Exhale

It's all over now. The mass is out, the operating room is empty, and Ozzie will have a brand new zipper decorating his chest. What a day! We met with this wonderful veterinary surgery at Animal Specialty Group in Scottsdale, and he was just as nice and as confident as we had been hoping. He spent quite a bit of time with us discussing the possibilities and explaining the surgical procedure. His differential diagnosis was fairly brief: an abscess caused by a lobar pneumonia or a foreign body, a granuloma from a fungus or foreign body, or a tumor, benign or malignant.

Having had 4 other veterinarians tell us that the "inoperable" mass was classic for a high grade aggressive bronchoalveolar carcinoma, just hearing a differential diagnosis felt like the sweet comfort of an old friend. Because, my friends, until you have a pathologic diagnosis, a differential diagnosis is really all you have as a doctor! If a veterinary radiologist can make a cellular diagnosis based upon a CT scan, then he is kidding himself! Even in my job, looking at breast cancers day in and day out in its many varied forms, I still get surprised here and there. I would never send a patient to treatment without obtaining a tissue diagnosis! There is absolutely no reason that veterinary medicine has to be any different.

Anyway, our boy sailed through the surgery without any complications, and what did the surgeon find? A humongous pus pocket! An abscess!! He suspects that Ozzie inhaled a foreign body and/or developed a pneumonia, and that his body then walled off the infection over time into this huge bag of pus! Yahoo! And, in case any of you were wondering - No! The surgeon did not see any hilar lymph nodes either! Not that this was at all about me being right...

For now, Ozzie is on a host of strong antibiotics until the cultures return. And the surgeon did send tissue to the pathologists just to be sure that there is no evidence of malignancy. Because, remember, until you have a tissue diagnosis, a differential diagnosis is really all you have, right? Apparently Ozzie is recovering nicely, and now we can start to recover, too. Exhale. A big, long, ex....hale... If I have ever felt so close to God, it was this afternoon when I got that joyous phone call. What a beautiful day for my sweet beautiful dog!