I got a text this morning that one of my crazy cases from yesterday is doing great.

One year ago, the dog almost died from an inner ear infection which spread to the brain. Got that sorted out and a few weeks ago the dog came back with a relapse of its balance problem. And oh by the way, a new little skin mass.

MRI of the brain is unusual- there is a problem in the same general area we had the brain infection in last year. But this time no white blood cells in the spinal fluid, no bacteria, neg culture, no response to antibiotics, two different ones in succession. Meanwhile the skin mass comes back as a malignant tumor, something called a round cell tumor, round cells are a general class of white blood cells.

Search for cancer somewhere else in his body, find nothing. The round cell tumor could be a no-big-deal thing confined to the skin and already completely excised. Or a serious cancer with a high likelihood is metastasis. I order some extra tests to be run on the biopsy samples that will tell me which type of round cells I’m dealing with and that result came back 2 days ago as T cell lymphocytes. Meaning the dog has T Cell Lymphoma which could definitely be the lesion we’re seeing in the brain one year after he had a bacterial brain infection at that same site. Weird.

Anyway, the dog walked into the appointment not much different neurologically than when I’d last seen him 2 weeks prior. I recommended chemo, the owners were reluctant and wanted a 2nd opinion and got one scheduled for next week. Then in the car, still in the parking lot, the dog had a seizure and even after the effects of the seizure and seizure medication wore off, he was mentally very out of it, couldn’t walk etc.

Try to have the come to Jesus conversation, T Cell Lymphoma in the brain of a dog now in poor Neuro condition has a poor long term prognosis. Median survival with aggressive treatment is only 6 months. The people are in disbelief, the dog was way sicker last year and it turned out ok. Oy, this is brain cancer this time, which has already spread to the skin. Way worse thing even though last years thing was pretty bad.

TL/DR set the dog up with a chemo infusion over night and he’s back now to his pre-seizure Neuro status. Won’t last long but I’ll take it.

The dog with the tracheotomy is doing great. Super weird too, has an inner ear infection that is so severe it’s causing massive swelling of the right side of the head, the swelling was extending down into the soft palate area which, when combined with a pre-existing issue with the soft palate being congenitally too long, was causing an airway obstruction. That’s a new one. I’ve seen lots of inner ear infections in my day but never one that caused an airway obstruction.

All day long long yesterday I was talking to people whose basic response to me was “wut?”.