Coated With Fur: A Blind Cat's Love

by Kristen Nelson

  “Allie, did Bridget have another hunting injury?” I asked, remembering her lacerated paw last year.

  “No, Sally is worried she ate a Christmas ornament, so she’s bringing her in for an X-ray,” she replied.

  While I worked with the one o’clock appointment, Allie and Kim took Bridget to the back for her X-ray. The well-trained Irish setter needed a little guidance to keep her still for the films because she wanted to check out the birds. She forgot that these birds have sharp beaks. Bridget hated lying on her back for the VD view. Allie blew in her face to keep her mind off the pressure on her hips and spine. The lanky hunting dog had no subcutaneous fat to cushion her bones.

  Reading X-rays is an art that develops with time. I remember struggling to see what my professor thought was obvious, like the first time I heard a heart murmur.

  Fortunately, the composition and shape of the ornament hook made this diagnosis easy. I brought Sally back to the treatment room and let her make the diagnosis. The film revealed the outline of a metal ornament hanger in Bridget’s stomach.

  “I knew it,” she said. “Gosh darn it!”

  “Is there anything attached to the hook?”

  Sally nodded. “A gingerbread man. I decided to make some gingerbread ornaments. I covered the cookies with shellac, then painted on details. They were drying on the counter while I put a load of wash in the dryer. When I returned, the ornaments were scattered all over the kitchen floor. Joe helped me piece them together.” She stopped to exhale loudly. “Joe thought we had them all. I didn’t.”

  “Well, he tries hard but sometimes that Y chromosome is a heavy burden,” I replied, trying to lighten her mood. I wasn’t sure if she was mad at Bridget, Joe, or maybe both.

  “She needs surgery right away, doesn’t she?”

  “Yes, I’m afraid so.” I pointed at the hook. “I’m worried that might pierce her stomach or intestine, causing peritonitis. If the cookie is small, it could be removed with an endoscope.”

  Sally held her fingers in the shape of a five-inch square.

  “But that size will require surgery,” I said.

  “That’s what I was afraid of.”

  “When does hunting season end?” I asked.

  “It’s over now,” she replied, stating the obvious. “When will you do it?”

  “Since she’s not critical, I’ll start as soon as appointments are over.”

  “Tell Steve I’m sorry,” she said.

  “The one you need to apologize to is Kim. She wanted to go shopping tonight.”

  “Well, I’ll bring her something to make it up to her,” Sally said. “How about some beautiful handmade ornaments?”’

  I chuckled but shook my head.

  “Joe is going to be worried sick about Bridget. Can we come back to see her before you close?”

  “You’re welcome to come back, but she might be in surgery then,” I warned. “I don’t want another fainting hunter.” Sally chuckled at the thought of her outdoorsman husband fainting from a little blood.

  “See you later,” she replied. “I need to pick Jason up from daycare.”

  At 5 o’clock, Allie checked out our last appointment while Kim and I worked on Bridget. The pre-anesthesia tranquilizers transformed this hyperactive dog into a laid-back mahogany marshmallow. She rested on the treatment table, her head bobbing ever so slightly. Her dilated pupils completely obscured her beautiful brown irises.

  “Kim, you can place the catheter,” I suggested. “I’ll hold.”

  Kim nodded and traded places with me. She clipped a two-inch area on Bridget’s leg, disinfected it and placed the catheter on the first stick. Five minutes later, the dog slept peacefully on her side. The clipper buzzed and chugged as Kim pushed it through the long abdominal hair. A pile of silky fur covered Kim’s white tennis shoes.

  “Wow, you two are motoring,” Allie observed. She stood three feet away from the table, evaluating our work. “I think you missed a spot right here.” She pointed to a small tuft of hair behind Bridget’s ribs. Kim shaved it off, surveyed the clip job one more time and turned off the clippers.

  “Wow, she has a beautiful coat and great skin,” she remarked while cleaning hair out of the clipper with a brush. “I think this is the nicest coat I’ve ever seen on a hunting dog.”

  Allie and I smiled at each other.

  “She’s not really a hunting dog,” I said. “She’s a pet who happens to be a great bird dog. Sally lets her sleep in bed when Joe’s away on business. I hear she hogs the middle.”

