Wednesday, May 4, 2011

now that's a bloody mess.

Last night, I had an adult yellow labrador, "Tucker" present for symptoms of lethargy and abdominal discomfort. His owners knew he just wasn't feeling well.  They had just fed him a meal, and were worried about GDV, so they brought him in immediately.

Tucker arrived and had a semi-painful abdomen, but it was not visibly bloated.  His mucous membranes were pink and his pulses were fair.  Something was definitely going on, but it didn't look like GDV.  The owners approved radiographs (x-rays) to investigate the source of his abdominal pain. 

Radiographs revealed a food-filled, but not enlarged stomach.  The x-rays had a haziness which my technician noticed right away - and I noticed the mass.  I ultrasound to confirm a large splenic mass, which was bleeding right now, and the source of his symptoms.

Fortunately, his owners had caught the symptoms early, and he was not yet anemic.  We discussed the most likely diagnosis - cancer - and the possibility of benign disease.  The family elected to proceed with exploratory surgery and splenectomy to stop the bleeding.  This is a difficult decision for any family who faces it: Take the higher likelihood of a cancerous mass and elect euthanasia?  Go forward with an expensive and potentially risky surgery to stop the bleeding, and potentially only palliate the macroscopic cancer? Ultimately, there is no right answer since in each case, we can't know if it's cancerous until 3-5 days after surgery, when the biopsy results return.  I'm not even sure what I'd do with my dog if I was in this situation.

Anyway, Tucker's family authorized surgery.  We  performed bloodwork, provided him with fluids, pain medications, and anesthetized him.  We prepared him for a sterile surgery and moved him into the operating room.  Surgery went quite well; and the spleen was removed with relative ease.  Darwin recovered well, and is now awaiting the pathologist's decision regarding his fate.

Not to be forgotten -- there was one casualty -- me.  By the end of the surgery, my scrubs, socks, shoes, surgical gown and even my underwear were soaked thru, to my skin, with blood and bloody fluid.  Our suction unit hadn't been able to keep up with the speed at which fluid poured from his belly, and a large amount of it ended up on me, or on the floor. 

Sticky, icky, itchy, blood. Blech. All over.  Fortunately, I always keep extra scrubs and socks at work, but now I guess I should start keeping extra underwear?!!

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