I AM NOT AN E.R. The Story Of Sophie. Baclofen Toxicity

It has been a week since I last flossed. It seems like a confessional to the internal self to seek a pardon, and once again, promise to do better. It seems I seek a peaceful acceptance of all of my inadequacies within my inabilities too often.

This week was exactly like this… a series of internal confessions with a humble begging for forgiveness to a self that doesn’t take disappointment, or failure, easily.

This day, this Wednesday evening, within this moment, was about Mollie, Genie, Maxi, Taylor, and Sophie. They were all in some degree of desperate dying. Each patient was supported by at least two technicians, all wondering the same thing as I; how could so many catastrophes happen at once?, and, which one would start to crash/die on us first?

“We are not an E.R.” I hear myself produce these words almost daily these days. I am not sure why I even try to explain, or, perhaps more realistically, excuse myself. For every 100 times I recommend to a client that they transfer to the ER, 1 actually consents and goes. People just don’t/can’t/won't/refuse to go. For some of these cases they have already tried to get in. They have called, been directed to sign in via the online portal, and been notified that there is a 10 to 24 hour waiting period. People who are desperately worried for their pet’s life are not going to wait 10 hours. So, they drive to us. Many just show up. Arrive unannounced. Crash a party and hope that the door is open and the staff is welcoming. Depending on the degree of the emergency they may have called us. May have spoken to our Charge Tech to plea their case, which gets parlayed to a vet, and almost always given permission to “come up, be patient, and we will do our best.” I try with each case to set the stage for the reality that we are “not an ER” and may have to transfer them to one should it be in the best interest of the patient to do so. I know that even with this preface, this CYA blanket statement, that I invite the chaos, and hence, I internally beg for forgiveness yet again when I get myself too deep in the shit pile.

At 7 pm I was standing, circling and losing my mind amid the evenings vetmed emergency offerings I had unintentionally invited to my own misery party. I looked into the surgery room. On the table to the left was an 8-month-old puppy. I’ll call her Sophie. She was intubated, on oxygen, and poorly to absently responsive. Under her head sat a bucket of vomit with specks of white pills. To the right of her was Taylor. A five-month-old tabby with fluid in his chest. He was sleeping in a clear plastic box full of life saving, life giving super saturated 100% oxygen. He was happy and loving his time with us, thanks to the oxygen. Just outside the doors to the surgery in a little stainless-steel cage sat Mollie. She was barely visible behind her cluttered cage door with its two fluid pumps, iv fluid bags, (also two), and a clipboard holding checklist of her too numerous medications. You couldn't see her adorable face with its white fluff mane that surrounded her blunted nose and omni present wide mouthed grin framed within the haloed plastic e-collar. She was sitting up on her front feet but straining and posturing her back legs. She had spent the last week like this. Trying in vain to push out a stone that was lodged so deep down her urethra it was only permitting a drop of urine at a time to pass. In the cage beneath Mollie was Genie. A sweet, slow, aged Dobie who had been vomiting for four days. She came in as a mystery ailment and she remained the same until the next day when the 4-year-old in her family confessed to feeding her a whole box of chewy milk-bones. She was in critical condition and not able to move, except for the vomiting that just spilled out of her mouth as she lacked the strength to pick up her head. Skip a few feet to the left and there was Tigger. I.v. catheter running saline into his veins in the hopes we could flush out the grit in his bladder and dodge the need to place a urinary catheter. He had arrived 3 days earlier just about to block. We mounted the most aggressive defensive plan we could to spare him a urinary catheter and his mom the price tag it came with.

Gastric lavage

Within these moments time stands still. I have to suspend it. It is the only way I can muster all of the senses to attention to compute the vulnerabilities and re-assign staff to guard the weak points. I know, I know deep in the seat of my gut, that at least 2, maybe even four of these guys are going to die in front of me. Probably in the next few minutes to hours. “I am not an E.R.” I remind only myself this time.

This is one of the best examples I can give of where vetmed is now. We have burnt so many people they don’t trust, or don’t want to be sent to an ER. For all of the many reasons the ER’s have gotten themselves in the predicament our clients see them as, it doesn’t change the reality that accidents, illnesses and yes, even death comes to find us.

