Tales from a Wild Vet

by Jo Hardy

‘It took me ages to get her in there,’ the puzzled owner will say. ‘I just don’t understand why she won’t come out.’

  Because she’s at the vet’s.

  It’s extraordinary how, despite the fact that there’s nothing in the cat crate to hold onto, a cat can jam itself inside so firmly that it takes a lot of coaxing, prising and effort to get it out. At which point some cats give in, while others make their displeasure clear by biting or swiping at the hapless vet. Many dogs will patiently put up with a vet gently prodding and poking to find out what’s wrong, and warn you by growling if they’re thinking of snapping at you, but cats give no warning at all – then they can object, loudly and speedily, claws unleashed and sharp little teeth at the ready. The only indication of approaching trouble is the occasional twitch of the very tip of the tail.

  Owners are always terribly embarrassed when their cats bite or scratch, but we tell them it’s not their fault – the cat is in a strange environment and doesn’t like it.

  Don’t get me wrong, I love cats, and I know that some are docile, easy to manage, cute little felines, but others, as every vet knows, are tigers hiding inside the bodies of apparently innocent moggies. Do something they don’t like and suddenly it’s war.

  Cats get stressed very easily. A lot of feline complaints are due to stress, and one of the biggest causes is change, of any sort. Owners often don’t realise that even something small – moving the furniture around, having strangers in the home, a new cat in the neighbourhood – can provoke stress symptoms in their cat. As for a major change, like moving home, many cats protest by simply disappearing for days at a time.

  In my second week at Downe I had a run of cat cases that reminded me of just how hard cats can be to understand. One morning Joe asked me to go on a house call to see an elderly woman who wasn’t able to bring her cat into the surgery. The cat had been diagnosed with cystitis the week before and it didn’t seem to be clearing up. He suggested that, as I was new to the practice and the area, I take Sammy with me. Sammy was a cheerful, bright young nurse and she knew the way to Mrs Dixon’s house, so I was glad of her company.

  When we arrived Mrs Dixon, who was in her eighties, introduced us to her rather elderly ginger cat, Clarice, who glared at us from behind a chair.

  ‘I’ve shut her cat flap so that she can’t get out,’ Mrs Dixon explained. ‘But she’s not happy about it.’

  We could see that. Clarice may have been elderly, but she clearly had plenty of fight in her.

  I asked Mrs Dixon how Clarice was doing.

  ‘She’s still using the litter tray, far more often than usual, and she seems to be agitated. She’s had antibiotics, but it hasn’t cleared up. Is there something else we can try?’

  Cystitis, in other words an inflamed bladder, is common in cats. And while in dogs the cause may be a bacterial infection, cats have very concentrated urine that kills off bacteria, so the more common cause of their cystitis is stress. We call it Feline Idiopathic Cystitis – ‘idiopathic’ meaning of unknown cause. When that happens a bit of detective work is often what’s needed.

  ‘Has there been any change in Clarice’s routine, or in your home, lately?’ I asked.

  ‘Well, no, I don’t think so,’ Mrs Dixon said, pausing to think. ‘The only thing that’s different is that I’ve had a new back door fitted. But it couldn’t be that, could it?’

  ‘May I have a look at it?’ I asked.

  The old lady led Sammy and I through to her small kitchen. There was the smart new door – with glass panels fitted in the top and bottom.

  ‘Did the door have glass in it before?’ I asked.

  ‘Actually, it didn’t. I wanted glass because the kitchen was so dark. It’s much lighter now; I’m really pleased with it. That wouldn’t be what’s bothering Clarice, would it?’

  ‘It could be. Has she been reacting to the new door in any way?’

  ‘Now you come to mention it, there’s a tomcat next door that sometimes hangs around outside, especially with this new door. He parades in front of it. Clarice doesn’t like it at all. When she sees him there, she runs out of the room.’

  ‘I think that might be the cause of her stress. Perhaps you could cover the glass in the bottom half of the door with cardboard and see how she is then. I’m sorry, it will mean a bit less light in the room, but you won’t need to cover the top half, just the bit at Clarice’s eye level. And if it makes a difference we have our answer.’

