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Veterinary Forum October 2007 (Vol 24, No 10)

Editor's Note: Am I hearing you right?

by Marie Rosenthal

    When I noticed Bogart's droopy, swollen eyelid, I thought he had been stung by a bee or had poked himself while running in the woods. I let it go for a few days, but when I saw the third eyelid and dilated pupil, I freaked. I thought "stroke" or tumor, so I took him to the vet, who diagnosed Horner's syndrome.

    However, naming my fear didn't help because Horner's syndrome can be idiopathic or from trauma, infection or tumor. We eliminated eye trauma and took blood and urine for testing, which were within normal limits for a 9-year-old. A quick test was positive for anaplasmosis, so the vet put him on doxy­cycline, but she seemed doubtful that it was the cause.

    We talked about how far to go because it was becoming expensive. Should I pay for more tests if it was idiopathic?

    "It's reasonable to wait and see how it goes," the vet said when I asked if we should take radiographs now rather than later. We decided to wait, but I continue to question my decision.

    On the way home, I remembered the week before my mother died. She had a GI illness and was pretty dehydrated when we finally convinced her to go to the emergency room.

    In the ER, she had a myocardial infarct. The cardiologist said, "Your mom's pretty sick." "Yeah, I know, that's why we're here." He tried again, hoping to be compassionate as he explained her situation. It took me a moment to figure out what he was trying to tell me — that my mother could die.

    My problem is, I know just enough about medicine to be dangerous.

    I have probably read too much into the phrase: "It's reasonable to wait and see how it goes." Does that mean we can wait because Bo's problem might get better on its own? Or does it mean that if it doesn't go away, it won't matter because the tumor is probably not in a good spot and he's a goner anyway?

    Veterinarians are trained to take a logical approach to illness, but owners must make important treatment decisions when we are most emotional. I think that causes communication to break down — veterinarians want to soften the blow, and owners have trouble hearing bad news. No matter how clear veterinarians might be, there will always be clients who won't understand what they are trying to say. We want quick answers, but sometimes the diagnosis takes time.

    So far, 2 weeks on doxy — Bo isn't cured, but he doesn't seem worse. So, I have to go back for a follow-up. As Tom Petty says, "The waiting is the hardest part."

    NEXT: Emergency visits may be a phase
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