By Joe Spoo DVM

Sometimes life throws you a curveball when you’re sitting waiting for a change-up. To say that I’ve been having trouble “reading pitches” lately would be an understatement. In an effort to further complicate my life, I returned to a more regular practice schedule at the Tea Veterinary Clinic with my good-friend and classmate Dr. Tom Rentschler…of course this is in addition to my consulting responsibilities and all part of my grand plan of finding the perfect career balance.

About a week prior to starting my more regular practice schedule, I had found a BB-sized mass on Maggie, just next to her sternum. With her history of migrating plant pieces, I was a little suspicious we were in for round two and after giving her a week to adjust to the new puppy I brought her in for Tom to remove the mass. There are some procedures I can perform on my own dogs, and others that I just would rather have a trusted colleague perform, as it’s kind of like operating on your own kids for me. The mass was small and the procedure was quick. After it was removed Tom cut it open to make sure it wasn’t a foreign object and satisfied he had gotten all of the well-encapsulated mass, we sent it off to an Iowa State pathologist for confirmation.

Two-days later (a near record turn around of results) I got a call from the clinic that the fax had just come in with results. To my utter dismay it was a cancerous mass, a Mast Cell Tumor to be exact, but to make matters worse it was a Grade II-III (III being the most aggressive and absolute worst). It appeared there was no capsule, and we may have not gotten it all. While I wasn’t in the mood for such a lesson it did illustrate why we send these samples out even when we’re confident we removed everything at surgery.

By that afternoon I had consulted with the internal medicine specialist, whose opinion I hold in the highest regard, the pathologist who examined the slides and the oncologist at Iowa State, and I had an appointment scheduled in Ames for Monday morning. The next three days were miserable, contemplating the what-ifs, especially since I have a tendency to only focus on the negatives in a situation. To top it off, a major snowstorm was scheduled to arrive in the Midwest, and so Maggie and I headed out a day early to make sure we made it to Ames for our appointment.

Monday morning we met with oncologist, Dr. Jennifer Locke, who I cannot say enough about. Dr. Locke laid out the game plan she would recommend and was honest with her concerns about the potential for a Grade III classification. Dr. Locke is a recent addition to the Iowa State faculty, and as an alum, I could not have been happier with the school's selection for this position. Not only is she a knowledgeable and an astute clinician, she also has an upbeat personality that is so necessary when day-in and day-out you are dealing with people who are dealing with cancer in their pets.

The first day was spent staging Maggie’s cancer, or essentially looking to see if they could find any evidence of spread of the disease. This entailed taking x-rays and ultrasounds of pretty much her entire body. Throughout the process samples were also taken of Maggie’s blood, lymph nodes, bone marrow, liver and spleen. Thankfully everything came back well within normal limits, and no evidence was found that the disease may have spread.

That afternoon Maggie and I headed back to the motel with my spirits lifted--at least somewhat--and with a surgery scheduled for early in the day on Tuesday. While I’m slightly biased that Iowa State has an incredible vet school, having received my degree from there, one thing I can say for certain is that the surgical training and skills of those at the school are among the best in the country. Not to slight the other departments, because they are great, it is just a fact that they have an excellent surgery program.

We awoke Tuesday morning to six inches of snow and headed off to turn Maggie over to the skillful hands of Dr. Brent Reimer (also an ISU alum). The goal of the surgery would be to get “clean” tissue in 3 cm in all directions from the original surgery site.

Since they knew I was planning on taking Maggie home right after surgery on Tuesday they got her in right away. Before noon, Nicole the surgery technician, came walking down the hall with a very groggy Maggie. Surgery had gone well, and everyone was confident that they were able to get good clearance around the mass.

I stuck around the school for a couple of more hours to allow Maggie as much time to recover as possible before heading for home. The ride home proved to be somewhat traumatic on the little dog as she was extremely painful and could not get comfortable. Throughout the ride she would fall asleep sitting up and at certain points would slowly start to lie down only to be rocketed with pain and start screaming as she sat back up. It was several hours into the ride before she was able to get comfortable.

As if the trip had not been filled with enough adventure, just after dark and about 100 miles from home, a rear tire decided to give out on the truck, and we shredded it going 70 mph down the interstate. I was able to creep into a rest area, only to be further frustrated that the mechanism to get my spare down was broke. After a frustrating call to AAA, it took 45 minutes for the individual on the other end to figure out where the interstate rest area was…I was beginning to think I was part of some cruel joke, as I thought my location could not have been simpler. When the tow truck operator arrived he had no further success with the spare than me, and so with sledge hammers and pipes we proceeded to bust the spare loose from the bottom of the truck. After a two-hour delay, we were finally back on the road and arrived home hungry, emotionally spent and physically exhausted.

The next day, late in the afternoon, I received a call at the clinic from Dr. Locke. The pathology results were in and it appeared there were still tumor cells at the original site; however, it appeared surgical excision was complete. With all the evidence now in, she felt there would be no need at this time for chemotherapy or radiation…and finally I could breathe a sigh of relief.

If you’ve followed me this far I’ll finally get to the root of why I’m posting this on the site. The first is that as practicing veterinarians we are thoroughly equipped in our education to handle almost any situation that walks through the doors; however, there are times that even we like to turn things over to the experts in the field. The money I spent at Iowa State was meaningless compared to what I received in return…the peace of mind knowing I had done everything I could for my four-year old little setter, and that as a result she likely will still be hunting with me this fall. Professionally I also made some new connections that I’m hoping will open other doors in this fabulous career of veterinary medicine that I have chosen. The compassionate and knowledgeable care I received from Drs. Locke and Reimer was absolutely spectacular. And while the pathologists are somewhat the unsung heroes in these cases, this is another area that Iowa State excels at, and Dr. Amanda Fales-Williams is one of their best.

The second point I would like to illustrate is Maggie’s case stresses the importance of twice a year exams by a veterinarian, no matter the age of the dog as Maggie is only four. This is a lump that I am relatively certain would have gone unnoticed by most. When people get hung up on vets being money-hungry as the reason for recommending annual visits for vaccines, it is cases like this that I like to use to illustrate the real reasons behind those recommendations…to get your pets in for an exam. I often tell people that you could probably train a monkey to give a vaccine, that’s not why I went to veterinary school, but rather to be able to detect these very small problems and deal with them before they become catastrophes. The other important point is that if you spend the money to have a lump taken off, spend the little bit extra to send it in and have it analyzed. The garbage can never would have told us we hadn’t gotten it all as we were certain we had. Money spent on peace of mind is money I will always spend.