Coated With Fur: A Vet's Life Read online

  Allie unclamped the chamber lid and nodded. I gingerly opened the door to his carrier with a towel wrapped around my hand for protection. Next, I slowly inverted the carrier over the chamber. But Spaatz remembered this maneuver from before, braced his body against the sides and hissed.

  Allie bent over and strained to look up into the carrier. “He’s not coming out,” Allie said. Spaatz assumed a spread-eagle position inside. He dug into the edges of the carrier with his claws and growled.

  “Let me give him a little help.” I rocked the carrier until I felt him move. He lost his toehold and slipped out into the chamber. Allie covered it before he could escape. She hooked the hose from the anesthesia machine to a fitting on the chamber and turned the dial to high. Spaatz wiggled his nose when he smelled the anesthetic gas mixed with oxygen and spun around the chamber, clawing and digging to get out.

  “Stop fighting it,” Allie encouraged the cat. “When you wake up, the nightmare will be over.” Spaatz ignored her. He continued to fight and claw, but he was no match for the isoflurane. With every breath, he became more and more sleepy. Finally, he lay quietly in the chamber.

  “Do you think he’s ready, Dr. Nelson?” Allie asked.

  “Let me check before you take the lid off. I don’t want to take any chances,” I replied. I tilted the chamber. Spaatz slid from one end to the other without resistance. He was out. The worst part was over, and no one, including Spaatz, got hurt. It was a small victory, but those count, too.

  With Spaatz asleep, we removed him from the chamber and passed a tracheal tube down his throat. Two minutes later, he lay on the table surrounded by beeping monitors. Allie placed a half-inch of lube in both of his eyes to protect them from drying out. I put a towel under his head and thrust an otoscope cone down his ear.

  After dealing with Spaatz’ attitude, the ear flush itself was a piece of cake. We flushed out the ball of wax with a long catheter. He returned to his cage with spotless ears and a dose of pain medicine. We propped his head up on towels to decrease the amount of swelling. He winked his eyes and for the first time, I heard him purr.

  “What’s next on the agenda, Allie?” I asked as I washed my hands at the surgical prep sink.

  “Bridget Smith will be here soon to recheck her foot,” she answered. “After that, I thought I would give Scruffy a bath.”

  With only a week to go before the big hunting trip, Bridget’s paw took a turn for the worse. I removed the bandage, horrified by what I saw. The surface of her pad had softened up and begun to slough. The normally calloused surface was pliable. Worse, the sutures had fallen out. They cut through the abnormal tissue like it was butter. Large chunks of her central pad fell off, and the remaining tissue looked like raw hamburger. Nothing would hold the laceration together now. I decided to leave it open for few days under a protective bandage. If things went well, perhaps I could try to close it again in a couple of days. The hunting trip looked highly unlikely for Bridget.

  As soon as Bridget left the clinic, Allie carried Scruffy to the kennel and gently placed him in the empty bathtub. The large tub dwarfed his small body. He stood motionless, surveying the new surroundings. Across from the tub, he heard the washer rock back and forth as it cleaned a load of towels. The strange noises intrigued him. Bottles of shampoo and various flea and tick dips filled the corners of the tub. He stood up on his hind legs and sniffed the bottles.

  While the water warmed, Scruffy explored the other end of the bathtub, away from the faucet. His eyes were huge. When the temperature reached perfection, Allie held the back of his neck with one hand and sprayed water over him with the other. Scruffy arched his back and meowed pathetically. A look of disdain spread over his face. He held up one paw at a time and shook the water from it.

  “What’s wrong, Scruff?” Allie teased. “Don’t you like your bath?” Scruffy stared into her eyes and meowed again. Before lathering him in flea shampoo, she protected his eyes with ointment. He stood on his back legs with both front feet resting on the side of the tub and continued to shake his paws. Water flew in all directions. Dark wet spots dotted Allie’s scrubs.

  Poor Scruffy looked like a skinny drowned rat. He continued to meow forlornly, all the while looking for an escape route. Genny hopped into the room to see what all the fuss was about. She stood below the tub, looking up at the bedraggled kitten. Both were about the same age, yet Genny – three legs and all – was much bigger.

