In the beginning, Maria’s parents worried about her marrying the tall, blond American. But Walter’s humble personality and habit of bringing Maria flowers every day won them over. The newlyweds bought a home a few blocks from Maria’s parents so she’d have company when Walter traveled. It was a fairy tale life that ended when Walter’s company transferred him to back to Minnesota. Maria thought she was moving to Canada.
Maria and Walter bought a house not far from the clinic. Maria transformed the interior of their rambler into a Mexican hacienda with faux-painted walls that looked like plaster. She filled the home with colorful images of the people and places of Mexico. But she still felt out of place in the land of 10,000 lakes. Although she put on a brave face for her husband’s sake, Maria slept on a tear-soaked pillow every night. She was homesick.
Walter responded like all men do. He created a plan. On Mondays, Wednesdays and Thursdays, she volunteered at their church, helping students learn Spanish. On Tuesday, he signed her up for a neighborhood book club. On Fridays, she took tennis lessons. But nothing helped. Walter thought about quitting his job and moving back to Mexico but decided to try one last thing — a dog. He found a breeder in Wisconsin with two long-haired Chihuahuas for sale. Walter drove to Eau Claire and bought Chica on the spot. He drove home with the pup asleep in his lap.
“Walter walked in the door, kissed me and pulled Chica out of his coat,” Maria told me. “My best surprise ever.”
Chica slept through our entire lunch. Maria felt better after watching her beloved pet rest comfortably in the cage without any issues. Chica laid in a cat bed with legs tucked beneath her. She rested her head on the lip of the bed with the tip of her tongue protruding through the side of her mouth. Maria prayed over her before tiptoeing back to the lobby.
At 3 p.m., Allie brought Maria back to the treatment room. Chica laid in the same position. Her temperature was now 104.3. I wasn’t sure if this was a sign that the treatment was working or a sign that Chica was slipping into cold septic shock. The lab results were worse than I anticipated. Her white count was low with a left shift. This meant her bone marrow was releasing immature cells to fight the bacteria. Some of the neutrophils looked toxic; they were losing the fight. Her kidney enzymes, creatinine, BUN (the concentration of nitrogen in the form of urea in the blood) and phosphorous were off the charts. At least her electrolytes were still in the normal range.
“Maria, Chica’s lab results came back,” I told her, pulling a chair next to hers. She sat in front of Chica’s cage with her arm inside, touching the dog. She looked at me, hoping for good news. “Unfortunately, the results are not good.” I pointed to the abnormalities while explaining their importance. “She’s really sick, Maria.”
“But you can still save her,” Maria begged more than asked.
“The honest answer is that I don’t know,” I replied. “She has a really bad kidney infection. We won’t know until after the infection is gone how much damage it did to her kidneys. She could survive the septic shock and then die of renal failure.”
“Does that mean there is no hope for Chica?” Maria asked, wiping tears from her eyes.
“No, but I think it would be a miracle for her to come out of this without significant kidney damage. She’ll need a special diet and maybe even daily injections of fluids,” I continued. “I want to make sure you understand how serious her condition is. Some people might choose humane euthanasia at this point.”
Maria started shaking her head before I finished my sentence.
“No, no, no. I would never do that to her.”
I looked at the floor for a second, trying to choose my words more carefully.
“I am not saying you should do that, Maria,” I said gently.
She nodded twice while closing her eyes.
I touched her shoulder. “I’m sorry to have upset you.”
“I know you are only doing your job, Doctor. But Chica will make it. You will see.” She jumped to her feet and slung her purse over her shoulder. “What time do you close?”
“Six,” I replied, shocked by her behavior. “Where are you going?”
“I will be back at 6,” she answered. She marched through the clinic, got into her car and sped off.
Kim and Allie rushed into the treatment room, fearing the worst. The stress of seeing a beloved pet fighting for its life can bring out the worst and best of people. They were worried that Maria might have lost it, or that Chica might have arrested.
“What happened?” Allie asked, surveying the room.
