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I have a close friend that has a dog with a bad diagnosis. The closer the patient and/or the client is to me, the more I see I have trouble with objectivity. This manifests in two ways.
Number one, I have a tendency to think in my mind that the problem is less likely to be a bad thing than it is.
Number two, I have trouble presenting the information regarding choices of therapy without putting in my own opinions.
I know this about myself, and alot of my clients and patients feel close to me. I get to know each person and their pet, and over the lifetime of the pet, I get very attached.
So, to get around this, I go back to my training and look immediately for a definitive diagnosis. That means what it sounds like....proof of what the problem is.
Then when sketching out the options, I review the literature and don't just say what I would do. The other problem is that the closer a client is to me, the more they are likely to trust my opinion.
...and that is a bit of a problem when the outcome is hard to predict.
I want to introduce you to Sullivan. Sullivan is a 10 1/2 year old Golden and he is a sweet one.
Sullivan came to me limping a few weeks ago and I radiographed (xrayed) his leg. There was a lesion in the bone and I wasn't sure what it was. So I sent the radiographs to a radiologist. She wasn't sure what it was either, but recommended biopsy.
Last week we did a biopsy and it came back osteosarcoma. Osteosarcoma is a bone cancer.
A bad bone cancer.
I took radiographs of his chest and there is no evidence of cancer there. We know that 10% of dogs with bone cancer have metastasis to the chest at the time of diagnosis. Many more have microscopic metastasis at the time of diagnosis, but there is no way to tell.
With no treatment, the survival time is about 3 months. New medications allow pretty good pain relief during that time, but eventually the pain gets too bad, the tumor spreads or the bone fractures.
Amputation alone allows for a little longer 3-6 months survival, with 10% still alive at 1 year.
Amputation and chemotherapy is the best outcome , with 50% of dogs alive at 1 year and 10%-20%at two years.
The chemotherapy protocol requires regular injections and testing of blood to check for low white blood cell counts. Most dogs do ok with chemo as far as side effects, but it is a big commitment.
For the sake of this vote, assume you can afford the amputation and chemo. Factor in chemo every 3 weeks for 4 months. Also, on off weeks Sullivan will need bloodwork to determine if he is tolerating the chemo. Also assume his hair won't fall out (lots of people ask that).
I will hold on my opinion, although I will share it when the results are in.
I know this seems like a harsh situation, but it is real. The exercise of putting yourself in Sullivan's mom's position may help you in the future with your pet....plus many people wonder what other people do in difficult situations.
So here goes...
Take our first Poll
Sorry to start the new year out with a difficult decision, but I appreciate your opinion.
I'll let you know how he does and what the poll results are.
On another note, you may notice you are getting this in your mailbox. The last email I wrote encouraged everyone to join our Facebook page.
Several people emailed me and said that they didn't have a facebook page, so they were going to miss my emails.
Don't worry, you'll still get these as long as you want. I will ADDITIONALLY be pasting them on our facebook.
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