Generalizations

It is our nature to make generalizations. For one thing, it prevents us from having to learn things the hard way. For example, if you have learned that lions can attack and kill people, you will probably not trust any lion, no matter how friendly it seems. Another example is that we can put away our winter coats in June, because it shouldn't get that cold. June is generally a warm month (2011 possibly not withstanding).

However, generalizations can come back to bite us. Take last Sunday, for instance. A tornado crashed through part of Minneapolis and some north and west suburbs. We are all lucky that more people weren't hurt because the tornado came as a surprise to many. Usually we think of tornadoes as occurring during hot, humid days. Sunday was cold and rainy. And for some reason we think they can't hit a large city. Wrong again.

We use generalizations a lot in vet med. We have to. Otherwise, we would be testing every animal for every known disease regardless of their breed, age, and symptoms. Example: a 2 year old golden retriever that is vomiting - think GI foreign body. A 15 year old cat that is vomiting - think kidney disease. So, my first diagnostic test would probably be abdominal x-rays on the golden, but a blood profile on the old cat.

However again, these generalization can get a vet in trouble. A few weeks ago I saw a 3 year old Lab retriever for front leg lameness that seemed localized to the shoulder. A muscle or tendon sprain seemed most likely, followed by a developmental defect in the cartilage of the shoulder (most common in young large breed dogs). Rest and pain medication didn't help, so I took shoulder x-rays, which were normal, and tested him for Lyme disease, which was negative. Since he was getting worse, I referred him to a surgeon, who found a tumor on the top of his shoulder blade! It was not visible on exam when I saw him a couple of weeks ago, and that part of the shoulder blade was not in the radiograph. However, maybe if I had palpated that area instead of focusing on the actual joint, I would have localized the pain better.

You see, older dogs get bone cancer, and I have seen it in the scapula (shoulder blade). But this dog is only three years old! Cancer was nowhere on my list of possibilities.

The owners have consented to removal and biopsy of the scapula (I guess he will still be able to use the leg without it). Depending on the type of cancer, his prognosis ranges from fair to poor. I'll keep you updated on what transpires.

Jeez, after doing this for 15 years, you would think I would have learned all of my lessons. Hardly.