  ‘Goodness, I would never have thought that could be a problem,’ Mrs Dixon said. ‘Poor Clarice, she must be feeling very upset.’

  ‘If we’ve found the cause, she’ll soon be better,’ I said. ‘And in the meantime make sure she gets as much water as possible, it will help ease the symptoms. Put a bit of water in her food and try running the cold tap slowly – cats love running water and she may drink from it. I’ll give her some anti-inflammatories, too. Give me a call in a few days and let me know how she’s doing. If she’s not better we can run some more tests.’

  It’s always nice to do a bit of detective work and come up trumps, so I was really pleased when, five days later, Mrs Dixon rang to say that Clarice was much better.

  Problem solved.

  Another stress reaction in cats is pulling their hair out. When they’re upset they often over-groom and they have such rough tongues that they create bald patches where they break the skin, which can lead to infections.

  A day or two after visiting Mrs Dixon a tearful woman brought in her cat, Olive, a little tabby with a couple of nasty-looking bald patches on her belly and back legs.

  ‘I don’t know why she’s doing this,’ her owner, Mrs James, said. ‘She sits on my lap licking at herself and I can’t stop her.’

  ‘Let’s start with a few tests,’ I said. ‘We’ll do our best to get to the bottom of it.’

  After prising Olive reluctantly from her cat crate I gently checked her over, before taking a sample of blood and some skin samples, a few hairs and a tape impression of the bald patches (sticky tape pressed onto the skin to get some cells).

  ‘We’ll run some tests on this and I’ll call you with the results,’ I told Mrs James. ‘But in the meantime see if anything at home or in her routine has changed. The problem may be stress, and if it is then she may want to feel safe by hiding. You can even feed her in a quiet corner where she feels hidden away and put litter trays in unusual sheltered places. It might help her feel more secure.’

  The test results came back a day or two later clear of any medical cause for Olive’s behaviour. I phoned Mrs James to let her know and to say that I’d leave out some cream for her to collect, to calm the redness on the worst of Olive’s bald patches where her saliva had caused a mild skin infection.

  Mrs James had been so upset when she came in, but over the phone she sounded a lot more cheerful.

  ‘I think I know what’s wrong with Olive,’ she said. ‘We’ve been having some work done in the house, a new bathroom, so the plumbers have been going in and out and making quite a bit of noise. I’ve been watching Olive and each time they come in she runs to hide behind a chair. As soon as I realised it might be that I made sure that Olive was nowhere near them and moved her bed and her feeding bowl to a quieter part of the house. She already seems a little better and as the plumbers will be finished tomorrow I’m hoping that will sort things out.’

  I was very glad to hear it, and asked her to let me know how Olive was getting on.

  While stresses in the home can be a problem, what cats get up to outside is often worse.

  When cats go out at night, and many cats do, they get up to all sorts of mischief. Fights, falls, eating something poisonous and collisions with cars can all result in the cat coming home sick or injured and it can be difficult to know what the cause is.

  Sophie was a pretty little white cat who was brought in by her owner because she had arrived home that morning with her back hunched, tip-toeing on her back legs and with a droopy, dragging tail.

 
; The moment I touched her tail she yowled. It was clearly very painful and X-rays showed that there was damage in the sacral area of her lower spine. She had been injured, and the most likely cause was that her tail had been run over. Cats flee from the path of a car, and often it’s their tail that doesn’t quite make it. The result is a lot of pain for the poor cat and often the loss of bladder or bowel control – an injury called, appropriately, a tail-pull.

  In many cases the cat’s tail has to be amputated, and in the worst cases, when the cat can’t regain bladder and bowel control, it has to be put to sleep. But I was hoping that Sophie would be one of the lucky ones. Her injury wasn’t the most severe and she stood a 50/50 chance of recovering.

  I gave her a pain-relief injection and told her worried owner that I wanted to keep her in for a day or two to monitor whether she had any control of her bowels and give her strong pain relief. After 24 hours I was convinced she could urinate and defecate with some degree of control, so I sent her home with strict instructions to keep her quiet and rested. It took several visits over the following weeks, but Sophie did make a steady recovery, including use of her tail again, much to her owner’s relief.

