Second Opinion: Balancing Act

A Vet’s Perspective
By Nick Trout, October 2011, Updated February 2015

Gilberto had it bad. when I asked, “When did you get Carly?” he recited the exact date he had adopted his beloved Pointer cross from a shelter two years earlier.

“They told me she only had a couple of months to live — cancer — and, for that reason alone, no one was going to take her. Not to mention her problem with other dogs.”

Gilberto and Carly had been sequestered in a private room, isolated from the waiting-room hubbub. She seemed like a perfectly socialized, gentle, malleable creature, though the swelling around her hock gave me pause.

“She was found wandering the New Jersey Turnpike. Her body was covered with scars and there were deep indentations over the bridge of her nose from wearing a muzzle. The shelter thought she had been used as a bait dog.”


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“I’m not sure what you mean by ‘bait dog,’” I said.

“Among other awful things, an intact female dog to excite and wind up male dogs before a dog fight.”

Appalled, I shook my head. I didn’t know what to say. No wonder Carly demonstrated fear aggression around other dogs.

“My mother was visiting for the summer from Brazil,” said Gilberto, “so I thought, why not; I’ll give Carly a home and some quality time. It felt like a winwin for both of us, and Carly’s fantastic with people. Naturally, I spoiled her — she got to sleep with me on my bed, she always got the last slice of pizza and where was the harm in taking her out for ice cream? But summer came and went and Carly seemed absolutely fine.”

“What kind of cancer are we talking about?” I asked.

“Breast cancer. The pathology report said it had already spread to her lymph nodes.”

I frowned into a slow nod. This certainly sounded grim. “My friends started ribbing me, telling me I’d been suckered into taking her because of her aggression. But look at her — she’s great.”

Carly was investigating the room, sniffing the air, somehow catching the aroma of low-fat dog treats high on a shelf and out of sight. She seemed as affable a creature as one would ever want to meet.

“I arranged for pet-sitters when I was away from home, and started Carly on a more civilized diet. We also tried working with a behaviorist, with limited success. And here I am, two years later, with a dog who jumps off a bed and comes up lame.”

As touching and miraculous as Carly’s story was, alarm bells were ringing inside my head. The cancer diagnosis was detailed and specific. Shelters do not try to con to secure an adoption.

Carly was toe-touching lame on her right hind leg and, given the high risk of a canine encounter, I figured nothing would be gained by a “best in show” stroll up and down the corridor. Jump off the bed, roll an ankle and hey presto, lameness and joint swelling. But this swelling was all wrong: firm, focal and slightly above the joint. Was the cancer finally back? And if so, was the man who had taken on a death-row dog and treated her to a wonderful stay of execution, now — after all this extra time — in denial?

“There’s something not right with Carly’s ankle. I’d like to take an X-ray.”

Gilberto agreed and we hurried Carly into radiology like we were smuggling a rock star into a building full of restless fans. The films confirmed my suspicion: subtle boney changes suggestive of metastatic spread of a cancer.

“Can I get a copy of the image?” asked Gilberto. “My wife is a pathologist. I’d like her to take a look at the films.”

“Absolutely,” I said, wondering if perhaps he didn’t believe me. For a guy who took on a dog knowing she was going to break his heart, he seemed completely broadsided.

“I would also suggest that we take a series of chest X-rays to see if it has spread to the lungs.” Gilberto agreed. Sadly, the X-rays confirmed the presence of golfball- size masses within the lungs.

I offered the possibility of a biopsy, set him up for a consultation with oncology and, most of all, encouraged him to go home, absorb the information, speak with his wife and then give me a call. In the end, Gilberto chose to manage Carly’s pain with medications at home.

Some weeks later, I checked in with him.

“I almost wish you’d never taken those X-rays,” said Gilberto.

“You were doing your best, but sometimes I feel as though it would have been better not to know.”

I said nothing, but was reminded of the delicate tightrope act we veterinarians constantly perform. Some dog owners seek a diagnosis and treatment at all cost. Others simply seek assurance and support that they are doing the right thing. It’s never easy to find a balance. Gilberto was the kind of pet owner most of us can only aspire to be — selfless, invested and humbled by how much we get back for how relatively little we put in.

“These days, I’m mainly working from home, which is great. I’ve always been into cooking, and recently, I made a big batch of fettuccine Alfredo; Carly loved it. She sleeps beside me every night, and I know she’s doing okay because she still freaks out when she hears a motorcycle.” I hope Gilberto knew that on the other side of the phone line, I was smiling. This remarkable man was being forced to anticipate the loss of his dog for a second time, and he was still awed by how much he stood to lose.

Nick Trout is a Diplomate of the American and European Colleges of Veterinary Surgeons and a staff surgeon at Angell Animal Medical Center in Boston.