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This post is intended to convey information that may help a dog/owner, not a vet rant. I anticipate in advance, and appreciate, all well-wishes and expressions of sorrow.
I just lost my 8.5 y/o male GSD, "R" (no name here to protect vet) on the operating table. It didn't have to happen, and, if my dog's vet had been better informed, it likely wouldn't have. Knowing what I know now, I could have prevented it, as well. I'd researched lots of GSD health issues, but not cancer.
Context - I haven't been on here for 6+ years because R had no health issues, beyond the occasional hotspot. I work at home and spent every hour of the day with the dog - my point is that I knew the dog better than I would have if I spent hours away every day at a job, recreated a bit on the weekends, etc. R got great food/exercise, and annual vet visits with the same vet, for continuity of care. Food was NW Naturals (raw bagged frozen nuggets of goodness). No flea or other chemicals. I say no health issues, but he did get an infection in his upper jaw, behind his eye, from a stick splinter (don't let them carry/chew sticks), and this vet spotted the issue quickly and did a great surgery, hence, increased confidence. My point here - healthy dog and diligent/observant dog owner meet lifelong competent vet for great relationship that benefitted all parties. Or, so I'd hoped.
January 5, or so - R ate his morning snack, then tossed it up with the yellow bottom of his stomach. Hmmm. Unusual for him, but, dogs vomiting stuff is not that unusual - I'll keep an eye on it. Normal after that.
January 9 - R suddenly lethargic in late afternoon (walk time, usually very interested) and yelps when exiting the car (after the walk, and again at the house), panting on the walk when it's 37 deg. F., and neglecting his zigzag visits to the trees. Just trudging along 20 ft behind me. Refuses dinner/snack - something is wrong with this dog. I don't panic, but I want him seen. Called vet, she's down to 1 day a week, can't get him in to her for a week. I could see another vet in the office, but that breaks history/continuity - new vet wouldn't know me, the dog, or the life he's led, so wouldn't be as helpful to the issue, imo - I've spent time (other dogs) wasted on fill-in vets. It doesn't look like an emergency, really, so I elect to keep the 1-week out appt. I get queasy about an hour later when looks a bit worse and decide to take him to the local doggie ER, just in case it's bloat, or something life-threatening. I noticed him drinking more water than usual.
ER vet is young/inexperienced (they work there on a fill-in part-time basis, I believe, not a regular gig). She does the usual exam, all looks well. She doesn't know him, so she didn't know that he should be whining and pacing at the vet's office, not just sitting patiently. He looked "normal," but he wasn't normal, for him. She checked his gait due to the yelp on impact. He seems tentative when walking. I had told her his vet said he had some arthritis starting in his elbows. Her diagnosis - likely arthritis discomfort and a sensitive dog = cause of the symptoms I'm seeing. She said "I could run bloodwork, but I wouldn't know what I was looking for." She prescribed an anti-inflammatory (carpo), and I took him home (I didn't give him the carpo). He seemed to get better later in the evening, and ate his dinner. Maybe it's nothing.
Between Jan 9 and Jan 16, he had several episodes like this - he'd be "sick" for half/full day (no appetite, lethargy, no interest in the walk), then get better - as if nothing was wrong. No yelp (used ramp for car, now) jumping off bed when "good," but slight yelp when he was feeling "bad." Drank much more water when "sick." What is going on with this dog? Also, on Jan 15, he had diarrhea (really loose, but not liquid - it smelled mostly like asparagus urine, not fecal matter, kind of a sulphur smell), on his bed - he'd never had any kind of accident in the house before. Can't wait for that vet visit.
Jan. 16 - Vet visit - By this time, I'd researched everything I could find about these symptoms, including the "good/bad" waxing/waning episodic nature of the illness events. What makes a dog sick, then allows him to get well? The only thing I could find that fit his symptom set (which now included that single episode of diarrhea) was Giardia - he did drink from streams on the walk (he had a Lepto vaccination, but I didn't know about Giardia). He was subdued during the exam, but not as much as when at the ER. The vet did her usual exam (including palpating him for pain), heard the symptoms (including the waxing/waning), heard from me on the Jan 9 ER visit, and found nothing wrong (she even looked at a fecal sample). I suggested Giardia, she didn't necessarily agree/disagree, but agreed to treat prophylactically, which we did. She also suggested, and, took blood, the results of which showed (1) evidence of inflammation, and (2) evidence of dehydration (phone message: "let's check it again in a month") - if only we could.
