On 8/21/25, I brought my 10 1/2-year-old Lab/Boxer, Kammi, to Village Veterinary Care of Merton…read morebecause her abdomen was distended and she would no longer jump into or out of the car.
Dr. Robert Patyk examined her and stated her liver felt enlarged and he suspected spleen cancer. In her chart, he documented, "Internal problems likely. Neoplasia?" But after reviewing her abdominal X-ray, he said it showed "no tumors".
I later learned an X-ray cannot reliably rule out tumors and ultrasound is used to identify and characterize masses. No ultrasound was recommended or performed.
Kammi's labs showed a markedly elevated liver enzyme--ALKP 769 (normal 23-212)--and a very low thyroid value--TT4 less than 0.5 (normal 1.0-4.0).
He diagnosed Kammi with hypothyroidism and started her on levothyroxine. (I later learned a low TT4 alone cannot confirm hypothyroidism, since other illnesses can also cause a low result. Free T4 and TSH testing can help distinguish true hypothyroidism but neither was performed.)
Four days after Dr. Patyk started Kammi on levothyroxine, she began vomiting repeatedly. Her labs showed a higher than therapeutic TT4 and her levothyroxine dose was reduced by 50%. Although the vomiting improved, Kammi never returned to her normal self.
Twice over the next two months, (on 9/30 and 10/20), Kammi's abdomen became more distended and she would no longer jump in or out of the car. Each time, I brought her back to the clinic for bloodwork, thinking her medication dose needed adjustment.
Both times, Frank Mahler (whom I later learned was the clinic owner) drew Kammi's blood. At her 10/20 appt., I told Frank that Kammi had lost weight yet her abdomen remained enlarged; he told me that "dogs can carry weight in their bellies just as people do". On that day, he drew an additional tube of blood "in case the veterinarian wanted further testing" and told me someone would call me the following day. No one called, so I assumed no additional testing was needed.
When Kammi failed to improve and became noticeably thinner, I asked that she instead, be evaluated by Dr. Michael Aspan. An abdominal ultrasound was finally performed and revealed multiple masses and nodules in her spleen and liver.
Less than 48 hours later, Kammi's abdomen was severely distended, she struggled to lie down and stand, and was breathing loudly and groaning in her sleep. It was evident she was suffering.
Dr. Kathleen Blessing of Gentle Blessings (an independent in-home euthanasia veterinarian not affiliated with Village Veterinary Care) came to my home to help Kammi pass peacefully. Dr. Blessing said one of Kammi's masses was likely bleeding into her abdomen. She explained the body can often reabsorb smaller amounts of blood (which I believe explains why Kammi's abdominal swelling and refusal to jump had come and gone). Dr. Blessing said larger amounts of blood may not be reabsorbed and can cause severe pain and difficulty breathing. Kammi was experiencing both, and I had no choice but to let her go.
After losing Kammi, I carefully reviewed her medical records and wrote a detailed letter to Frank Mahler. I hoped Kammi's case would at least be acknowledged as a missed opportunity to recognize serious disease sooner and improve care for future patients. Instead, I received a written response stating her care met accepted standards and nothing had been done wrong. That response is why I am writing this review.
I cannot say whether an earlier diagnosis would have changed Kammi's outcome. However, knowing about the masses--months, rather than days before Kammi's death--would have allowed us to make informed decisions, focus on her comfort, and spare her suffering.
I believe Kammi's case involved repeated missed opportunities to investigate the possibility of cancer that Dr. Patyk himself had initially suspected. If your pet continues to decline despite treatment, ask questions and do not be afraid to seek a second opinion. I will forever regret that I did not do so sooner, and I hope sharing Kammi's story can help protect other beloved pets.
