Today is the full moon.
Give your monthly preventatives!
Note: If you have another way to remember to give your preventatives, that’s okay too! Do what works for you. I thought it might be fun for us to all give it together.
It is finally spring and I have finally taken down my outdoor Christmas lights at my house. They kept me cheery through all of the big snowstorms! I so love the look of the lights in the snow.
I do not love that we are at war with Iran. The war started with us bombing a girl’s school and killing nearly 200 people. Then it took a week for us to admit that we did it. It is happening with my tax money. I just can’t support this.
When I was in second and third grade we lived in military housing and a chain link fence separated our home from the elementary school on the base in Monterey, CA. The Iranian girl’s school had been built near a former military base. A fence separated the base from the school. I am waking up every morning thinking about those girls and asking myself if those parents can ever forgive us. I don’t know if I could if it were my children who were killed.
I am saddened to say that my patient that I wrote about in the last newsletter did pass on at the referral hospital after her surgery. I am so very sad for her and her family. It leaves me questioning how far we should go with older dogs that have multiple problems.
There are never any right answers.
Dr Toomey used to come and do ultrasounds for us when I worked at West Greenwich Animal Hospital. She was so smart and a great mentor and boarded in Small Animal Internal Medicine. She said the dogs that make it to be really old are sometimes the ones that we have done everything for. You end up stuck between the rock and the hard place because if you do nothing, the disease they have will eventually get them.
In Lucy’s case, and in hindsight, I think she would have lived longer and had a higher quality of life if we did not take her to surgery trying to fix problems that would, untreated, go on to end her life.
There are no easy answers.
I have to go on living with myself after I have given my best advice and things did not turn out
as I had both hoped and anticipated. While I worry now that the pendulum has swung back the other way where I don’t want to recommend potentially curative surgery, I know this is untrue.
I am always going to lay all your options on the table. I do not want to paint the picture too black. There is no way (except in hindsight) to know what the outcome will be beforehand. I have to give advice based on what I know and move forward.
It is not always easy and not always straightforward.
All I can do is my best. When a dog or cat is diagnosed with what I think is cancer, I try to make sure that the cancer is not in any other places before making recommendations to take the animal to surgery to remove the original cancer.
Typically this consists of three view radiographs of the chest to look for metastasis there and of a good abdominal ultrasound, with an experienced ultrasonographer, to make sure we don’t find any tumors or masses in the abdomen. We look carefully at the rest of the body for other tumors or masses and we may aspirate local lymph nodes to make sure we do not see any evidence of tumors there.
If we find tumors in other places, it does not mean we can’t move forward, but that we want to make plans to remove cancer everywhere we find it. And we want to know when it is best to just stop. Additional diagnostics give us the information we need to make informed decisions for care.
If you are ready for something lighter, here is a newsletter that I subscribe to. I’ve included the website;s description below.
“Each beautifully crafted issue from artist, author, and speaker Jason Kotecki provides museum-quality insight delivered to your inbox every Sunday morning. Jason shares his trademark wit, whimsical art, and practical tips for creating a life with more adventure, meaning, and joy. It’s been described as field notes from the front lines of the war on Adultitis. Another subscriber called it a cup of hot cocoa for your soul. ☕️ But it’s not for everyone. It’s for joy rebels and rule breakers and ragamuffins, for hope dealers and dreamers, for the young at heart, and for those who see things differently… or want to.”
It really is finally spring!
These came up through the snow!
They are in front of the animal hospital and they open and close each day.
I have thoroughly enjoyed them!
Lastly, I follow the Joy of Cooking podcast. Link is here: https://joyofcooking.com/podcast/
I want to share a recipe for Easy Dulce De Leche (Caramel Sauce)
I love to boil things. Last month it was oranges.
This recipe is on page 809 of the 2019 Joy of Cooking.
You cover an unopened 14-ounce can of sweetened condensed milk, label removed, with 2” of water, bring it to a boil and then turn down the heat and simmer for 3 to 4 hours.
Keep the can covered with the water and COOL the can COMPLETELY before opening it.
(We don’t want burns or kitchen disasters!)
I was a little too enthusiastic with my boiling and mine was more like caramel but it was DELICIOUS and I was able to soften it with a little water in the microwave to get it back to sauce.
I made a pear tart to go with it.
See the crumbs?
Dr Mo is seeing all the little critters that aren’t dogs and cats.
Remember your monthly heartworm and/or flea and tick prevention!
Happy Spring!
– Dana