“But she’s filthy,” Stephanie objected.
“Use a waterless shampoo. You can also sponge bath the problem areas.”
“I’ve tried those waterless shampoos, and they don’t work.” She looked at the floor, arms crossed in defiance. “She needs to be groomed, Dr. Nelson. Pleassssssse write a note for me.”
I walked around the table and put my hand on her shoulder. “Stephanie, I know that you spare no expense when it comes to Bianca because you love her so much. She is your baby.” Stephanie nodded. “And because you love her so much, I know you will follow my advice and hold off on grooming her until her pelvis has healed.” I smiled. It wasn’t sincere. “I wish all my clients loved their pets as much as you do. It would make my job so much easier.” I smiled again, squeezed her arm and opened the door to the lobby. “Please wait up front, and I’ll have Allie get a bottle of the waterless shampoo we use in the clinic. It works really well.”
Without saying a word, Stephanie slowly walked up to the counter.
In the treatment room, all three of our patients wanted to go home. Tom and Jerry rubbed their bodies back and forth along the cage front, blissfully unaware of the fate that had befallen them. In the cage below, Polly Schmidt sat in the corner with an IV catheter in place. I opened the cage door and called the schnauzer to me. Polly jumped up and limped over, holding the bandaged leg with the catheter off the floor. I cradled her head in my hands and looked into her beautiful brown eyes. She pawed me with the bandaged leg.
“No, I’m not going to take off your bandage. Stand for exam,” I instructed. Polly immediately put her leg on the ground and looked straight ahead. I lifted her lip eager to examine the color. A healthy pink replaced the sickly red I remembered. Her gums were moist, and her capillary refill time (CRT) was less than a second. Her heart and lungs sounded great, and her pulse felt strong under my fingers. I slipped my hands around her abdomen. Everything felt normal except for a large amount of gas in her intestines. I quickly moved my head away from her rear end just in case my palpation stimulated a release.
“Good girl, Polly,” I praised her. Polly wagged her little stump of a tail while continuing to stand for exam. “You can relax, the exam’s over.” Polly stood like a statue with all four feet perfectly aligned. “That’s right, I need your release word.” I thought for a minute. “OK, Polly!” She spun around to get out of the cage. I pushed her back inside and closed the door as Allie entered the room.
“Grooming,” she fumed. “On what planet is grooming considered urgent?” She waved her arms in the air as she spoke. Her eyes flashed with anger.
“You were right about Polly,” she said changing the subject abruptly. “Her lab work confirmed HGE.” Allie put her fingers through the bars of Polly’s cage to touch her nose. “She says thank you for the fluids. I feel much better now. Barbara and her husband Jerry will be here at 6. I told them we wanted her to get fluids for as long as possible.”
Tom pawed Allie’s shoulder through the cage door. When she petted him, Jerry stuck his paw out and meowed. “And you two,” she smiled at the boys. “Your family should be here in a few minutes.”
After all the campers left, I gathered up Snowflake for yet another night at home.
Chapter 11
Green Iguana
At 6:45 a.m., Steve drove into the parking lot with precious cargo on board. An eerie silence engulfed the lot. No whistles or team cheers echoed from the practice field. On Fridays, the football team had the morning off to save energy for the big game. Steve parked right in front of the clinic. All the other businesses were closed. Even the boarding kennel was dark. He unlocked the front door and flipped on the lights before retrieving Snowflake from the car.
Kim was right about Snowflake. He seemed less nauseated, based on the lack of drooling during meals. At his 8 p.m. meal, I doubled the amount of food, then gave him his next meal at 10. He did so well that I continued that feeding schedule overnight. Steve took the 6 a.m. feeding so I could sleep in. I never heard him leave.
Steve carried Snowflake into the treatment room and placed the carrier on the treatment table. He folded back the blanket surrounding the carrier and began to unfasten the top.
“Hey, what are you doing here?” Kim asked. She unzipped her windbreaker, placed her purse on the counter, then helped Steve.
“Hi Kim. Since the first appointment isn’t until 10, I decided to drop Snowflake off and let Krissy sleep in.” He removed the carrier’s top. Snowflake lifted his head off the blanket and meowed at Kim. She reached down to rub his chin.