  “I don’t get it,” Kim said. “How can the Smiths hunt when they seem to really love animals?”

  “I don’t know,” I replied. “My dad is the same way. He helped me rescue injured ducklings and other animals all the time. We released them into the pond behind our house. But in the fall, he would go duck hunting on Lake Dexter. No hunting was allowed on our farm, but he thought it was fine on the nearby lake.”

  “I think they compartmentalize animals into pet or prey,” Allie offered. “The animals they have personal contact with are pets, while the others are prey because they don’t know them.”

  “It’s also a family tradition,” I noted. “For example, Joe grew up hunting with his dad. He remembers all the good times in the great outdoors with his friends. I think the hunting is more of an excuse than the driving force.”

  “Enough talking,” Kim said. The clock on the wall read 5:30. “If you get going, I can still make it to the store before they close.”

  Allie and I pulled on our caps and tied our surgical masks over them. I helped Kim carry Bridget into the OR while Allie wheeled in the anesthesia machine. I left to scrub after all the monitors were hooked up. I kept track of a patient’s condition by listening to the beeps of the EKG.

  Ten minutes later, I stood by the table in a blue surgical gown with a scalpel in my gloved hand. “Ready?” I looked around the room.

  Kim and Allie nodded.

  Since we knew the ornament was in the stomach, I made an incision in the skin just below Bridget’s sternum to get good access. Because of her excellent condition, there was little fat to deal with as I entered her abdomen. I found the ornament right away but checked out her entire abdomen before removing it. If she ate one ornament, there could be more. Gingerbread does not show up well on X-rays.

  “I only found one ornament in the stomach. Let’s go get it,” I mumbled under my mask.

  “What did you say?” Kim asked. “I don’t speak mumble yet.”

  “She said she’s starting the gastrotomy,” Allie answered.

  I packed off the stomach from the rest of the abdomen, made an incision through the tough muscular wall and milked the ornament into view. I grabbed the hook with a forceps and gently pulled the ornament through the incision. The entire cookie/ornament hung in the air for an instant before I dropped it onto a towel.

  “Here you go,” I said to Kim, handing her the towel. “Make sure nothing is missing.”

  Kim wiped it off with the towel, exposing Sally’s craftsmanship. In addition to painting his face, Sally gave him buttons, mittens and boots. She even painted hair on the back of his head.

  “Wow, this is really cute,” Kim said. “I don’t see anything missing.” She held it up for me to inspect.

  “Sally is the queen of crafts and decorating. You should see their house at Christmas. It looks like a winter wonderland, with a Christmas tree in every room. The one in the living room is covered with white lights and crystal ornaments,” I said while closing the incision. “It’s magnificent.”

  “Quit talking and keep sewing,” Kim instructed. I moved all the contaminated instruments off the Mayo stand and changed gloves before the next stage of surgery. After checking the stomach one last time for leaks, I removed the retractors and lap pads.

  “Four laps,” I said then counted the gauze squares to make sure I didn’t leave any inside. “Twenty clean gauze squares.”

  “And I count 10 dirty. You are good
to close,” Kim announced. She dropped a pack of sterile suture material on the Mayo stand. This heavy-duty suture would dissolve after the wound healed. I started on the side toward Bridget’s back legs and worked my way toward her head. Stitch by stitch, the muscles closed, keeping her insides inside. Next I used a lighter version of the same suture to close her subcutaneous tissues. The clock behind me read 5:45.

  “When does the store close, Kim?” I asked.

  “Six thirty. I need to leave by 6 to make it in time.”

  “I think Allie and I can handle this from here.”

  Allie listened to Bridget’s heart with a stethoscope, missing everything we said.

  “Right, Allie?” I shouted.

  She looked up to find Kim and me staring at her.

  “What?”

  “I was telling Kim she could leave now,” I repeated.

  “If you could wait till 6 and lock the door behind you, then we’ll be fine,” she agreed.

  “Thank you,” Kim said. “It’s a special surprise for my boyfriend.” Once outside the OR, she ripped off her mask and threw it in the garbage. She stuffed her cap into her scrub pocket and headed to the bathroom to fix her hair.

