Today I ran into a rather unfortunate situation. A couple brought in a six year-old unspayed female pit bull that hadn't had any veterinary care since it was a puppy The dog was very sweet, which makes the problems we discovered more unfortunate.
The "minor" problems were some worn and broken teeth, dirty ears, and about 15 pounds of extra weight. During the exam we found a small (about 1cm) firm mass in one of the mammary glands. With her being a middle-aged unspayed dog I immediately began worry about cancer. Part of our discussion at that point was about doing chest x-rays to look for metastasis, spaying her, and doing a partial mastectomy to remove the mass and send it for biopsy. Because these kinds of tumors can grow and spread rapidly, it was important to try and remove it and make a diagnosis as soon as possible. So this was problem number one.
Since she didn't have any preventative care so we began with with heartworm and fecal testing. This revealed problem number two as the heartworm test came up positive. A quick look at a blood smear showed more microfilaria (heartworm larvae) than I've seen in a long time. So now we had two serious problems going on at the same time, both potentially life-threatening.
The real dilemma came in trying to fix both. Because of her mammary mass she needed surgery pretty quickly to prevent possible spread. However, heartworms can severely compromise the heart, making anesthesia very risky. So should we treat the heartworms, possibly letting the tumor grow? Or would we risk her in surgery to get the mass off?
In the end we elected to treat the heartworms first. It will probably be about four months until we can get to a point where it's safer to do anesthesia, but the surgical risk of a heavy heartworm infection was too great in my mind. Thankfully the owners are ready to do treatment and we're starting this week.
But what really got me was that both of these situations were preventable. If they had her on preventative medicine she wouldn't have had heartworms and we could have done surgery quickly. If they had spayed her when she was young it would have dramatically lowered the risk of her getting this kind of cancer (if it's what I think it might be). So with proper preventative care started at a young age we wouldn't be in this situation. And the owner wouldn't have to be paying almost $2000 for treatment and eventual surgery.
When a vet talks about preventative care, please listen to him or her. We are honestly looking out for your pet's best health and are trying to keep them from having serious illnesses.