I see my husband for about 15 minutes daily. 15 minutes when I get home, typically around 9 pm, starving and exhausted. He has a meal waiting, typically two hours old, as I never get my ETA correct. I do not recollect any of the meals from the last week. Only that I inhaled them, and that the portions were too large. We go to bed with me feeling like a bloated corpse, and him angry that I cannot ever say “no.” He reminds me of my limitations and the power of “NO.” I remind him that there are few options in these scenarios that I can live with. I remind him that I am reminded that if I don’t help, I don’t know if anyone else will. If martyrdom was a pageant, I could have a crown to sit upon. Think I am being foolish? Well, lets talk about each of these cases in a little more detail. Wonder why I don’t floss? Well, I don’t do anything in this state. I fall asleep as soon as I hit my bed. Surrendering to the exhaustion like the coma that claims me. I repeat this Monday-Tuesday-Wednesday and Thursday. I fall off to sleep worried for the patients I saw. Fearful for those I failed, and afraid for those I will see. I cannot say “No” to these either. They find me in my dreams.  Even here, as I try to rest I see them. I worry and react for them. I send them treatments, and apologies. A figment of a life preserver even here, when they aren’t near me. 

The routine day

On the night before a dog arrived with much the same scenario; "ER has a 10 hour wait. Patient is bleeding everywhere from a dog fight." We explain to the caller that we will do our best to help, but, if sedation or anesthesia is needed they will have to head to the ER. When they arrived it was after 6 pm. I was told that he was "bleeding everywhere" so I rushed in to see him. There was blood splatter on every wall in the exam room. He had been there for less than 5 minutes. The wounds to his left ear were so significant that I was not able to fully assess whether ear needed reconstructive surgery. The ear was not being held up at a normal (or symmetrical) angle on head. There were about a dozen (maybe more) wounds to the top of his head that included both puncture wounds and lacerations. Some appeared to have pocketing and underlying muscle damage. Again too bloody and painful to assess. Wounds appeared to go over to right ear, base of ear and included the neck. As with all wounds of this severity he was too painful to assess fully without pain meds and sedation, and most probably required general anesthesia. I advised them to go to ER. When I mentioned the ER the owner became volatile. She shouted and became angered. She would not to go to ER! she yelled, so I offered analgesics and antibiotics as initial treatment option but again warned that wounds may need clean up to check for degree of soft damage, and tissue damage. I told the owner I was also concerned about pain, bleeding, and high infection rates with dog bite wounds. Owner declined again to go to the ER, and take any medications. The owner went on to say that "this dog had cancer and she would not wait 10 hours at ER to be told he doesn't need anything." I attempted to diffuse her and offered pain management and antibiotics again. She stated that I was being rude. The owner got up, took her dog by the neck and began to leave exam room. She kept yelling, repeating that I was rude, and she was not going to ER. As she was leaving I told her to not return to us, nor treat staff this way. When I said this she turned around and charged at me with a hand in my face and the words "I'm going to beat your face." 

That's what advising someone to go to the ER can get you. She was served with banning papers from the Sherriff the next day. Yet another gem to add to my Wednesday fiasco.

My Storm,, his happy place.

Sophie is 8 months old. She is a wire-haired terrier just fostered and adopted by an older couple who adore her. For all of the mischievousness of a terrier, (vets tongue-in-cheek refer to them as “terrorists”). They find her antics, her strong opinions, and fierce compulsions, adorable. (I can relate, my parents felt the same about theirs. I grew up with 5 generations of Jack Russell Terrorists. They killed our cats. They killed any small thing that scurried). Sophie has a boxy face, tan highlights to a brown face and inquisitive soft intelligent eyes. Her ears stand with a little bow at the tips and she is formidable in a compact package of taught muscles and youthful velvet softness. Sophie was carried into the clinic in her mom’s arms as she burst in the front doors like a hurricane. I was alerted to their arrival by my receptionist who quickly came rushing into the treatment area yelling, “EMERGENCY! WE HAVE AN EMERGENCY!” arms flailing above as if waving down a passing car. I walked to the front and her sobbing mom attempted to pass over her lifeless puppy to me and asked myself, “why does this place feel like a firehouse on some days?” 

