Duncan is not a morning dog, so it was no surprise that he was fast asleep at 7:00 when I got up last Friday morning. When he finally did get up, he was not himself. He struggled a little getting up and was somewhat wobbly as he came to greet me. He seemed quieter than normal. At first glance, I thought that perhaps he injured himself the night before and was now sore after sleeping all night. (You older folks know exactly what I’m talking about.)
For those of you who don’t know Duncan, he is an eleven year old male Golden Retriever, with a heart of gold. He is a people dog, who insists on being petted frequently and for long periods. He still loves to run and play, but not quite like in the old days. He goes to work with me every day and visits with many clients. He sleeps more than he used to, and he sleeps more soundly than he used to (a normal aging fact of life). Still, he is very happy to see me every morning; except for last Friday.
By the time we got to work (County Line Veterinary Hospital), Duncan was looking better. Not perfect, but much more normal. Knowing the problems older large breed dogs can develop, I decided not to take any chances. We ran some blood tests and compared them to the WELLNESS TESTS we ran three months ago and found that Duncan was borderline anemic. He was mid-range normal three months earlier. This gave us valuable information, suggesting that Duncan was bleeding internally or had developed an immune mediated disease that destroys red blood cells.
My primary concern was that Duncan had cancer, specifically hemangiosarcoma. This is a tumor that often develops in the spleen, most commonly in older, large breed dogs. It frequently ruptures and causes internal bleeding, weakness and shock. It often spontaneously stops bleeding and the dog appears to recover, only to have the process recur, as well as the tumor spreading, until a fatal episode develops.
On physical examination, Duncan’s gums were only slightly pale, and I could not feel an enlargement of his spleen. We took x-rays of his chest and abdomen, but did not see any obvious changes. Blood was sent to an outside laboratory for special testing of the red blood cells, and to look for possible tick-borne diseases. We also sent a stool sample just to make sure he didn’t have intestinal parasites. As the day progressed, Duncan did better and better.
The test results came back on Saturday morning. There were no problems detected other than the slight anemia that we already knew about. We repeated a test to measure his red blood cells. It was essentially unchanged from Friday. We repeated abdomen x-rays, and again found no obvious changes (no enlargement of the spleen, no obvious fluid in the abdomen, etc.). Duncan was back to his old self. I was, none-the-less, convinced that I was missing a tumor. I had to restrict him from running and jumping for fear that he would start to bleed internally. We called the ultrasonagrapher that we use and set up an ultrasound for Duncan on Monday.
I ran a test again on Sunday to check the red blood cells. It was normal; significantly higher than the day before. This was consistent with a previous abdominal bleed that was now stable. To look at Duncan, one would never suspect that there was a life threatening problem going on. He looked great!
Monday came not nearly quickly enough for me. We did the ultrasound. Duncan’s spleen looked mildly abnormal, but no masses were noted. Unfortunately, a 5 cm (2”) diameter mass was found in his liver. There was also a small amount of fluid in the abdomen (too little to see on x-ray). Interestingly, Duncan’s liver enzymes were all normal on the blood tests that we ran.
I elected not to operate on Duncan, myself. He needed to have a liver lobe removed, and I am much too emotionally attached to him to be involved. So I brought him to NorthStar Veterinary Hospital; the same place we so often refer special cases to. They removed the affected liver lobe and his spleen on Tuesday. He is back at home today (Wednesday), recovering. We will wait for the biopsy results and go from there.
There are several important points to take away from Duncan’s story.
1 Know your pet. Think about his/her age and breed. What seems like a small departure from normal may be more significant than you realize.
2 Don’t wait too long to have problems checked. Your pets can’t talk and they can’t tell you how they are feeling.
3 Problems are not always easy to diagnose. Some tests may need to be run multiple times to look for changes or stability. Additional tests and escalation of tests may be required to rule in or rule out suspected problems. For instance, I repeated Duncan’s red blood cell tests four times, ran special tests to evaluate the condition of his red cells, and progressed from x-rays to an ultrasound to make his diagnosis.
4 Wellness testing is very important. Running routine tests on a scheduled basis provides critical information about what is normal for YOUR pet. This can be invaluable when illness develops.
5 Wellness testing generally consists of screening blood tests for young animals, adding in a urinalysis for older animals and should go further. Electrocardiograms, blood pressure testing, eye pressure testing, screening x-rays of the chest and abdomen, and even abdominal ultrasound may capture unseen illnesses at an early stage, BEFORE permanent damage is done.