Coated With Fur: A Vet's Life Page 22

  “I know this looks bad right now, but I’ve had good luck treating these cases,” I said. I petted Sadie’s head. “We’re going to give her supportive care for tonight. Right now she’s really nauseated, so she won’t eat or drink. Tomorrow we’ll pursue further diagnostic work.”

  “So she’ll stay in the hospital tonight?” Paula asked.

  “Yes, most of the animals with this condition stay in the hospital for a few days,” I said.

  “Maggie is going to go crazy without her,” the owner replied. “These two are inseparable.”

  “Don’t worry,” I soothed. “I’ll give you some tranquilizers for Maggie.” I motioned for Allie to take Sadie in back. “Give Maggie one as soon as you get home and then another before bed. That should get her through the night without any problems.”

  “Can I take one, too?” Paula asked.

  “Sorry, you’re on your own.” I squeezed her arm. “I promise to call if anything changes.”

  “Thanks, Dr. Nelson, please take good care of her,” Paula said. “You have no idea how traumatic this is. I’m going through a divorce. I just can’t lose her now.”

  “Hang in there, Paula,” I said. So often, other events in people’s lives are magnified during times of medical crisis. It only added to the pressure I felt to help Sadie recover.

  At 5 p.m., I sat down in the office to catch up on paperwork. A six-inch stack of records occupied one side of the desk; Genny took up the other. Her beautiful tortoiseshell markings matched the teak wood perfectly. Although I enjoyed her company, she left me no room to work.

  I pulled the first record off the pile and laid it on my lap. The label on the front cover read “Sadie Anderson.” I flipped to the examination sheet and made notes in the medical history and physical examination sections. In the short time since her admission to the hospital, Sadie seemed less disoriented. Her nystagmus slowed from 10 oscillations in 10 seconds to five. She still held her head in a twisted position, but wasn’t rolling anymore.

  Under the treatment plan category, I made the following note: “Sadie is responding well to conservative therapy. Continue with supportive care overnight. Consider further diagnostics tomorrow as warranted by her condition. Keep her cage padded to prevent injury if she starts to roll again. ****Do not leave her alone with the I.V. line attached. Monitor closely to make sure she does not entangle herself in the line. Owner was notified that Sadie is progressing faster than expected.”

  I closed the chart and dropped it to the floor. Genny jumped when it hit the ground. One by one, I continued to update the records on my desk. Business was picking up. I was so grateful, and Steve’s stress about the practice seemed to be abating. I welcomed the increase in revenue, but with it came a decided increase in paperwork. With two records to go, Allie stopped by. In her hands were a bowl and a tongue depressor.

  “Dr. Nelson, I’m fixing Trudy’s dinner,” she said, tilting the bowl toward me. Inside I saw two chunks of canned dog food, about a quarter of a cup total. “Is this enough?”

  “That’s plenty for her first meal.” I stood up, and so did Genny. She stood facing the bowl with her nose high in the air. “I sure hope she eats this!” I said.

  “Me too,” Allie echoed. “Me too.” Allie used the tongue depressor to break the two chunks into smaller pieces as we walked back to the kennels. Genny jumped from the desk to the chair to the floor and followed us. Every few steps she stopped and sniffed the air again. If ever a cat was precious to observe, this stunning three-legged beauty was it.

  When we reached the kennel, Genny stopped at the doorway and rubbed on the doorjamb. The friendly Samoyed next to Trudy started to bark and whine. Genny sat down and looked at him with utter disdain, casually licking her paw and rubbing her ear. She took a sinister delight in reminding other animals that they were behind bars. The dog moaned and spun in circles in his run.

  “Time for dinner, Trudy,” Allie announced as she opened the door to the run. Trudy rolled up onto her side and blinked. Allie held the bowl out in front of her. When the aroma of the food hit Trudy’s nostrils, she sprang to her feet and shoved her face into the bowl, almost knocking it out of Allie’s hands. Two gulps later, Trudy looked up with ears at attention. She clearly wanted more. She licked the bowl and continued to beg.

  “May I give her a little more, Dr. Nelson?” Allie asked.

  I shook my head to emphasize the point. “No, that was plenty. She’ll get more if she holds this down.”