It is exactly in this moment that I have to decide. I do not extend my arms. I do not rush to offer some act of heroism in a crucible of mercy. I have to make that split second decision as to who I am and who I want to be remembered as. It is in this second that your marrow matters. It is here that your consequences, your good deeds, your ethos, and every second of every tid-bit of training finds you. Your actions here will haunt you. I know this. This is the place where some vets will offer “humane euthanasia” while others will offer extremis estimates for a chance, and many will take a bad situation and make it hopeless. (To be honest I never quite know if I ever pick the right offering of an answer. More on this with Genie’s story to follow). What I wanted to do was ask her to remain there. Put her on a pause, holding her rag-like puppy and make a quick physical exam assessment and,,, punt. HARD. I did not want to be responsible for her. I did not want to be responsible for a hysterical mom feeling guilty about an accident I have seen so many times before. I did not want this dying puppy. I didn’t want any of the hers in front of me asking for help. Now I know this sounds cold and cruel, but the reality was that I had just finished a long morning of over booked surgeries. I had come in early, after getting home very late, to try to cram in all of the things that I had scheduled. There was not enough room for them, never mind the falling deaths from the skies. I know this. I know I am supposed to say "NO!" I looked at her puppy, I looked at her, the words slipped out softly, “I am not an ER.” I knew we didn’t have the manpower, the time, nor the facility to help a puppy in this state to the degree she needed. Sophie was purple, barely responsive and I was pretty sure she was dying in her moms arms, if not already dead, and would die on her way to the ER. I clumsily said as much. Mom begged me to “try” and I am a sucker for that word. It is my verbal kryptonite. No other word compels me. Mom was hysterical. Mom was not safe to drive. Mom was not going to make it to the ER with Sophie alive.

 

Sophie was in such a terrible state that I knew she had a very narrow window. I took her in my arms and we headed into the treatment area. Over the next few minutes the story of Sophie’s predicament unfolded. Her parents had left her at home for a few hours. When they came back she ran to greet them, same as always. Within a few minutes she had vomited and then they found the chewed up pill bottle. Scattered around the bottle were large white aspirin-powdered pills. Baclofen. The label was so chewed up that we had to use the pills and pharmacy information to identify them. The bottle was filled for a 30 count. 13 remained. As the technician called Pet Poison I debated her degree of consciousness and whether she was awake enough to induce vomiting. She was not. Sophie had dried bloody, thick, taffy-like saliva and vomit in her mouth. I tried to clear it. It was a sticky-spiderweb goo that left your hands incapable. Sophie was placed on the x-ray table. She had a huge distended stomach full of,,,, well, seemingly dog food and pills. We whisked her to the surgery table, quickly intubated her and provided oxygen to her purple lips and tongue. She was slipping into a coma. Four people, two of them veterinarians, swarmed around her tiny new body. We placed a stomach tube. We lavaged the stomach contents in a desperate effort to remove as much pill-peppered-ingesta from her stomach as we could. The clear plastic tube sucked out tan kibble speckled with white powdery-pieces of pills. She gagged once, whimpered once, and lay lifeless for the rest of it. I gave her intermittent breaths of oxygen and told her that I was sorry. I told her she was loved and I watched the staff so desperate to help and so foreign in this act of emergency procedures. Sophie gathered a crowd and I barked orders to try to turn a tide I knew we were all likely to drown within. I called the hospital manager down. I told her to call all of the rest of my evening appointments and tell them we were swamped with emergencies. “Offer to reschedule, (knowing this never works), and ask them to be patient if they don’t want to. Go in all of the exam rooms, (I knew all 7 were filled with people waiting for us), and tell them the same.” I put her on the reception desk and pulled the last two techs to the back treatment area. For three doctors we had 8 technicians scurrying. We also had 17 patients in our building, 7 wanted to crash and expire if you blinked.