Jan 16 - Jan 30: The same pattern repeated. He went through the Giardia meds - no change. Good days and bad days, no better, no worse. Having no answers from 2 different vets, I was resigned to his having to get worse before we'd know what it was. We got our chance on Jan 30, a "bad" day (Jan 29 was a very good day). I left a voice message for the vet updating her and wondering now, after research, if he didn't have Salmon poisoning, as some of his food previously contained salmon), and asked for a call back. He refused dinner, though he'd eaten breakfast. Looked sick. He suddenly began to try to walk around to get to the water, and it was clear he was very unsteady on his feet, esp his back end, AND his right foot was curled under, where it stayed. Dull-eyed, panting, labored breathing. Uh-Oh. This is Not Good. Into the car and rush to the ER where the owner (and very senior vet) was in attendance. Tech checked R's gums and she took him away without a word. That can't be good. Vet comes in with the bad news - abdomen is full of blood. Ultrasound shows mass on spleen. Most likely hemangiosarcoma, very common in big dogs, very common in GSDs, and usually shows up after age 8 years (R's 8.5 years). 75+% chance it's malignant, but 25% chance it's not. Prognosis very grave if malignant as it would have metastasized by now. Surgery to remove spleen is one path - might show it's benign, then all's well. If malignant, then R's got only a few months before the cancer pops up again and we have to put him down. Or euthanize now. What would doc do? He went through this himself recently and he elected to remove the spleen, it was malignant, and his dog died 1 month after the surgery. Hmmm. It's a gamble, but R's a great dog, and who knows? Maybe it's benign, so I go ahead with the surgery. Doc warns me R's lost a lot blood, he's going into shock, and there's always the risk of death with surgery. I get that, but still see it as the best option. Doc closes the ER to incoming, takes my deposit, tells me I can wait there or go home and he'll call. I don't live far, so I elect to go home and wait for the call, since I don't want to angst in front of the receptionist. I get the call an hour later that R arrested as they were sewing him up. Spleen wasn't sent for pathology (why bother?).
So, that's what happened. What should have happened, imo? I give the first ER visit vet a pass - she didn't have the knowledge re: episodic good/bad. With the research I've done over the past 2 days, I'm now a quasi-expert on hemangiosarcoma - it seems any vet recently out of vet school should have known that R fit the profile of a dog with hemangiosarcoma, but she didn't think to suggest an ultrasound of the abdomen. With her relative inexperience, I'm not surprised - she'd have to be a pretty special vet, I think, to have come up with that at her stage, but who knows whether she fell below the standard of care?
R's usual vet, on the other hand, was a disappointment to me. 20+ years experience, and confronted with a middle-aged GSD having episodic waxing/waning constitutional symptoms? I've read a bunch of science journal articles by now and that's the pattern for this disease, even if people/vets who don't spend 24 hours a day with their dogs don't know it. What happens is the mass on the tumor is not constructed well (complicated to explain), so it cracks open and bleeds into the abdomen. That's the cause of the "bad" or sick periods - the immune system kicks in with inflammation to heal things up. The mass then clots and stops bleeding and the dog's body reabsorbs the blood - that's the "good" period. All's well until the mass cracks open again and the cycle repeats. At some point, there is a "big" one that bleeds so much it can't clot in time before it kills the dog. No, imo, under these facts, R's usual vet was remiss in not suggesting an ultrasound or other look-see into the abdomen, especially near the spleen (most common site). Yes, this is very common in GSDs per the literature of her profession, and no, I don't expect her to be an expert in every obscure disease that may be out there, but GSDs aren't the only breed that gets hemangiosarcoma.
She should have offered an ultrasound - that's how the ER found it. $150 - I'd have been happy to pay it. She'd have found the splenic mass 2 wks earlier, and I could have had the surgery done when he wasn't in shock. He would likely have survived the surgery, and I'd be tending his recovery today, rather than typing this while looking at his empty bed (I understand it was probably malignant, and I'd likely have had to euthanize him a month or 3 - a scan wouldn't have meant a cure.). If you can't figure out what's wrong with the dog, and you know you have a vigilant owner who really knows his dog, why wouldn't you recommend some kind of abdominal scan to see if there's, oh, I don't know, some kind of cancer lurking around causing problems? It's not as if there's not 1000 articles about this problem, including the waxing/waning illness symptom scenario.
I understand that part of the problem for the vets is that they usually see this disease at a later stage (usually a major hemorrhage), not an early stage where the owner can identify significant but subtle symptoms over many days from constant observation. Still . . . .
I feel R was let down by the veterinary profession, as was I. Hopefully, someone reading this will, now or in the future, recognize the same symptoms in their dog and share their concerns and the suggestion of a scan with the vet, before it's too late for the dog.