“I’m not sure,” I replied. “We were talking about Chica’s condition when Maria stood up and said she would be back by 6. She left without telling me anything more.” I folded up my chair and rested it against the wall. “I guess we’ll find out then.”
“Aw, I’ll be gone by then,” Kim complained. “The good stuff always happens on your shift, Allie.”
“You mean the weird stuff,” Allie corrected. “I always get the weird stuff.”
Allie and I worked through our afternoon appointments, still wondering about Maria. Allie called her home number to check on her, but no one answered. At 5:45 p.m., we began to worry. Should we try to contact her husband or call the police? As we discussed possible courses of action, a black Mercedes screamed into the parking lot. Maria jumped out of the car, a small bag in her hand.
“I got it,” she said.
Allie and I exchanged puzzled glances. We each waited for the other to ask what was in the bag. Maria pulled a small object wrapped in tissue paper out of the bag. She used her long red fingernails to remove the paper, one layer at a time. When she finished, a small figurine laid in the palm of her hand. “It’s St. Francis,” she said smiling at the statue, “the patron saint of animals. You must keep this with my Chica at all times.”
“I will,” I promised. “Allie, please escort Maria back to see Chica. I’ll call you right away if anything changes.”
“Thank you, Doctor. I know she is in good hands.”
After Maria visited her dog and left, Allie and I rechecked Chica’s blood sugar. It was low even though we had her on a five percent dextrose drip. Her temperature dropped to 103.9. She still shivered, but not as violently as when she first arrived. She barely responded when we petted her, leaving her head on the blanket. Allie added more dextrose to her bag of fluids to increase the concentration. I feared she was slipping into the cold phase of septic shock.
“Need anything else before I leave, Kris?” Allie asked. She unsnapped her clinic jacket and hung it over her arm.
“A miracle would be nice,” I responded.
“Do you think she’ll make it? She looks so limp and lifeless.”
I shrugged. “The next two hours are critical. She’ll either turn the corner or slowly fade away.”
Allie nodded while pondering my words.
“That’s why I’m staying here instead of taking her right home. I want to have all the equipment nearby if she arrests.”
“I put the leftovers from lunch in the fridge,” Allie said. “Save some soup for Kim. She’s planning on that for lunch tomorrow.” Allie grabbed her coat from her locker outside the bathroom and headed out, locking the front door behind her. I spread records out on the treatment table and settled in for the evening. Kim didn’t have to worry about the leftovers. My stomach churned with worry. I wasn’t hungry.
At 8 o’clock, Chica’s treatment sheet called for antibiotics in addition to vitals and another blood glucose check. I pricked the accessory carpal pad on the backside of her wrist and watched blood form a bubble. I touched a test strip to the bubble and loaded it into the glucometer. When the instrument beeped, I couldn’t believe my eyes. It only read 80! Her body temperature dropped another tenth of a degree. I took a deep breath, trying to prepare myself for what was to come.
I called Maria. “I have an update on Chica,” I told her. I hesitated.
“Yes,” Maria encouraged me.
“I’m afraid Chica is
going into the cold phase of septic shock. I don’t know if she is going to make it. You might want to come down now to see her before anything changes.”
“Doctor, have faith,” she replied. “I have been praying all evening. This is not her time. You will see.”
I agreed to call with an update in 30 minutes. If Chica’s condition continued to slide, Maria would come to the clinic.
For the next 30 minutes, I paced in front of Chica’s cage. I thought through her case again from start to finish, hoping for some new insight that would help me pull her through. She already had received everything I could think of to help. With all my years of medical training, the advances in medical equipment and drugs, it still wasn’t enough. I felt helpless.
When I opened the door for her next set of vitals, Chica raised her head off of her bed for an instant. Her mucous membranes looked less muddy, more pink. Her whole body shivered in waves from head to toe. The thermometer stopped at 104.6, and her blood glucose was 120. I called Maria with an update.
