Sunday, November 13, 2011

It's Never Simple

Of course, Lanie's dental did not go off as planned.

The day before, I took her to the vet for a blood panel and an EKG. Her bloodwork came back perfect, but the EKG detect an abnormal beat or two over the space of 30 seconds. No big deal. The plan was to repeat the EKG with a longer duration in the morning.

The longer duration EKG was less than ideal. As seems standard with these things, the information is relayed over the phone to a company that specializes in interpreting it. They expressed concern over the results. Again, there was an abnormal beat or two; no clarification of what that actually means. They also said there were "indications" of an enlarged heart.

The vet working with me is trying to get more information from the EKG people, who insist that for a more in-depth analysis they will have to charge more. Meanwhile, an x-ray of Lanie's heart looks normal from the side and maybe, possibly "borderline" large from the top. Lungs are clear. She has no symptoms of any illness (other than the mental caseload she's always carried, obviously.)

So the vet recommends that we do an ultrasound of the heart to be extra-super-sure that Lanie does not have any enlargement issues.

If I were wealthy, this wouldn't be a problem. But I'm not. I'm really not. I checked. In fact, I checked right before I started writing this post and I'm still pretty not-wealthy. So I am left trying to decide if I want to give my dog a $300 ultrasound on a heart that might maybe be a little enlarged, so that we'll know that before she has dental surgery. Because she still needs her teeth cleaned and one of her canines probably needs to come out. That three hundred bucks is the money we have set aside for her dental.

She has no symptoms of anything. As far as anyone can tell, she's in perfect health and full of joyful, deranged energy. We're really unsure what we should do. Either way she's getting her teeth cleaned, but our choices are to get the ultrasound and put off her teeth until tax time, or get her teeth cleaned without an ultrasound and take our chances -- which we're doing anyway, given that Lanie is an elderly greyhound.

My favorite part of having this blog is reading the comments, especially when people share their own anecdotes. I don't think I've ever said that before. So I'm telling you now, I love the comments. I love the experiences, and I especially love the wisdom.

If you have any wisdom to offer here, I would love to hear it.

(Preemptively because I know some of you: Thank you deeply and sincerely but please don't construe this as a plea for financial aid. ;) )

15 comments:

  1. I have a wonderful vet and we discuss things like this all the time. You can take them for expensive tests, but then you may not find out anything new anyway. My dogs are pretty much my life these days, so I would do whatever I could, but I am not wealthy either. My Sadie has heart problems. She required surgery last year and my vet's office said it would be in her best interest to take to her to the specialty vet about 1 1/2 hours away (which she has gone to many times for testing not available in our area). I asked them if I decided against would they do the surgery anyway. We were lucky and the surgery went fine. I would rather have attempted to do the surgery than not do anything and if she passed, at least I tried. Not sure if this helps or not. My personal e-mail is macmadday@aol.com if you would like to drop me a line. Thinking of you in your decisions.

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  2. We're facing a similar dilemma with Harley and his neck/spine issues. A $1500 MRI would give us a better idea of what we're dealing with, be it tumor or arthritis. But would it change what we're doing now? Not likely. So, for the time being, we're keeping Harley comfortable with meds and he seems to be enjoying life mostly pain-free.

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  3. My question to the vet is what would they do differently during the dental if the ultrasound does show something? And, can they just do it like that without doing the ultrasound?

    If nothing would change one way or the other, or if they can take their precautions that they would take if the ultra sound did show something, it seems like it would not be a needed test before going in for the cleaning.

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  4. It is always a gamble isn't it. It seems we always have to choose. Bad teeth can affect the heart and other organs and I don't know really how bad they are. How long can she really wait for this? Can you handle the risk so soon after losing Drive? I guess I am no help but the comments above are great.

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  5. It's so difficult when It's someone else's pet but here in the UK i'm kind of cynical about vets - even the good ones. It's generally accepted that being a vet is a licence to print money! If every thing looks pretty much ok, I think I'd proceed. Dec has never had to, but Flynn went under anaesthetic a couple of times and no one carried out any tests before hand. Maybe it's a more causious culture where you are? I wouldn't want to take risks but you can't test for every eventuality. Deccy's Mum x

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  6. Well, I don't have any experience with elderly dogs, but my young (1y/o) dog just had an echocardiogram at the end of August.