I got on the phone with a veterinarian from the Pet Poison Helpline. He was slow spoken, jovial, and the calmness on his side of the line was re-assuring and yet vexingly annoying. “Baclofen is a common toxicity. Have you had one before?” There it came again, “No, I am not an ER.” ‘Don’t kill the messenger’ and ‘be nice.’ I said to myself. He is here to help me. (Does he know that I have 7 other animals trying to die around me?).

“Baclofen is a muscle relaxant,” (yeah, I can see that). “It has a very narrow index of safety in dogs” (Like 1 pill? How about 17?). “Unfortunately, (never want to hear a sentence start with this), most dogs, if they survive, (never want to hear this either), need supportive care for 72 hours to up to 6 days. Many need to go on a ventilator.” (Crap, who has a ventilator? Only the veterinary teaching hospitals, I thought). I kept going. We kept lavaging, hoping, and telling her that I loved her with a gentle pat to her head. I stroked her ears in between her oxygen bag compressions. If she was going to slip away it would not be without my whole heart and soul going with her.

Over the next hour we tried fluids and desperate attempts to stabilize. She was the last patient to leave the hospital that night. I called the local ER to refer. “No,” they had not had this toxicity either. “No,” they didn’t have a ventilator, but, “Yes” UPenn vet hospital does. They had sent a patient last week. Estimate given for this was $18,000 to $30,000. OMG Crap.

I look back on Sophie and I want to cry. I want to be upset about how many times pets get into things we think that they are smart enough to avoid. I want to put up billboards to say, “NO! crate training is not punishment. It is the safest place for your pets to be.” My pups are 4 years old. They are my children. My most beloved. They are also raccoons in autographed collars. They will get into everything if I turn my head for a second. They are trouble. I know that. They are crated when I am at work. They are in a cage at the clinic. They are in a crate in the bedroom when we go out the door. I don’t care if it is 5 minutes or 5 hours. They have been raised this way. Every pill bottle in this house is double locked. A bottle in a closed drawer. Never, ever is it out. Have you ever shaken a pill bottle next to a pet toy? It’s all the same inviting tune.

In a sea of crashing waves, tumultuous and treacherous, I will never forget Sophie’s face. I will never forget that yellow pill bottle with its perfectly intact child-resistant white top, labeled as such. Tattooed with its cursory; “push-down and turn” orange letters. Shrapnel-ed bottle, completely missing any recognizable bottom, or rounded edges. The label chewed, swallowed and obliterated in casual terrorist fashion.

Sophie was sent to the ER at 830 pm. She was transferred without her breathing tube. She coded overnight. She never regained consciousness.

I hope that she heard me. I hope that she knew she was always adored. I hope that she forgives as much as I hope I can forgive myself. Maybe I could have/should have used warmer water in her lavage? Maybe I should have done it just one more time?

My Raffles,, on our daily "dog" walk

Maybe forgiveness holds as much power as intentions? Maybe peaceful acceptance maintains the balance?

Maybe the other 6 will survive. Maybe I am an ER, if only in sheep’s clothing?

My Frippie and Storm

This Time Around. Coming To Terms With The Death of My Beloved Pup..

Veteran territory. I have been here before. The wound is soo deep it seems fresh, draining, life threatening. Death has been to visit me before. We haven't come to terms with each others presence, nor purpose. IT is still an unwelcome intruder. Albeit, ominous and undeniable, still IT calls, I collude, and yet, IT always wins, as I feign fractured and defeated. Again, and, again.

Our pets never live long enough. You can try to push the limits of pet-mortality with purchasing a parrot,, get yourself a good chance at a millennia, but dogs, if you stay mainstream canine, are lucky to see their teenage years, incredibly blessed if they hit two decades, and if you like to go big, or even "giant" you may not ever see double digits together.

I have learned that my heart can barely handle this pain every 10 years. I need, want, choose, hope, pray, beg, for a decade of longevity. Turns out my track record reflects this. "The older I get, the smaller my pets get." It is a hard-learned trade secret to try to spare me the loss every 5 years, or so, and it allows me to be able to carry them when their winter starts to wither and their bones can no longer support their ambulatory requirements.

