Tuesday, November 30, 2010

The End of Life Sub-Blog 1(2)

We still have no idea what is going on with Mrs. Maize but we have picked a path. I met with the vet and we agreed her lump is not smaller, and that doing blood work would not yield any additional answers. Yes, it could tell us whether she had an infection or not -- but that answer could be unrelated to the lump.

Complicating the picture (and creating context) are these things:

1. Maize keeps having front end limping -- it is mostly just a little hitch but three times in the past week has been significant enough to require an anti-inflammatory. Related to the lump -- or not? An infection -- or not? Age -- or not?

2. If the lump is a symptom of something treatable (based on a benefits/burdens analysis), we will treat -- there is no shame in wanting to extend life.

3. Maize had what seems to have been a seizure three weeks ago; this makes me reluctant to use a general anesthesia with her, which was recommended for the biopsy.

4. Maize seems to be feeling fine and is happy -- in no way is she acting sick or ready to make her earthly exit.

And so I talked to the vet about all this, and we agreed that a reasonable plan was to use a sedative and local anesthesia to do a biopsy of the lump. This eliminates the risks of general anesthesia but will give us knowledge of the composition of her lump, which will suggest a direction (or not). Dear Husband was consulted, and he also agreed with this plan -- so we are set for Thursday.

Two things about the biopsy -- we will send it to two different labs in order to immediately have a second opinion. Also, we will put "breed unknown" on the paperwork in order to increase the odds of an objective opinion. There is concern that when "Bernese Mountain Dog" is attached, there is a leaning towards histio; we want to avoid even the chance of a breed bias.

And so that is the plan -- Thursday at 8:45 we will go to the vet and I will stay there as I will not leave dogs at the vet. They will do the biopsy, Maize will have a few stitches and a sore shoulder, and then we will wait and see what the results suggests for the next step.

I think this is a nice "middle" approach, honoring both the possibility that Maize might need life extending care and that Maize does not deserve to assume unnecessary risk.

That said, given all this -- Maize probably has a benign mass and will live to be 15, dropping dead only after George the deer attacks her for chasing his mom, Heidi Marie.

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