I just lost my 8.5 y/o male GSD, "R" (no name here to protect vet) on the operating table. It didn't have to happen, and, if my dog's vet had been better informed, it likely wouldn't have. Knowing what I know now, I could have prevented it, as well. I'd researched lots of GSD health issues, but not cancer.
Context - I haven't been on here for 6+ years because R had no health issues, beyond the occasional hotspot. I work at home and spent every hour of the day with the dog - my point is that I knew the dog better than I would have if I spent hours away every day at a job, recreated a bit on the weekends, etc. R got great food/exercise, and annual vet visits with the same vet, for continuity of care. Food was NW Naturals (raw bagged frozen nuggets of goodness). No flea or other chemicals. I say no health issues, but he did get an infection in his upper jaw, behind his eye, from a stick splinter (don't let them carry/chew sticks), and this vet spotted the issue quickly and did a great surgery, hence, increased confidence. My point here - healthy dog and diligent/observant dog owner meet lifelong competent vet for great relationship that benefitted all parties. Or, so I'd hoped.
January 5, or so - R ate his morning snack, then tossed it up with the yellow bottom of his stomach. Hmmm. Unusual for him, but, dogs vomiting stuff is not that unusual - I'll keep an eye on it. Normal after that.
January 9 - R suddenly lethargic in late afternoon (walk time, usually very interested) and yelps when exiting the car (after the walk, and again at the house), panting on the walk when it's 37 deg. F., and neglecting his zigzag visits to the trees. Just trudging along 20 ft behind me. Refuses dinner/snack - something is wrong with this dog. I don't panic, but I want him seen. Called vet, she's down to 1 day a week, can't get him in to her for a week. I could see another vet in the office, but that breaks history/continuity - new vet wouldn't know me, the dog, or the life he's led, so wouldn't be as helpful to the issue, imo - I've spent time (other dogs) wasted on fill-in vets. It doesn't look like an emergency, really, so I elect to keep the 1-week out appt. I get queasy about an hour later when looks a bit worse and decide to take him to the local doggie ER, just in case it's bloat, or something life-threatening. I noticed him drinking more water than usual.
ER vet is young/inexperienced (they work there on a fill-in part-time basis, I believe, not a regular gig). She does the usual exam, all looks well. She doesn't know him, so she didn't know that he should be whining and pacing at the vet's office, not just sitting patiently. He looked "normal," but he wasn't normal, for him. She checked his gait due to the yelp on impact. He seems tentative when walking. I had told her his vet said he had some arthritis starting in his elbows. Her diagnosis - likely arthritis discomfort and a sensitive dog = cause of the symptoms I'm seeing. She said "I could run bloodwork, but I wouldn't know what I was looking for." She prescribed an anti-inflammatory (carpo), and I took him home (I didn't give him the carpo). He seemed to get better later in the evening, and ate his dinner. Maybe it's nothing.
Between Jan 9 and Jan 16, he had several episodes like this - he'd be "sick" for half/full day (no appetite, lethargy, no interest in the walk), then get better - as if nothing was wrong. No yelp (used ramp for car, now) jumping off bed when "good," but slight yelp when he was feeling "bad." Drank much more water when "sick." What is going on with this dog? Also, on Jan 15, he had diarrhea (really loose, but not liquid - it smelled mostly like asparagus urine, not fecal matter, kind of a sulphur smell), on his bed - he'd never had any kind of accident in the house before. Can't wait for that vet visit.
Jan. 16 - Vet visit - By this time, I'd researched everything I could find about these symptoms, including the "good/bad" waxing/waning episodic nature of the illness events. What makes a dog sick, then allows him to get well? The only thing I could find that fit his symptom set (which now included that single episode of diarrhea) was Giardia - he did drink from streams on the walk (he had a Lepto vaccination, but I didn't know about Giardia). He was subdued during the exam, but not as much as when at the ER. The vet did her usual exam (including palpating him for pain), heard the symptoms (including the waxing/waning), heard from me on the Jan 9 ER visit, and found nothing wrong (she even looked at a fecal sample). I suggested Giardia, she didn't necessarily agree/disagree, but agreed to treat prophylactically, which we did. She also suggested, and, took blood, the results of which showed (1) evidence of inflammation, and (2) evidence of dehydration (phone message: "let's check it again in a month") - if only we could.