The last few years has marred me with the loss of two beagles; Jekyll (just last month), and Savannah, a few years ago.

It took me weeks to get out of the grey fog I was flailing in with Savannah's loss. I just couldn't get out of the programmed repetitive daily motion I had become so accustomed to. The getting up at all times of the night. The managing her hysteria, messes, and failing functions. Undoing the habitual duties she set into my daily life took time. All the while desperate to go back to that place of interrupted sleep that her deprived mania brought just to have her back with me. But her loss was explainable, excusable, sensible. She had made it to 16. A ripe old age. A respectable age for any dog. She could be grieved but not denied a silver lining sentiment for surpassing the acceptable tenure. I could complain that her loss hurt, but I couldn't expect sympathy that she hadn't been afforded a long loving life.

Savannah

Jekyll, my most recent loss, another beagle, passed away at 8. He got cheated. I have anger lining that grief. Bitter shards to embalm him in. Seething pain to intern him with. Dust to damnation. A cursed cruel loss.

jek

The pit of my grief with his death lies here. The time frame cut too tragically short. The agony of desperate attempts to buy another "good" day for him. The exhaustion in losing the big battle. The responsibility I feel as having been the ultimate master of his destiny and purveyor of his curtain call. It is a terribly painful place to be. The ultimate responsibility can leave you with the lifetime of despair in second guessing and brow beating every previous decision. Sad couldn't begin to capture my angry bitterness. Except to mar it with also feeling responsible. That little fact made it crushing to swallow, impossible to move on, and fraught with such self doubting so that no piece of me was big enough to reassemble.

The days after his passing were simply about getting up, getting dressed, crying in the car to work, choking on grief and visible despair , all the while attempting to trudge into a day I dreaded facing. It also brought me back to why. The why of this profession? The immense magnitude of the responsibility we carry. The joy and the pain and the immeasurable grief it brings when you build a life around another.

The why we let them into our homes and hearts? The why we incorporate them into all parts of our lives? The why it is so easy to love them and yet so impossibly hard to lose them?
The why is the reason for everything we do as a parent and a veterinarian. It is important to always remember the WHY's?

I can love this pup, let him go knowing life too often works in its unfair ways, and not be ashamed, embarrassed or surprised when it repeats itself in my clients lives. If you can't feel a loss you cannot love. They are inseparable. It is what makes a vet a real person in the right profession for the right reasons.

I know this. I believe this. The tough part is living this when my own heart is shattered after losing the little one I loved so completely. It is grieving. Understandably. Grieving without withdrawal from ever opening your heart again is what I believe to be the most devastating part of pet loss. This is where I spend time talking to clients. It is normal to grieve. Grieve, however you need to, for you. Take time for yourself. Make a place to memorialize your pets life. A place to know you can go to to tell them how much you miss and love them. Live in the memories of your time together. But, try to not blame yourself. Try not to get stuck here. I know it is hard. I spent weeks here feeling like I, me the great powerful veterinary healer, could surely have saved my beloved boy. I had time, financial resources, access to the best specialists. Every tool to make him survive even the worst disease. It didn't happen, He left too soon. I lost him. I failed him.

Me and Jek at the oncologist's office.

That was exactly how I felt. Can you imagine how everyone else who doesn't have a decade of being a doctor, a clinic at their disposal, an Army of specialists, a bank account dedicated to dog care feels?

We will all lose a love because life always meets death. But giving up on loving again, ever having a pet again, that's where the real tragedy for me is.

So many clients give up after their pet dies. I think they feel it is too painful to go through again, or, like me they feel as if they will never find another pet who fills the shoes, measures up to the caliber of loyal/obedient/dedicated/wonderful there pet did. It is natural to not want to feel awful again. But not feel again? That's a loss that costs more than any heart should endure.

You cannot go through life living it if you try to not feel it,, good, bad and everything in between.