  “You want to be next, Genevieve?” Allie teased. Genny promptly turned and left.

  After a 10-minute soak, Allie rinsed the shampoo from Scruffy. His meows increased in intensity the closer the spray came to his face. He had been a good sport in the beginning, but enough was enough. When Allie momentarily loosened her grip, he jumped over the side. She caught him in midair, returning him to the dreaded bathtub. Like I said, you have to be quick in this profession.

  Wrapped in a towel with only his face showing, Scruffy continued to meow. “Meeeeoooowww, meeeeoooowww.” His cries formed a staccato rhythm as Allie toweled him off. She smiled and planted a kiss on his forehead. After a quick blow dry, the bath was over. Scruffy returned to his cage, exhausted but clean. He snuggled into a thick blanket and drifted off to sleep.

  With the oil and dirt gone, Scruffy’s true colors came to life. He was a gorgeous specimen. Short white fur that felt like a fine cashmere sweater, soft and thick, covered most of his body. Patches of charcoal grey adorned his face, back and tail. It looked like someone sponge-painted these blocks of color along his dorsal line. His nose and pads were pink with a few black spots. He looked great except for the frayed whiskers sticking out in unusual directions on his face.

  Allie walked into the office, rubbing lotion onto her hands. “Scruffy is done,” she announced proudly. “Let’s get Genny’s last set of vaccinations done before the afternoon appointments start.” I nodded and followed her into the treatment room. Genny sat in front of the bank of cages, tormenting the animals inside. She so wickedly loved to do this. She held her stump off the floor. A thick callus now covered the end.

  “Come here, little princess.” I scooped her into my arms. “It’s your turn.” Genny cried and fought to escape. As a little kitten, Genny would lie in my arms for hours. She purred and kneaded my stomach as she nursed on my finger. Now, as a five-month-old teenager, she hated being held and exuded the most bloodcurdling sound whenever an insignificant human tried it.

  “Here’s her last vaccination, feline leukemia,” Allie informed me. She placed a syringe filled with pink fluid on the table. “I’ll take the Princess.” Allie held her arms out toward Genny.

  “Don’t you want to give her the shot?” I asked, still holding Genny.

  “No, I don’t want her to hate me.”

  “But it’s OK for her to hate me?” I asked with a smile. Allie ignored my question. I obediently handed Genny to her. Allie laid her on the table, holding the scruff of her neck with one hand and her one normal back leg with the other. While Allie blew into her face, I popped the needle beneath the skin on her stump leg and injected the vaccine.

  “See, it wasn’t so bad, Miss Genevieve,” I cooed. Genny’s eyes narrowed, and she swished her tail back and forth. She was not pleased. She lay on the table and licked the injection site, her tail still swishing. She was mad with a capital M.

  Allie, still with a firm grip on the cat, bent over and whispered, “Just remember Genny, it was her, not me.”

  Chapter 8

  Owner’s Intuition

  We only had one appointment scheduled for the entire afternoon. A cat named Max was having accidents in the house. While his owner Joyce Segal, got ready for work, Max jumped into the sink, postured and urinated right in front of her. At the end of his stream, he produced a few drops of blood-tinged urine.

  A year ago, Joyce found him lying in the litter box, straining to urinate. She rushed him to the emergency clinic for care. The veterinarian felt his abdomen and made the diagnosis. Max had feline urinary syn
drome (FUS). Minerals in his urine precipitated out of solution and formed small pieces of grit in his bladder. When he urinated, the grit clogged his urethra. The cat could not urinate, and his pain seemed unbearable. The veterinarian knocked Max out, passed a urethral catheter and drained his bladder. The urine looked like tomato soup as it flowed into a collection bag. After three days of treatment, and being tethered to a bag, he went home. He now passed yellow urine with ease.

  The large orange cat sat on the table as his owner recounted his medical history. His magnificent markings caught my eye. Beautiful swirls of deep rust-colored fur danced across his sides. The swirls formed a perfect M on his forehead like Genny, the final exclamation point for this classic tabby. He thumped his tail as cats do when annoyed. When Joyce finished speaking, he stood up, walked to the end of the table and urinated right in front of us.