“Did you have a good night, buddy?” she asked softly.
“I need to get downtown for a meeting, Kim,” Steve said. “I’ll leave his record and bag of supplies on the counter.” He pulled his keys out of his pocket. “Who’s working tomorrow, you or Allie?”
“I’ll be here,” she answered.
Steve looked at her and smiled, noting that she didn’t giggle.
“We are so happy to have you as part of the team, Kim,” Steve said. “Especially on Saturday mornings so I don’t have to be the tech anymore!” Steve winked.
Kim giggled and looked at the floor, her cheeks a rosy pink.
Kim placed Snowflake on the baby scale for his morning weight. He watched a drop of water form on the faucet of the scrub sink and fall onto the drain below. Kim placed a new treatment sheet on a clipboard and wrote 6.9 pounds on the form. Next, she listened to his chest with a stethoscope while looking at her watch. His heart rate and respiratory rate were WNL — within normal limits. She finished his morning vitals, checking his temperature. Snowflake kicked his back legs when the cold instrument touched his anus.
“Sorry, buddy,” Kim consoled him. “But I have to take your temperature.” Two minutes later, the digital screen read 99.9. Kim frowned as she recorded the number on his sheet. 99.9 was better than when he first arrived, but not the 100 to 102.5 for normal cats. She rubbed his chin again before settling him into the incubator.
“Ding, ding,” the doorbell sounded. Steve forgot to lock the front door in his hurry to go. Normally, the door is locked until 8 a.m. Kim put down Snowflake’s record and headed up front.
“Hello,” she said to the man standing on the other side of the counter. He wore navy blue work pants and a fleece jacket with “Al” embroidered on the front.
“Hello,” Al Rigberg replied. “I wasn’t sure if you were open yet.”
“We don’t officially open until 8, but…” Kim noticed an iguana peek its head out of the collar of the man’s jacket, right under his chin. “Is that an iguana?”
“Yes, this is Guacamole,” he said while trying to push the lizard back into his jacket. “You do iguanas, right? I mean.” he paused. “I was told that this clinic treats reptiles.”
“Dr. Nelson will treat just about anything,” Kim replied with a smile. “What’s wrong with him?”
“Her. She’s not using her right front leg. I think she sprained it.”
“Well, Dr. Nelson won’t be in until later. You can make an appointment to come back or you can leave her with me, and Dr. Nelson will examine her as soon as she gets in.”
“I was kinda hoping you could treat her now,” he said, looking out the front window. “I have an hour before I need to get to work.”
Kim waited silently behind the counter for the man’s decision.
Finally, after a minute of hemming and hawing, he agreed.
Kim held Guacamole while Al filled out a client information sheet and history of the small iguana. Kim’s red fingernails fascinated the 12-inch juvenile. She kept trying to chew on them.
Prior to working at the Minnesota Veterinary Center, Kim worked in a traditional small animal clinic with dogs, cats and the occasional hamster. Although nothing frightened her, she wasn’t comfortable working with the variety of animals that entered my clinic. On her first day, she helped me with a purchase examination of an albino python. Since mouth rot is common in captive snakes, I nee
ded to look at the snake’s mouth. I asked Kim to get a credit card from the cold sterile tray. The cards are the perfect size to wedge between the upper and lower jaw. The plastic is soft enough to prevent injury if the snake bites it. Kim asked me why I kept my credit cards in the cold sterile tray. Allie still teased her about that one.
Kim retrieved a small cage from the closet for Guacamole. She removed all the perches to keep the iguana from further injuring her leg. Green iguanas are native to the tropical regions of Central and South America. They need plenty of warmth and sunlight, making them expensive pets in Minnesota.
The perfect iguana habitat requires a temperature gradient of 78 to 92 degrees. Kim placed a heating pad under one end of the cage to give Guacamole a warm side and a cool side. Because iguanas need UV light every day to metabolize calcium, Kim hung a special UV lamp over the cage. She then covered the entire setup with a towel — seeing predators like dogs and cats is stressful for iguanas. She placed Guacamole in the cage and gave her one shredded spinach leaf. Guacamole ignored the leaf, preferring to hide in the back corner of the cage.
