Saturday, December 8, 2012

When the Doctor Becomes the Patient

     Cancer is a scary word. Usually I am the one giving the diagnosis or discussing the prognosis and treatment with heart broken pet owners. It is a lot different when my pet is the one with the diagnosis and I am the one hearing about the prognosis and treatment. Two of my own dogs have previously been diagnosed with and treated for cancer. As a pet owner it was devastating for me but as a veterinarian it was an invaluable lesson into the emotional roller coaster my clients endure on a daily basis. 

     As many of my clients and friends know, I love basset hounds! My current basset hound, Walter, is my third basset. I got Walter about 2 years ago, several months after losing my second basset, Kirby. Kirby was a "special needs" basset hound, whom at 8 years of age found himself in search of a new home. I found Kirby (or maybe he found me) when he was almost nine. We had 3 and a half great years together when he was diagnosed with lymphoma. I was devastated, but as a fourth year veterinary student I knew a few things about lymphoma and took Kirby to see an oncologist right away. I already knew that I wanted to be as aggressive as possible while maintaining Kirby's excellent quality of life. Kirby was quickly started on an injectable multi-agent chemotherapy protocol (the CHOP protocol). As a vet student I knew that Kirby's lymph nodes were supposed to shrink quickly and return to normal after receiving his first treatment. I checked his lymph nodes multiple times a day waiting for them to get smaller. But days went by with no change, he had further treatments, weeks went by and still no change. Kirby still felt great and was handling his chemotherapy well but his lymph nodes were not budging. I was again devastated, the chemotherapy was not working. 

    But I wouldn't give up and neither did Kirby's oncologist. We decided to switch to a different treatment protocol, one in which Kirby received oral medications by mouth daily. Again, I hopefully felt his lymph nodes every day, willing them to get smaller. Again, there was no change in the size of his lymph nodes. I was starting to feel defeated, but lucky for me and for Kirby, his oncologist was not defeated. We switched Kirby to yet another treatment protocol. Full of new hope, I continued my ritual of daily lymph node palpation. This time it worked! Kirby's lymph nodes were normal and he still felt great! I was beyond thrilled. Not only did the new protocol give me 5 additional months with Kirby (who sadly was euthanized for a reason unrelated to lymphoma) but I also learned an important lesson; never give up hope. Sometimes hope is all we have, we hope that the next treatment will work, we hope that our friends continue to feel well during treatment and we hope that when the time comes to say good bye it is peaceful. Kirby and his doctors taught me a lot and because of them I will always have hope for my patients and my clients.

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