  A look of horror spread across Joyce’s face. She grabbed a tissue from her leather purse. “Don’t clean it up,” I instructed. Her hand froze in mid-air, and she shot me a quizzical glance. I retrieved a syringe from the cabinet drawer and aspirated the urine off the table-top. I needed to analyze it for crystals. Since Max provided a sample, we would not have to stick him.

  While Allie studied the urine, I examined Max. His bladder felt empty and soft.

  “Good news, Joyce,” I announced. “He’s not blocked. You caught it before it became an emergency.”

  A look of relief spread over Joyce’s face. “That’s the first thing that’s gone right all day.” She smiled but did not elaborate. “Why did this happen?”

  I needed to do a little detective work before I could answer. Once Max received the FUS diagnosis, he started on a special diet to dissolve crystals in his urinary tract, then switched to a maintenance diet to keep any more from forming. Logically, the maintenance diet contains a higher amount of salt to increase water consumption. It also has reduced amounts of the minerals that form crystals.

  Even so, some cats require distilled water to keep the problem in check. I have also observed that cats who suffer from chronic upper respiratory infections seem to have more recurrence than those who do not. I asked Joyce about his food and water. She reported that Max only ate a special diet.

  “Do you remember the name?” I continued to probe. Unfortunately, she couldn’t come up with the exact name. I listed a few, hoping to jog her memory.

  “I used to feed him food that I purchased from the vet,” she replied. “But he gained a lot of weight, so I switched him to another brand one month ago.” She picked it up at the grocery store. It was cheaper and more convenient than making a trip to the clinic.

  “Well, that’s the problem,” I replied. “Only the prescription diets are formulated to prevent the crystals from forming. The food is actually a treatment, which is why you have to purchase it from a veterinarian.”

  “But the package said it was good for urinary health,” she countered.

  I wish I had a dollar for every time I heard that statement. I could buy an incubator and still have money left over. Many brands of commercial cat food recently added this language to their packaging. Typically, these diets contain reduced levels of magnesium and ash to discourage crystal formation. But they do not contain acidifiers and all the other modifications needed to fully treat this condition. Sometimes marketing and medicine make poor bedfellows. The language confused people into buying the wrong food.

  When Joyce realized her mistake, she placed her hand on her head and rubbed her temple. “I thought I was doing the right thing for Max,” she whispered.

  “Don’t feel bad. I’ve seen many other people do the same thing.” It was too bad for Max, though. He could have been spared a lot of discomfort. From her perspective, the vet bills would now exhaust the savings in food and then some. I made a note in Max’s record. “Also, I want him to drink as much water as possible to flush out his bladder.”

  “He likes to sit in the sink and catch drips from the faucet,” Joyce said.

  “Great, let him do that several times a day.” I picked up his record and got ready to leave the room. Joyce promised to never change his food again without prior consultation.

  While I worked with Max, a woman arrived at the clinic with Sadie, her cocker spaniel. Paula Anderson found her beloved pet huddled in the corner when she returned from work. Small puddles of foam surrounded her. The poor dog moaned and gagged when Paula patted her abdomen. More white foam dripped from her mouth. Sadie’s regular vet could not see her. They recommended going to the emergency clinic when they opened at 6 p.m., but Paula didn’t think Sadie could wait. She remembered our sign for the Minnesota Veterinary Center and brought the dog here.

  From the history and clinical signs, I suspected a condition called bloat. The stomach fills with gas or food until it can no longer empty. As more pressure builds, the stomach stretches to its limit. Blood flow through the body is interrupted. If the stomach is not decompressed quickly, shock develops. In the worst-case scenario, the stomach actually twists on itself. These patients require emergency surgery to reposition the stomach before the tissue dies.

  As I examined Sadie, her buddy, Maddie, paced around the room. The vizsla stopped every few steps to look up at Sadie. White foam continued to fall from Sadie’s mouth. I wiped it away and pushed my finger-tip into her gum, just above the big canine tooth on the left side. The pale pink gum blanched white and stayed that way for over two seconds. I ran my hand down the inside of her back leg until I felt the femoral artery pulse beneath my fingers. It was much weaker than I expected. With the stethoscope on her chest, I counted heartbeats and breaths. Both were elevated.

