A tiny dog with a grapefruit-sized mammary tumor received a mastectomy at our hospital about two months ago. I saw the little Yorkie the other day since her owner noticed that the lumps came back. I had the conversation about metastasis with her, and she understood that it was not a good prognosis. She was at peace with the idea of not pursuing another invasive operation and not putting her dog through that again. She was pleased that her dog was eating and drinking normally and, for the time being, acting like her old self at home.
“Benign neglect” is a term we frequently use to describe monitoring a patient’s clinical sign or lesion, but not intervening with medication or a procedure. I employ this approach in a large number of cases. Small skin growths that are not bleeding, appear discolored, or feel firm, often qualify for this particular form of treatment, or lack thereof. Typically, a wart on the face or suspect lipoma near the sternum may actually be more bothersome to an owner than it is to the patient and may not require any treatment.
On the other end of the spectrum, our Yorkie friend with metastatic disease had a terminal disease, but we decided that we were not going to attempt a second surgery. It is important to let owners know that sometimes not treating our patients is a form of treating them, giving them dignity and strength through supportive care and love — the latter of which I tell my clients is the most important thing that our pets can be given!
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