“So what’s next, Doc? Can I take her home now?”
I frowned.
“I’ll let her sleep in bed with me,” he pleaded.
“I’m worried about the edema returning to her lungs,” I said again. “I like to watch them for 24 hours so I can treat it early, before it becomes life-threatening.”
“But couldn’t I watch her breathing and bring her back if her rate increases?” he countered. “I only live 15 minutes from here.”
I sat quietly. On the one hand, I would love to go home and sleep. On the other, I worried about Zip’s lungs.
“I think she would do better at home,” Tom pleaded.
“Here’s the deal, Tom,” I finally answered. “We’ll take another set of chest films on Zip. If the edema is worse, she stays.” I paused to clear my throat.
“And if it’s the same, she gets to go home,” he finished for me. “That’s a deal, Doc.” He stood up and carried Zip into the X-ray suite. Steve and I donned our lead aprons, gloves and thyroid protectors before having Tom step out of the room. Zip squirmed against us as we held her in place for the films. She even tried to chew on my lead-lined gloves. I headed to the dark room with the films while Steve tried to keep Zip out of trouble. The films confirmed what her behavior was telling us…Zip was back to normal.
Tom carried her out to the truck, opened the driver’s door and placed her on the seat. She immediately started to chew on the steering wheel. Tom used both hands to remove her mouth from his custom wheel cover. Steve and I smiled at each other as they drove out of the parking lot. Zip was back to normal, which meant we were going to get more sleep than Tom, even though we had Snowflake!
Chapter 9
Gurney Nap
“Dr. Nelson, you look awful,” Kim said without thinking. “Uh, I mean, uh,” she stammered. “You look…,” her face turned red as she fought for words.
“It’s OK, Kim,” I said. “I feel awful.” I gave her the carrier containing Snowflake, his record and bag of supplies, then headed straight to my office. Kim carried Snowflake to the treatment room where the incubator awaited him. Snowflake waited for a chin rub, purring loudly. His skin looked a little less yellow, but he was still unable to stand or roll over on his own.
Kim recorded his heart and respiratory rates, then lubed up a thermometer for the final vital sign. She inserted the digital instrument and watched the screen. Initially, the word “low” filled the screen, but with time, numbers appeared. 96.5…97.3…98.4 until the instrument beeped at 99.9. Although it was still below normal, this was his highest recorded temperature since he arrived. Kim transferred him into the incubator, then warmed his 9 a.m. feeding. Saliva dripped from his lips as she fed him, leaving wet spots on the towel.
In the office, I hung my windbreaker on a hook in the closet. Genny followed me inside, rubbing along my legs. After being cooped up all night in her room, she scampered about the clinic as a tiger would stalk her territory. Although she had plenty of doorways to mark, there were no animals in the cages or kennels to torment. I bent down to pet her, running my finger along her chin. She purred and flopped on the ground. When I petted her again, she nipped me and escaped into the back of the closet, in the tight space under the stairs that went to the attic.
“Genevieve,” I protested. “Of all the animals I have rescued, you are the most ungrateful. Just wait until your brother comes.” Genny stayed in her safe place, twitching her tail. I pinned my name badge on a fresh lab coat and headed up front for what I hoped would be an easy day.
The first appointment belonged to Winston, a handsome Airedale. Harold Warren brought his dog in on the fourth Thursday of each month for me to drain Winston’s anal glands. Harold and his dog always arrived 10 minutes early for their 9 a.m. appointment and paid in cash.
When Kim and I entered the room, Winston waited for me on the table. Unlike the first time we met, I knew exactly what to do. With Kim holding his head, I quickly emptied his glands while Harold stood in his normal spot by the door. Most dogs squirm and try to get away when I do this, but not Winston. Harold trained Winston to “stand for exam,” and he did, without moving. Once it was over, Kim gave him a treat and placed him on the ground. Winston ran over to me for our traditional ear rub. We loved starting our day with Winston!
