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Sunday, May 17, 2009

Sometimes You Win

Being a doctor can be hard, and unfortunately you can't help every case. Sometimes the diagnosis itself is pretty difficult. Sometimes there isn't a good treatment available. And sometimes the patient doesn't respond to your best care. So when you get the difficult cases that turn out well, it makes it all worthwhile.

Tucker is an 8 year-old golden retriever that I have been treating. Several months ago he came to me with a swelling around his right eye. I suspected an allergic reaction, and we treated him with short-term anti-inflammatories. He responded well, but then a short time later it came back even worse. This time that side of his face swelled and he started having pain eating or opening his mouth. An aspirate of the swelling didn't show any signs of cancer or abscess. Based on the location, I suspected an inflammation of the muscles involved in chewing (a condition called masticatory myositis). So we put him on fairly high doses of steroids (glucocorticoids) for a few weeks. That helped, but the problem started to return. In cases like this you may have to treat for a longer period of time, or you may have to keep the patient on steroids for life. Hoping for the best, I put Tucker on the medication for a couple of months.

I saw him a few days ago and he has been off his medications for almost three months. Thankfully, he is doing great! No more pain or swelling, and he is such a happy dog. Tucker is a great dog, and his owner is very nice and willing to do what is needed. This is one of those cases that you are greatful to see come back. And this is one of those happy endings.