Coated With Fur: A Vet's Life

by Kristen Nelson

  “Genny,” I cried again as my father smiled. She responded with baby mews – the kind that melt your heart. She stuck her paw out the front of the carrier. I opened the door and cuddled her in my arms. “Did you have fun with Grandma and Grandpa?”

  Dad squinted and frowned. “I’m not so sure Bobbe wants to be a grandma to a cat, Kris. Better not mention that around her.” I ignored him and continued to cuddle Genny. She nuzzled her face into my neck and purred and purred and purred. She had grown a lot in the two weeks she stayed with my folks. Her body reminded me of teenager’s, big feet that look out of place with a little body.

  “I keep forgetting to ask about the dog that was hit by the car. What happened to him?” Dad asked.

  I explained that Cody had broken his hip. He had surgery a week later. His owner included a nice thank-you note with a check for his care. When Cody returned home, he searched for the other dog. After a few days, he stopped looking and seemed to resign himself to the fact that his buddy was gone. Tommy said it was heartbreaking to see him so depressed and planned to get Cody a new friend as soon as his leg healed.

  While Allie and I worked on our one and only surgery of the day, Dad worked on installing a new doorbell. He settled in with the directions and a thermos of coffee before attempting the project. Allie made a home for Genny in the bottom cage in the treatment room. She gave her a litter box with low sides, a bowl of water and a plate of food. In the corner, she placed the carrier with her favorite blanket inside. Genny ate two tablespoons of food and then settled into her crate. Within minutes, her eyes closed, and she drifted off to sleep.

  The doorbell dinged over and over again as Dad fiddled with the installation, but Genny slept through it all, her body twitching as she dreamed. Even her little stump moved. She seemed glad to be home.

  As always, Dad needed parts not included in the doorbell kit. He entered the treatment room and spotted Genny in the lower cage. He frowned with displeasure. “You’re not going to keep her in there are you? That’s cruel.”

  “It’s not cruel,” I responded and removed the surgical cap from my head. Animals, especially youngsters, need a safe spot to call home. Setting her up in a cage and sticking to a routine will help her feel secure. I also explained that I needed to limit the amount of exercise she received because of the stump. The bone had nothing but skin covering it. I did not want Genny to damage the hairless end on our hard clinic floors. Dad looked the other way and shook his head. I knew he disagreed. I would have to keep a close eye on her when he was in the clinic.

  He cleared his throat. “I also came back to tell you that you have a client up front.” Allie removed her cap and fluffed her hair. Two minutes later, she returned, fuming.

  “It’s the family with the bird.” She pulled out a step stool and placed it in front of the bank of cages. She stepped up and pulled down a small birdcage. The family wanted to keep the cage and toys so they could get another bird when they settled in South Carolina. Allie rolled her eyes. “They don’t have room for the little bird, but they have room for the cage. People make me so mad.”

  Dad looked at me in disbelief. When I was young, we always took our dog with us on trips. I remember sitting in the cab of the truck with Duchess. I passed the time by dressing the German shepherd in bandanas and headbands. The good-natured dog put up with me for hours on end. Soon, my parents would head south to their home in Florida with their two dogs, Peeper and Louisa. Dad had never heard of a family abandoning their pet. To him, animals were part of the family.

  I explained that moving is a common reason people give when surrendering their pets. One cause may be our societal view of pets as property. Some people think animals are a commodity that can be exchanged without consequence. They forget about the emotional distress the animal experiences. When it’s relinquished, the poor pet feels abandoned by its family. The animal goes from sleeping on the bed with its people to a cage at a shelter with countless other homeless pets. If only people looked beyond themselves and considered their actions from the pet’s point of view, this might not be an epidemic problem.

  Dad stood for a minute with his lips pressed in a frown. He jingled the change in his pocket but did not speak. For the first time, Dad experienced my world as a veterinarian. He understood why my patience with people does not always match my unlimited patience with animals and why the work is both rewarding and depressing at the same time. He understood the horrible situation that many veterinarians find themselves in – adopt the pet or else. Now he knew why veterinarians and technicians have so many pets. It’s hard to say no to an innocent victim, especially when it has an adorable face like Genny’s.

