If I Had A Dollar For Every Time I Said "Spleen" This Week...

(Contributed by Lori Whitwam)

WARNING: This post contains graphic pictures of a surgical procedure.

I wrote last week about the situation I was facing with the tumor we'd discovered in my dog Ozark's spleen. His surgery was yesterday, and that's the story I want to tell today. Even though I've worked in veterinary hospitals since 1998, and managed Whole Health Veterinary since it came into being in April of 2005, when it comes to my own dogs I'm every bit as involved - and worried when they are sick - as each one of you.

Being an "insider" in the veterinary business is a curse as much as it's good fortune. I know things, and over the years I've seen things. Sometimes cases go wrong for no reason, and illness (especially cancer) doesn't always follow the rules. On the other hand, I have access to specialists, and to knowledge of which many pet owners aren't even aware. In addition, we're a holistic practice, so our doctors think outside the box. I had the information and the resources to do everything in my power to stack the deck in Ozark's favor.

Another wonderful benefit of working for a veterinary practice (and being the one who makes the schedule) is that I was able to rearrange my work hours to allow me to care for Ozark. He received his pre-operation sedation at around 9:15 AM. The surgeon arrived around 10:30, and his surgery was over by noon.

Surgery always amazes me. Whether human or animal, surgeons are able to open up the body, take things out, put things in, rearrange various bits and pieces, then put it all together again... and the patient is still alive. Consider that one tiny wound from a gun or a knife or a pointy stick can be fatal within moments. A surgeon had better know what they're doing!

Here are some pictures from Ozark's splenectomy (removal of his spleen):

(Pre-operation. He's zonked on his sedation, and the IV catheter has been placed in his right foreleg.)

(On the table, shaved, anesthetized, waiting for Dr. Hammel. Vet tech Jenna is monitoring Ozark.)

(Dr. Scott Hammel, of Veterinary Surgical Specialists, begins the incision that will give him access to all the squishy, oozy stuff in Ozark's abdomen.)

(Dr. Hammel has located the spleen and brought it out of the body cavity in preparation for removal. The spleen should look like the part on the right. Sort of flat and dark red and mushy and shiny, like raw liver. The mass is the roundish area beneath the light-colored fatty material at the top left of the spleen as pictured. More pictures of the spleen coming up.)

(The spleen, again. The healthy tissue is the bottom - both right and left - and the tumor is the roundish area at the top-center.)

(Removing the spleen. What alarms ME is the incision visible above. Seems so... large. And look how thick Ozark's body wall is. Who knew there was so much meat on our canine friends???)

(Get that thing out of my dog, Dr. Hammel! Thanks!)

(A good shot of the spleen. If there's such a thing as a good shot of a tumor-ridden spleen. Doesn't it look like someone tucked an orange there in the top-middle part? The whole thing should be flattish and floppy, similar to a liver.)

(Since he was in the neighborhood, and because he's a skilled and thorough surgeon, Dr. Hammel also checked Ozark's intestines for signs of tumor growth. He checked the liver, too, and sent a small sample of that tissue to the lab, along with the spleen, to look for microscopic signs of cancer.)

(Getting that little bit of the liver to send off to the lab. The liver looked healthy, but there could be microscopic cancer cells sitting there waiting for a chance to cause trouble.)

(Everything back where it belongs - minus the spleen - and Ozark getting put all back together.)

Was I a nervous wreck? Yeah, pretty much. As soon as he was in recovery, we set him up in our healing and holistic treatment room, and I spent the rest of the day sitting with him.

One thing we learned is that Ozark is extremely sensitive to anesthesia. I'd expected him to be able to walk to the car with assistance around four hours after surgery. Dogs are way more resilient than we are. When I had abdominal surgery, I was in the hospital for 2 days and then spent three weeks in bed, whining. But at 6:00, six hours after his surgery, Ozark had done little more than flutter his eyes and move his head a few times. It was taking his body much longer to purge the anesthesia than normal.

Finally, we loaded him into the back of our Blazer, on a padded sled with blankets and heating discs, and my husband and I brought him home. He'd had his bladder catheterized to empty it, his temperature was steady and his blood tests looked fine. He'd had Reiki from both our technician Sabrina and Reiki Master Peggy Edman, and some homeopathic remedies. He'd mouthed some treats and swallowed some water syringed into his mouth. I knew what to watch for, in case of trouble.

So, we brought him home (dragging him up the stupid stairs in our stupid split level house on that stupid-but-handy sled) and set him up in our spare room on a dog bed and some comforters, with the heat discs to keep him toasty, and an afghan covering him. I slept on the futon, so we could keep him separate from the other dogs, and so I could keep an eye (and a hand) on him all night since the futon is so low to the ground. We had to turn him every couple of hours to keep his circulation going. It was an anxious night.

(Such a sweet, sad boy!)

But this morning, when my husband got up, Ozark stood. He went out on the deck and emptied his bladder, and ate some raw venison meatballs with medication in them. He's decided he wants to be with Brody, Darwin and me in the living room, so he's napping on a comforter across the room.

Now, if I can keep him from trying to sneak down into the basement family room to poo - which he wants very much to do, hating to do anything on the deck, which is his only other choice right now - at least until his incision heals a little, we'll be all set. His dog-brothers are behaving pretty well, and I'm keeping a close eye on him.