  My next visitor was Bob, an elderly black tomcat who had disappeared for a week and then reappeared with a large swelling on his face. His owner, a builder named Andy, a broad-shouldered, sturdy and cheerful man in his forties, was glad to have him back, but concerned about the state he was in.

  He may have been getting on in years, but Bob was a proper tomcat. He had never been castrated and, like all un-neutered toms, his face had grown larger and he stank to high heaven. The swelling on his face was so large that his eye was almost shut. He had a temperature and his coat was dull and greasy.

  ‘It’s what we call a cat-bite abscess,’ I told Andy. ‘He’s probably been fighting and had a bite or a scratch that has become infected and developed into an abscess. Luckily it’s fairly easy to treat.’

  A cat abscess is pretty common, and while they’re not all a result of fighting, a lot of them are. Cats, especially male ones, do fight. It’s a territorial thing; they like to guard their own little realm and an invader is not usually welcome. Sometimes owners get a second cat to keep the first one company and the result is disaster – the first cat may see the newcomer as a threat, not a pal. Cats are solitary characters.

  I clipped the fur on the side of Bob’s face, cleaned it with antiseptic and then stuck in a needle to make 100 per cent sure it was an abscess. Then, using a small scalpel, I made a little incision into the abscess to drain it – which took quite some time – before washing it out with antiseptic. Bob behaved beautifully and I was grateful to him, because draining an abscess is one of my least favourite jobs and an angry cat on top would not have helped. The procedure sounds as if it would hurt, but relief of the pressure actually far outweighs the pain of the incision.

  I sent Andy home with pain relief and antibiotics for Bob and told him to wash the abscess twice a day with salt water and to keep the hole open so that it could continue to drain.

  ‘In a few days,’ I told him, ‘Bob will be fine. And no doubt ready to go off on another jaunt, hunting and fighting. Won’t you, Bob?’

  But Bob was looking bored. His secret world was his alone. He was a chunky cat, and no doubt caught himself a few extra meals when he was out at night. It’s something owners often don’t take into account. Cats get fat and owners protest that they feed them the correct amounts. But cats often supplement their meals at home with tasty morsels like mice, voles and birds, and these extra snacks can sometimes be the source of problems as well as plenty of extra calories.

  My next patient, Lily, was a pretty tabby brought in to see me because she was vomiting and had tremors. Her owner had rushed her in after dropping the children at school.

  ‘Lily keeps twitching,’ she said. ‘What on earth do you think has happened?’

  As is so often the case with cats, I had to look at the available facts and guess. After a clinical exam, and a check on her sugar levels to make sure they weren’t low, I was pretty sure that Lily had been poisoned, probably by something she’d eaten while out on the prowl.

  ‘We’ll need to keep her in,’ I told Mrs Needham. ‘I’ll put her on a drip to try to flush anything toxic out of her system and we’ll keep a close eye on her.’

  ‘Can I bring the children to see her?’ Mrs Needham asked. ‘They adore her and they’ll be worrying about her.’

  ‘Yes, of course you can. It will be good for Lily to see you and the children. She’s going to be in a cage in a strange place, and feeling unwell, too, so I’m sure a visit would do her good.’

  That afternoon Mrs Needham arrived with Ben, ten and Chloe, eight. The children, still in their school uniforms, were very quiet, but as soon as they saw Lily they brightened. I opened the cage door so that they could stroke her and she lay quietly and purred.

  After that the family came in every day to see her, and as Lily gradually improved they were full of excitement. By the time she was pronounced well enough to go home, three days later, Ben and Chloe were chattering happily and fighting over who would hold the cat crate and who would feed Lily when they got home.

  ‘Thank you,’ Mrs Needham said. ‘Did you ever have any idea what had poisoned Lily?’

  ‘No,’ I said. ‘There’s really no way to tell. It could be any number of things: toads, slug pellets, toxic plants and some human foods are poisonous for cats. But she’s a strong little cat and hopefully it won’t happen again.’

