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Monday, September 16, 2013

Kiki and his Terrible Tussive Tickle

He arrived as they all do.

In a small carrier hidden from view in a dark enclosed plastic box.

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Designed to be light weight, these carriers are like a little treasure chest to a veterinarian. You really never know what you are going to find inside. Sometimes the smell gives you a big hint, but I’ll get to that later.

Every vet has learned to take a tiny peek inside these boxes before opening the door, or even contemplate daring to stick your hand in. We have all learned the hard way that there are sometimes ferocious little lions hidden beneath a seemingly gentle puff of orange fluff.

Today's fortune cookie was Kiki.

Kiki is a part of the over 700 cats living in the Animal Rescue Farm just along the Pa-Md border, in a little town called New Freedom. They are the most devoted bunch of amazing, inspiring, compassionate people I have ever met.

To begin, Kiki is a boy, (I know it’s confusing. I can’t really explain why, but that’s a lot of cats they have to manage so some of those cats get some pretty funky, or down right mis-appropriated, names). We have learned to just accept them and go with it.

As I approached his carrier and peeked inside I noticed that he wasn't moving. Kiki just sat in his little plastic cat carrier box hidden quietly in the back. As I opened the door he didn't lift his head, he didn't move, he didn't care about me, or where he was, nor did his internal survival drive tell him to even care about pretty much anything anymore. I could see and hear his rattle and crackle of the all to common ailment of rescue cats “chronic upper respiratory disease”.

How many of these rescues cats do I see? A LOT! You put too many of anything together, and you know what you get? A lot of disease. Send your kids back to school with a whole cackle of other little kids, none of them washing their hands, and be prepared to grab the tissues, because you’ll need them soon.

Kiki had yellow-green snot just caking his nose. Some of it had dried leaving a crust, but more was right behind that cascading down the chute like a slow flow of yellow-green lava. He could barely breathe, and when you can barely breathe you barely move. I lifted his lifeless thin black body out of the carrier. He didn't fight, or protest, or struggle even a little.

I gingerly placed him on the scale. He weighed in at a paltry 5 pounds. That’s was least 2 pounds less then he should have based on his age. When you only weigh 5 pounds those 2 pounds really count.
We quickly made up a very basic treatment plan for him. The good ole basic stand-by treatment plan of fluids, food, and antibiotics. I instructed them to feed him any damned thing he wanted and to try to make it as smelly as possible. Because when you have a whole nasal cavity full of snot it takes a smelly-smelly morsel to convince you to open your mouth and eat.

 We also started him on the antibiotic I call “the big guns”. “The big guns” are those antibiotics that we reserve for the severe cases, the cases that have previously been treated to little or no avail, and they are also expensive. (Funny how life always works that way?) I was going to hit him hard with these drugs and keep him on them for at least a month. My hope was that the previous treatments  were either not the strong enough, or they weren't used long enough. I was covering my bases and stacking the deck.

We put Kiki in a hospital cage with my treatment plan in place and I moved onto the next little plastic chest of mysterious disease.

I told myself coyly that I didn't really need 12 years of college to treat this guy, and I moved onto the next carrier in the processional line.

 Over the next few weeks we cleaned more slung snot from the walls, the doors, and the ceiling than anyone could imagine a 5 pound creature could produce. Kiki sneezed, spit, and re-painted our walls. If any of you are ever thinking of working at a vets office, and need to start at the bottom, (aka kennel), be prepared to not only pick up poop, scoop litter, but also to scrape snot off of walls. After 4 weeks of “the big guns” he still looked puny and miserable.
I called the rescue director and confessed that my hopes had fallen far short for poor Kiki. I asked if I could put him under general anesthesia, look in his mouth, flush his nose, take head x-rays, and pretty much make any stab in the dark that was listed in my text book under ”chronic upper respiratory disease." I heard the pause in her voice, (that little jab of falling short of expectations, I get used to it), and a reluctant “OK”.

 The next day, I said "good morning" to Kiki with a little quiet prayer, crossed my fingers and put him under general anesthesia. We took some x-rays of his head. The x-rays showed the damage to the very fine bony turbinates, years of snot eating your nasal passages, but no tumor. Score 1 for Kiki.

We next flushed his nasal passages, until the snot ran from a thick ropy yellow string to a clear saline. Score 2. He can breathe clearly when he wakes up, at least for a little while, I thought.

We next took a peak behind his soft palate. This is the area where the hard bony roof of your mouth transitions to the soft part then heads down into your larynx.

And there it was an enormous irregular cluster of grape like tissue the size of your thumb!!! I was never so happy to see such a hideous structure. The veterinary treatment for a big wad of tissue growing in the back of your throat? grab, yank, and pull. (And, hope it doesn't grow back). Kiki and that hideously huge throat mass was the center stage curiosity of every staff member in the building. We were all so happy to finally have a clear culprit to assassinate for him and yanking that bugger out was one of the most rewarding moments of my opprobrious career.

 Kiki woke up without any complications and since then he has put on 4 pounds and become the most extroverted, playful, and rambunctious kitty you have ever seen. He decides when it is time to start playing, when you are done playing, and he will slap you if you walk away without his permission. He has become one of our resident cats. And he reminds me everyday why I do what I do.

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If you would like more information on this topic; Nasopharyngeal polyps.

Kiki lived with us at Jarrettsville Vet for almost a year. He was then adopted by one of our veterinarians and moved in with his own family. A few months later he developed an inner ear infection that was treated by yet another surgery. He has been happy and well since. He will always be a unique kitty even with with his signature perma-wink and ear bow.

Best wishes Kiki!

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If you have any questions about Kiki, polyps, respiratory infection, or anything else pet related please visit me, and the rest of the Pawbly people and ask us! We are here to help you and your pet!.

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