  Chapter 5

  Allie Rescues a Cat

  I arrived at the clinic late. Allie sat behind the counter with the phone wedged between her ear and shoulder. A small colorful bird ran back and forth across the counter, his nails clicking against the slick vinyl surface. At four inches tall, he was dwarfed by the pencil caddy. He stopped to chew on the business cards in a plastic holder, his colorful red beak shining bright against the white cards.

  “Good morning, Romeo,” I said, moving the card-holder out of his reach. “Let’s save a few for the clients, OK?” Allie hung up the phone.

  “What happened last night?” Allie asked without offering a greeting.

  “I treated a Pomeranian for an allergic reaction.” I extended my finger toward Romeo. He put his foot up and then changed his mind.

  The poor Pomeranian could not breathe when she had arrived at the clinic, gasping, for each breath. Her swollen face reminded me of a beach ball. She could barely open her eyes. I injected her with diphenhydramine and steroids to calm the reaction and placed her in an oxygen chamber. Thirty minutes later, her face returned to its normal size. With the swelling gone, she breathed with ease. The little dog licked me when I sent her home.

  Romeo walked over to the plant sitting in the corner, stood on his tiptoes and reached up with his red beak. He couldn’t quite reach the leaves. He stretched even further, but the lowest leaf still hovered half an inch above his head. “Anything new this morning?” I asked.

  “Spaatz’s owner called and scheduled a recheck for next week. Your Dad called and said he’ll bring the dogs with him when he comes to fix the doorbell.” She took a deep breath. “And there’s a stray cat in back.” She shot a tentative glance my way.

  On the way to work, Allie noticed a lump of fur lying in the road. She thought it was another roadkill. Many raccoons and skunks die around here when they try to cross the roads. Allie swerved to avoid the body. As the car sped by, the animal lifted its head. Those were not the ears of a wild animal. They were perfect little triangles of white. The lump was a kitten.

  Allie clapped a hand over her mouth in horror and slammed on the brakes. She ran toward the kitten, hoping to rescue it before another car whizzed by. When she approached, the kitten lifted its head and meowed. Allie knew that rescuing an injured animal is risky. Fearful and in pain, many typically wonderful animals will bite the good Samaritans trying to help them.

  Allie paused for a split second and looked down the road. Headlights glowed in the distance. Because she’s a veterinary technician, and with the kitten in danger, she scooped it up and ran back onto the shoulder of the road. A minute later, a large supply truck rambled by. It would have finished off the kitten.

  Back in the car, Allie placed the animal on the passenger seat and cranked up the heat. The poor little thing looked so small and emaciated. Allie lifted its tail and determined it was a boy. He purred all the way to the clinic, happy to be lying on a soft leather seat instead of hard pavement.

  The bedraggled kitten allowed me to remove him from the hospital cage without a struggle. I laid him on the treatment table and watched his chest move. Breathing was work. Based on his size, I guessed his age somewhere around 10 weeks. Performing a physical exam on him reminded me of anatomy lab in veterinary school. I could feel all of the bones and internal o
rgans easily beneath the skin. He had zero subcutaneous fat; his hip bones stuck out like a milk cow’s. When I parted his oil-slicked fur, little black dots scattered. Fleas! I felt itchy again.

  I started at his head and worked down to his tail. Our instructors drilled this methodical approach into us as interns. The attending docs were unmerciful if we deviated from the protocol. Through the years, it helped me discover many surprises and unlock several mysteries. In the exam room, I encourage owners to examine their pets, touching every part of their bodies. I give examples of how owners caught problems early and saved their pets’ lives. I also tell the owners how touch reduces blood pressure, calming both humans and animals in the process.

  Black debris filled both of the kitten’s ears, making it difficult to visualize his eardrums. Probably ear mites, based on his condition. I collected a sample on a cotton swab for examination under the microscope. His green eyes sparkled in the light of the ophthalmoscope. Much to my surprise, his retinas looked great. I expected to find lesions due to poor nutrition.

