For me, the answer is 4. Prior to the accident, we had taken the dogs to the vet the day before for some routine work. I called Cobb ER at about 9 AM to see how she was doing. They said she was doing fine and had shown some improvement. A surgeon, Dr. Wagner, had evaluated her and believed that she actually had a spinal stroke (or FCE-fibrocartilagenous emboli). Again, just too many details about something I do not know anything about. She wanted to continue Katie on the conservative course of action and said I could take her home this afternoon. However, there was one concern. Katie had indicated pain during a rectum exam and that was not typical for a spinal cord injury, so she wanted to get a pelvis x-ray which I agreed to. I called my vet, Diane Castle. She had already received a fax from Cherokee, but wasn't sure what was going on, so I explained.
I was really concerned about having to choose surgery and discussed this with Diane. The price was not worth the benefit if she did not live 2 or 3 more healthy years (remember that year 1 would probably be spent rehabing). At age 9, I felt that it was a crap shoot. If she were any older, I think I would say no to surgery. Any younger and I'd say yes. It is such a terrible thing having to put a price tag on your dog's life, but I'm a big believer in quality of life, so there is a limit to how much I will put my dogs' through. Diane mentioned that she other clients that were faced with the same and simply couldn't afford it. They came in for accupunture and had had good results. She suggested that we start accupuncture as soon as possible, so I took her latest appointment for that day hoping that I would be able to pick her up in time.
I hadn't heard from Cobb ER, so I headed down there at 2 PM, so that I would be ready to pick her up the instant she was ready to go. It worked out perfectly. The surgeon was ready to discuss her x-rays within 10 minutes. Unfortunately, there was something. On her pubic bones, there was definitely something going on. She said it could be bruising, but it could also be bone cancer. The surgeon wanted to do a biopsy right away to confirm and started to explain that dogs can live without pubic bones. I questioned her and said that its still bone cancer that probably has spread to somewhere else and that she'd probably die of the cancer 6 months later anyway. She agreed. I questioned her about the pain caused by a bone biopsy since I have friends that have told me that they would never put their dogs through that again. That the biopsy was worse than the amputation for the dog. Dr. Wagner didn't agree, but then she's not the one who goes home with the dogs either. Talk about overwhelming and keep in mind that I'm sobbing during this entired conversation. A chest x-ray was also recommended since we would want to know if tumors had started elsewhere. In my mind, I knew I would not do the surgery for the bone cancer with Katie being so badly injured already. Talk about adding insult to injury. But I did want to know if it was cancer because if it was, I didn't want to torture with this spinal injury............... but I didn't want to miss the accupuncture appointment either. If she was just bruised, we need to be doing all we can for her back and as soon as possible........... so I told Dr. Wagner that I was going to take her home.
Katie was pretty glazed over when she came out with the support of 2 techs. Such a heartbreaking sight. The techs tried to lay her on her left side in the van, but she fought them and I finally figured out that she had seemed to prefer her right side during all of the other travels, so I told the techs to just leave her and let her figure out what is best and Katie positioned herself on her right side. So off to Diane's.
Dr. Wagner had already called Diane and given an update. She wanted Diane to convince me to do the biopsy, but Diane felt it was rather invasive and agreed with my decision. I explained to her that I did wish I knew because I really hated to see her so disabled and helpless and didn't want her to suffer anymore if she was just going to die of cancer in the near future. So we decided to do a chest x-ray. If we found a chest full of tumors, I was prepared to let Katie go. As much as I was not ready for this and with little time to think, I really felt it would be selfish of me to keep her around in this state for my sake. I called Stephen to see if he would want to be there if I made that choice. He did, so he started towards Diane's just in case.
Well, the chest x-ray was clear. I calmed myself down and I told Stephen to turn towards home. Poor Katie exploded with pee and urinated all over Diane's pant leg and then we settled in for some accupuncture. Katie slept through the procedure. Diane felt that if it was bone bruising, the x-ray would look clearer in a week, so I tentatively thought I would have the x-ray redone in a week to see if it had improved.