Update - Ava's really sick

[Stacy]

I just got off the phone with one of the Internal Med doctors at the emergency vet. Ava has a fever, and her abdominal ultrasound looked normal, but her chest x-ray shows some significant patchy infiltrates. The vet said that it doesn't look like pneumonia, but it doesn't quite look nodular like you would see in cancer either. They aren't sure what it is. T

hey're going to ultrasound her chest and try to get an aspirate that way, but if they can't they're going to keep her overnight and give her fluids and in the morning do something called a BAL, where they put fluid into her lungs and suck it out and try to get some of the abnormal tissue out with it. The vet sounded... not overly optimistic. Her labs on Thursday didn't show an elevated white count, so I'm afraid that it's not something infectious, but instead cancer. It isn't a typical presentation, but neither one of these girls have ever had a typical presentation for anything.

I can't believe this is happening. This was supposed to be something orthopedic. She was supposed to have arthritis. But I had a really bad feeling. And my bad feelings often have a way of being right. I just don't want her to hurt. She's such a good girl and she's had such a hard life. We haven't had enough time to make up for all the things that happened to her before. I just love her so much.

[Stacy]

Thank you for your kindness. I'm sort of lost for words at the moment. I'm not sure whether to scream or cry. I'm not sure where to go when you've stumped the vet specialist. Or how to accept that "we don't know," may be the only answer anyone can offer. 

[Stella]

Ugh, so much testing and still no answers, so frustrating. Except that they have ruled a whole bunch of stuff out at least. Did they have any suggestions where to go from here?

[Stacy]

They didn't have any further suggestions, at least that I've heard, at this point. 

I feel like they are ruling everything else out to leave us with a cancer diagnosis. 

Anecdotally, my grandfather was diagnosed with lung cancer a couple years ago (not looking for sympathy, it's just an interesting corollary.) He had pneumonia that they couldn't kick. Then they did a chest x-ray and CT and they said they saw something on it, but it wasn't cancer. I was perplexed that they would say something like that. How can they possibly rule out a diagnosis like that from an image? I doubt any of the doctors I know would say that. But they were insistent that it wasn't cancer. They went down the fungal route. At one point they insisted that he had tuberculosis. I can't remember what all they attributed it to, but one by one they ruled out those things until they biopsied his lung and shockingly (not to me,) it was late stage lung cancer. My dad said the doctor was so surprised, he was sure it wasn't cancer. The biopsy nearly killed him.  I feel like the same thing is happening with Ava. Rule everything else out until we're left with a cancer diagnosis. I really want to be wrong, but I have a gut feeling about this. She does seem a little better, the steroids maybe? I just see the similarities, and I can't help  think that this is the same road we're walking. 

[Amy and Annabelle]

I hope it isn't cancer. Kind of the same thing happened with my brother-in-law. He had a nagging cough for over a month, finally went to the dr. The first time they told him he had bronchitis. He went back maybe 2 more times and they even gave him an inhaler. Finally they decided to do a chest x-ray and discovered Mesothelioma. I feel like they wasted precious time when maybe the chest x-ray should have been done the first time he went in. I know hindsight is always 20/20. It sounds like Ava is being seen by specialists already, not sure if there is anywhere else you can take her. They sound like they are giving up on finding out what it wrong. I would be taking her somewhere else if they aren't willing to get to the bottom of her illness. If Annabelle ever became ill, I would take her to the U of M veterinary school. I hope they figure it out and your sweet girl gets better soon.

[Laurie, Fudge, and Vern]

I am just catching up about Ava. I am so sorry to hear all this news. I hope they figure out what is going on and that it is not cancer. Hugs to both of you!

[Stacy]

Thank you. I hope we figure it out too. 

[Trudy Harlow]

Just checking in to see if there's been any more news. Still praying for you both, and I hope you were able to have a bit of joy in your holiday, even as worried as I know you are.

[Stacy]

Oh, thank you. Nothing new, really. Ava finished her antibiotics and seems to be feeling a little better on the steroids. She's eating better and she seems more alert. She is sometimes asking for attention again. She hasn't been febrile. I check her temperature intermittently and she's been around 100.5. But she went from having difficulty jumping on and off the bed to not being able to jump onto the bed at all. I've been picking her up and down and the couple times she's attempted it without me she just gets her front feet up and hits her belly on the mattress. I also feel like she's still losing weight. That, or I'm getting stronger with this new dog-lifting regimen.

I need to make another appointment with the vet to figure out what the plan is. Are we just going to continue with the steroids? I would like to repeat her chest x-ray. But that calls into question how that would change our course of treatment. If it looks worse, what are we going to do about it? None of the vets seem to have any suggestions about what else we should do that doesn't involve practically cutting her in half. And I just can't do that to her. The vet really indicated to me that the prognosis of what we would likely find on biopsy wouldn't be worth putting her through that surgery. So we're just sort of stuck.

The optimistic side of me thinks maybe it's not so bad. She's just slowing down, but we will still have years and years. The pessimistic side thinks we might not have much time at all. But since I don't have any real answers we are just taking it day to day. Her quality of life today seems okay. That's the only thing I know for sure.

[Nancy, Ned, Clancy, and Charlie]

I’m so sorry you still have no clear diagnosis. I agree with you on limiting how much more you want to put her through when it appears that even going to extremes might not be useful. We are here to lend support and hugs to you and Ava. 

[Stacy]

Thank you so much! I'm at the stage of constant questioning if I'm doing the right thing - if I've done enough. There have to be other specialists out there somewhere. Maybe my current panel of vets are all missing something together. But then I think about how much she hates going to the vet. How much she hates being taken away from me and how much I hate it when she's gone. And we've done everything they suggested. The only thing I turned down was the biopsy and only because the vet said she wouldn't do it to her own dog. If there was something else they thought would be helpful all they would have had to do is suggest it and I would have done it.

I don't know if it would be easier if I had a diagnosis and still didn't have a fix. I like to think it would, but really I think I would be just as sad.

[Stacy]

Ava has a follow up vet appointment for Monday. At least we can figure out what to do about the steroids. I feel like, even low dose, it would be a bad plan to just stop them after a month. It's really hard to let go of my need for answers. I want to know what is wrong, what's happening, and what to expect. I know they're not, but I feel like they're holding out on me. Just tell me! 

I think I need to work on meditation or mindfulness or something. There was a woman who came to our work updates this year and talked about mindfulness. She's really lucky no one threw their shoe at her. It's not that I disagree with the theory, but I'm way too busy worrying about everything to be mindful!

[Karen, Jasper and Jackdoodle]

You never just stop the steroids, even a low dose. They have to be tapered off. :)
Let me know how that mindfulness stuff works for you, lol. I'm considering yoga classes. Well, okay, I looked online for places near me that offer  them. It's a start, right?