Monday. Olive is a very small, two year old Boston terrier with a very big problem. Her lymph nodes are enlarged and firm—not a good symptom. Lymph nodes are multiple structures dispersed all over the body that serve as a sort of clearinghouse for white blood cells.

Lymph nodes will usually get bigger when the body is actively trying to deal with an infection. They will also swell under some more sinister conditions, including cancers of the blood and other tissues.

In young dogs, multiple lymph node swellings, referred to as generalized lymphadenopathy, is a common sign of leukemia. The most common leukemia is known as lymphoma, and while it is treatable, a dog’s lifespan will be drastically reduced. If untreated, their life spans often dwindle to only days or weeks of comfortable life beyond the time they are diagnosed with the disease. Other leukemias can take longer courses, but rapid treatment is important to the dog’s longevity.

No matter the variety, these are not good cancers to get; not least because, as in humans, they affect young, otherwise healthy animals.

So now that you have the background, I’ll tell you Olive’s story:

Her owner sees lymph nodes enlarged back in February. We run preliminary tests, which prove inconclusive. The owner, a really sweet young woman, says Olive feels fine. No need to run further tests. We have the cancer talk. I urge that she see a specialist, especially since treatment of some leukemias can be time-sensitive

I don’t see her again for months.

She comes in today (sans Olive) to apologize for having been to another vet for a second opinion (no apology necessary, I just wish she’d spent her money with a visit to an internal medicine specialist, a far more productive option she should have taken long ago).

The other vet (a fine clinician) had performed the same tests. They amounted to the same thing—no diagnosis. Now Olive has five months less on her disease, whatever it is. I don’t know it’s cancer—but what if it is??

And, guess what? Her owner still doesn’t want to go the next step: a lymph node biopsy (a 15 minute anesthetic procedure) or a trip to the specialist. Olive feels great. How about some pills instead?

So now I think to myself: What is wrong with this woman? Denial is a very long river, indeed.

My plan: tonight I will research Olive’s condition in lots of client-friendly language and print out a bunch of useful information with yellow highlighter all over it. No one can ignore all that info when someone went to a whole lot of trouble over it.

Right?

To be continued…