  Genny stood on her hind leg with her front feet over the block threshold. She looked around for a minute and then jumped right into Trudy’s run. Trudy sat down, a puzzled look on her face. Genny stood on her one back leg, placed one front leg on Trudy’s neck for balance and the other on the dog’s face. She licked the corner of Trudy’s mouth.

  “Genny!” Allie exclaimed. “That’s Trudy’s dinner. I’ll feed you next.” She picked Genny up and closed the gate behind her. Genny struggled in her arms and complained loudly. “I don’t know how to tell you, Dr. Nelson, but you and Steve raised a brat.” Genny continued to meow.

  “It wasn’t us,” I replied. “Blame it on my parents. They undid all of our good training when she stayed with them.”

  “Yeah, right,” Allie responded. She placed the matron of the clinic back on the floor. Genny’s eyes flashed with anger. She sauntered over to Allie, swatted her leg and then scampered away. I erupted in laughter. Allie was not amused. “See what I mean?”

  Trudy stood on her back legs with her front feet braced against the gate. She barked loudly twice, making both of us jump. When we looked at her, Trudy swung her tail in enormous arcs. Her entire rear end swayed back and forth. Joy has seldom been expressed with such eloquence.

  “See, even Trudy agrees with me.” Allie reached over the gate and petted her head. Trudy continued to wag her tail. She felt great. Trudy, Officer of the U.S. Customs Service, was coming back!

  Chapter 27

  Cow Doc

  At precisely 9 a.m., Frank walked through the front door with Trudy at his side. She pranced into the clinic, eager to see her friends, her black fur glistening in the sunlight. In the three weeks since her hospital stay, Frank slowly worked Trudy back into her normal duties. Now he eagerly awaited this recheck, hoping they could put the long ordeal behind them.

  “Good morning, Allie,” he said. Without waiting for a reply, he marched Trudy straight to the scale. She pranced onto it. “Stay,” he commanded with a seriousness reflecting his role as a law enforcement officer. Trudy froze and locked her eyes on his face. The numbers on the digital display bounced around for a few seconds. It stopped on 47 pounds, almost her normal weight. So far, her recovery was right on target.

  At Frank’s signal, Trudy jumped off the scale into Allie’s arms. The dog’s ears flopped back against her head, her mouth open in a silly grin. Allie ran her fingers through Trudy’s coat and scratched the area under her collar. Trudy closed her eyes and savored the moment.

  “OK, let’s go draw your blood. Follow me,” Allie said. She escorted Trudy and Frank into the pharmacy area. Trudy heeled by his left leg, her eyes darting around the room and her tail waving back and forth. She wanted to explore, but the highly trained canine that she was, she stayed in perfect heel position.

  “Hello, Frank, it’s good to see you again,” I said, shaking his hand. “And Trudy, how are you?” Trudy looked up at Frank and waited for a signal. Her tail continued to wag at warp speed. Once he gave her a sign, she jumped toward me with a wild grin on her face. I wrapped my arms around her. “Well, I’m glad to see you, too.” She looked into my eyes and licked me silly.

  As the blood test processed, Trudy zipped around the clinic. She stopped in front of the treat jars and waited for Allie to give her one. When the dog finished exploring, she returned to the pharmacy and lay down next to Frank. Genny caught a glimpse of her from her perch on the office desk chair. She sauntered over and sniffed Trudy’s body from head to toe. Trudy looked at Fr
ank for guidance. She couldn’t understand Genny’s forward behavior.

  “Trudy, you remember Genny, don’t you?” I smiled, showing my dimples. “She tried to steal your food, remember?” Trudy got up and stood behind Frank’s legs. This big brave dog that searched warehouses and luggage carousels was visibly uncomfortable around my little cat.

  When the timer read five minutes, I picked up a small tube marked “Trudy” from the test tube rack. Slowly, I inverted the tube. Trudy’s blood sloshed down to the other side. It was still liquid. My heart quickened as I repeated the process. Each time I inverted the tube, blood ran from one end to the other without any signs of clotting.

  “I’m afraid she’s not clotting, Frank.” His face blanched. I showed him the tube. His jaw quivered ever so slightly as he watched the blood inside. He took off his gold-rimmed glasses, wiped them on his shirt and replaced them.

