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Wednesday 17 August 2016

Just another day at work with sentimental feelings

I have a case that was presented to me few months ago.


A very happy Rottweiler, endure everything with smile. Won't attempt to bite. A beautiful dog with lovely family. Just there's some problem with the skin. A lesion that started with eczema, then became a lesion bit like  ringworms... 

I'm suspicious that it could be a skin cancer.. Did a fine needle aspiration, what I've seen under the microscope is not good. It is a type of round cell tumour, and together with the lesion like that, most likely it's cutaneous T-cell lymphoma.  Even so, I did not tell the owner right away. Because this bad news gonna break their heart. I need to double confirm, triple confirm.  I hate it when comes to moments like this, when I'm gonna deliver sad news to the people who see their pets not just pets but family members. So, I confirmed it with my friend who is now working at the clinical pathology lab (who is also a vet), and a oncology lecturer. And they both agree with my tentative diagnosis.


What's next? A phone call to deliver the news. They needed time  to digest and they wished to try with antifungal medicine first, but I asked them better go for a biopsy.

Then time passed. I called the owner few weeks later to follow up... She had went to another vet, and was prescribed with fungal medicine, and is doing fine....... And that awkward moment that she didn't know how to let me feel less embarrassed of the "wrong" diagnosis. And I was embarrassed of course because I was so sure and confident with my diagnosis, but I'm happy at the same time. I told the owner, "it's ok, no worry, we have the same aims, whatever that would make your dog better. "  I ask the owner keeps me updated.

Deep down, I'm talking to myself, "if it's tumor, it won't be responded with the medicine... I think maybe I was wrong. May be. Aiya. Nvm la, the dog is fine now."

Then few months later,, the owner came back to do all full body check up on another dog, and told me she lost her dog.

I asked her "why you didn't go for chemotherapy?"

She replied "we did... But in the end she can't take it more. The fungal medicine works at first, but it grows back again... And we request to do a biopsy, and it's cancer .. And went for the oncologist that you previously referred us to, and continue with chemotherapy... But I guess, it goes into thebody already. "


I'm very sorry to the owner for the lost. And the rudeness in me, that I doubted at them wether did they go for chemotherapy. I'm very sorry. She told me how hard it was for them to accept. And I'm sad too. Because I understand they really loves her...  It's heartbreaking even listening to the journey they went through...


So, my diagnosis was correct. But the dog died. The owner didn't blame me for not pushing them hard on doing the biopsy at the first place. But I feel sorry still.


Today, I put down a golden, because a very bad oral cancer that had metastastize to the lungs. But I didn't do a FNA on him....  I think, he can't cope with chemotherapy anymore at his stage. It was that bad that I accept their request to put to sleep from the owner when the dog is suffering. Owner asked me, when is the most suffering ...


 "When the dog doesn't wag his tail when he sees you, when the dog can't walk to you, when the dog doesn't eat anymore, when even breathing also seems difficult to your dog"


 So it seems today is the day.


Cytolog, is amazing. Cancer, is traumatizing. To everyone. The pets, the owners, and the vets.