Info Dump, sort of (Part 3)

Yesterday I left my house at 4 a.m. with Sparkle and Capella and headed up to Montana. The first stop was Suzanne’s house to hug her and drop off the dogs before heading to campus for a work thing.

When that was done, I met Suzanne and Sparkle at our super smart veterinarian’s office in Missoula.

The cytology report arrived in the middle of all that as did a voice mail from the Boise specialist about the results. The message about the results included, “…not terribly impressed with their description...”

I hope to talk with the Boise specialist today but our Montana vet also got the cytology report and so there is a few things we do know.

The hip lesion appears to be a sarcoma. It is likely osteosarcoma but apparently this is not for sure.

The lung mass is not the same thing as the hip lesion. Huh. Interesting.

We need more data to try and get better info about things.

On Friday, I asked that — if possible — they collect enough sample from the biopsies to be able to send to a second lab if we had any questions/concerns about the results from their usual lab (IDEXX). They were able to do this.

I will ask them today to send those samples/slides to Vidium, a specialty pathology service. Take note of the place — we have choices about who/where gives us info about what ails our dog. I prefer academic labs but they are slow. Vidium has big names/former academics and is speedy.

I say this without judgement or rancor: I have had multiple dogs diagnosed with one thing that turned out to be something different when additional testing was done. There is no shame in that — it simply points to the need to be persistent and strategic in the information gathering. Our veterinarians cannot know to keep looking if we fail to be effective communicators and respectful advocates for our dogs.

So go ahead and be that polite pain in the a$$ — accurate diagnosis matters.

But make sure and deliver cupcakes or things like that to your well-loved veterinarian on a regular basis!!! They are your teammates and it is important to let them know that you appreciate them so much 🩷

Happy Tuesday!

About That Lung Mass... (Part 2)

Last April I noticed a very slight decrease in exercise tolerance in Sparkle while on a walk. My MT vet trusted my crazy paranoia enough to do a chest x-ray. There was a small mass in one of Sparkle’s lung lobes.

It was not in a good spot to do an ultrasound guided needle biopsy. The invasive/open-the-chest-surgery-to-remove-it option failed the Benefit/Burden test. Specifically, that would have been a major surgery for Super Senior Sparkle (high burden) and unlikely to be curative (low benefit).

We expected the mass to grow/spread and send her to the Rainbow Bridge within a month. Instead she just kept trucking along and the periodic rechecks showed the mass was not doing anything too interesting nor did it progress to a size where it could be safely biopsied.

That doesn’t mean we did nothing — Sparkle has been on Doxycycline, Rimadyl, and Turkey Tail mushrooms since last April.

She has also been living her best — normal — life, without any progression of the very slight exercise intolerance I noticed early last spring.

Sparkle at Lake Odell in September

It is possible that the lung mass and the hip thing are related — it is also possible they are not. Since Sparkle would be having the CT scan anyway, the team and I discussed this question: Would more information about the lung mass be helpful and/or change anything?

Maybe yes, maybe no. The Benefit/Burden test got involved again. Sparkle would already be sedated and it would be easy for them to also scan her chest. It is just $$$$ 💸

Sparkle yesterday — definitely more comfortable.

I am committed to data transparency. I place puppies only with people who pinky promise and sign a contract saying they will get certain health testing done, and also will establish cause of death when that sad day arrives. Informed decisions cannot be made without accurate information, and family data matters so much.

I cannot ask my puppy families to do what I would be unwilling to do. People who have close relatives of Sparkle were told last spring about the lung mass. Additionally, there was a plan in place to evaluate the mass when Sparkle did not need her body anymore; the info would then be added to her Berner-Garde record.

Sparkle yesterday in yard

And that all explains why the lung mass was also evaluated during the CT scan on Friday and even better, the CT scan allowed a safe way to do a guided needle biopsy of the mass. The burden to Sparkle was low and the information could potentially be beneficial for the greater good, so to speak.

Sparkle this morning 🩷 You can see where they shaved to do the biopsy.

We are still waiting for the results of the two biopsies. I know exactly what I will do once I have those results: The next right thing.

I don’t know what that will be yet and that is fine. In the meantime, the next right thing is being with Sparkle 💖 and making sure she is comfortable enough to enjoy normal life.

Thank you, Friend, for caring 🙏🩷 and have a wonderfully normal Sunday.

So Much to Say (Part 1 of Who Knows How Many)

Here is the summary: I was right. I wish I had been wrong.

Having the Gaslighter blow himself (and me) up in a most spectacular fashion 3+ years ago taught me to trust myself. My journals over many years documented suspicions and discomfort, but I gave more credence to his deceitful and very convincing gaslighting than I did my own perceptions and experiences.

Never again.

Assuming good intentions of people is so important — I won’t stop. Most people are good, decent, honest, and doing their best. But now my voice is heard and honored. I won’t ever again ignore what I feel in my heart to be true, no matter how skillful the gaslighter.

Professionals can exist in a kind of gaslighting patriarchy, whereby we — the non-professionals — are too often expected to do or believe what we are told. The professionals, after all, are the ones with the superior knowledge, skills, and expertise. Who are we to question?

But as both a professional and an educator, I know that no one person — no matter how educated or experienced — can know all. It is not humanly possible, and there is no shame in that.

Hanging out before the CT scan

The workaround for the limitations and imperfections of being human is a well-functioning team. One that communicates, collaborates, and keeps professional hubris out of the team spaces. One that is unafraid to acknowledge mistakes and dead ends, and will nimbly change directions with new data.

Sparkle had x-rays on February 10. Five different veterinary professionals have looked at them, and the opinions ranged from “looks fine” to “suspicious knee” to one of them saying, “hmmmm — hip?”

I am not bothered by any of that. It is just data about a challenging diagnosis.

I was especially impressed that a radiologist and ortho/surgeon looked at the x-rays together, discussed them, and disagreed! That is what collaboration is all about. Even better — I was told about the disagreement!

Stoned Sparkle post CT Scan

I had already shared my perspective — right hip. I had also said I was worried about a malignancy in a bone because of the level of pain Sparkle was experiencing. Only Professional Opinion #5 aligned with mine — I guess that made it four against the two of us on Team Hip Oh 💩.

I wish I had been on a different winning team.

The CT scan showed she does indeed have an issue with her right hip that is almost certainly a sarcoma lesion of some kind; a needle biopsy was done and we will known more soon.

If you look closely, you can see the spot where the needle went in — an easy procedure done while she was under anesthesia.

This is where a career focused on end-of-life/loss/grief comes in handy. When people ask what I will do, I have no answer because I am focused on the right now.

Huh!

Here is another useful thing I learned from having that whole Gaslighter Explosion Thing happen — just do the next right thing. Worked like a charm — I made through that giant hot mess of a dumpster fire relatively intact. The next right thing — that is all you have to do in a crisis.

And yesterday, after the CT scan, the next right thing was getting better pain meds on board for my girl. Sparkle is now much more comfortable as we await the biopsy results.

Sparkle this morning 🩷🙏

There is more to say but I only want to be working on one book at a time and so I will end this blog update here and pick up the story again tomorrow.

I know Sparkle is well-loved by so many of us — thank you for that 🩷