  “I didn’t know Kim had a boyfriend,” I mused. “Do you know anything about him?”

  “Not really,” Allie answered. “I think it’s a guy she dated before, and they got back together.”

  “And what about your new boyfriend?” I asked. “How is that going?”

  “We broke up last week. He turned out to be a jerk.”

  “Well, I guess it’s better to find that out sooner rather than later.”

  With the subcutaneous layer finished, I turned my attention to the skin. I threaded an even smaller suture through the skin to hold it together. When I finished, Bridget had a seven-inch line down the center of her belly with no suture showing. I wasn’t going to give her a chance to chew on anything.

  When I turned around, I saw Steve’s face staring through the small window in the door. He smiled and waved. In the larger viewing window, I saw Joe and Sally and the top of Jason’s head. I’d recognize his brown hair anywhere. When I waved at them, Sally waved back, but Joe frowned. His eyes darted around the room, from Bridget lying on her back on the table connected to all sorts of machines to my bloody surgery gown. I raised my hand with my thumb extended before returning to Bridget. I removed the surgical clamps and drapes while Allie unclamped the EKG leads. Steve opened the door for us to carry her out to a bed of blankets.

  “How’s she doing?” Sally asked.

  “Great,” I replied after I removed my mask. The mask left a red mark across my nose. “Since you caught it early, the ornament didn’t do any damage to her stomach. She looked great on the inside.”

  “Here’s the ornament,” Allie said holding up a plastic bag with the gingerbread man inside.

  “No thanks,” Sally responded. “I threw all of them away.”

  “But it’s your most expensive ornament now,” Steve joked.

  “That’s for sure,” Joe answered. “Looks like you have been busy.” Several open surgical packs were open on the counter by the autoclave, taking up all the space. Instruments of all shapes and sizes soaked in a bowl in the sink. Used drapes, towels and gowns filled a laundry basket under the sink. The treatment room looked like a scene from M*A*S*H after a long day in the OR.

  “Yes, we had a full book today,” I replied. “The holidays create a lot of business for veterinarians.” I smiled.

  Bridget suddenly lifted her head with the trach tube still in place. She blinked her eyes twice then slammed her head back on the bed. Allie held her down with one knee on her shoulder while she untied the gauze holding the tube in place. Before Bridget tried to move again, Allie pulled the tube out, sending the dog into a fit of coughing. A look of panic spread over Joe’s face. Jason wailed.

  “That’s normal,” I explained. “The tube irritates their throat.”

  Allie rubbed Bridget’s back while she cleared her throat. A minute later, the coughing stopped and Bridget went back to sleep on her bed. Joe knelt beside her with Jason hanging over his back, still crying.

  “What’s that?” Jason asked. He pointed at the incision.

  “That’s were Dr. Nelson did surgery,” Sally explained. “It’s an owie so we must not touch it.”

  “Kiss it and make it better, Mommy,” the child answered.

  “No, we don’t want to wake Bridget up.”

  “Jason, Bridget is going to sleep here tonight so I can take care of her owie,” I told the boy. “You’ll come and pick her up tomorrow.” He stuck out his lower lip as he pouted. “If you’re a good boy, and Bridget is a good girl, you’ll get a coloring book tomorrow.”

  His expression changed completely when he heard “coloring book.”

  “Let’s go,” he said, pulling on Joe’s hand. “Bridget needs her nap.”

  I turned my face to hide my laughter. Joe winked at me and headed for the door.

  “Call me if anything changes,” Sally whispered.

  I nodded.

  “But you think she’ll be OK. I mean, she won’t have any permanent damage?”

  “I think your biggest problem is going to be keeping her still while the incision heals,” I replied.

  “Thanks, we’ll see you tomorrow.”

  By the next morning, Bridget was back to normal. She stood at the front of her run, begging for more breakfast. When we ignored her, she barked and tried to climb out over the walls. Kim transferred her into a covered cage where she paced in circles. After stomach surgery, I like to feed the patient several small meals to keep the stomach small. I don’t want to stretch the incision for a few days. Bridget couldn’t believe she was only getting a quarter of a can of food for breakfast. She wolfed it down in one large gulp.

