Pet medical choices ultimately about trust
If you’ve ever loved a dog or cat, you know the terrible helplessness you feel when they’re in pain. You would do anything to make them better, but you don’t know what is wrong, or how to fix it. Suddenly you find yourself immersed in the conundrums of modern veterinary care, with its nearly miraculous capabilities, heart-wrenching choices and too often, out-of-reach price tags.
This summer, I experienced this dilemma with my beloved old dog, Chumley.
At nearly 14, Chum was notably slowing down this spring. Eager to go for walks, he ran out of steam too soon, limping as he tired. I knew he had mild elbow arthritis for which he’d been taking some joint supplements, and his vet added acupuncture and medication to his routine. But they only helped for a short while.
We tried several pain medications with only mediocre results. By August, he fell into a steep and rapid decline that nothing seemed to help. He could barely get up without help. I was carrying him out to relieve himself, and he’d take a few steps, do that, and wait to be carried back to his bed.
Trying to find the cause, his regular vet took a whole body series of X-rays, which looked pretty normal, so I took Chum and his films to a specialist. This vet didn’t pay much attention to my account of his symptoms but focused on manipulating his neck and limbs and noting when he elicited pain.
In about 5 minutes, he said he felt the likeliest problem was a tumor in a difficult location, for which an MRI was needed to confirm. If correct, the only treatment would involve a radical amputation of his front leg and shoulder. The MRI would cost around $1,500; the surgery, about double that. Then there might be a need for chemo, or radiation therapy if it was malignant “which these usually are.”
I asked, “if he were your dog, would you put him through that?” He shrugged. Without an MRI, he had nothing to suggest but to treat the pain.
Intuitively, I thought that specialist was wrong, so I consulted a different specialist. This doctor examined him carefully, asked detailed questions and thoughtfully answered mine. He thought Chum probably had a polyarthritis (a canine version of rheumatoid arthritis), which could be confirmed by a joint tap, examining fluid extracted from several sore joints. His hypothesis fit with both what I had observed and what we had already ruled out. The cause might be autoimmune, but if it resulted from an infection, it might be curable. He asked if Chum had ever had a tick bite. I thought not. But tick-borne diseases were likely culprits for this syndrome.
The joint tap, which was neither invasive nor expensive, confirmed the polyarthritis, which could be treated with steroids. But before starting that, we decided to send in blood for a tick-borne disease test. To everyone’s astonishment, it came back positive for Lyme disease.
We began a course of the antibiotic that potentially could cure him, along with the steroids that immediately relieved his pain. Within hours, he felt better. Now, six weeks later, he’s cut way down on the steroids, enjoying long walks, chasing squirrel — even being naughty again. The retest sample taken this week should tell us if his Lyme disease is cured.
So what do I take away from this roller-coaster ride the serious illness of a loved one entails? Just that, despite the breadth and depth of medical science behind the choices laid out before you — or maybe because of it — the ability to give or withhold trust is inescapable.
Whom or what to believe? What to try and what to reject? Given what you know about your dog’s resilience and your own resources, what commitment can you make? It’s ultimately about trust. Your dog believes you are trustworthy. Whether he would like every decision you make or not, he trusts you. Something like that is in play when you wrestle with the powers of science, emotion and luck, on his behalf. You judge the correctness of information and the trustworthiness of people. When you choose this way, you might be mistaken, but you can’t be wrong.
Laurie Raymond owns High Tails Dog & Cat Outfitters in Glenwood Springs.