  Next, he permitted me to open his mouth for a full inspection of the teeth. Six adult incisors filled the space between the right and left canine teeth on both the upper and lower jaws. Right beside each fang, a second smaller tooth poked through the inflamed gingival tissue – his adult canines. He was teething. In cats, the adult canine teeth erupt at four to six months of age. Based on this dental examination, I now estimated his age at five months. He was much older than his size indicted. Baby teeth filled the rest of his mouth.

  As a general rule, kittens weigh about 100 grams at birth and gain five to 10 grams a day. At five months, a normal kitten weighs between two- and three-and-a-half pounds. I stood staring at the scale in disbelief. Our little stray weighed in at a minuscule pound. His emaciation was far worse than I imagined. I found no palpable fat anywhere on his body. A wave of dread spread over me. Many animals in this condition die regardless of the course or duration of treatment.

  As I listened to his heart, the tiny kitten purred. He seemed to soak up the attention, even from a vet. The purring made it tough to listen to his heart. I bent down and blew on his face. He stopped purring, looking at me with an annoyed expression. “Lub dub, lub dub, lub dub.” The rate and rhythm sounded good. I did not hear a murmur.

  “I’m sorry little purrbox, but I needed to listen to your heart.” The kitten looked up at me for an instant before closing his eyes and purring again.

  The next phase of the physical exam involved palpating his swollen abdomen. Both kidneys palpated normally or were “within normal limits,” as I was trained to say. The urinary bladder felt small and soft through the abdominal wall. I squished gas through the intestines with my fingers. The intestines felt kind of “ropey” instead of the normal soft and doughy. Worms, I guessed. I finished the exam by feeling each of his legs. I did not find any fractures.

  “What do you think, Dr. Nelson?” Allie asked as she walked into the treatment room. She stroked his dirty face as a look of concern spread across her own. “He’s so small,” she muttered.

  I smiled but did not answer. Based on his rapid respiratory rate and pot-bellied appearance, I worried about feline infectious peritonitis. He could also have feline immunodeficiency virus or feline leukemia virus. If he tested negative for those three diseases, he might have a chance. If, that is, his internal organs weren’t already damaged by the starvation. I felt a pit grow in my stomach. He needed every one of his nine lives to survive. He needed them all now.

  Blood tubes with different colored tops, needles and a syringe appeared from beneath the table. Drawing blood from a cat can be done in a variety of ways, although it is usually a two- person job. Small veins on the inner aspect of the back legs work well for fractious cats, as these veins are far from the teeth. The technician holds the cat in a stretched position – on its side by the scruff of the neck, with the back legs extended. Another reason to use back legs for drawing blood is to reserve the veins on the front legs for intravenous catheters. The only drawback associated with using the veins on the back legs is size. They’re small, limiting the rate at which blood flows into the syringe. Sometimes, clotting occurs before the sample can be mixed with anticoagulant.

  A faster choice for drawing blood is to use one of the two large jugular veins on the neck. One person restrains the cat with its head up and front feet pulled down, usually over the end of a table. A second person draws the blood. Rubbing alcohol flattens down the hair, exposing the vein. The phlebotomist places her finger low on the cat’s neck, blocking the flow of blood and causing the jugular to swell from the pooling blood. A quick poke later, the blood draw is over.

  “He needs a name,” Allie said as I positioned the kitten with his front feet over the end of the table for a jug stick. “What do you think we should call him?”

  “I think you should wait until we know the results. I don’t want to get attached to him if we have to euthanize.”

  Like most techs in these situations, Allie ignored my suggestion and offered a few names, all related to Star Trek. She loved the kitten already. Like other veterinary professionals, she dealt with serious disease by assuming the best until the worst actually occurred. Staffs name strays to bring them good luck. I knew she would clip his nails as well, another good-luck ritual in the veterinary profession.

