I recommend a post-mortem exam on any unexplained or sudden death in any animal. Why? It can give real peace of mind if we find that the animal had a severe illness, such as cancer or heart disease. Also it helps us to know that the cause is not contagious, so that other animals living together would not be at risk. Finally, if the death was suspicious it can help us be reassured whether there was a toxin, foul play, or any other unusual factors involved.
As with any test, a post-mortem is not perfect. Some things don't show up well on post-mortem exams and are better tested with antemortem blood tests, for example, such as cantharadin or oleander poisonings in horses. However many causes of death are apparent and having a post-mortem can help explain what happened to your beloved animal.
Here is a recent example from a fellow veterinarian, about a client whose dog died suddenly after surgery and taking pain medication. The vet and owner were worried the death might have been due to the surgery or a reaction to the medication.
Last week I had a patient come in because he did not feel well early that weekend and the owner noticed a mass pop up at the sternum. In talking to the owner, Sam had some vomiting but felt better later that week. I examined him and everything was fine. I did note that the 3 cm mass at the sternum did not feel like your typical lipoma and every time I did a fine needle aspirate I would get blood. So I recommended the removal of the mass. I normally do surgeries on Tuesdays but because the man was going out of town, I decided to remove the mass the previous Friday.
Well Friday came around and removed the mass. The mass had like a large clot in the center of it and I sent it off for pathologic analysis. No issues and sent the animal home. Well Saturday night I get a call from the owner that Sam as not doing well and it all started after the Deramaxx tablet (pain medication). I did not see the call until the next morning. He called me the next morning to say Sam was barely breathing. I told him to take the dog to the e-clinic where he came in DOA (dead on arrival). Of course the man was very upset and wanted to know what happened.
I know we are super careful about recording parameters during anesthesia. We have charts that must be filled out by the techs every 5 minutes. I explained to him that I did not know what happened and recommended he have an autopsy done. I explained that I would pay for it and I would help us know if there was anything we missed. Couple hours later, I got a call from the University hospital stating that he was there for a necropsy (post-mortem). I get a call from the pathologist stating that Sam bled out from a splenic tumor. He also had mets [metastatic tumors that spread] to the lungs. I got the biopsy report of that mass which came back hemangiosarcoma [malignant cancer of the blood vessels which often starts in the spleen and spreads from there].
I spoke to the man who thanked me for having him do the necropsy. He said it turned the whole situation from the worst possible outcome to knowing that there was nothing that anyone could have done. I also think in hindsight that the vomiting/lethargy episode early that week was probably an acute bleed.
No comments:
Post a Comment