Saturday, April 7, 2012

Cooper's Quickie

I have a wonderful young couple who have been clients of ours for years. Erin and her husband are actually a second generation client for us. I first met Erin when she came in with her parents and their Boxers over 7 years ago. Back then it was always two boxers and mom, dad, and Erin. Two bouncing, happy, eager, paws and kisses male and female Boxers and three apologizing, trying to maintain the reigns adults in tow. Those dogs were always happy to see anyone, and the Vets office was no exception. Their joy was contagious, and it the big draw to the breed in the first place, so there was never any need to apologize. Their rambunctious attitude was their most charming attribute. I loved seeing them at every visit.

They were a wonderfully devoted happy family. The Boxers joy kept the family constantly smiling and the family unit very tight. Unfortunately, their first generation Boxers succumbed to cancer and heart disease (these are is not uncommon in Boxers after 7 years old). But along the way there were more than a few episodes of skin disorders, random "lumps and bumps" and a few minor scratches, so we got to see each other more than the traditional yearly vet visit. All of theses conditions are common in Boxers and all were faced and challenged head on by this family as they arose. Near the end of the first generation Boxers lives we saw each other more and more frequently, and the visits became more and more subdued.

We were already mutually fond of each other, but becoming such an integral part of their pet starts slow gradual decline is especially emotionally difficult for everyone. Holding back the tears  as we said our finally goodbye to these two Boxers was impossible. I know they were a part of their family that would be very sadly missed and I knew that my grief for these dogs I had watched grow old and tried to help along their path was nothing in comparison to the grief the family felt.

There are many families that we become close to because we see their pets at the best of times and the worst of times. I am incapable of not having an emotional attachment to a pet, and I am also unable to maintain an emotional detachment to a family struggling with the eventual reality that their pet is not going to be with them long.

When the first two boxers departed I was not sure I would ever see this family again.

It is difficult for me to understand how people can lose a pet that I know brought them so much joy and not want to bring another pet back into their lives. For me I know I cant ever enjoy my life as much as I do because a pet is a part of it. I try very hard to be respectful even if I don't understand.

I tell our grieving clients that life is a short fleeting glimpse and the best part of every life is getting to share it with someone and something you love and who loves you back. If we didn't have the beauty of life and the eventual knowledge that it will not last forever we would squander the opportunities and overlook the incredible beauty of it all. Without death there would not be life, and life is a beautiful precious finite thing.

I don't know if any of that helps, and I know that my seeing a pets life end on almost a daily basis reminds me how lucky I am to be alive and how much I cherish my pets and my family.

As I said goodbye to the family at the passing of their last Boxer I wished them well and I hoped I would see them again.

When you see as many wonderful loving dogs and cats being euthanized because there aren't enough homes for them it is hard to see a wonderful loving pet family walk away from loving another pet again.

A few months later I met Erin and her boyfriend with a new brindled bouncing baby Boxer boy, Cooper. He was every bit the bundle of joy his predecessors were with about a hundred times more energy. He was a great match for the younger generation, and they cared for and coddled him as if he was their first born.

I have watched him grow up into an energetic self confident respectful teenager. He has given them a few challenges along the road but the challenges were met and overcome just like the last generations were. He had a few visits to a puppy trainer and doggie daycare and has finally learned how to curb his enthusiasm just enough to be a model canine citizen. He has also become the real-life model for every and all kinds of restraining halters. (They have had to try every single one, to hold back his jumping, lunging, pulling, and self taught Houdini escapism). He has learned to take off the latest (a best performing) harness off by manipulating his back foot inside the chest strap, bowing his head, and shimming backwards as he pulls it over his head. He actually demonstrated this in the room as we talked. I suppose he was bored with the chatter and was ready to investigate the room and preferred to be unrestrained as he did so. If I ever have a client who needs advice in the dog harness/leash/training tools department they are my resident experts.