At 8:45 p.m., Chica shifted positions. She pulled her legs out from under her body and stretched them to the side. Her body stopped shivering. Thirty seconds later, she started to pant. She rolled onto her stomach, lifted her head and surveyed the room like she’d never seen it before. Her tongue flickered with each breath. Dogs sweat from one place, their feet. Chica’s pads sparkled with perspiration. They left a musty smell on my fingers. Her recheck temperature told me what I already knew: Her fever had broken. The shock was over.
“Maria, her fever broke,” I blurted over the phone without identifying myself.
“Praise God!” she replied.
“She’s lying in her bed panting. The shivering stopped, and her temperature is 102.5.”
“I knew St. Francis would help. I asked him to intercede on Chica’s behalf.”
I remained silent, not knowing what to say. The Catholic concept of saints and asking them to intercede with God was not taught in my Sunday school classes. During my first Mass with Steve, it shocked me to hear all the disciples referred to as saints. “A letter from St. Paul to the Ephesians” sounded really strange to me. But I want my patients to get better, so I’m open to help from all sources. And because St. Francis was the patron saint of animals, he deserves to be a saint in my book.
“May she come home now?” Maria asked.
“Oh no. We still have to worry about her kidneys. She’ll stay on fluids until her BUN and creatinine are back to normal. By then, the culture results should be back. Hopefully, the infection is sensitive to an antibiotic that can be given orally. The antibiotics she’s on now are injected into her bloodstream. They can’t be given by mouth.”
“I see,” Maria said.
“Chica will come home with me to continue her treatments during the night. As long as she’s doing well, I will talk to you tomorrow when you come to visit.”
“Very well,” Maria replied. “Tell Chica her mama will be there tomorrow and remember to keep St. Francis with her at all times.”
“I will, I promise. See you tomorrow.”
For the next two days, Chica spent her days at the clinic and her evenings at our townhouse. Maria sat with her every morning from 9 to 11, then returned for another visit in the afternoon. On the recheck blood work, Chica’s BUN and creatinine decreased by half. Although they were still abnormal, her progress delighted me. If she continued to recover at this pace, she might be able to go home in three or four days.
Hospitalized animals always pick one of the staff to be their substitute parent. Most of the time, they choose Allie or Kim because they spend the most time with them. Chica bonded to me when Maria wasn’t around. If I walked by her cage, she jumped out of bed and sat by the front, her tail beating the bars.
I let her sit in my lap when I worked at the desk. When Genny approached, Chica bared her teeth and growled. Genny put up with this at first, but quickly grew tired of sharing me with another animal. She stood on her back leg, flicking the end of her tail. When Chica growled, Genny swatted her head. One quick jab to the muzzle put an end to Chica’s growling, at least when Genny was around.
Chihuahuas can be difficult to work with in the clinics. I think of them as the Dr. Jekyll/Mr. Hyde of the animal world. One minute they’re playing kissy face with their family, the next they’re drawing blood from an unprepared veterinarian.
Growing up in Minnesota gave me little experience with this breed. I met my first one at the Animal Medical Center while working the late shift. Cleo whelped two puppies, then started to convulse. Her family rushed her to the clinic in a yellow taxi. Hypocalcemia — low blood levels of calcium — are common in females of all kinds when they start producing milk. With their small body size and skinny bones, hypocalcemia is a common condition in Chihuahuas. I rushed Cleo to the treatment room, placed a catheter and administered calcium. She stopped seizing immediately.
When it was time to go home, I expected a warm reception. She greeted me with teeth instead. She was so mean that I couldn’t get her out of the cage. Every time I opened the door, she rushed me. Finally, I asked her family to come back for her. She jumped into their arms with her tail looking like a helicopter. The family passed her from one person to another so she could greet them all with kisses. When the family turned to go, Cleo looked back and growled at me one more time.