After Winston, Maggie, a sandy-colored vizsla, needed a Bordetella booster. Paula Anderson waited in the cat room with the dog nervously eyeing the fish tank. Her buddy, Sadie, a cocker spaniel, explored the room with her nose, starting under the chair, looking for biscuit pieces that might have been missed. Unfortunately, Allie did too good of a job cleaning the previous night. Sadie came up empty.
“Good morning, Paula,” I said, trying to sound perky. “Good morning, girls.” Sadie walked toward me, expecting a treat. Maggie hid behind Paula, her tail tucked under her legs.
“Good morning, Dr. Nelson,” Paula said. “Do you remember the last time we were in this room?”
“When Sadie bloated,” I said. “How could I ever forget? Sadie looked like she’d swallowed a beach ball. It was the first bloat I had ever seen in a cocker spaniel.” Sadie’s glossy blond fur glistened under the clinic lights. She sniffed my hand, then followed her nose to the pocket of my lab coat. It was loaded with biscuits. “Not until the end of the appointment, young lady,” I said, pushing her nose away.
“So just a Bordetella for Maggie?” I asked.
“Yes, Sadie is here for moral support,” Paula said. She stepped to the side to give me access to Maggie. The nervous dog slunk behind her again. She peeked at me but would not look directly at me. Every time I moved toward her head, she hid behind Paula. She completely ignored the treats in my hand. Now the tip of her tail was plastered against her abdomen.
“Paula,” I said while backing away. “Since she’s so nervous, I’m going to start with her rear end instead of her face. Please bring her to the center of the room. I don’t want to corner her.” Paula did as instructed, then held Maggie’s collar firmly. I started the exam by rubbing her back.
“You’re OK, Maggie,” I cooed. “You’re such a special dog that you get a massage today.” I continued to rub her back, especially the area right in front of her tail. After a minute, she relaxed her tail in a normal position. From that point on, it was a routine appointment until I inserted the syringe into her nose for the vaccination. Maggie jumped backward into Paula’s legs, almost knocking over the petite woman.
“Did you get it?” Paula asked, both hands gripping the table for support. I held up an empty syringe and smiled.
“Got it. Now who wants a treat?” Sadie sat at my feet with her stump of a tail swishing on the floor. As I reached into the treat pocket, she stood on her hind legs to get closer. “Sit,” I instructed. Sadie planted her rear end on the ground. “Good girl.” I handed her a biscuit. Bits of the brown treat fell on the floor. Maggie came out of hiding to see what her friend was eating. I held out another biscuit for her while looking at the wall. She crept forward, picked the treat out of my hand and retreated to the corner to eat it. Paula snapped leashes onto both of their collars and picked up her purse from the chair.
“Thanks, Dr. Nelson.”
“My pleasure, Paula. See you soon.”
“No offense,” she said with a smile. “But I hope we won’t see you for a long time.” She cracked open the exam room door before adding, “A long, long time.” Maggie poked her skinny body through the slight opening and pulled Paula out to the lobby. Sadie batted her long eyelashes at me before following her mom.
As the morning wore on, I felt more and more tired. No amount of caffeine could make up for three nights of missed sleep. I plodded from room to room, having Kim and Allie double check my work, especially the drug dosages. By the time the last appointment arrived, a mind-numbing fog replaced my normal energy. I blinked my eyes twice and shook myself before heading into the 11:30 a.m. appointment.
Inside the dog room, a German shepherd rushed to meet me, her ears flo
pped back against her head and her tongue hanging out of her mouth. Her head was level with my waist, making it easy to pet this beautiful girl. I stroked her head twice, then she spun around until her rear end was right in front of me.
“Let me guess,” I said to the woman seated in the corner. “She likes her rear scratched.” I plunged my fingers beneath her coat. Hair flew in all directions with a few strands ending up on my face.
“Hello, I’m Dr. Nelson,” I said. I shook the hair off my hand before shaking the woman’s hand.
“I’m Kay Beaumont. And this is Lilah.” She gestured to the dog. “I want to breed her, but she’s not coming into heat. Her breeder told me to have her checked for a low thyroid.”