Yesterday Cooper came in for a skin tag removal. I had seen him last Tuesday evening for a pencil eraser sized skin mass that was near his lower lip. It resembled a skin tag or wart but was right next to his lower lip so it got licked a lot and was growing. I told Erin and her (now) husband that I was confident it was a benign skin mass but because it bothered him and was unsightly we should remove it. Unfortunately because it was so close to his face and mouth he wouldn't willingly sit still for it long enough for me to have the 15 seconds I needed to remove it with eletrocautery. (I am not sure he has ever sat still for 15 seconds, so I guessed it was unlikely to happen in our office). We decided that they would bring him back to the clinic on Monday (yesterday) to sedate him just long enough to remove it and then reverse his sedation. I estimated that it would take about 20 minutes so I suggested that Erin just stay with him the whole time.

In typical Monday fashion Monday was a very busy day.

Erin came in right before lunch. I looked at Cooper and he seemed his normal happy healthy self. His color was perfect, and his lungs and heart sounded perfect, so I gave him an intramuscular injection of the sedation we all use, at a moderate dose. We watched him settle into a "twilight" sleep within the normal 10 minutes. I then quickly removed his mass and reversed his sedation. Within about 15 minutes he was awake enough to walk out the door and I discharged him to go home with Erin.

Erin called me a few hours later and reported that he was still sleepy. I told her that "as long as he was breathing OK, she should just continue to watch him and enjoy the quiet time."

Two hours later she called again and reported that he was now vomiting and having bloody diarrhea. I told her to come in right away. When he arrived he was groggy, but had good color, clear lungs and the rest of his examination was normal. Dr. C gave him something for his nausea and inquired if I had given him anything else, because his clinical signs didn't make sense with the sedation we had given.

I assured Dr C. that I had pulled up his drugs, I had double checked them, I had given them, and I was sure he had not been given anything else or anything out of the ordinary doses. I told Dr.  to make sure that Erin had my cell phone number and told her not to hesitate to call me if she had any questions or concerns. I worried in bed all night.

I called Erin first thing the next morning to check on Coooper. She said he was still a little groggy, wouldn't eat, and wasn't very active. (OK, STILL NOT the normal Cooper). I told her to bring him in so we could put him on some i.v. fluids and flush out his system. I was worried his liver (?) wasn't processing the drugs normally, and if he wasn't eating or active it was going to take even longer to do so.

Cooper spends the day.
On i.v. fluids, and calm in his cage.

When Cooper arrived he looked pretty close to normal. We placed him on i.v. fluids and I told her that as soon as he started to complain, jump around, or otherwise act like his old self we would call her and send him home. I wanted Cooper to tell me that he was feeling better, but until then we would monitor him and flush out the system. He stayed with us for most of the day.

Starting to feel better. Interacting more with the staff, and the other pets in the hospital.

About to tell me that he is "ready to go back home."

Bright, alert, responsive, but still sitting and has four feet on the ground.
That means he is about 85% back to normal.
We checked his blood work to check his organ function and we made a note in his file about his adverse drug reaction.

His blood work all returned normal and over the next few days he returned to his normal self.

Perhaps he is a "sensitive" dog? Perhaps he doesn't metabolize the drugs as the rest of the dog population does? Perhaps he has an underlying problem we haven't found yet? I don't know, but I know that from now on, he isn't a candidate for a "quickie" procedure.

Cooper and Erin.

Cooper feeling much better. Can't sit still for a picture! Ready to go back home!

Lesson to learned:
Abnormal is not normal and there is a reason why, so go look for the reason! And be ready the next time.

(see also Timber's story).

I spoke to Erin last night. She told me his big turn around was when they bought him a new toy on Thursday. Now he is running through the yard attacking his toy. She thinks he was emotionally distraught, I think he is the smartest Boxer on the planet. He has trained, (and scared) us all into being afraid to do anything in the future. Kisses to Cooper, and I am very relieved he is feeling better.

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