  I saw another little survivor the next day. Jazz, a lovely, soft grey cat, was rushed into the practice by her owner, Helen, after she was hit by a car. Unusually, Helen had actually seen the accident and she was beside herself. A pretty woman in her early thirties, with shoulder-length dark hair, I recognised her from the local bank where she worked. She arrived with Jazz in her arms and laid her on the consulting-room table. Jazz was conscious, wide-eyed and clearly very startled.

  ‘The car hit her full on,’ Helen said. ‘I’d just got home and Jazz dashed out of the house. It wasn’t the driver’s fault, he didn’t have a chance to see her and he was terribly sorry. Please tell me she’s going to be all right.’

  I reassured Helen that we would do our best and I asked Paula, the receptionist, to make her a cup of tea while I examined and X-rayed Jazz.

  An hour later I went out to find Helen, who was sitting in the waiting room.

  ‘Jazz hasn’t got any major internal injury, which is great news. We worry about ruptured diaphragms or bladders or broken bones and she hasn’t got any of those. But she has some nasty cuts on the inside of her back legs, and she has a lot of soft-tissue swelling around them.’

  Helen gasped. ‘Oh no. Will she be all right?’

  ‘Yes, she should make a full recovery. She probably feels pretty miserable at the moment, but I’ve given her pain relief and cleaned the wounds with antiseptic. She should feel a little easier soon. You can take her home, but she’s going to have trouble walking comfortably for a few days. She needs lots of TLC, and of course if you’re at all worried bring her straight back in.’

  Half an hour later Helen left with a very sleepy Jazz wrapped in her coat.

  ‘Thank you,’ she said, tears in her eyes. ‘I thought I’d lost her. I don’t know what I’d do without her.’

  ‘She’s lucky,’ I said. ‘Lucky to have survived and lucky to have an owner who cares so much and who got her straight to us.’

  What happened to Jazz is all too common. Most veterinary practices get cats coming in every week with injuries that indicate they’ve been in an RTA – road traffic accident. One of the ways you can tell is that after an RTA if you press the cat’s feet to get them to extend their claws they’re often scuffed because they’ve been dragged along the road by the car with the cat trying to brace with its claws.

  If the cat is lucky it will make a full recovery, but sometimes they’re left with residual effects of their injuries th
at can be hard to live with – for the cat and for the owner.

  Mary was devoted to her cat Jeremy. Her children had grown up and left home and her husband had died, so Jeremy, a quiet, good-natured cat with black-and-brown striped markings, was her only companion. The two of them got on very well, until one day Jeremy was hit by a car. His spine was damaged and as a result he had a lot of muscle wastage in his back legs. He couldn’t jump and could only pull himself up onto a chair using his front legs.

  Jeremy had been coming in every couple of weeks for check-ups, but he was making very slow progress. I suggested to Joe that I might be able to help out by teaching Mary some simple exercises she could do with Jeremy to help strengthen his back legs. While not trained as an animal physiotherapist – they are highly trained professionals who do a physio degree followed by a Masters in animal physio – I had picked up some useful tips during my neurological placement in my final year.

  Joe was happy for me to go ahead, so I asked Mary to book in with a double-length appointment. She was delighted that there might be something she could do to help Jeremy, and she paid close attention as I showed her some massage techniques and something called ‘passive range of motion’ in which you gently pump the animal’s legs up and down, flexing and extending. Essentially you move the leg for the animal, but it still means that the animal’s muscles are working and growing stronger.

  I also showed her a technique that helps the postural core muscles. You fill up a water bottle so that you have a wobbly surface and then put the animal’s back legs on it. That helps the animal with posture, spatial awareness and core muscles.

  Mary went away promising to work through the exercises with Jeremy several times a day and when I revisited Downe for a few locum days a month later she called to say that Jeremy’s back-leg strength had improved.

  It feels good to be able to do something positive, and as vets most of the time we can. But sometimes all our best efforts fail, and it’s always the failures we remember most. Sweetie was a cat who stayed on my mind for a long time after I treated him.