Bao and I managed to get to Mexico for a few days, but last week, another pericardial effusion. This is the fourth time he's had to go through this. Nobody knows what's wrong. The antibiotics don't seem to be making much difference. Today we saw an internist, and they ultra-sounded Bao's whole body and found "nothing remarkable". Now they're saying it's probably cancer, mesothelioma, which doesn't show up on scans and sometimes, doesn't show up in a biopsy. So how do they know whether or not he's got it? Well, they don't. Apparently, when they can't find anything else they simply assume it's cancer.

Cancer or no cancer, the only way to stop pericardial effusions is to cut a "window" in the pericardium. Unfortunately, there is a fairly high element of risk attached to this procedure. In fact, I'm not nearly as scared of the cancer (if it's there) as I am of heart surgery, which is what this is. (Amazingly, there is a video of this surgery on YouTube. I haven't watched it. There is such a thing as too much information)

Our cardiologist has suggested that we go back to the University of Colorado Veterinary Medicine Hospital to have the surgery done. He says all the best people in the field are there, under one roof. Although he could do the surgery himself, he told me that if Bao was his dog, he'd take him to Colorado. So I guess that's what we're going to have to do.

The internist did some blood tests, and we'll have the results of those tomorrow. But I could tell that even without the results of the tests, she thinks the pericardectomy is our best -- and only -- option.

In a way, she's right. Even if we never find out what's causing this, the surgery will eliminate the pericardial effusions, which could kill him instantly. After the pericardectomy, if fluid does continue to accumulate, it will accumulate in Bao's pleural cavity, where it's more easily dealt with. And if he does have cancer, I suppose it's better to know sooner rather than later.

Bao is snoring happily on the couch. He doesn't have a clue what's going on. He's not in pain. He's not frightened. He's fast asleep, with his dear little head pillowed on one of his stuffed toys.

He's fine. I'm terrified.