What's happening on the inside?
Benny, my beautiful 15-year-old golden retriever, has a tumour on his spleen. I know this because he had a CT scan, and before that an abdominal ultrasound. It’s certainly not great news, but I’ve got a lot to be grateful for. The tumour hasn’t spread, nor has it burst (which often happens with advanced splenic tumours). I’ve caught this early so I can still do something about this. Benny is having his spleen removed next week - certainly a big operation for an old dog, but a decision I think is right for him. Hopefully Benny can go back to living a normal doggo life without a spleen!
Who’s Benny?
For those that don’t know, Benny otherwise known as Benjamin Button, is the love of my life. I’ve had him since he was eight-weeks-old and I was fresh out of vet school. Together, we’ve lived and worked all over Australia - both city and country. Benny has been an emergency blood donor many times - saving countless canine lives. Today he's a staple fixture at Bondi Vet Hospital where he and I spend much of our days.
I don’t even have to speak to Benny. I don’t tell him what to do. He just knows. He knows when I’m upset, happy, frustrated, or excited, even before I’ve said anything, and I know him just as well. He has been with me through the many boyfriends, through the challenging times I’ve worked 100-hour weeks with no money, through the years of building Bondi Vet Hospital and having risked my entire savings on a dream. Benny taught me what it was like to be an owner rather than just a vet, and he has made me a better human being.
Of course, as a vet I’m very aware that I’m going to lose him in the not-too-distant future. But in my book, that is no excuse for not trying to keep Benny around as long as possible.
I hear it over and over: “he’s an old dog Kate” or “maybe I should just say goodbye”. I listen to everyone’s opinion, but at the end of the day, I’m his Mum and I’m a very experienced veterinarian. I’m not scared of death, and neither is Benny. We live and breathe death every day and when it comes to knowing when to call it a day, it’s my expertise. I know what’s doable and what isn’t. And this one, I am sure, is doable! I decided a long time ago I’m not sitting around watching him wither. If he dies in surgery, so be it, we gave it a hell of a shot.
That’s not everyone’s view. But in my time as a vet, I’ve learnt everyone has their own opinions on life and death, and it’s never for me to judge. And I think many people afford me the same respect.
What lurks beneath? The value of routine scans
Three months ago, I did a routine abdominal ultrasound (and echocardiogram of his heart) and I found he had a tiny little nodule on his spleen. It was too little to tell if it was just an old-dog harmless nodule or something more, so I decided to leave it alone and do a CT scan in three months to see what it was doing.
A routine abdominal ultrasound? But who does this when there is nothing outwardly wrong with your pet? Me. And I suggest it for my clients' patients as well. What’s funny about pet owners is we are so used to looking at the outside of our pets. Numerous times per day I have worried owners come to see me for a skin lesion - cuts or lumps, or maybe their pets are itchy or have a weepy eye or smelly ear, but we all forget that we can’t see what happens on the inside.
What about blood tests? Is that enough?
There’s a widespread common belief that if they’re eating well and their blood test is ok, then everything is cool. That is one hundred per cent wrong! Some cancers can be detected on a blood screen, but many can’t until it’s too late. And any person that’s known someone with cancers such as pancreatic, stomach, colon, bladder (the list goes on) knows, blood tests aren’t worth much. Blood tests tell us the way something is functioning, so until say, Benny’s splenic tumour has bled out, ruptured, or is affecting the organ itself there is really no way a physical exam or blood test would detect it. Neither specialists nor I could feel the lump on his spleen, his blood tests were perfect, and he’s a well and happy, very much eating (with perfect teeth) old “goldie”. He’s not sick yet, and that’s the perfect time to find out!
How do you look at the inside of your pet?
There are a few ways and there’s no rule here. Abdominal ultrasound is a bit cheaper and you can do it without having to sedate your pet, but it’s not as good at picking up little details as a CT scan. Echocardiograms (ultrasounds of the heart) are also really helpful, and not break-the-bank expensive and can be done without anaesthetic as well. Both echocardiogram and ultrasound are non-invasive and certainly don’t hurt your dog in any way. CT scans are great. You can do the whole body from head to tail and pick up detail about lumps and other things that ultrasounds won’t, but pets do have to be sedated or go under an anaesthetic for this (to keep them still) and they are quite a bit more expensive to do.
I haven’t mentioned Xrays: while they’re the cheapest way of looking at the inside, they are my least preferred when it comes to non-bone related scanning, as they just don’t provide the detail to proactively chase an abnormality.
How often should they have routine scans?
Whether it be CT or ultrasound, I scan Benny at least once a year. In a dog’s life, a year is a long time. Yes, blood testing is important, also every 12 months, but in some cases and with some dogs such as an old goldie like Benny, I would choose a scan even before a blood test. It might seem overkill to some, but it’s saved Benny’s life a few times not to mention the many other pets I treat.
But what about the cost?
I hear you. Routine scanning whether it be ultrasound or echocardiography (at Bondi Vet Hospital both are around $800) or CT scans (about $3000 at the time of writing this) are expensive. For some people it’s doable but for others it’s not.
Benny’s surgery will probably be around $10,000. Luckily for Benny, he has been insured since he was 8 weeks old - that’s a lot of premiums! And in fact, I did not make even one claim until he was eight years old. I paid every year's premium for eight long years before his knee blew and he had his first cruciate repair.
With insurance, the ultrasound cost is reduced to $200 out of pocket and the CT to $600. Expensive but a lot better than $3000. So, if you’re on the fence about getting pet insurance or people are telling you it isn’t worth it because they didn’t pay the $200 for your mate's staffy with an itchy ear… that’s baloney. Insurance does pay out for these big, ugly serious things (which is when you need it) and for an old dog, pet insurance often means life or death.
As a side note, you can’t get insurance once you or your vet knows! It’s like trying to insure your house the moments AFTER it burnt down. It won’t work!
Why did I write this? Because sometime, somewhere I hope it helps another pet owner. While routine scans aren’t for everyone, or if cash is tight, for those pets who are insured and or have very committed mums and dads, do it. And if your vet doesn’t offer, ask! One day, it’ll save their life.
Benny’s surgery is scheduled for next week. I’m nervous. It’s a big surgery for my old boy. But he’s tough, he still wants to live and most importantly he’s my best friend and I owe it to him to give this a crack. I’ve got this.
Love, Dr Kate