|Otzee, The early days.|
One Monday morning I was asked by one of my associates to look at an x-ray of a patient she was seeing in an exam. Somehow I have been designated the resident orthopedic specialist in the practice. I am one of five vets under the JVC roof. It is a title I am reluctant to don and confused as to how I assumed it. I suppose it is simply because I am the only one amongst us who will jump into a broken bone and try to fix it. As much as I shouldn’t confess it, I think it is simply my love of challenges much more than my ability. Present me with the following scenario “If you don’t do it then ___ has no chance,” and I jump in without much thought as to how I am possibly going get that bone fixed.
It is more a badge of sincere desire to try to help without any regard as to how incredibly stressful it is to me when I am in there, all by myself, without a clue as to how to get out with my mission accomplished. I understand why general practitioners just say “No,” to these patients. It is too hard in most cases to fix these poor guys broken bones without the training to know how to correctly fix a fracture. This training is the reason boarded surgeons need 4 years of a residency, and also why they command the prices they do.
As I began to peruse the video screen I asked her “What the story on this kitty was?”
“She is an outdoor kitty who has never been to the Vet before. No vaccines, no history. But the owners have been feeding her for awhile.” It is a typical scenario for us in rural northern Maryland.
“Do you know what happened to her?” I asked as I started to assess the picture on the screen in front of me. I then started my internal assessment as she started with her patients’ story. “No evidence of fracture in the radius or ulna,” I said to myself as my mind started to assess the rest of the film. We are taught in vet school to assess an x-ray in some order and then taught to repeat this every time. It doesn’t really what order you use, but that you use the same order each time so that you don’t inadvertently overlook anything. My order is top to bottom when I am looking at extremities (aka legs).
|The foot on the right shows soft tissue damage, just above the carpus (wrist)|
“We think that she got her foot caught in a leg hold trap.” My mind stopped scanning the film, and I looked at her, giving myself a moment to switch from film assessment to digesting her words.
“Good god! People still use those things?” the expression of disgust and horror evident in both my words and my expression. “I thought that they were illegal?” As the words came out of my mouth I realized I was once again preaching to the choir and once again I knew I was just voicing the thoughts of everyone else in the room. I cannot imagine a more cruel device. Can you imagine being trapped by your leg by a steel device that is ripping into your flesh, chewing at your bone, and you are helpless to do anything about it? Stuck there until you starve to death. It is torture in the worst most imaginable way. Please lord let me die quickly and painlessly. Please lord let me not know the cruelty of mankind.
I looked at the x-ray and said aloud, “Good news! There is a great deal of soft tissue injury, but I don’t see any evidence of a fracture.”
|Same foot, but lateral (side) view|
“OK, but can you look at the leg for me?”
“Sure,” I said.
I walked over to the surgery area and saw a very frightened, fully dilated pupils and frozen to the table top tabby cat. There is an acquired art in reading a cat. If you ask a vet what they are more afraid of they will tell you a cat vs. a dog everyday of the week. A dog will tell you in advance that they want to rip your face off, but a cat will just attack you without any advanced notice.
Before me crouched one very scared seemingly on the verge of striking, tabby cat. Dr. H told me that her name was Otzee. I skipped the introduction assuming she didn’t want to know me in the first place. I approached her slowly and quietly. When I looked at her foot I realized that the x-ray had not done her foot any justice. The soft tissue trauma I had diagnosed was instead a circumferential wound that left only her bone visible. There was a small strip of skin that attached the upper part of her leg to the foot.
I have done this job long enough to know that there is a bit of truth to the old saying about a “cat having nine lives.” I have learned to not make an assumption on a wound until you give that patient a few days to decide whether or not they are going to heal. Never assume you are smarter than the body’s ability to heal (remember Abby’s story?). Now, don’t get me wrong that leg looked terrible.
|Being a good patient, mostly because she feels soo bad.|
I asked Dr. H what she had discussed with the owners so far. “Well,” (long pause), “I haven’t said much to them yet.” “They have told me that this is an outside cat, and that they can’t keep her inside. They also don’t have any money to pay for any extensive treatment.”
“I think that at minimum this kitty needs to stay inside so someone can monitor that wound in the hopes of saving that leg.” I said. “Do you think they will let her stay inside for a few days?”
“I can certainly ask.” Off she went to discuss the treatment options for Otzee.
She came back to me and said they Otzee’s owners were willing to give her a few days to see how her leg did.”
Otzee went home and her owners kept her inside and quiet for four days. When she returned for her re-check Dr. H brought her back to the treatment area she called me to verify what she thought she was looking at.
Her foot was now three times the size it was. She was not using the foot at all and the smell of rotten flesh permeated the air. There was now no doubt that this foot wasn’t going to heal. There was just enough tissue to allow some blood to flow into the foot but not enough infra-structure left behind to allow any of that to flow back up the leg. That foot was rotting off of her leg and it was time to say goodbye to it.
|The foot, much bigger than it should be.|
We talked about this, the cost of the surgery, and that her life needed to change from “outdoor” to “indoor.”
Dr. H went back to the exam room to talk to Otzee’s owners to see what they thought about our plan.
She came back to me and said that they were going to leave Otzee with us while they went home and talked about whether or not they could handle her as an indoor cat.
They called a few hours later and told us that they had decided to euthanize her. I asked them if could make a few phone calls to the rescues to see if I could find them some help for her. They politely and gladly accepted.
I called Animal Rescue and presented Otzee’s case to them. They offered to perform her amputation but said that they didn’t have room to keep her. They suggested that I offer to Otzee’s owners that they would do the surgery for them but that they then needed to take her back home.
I wanted to clarify the conversation because I couldn’t believe they honestly were suggesting this. “You mean you don’t mind doing her surgery for free if they take her back?” I said.
“Yes, that’s right,” they replied.
“OK, I’ll let them know.”
I called Otzee’s owners and asked them if they could keep her inside if we did her surgery?”
“No,” they quickly replied. I let it go at that.
Otzee went to Animal Rescue for her spay and leg amputation and returned to us the next day. She stayed in the far corner of her cage and never said a peep. She was as much a part of the woodwork as she could make herself to be. We tried to talk to her without intimidating her, without getting too close, and without forcing her to join the civilized world.
It has been a few weeks and she has decided that life with humans around isn’t as awful as it first appeared. She has made a friend with Kiki and has slowly come out of her shell.
She remains with us, looking for a second home that will allow her to be safe inside.