Recently, I heard from my friend about her pet past away during CNY. The story quite tragic even I didn’t own a pet, but I feel for her, hence I decided to post her story….
It’s been a month since you left us. It took me a while (1 month exactly) to decide if I should write or just live on with life anyway no one will be bothered by a pet but with encouragements from friends and neighbors, I decided to write this post in the hope that it will help other fur parents when dealing with their vets.
19 Jan 2018
I brought you to the vet as your eye was red and the eyelid was sort of flipped out. Cherry eyes was the diagnosis. But upon further observation and checking from the vet, she found that your body shape felt slightly out of shape and did a scan. There she found sort of a mass in your body but further examination was needed and so we arranged an ultrasound the next day. The results were out and it wasn’t very positive. They found a cancer cell in the liver and it’s suspected to be Cushing disease. The vet recommended three specialists. We chose one out of the three after researching and going through their reviews.
24 Jan 2018
We sent her to the specialist/hospital for consultation.
Fast forward…
Fast forward the specialist did rounds or tests and scans, MRI, blood test etc. Her results came out and she was tested positive for Cushing but the “good” news was that the tumor in her gland was still contained and it did not spread to the invertebrate and the other mass in her liver was benign. We were thankful at this point and decided to proceed quickly with the op to remove it.
We did quite a fair bit if research but as her tumor was still small and contained, we decided to proceed as vet assured us with his professionalism and past cases of dealing with similar cases and we went ahead with the op. We did think of long term medication although the vet did not suggest medication as an option, only surgery. Furthermore, everything pointed to a contained cancer tumor and there are side effects of medication too. (12.5 years old and the vet suggested surgery? We were hesitant but he assured us that age is the last thing that we should worry about for a surgery and he handled a more severe case before where a 14 yr old dog had over reactive adrenalin gland and cortisol-producing gland.)
“Are There Traditional Non-Drug Treatment Options?
Surgery For Adrenal Gland Tumors
If your veterinarian can identify discrete tumor(s) in one of your pet’s adrenal glands (the uncommon form of Cushing’s), that gland might be removed successfully through surgery (adrenalectomy). It is ticklish surgery and would need to be performed at a veterinary surgical center by a specialist in the procedure.
This surgery is not commonly attempted. First, in most canine Cushing’s cases, the tumor(s) are in the pituitary gland. Secondly, the tumors in many adrenal cases are small, diffuse, and impossible to see. Thirdly, the tumors are sometimes malignant and have already spread to other locations. And lastly, these tumors are usually diagnosed at an advanced age.
Postoperative complications after this surgery are common. This is because the normal remaining adrenal gland has often shrunken and lost its ability to produce the pet’s required amount of cortisol. Sometimes, a post-surgical period on prednisone gives the remaining adrenal gland time to recover.
It is also possible to attempt to destroy these tumors (and the rest of the pet’s adrenal glands) with high doses of lysodren. Dogs that have had this done, accidentally or on purpose then have the Addison’s problem and will need supplemental prednisone and, possibly, a second hormone replacement (Florinef, percorten-V) for the rest of their lives. (ref)”
http://www.2ndchance.info/cushings.htm
He too told us that the max that we will have to pay for this entire surgery, tests, etc. anything to do with Cushing disease will be capped at 10k
The op
We proceeded with the op and she was placed on blood thinner for 5 days (she has to be placed on blood thinner as blood clot is a common occurrence after surgery and she has to be monitored closely to ensure the other gland starts to take over the normal function) She developed a complication along the way as the benign mass in her liver was rather big and close to her stomach, thus they might have irritated her stomach during her op and she had pancreatitis.
Fast forward again. She was finally cleared of pancreatitis as her appetite was back to normal and she showed signs of recovery. She was being discharged.
Home finally?
We were overjoyed, settled the bill and was glad that she was finally home with us. I brought her back for a regular vet check up at the hospital / specialist within the week that she was discharged. The specialist did a normal check and diagnosed that she was doing well.
Tragedy struck
She was eating well and all but slightly slow in her movements while she was home. Then tragedy unfolded. She was walking lop sided, vomited and seems to be having a seizure.
We rushed her back to the hospital. (She was only home for 2 days and this was the third day at home)
It was a Sat night when we rushed her there and her specialist was not around but the night doc suspected that she might have suffered from stroke but will need further tests to confirm. She couldn’t walk couldn’t eat and couldn’t sleep. She was in a state of confusion and was banging her head everywhere while she was admitted.
The specialist was on duty on Sunday and checked what happened prior to the episode. We told him that she ran out of the house while I was talking with my neighbor at my doorstep but as her movements were still slow her “run” wasn’t that fast of a normal dog when she went into the house thereafter and she walked closely against the wall for support and started vomiting. But we were confident that she did not knock into anything as our pathway to the door was clear.
So he commented that it is might be a slip disc or blood clot that caused the stroke and it if it is later, he commented that he should have given her two types of blood thinner instead of one after the op.
The results from the MRI came back as stroke and there were a few blood clots in her brain. (The specialist said that he won’t rule out the possibility that the clot was a post-op complication.)