We all write the chapters of our own book. My book, each deep rich chapter of it has always been delineated and defined by the four legged family who made the tapestry the vivid, meaningful experience it was. The many homes, the varied geography, assorted jobs, were all the background that set my stage for each chapter whose central characters were always the dogs, cats, and pigs who made this life colorful and rich. They were, and are, the most important and meaningful pieces of the life I created and treasure. Some took up hundreds of pages. Some saw me through decades of questions trying to create the adult the kid was dreaming of. Some were short poems, a life too little, too fragile and too small to last past a haiku on an abbreviated page. But I am a richer, wiser, more content and accomplished thanks to their acceptance, love and wisdom.

You would think that with all of these chapters, all of the times I have been through loving and losing them that I would be better at grieving? My previous practice would make perfect assembly line efficiency of recovery? Yeah, not so much. I still invest whole heart immersed, drown in despair with loss, and trudge ugly through getting over it. Practice has not made perfect, unless that perfect implies pitiful.

The loss of Jekyll and Savannah took me weeks, months, longer/forever, to come to terms with. I will never "get over them." They were too monumental for that. All I wanted from myself when getting through their loss was to not give up. It was all I could hope for. They were loved. (I can say that with total conviction). There are millions (millions) of equally deserving (I can say that with complete honesty also) who never know a kind hand. I still have that to give. I may be broken and hurt, but I can still be kind to a furry face. I have to think beyond me. Society, civilization rests on this. It does transcend past human to human. Anyone who has ever loved a pet knows that. The world is better for all of us because we can love each other, regardless of size, shape, color, claws, fur, or fins. Love that is compassion is the key to life. All life and all living. This is what I believe, and remind myself of when reeling in loss.

Here's what happened to me after Jekyll passed away. I cried a lot, for days, weeks.  I told the people around me that while I appreciated their sympathy I couldn't talk about it at work. I had to stay busy and focused around the grief.

After two weeks I started trying to put my toes back in the water. I started looking at the pets in the shelters and at the local rescues. None of them were Jekyll. None of them pulled me into compulsion to step forward for them to come home with me. None of them were Jekyll. I was looking for that face. That smile. Those ears. Some tiny resemblance to jar me into adoption and out of affliction. I realized that obviously I wasn't really ready. I wanted to be ready. I just wasn't. I started spending loads of time with Charleston, my other dog. The left behind dog while we were all so focused on Jekyll. He had been neglected while Jek took so much of my time to monitor, treat, and obsess on. I owed him help in his grieving to. He was as heart broken as I was. We went on lots of walks, changed the room around. Got new toys. A little distracting helps pets adjust to a different routine and life. He got quiet and withdrawn. He missed his instigator and boisterous beagle brother. He was always the shadow behind that dynamic personality. He never saw his own sunshine  without Jekyll pointing the way.

Charlie was depressed.. But, he seemed more than withdrawn. He seemed deflated.. Vet mode mom kicked in (although it felt like paranoid vet mom). What would I do if he was dying too? Charlie's blood work revealed a low thyroid. I put him on medication to see if this would help resolve his lethargy, depression and sadness. It helped quite a lot. He started to wag again.

The next set of events changed everything. It added a new chapter and pulled me out of isolation and despair. A hurricane hit. Storm landed. (more on him soon). Hurricane Florence lands.

I added two very sick puppies within 3 weeks. We needed each other. I remembered I had a purpose outside sadness. I am alive again with them. I can go on. Being needed and loved helped me remember to start writing the next chapter, again. I was pulled out of grief by two sick puppies. I reinvested my energy into them, constructive caring, versus my grief soaked couch. Charlie, well it took about a week to realize they were residents, but when he could no longer ignore their incesant chew-bite instigation, he started to play. Within two weeks we stopped his thyroid meds (there is no medical study to back this, but its true). Charlie, and I, were back with the living.

I wasn't ready. I have no idea how long we will get together. But the time with them is far better than the wallowing in despair. We need each other, all of us. Loneliness is the gateway to despair and my puppies are waiting for me at home.

To all of those out there drowning in grief I hear you. I know. There is a way out. Reinvest your whole self in a pet. They need you as much as you need them. You can help each other to the shore. I send you all love and support.

