Pinky the dog 6/21/09
He was a white ball of fast moving fur when I first met him. As with all creatures, there is something to learn. You just have to know where to look for the kernel of truth. He was an American Pit Bull Terrier. He had all the characteristics expected in an American stereotype. Pinky was independent, loyal to the limit and willing at the drop of a hat to show you how far he was willing to go to illustrate his sincerity. He was right out of Urban Cowboy. He was sleek, muscled, and wound tighter than a 30-day clock. It was as if he was a hair trigger set to the pressure of a human breath. There was no doubt he would protect his people to the last growl.
I met his owners when they brought in their son's dog, a Rottweiler. She had a very severely swollen hygroma needing surgery. After a number of visits, Pinky was introduced to us. He was very protective of his owners. He would bark and carry on with great voracity. It was so intense that he needed a muzzle when he was in our exam room and other parts of the clinic. We did the routine preventative care, worming, vaccinating, heartworm preventative. Pinky tolerated us better when Mr. P came along with him. There was no doubt whose dog Pinky was.
Six months later Pinky came in after being hit by a car. He was bruised up, showing road rash abrasions and was passing blood from his rectum. This is usually an indication of a serious abdominal problem. There were no fractures detected. Some bleeding on his tail was seen treated and bandaged. Pinky was sore but manageable. Pain abatement medication helped and he was eating, ambulating and healing started. Things got better every day. The road to healing was started.
Eight months later during a vaccination, updating appointment Pinky was very aggressive. I mentioned to Mrs. P neutering would dampen down his aggressiveness. She was sure Mr. P would not have that done. I mentioned that when he cannot handle the dog he might consider it. Four months later, his surgical appointment was set. I dreaded the day we scheduled neutering.
Some dogs fight injectable drugs. Pinky turned out to have a great tolerance to opiates, alpha-2 agents and dissociative agents. He required supplemental doses to reach an induction level of anesthesia. His surgery by it self was uneventful as was his recovery. I tend too mother hen the rough acting male dogs through recovery as it is very troublesome to give the correct dose to an agitated critter. They tend to resist and not give into a recommended dose rate. If you give them the high end of a drugs range they fight the drug and they tend to wake up twice as slow as relaxed dogs. He healed up fine with no adverse events during recovery. His incision was fine though I never was inclined to roll him over and look if it was not warranted. He did well for a 3 year old male neutering.
Fifteen months after neutering in August of 2006, Pinky came in real sick. We had to sedate him to get blood samples and radiographs. There was a huge mass in the area of the spleen. This hummer was 12. 0 cm (just under 5 inches) in diameter. This was the biggest lesion I have seen on a spleen. I referred to Dr Fulton @ the Animal Emergency Clinic for an ultrasound examination and possible needle biopsy. Dr Fulton's recommendation was splenectomy and histopathology.
We scheduled Pinky and surgery revealed this black colored nasty looking mass that certainly matched radiograph and ultrasound images. After getting the splenectomy done I prepped the spleen for histopathology submission. I cut through and it looked like a grapefruit with the juice removed with the mushy fiber strands still in place. This was going to be an unusual lab report. I was anticipating a weird tumor report.
The histopathology report came back as a hematoma and splenic siderosis. This is a giant blood clot with trapped red blood cells in side the matrix and was not able to reabsorb the hemoglobin and iron complex back into the system. The only trauma in his history was from the hit by car incident twenty-two months before. This clot lay static and dormant until his system rejected it and it started to become necrotic and was starting a variation of gangrene. This is what caused the illness to become apparent. I am continually amazed at the body's resilience to major insults to organs. Almost two years His systems were working at Walling off the hematoma.
Pinky recovered from the splenectomy. He was a real handful getting him through anesthesia recovery, without our staff or his family getting chewed up. I hear from owners how their dog would never bite them. I agree with out pain and discomfort clouding a pet's judgment they probably would not. Pain requiring morphine and heavy narcotics to give control all bets are off. Those of you that have had a broken bone do understand why you are not courteous when some one moves the fracture.
Things I re-learned from this case: You need to evaluate all aspects of a case.
How is the family going to be able to control pain at home? Can they handle bandage changes? Pain abatement is needed for healing. A correct diagnosis of masses is needed to give the correct prognosis, follow-up and hope for a family. Dr Barb Kitchell eloquently stated, "The space between your thumb and index finger is not a microscope. " She is so correct palpation information will give you an incredible amount of information but it will not give a histopathology definition of a problem. Veterinarians need to assemble data from all available sources to give a valid recommendation. Communication with owners is important. Pinky's owners speak Spanish. We were able to get ideas back and forth. It required the younger generation to complete understanding.
Pinky came in this spring looking very trim and muscular as always. He put on five pounds, but was not grossly obese. We did the vaccinations, heartworm testing and exam. There was no indication of other issues. I even got the expected growl through the muzzle. Three weeks later, he was in terminal renal failure. He had used up his luck. His owner elected to say good-bye. His owner loved him very much.
For more information about a specific case, consult your veterinarian.