Wednesday, February 25, 2009

Lumpy Dog

So I had posted earlier about my dog, finding his melanoma tumor during a dental, subsequent workup, and starting the melanoma vaccine. He is doing well, had two injections with very little redness or irritation (except having to go to the vet clinic at all!) And so I was feeling good, that we had dodged a bullet finding the tumor so early. So when we were sitting on the couch watching TV on Friday I was surprised to find a lump on his leg. He's had lumps before, and they have been aspirated and found to be benign lipomas- no worries. Well this one was larger and close to where the lymph node should be on the leg where he had just gotten the second vaccine. Sometimes dogs' immune systems overreact to vaccines and there can be some minor inflammation in the regional lymph nodes, okay, no worries.

So I kept patting and feeling around, and there was another one, on the opposite leg, on the inner thigh. There's supposed to be a lymph node there too, but now it's on the other leg, which doesn't fit the reactive lymph node theory. The other main reason for enlarged lymph nodes is cancer- lymphoma. And when I found the third one, on the belly in between the prepuce and the body wall... I stopped petting him. And of course this coincided with the crappiest day at work in a long time, one of the days where you decide working at McDonald's would be better than being a vet. Or maybe I could go work for the IRS crunching numbers in a cubicle. That would be better. Luckily those days come maybe once a year, but today was the day. And finding the lumps was just an added bonus to the crappy day.

The next night I got him on the couch and started palpating and found all the previous lumps and then another one in the armpit. I started preparing myself for making the euthanasia decision. This was lymphoma, and we'd have to do chemotherapy, which he would hate having to go to the clinic all the time, and feeling crappy, and I said I would never do that to him. We'd dodged a bullet the first time, but it was going to hit full on now.

So Monday I call Dr B and she's concerned, calls the vaccine manufacturer who says reactive lymph nodes have never been reported, and she says she'll work me the next day. So I'm resigned to the fact it's lymphoma, am eating everything in sight, sleeping poorly, and skipping workouts. Luckily, K is oblivious, happy to go pee on trees during our walks. I know I can aspirate the lumps myself, but I am going to see them all as lymphoma whether they are or not, so I decide to let Dr B do it.

At the appointment, which we do wait a while for, but that's okay because I've been warned. K shakes like Elvis and sheds incessantly. Her techs map and measure all the lumps, and she can feel the popliteal lymph nodes on the legs separate from the lumps. And the two on the belly are not where lymph nodes should be, but that doesn't they're not malignant. And the one in the armpit turns out to be a fold of skin- nothing there at all. She premeds him with Benadryl in case they are mast cell tumors- tumors that release histamine and can cause bad anaphylactic shock type reactions when poked too much. And while we're waiting, she wants me to look at her dog who had a weird fall and is now ataxic and wobbly, and maybe a head tilt, and she's sure there's something bad neurologic going on. Of course, she was a teacher of mine in vet school and I am SO unqualified to even trim her dog's toenails, so I beg off. She has an appointment with the neurologist on Friday anyway.

She aspirates the three lumps and goes to look at them under the microscope. Kieran is getting a little gorked from the Benadryl, which is just fine with both of us. And she comes back and says they're all lipomas- no scary cells of any kind in there at all. YAY! And the immediate relief is followed by the feeling of stupidity that I got all worked up for nothing and he's probably been growing these lipomas for months or years and I haven't noticed. But really, he's my dog, he's been mine for 13 years, and he was my dog before I was a vet. All my vet knowledge goes out the door when I look at him. It's all emotion only.

So since they're only lipomas and he was scheduled for vaccine #3 on Thursday, we went ahead and gave it today. And while the techs were doing that, Dr B showed me her dog that's she so worried about him having bad neuro problems and he's going to need back surgery or neck surgery, or maybe no surgery because it's something worse.

And he's fine. There is no head tilt. There's some old dog arthritis pain going on, but nothing that screams neuro, back surgery, euthanize, or anything. The neurologist will be able to localize and tell her better exactly what's going on later this week of course. But I realize she's the same with her dogs that I am. Even with all her advanced degrees and specialties, she's still human. We are all just pet owners with our own animals and need a vet to tell us what to do. And that's okay.


F said...

He's your baby. NO brains when it comes to your baby (and I mean any baby, animal, human or whatever you love beyond reason). So glad that he is ok. SO glad.

KB said...

Phew! I'm reading your post getting all anxious on your behalf so I'm relieved it's just lumps. Can we call him Lumpy now?

It is amazing how you can go from 0 to 60 and lose all perspective when something like this comes along.

Do you need to treat the lumps or are they just dermatologic things to ignore?