We should get the biopsy results Friday or Monday, then we'll know if we're likely out of the woods, or just starting a rough fight. Again, being part of the veterinary business and knowing the things I know is often helpful, and sometimes it makes things a lot harder. Until we get the report, I'll just hope. Really, really hard.

Sometimes You Shouldn't Wait And See

(Contributed by Lori Whitwam)

My 10-year-old Great Pyrenees/Labrador mix, Ozark, has a mass on his spleen. And in a very strange way, I almost feel lucky.

What? How can someone who adores her big, gentle dog feel lucky that he has something abnormal growing inside him? It’s because I’m so glad that I paid attention to my instincts, listened to my dog, and found out what was wrong much, much earlier than I otherwise would have.

Let me explain.

I tend to be a non-worrier. At this point in my life, and after as many years as I’ve worked in veterinary hospitals, I’ve had a lot of dogs, and I’ve seen countless others. I’ve seen all manner of trauma, as well as chronic and acute illness. I’ve gotten very good at “wait and see.” Whereas some owners are vigilant to the point of scheduling an “emergency” appointment every time their dog sneezes or has soft stool, I tend to wait it out. In truth, many minor things do resolve on their own.

A little over three years ago, I lost my precious “heart dog,” a 12-year-old golden retriever named Ripley, to hemangiosarcoma. He’d been panting more and more over the preceding month, but…

Granted, hemangiosarcoma is nasty, fast-moving, and nearly impossible to catch in its early stages. But should I have listened to my instincts a little more?

With Ozark, it was nothing obvious or overly alarming. He seemed a bit more subdued than usual, but he’s a very mellow dog in general. He needed to go out twice during the night on Saturday, but that happens with dogs sometimes. He always eats snow, but he seemed to be eating it more. He threw up once on Tuesday. Dogs do that. There was no one thing to which I could point and say, “Hey, something is seriously wrong.” But I know my dogs, and my gut was telling me that there was more to it than his subtle symptoms might indicate.

I brought him to work on Wednesday, and his blood work was just a bit off. There were definite signs that his immune system was working on something. We took x-rays, and the mass on his spleen was evident. I immediately panicked, because since I lost Ripley to hemangiosarcoma, anything in my dog that doesn’t belong there is especially terrifying.

Today the ultrasound specialist came and took a good look at what was going on in Ozark’s innards. Given the situation, we got the best possible news. Yes, he has a baseball-sized mass on his spleen. But it appears to be very localized and contained, and there is no evidence of abnormalities in his other organs. It is almost certainly not hemangiosarcoma.

I am always reluctant to subject any of my dogs to surgery. I want to do the least-invasive thing, and keep treatments as natural as possible. But since Ozark is otherwise very sound, with no other underlying health issues, I’ve decided to go ahead and have the spleen removed and the mass biopsied. This will take place on Tuesday, January 19.

We still have no idea if the mass is benign or malignant, but even a benign growth can rupture (especially on the spleen, which is a vascular-rich organ) and the dog will quickly die of internal bleeding. It feels like a time bomb. Of course, if it is malignant, it will grow and spread. So we’ll remove the spleen, and if the mass turns out to be malignant, we will ultrasound again in a few months and see if we can detect any signs of metastasis to other organs. If it is benign, the splenectomy may be curative.

I’m still pretty scared. My dog has a tumor, and he’s going to have major abdominal surgery. That’s never good. Yet I’m glad I listened to that little voice that was telling me that something was “off.” I didn’t put it down as “Oh, he’s getting old,” or “He’s just feeling down with all the cold weather,” or “He must’ve eaten something that didn’t agree with him.” Something in his energy and demeanor, combined with his minor symptoms, and my deep knowledge of him told me it was something more.

It took me a while to arrive at my point, but here it is. Many people are hesitant to schedule an appointment for their pets when they start to feel that way. They don’t want to be a bother. They don’t want the doctor to think they’re over-reacting. They don’t want anyone to think they’re being paranoid or “one of those kinds of pet owners.” They are reluctant to spend the money. If you are one of those people… get over it! Nobody knows your pet better than you do. If something is telling you that something isn’t right, call your vet. Get an appointment. And go!

No, every time your pet vomits is not an emergency. Every time he has a bit of diarrhea it is not a symptom of serious illness. But when small things begin to add up, and you sense that something is wrong, don’t let anyone tell you to stop worrying and wait and see what happens.

Sure, sometimes it will turn out to be nothing. But sometimes it will turn out to be something, and the sooner you know what that something is, the more options you will have and the better chances you have of a successful treatment.

A Bright Spot In Every Day

One of the reasons it's so much fun to come to work! The office is always full of animals. There are usually at least 3-4 dogs, and the clinic cats come and go as well. This clip is practice manager Lori's 10 year old Great Pyrenees mix, Ozark, playing with Dr. White's 5 month old Mini Australian Shepherd puppy, Murphy. This will go on all day! It makes it really hard to be in a bad mood when you're surrounded by this much cuteness!

(Ozark and Murphy take a break to pose for a picture. If it's possible for them to be any cuter, we can't figure out how!)