The clock in the treatment room read 7:30 when Kim finished setting up Guacamole’s cage. Typically, she would be pulling records for the upcoming appointments, not still treating animals. Genny meowed, and the birds squawked to let her know they were hungry. Kim grabbed broccoli, carrots and a squash from the fridge, washed and diced them into a variety of sizes, minced for Romeo to chunks for Bongo. Then she added peas and a few kernels of corn for fun. Windsor hung on the bottom of his cage, peeking under the night sheet. When Kim removed the cover, he scurried up to his dish, weaving back and forth with excitement.
“Chirp, chirp,” Windsor called out. Kim opened the little door above the dish and filled his cup with mixed veggies. He grabbed a pea and munched happily. We had to limit the amount in his diet to make sure he ate the other vegetables.
Next she turned her attention to Romeo. During the past year, Romeo became aggressive around his cage. He charged anyone who came near, even when it meant food. Kim threw one sunflower seed on the floor of his cage. Romeo slid down the bars like a fireman on a pole, snatched the seed and scurried back up to a perch while Kim filled his bowl.
Although Bongo was bad about screaming, she was great for feeding. Kim jiggled her food bowl, which prompted the green parrot to move on to her water bowl. She sat patiently while Kim filled her bowl.
“Meow, meow,” Genny cried from her room. She stuck her paw out under the door as she complained. When Kim finally opened it, Genny was on her side with her beautiful rust-colored abdomen exposed. Kim stepped over her, filled her bowl with canned food and cleaned the litter box. Genny pinned her ears back against her head and twitched her tail. When Kim left the room, Genny jumped up and took a swipe at her ankle.
“Genny,” Kim exclaimed. “Bad girl!” She lifted her pant leg and pulled down her sock, exposing four long red marks across her ankle. Genny scampered away to start her morning rounds with a gleam in her eye. She taught Kim not to be late with breakfast.
By the time I arrived, the clinic was back on schedule. Blood tubes labeled “Snowflake Olson” waited in the fridge for the courier. A stack of animal charts rested on the counter next to the appointment book with a blank physical exam sheet for each scheduled patient. The plastic file holder labeled “Callbacks” was empty while a stack of charts filled the “To Be Filed” tray. Bottles of medications placed in small paper bags waited on the shelf. Kim and Allie hated starting the day feeling behind.
Between appointments, Kim helped me examine Guacamole. I started with her head, noticing that both the upper and lower jaws were swollen. Instead of being relatively straight from the TM joint to the nostrils, Guacamole’s mandible and maxilla bones curved outward like a bow. Using light finger pressure, I could wiggle the bones in all directions. I was sad to note that this poor iguana suffered from metabolic bone disease (MBD).
In the wild, iguanas spend most of the day basking in the sunlight because they are hindgut fermenters, which means they use a fermentation system to digest their fibrous diet. For optimum fermentation to occur, iguanas must keep their body temperature around 98 degrees — hence the basking. Iguanas also need copious amounts of sunlight for vitamin D synthesis. This is vital for calcium regulation.
In captivity, most owners unknowingly commit three husbandry errors that cause this disease:
1) The cage temperature is too low for proper fermentation.
2) The diet does not contain enough leafy greens. Iceberg lettuce is not appropriate for iguanas unless they need to lose weight.
3) There’s a lack of full-spectrum light. In captivity, a full-spectrum light bulb needs to replace the natural sunlight iguanas need for calcium metabolism. Unfortunately, most people do not know that the full-spectrum, UV part of the bulb only lasts for about a month. Because the light still shines, they think the bulb is good, and their pet is getting all the light it needs. I wished the packaging for these bulbs had the 30 day warning on the front of the label in bold letters. It would save many iguanas a lot of pain and suffering.
Iguanas with MBD cannot properly absorb and metabolize calcium. As their blood levels drop, calcium is removed from the bone to satisfy the deficiency. As the bones are depleted of calcium, the long bones become weak and often fracture while the jawbones become soft, leading to the term rubber jaw. When there’s no calcium left to withdraw from the bones, the calcium blood level drops, causing muscle fasciculation (muscle twitching). I like to think of it as the reptile version of a seizure although the mechanism is different.
