This isn't the call I was expecting to make today

It has been a weird week. I'll back up to a couple months ago to get the back story.

When we adopted Phineas, his "mom" had gotten all of his shots and medical needs taken care of in 2021. This February it was time for us to take him in for a checkup and Rabies shot and the whole thing. 

His former Mama came to visit us right before the appointment and noticed something we'd also noticed - he was walking funny, favoring his back right leg. I said it was on my list of things to check on with the appointment. 

Appointment came and I asked them to check it out. The vet called me and said his back right leg was kind of "Jacked up" and asked if he'd been in an accident recently, fallen, something. Nope. A whole lot of nothing. We'd noticed the sudden onset of the gimpiness, he wasn't bending his knee much and sleeping with it straight out. He has been a little extra moany and groany, which he always was a little but it has increased to a noticeable way. He had been a little more reluctant to jump up into bed too lately, and one of us always spots him, just in case he can't make it. 

She suggested that he needed a dental cleaning, which had to be done with sedation. We could do X-rays at the same time and see what the story was. 

The appointment was Tuesday, and the vet called me when it was time to pick him up and give me the update. I fully thought he'd tell us he has arthritis. He thought he would be telling us the same thing.  

"This isn't the call I was expecting to make today..." he started with. 

"Oh no," I replied. 

He told me the dental cleaning was great. Teeth are perfect. No worries there. But the leg X-ray indicated nothing wrong with his knee, his hip was showing a fracture that didn't look like a fresh injury, or even a normal fracture. He described it as a "Pathological Fracture" meaning it was caused by something, such as cancer. 

Really? What? You're joking. He said no.

They went back in for more images, and found a mass in his abdomen. So his thoughts were that Phineas either had bone cancer that had metastasized, or, the mass was the original cancer and had spread to his bones. He recommended a pathological radiologist look at the X-rays, and try to make a call on what was happening. We agreed to have that done. Got the results today. Here's the medical jargon: 

FINDINGS: The left coxofemoral joint is normal. There has been prior trauma to the right coxofemoral joint. It is very likely that there has been a chronic fracture of the femoral neck with a markedly displaced femoral head. There is severe remodeling to the acetabulum and there is dystrophic mineralization around the presumably fractured femoral head and neck. The greater trochanter is cranially displaced. There is marked muscle wasting on the right. The lateral position of the patella bilaterally is considered positional. A focal lucency within the proximal tibia bilaterally is a normal finding. The stifles otherwise appear normal. 

Within the included abdomen there is a large mid-abdominal soft tissue mass.

CONCLUSIONS: This is very likely a chronic fracture of the right femoral head and neck with secondary severe remodeling and dystrophic mineralization. A more aggressive process is unlikely. However, there is also a large intra-abdominal soft tissue mass which may be arising from the spleen. Malignant neoplasia such as hemangiosarcoma or a benign hematoma are possible. Other origins of the mass are not excluded.

Above here, in the right hip, you can see that his right femoral head and neck are completely trashed, compared to the left one there which looks perfect. 

And it is almost like his right leg is shorter than the left too.

And there's the mass - it's kind of huge. That's the major issue right there for him. 

We are not sure at all what happened to the hip but it's probably been that way forever. If he's never had X-rays, his former ma would not have known. No one would know. 

And then there's that mass. I asked if they could do a needle biopsy and he said he wouldn't do that. If it is a hematoma, he could puncture it, cause internal bleeding, and it would be the end. He also said he wouldn't get a good sample of anything to test with a needle biopsy, so they'd have to operate anyway. 

Here's what he recommended: We remove the spleen and the mass.

1. If it is a hematoma, he's all set - no further fixing needed!
2. If it is cancer, it's out of there and we bought him time. Who knows how much. 
3. If it is cancer, we probably wouldn't do the whole chemo/radiation thing to an 11 yr old dog. We'll just give him his amazing life.
4. Removing it would be a good safety move, in case it bursts or he gets hurt and it ruptures. It could continue to grow, and rupture. And if it is cancer it will probably spread to the next vascular neighbor, his kidneys or liver. So his prognosis would be very short.

If we thought everything with him was perfect in January, his gimpiness and wobbly walk could be because he's uncomfortable, because the mass has gotten so large he's just having a rough time with it. 

Doug asked for an estimate for surgery, and it actually affordable and reasonable. We were kind of surprised. 

I believe I'll call tomorrow and set things up, the sooner the better, I think. 

We thought we'd get another 3 or so years out of the old bean but it feels like we'll be lucky if it is 6 months. 

We will see what happens.