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…