I continued the examination by listening to her heart, palpating her abdomen and feeling all of her legs. Her right front leg was swollen from the elbow to the wrist. I suspected a folding fracture, common with this disease. An X-ray would confirm my diagnosis, but I needed blood work to determine the severity of her condition. In my experience, anorexia is a bad sign in iguanas with MBD. At least she wasn’t twitching.
“I want you to draw blood and take an X-ray of Guacamole,” I told Kim.
Her eyes widened but she said nothing.
“Allie will show you how,” I continued.
Kim relaxed.
“Any questions?”
“This iguana keeps trying to chew on my fingernails. Why does she do that?”
“Reptiles have excellent color vision. I think she’s confusing your red nails with a berry.” I smiled at Kim. “Now get the blood drawn right away so we can start treating her.”
While I went back to seeing patients, Allie showed Kim how to X-ray a reptile. The resulting film confirmed the diagnosis. When an X-ray hits bone, the dense material defects the beam of radiation away from the film, leaving a white mark. When an X-ray beam passes through gas without interference, the film turns black from the exposure. Guacamole’s bones created a gray shadow on the film instead of a white line. Her bones looked like they belonged to a ghost instead of a young iguana.
The radius and ulna in Guacamole’s right front leg had horizontal cracks across the diameter. The ends of each fracture were still lined up with each other. If I could keep them together with a splint, they might heal without surgery.
“Kim, do you know how to inject a reptile?” I asked after viewing the film.
“No,” she said with a giggle and looked at the floor.
“Well, you’re going to learn today.” I motioned for her to hand Guacamole to me and handed her the syringe. “Some veterinarians believe that medicine injected into the back half of a reptile will be removed by their livers because of their circulatory system. Other veterinarians say this is false. Until we know the truth, always inject reptiles on the front half of their body.” I pointed to a spot on Guacamole’s chest, just behind her elbow. “Clean this area with some rubbing alcohol.”
Kim grabbed a cotton ball, but I pointed to a cotton swab. She dipped the swab in alcohol and rubbed the area.
“OK, now put the bevel of the needle up and
pick a spot between the scales.”
Kim pulled the cap off the needle, spritzed out the air bubbles and prepared to inject with the syringe perpendicular to Guacamole’s body. “Keep the syringe as parallel as possible,” I instructed. I guided her hands into the proper position.
“Ready?” Kim asked with the needle hovering a half inch above the iguana’s side.
I tightened my grip on Guacamole and nodded.
Kim tried to insert the needle into the skin. No luck.
“Reptile skin is pretty tough,” I coached. “Use more force and make sure the needle isn’t on a scale.”
Kim pushed harder, and the needle popped into place. Guacamole jumped but settled down once the needle was set. Kim slowly injected the lifesaving calcium, then withdrew the needle. A clear liquid immediately oozed from the hole in Guacamole’s skin.
“Cover the hole with your finger,” I ordered.
Kim placed her index finger over the injection site.
“Reptile skin isn’t as elastic as mammal skin. You need to apply pressure to the injection site for two minutes to prevent the medicine from leaking out.”
Kim started to giggle. “First she confused my fingernails with food, now I have to plug the hole for two minutes. My friends are never going to believe this.”
I handed Guacamole to Kim so I could gather bandage supplies for the splint. The distance between Guacamole’s wrist and elbow measured one inch. None of the standard bandage material would work. I cut one inch-wide tape, cotton and Kling into half-inch strips. Now, what to use for the splint? I had a variety of lightweight plastic splints like the one I used on Mariposa, but they were all too large. I also kept metal rods that I could cut and bend into the perfect shape for each patient. But they were too heavy. I stood and thought for a moment.
“Is something wrong?” Kim asked.
“No, I’m trying to decide what to use for the splint. Her leg needs something strong to take the pressure off the bones while they heal.” On the shelf above the treatment table, glass jars filled with all kinds of supplies sat in perfect order. I opened the first one and pulled out a cotton swab. I cut the handle end of the swab into two one-inch pieces that were strong and lightweight.
Coated With Fur: A Blind Cat's Love Page 12