we consider referral to a specialist? What about a second opinion? Never be afraid to ask for a referral to a specialist or just for a second opinion. My approach to this has always been:

  • I don’t know everything (nowhere close), and I certainly haven’t trained extensively in a specialized field (such as ophthalmology, internal medicine, or surgery) for many years, and
  • It is always helpful to have a second set of eyes looking at a patient and that patient’s problems. What’s the worse thing that could happen (from the perspective of the pet owner)? iT may turn out that the first opinion was accurate. Most of us could live with that.

9. Do you have any information to read up on this condition? If not, where should I go online to do some reading? As a veterinarian, I will admit that it is often the last thing I want to hear form a client, especially before we’ve even started the exam – “I read on the internet…”.  We all do it (search online), so we should all know how to do so “safely”. Ask your veterinarian for a short list of websites that he/she would approve of or would recommend. There are a lot of poorly informed websites and blogs out there which purport to offer facts and expertise. Most of them have neither. You wouldn’t want your veterinarian consulting Most of us want our own physician’s to be studying the latest in peer-reviewed journals, or listening to lecturers that are recognized as experts within their own fields. This is what you will get from reputable, scientific websites that you won’t get from Joe’s Pet Information Blog.

Until next time,

Todd Worrell, DVM

PetDocks Veterinary Hospital

Morehead City, NC

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10 “Poison Pills” for Pets

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See on www.avma.org

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