Go With Your Gut

I saw a dog yesterday that had vague signs: not eating well and lethargic. This can mean a lot of things of course. Well, the dog was 10 yrs old so that does tend to make us focus on certain things - most of which are not good.


This dog's exam was pretty normal except she had a fever. We pulled some blood work on her to go out to the lab. That would be back in 24 hours. 


Still..in the back of my mind, I thought "x-ray this dog's abdomen." I didn't though. Her abdomen was rounded a bit but she was tense and difficult to palpate. Still, you can never go wrong with a chest and abdominal x-ray on any patient, especially an older one.


AND she had a fever and lethargy so I was more curious about the blood work - she had no signs of an upper respiratory or some other obvious source of infection.


Her blood work came back today and it was VERY abnormal. Her red blood cell count was low and her white blood cell count was very high. The lab did an internal review (which they only do when things are "odd") and found she had a regenerative anemia which means her body was losing blood but responding appropriately by producing more red blood cells. The biggest concern I had (that little voice in my head yesterday said it too) was a bleeding mass in her abdomen. 


I called the owner right away and had her come in for x-rays. Sure enough, there was a LARGE mass, which was likely her spleen and some free blood in her abdomen. Her chest x-ray was clear which is good. That doesn't mean this isn't malignant but at this point, it hasn't spread to the chest (the most common place it does this.)


So, the only way to deal with that is surgery. This is what my boss saw when she opened her up:

There were adhesions all over the place. This mass was the spleen but fortunately other organs looked fine! She sent out a few pieces to the pathology lab. That's the only way we will know if this is cancerous or not. 


For now though, we definitely saved the dog's life and bought her some time!