“Does it run in her lines?” I asked.
Kay nodded. “But her breeder told me it was no big deal,” she explained. “You just give them a thyroid pill, and they start cycling right away. I’m here to get the pills.”
“Well, I’m afraid it’s a little more complicated than that,” I replied. “Problems with cycling can be caused by a variety of conditions. Besides hypothyroidism, she could have Addison’s, Cushing’s, cystic ovaries, or ovarian or uterine cancer, just to name a few. Let me take a look and see what we find.”
“I’d rather just try the pills,” Kay replied with the confidence of someone who believed the breeder knew best. “I need to make money on the litter.”
“Trying treatments without knowing the diagnosis will end up costing you more money in the long run,” I countered.
Kay stared at me but did not say a word. She drummed her fingers against the armrest in a constant rhythm, starting with the pinkie and ending with the index finger.
“The bigger issue is, what if Lilah is hypothyroid. Is it ethical to breed a dog with a medical problem that might be hereditary?” I paused to let Kay respond.
She looked at me with narrowed eyes through her wire-rim glasses. Streaks of gray radiated through the long, straight, black hair that hung around her face. The hair clumped at the roots, making it look like she might be hypothyroid herself.
Another minute of awkward silence passed before Kay reluctantly said, “OK, do the test.”
I called Lilah to me for her examination. She sat in the middle of the room with a happy grin on her face. She loved the attention. She let me look in her ears, eyes and mouth without a fuss. I marveled at the size of her canine teeth, which were especially large for a female.
During my internship at the Animal Medical Center in New York, I had to remove all four of these important teeth on a young German shepherd. It was the most frustrating dental experience of my career. The roots are much larger than the crowns and are embedded into the jaw. The veterinary dentist would not let anyone use her equipment, which meant no drill. I had to extract all four by hand. My entire body ached by the time I was done.
Lilah jumped when I placed my stethoscope on her chest but settled down right away. While I was listening, she turned her head around and licked my ear. When I pushed her head away, she licked my hand and brushed the floor with her tail. In my experience, most German shepherds are timid dogs and need time to warm up to people. They become aggressive out of fear. Lilah acted more like a golden retriever, full of love for everyone she met.
While I palpated her abdomen, I noticed that her mammary glands were big. When I parted her hair, they hung down from her body about three inches. “How many litters has she had?” I asked.
“A few.”
“When was the last one?”
“Little over a year ago. She hasn’t come into heat since then.”
I palpated each gland from top to bottom, checking for any lumps or other abnormalities before moving on to her skin. Most dogs shed their summer coats in the fall, so seeing some hair fall out during an examination did not concern me. But Lilah’s hair loss was excessive, even for a German shepherd. Her hair was thin over her top line, with several bald areas on her legs and neck. The remaining fur felt dry and stiff, more like a whisker than normal fur. She also had a lot of dandruff that was easy to spot on her black saddle. When I finished palpating her, a greasy layer covered the tips of my fingers.
“Based on my examination, I think she needs general blood work as well as a thyroid profile.” I wiped my hands on a paper towel. “Allie will do an estimate for you and then draw the blood. I’ll call you tomorrow with the results on the general blood work, but it will take a week to get the thyroid profile back.” I petted Lilah one more time, grabbed her record from the drawer and excused myself, thankful to have finished my morning appointments. With only two cats to neuter, I hoped to dash home for a nap before the afternoon appointments started.
As I walked toward my office, I saw a chart in the plastic file holder outside the cat room. “What is that?” I asked in a less-than-civil tone.
“Surprise,” Allie said. “We have an emergency.” I studied her face, hoping it was a practical joke. “Polly Schmidt started vomiting this morning and can’t keep anything down, even water.”
“Polly Schmidt,” I repeated. “Is that the golden with allergies?”
“No, she’s a miniature schnauzer that always comes in with her buddy, Misty,” Allie said.
I still couldn’t place this dog.
“You know, they do obedience. Mrs. Schmidt trains Polly while Mr. Schmidt trains Misty. Whoever has the lowest score has to clean up after the dogs until the next competition.”