  Next, I placed my hands on her abdomen. Most bloats occur in large or giant-breed dogs because they simply have more room in their abdomens than they need for their stomachs. While bloats may occur in any breed, I had never seen one in a cocker spaniel. Sadie’s abdomen felt hard beneath my fingers. She moaned when I tried to palpate her stomach. I stopped immediately and patted her head.

  “I’m glad you brought her right in, Ms. Anderson.”

  “Please, call me Paula.”

  “I think she’s bloated. It’s unusual in small dogs like Sadie, but her signs are classic. We need to take an X-ray of her abdomen to confirm the diagnosis.”

  Paula’s lower lip quivered. “Is it fatal?” Her voice cracked as she spoke.

  Her response surprised me. Perhaps I had not been as attentive to her nonverbal clues as I should have been. I tried to be more supportive and explained that while bloat can be fatal, most patients survive. The key is early diagnosis and treatment. We would start Sadie on fluids right away. If it was a simple bloat, I would pass a tube to relieve the pressure. If the stomach was twisted, she would need surgery.

  I paused to let Paula absorb my words. Tears welled up in her eyes. She hugged Sadie then backed away from the table. Maggie put her front paws on Paula’s knee. The sandy colored dog studied her owner’s face for a minute before looking back at Sadie.

  I wrapped Sadie in my arms to carry her to the treatment room. She moaned in pain.

  A fresh bag of fluids hung from the I.V. stand in the treatment room. Allie clipped the dog’s leg, disinfected it with iodine and placed the catheter. In less than two minutes, fluids dripped into Sadie’s vein. The sickly pale pink color of her gums blossomed into a deeper hue of pink. Now it was time for an X-ray.

  I carried Sadie through the kennel into the radiology suite. Allie pushed the I.V. pole and fluids behind us. We suited up in our colorful blue thyroid collars and lead-lined aprons, the heavy protective garments weighing us down. We lay Sadie on her side for the first film and on her back for the second. Allie slipped off her lead apron and headed to the darkroom with two cassettes in hand. Still clad in protective gear, I sat on the radiology table with Sadie until she returned.

  “OK, both films are in the processor. It shouldn’t be long now.” Allie pulled out a large storage folder and wrote “Sadie Anderson” on the patient l
ine. Next, she pulled a warm towel out of the dryer and wrapped it around the dog. The room-temperature fluids made her shiver. As I put my arm around her for added warmth, her blond fur felt like silk.

  Cocker spaniels express so many emotions with their eyes. Sadie looked at me with her big brown eyes and begged for help. Her abdomen had grown larger in the short time she’d been in the clinic. She fidgeted back and forth on her front feet. The pain must have been unbearable.

  The first film landed on the tray with a thud. Allie walked into the radiology suite, holding the film above her head. She used the overhead lights to illuminate it. I watched her eyes widen as she focused. “Whew, she’s bloated all right.” She handed the film to me. I snapped it in place on the view box.

  “Wow!” I gasped at the size of Sadie’s stomach. Never in my short career had I seen such a big stomach in this size dog. “We need to decompress her right away,” I explained to Allie. In the center of the X-ray, a large black-colored circle filled most of the area underneath Sadie’s ribs. Allie joined me at the viewer with Sadie in her arms. I scanned the film, looking for additional problems. The stomach did not appear twisted, and I found no obvious masses that might initially have caused the bloat. “I’ll talk to Paula and get permission to knock her out.”

  Paula assented without hesitation. Allie and I worked quickly. We anesthetized Sadie and placed a trach tube down her airway. When she reached a good plane of anesthesia, Allie rolled Sadie on her side. I threaded a clear plastic tube down her esophagus; the tip stopped as it hit the stomach. I pushed with a little more force, but the tube would not budge. The distended stomach pinched the cardiac sphincter closed. It felt like the tube hit a brick wall.