Questions
Questions were running through our minds.
Was there sufficient checks after the op to ensure that there was no blood clotting after their SOP -5 days blood thinning?
There wasn’t any blood thinner med given when she went home only pancreatitis and antibiotic medicine.
Should they have prescribed some blood-thinning medicine for us to allow her to have them at home?
Did we proceed with the right course of treatment as she was eating well and was a happy little girl before the op. She was only eating more and peeing more often (symptoms of Cushing) and she was actually brought to the vet for an eye infection instead of Cushing.
If we didn’t proceed with the op and placed her on long-term medication instead for Cushing as opposed to the suggested op by a specialist, could she have just stayed on longer with us?
Did we just murder her?
“What If I Don’t Treat My Dog’s Cushing Syndrome?
About 100,000 dogs per year are diagnosed with Cushing’s. Generally speaking, a dog with Cushing syndrome will live about as long as he or she will if not treated for the disease. It usually does not prolong the dog’s lifespan.
However, dependent upon the symptoms of course, it may be preferable to treat the dog if the symptoms are severe enough, such as constant urinary accidents, extreme hair loss, fatigue, etc.
As in all pet diseases, we as their human caretakers have to decide if the treatment far outweighs the benefit to our beloved pets and if it is financially feasible for us to try and prolong their life or relieve their symptoms. Sometimes the treatments can also produce more problems than merely accepting the outcome of our pet’s medical condition and allowing them to live out their remaining time without complications.”
https://pethelpful.com/dogs/Cushing-Syndrome-in-Dogs
We could only pray that her blood clots clear up and hopefully she recovers from stroke.
15th Feb 2018 (eve of CNY)
The specialist called and told us to rush down. She didn’t make it.
We spent some time with her body in the room. Specialist came into the room. He was sorry for the lost and Z told him straight that we are not paying any more medical fees after the 10k payment. But he said it in an angry tone. Specialist said that he knows that he is angry with him now and Z said yes he is. Specialist left the room. I told Z to calm down and to discuss calmly while I carried her to the cremation place.
Z agreed and joined my parents and I at the cremation place after the discussion. He said that the vet will discuss with his partner on the fees waiver. (as of today, 15 march 2018 we supposed they waived it as we didn’t receive any call or whatsoever or letter of waiver notification. Even if they didn’t or if they were to get back to us after reading this with the bill, we will like to tell them that we won’t be paying the remaining amount as it really didn’t warrant us to do so. Period)
Huh? “What did you say”?
We were in a “sobby” condition after our reunion dinner. I broke the news to my sis and bro in law. Z couldn’t contain it and chipped in. He didn’t want to upset us further earlier on as we were all rushing for our reunion dinner.
Z: “I told him we do not have the cash (the vet wanted to charge us another 3k). I told him that isn’t it agreed that the cap for the entire treatment stops at 10k and that blood clot is a common side effect from Cushing op?”
At this moment, the specialist said that the blood clot was totally not related to the op. However, I have mentioned in an earlier paragraph that he mentioned that he won’t rule out the possibility of blood clot being related. (“Roti canai-ing/ prata-ing” your words or perhaps in your language “la cliquenaude” as translated for “flip” by google translate Now that she has passed on due to stroke from blood clots in her brain?)
Z said do you know what the vet told me next.
As said by the vet: “oh we are going to have a similar op next week but because of her, we are going to extend the number days for blood thinning treatment from 5 to 7 days for the next dog.”
Z was speechless and he left the room.
We were surprised at the way that the vet handled the situation and of course his remarks. We just lost her 20 to 30 mins earlier and the vet had to make that remark? Are we supposed to feel consoled or happy that she was an experiment and she died in an “honorable and sacrificial” way for your practice/hospital?
She might be another patient/ dog to you but she is everything to us.
Perhaps, perhaps, perhaps
Perhaps there are good and dedicated vets/specialists out there but sadly perhaps we have chosen a wrong specialist.
Perhaps asking more questions, seeking second opinions or even taking time to pause and to really ponder hard before making a decision like op or putting your pet under anesthetic might just help to save your pet’s life?
Is the op/anesthetic process necessary even if he/ she is living well and eating well at the point in time?
Will long term medication be just as good to allow them to live out their life fully?
It is devastating to know that she might be on her way to recovery and she might just recover fully if only she had been placed on blood thinner for a longer period instead of on the specialist’s or hospital’s SOP of 5 days?
Perhaps medical negligence can never be determined or pinpointed as we signed an indemnity form before the op that the specialist will not be responsible for anything?
How much control do we have over our life or another’s life when we ourselves or others are at the mercy of medical professionals?
The worst has happened and we didn’t want to pursue or make it viral but after telling our story to our friends they felt that we had to spread this to perhaps allow other fur parents not to take for granted that their fur kid /s is/ are definitely in safe hands once they are with the vet/ specialist.
Cross the rainbow and be happy
Cross the rainbow, my little girl. You will always be in our hearts. Till we meet again…
Credit source of pic: https://en.m.wikipedia.org/wiki/Maltese_dog#/media/File%3AMaltese_puppy.jpeg