  “How about Kirk or McCoy?” she asked. “Or maybe Tribble ... that would be cute.” None of the names she tried fit the scruffy little dirtball. My suggestion of Scruffy stuck by default since Allie could not settle on a superior alternative. Other than purring, the kitten was too weak to display any kind of personality. His filthy hair made it impossible to even tell the true color of his fur. Scruffy would have to do until we learned more about this tiny creature.

  With the blood draw over, I needed to establish his feeding schedule. The biggest mistake people make with starving animals is feeding them too much, too soon. It’s counterintuitive, but restraint is the key to prevent a condition called “re-feeding syndrome.” Through the years, in both human and veterinary medicine, we have come to understand that individuals who gorge themselves after a period of prolonged starvation die, while those who gradually increase their caloric intake, live.

  During starvation, organ function drops as the body shifts from metabolizing carbohydrates to using its own reserves of fat and protein for energy. Overfeeding a patient in this condition causes a precipitous drop in magnesium, potassium and phosphorous as well as overexpansion of the extracellular fluid volume. Death results from such complications as respiratory failure, heart problems, red-blood-cell destruction, generalized muscle weakness, coma and seizures.

  To avoid this syndrome, patients should be treated with a high-fat, low-carbohydrate diet supplemented with potassium, magnesium and phosphorous. Even with careful monitoring, some patients cannot overcome the severe problems caused by starvation. Scruffy had long odds stacked against him.

  “OK Allie, feed him two tablespoons of our critical-care diet.” I looked at her sternly. “Only two.” She nodded and placed two tablespoons on a small plate. Scruffy sniffed the food, froze for a second and dove in. He gulped it in four large mouthfuls. Some food oozed from the corners of his mouth. He licked the plate for a minute after all the food was gone, then looked up and begged for more.

  “Sorry, bud, Dr. Nelson says only two,” Allie responded. She sprayed him with flea spray, wrapped a towel around him and put him back in his cage. We didn’t want fleas spreading to any other animals in the clinic. She placed two hot water bottles around him for extra warmth. Short of owning an incubator, it was the best we could do. The exhausted little guy closed his eyes, purred and drifted off to sleep. Hopefully, the nightmare of his ordeal would fade from his dreams.

  Chapter 6

  Bridget Lacerates Her Paw

  Dad walked into the clinic with a triumphant look, holding up a plastic bag filled with parts. “What are you going to work on today, Gordy?” Allie asked.
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  “I’m going to finish the doorbell,” my dad replied.

  Allie raised her arms and danced in place. Without a doorbell, we didn’t know when clients entered the building. Poor Allie ran from the treatment room to the lobby constantly. Her shins ached from running on the hard floor.

  Dad smiled. He wanted the project finished just as badly as she did. My parents were eager to leave Minnesota before the snow flew. The surf and sand of Florida called. Most importantly, Dad’s golf league started in two weeks.

  By noon, a loud “ding, ding” rang out every time the front door opened. While he worked, his pups, Louisa and Peeper, stood vigil in the truck. Because of the cool weather, they could stay in the cab with the windows partially rolled down. A tall Lab mix, Louisa looked like a person sitting in the passenger seat, watching people come and go from the clinic with a smile on her face. A terrier mix, little Peeper stood on her back legs with her paws resting on the back of the seat. She could care less about people. She scanned the horizon for anything that moved. Her persistence paid off when she spotted a squirrel in the grassy area on the far side of the parking lot. A squirrel maniac, she pushed her snout through the open wing window and drank in the scent.

  Dad and I walked down to the local Burger King for lunch. We stood in line surrounded by high school students wearing faded jeans and letter jackets. When it came time to pay, Dad pulled his wallet from his back pocket.

  “I’ve got it, Dad,” I told him. He looked surprised. “Just a little thank-you for all the work you have done at the clinic. I don’t know what I would have done without you.” He smiled and put away his wallet. Like all fathers, he typically paid for everything. Watching me pay for lunch filled him with pride. It was a small gesture, financially insignificant, but he reveled in the moment.