Although Chica was nice to everyone, we learned she had a mischievous side the hard way. On the fourth day of treatment, I was in the OR when I heard Allie scolding Chica. I peered through the window to see what was going on. Chica stood at the front of her cage surrounded by cotton. Shreds of her drip line laid on the floor in a puddle of fluids; a brand new bag of fluids hung empty above her cage. When I finished the surgery, Kim helped Allie replace the catheter. Allie fitted the troublemaker with a cat e-collar to prevent another disaster. Chica sulked in the back of her cage for the next hour. She hated the new bonnet.
Her next set of blood work looked great. The culture revealed that a strain of E. coli caused her infection. We were lucky that this bacteria was rather wimpy, sensitive to several different oral antibiotics. I had had many other patients not as fortunate. I tapered Chica off her fluids and switched her to a prescription diet formulated for animals with kidney damage.
When Maria came to pick her up, she brought along her husband and a special surprise. Walter carried a picnic basket filled with homemade Mexican delicacies into the clinic. We feasted on chiles rellenos with rice and refried beans while Chica danced at our feet. She went from person to person begging for a taste.
“Walter,” Maria yelled when I saw his hand descend toward Chica. “She can’t have that. She’s on a special diet from now on, remember?”
Walter looked to Allie, Kim and me for a different opinion but was greeted with icy stares.
“Sorry, Chica. I’m out numbered.”
When we finished eating, Walter packed the leftovers into plastic bags and placed them in the fridge. Allie went over Chica’s discharge instructions one more time to make sure Walter would comply. Based on Maria’s reaction, we were sure he would.
I hugged Chica, then handed her over to Maria. At the doorway, Chica turned her head toward me, her tail wagging. Nice Chihuahuas do exist!
Chapter 18
Gingerbread Man
After Thanksgiving, Minnesota gears up to celebrate Christmas, Chanukah and the beginning of winter. Strands of lights decorate trees and houses, creating a festive glow to the long, cold nights. Winter-loving Minnesotans oil up their snowmobiles for the fun to come while the summer-loving ones sit by the fire with a travel brochure, planning their winter escapes. The one thing everyone talks about is: Will there be snow for Christmas? Believe it or not, Minnesota, the land of 10,000 frozen lakes, does not always have snow for Christmas. Snow in December is hit or miss in the state known for testing cold-weather products.
The week after Thanksgiving, Allie and Kim decorated the clinic for Christmas. They hung a bell on the front do
or, hung lights on the Norfolk pine by the window and set up a miniature Christmas tree on the counter. It was covered with small gold ornaments that moved every time the front door opened.
“Genny, no!” Allie screamed. The cat bounded off the counter with a shiny ornament in her mouth. She bolted for her bed in the office closet with Allie in hot pursuit. Kim leaned against the wall to get out of Allie’s way as she race through the pharmacy/lab room. A minute later, Allie returned with a little star hanging from her hand, victorious again. Genny trailed behind her, looking for another opportunity to get it back.
“When is the blind kitten coming?” Kim asked as she stocked the cabinets with new supplies.
“I’ve arranged to pick Radar up after Christmas,” I replied.
“Radar — is that what you’re going to name him?”
I nodded.
“I like that,” Kim said.
“Originally, I wanted to get him before Christmas, but I thought it would be a bad idea to bring a new animal into the house or clinic during the holiday.”
“That’s good that you’re following your own advice,” Kim said with a giggle. During the last two months, Kim had blossomed into a fantastic technician. She was always excellent with dogs and cats, but it took time for her to learn how to handle the exotics. As her confidence grew, her true personality emerged. She was quiet but definitely not shy.
“Have you finished your Christmas shopping yet?” I asked.
“I have one more present to pick up. If I can leave on time tonight, I’ll be done with my list.”
“You know you just jinxed yourself.”
“Yes, I probably did,” she said with a smile. “But I’m trying to keep a positive outlook.”
I walked up to the reception desk to check the appointment book. Between the 1 and 1:30 appointment slot, a red arrow pointed at a note off to the side. It read, “Check Bridget Smith.”
Coated With Fur: A Blind Cat's Love Page 19