Forty-Six Hours in Hell   2 comments

On Wednesday this week, we had our 17-year-old cat, Bubba, in to the University of Minnesota Small Animal Hospital (reported to be the largest veterinary teaching hospital in the world) for an abdominal ultrasound, chest x-rays, and a blood pressure check.  I took the day off from work to be there, and Dale also came along since he was both in the country for a change and on vacation.  We got there at 10:00 AM and the festivities began.

First, the abdominal ultrasound was done.  That took about an hour.  The veterinary resident who was taking care of Bubba talked to us after that and said that the only significant findings were that his pancreas did have the appearance of chronic pancreatitis and his intestinal wall seemed a bit thickened.  These findings were entirely consistent with the elevated serum amylase and the other symptoms he’s exhibited.  She did say that they saw a cluster of enlarged abdominal lymph nodes and one of these was needle-biopsied for cytological examination.  I didn’t like the sound of those reactive lymph nodes, but in and of itself, it wasn’t cause for alarm.

Then the chest x-rays and blood pressure check were done.  The chest x-rays were being performed for the sake of a complete exam and to assess the general condition of my senior cat’s heart.  Both Dale and I commented that it seemed to be taking an awfully long time to do the x-rays and blood pressure check.  Close to an hour later, the resident came out to us and said, “I’m sorry, there’s something there.  There is a mass in front of his heart.”

She then explained to us that this was most likely either a lymphoma, a form of cancer of the lymphatic system, or a thymoma, a tumor of the thymus gland, which may also be malignant.  She said that it might be a cyst but she really didn’t think so; the mass looked too solid to be a fluid-filled cyst, the only benign diagnosis on the list.  She kept saying, “I’m sorry, I know this is bad news and it’s a lot to take in.”  She thought that lymphoma was likely and the most probable explanation for what’s been going on with his weight loss and lack of appetite as well.

We made a plan to wait for the results of the lymph node biopsy before doing anything else.  If the lymph node came back positive for malignant cells, then we had our answer without requiring a lot of further diagnostic workup.

My tears started flowing right away, as soon as she said, “There’s something there.”  It was virtually unfathomable to me that I was going to soon lose my Bubba-cat to cancer so soon after the death of his sister in February.  It was just all too much to wrap my head around.  I sobbed in the arms of a volunteer whom I had just met two hours earlier.  I sobbed all the way home.  I’ve been emotionally exhausted these past three months since Katie died, and somehow I was going to have to find the strength to get through another major loss right on top of that one.  I didn’t know how I could do it.

A gentle reprieve from bad news came that afternoon when a vet student called and said that the results of the lymph node biopsy had come back.  There was no evidence of malignant cells.  That was encouraging news, but then we still didn’t know what that mass was in his chest.  We scheduled another biopsy to be performed under I.V. sedation Friday morning.  This one would also be a needle biopsy guided by ultrasonography.

Dale took Bubba to the University Friday morning at 7:00 AM.  I chose to go to work.  I had things I needed to do,  and in my fragile mental state, I didn’t think that hanging around the hospital was the best thing for me.  I had my cell phone on me at all times, though, in case someone needed me.

Dale called at 10:30 that morning.  He said, “We have good news!  The radiologist wanted to take a look at the situation before beginning the procedure and looked at the mass under ultrasound.  He said that it was a small cyst, didn’t appear to be causing any problems, and was nothing to worry about.  We can bring the Bubster home.”

My unlikely response was, “You’re kidding.”

“No, I’m not kidding.”

“Really?”

“Really.”

And then I cried.  I had been so prepared for the lymphoma diagnosis: the oncology consultation, the options of chemotherapy, radiation and/or prednisone, the do-nothing option.  I had envisioned the downhill course, the awful decision of when to proceed with euthanasia, the chance that we wouldn’t decide in time and he would suffer.  To hear that he had a benign cyst that was causing no harm to him (and by the way, his heart and blood pressure were fine) seemed like being handed a miracle that morning.

Of course, it wasn’t a miracle.  It wasn’t like there was a malignant tumor in there that had changed to a benign cyst overnight because people were praying their asses off.  It was a benign cyst all along that a resident misinterpreted on an x-ray film and jumped to erroneous conclusions.  No miracle there — just plain old human error which is as common as dirt.

I’m relieved that my old boy is just dealing with a recent flare-up of chronic pancreatitis.  Nothing more.  He seems much better now.  He’s sleeping about eight feet from me in a cardboard box in the TV room and looks quite peaceful right now.  I’m so happy he’s here and we have yet another beautiful day together.  I do not take that for granted.

I’m irritated with that U of MN vet resident, though.  She handled the situation inappropriately and caused a lot of needless emotional pain.  As a health care professional, which I’ve been for many years, I would have said something like this Wednesday morning: “Mr. and Mrs. Bubba’s Folks, he’s got a small mass in front of his heart.  On a simple x-ray, it’s hard to know exactly what that is.  We need more information at this point.  The results of that lymph node biopsy may provide us with further useful information.  We may need further testing.  We’ll gather some more information so that we can figure out what this mass is all about and deal with it from there.  We’ll take this a step at a time.  How does that sound?”

Well, it sounds a whole lot better to me than, “Your cat probably has cancer.  I’m sorry.  Enjoy the rest of your day, if you can.”  A doctor does not deliver a kid’s cancer diagnosis to his mom without having the confirmatory data in hand and a plan in mind.  To do anything else is demonstrating poor judgment, pure and simple.  I hope that young Dr. Stiller learned something from this experience.

So, Bubba and I are chillin’ together today.  Mia is beside me on the couch.  The wind chimes on the front porch are singing through the open window, and life is good.  It certainly beats those 46 hours I spent in hell this week.

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Posted June 4, 2011 by StPaulieGrrl in cats

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2 responses to “Forty-Six Hours in Hell

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  1. So glad he’s ok, except for the pancrea issues. I hope you will write a letter to the vet hospital about your experience.

    (((HUGS)))

  2. I’ve been contemplating that. I think that my feedback is important on this matter.

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