Tag: Ontario (page 2 of 2)

Lessons Learned

This is part 3 of 3.  For part 1, click here.  For part 2, click here.

 

Lessons Learned

 

The first 48 hours was challenging.  I hadn’t slept that first night as I was constantly checking on Charlie to make sure he was comfortable and that his IV fluids were running.  Multiple times I found myself giving him small pep talks.  I just had to make sure he knew how special he was – to me, to Jennifer, our other pets & family, and all the dogs he had helped save over the years.  They were all pulling for him.  I was even more touched when we noticed our cats had taken up a bedside vigil with Charlie for a short while.

Our oldest cat Gremlin providing moral support

Our oldest cat Gremlin providing moral support

 

The next morning I had to go into Kingston for work at the clinic.  It was never a decision that required any contemplation; Charlie was going to travel with me.  My boss understood and my co-workers were amazing with the nursing care they helped provide during the day.  Charlie had not yet started to eat and even more concerning was the fact that he had not urinated.  We passed a urinary catheter and he seemed to be a lot more comfortable once his very full bladder had been emptied.  It was later in that day that Charlie stood up on his own for the first time since surgery and I was beaming like a proud parent whose baby had just taken its’ first step!

 

It was time to go home that first day and fortunately when I arrived home, my neighbor was kind enough to help me get Charlie in the house.  We had been keeping Charlie’s pain under control with plenty of pain medications and it would have made walking very difficult, especially with stairs.  Once Jennifer arrived home, we tried to coax Charlie to eat but to no avail he continued his 48 hour fast but on the plus side he gave us a tail wag!

Jennifer & Louie helping to cheer Charlie up

Jennifer & Louie helping to cheer Charlie up

We still had to pass a urinary catheter to relieve his bladder and ultimately the next day we found out this had created an unusually bad urinary tract infection.  Upon getting some antibiotics on board, Charlie began taking an immense liking to one of our technicians and he began to eat for her.  Again, I felt the joy of optimism that everything might turn out well.

 

The next couple of days passed quickly as we saw Charlie regain his appetite and his personality.  My most joyous moment was when I went in to the kitchen where he followed me and then proceeded to beg for treats.  It was also that night that I received the pathology report with the findings of really what we had removed.  It wasn’t very clear as it only said “probable hemangiosarcoma” of the spleen so there were no definitive cancer cells seen.  Good news arrived in that it had not spread to the liver as the nodules seen in surgery were normal liver cell regeneration.  We took this as a small victory and hoped that it meant he was going to be okay.  On the advice of some colleagues, I got the slides sent off to a second pathologist who was considered to be “the authority” on such matters in her field.  Roughly one week later, I received the news I had hope to hear – benign hemangioma!

 

"I'm ready for a walk!"

“I’m ready for a walk!”

My two weeks of fear were instantly erased.  Charlie was a cancer survivor!  We had taken the skin staples out, he was eating, walking around on his own, and taking in all the comforts of our couch.  I had my senior dog back who was again acting like a puppy.

 

Jennifer & I are very lucky.  Charlie beat the odds and is healthy again.  Most dogs who present to the clinic with a splenic tumor never get to go home and share more time with their families.  Charlie has saved countless lives as a blood donor and provided lots of emotional support to help me get through school.  Now he has worked his charm again and taught us how to use the greatest gift for a veterinarian – compassion, understanding, empathy – whichever term you prefer, these are things no professor in school can teach.

 

The profession of veterinary medicine has a gravitational pull for people who have a natural tendency for caring, compassion, and service to people & animals.  There are days when everything goes right; and days where everything seems to go wrong no matter how hard we try.  This is part of the the heart of the term “compassion fatigue.”  We, as veterinarians, care so much but sometimes in the field many of my colleagues have experienced a burn out and lose the soul of what led us to this profession in the first place.   Charlie has once again kept me on the path to bettering myself as a compassionate veterinarian as I have now been in the shoes of many of the pet owners I have worked with.  It’s amazing what four furry paws, big brown eyes, a wet tongue, and wagging tail can teach us.  Thank you, Charlie.

Charlie & I two weeks post-op (our photo from the clinic webpage)

Charlie & I two weeks post-op (our photo from the clinic webpage)

Cuts Like a Knife

This is part 2 of 3.  For part 1, click here.

 

Cuts Like a Knife

 

I knelt down on the floor and had a pep talk with Charlie.  There was a chance that it might be that last time I would get to hug him and tell him what a great dog he was.  I have amazing co-workers here in Kingston, Ontario that volunteered their time to stay and help as we took Charlie into surgery that night.  They got his IV fluids hooked up and gave him the anesthetic drugs to prepare him for surgery.  I couldn’t bring myself to hover around as it just made me more anxious.

Charlie was moved into the surgery room and hooked up to the anesthetic machine and monitoring equipment.  I had already scrubbed and gotten my gown & gloves on.  Now, I’m not sure how many other veterinarians would do something this intense on one of their own pets but I had to be there.  I placed the surgical drape over Charlie and at that moment, there was a part of me that held everything together with the cool calmness that I approach with all of my patients undergoing surgical procedures.  It doesn’t pay to panic during surgery and I knew to expect the worst going in.  Basically, I knew it was Charlie under the drape, but at the same time I was able to detach myself emotionally – for a while.  Then I made the first cut.