Jan 16 - Jan 30: The same pattern repeated. He went through the Giardia meds - no change. Good days and bad days, no better, no worse. Having no answers from 2 different vets, I was resigned to his having to get worse before we'd know what it was. We got our chance on Jan 30, a "bad" day (Jan 29 was a very good day). I left a voice message for the vet updating her and wondering now, after research, if he didn't have Salmon poisoning, as some of his food previously contained salmon), and asked for a call back. He refused dinner, though he'd eaten breakfast. Looked sick. He suddenly began to try to walk around to get to the water, and it was clear he was very unsteady on his feet, esp his back end, AND his right foot was curled under, where it stayed. Dull-eyed, panting, labored breathing. Uh-Oh. This is Not Good. Into the car and rush to the ER where the owner (and very senior vet) was in attendance. Tech checked R's gums and she took him away without a word. That can't be good. Vet comes in with the bad news - abdomen is full of blood. Ultrasound shows mass on spleen. Most likely hemangiosarcoma, very common in big dogs, very common in GSDs, and usually shows up after age 8 years (R's 8.5 years). 75+% chance it's malignant, but 25% chance it's not. Prognosis very grave if malignant as it would have metastasized by now. Surgery to remove spleen is one path - might show it's benign, then all's well. If malignant, then R's got only a few months before the cancer pops up again and we have to put him down. Or euthanize now. What would doc do? He went through this himself recently and he elected to remove the spleen, it was malignant, and his dog died 1 month after the surgery. Hmmm. It's a gamble, but R's a great dog, and who knows? Maybe it's benign, so I go ahead with the surgery. Doc warns me R's lost a lot blood, he's going into shock, and there's always the risk of death with surgery. I get that, but still see it as the best option. Doc closes the ER to incoming, takes my deposit, tells me I can wait there or go home and he'll call. I don't live far, so I elect to go home and wait for the call, since I don't want to angst in front of the receptionist. I get the call an hour later that R arrested as they were sewing him up. Spleen wasn't sent for pathology (why bother?).
So, that's what happened. What should have happened, imo? I give the first ER visit vet a pass - she didn't have the knowledge re: episodic good/bad. With the research I've done over the past 2 days, I'm now a quasi-expert on hemangiosarcoma - it seems any vet recently out of vet school should have known that R fit the profile of a dog with hemangiosarcoma, but she didn't think to suggest an ultrasound of the abdomen. With her relative inexperience, I'm not surprised - she'd have to be a pretty special vet, I think, to have come up with that at her stage, but who knows whether she fell below the standard of care?
R's usual vet, on the other hand, was a disappointment to me. 20+ years experience, and confronted with a middle-aged GSD having episodic waxing/waning constitutional symptoms? I've read a bunch of science journal articles by now and that's the pattern for this disease, even if people/vets who don't spend 24 hours a day with their dogs don't know it. What happens is the mass on the tumor is not constructed well (complicated to explain), so it cracks open and bleeds into the abdomen. That's the cause of the "bad" or sick periods - the immune system kicks in with inflammation to heal things up. The mass then clots and stops bleeding and the dog's body reabsorbs the blood - that's the "good" period. All's well until the mass cracks open again and the cycle repeats. At some point, there is a "big" one that bleeds so much it can't clot in time before it kills the dog. No, imo, under these facts, R's usual vet was remiss in not suggesting an ultrasound or other look-see into the abdomen, especially near the spleen (most common site). Yes, this is very common in GSDs per the literature of her profession, and no, I don't expect her to be an expert in every obscure disease that may be out there, but GSDs aren't the only breed that gets hemangiosarcoma.
She should have offered an ultrasound - that's how the ER found it. $150 - I'd have been happy to pay it. She'd have found the splenic mass 2 wks earlier, and I could have had the surgery done when he wasn't in shock. He would likely have survived the surgery, and I'd be tending his recovery today, rather than typing this while looking at his empty bed (I understand it was probably malignant, and I'd likely have had to euthanize him a month or 3 - a scan wouldn't have meant a cure.). If you can't figure out what's wrong with the dog, and you know you have a vigilant owner who really knows his dog, why wouldn't you recommend some kind of abdominal scan to see if there's, oh, I don't know, some kind of cancer lurking around causing problems? It's not as if there's not 1000 articles about this problem, including the waxing/waning illness symptom scenario.
I understand that part of the problem for the vets is that they usually see this disease at a later stage (usually a major hemorrhage), not an early stage where the owner can identify significant but subtle symptoms over many days from constant observation. Still . . . .
I feel R was let down by the veterinary profession, as was I. Hopefully, someone reading this will, now or in the future, recognize the same symptoms in their dog and share their concerns and the suggestion of a scan with the vet, before it's too late for the dog.