“Oh, now I remember,” I replied. “They’re the nice retired couple.”
“That’s right. Do you want a CBC, superchem, UA with a thyroid profile on Lilah?” She held a syringe with several blood tubes in her left hand with an estimate in her right hand. Before I could answer, she added, “I’ll have Kim hold for me.”
I walked over to the sink in the lab area, pulled back my sleeves and washed my hands. I shivered even though the water was warm. When I was the night doctor at the Animal Medical Center during my internship, I went a week without sleeping much. The shift started at midnight and finished at 9 a.m. Back at my apartment, I would sleep for a couple hours before waking up. The more sleep deprived I was, the colder I became. The last shift, I fell asleep while sitting in a chair. I woke up when my head hit the desk in front of me. Thank goodness my bangs covered the bruise.
“What’s going on with Polly?” I entered the room without even greeting Barbara.
“Thanks for seeing us today, Dr. Nelson,” she responded, sounding concerned. “Polly started vomiting this morning, and she hasn’t stopped. I’m worried that she’s dehydrated.”
“Did she get into anything?” I asked already knowing the answer. Barbara and Jerry took excellent care of their dogs. Their entire house was dog-proofed as well as baby-proofed for the grandchildren. These dogs were always supervised.
Barbara shook her head.
“Been to any shows lately?” I continued.
“We practiced last night, but we haven’t competed for three weeks.”
“Did you change her food or add any new supplements?”
“No, everything is the same,” she responded, a worried look on her face. “Except, we did have house-guests. Jerry’s cousins stayed with us a few days. Do you think they fed her something?”
I shrugged. “You know that schnauzers are prone to hyperlipidemia and pancreatitis. It doesn’t take much to set them off. I had one schnauzer get pancreatitis after he ate the corner of a peanut butter and jelly sandwich left on the floor by a grandchild.”
“They promised not to feed the girls anything,” she said. “They will never stay with us again.”
“We don’t yet know what’s causing the vomiting, Barbara,” I said, trying to summon a little bit of compassion for the relatives. “Let’s find out what she has before you start World War III with Jerry’s family.”
I lifted Polly onto the table. Long ropes of saliva hung from her mouth and stuck in her beard. Barbara wiped them away with a tissue. The dog’s gums were bright red and tacky to the
touch. Her heart and lungs sounded normal except that her heart rate was a little elevated. If Polly had pancreatitis, she would be painful when I palpated the cranial part of her abdomen, under the rib cage. I placed my hands on both sides of her belly and slid them forward until I touched her ribs. She stood quietly without any change in respiratory rate.
“She’s not showing me any pain, Barbara, so I doubt she has pancreatitis. Her abdomen is nice and relaxed.” Barbara stroked Polly’s head silently. I pulled a glove out of the drawer and placed a dab of lube on it. “I’m going to collect a sample for rectal cytology,” I said. Barbara pulled Polly close to her then nodded. I inserted my finger and rubbed the side of her rectum. “Well, I’ve got the answer for you Barbara,” I said when I saw bloody material mixed with mucous on my glove. It looked like raspberry jam. “Polly has hemorrhagic gastroenteritis, HGE for short.” I smeared some of the material on a glass slide.
The color drained from Barbara’s face when she looked at the slide. “Is it treatable?” she asked.
“Yes, with aggressive treatment most dogs make a complete recovery. We need to start IV fluids right away.”
“I have never heard of this before,” Barbara said. “What causes it?”
“Stress. I’m guessing your houseguests stressed her out.”
“Jerry’s cousins like to stay up late, and Polly kept leaving our bedroom to check on them. They also talk loud and keep the TV volume so high it gives me headaches.”
“My impression of Polly is that she likes a routine whereas Misty is more of a free spirit. That could be the cause.” I looked at my watch and noted it was almost noon. “If we hurry, we can get her blood ready for the courier and have results back by the end of the day.”
Coated With Fur: A Blind Cat's Love Page 10