Notes from Maine - 2024/03/03
My friend Finn (10-year-old English Mastiff) had to visit the vet last week for a sore leg. We walked away with no clear diagnosis of Finn’s issue. Instead, I believe that the new veterinarian spent their time diagnosing me.
The prognosis? I’m a cranky old man.
Finn had surgery on his left hind knee about sixteen months ago. The procedure sought to fuse the knee in one position, eliminating the bone grinding and stabilizing the joint forevermore. I believe it was successful. I was told that everything healed properly and he seemed good with that leg for a year after he recovered. But now he doesn’t want to put weight on that leg.
This brand new vet examined Finn’s knee and declared that they would need sedated X-rays to inform an opinion. I’m fine with X-rays, and I can even be onboard with sedated X-rays, but only if there’s a point to doing them. Sedation at Finn’s age is a risk that must be weighed. Manipulation of a his leg for X-rays will cause him pain and even more lameness for a day or two, and that must be weighed. So I asked, “What might you see on these X-rays that have treatment options?”
The vet stared at me. I think that a lot of young professional people have learned to not roll their eyes at cranky old men like me. But this veterinarian’s body language suggested that the lack of eye-rolling was only due to an extreme effort.
“We need the X-rays to form a diagnosis.”
“Sure,” I said, “but what diagnoses can you predict that might have treatment options for a dog of Finn’s age?”
When his knee surgery was performed, I was told that it was a “Hail Mary” and that if the bones didn’t fuse properly that treatment options would be very limited if any. If his current problems are from a hardware problem (screws came out or brackets broke), then there might be no options other than pain management. I understand that X-rays will give us more information but if we can’t even guess at a diagnosis that might have a treatment plan, what’s the point of having more information? Can’t we just skip to pain management and not torture Finn with more procedures?
I tried to explain that rationale to the vet, and I understood from the look in her eyes that I was some form of monster. I have never rejected a procedure for one of my dog friends because of the cost, but I need to know that there’s a reason to do it. I’m not going to put Finn through another sedation and another torturous day in a vet practice if it only gets us information that has no possible follow-up.
The young veterinarian gave up on me. Perhaps they decided that I wasn’t interested in chasing solutions. Maybe they correctly guessed that they had failed to earn my confidence. The veterinarian that I trusted retired a couple of years ago. I miss Dr. Freedman.
On Wednesday, Finn will go to a surgical practice that has expertise in orthopedics. Because they have people in-house who can make the recommendation whether Finn is a surgical candidate or not, I have decided to trust them to do whatever diagnostics they think are necessary. Maybe they’ll tell me that Finn has multiple issues (neurological, musculoskeletal) that are all contributing to his lack of coordination and that the best path forward is pain management. I would be okay with that, but I doubt that I’ll get that response. I’m taking him to see cutters, and cutters want to cut. If there is a surgical option, I expect them to recommend it regardless of the percentages of successful outcomes and rehabilitation requirements. Cutters want to cut.
It’s tough to focus on this one problem with Finn when he’s such a nice, gentle, kind fellow who seems to be so enjoying his elder years. He’s just a little wobbly.
