Thursday, December 2, 2010

Misty's visit with the specialist

Misty had her appointment with the internal medicine specialist on Wednesday night, which included a new ultrasound. We had to drive through a horrible rain/wind storm to get there. The hospital had lost power, but luckily they had a generator that kept everything up and running.

Unfortunately, I did not leave with a concrete diagnosis. I told the doctor I was really getting frustrated. However, the doctor thought we were finally getting somewhere. Well, I'm glad he went home feeling positive!

The results? Misty has a nodule in the front portion of her bladder that could be a benign or malignant tumor, or inflammatory polyp. He emphasized that this is not a common area of the bladder for cancer to form. She also had some mildly enlarged papilla and mildly prominent lymph nodes that could indicate inflammatory reaction to urinary disease or less likely, cancer.

See what I mean? Frustrating!

Next steps?
  • take misty off the antibiotic for a few days, run a new culture/sensitivity-may need to use a "phantom antibiotic"
  • if culture is negative, do chest x-ray to look for evidence that cancer may have spread
  • endoscopy of lower urinary tract(which can't be seen on ultrasound) and/or bladder surgery to remove nodule

I'm really hoping we don't get to the third option. I don't want to knock Misty out, or put her through surgery at her age. My philosophy for my pets at this stage is maintaining quality of life, not performing procedures to add months to it. So, option three will need to be explained more fully if we get to that point.

The internist did prescribe piroxicam to help with the inflammation. The added benefit is that this drug has been proven to shrink bladder tumors in some dogs, including my Munchkin, who saw amazing results from the drug.

Overall, I think the doctor believes Misty's problem is most likely a stubborn bug, that requires a rarely used antibiotic, BUT.....ugh!

18 comments:

Diana said...

Well thats frustrating. Sounds like more questions than answers. Sorry it didnt go the way you had hoped. Diana

AC said...

So, so frustrating! I'm sorry you didn't get more answers but I know you're going to make the best decisions, one step at a time.

I like your philosophy of quality life. As great as modern vet medicine can be, I sometimes think it can be selfish. Our pets live in the moment. They're not obsessed about being around forever, they thrive on a good now.

I know Misty's in for a ton more good nows! Strength and healing package coming your way...

madcobug said...

I don't know exactly what bladder surgery entails in a dog. I have had bladder surgery several times where I was put to sleep and some places cut out that was not cancer. That was several years ago. I was thinking a few days ago that I needed to have it seen about again.
Best wishes for her. Helen

Honey the Great Dane said...

Oh I hate that sort of uncertainty and not knowing - how frustrating and horrible for you!!

I wouldn't be surprised if it IS a "stubborn bug" - I did an article a couple of years ago on MRSA which was sweeping through vet hospitals and killing many dogs - but often not well understood or even in some cases, hushed up! not saying that this is what Misty has but it could be a similar thing. Certainly, with the over-use of antibiotics in recent years (in human medicine too), these "super bugs" are becoming more and more common.

Good luck with the next steps!

Hsin-Yi

Ricky the Sheltie said...

Extremely frustrating! Sorry Sara that this doctor did not find something more conclusive with a plan to follow to fix it! You keep running into more and more questions and no answers. Guess there is nothing to do but wait for the next test/results and go from there. I hope that Misty is feeling ok at least!

Dawn said...

Awwww Misty-girl. I'm sorry you're not feeling better. And all these strange places probably don't make you feel any happier do they! Good thing you've got a good Mama who will look out for your best interests. I hope the next tests are more definitive.

Helen said...

I know exactly what you're feeling Sara. I had new blood work done on Tucker this week. His triglycerides are down to normal but his liver enzymes are still climbing. The specialist wants to do another ultrasound with a fine needle biopsy of his liver. I called today to make that appointment. Good luck with Misty.

Patti and DeBoys said...

Most definitely FRUSTRATING! All we can say is that we are with MISTY all the way, PRAYERS are being said. Hang in there Sara!

Our PRAYERS are going out for you too Tucker.

Sam said...

I sure hope it's just some kind of crazy infection and nothing else. It sounds like the doctor feels pretty positive!

LauraK said...

Goodness, that's a lot to take in! I think you have a great philosophy about quality over quantity for your dogs. You and me both are having quite the fun time with Piroxicam, now aren't we? I'm so thankful that you told me your experience with the drug- it really gave us a lot of hope, and little Penny is doing amazing considering her condition. Best of luck to you and Misty- try not to get too frustrated :) As long as she's got that cute smile on her face, you're good to go!

Priscilla said...

I agree with your philosophy of life too. I'd much rather a happy old dog than one that has to go thru so many surgeries at their age.
I'm so sorry you still haven't got a concrete report. It must be terribly frustrating.

Jules said...

:( Stressful. I am keeping Misty in my thoughts!

Rob said...

Hi Sara, I know how it is for you and I really feel for you. Its very very tough making decisions about your dogs even when you have all the info. When Tippy got to the end of her time and she was flat out and couldn't hardly stand the vet kept on wanting to try different stuff on her and I had to say in the end that I didn't want to put her through this hell if it was only going to prolong the agony for her. I would love nothing more than to have her here now begging for a mince pie but in the end I couldn't justify putting her through more pain and misery if she wasn't going to get properly better just to make my living easier. Anyway hopefully Misty will continue to live a full and happy life with you for a few more years. There are lots of things that make you feel off colour and mostly it isn't the worst one you can think of. Just do what you need to do with the tests and try not to worry and enjoy Misty the way you always have because at the end of the day that is what's going to be the best for both of you.

Kathy said...

Give Misty a big hug and tell her I have been thinking about her a lot, she is such a sweetie, and sounds like she did good at the vets-she has had to be spending way too much time at the vets recently ;-), but sounds like she knows it is for her own good.

Hope it is a weirdo bug that the new C/S shows a good antibiotic to wipe this thing out for good. Did the addisons disease test come back negative?

Working as a human nurse in ICU...I totally agree about what you said with older dogs...letting them enjoy the time they have and making the most of that. When I get to the end of my time I would sure hate the last few days to be full of pain and rehab and not being able to do what I love for a few more weeks where I would not be able to do what I love anyway!

Lian said...

Really frustrating! I agreed with your philosophy of life, go and enjoy the life with Misty.

Kristine said...

Booo, no fun, no fun at all. I'm sorry this has all been so stressful and frustrating. I hope she recovers and in the meantime I hope you enjoy as much time with Misty as possible!

Marie said...

Frustrating seems like an understatement. I agree with you about maintaining quality of life as our pets get older, not just extending length of life.

I really hope that the specialist is right and that the antibiotic will do the trick.

Nicki said...

Good luck. On the plus side, bladder surgery is not terribly traumatic in most cases. Let me know if you have questions.