    She went to the vet for some boster shots and a normal check up. They found a 'concerning' heart murmur and sent us to the University hospital for an appt. with the cardiologist. $700+ dollars later (just for the U visit, not including the reg. vet charges) it was decided that she has 2 faulty valves in her heart (between the right atrium/ventricle and right ventricle/plumonary artery) BUT she will live a normal life and doesn't need any treatment.

    I'm glad I had it done, because she is very young to have a faulty heart BUT it was a VERY expensive way to find out I have a NORMAL (sort of) dog!!!

    I agree with K-Koira - What would the vet do differently if there was an enlarged heart?

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  7. I'm sorry, I have no words of wisdom. It's a tough spot. My guess is that if the test shows it's an enlarged heart, they wouldn't want to do the dental, but maybe I'm wrong. There's always a risk putting them under. I am not sure what I would do if it was my dog. I guess it depends on how badly I think she needs the dental and if there is any other way around it. Part of me says I wouldn't chance it, but then if she really needs it, then I might. I'm sorry, I'm really not any help. I hope you have a clear answer soon.

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  8. I'm still waiting for that money tree to grow in our back yard, too! If I can get mine to grow, I'll let you know the secret.

    We've sure been there with the decision on tests. Actually, last year I agonized about what to do for Blueberry after we got her cancer diagnosis. All the options were overwhelming, but a wise person told me to really take the time to think about it and not rush the decision. In the end, we decided not to put her through chemo, and we've been very lucky that there's been no recurrence. I did a lot of research on it, and I feel comfortable with our decision. I think you always have to balance the cost versus how much you need the information from the tests and how much it will affect your decision to proceed from there. It sounds like you've already decided that she needs the dental. If the vet is aware that this may be a problem, can they not take precautions as if it were for sure that she had a heart problem just to be sure? Even if it cost you a little extra money for that, it'd probably be less than $300.

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  9. I am thinking along the same lines as Bunny, especially given Lanie's age. I had a grey with heart problems and because she was only 18mons I spent over $1500 to run tests which gave me a lot of info regarding future treatment for her. At Lanies age and the fact that it may be only slightly enlarged I think I would just do the dental with the vet taking precautions as if she had this heart condition. I have been told that as we age our hearts can get slightly enlarged anyway and the function decreases just due to being old. If she has no symptoms such as coughing or excessive panting I would just give her the dental (which if she in fact has a heart condition it is ESSENTIAL that her teeth/gums be kept clean.)

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  10. I have no experience with greyhounds, but I had a miniature poodle who lived to be 20, and had a heart murmur for the last 8 of those 20 years. The vet was aware of it, and it wasn't severe enough to treat it, or even worry about an EKG, so when he did her teeth, he just took precautions and she did fine. (However, after the age of 18 the vet didn't want to do any dental work that required anesthesia - too risky for an ancient dog - so she was on a low-level oral antibiotic for her teeth issues, instead. But again, she was ANCIENT.) IMHO, I'd say go for the teeth and have the vet work as if she's got a heart condition, and just keep an eye on her for additional symptoms in the future, because I'd keep the teeth as good as possible, as long as possible.

    -Dr. Liz (and not Fiona the dog, who is young and doesn't worry about these sorts of things)

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  11. I think that the person above who asked if they would do anything differently depending on the results of further testing hit the nail on the head.

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  12. I'm not expert on these matters, and for all I know your vet may be a greyhound expert extraordinary, but I remembered reading this article a while back and thought it might be worth posting. It seems that greys are frequently diagnosed with heart problems because their hearts normal values are far far different than other dogs. Just food for thought. http://www.gcnm.org/heartnews.html

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  13. Since she has no symptoms of anything...not only the money, but the stress and fright she has to go through at the vet. Wawa shakes like a leaf each time he goes to the vet so I doubt if the tests would show the true state of a dog's health! Might as well let her be comfortable until some symptoms show up (if they ever show up).

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  14. Not really sure. I guess I keep asking the vet for more info. How necessary is it to know? What are the risk, if any? Do they believe this is an absolute must before performing the dental?

    Our vet is always really practical about how precautions are necessary to heln us work within our budget. If it is absolute must for the sake of Lanie, I wouldn't take any chances. But obviously you're in that grey area, so I suppose that last statement means nothing. BOL!

    So really my best suggestion is more info. Can you get a second opinion?

    Tough decision, but I'm sure you'll make the right one.

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  15. I hope she's doing well. I think I've heard that greyhounds naturally have larger hearts too. Still, it's no fun to not know for sure what's going on.

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