dogs don't look both ways

Just when we were thankful that our dog had survived being struck by a car, we are told by a veterinarian that our dog has an enlarged prostrate gland and needs to be castrated. Very soon. This is really upsetting to us. Clearly not in the same way as Joey's accident. But deeply disturbing.

First, please make sure you've read Joey's post, "this too was injured when I was hit by the car"?  (It's important to understand what was going on medically with Joey, one side effect of his injuries, that we didn't discuss much in the blog.)

Phil and I needed to go out of town for a few days, but Joey was still recuperating from his injuries. We didn't want to board him in the kennel, nor did we want to have somebody come to our home and take care of him and put this person in the position of caring for a dog who would need medical care.  Luckily, we found a place to board Joey where he could be medically supervised. And off we went, confident of Joey's' being in good hands.

Meanwhile, back at the animal medical center's boarding, one technician noticed that Joey was peeing - and that nothing was coming out. The technician noted that when Joey did pee, his pee seemed a little differently colored. Very observant, we remarked.

It's so interesting: I asked myself, How can a technician tell one dog's pee from another's?

Apparently the testosterone from whole male dogs creates a different odor than unaltered male dogs!

From Joey's point of view, as he writes in his post, suddenly at the animal medical center he was getting a lot more attention. Not a bad thing from his point of view! He likes the attention! This is his version of the fact that veterinarians where he was being boarded took a blood test to see if he had an infection, and that they also checked his prostate gland to see if it was normal or enlarged.

Our perspective was a lot different. While now away, we had received phone calls from the attending doctor. "We'd like to do some tests." "Yes", we answered, "Please do the tests." (Yes, and it did mean more money.) We were concerned.

Once we were back home again and Joey was back home with us, we noticed that our crazy Joey didn't exactly act like an ailing dog. But the doctor was unequivocal both verbally and in writing: Joey needed to be castrated - and soon.

Wow.  How things change - and suddenly.  Let's say that it was totally surprising to us that our ten-year-old dog should suddenly develop an enlarged prostate. But we thought to ourselves, "Maybe age is starting to catch up with him. Our big and strong and gentle and crazy chocolate Labrador Retriever is finally starting to show his age? We are also thinking to ourselves: How lucky we are that Joey was in hands just when this condition developed."

As Phil, Joey and I each got back into our respective routines back home, Phil and I tried to think about what all this meant, where to go from here.

Many people feel uncomfortable questioning a doctor's diagnosis.

Phil and I had originally agreed that there might be some medical issues here, not to be taken lightly; but now back home and with this diagnosis, we also decided to request a copy of the actual lab results. Hey, let's be sure. Let's know exactly what we're dealing with. We promptly received the lab results as an email attachment. And, upon reading the lab results, the case for castration was no longer so conclusive.  In fact, it was quite open.

This is what we read:  The doctor had indicated the following symptoms and observations: 1) Joey was seen marking with no urine coming out, 2) there was blood in the urine when Joey urinated or marked, and 3) Joey had an enlarged prostate gland detected upon a manual examination.

Joey's medical history was all there on the charts, including the lacerated penis from its being scraped along the ground when the car hit him. The doctor didn't seem to take this into consideration. But we did.

Phil and I also had explanations for Symptoms 1 and 2.  First, Joey loves dogs and we've observed that he marks so much that sometimes he marks himself dry. This would be a likely scenario at a place where he was being boarded, where dogs abounded and where Joey has been famous for marking.

Thus, our explanation for Symptom 1 is that, where he was boarded, Joey was, simply, pee-d out!

Second, as Joey wrote in his blog, when he'd been hit by the car the skin surrounding the penis had been pulled back and the penis lacerated as it came into contact with the ground.  The cut went fully around the penis and for a few weeks after the accident, whenever Joey got excited, blood rushed out his penis.  The first time it happened, we didn't know what caused all the blood: blood on his bed, on the walls, on the floor.  We were having friends over for lunch and Joey got so excited that one of us had to rush him to the hospital while the other entertained. Joey, of course, he couldn't have cared less. The trip to the animal medical center was just a lot of fun! But it wasn't fun for us.

This condition added to the restrictions on his life (and our life) after the accident until that could heal again. Keeping the shades lowered during the day was one of the restrictions we had to follow in order to keep Joey's level of excitement low, so that his penis could heal properly.

So our explanation for Symptom 2 is that being boarded, he was more excited than normal and that therefore blood from his penis injury was ending up in his urine.

We had no explanation for Symptom 3.

But we did have our regular veterinarian, Dr. Tamara, at Joe's regular and local animal hospital. I phoned her and spent a long time on the telephone discussing this situation. She'd been the emergency room doctor when we'd brought Joey in to the emergency room the month after he was hit by the car, on the occasion when he was bleeding massively. She also understood Phil and me and our concerns about castration.  (I hate even writing that word.)

She and I discussed our own observations of our dog, and our ethical (and other) issues around castrating our dog. She questioned us carefully about our observations of Joey - and why we were questioning the other doctor's diagnosis. She trusted our observations. She shared her knowledge of the medical issues involved. We listened to each other.  I took notes. 

And then she and we developed a plan of action.

Joey was due for an annual physical exam in a little over one month, and at that time we would bring Joey in for his physical and he would get his prostrate gland examined to see if it was enlarged and if it was asymmetrical. In the meanwhile, we'd be observing his peeing and pooping to see if we observed any peeing without urine coming out, if we observed any blood in the urine, and if we observed any straining on Joey's part when pooping.

I also telephoned the diagnosing doctor where Joey had been boarded and told her the plan we had reached with Joey's local veterinarian. I wanted her to understand our "issues" too. It's important for this doctor to also understand what our reservations are about her diagnosis.

So in these 5 or 6 weeks, what did we observed? Or, conversely, what didn't we observed? We didn't observed any blood. And when Joey would lift his leg, urine always came out. I mean always. Because Joey likes to mark almost every tree and almost every bush, he marks whether he sees another dog or a bunny, we'd seen plenty of urine and plenty of marking. 

Phil and I were glad to have a veterinarian with whom we could share our concerns - and can trust. Together we were going to look after Joey's well-being.

The big exam was scheduled for tomorrow.

Joey was going to have some surprise when it came time for his prostrate exam!  But more importantly, what would the examination show? Would the exam resolve our fears, or would it send us down another difficult path?

Please continue!