  At 5:30 p.m., the Smiths arrived to take her home. Since Allie and Kim were busy, I had Joe hold Bridget for me while I removed her catheter. The clutter from the day before was gone replaced by rows of neatly stacked surgical packs waiting for the autoclave. I covered the catheter site with cotton and a piece of hunter green Vetrap. Bridget danced around, happy to have the bandage off her leg.

  “What’s that?” Jason asked pointing at the bandage.

  “It’s a booboo bandage for Bridget’s owie,” I said.

  His eyes got big.

  “Would you like one, too?” The child nodded, smiling.

  I cut a piece of matching Vetrap and loosely wrapped his wrist. “Now you match Bridget.”

  He held his hand out, staring at the bandage.

  “She acts like she never had surgery,” Joe observed.

  “That’s the goal,” I replied. “Keep her quiet for the next two weeks. No wild running around, leash walks only.”

  Joe nodded.

  “And above else, keep the gingerbread locked up.” I smiled.

  “Will do,” Sally answered. “I won’t make that mistake twice.”

  Chapter 19

  Septic Shock

  “Kris, are you OK?” Allie asked. “You look awful.”

  “I feel awful Allie. My throat is on fire, my head feels like it’s going to explode, and I’ve got the chills.” I folded my arms over my chest for warmth. Even with my lab coat on, I felt cold. I did not need this one week before Christmas. I was only halfway through my list.

  “You only have one appointment left this afternoon. All you have to do is get through this, and then you can go home,” she encouraged. “I’ll close.”

  “OK, I can do that,” I replied. “I think.”

  She handed me a record and pointed me toward the dog exam room. Inside, a pudgy Beagle laid in his owner’s lap. Normally, Brady would be running around the room, exploring with his nose and then marking with urine. As an unneutered male, Brady made it his mission to mark every inch of the clinic. The techs always scheduled him at the end of the day to spare the other clients. His owner, Anna Brenner, always asked me what she could do to stop the
behavior but never followed through on my recommendation: Get him neutered.

  I opened the door expecting to see Anna sitting on the chair reading a book. Instead, I saw a gray-haired man wearing thick glasses holding Brady on his lap. Based on Anna’s description, I guessed this was her husband.

  “I recognize Brady, but I don’t think we’ve met,” I said. “I’m Dr. Nelson.”

  “Hi, I’m Mike Brenner. I hope this isn’t a wild goose chase, but I think Brady’s sick, and Anna is gone. She went to Vegas with her girlfriends for a couple of days.”

  “Sounds fun.”

  “Tell me about it. I worked from home today and noticed Brady moping around the house. Anna said he does this every time she leaves, but it seemed different this time.”

  “How so?” I asked.

  He frowned and looked at the floor before saying, “I don’t know how to describe it, but he’s not right.”

  “Well, put him on the table and I’ll take a look at him.” I held onto the table to steady myself.

  The minute Brady’s feet hit the tabletop, he plopped down with a grunt. He didn’t try to steal biscuits from my pocket like usual. His breathing seemed a little fast, even for an out-of-shape canine vacuum. I placed my hand on his face to lift his lip. His skin felt like he was burning up. His gums looked muddy like Chica’s.

  “It’s a good thing you brought Brady in, Mike. I think he’s really sick,” I said. I inserted a thermometer. “I’m worried that he has a fever.” We stood on each side of the table waiting for the thermometer to beep. When it did, the results scared me: 105.4 degrees.

  “I knew he was sick,” Mike said. “What do you think is causing this fever?”

  “I’m not sure, but I’m worried he’s in septic shock,” I said. For the next five minutes, we discussed the causes of septic shock, treatment and outcomes. Mike listened carefully, asking questions to clarify his understanding.

  “There’s one more thing I need to check before you go,” I told him while pulling a disposable glove out of the drawer. “I need to check his prostate.” Mike cringed as he stepped back from the table. I slid my hand into the glove, placed a large drop of lube on my index finger and slid it into the dog’s anus. Brady grunted but didn’t move. Wow, it felt like an oven inside his body. Brady’s back legs kicked when I touched his prostate. It felt soft and squishy.