  “But she seems fine.” He cleared his throat. “You can treat her, can’t you?”

  “We need to start vitamin K1 immediately, or she’s going to bleed again.” Frank looked down at Trudy, his eyes brimming with tears. Trudy sensed something was wrong. She searched his face, rubbed her body against his leg and nuzzled his hand with her nose. “I’m going to inject her again just to be safe. I want you to start the capsules tonight.”

  “But she’s going to be OK, right?” he pleaded. “I mean, did we catch it in time?”

  “Yes, we caught it in time.” I looked at the tube again. At 10 minutes, the blood still ran like water. “I’ve never seen one before that didn’t clot at all after three weeks. I’ve had a few with prolonged clotting times but never one that didn’t clot at all.” I inserted the tube back into the rack. “She got into some nasty, nasty stuff.”

  Frank held Trudy as I injected her with the vitamin. The thick solution flowed slowly through the syringe. Trudy squirmed but did not try to bite. With the antidote administered, she climbed into my lap and cuddled. Trudy needed time for the vitamin K1 to kick in. I instructed Frank to give her two days of rest before starting half days again.

  “We were supposed to inspect several flights this afternoon,” Frank replied. A somber mood spread over him. “My boss is not going to like this.”

  “Well, tell him to call me if he has any questions. But I don’t want her to work today, especially the luggage carousels. It’s just too risky.”

  “OK,” he replied. “Trudy’s health comes first.”

  After Frank left the clinic, I headed to the office for my scrubs. Allie had blocked off most of the morning for surgery. Interesting cases filled the schedule.

  Cleopatra Davenport was up first. Stacy had found another mammary gland tumor on the little poodle’s body. Although this tumor was smaller than the previous ones, it struck me as more aggressive. Many blood vessels grew into it, and the skin in the area had a strange purple cast. The skin looked like it was ready to rupture.

  When I emerged from the bathroom, Allie stood next to the treatment table. The clippers buzzed in her hand as clumps of white fur fell to the floor. Cleo lay on her back with a tracheal tube down her throat as monitors beeped around her. A few wisps of brown hair protruded from Allie’s surgical cap. A mask tied only by the bottom strings hung from her neck, swinging back and forth over Cleo as Allie worked. The radio played rock and roll in the background.

  “I can transfer Cleo myself, if you want to start scrubbing,” she said, continuing to work.

  “Is that a hint?” I asked.

  “Maybe,” she smiled. “I would love to finish surgeries on time for a change.”

  The instant Allie stopped speaking, the phone rang. She frowned and snapped off the clipper. I waved her off.

  “Minnesota Veterinary Center, how may I help you?” I answered without identifying myself.

  “Kris,” the feminine voice answered. “Is that you?”

  “Hi, Melanie,” I replied. “What did Rusty eat this time?” Allie looked up and laughed.

  “Kris, I’m not calling about Rusty,” she said, slightly perturbed. “Rachel is sick. Her pediatrician doesn’t know what’s wrong.” Her voice trembled. “I’m sorry to bother you, but I didn’t know who else to call.”

  For the past two months, Melanie’s daughter had suffered severe bouts of diarrhea, soiling her bed every night. I cringed at the thought. She had lost 10 pounds and looked like a walking skeleton. Her pediatrician ran all kinds of tests on her, but found nothing. The standard anti-diarrheal drugs were of no use. She woke up in a mess every morning.

  “Now they want to anesthetize her for another series of tests.” Melanie’s voice trembled even more. “She’s so thin, I’m afraid she’s going to ...”

  “What medications has Rachel been on?” I interrupted her. Melanie rattled off a list of different drugs. When the trade name was unfamiliar, I asked her to read the generic. I hoped the past drug failures would help me rule in and out possible causes.

  “Melanie, did the pediatrician check for Giardia?”

  “Uh, I don’t know,” she responded. “What’s Giardia?”

  That year, I diagnosed more animals with Giardia infestations than ever in my career. The waterborne intestinal parasite causes horrible diarrhea in animals and humans. It’s often seen in individuals who drink unpurified stream water when hiking. I suspected the heavy spring floods had contaminated our drinking water.

