Solving the Mystery

Regularly I find myself in a difficult position.  Someone has just paid me to examine their pet and offer my opinion.  The opinion is not a simple answer, as they would like.  Your pet has X disease and this is how we will treat it.  More often, it is that the findings are consistant with several different illness and tests will need to be performed in order to determine which disorder we are dealing with.  It is often at that point that the line is drawn. 

This is also the point where the client looks at me as if to say, "Did I just pay you to tell me that you don't know?" 

This is the reason I have practiced my own discerning look.   The one meant to say, "Yep, that's right.  I know enough to realize that I need to run this test." 

Often clients in the rural areas where I practice don't have the money to run extensive tests or diagnostic procedures on their pets.  As their veterinarian, I find myself scrambling to give the owner options and the patient a chance at life.  I  try offering medicines to treat the diseases on my differential lists that are inexpensive to treat.  Then, if the pet is still not improved....well....the owner has at least done what is within their ability/will.  It is at this point that the owners will usually elect to euthanize their pet. 

What a terrible feeling it is to have to take a life of something for an undiagnosed illness!  If I had been allowed to run a test, would this pet get to live?  Would we have found it worth the money to treat, after all?  Would we have found that there was no treatment and we are justified in stopping a disease process that would have caused suffering? 

It's always a difficult subject to breach with the owner, asking them to allow you to take a knife to dead body of their beloved. 

"I know you are hurting and want to take your pet home to bury it, but would you like me to perform a necropsy?"

Necropsy is what we veterinarians do to solve mysteries.  In the human medical world, the term is autopsy.  We disect and examine the dead body to look for clues and make our diagnoses.  We examine the whole animal, inside and outside, and note the gross pathological lesions which explain the array of symptoms of the creature placed before us.  We can take samples for further diagnostics.  We can learn from what we find and better help another patient in the future.

A dear friend texted me late in the evening last week.  She was worried about her guinea pig and asked me to examine him the next day.  It seemed that the little old pig was going downhill quickly.  Her daughter's gentle pet had stopped eating, stopped playing, and was suddenly thin. 

When I got to the clinic the next day, I found the pig in grave condition.  He was sluggish and depressed.  He kept his nose to the ground and offered little resistance when I picked him up.  He was very dehydrated and his gums were pale.  When I ausculted his chest with my stethoscope, I heard a disturbingly slow heart rate.  I felt it necessary to let the owner know right away that her pig was very seriously ill. 

When I felt the pig's abdomen, it squirmed in discomfort.  There were two large masses in his belly and they were painful when touched.  I asked several questions to try to rule in/out what the masses may be....but ultimately I would need an x-ray.  Worse, I would likely need to take this guinea pig to surgery.  In his current state of health, he would likely not survive it. 

Because of his age and degree of illness, my friend decided to euthanize her guinea pig. 

"Do you want to know what it is?" I asked, trying to squelch my obvious eagerness to look.

"No, I really don't," she said, with sadness in her eyes.  "You can if you want to, though."

We gently bantered for a few minutes.  Me, trying to make sure she was really alright with me cutting open her dead friend.  Her, likely, trying to decide what she would tell her daughter.  Likely, wondering if the decision she had made was the right one.  Likely, fearing that a necropsy would tell her otherwise. 

It was finally comfortably settled that she would permit the necropsy.  I gently incised to abdomen of the pig to reveal what appeared to be a large cluster of grapes.  On further exam....there were two large clusters of grapes!  We looked all around in the abdomen determined that the clusters of grapes were in the place of where the guinea pig's kidneys should have been found.  We gently removed them and found that these clusters were indeed the kidneys.  Her pig suffered from polycystic kidney disease and had likely been in renal failure. 

While polycystic disease is a common find in guinea pigs, it is usually the ovaries that are affected.  It is a rare find to have polycystic kidney disease in this species. 

Alas, the mystery was solved.  I now had another differential to add to my list of lumps-inside-a-guinea pig.  My friend could be assured that she had indeed made the best decision for her daughter's beloved pet. 

"Take a picture of that," she said to me with a smile, "...for the blog." 

Thank you, dear friend, for allowing me to learn and share your pet's disease with the public.