Upon getting into the abdomen, there was some blood inside surrounding his organs but not as much as I have seen in the past with other splenic tumors.  A colleague had joined me in surgery at my request because of the fear I felt that I might not be able to finish the surgery if something more horrific was found.  We found the spleen which had a portion of the omentum (a large vascular protective covering of the abdominal organs) attached to it.  The omentum was doing its job as it had adhered to the part of the spleen that had started to bleed.

Photo from UPenn Veterinary Pathology (sorry, I didn't get a photo of Charlie's actual spleen)

Photo of a splenic mass from UPenn Veterinary Pathology (sorry, I didn’t get a photo of Charlie’s actual spleen)

We were looking at a cantaloupe sized tumor in the spleen and it was difficult to find the vessels that needed to be tied off to remove it.  Methodically, the vessels were tied off and after a while, the hideous spleen was finally removed from Charlie.  It was time to move on to exploring the rest of the abdomen as splenic tumors often spread.  And then, there it was…a very ugly nodular liver.  Like the scalpel I use for surgery, this emotional wound cut me deeply as the second thing I was feared became reality.  I was silent as I could hear my co-workers talking in the room and offering their apologies, but the only thing I was listening to was the inner demons telling me that my best friend was going to die within a few weeks.  It was precisely this fear that I had asked a colleague to help me with the surgery.  A splenectomy and associated procedures were not new to me, but this was like treating my own kid.

As is customary, we took a piece of the liver to send off with the spleen so that a definitive diagnosis could be reached.  We rinsed out the abdomen and I began closing Charlie up, all the while not saying much.  Surgery was finished and the long road to recovery began.  Being a veterinarian, I was afforded the privilege of taking Charlie home with me that night.  I did not know how much time I had left with Charlie so every minute was important.  The first night was really rough as I lay on the floor with him watching for the slightest signs of problems or discomfort.  Sleep was impossible…

Charlie 1st night

Charlie’s first night at home

 

To be continued

The Other Side of the Table

Welcome to the first of a three part series that puts me in the shoes of a client and served as the inspiration to start this blog.

 

The Other Side of the Table

 

The words hit me like a sledgehammer.  I was devastated.  “Charlie has a tumor,” said my wife on the phone. At first silence, then tears.  A sudden wave of emotion swept over me as I digested the news about my best friend, my dog.  In a split second, I went from one side of the exam table to the other.  Let me explain…

Adoption Day! 12/15/2005

Adoption Day! 12/15/2005

Charlie and I had become best friends in veterinary school where he was part of the blood donor program.  He arrived shortly before I started school and I joined a group of students responsible for getting the dogs out to walk and play.  Charlie was more than just one of a group of dogs who helped save other dogs lives. When they say that dogs love unconditionally, Charlie epitomizes that.  During stressful times in school, exam weeks, getting bad news from home…whatever, Charlie was who I would go and spend time with and have conversations.  Though he never spoke back verbally, I knew he was understanding and nurturing; always wagging his tail, giving a sloppy kiss, and even being able to hug.  When I graduated, I got to adopt Charlie.  Later, a picture of him & I is what Jennifer told me helped break the ice between she & myself.

 

For 12 years, Charlie has been by my side even as we left Florida and moved to Kingston, Ontario.  As we don’t have any kids, I suspect the wave of emotions we were feeling was much like a parent with a child.  He had been eating less as of late and with the brutally long Kingston winter, I took his trouble with the stairs to be related to arthritis and a previous incident of slipping on the ice.  I had no idea what was brewing inside his abdomen.  The night before he just couldn’t get comfortable and he was panting more than usual.  The next morning he seemed more lethargic, weak, and would not eat.  My wife Jennifer, also a veterinarian, had taken him to her job that morning since he seemed very weak and lethargic.  The x-rays showed a large mass on his spleen.

Charlie's pre-op radiographs, enlarged spleen visible on the left side of the image

Charlie’s pre-op radiographs, enlarged spleen visible on the left side of the image

I was devastated by this news and I now know how many of my clients feel in a moment like this.  The fear of losing a family member, the uncertainty of whether he would be make it, the concern for his quality of life…all the things I had discussed numerous times with pet owners over the years were now swirling through my mind.  I left the clinic to go pick up my buddy and bring him back to the Kingston Veterinary Clinic where I work.  He was definitely weaker looking then when I left and it crushed me to know he was hurting.  How could I have not seen this coming?  I was upset with myself but I had to be strong for Charlie.  His chest x-rays had been normal and no blood was seen on the ultrasound as is often the case with these tumors.  Jennifer & I talked; we decided to go forward with surgery.  We knew of all the outcomes and the risks.  I had to try and save my best friend.  I couldn’t give up on him.  More importantly though, I wasn’t ready to let go.

 

To be continued

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