Death and loss of life is a regular part of being a veterinarian, yet it never ceases to hurt when we lose patients. However, no one lives forever and inevitably we are faced with disease circumstances for which there is no cure.
It hurts even more when we deduce from the diagnostic evidence at hand that there is reason to be hopeful but the case plays out nonetheless in a far less hopeful direction. Beyond that, it is more difficult when it is a cherished patient I have had the pleasure of knowing for most of his life, owned by a cherished client.
In 2006, a beautiful, helpless black kitten was found in a dumpster by one of my technicians. We were all taken by his remarkable affection despite having likely known nothing but hardship in his first 8 weeks of life. As we nursed him back to health, the techs affectionately named him McLuvin (from the movie Superbad that was popular at the time).
In a short period of time, word about McLuvin reached a dear client who adopted him, later to change his name to Captain Jack. Throughout his life, Captain Jack remained the lover he was as a kitten and it was always my pleasure to see him for over a decade for his well visits. Last week, Captain Jack came in for unexplained weight loss. Physical examination revealed a mid-abdominal, large, freely movable mass. Between how it felt and its location on a follow up x-ray, it appeared the mass emanated from his spleen.
The most common cancer of the spleen in cats is lymphoma, a systemic cancer that is very treatable in an inexpensive and minimally invasive manner following surgical resection of the spleen and attaining a diagnosis. That was the plan going in.
Upon surgically exploring the abdomen, I quickly realized that the large mass was not from the spleen at all, but was a pendulous mass that was projecting from one of his liver lobes. I proceeded to remove the mass via liver lobectomy and closed and recovered my patient without incident.
Everything seemed fine until the next morning when Captain Jack became hypothermic and poorly responsive for reasons we could not quite figure out. But after warming him and administering fluids, Captain Jack rallied, started eating, was purring and playful within a day and went home. I was excited for the biopsy report to come back Monday to see what further measures I could enact to further along his quality of life and longevity.
I returned Monday with the notification that Captain Jack passed away at home over the weekend. It was crushing for me to hear and I called the owner who I hold in very high regard to offer my condolences and give her the biopsy report if she still wanted to know what the nature of the mass was. I reported that it was a cholecellular carcinoma, a rare and aggressive cancer for which further treatment would not have been able to realistically stop or even slow significantly. Captain Jack never really had a chance at all.
The owner took the news well and she must have noted the sad tone of my voice when she said, “Please don’t feel bad, you did everything you could. You fought for him and I thank you for that.” From her perspective as a human nurse, she added, “Sometimes things just get beyond our control.”
Usually playing the role of consoler, this may have been the first time I had an owner console me over the loss of her pet. I really appreciated that and it set the tone for me to shake it off, go about my day, and fight for more pets to the best of my ability.
Dr. Roger Welton is a practicing veterinarian and well regarded media personality through a number of subjects and platforms. In addition to being passionate about integrative veterinary medicine for which he is a nationally renowned expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport. He is president of Maybeck Animal Hospital , runs the successful veterinary/animal health blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care, and fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.