The dark cloud has still not lifted and I am still encountering very challenging and heart breaking cases for my 4th week straight. I really need a few good winners to brighten up my spirit.
Just got back from an afterhours emergency call and it is almost 1 a.m., my patient is stable and has gone home but I will be readmitting her for full workup tomorrow morning!
Now back to my heartbreaking case of today. Two days ago, we admitted ‘Boss’, a lovely 10-year-old male desexed labrador, who presented to my colleague afterhours for excessive panting and a distended abdomen. He was xrayed and bloat/abdominal mass were ruled out but he had a fever and seemed quite painful. He was started on aggressive supportive treatment which included iv fluids and pain relief and antibiotics.
I arrived the next morning to see this adorable and morbidly overweight labrador panting away in his cage. He looked dreadful because he could not get comfortable and appeared quite distressed. We reassessed him and proceeded with further workup. We collected bloods and they indicated he was anaemic and had a severe infection. We have access to an excellent ultrasound machine but we are not ultrasonographers by any means and often use the ultrasound just to see if anything obvious pops up. We have been able to diagnose suspect liver or splenic tumours known as haemangiosarcomas based on ultrasound that were later confirmed during surgery!
In his case, the ultrasound was not very specific but we definitely saw a few abnormalities in the abdomen but they were very challenging to characterise.
We were concerned he had free abdominal fluid and collected a sample and sent it off to the pathologist for interpretation. We were suspicious of a ruptured liver/splenic tumour or peritonitis (infection of the abdominal cavity secondary to many possible causes).
We loaded up ‘Boss’ with heaps of palliative care while awaiting his abdominal fluid results. He seemed more settled but was not very interested in eating. That was very alarming, he would eat a few bits of chicken but then seemed more tucked up afterwards. I mean what labrador in their right mind would say no to food, right? But even though he was not feeling well, whenever you spoke to him or patted him or took him out of his cage to examine him, he would wag his precious tail. It was like he was putting on a strong face just to please us!
Ah labradors, such loving pooches, you just want to cuddle them all day!
His results came back and indicated there was pus in his abdominal cavity. The next step was an exploratory laparotomy (surgically exploring his abdominal cavity) to determine the source of the pus/infection and try to mend it if possible. Unfortunately, we discovered he had a very aggressive pancreatic tumour and so his owners opted for us to euthanize him while he was still under anaesthetic. It was a very peaceful parting and he is finally free of pain and wagging his tail at full pace!
I just really love Labradors and their dedication to wag their tails at all cost. All they care about is making you happy.
I am so sorry we could not save you ‘Boss’ and your lovely wagging tail…
Dr Rayya's Online Veterinary Journal 
August 10, 2011 at 1:40 pm
Dr. Rayya, I am no vet, but I have been reading about a woman whose dog has hemangiosarcoma. Her dog first presented with a distended abdomen, I’m sure your are very thorough in your exams, but thought it might be of help to you and the sweet lab. (You know I have a Lab Love going on.) 🙂
August 11, 2011 at 12:03 pm
Thanks heaps for your input Jodi…haemangiosarcomas are definitely a differential cause for acute abdominal swelling and anaemia in a geriatric lab…
August 10, 2011 at 4:35 pm
Awe what a sad story. Poor Boss.
August 11, 2011 at 12:04 pm
I know 😦
August 10, 2011 at 8:50 pm
poor little guy
August 11, 2011 at 12:05 pm
😦
August 11, 2011 at 2:37 am
Such a sad story. How do you cope Rayya?
RIP Boss with the waggy tail!
August 11, 2011 at 12:06 pm
Hey barb…very good question…u have to cope and move on and focus on saving your other patients…it aint easy, that’s for sure!
August 11, 2011 at 4:05 pm
Such a sad story Rayya… You’re doing so great though, and the animals are in the best hands in your care.. Sometimes they are just too sick.. Doesn’t make it easier to loose your patients though.. Boss is in a better place now, and wagging his tail at u from the sky!
August 12, 2011 at 10:23 am
Thanks heaps Elin..your support means the world to me especially because you experience this firsthand too…
August 22, 2011 at 12:30 am
Welling up here!
I used to have a gorgeous black Labrador inherited from my grandparents. Overweight and always hungry, she was a great tail wagger. We used to get bruised legs from her rudder like tail.
Thanks for visiting my page.
Maybe doing the best you can for an animal, even if you can’t save it, is the greatest service that you can give it and its owner.
August 22, 2011 at 2:09 am
Oh no, I put in a grocer’s apostrophe. The shame. Can you remove it for me please?
August 22, 2011 at 9:35 pm
you would totally understand how amazing labs are and how hy will never stop wagging their very dedicated loving tail….we cant save them al but we sure can try….
August 22, 2011 at 5:59 am
I had a lab growing up. They’re such happy-go-lucky dogs. It’s really sad when these types of things happen. As I was reading this, I kept hoping it would come out as the spleen as a best-of-the-worst scenario. But pancreatic is always a bad answer. I’m sorry for both his owners’ loss as well as yours. It’s difficult to lose any patient, but especially those that manage to endear themselves to you within the first seconds of meeting them.
August 22, 2011 at 9:23 pm
it is so sad because labradors will tolerate very high levels of pain…they will never stop wagging their happy loving loyal tail….