  Allie pushed the anesthetic machine into the O.R. with Cleo in her arms. I pressed my body into the wall to get out of her way.

  “I don’t think it’s that because they’ve checked her stool several times and never found anything,” Melanie replied.

  “I know, Melanie, but since human parasites are so rare in the U.S., our physicians aren’t the best at finding them unless they have third-world experience,” I said.

  The organism can be hard to diagnose. Traditionally, the discovery is made from a fecal sample. Unfortunately, the kite-shaped organism is difficult to spot because of its small size and transparent appearance. In addition, the organism is shed intermittently. Depending on the stage of infection, there could be thousands or none in the sample. A veterinary company is working on a snap test that will make diagnosis more straightforward.

  “Until a better test is available, I sometimes run a therapeutic trial,” I said.

  “A therapeutic trial,” she repeated. “What does that mean?”

  “It means you give the drug and see if the diarrhea responds.” The line went silent. “Melanie, if I were you I would run a fecal sample on Rusty. Since Rachel and Rusty are inseparable, I think Rusty might give us the answer to Rachel’s condition.”

  “You know, Rusty had some diarrhea awhile ago. I just thought he ate something again but ...” She paused. “It was about the same time Rachel started soiling the bed. I never put the two together.”

  “I’m not 100 percent certain that’s what Rachel has, but I sure am suspicious,” I replied. Allie motioned to me through the O.R. window. “Well, I need to scrub for surgery. Get a fresh stool sample from Rusty and bring it right in for ...” I heard the phone click, and the line went dead. Melanie was on her way. “... a fecal analysis.” I hung up the phone. It was time to work on Cleo.

  Now that Stacy knew how to check for breast cancer in dogs, she checked Cleo all the time. Every evening, she felt Cleo’s body while they lounged in bed. Lady lay next to them and waited for her turn. Last night, Stacy noticed the bruised area on Cleo’s mammary gland and tossed and turned all night, worrying about the new lump. She wanted it off immediately.

  When Allie had arrived at the clinic, Stacy was waiting outside with Cleopatra dressed in a pink sweater. Cleo seemed to like the sweater even in our hot, humid weather of July. This time I took the entire gland when I removed the lump. Allie placed the excised tissue in a large specimen cup filled with formalin and wrote “Cleopatra Davenport” on the label.

  Because of their small size, poodles lose body heat quickly. Poor Cleo shivered uncontrollably as she woke.
I wrapped her in towels warmed in the dryer and placed her in the incubator. While Allie set up the O.R. for our next patient, I sat with Cleo to monitor her recovery.

  “Ding, ding,” the doorbell chimed from the pharmacy. I instinctively knew who it was.

  “Allie, Melanie is here with a stool sample on Rusty.”

  Ten minutes later, Allie marched into the treatment room. She almost stepped on Genny who was playing with a dust bunny. “Dr. Nelson, you were right!” she exclaimed. “Rusty has Giardia.” I smiled with relief. “His stool stunk to high heaven. I found it on the direct. He was loaded with them.”

  “Draw up some metronidazole for him,” I instructed. “Tell Melanie I’ll be out to talk to her in a few minutes.”

  “Too late, Dr. Nelson,” Allie replied. “She took off as soon as I told her the results. She’s on her way to the pediatrician’s office. Her husband will swing by for the meds on his way home from work.”

  “I guess I would do the same thing if my kid was soiling the bed every night,” I agreed. “How is Rachel?”

  “She looks awful,” Allie observed. “And she didn’t get into trouble like usual. She just sat in a lobby chair.” I shrugged. Like Rusty, Rachel never sat still. She must be really sick.

  We finished our final surgery in record time. I pulled off the surgical gown, crumpled it into a ball and tossed it into the dirty clothes basket. With all the patients doing well, we could finally eat lunch. I grabbed mine and settled down in the office. Halfway through a sandwich, Allie burst into the room. Rachel’s pediatrician was on line one and demanded I speak with him immediately. I picked up the receiver, took a deep breath and hit the button for line one.

  “Hello, this is Dr. Nelson.” Allie stayed by my side.