For more information on who Jarrettsville Veterinary Center is please visit our Facebook page, or our website.

If you have a pet question or a story about your pet to share so we can start to help others who might be in the same situation you are (or were), please visit us at Pawbly.com. It is free to use and open to everyone.

If you want to learn more about pet care visit my YouTube channel here. 

The Aftermath.. The days after losing my beloved Jekyll.

It has been a day of crying. Just a puddle of despair....
.....and lots of self-doubting questions.

My dearest Jekyll-pup.. How I miss this face....

How will I go on?

How will I go to work today? How do I face anyone? What if they ask about him? How can I maintain any kind of decorum or composure? How can I talk, utter a word, without crying? And then how do I stop?

How do I go on?

How do I get through the rest of the days ahead when they can't possibly contain any light or joy in them?

Did I let him go too soon? Did I really (really) do all I could have? (Internally I never, ever, answer this question with conviction that "I did!" There was still chemically induced coma to let his gut heal for a while. Stem cells. Cloning. More radiation. More chemo? Bringing him to the teaching college to say "DO anything, everything. Money is no object."

Charlie, his roommate, companion, partner in crime for the better part of the last decade, is as lost and alone as I am. For the last year of Jekyll's intense treatments, unyielding all night emergency bathroom requests and alarms Charlie sat in the bed next to him. He never once got up with us. knowing these were just a part of his disease process. Not time to wake for the day. Not anytime to be going outside at O-dark-middle-of -the-night-morning for anything of interest. He would open one eye, check to make sure one of the parents was getting up to take Jekyll out and then go back to sleep. Charlie has been the guardian for Jekyll's whole life. The big brother overseeing the rambunctious energetic trouble seeking beagle-hound. He has kept a watchful eye, been very sedentary as Jekyll slowed down. Charlie's life had to sit in the wings waiting while Jekyll took so much time and attention. The daily 4 mile runs had to be truncated to long walks in the woods twice a day. The adventure remained but the stamina waned. Charlie, who has sat vigil or left his side in the last 6 months waited. He waited for his friend to get better. He waited for his mom to get more time to give him. His life got smaller, subdued, and simple. I owe him an apology for that. He never took time or attention away from Jekyll.. I didn't have any left over to spare. He was respectful of that.

Jekyll and Charlie,, always ready for another adventure.

On the first night without Jekyll, amidst the sobbing and the silence, and the loss, the loss of Jekyll's presence which brought a coldness and a stillness to the house which loomed, foreboding and haunting, Charlie got into his bed, curled up and closed his eyes like he has for years before. He is our steady sleeper. He never gets up at night. He never got up the thousands of times Jekyll needed to. He never made a peep until I got up and told him it was "time to start our day." That night, this past Sunday night, our first night without Jekyll in 9 years, Charlie got up every hour to summon me. Every hour he scratched me to wake up, he ran down the stairs, shot out the door, looking. Left. Right. Ears up erect. Listening. Looking.

 

Charlie looked for Jekyll all night long. Eight trips outside. Eight trips darting outside intent to find him. Eight trips being coaxed back inside reluctantly. Apologetically. Unwilling to leave him alone outside. Knowing he was not in the bed room, not next to him in his bed. Not with us.

It is so hard for all of us. The mark that this loss bears.

Two days after losing his best friend I still cannot get Charlie to eat. I have left over steak, roast beef, chicken nuggets. Charlie will only eat the snacks Jekyll was being blandished by. Charlie has retreated into a subdued routine. Nothing gets him happy. Nothing pulls him out. Not walks, not food, not me. 

I lost one kid on Sunday, and I cannot seem to cajole my other into rejoining the world. I get it. I do. I don't want to be here without Jekyll either. It just not the same.

People, souls, all of us, retreat into ourselves when life denies us the comfort we need. It is safer, quieter, peaceful here with my memories and loss.. no one will ask me anything here. I don't have to answer the why's, the how's, the dreaded "how are you doing?" I can just hug my dog who already knows the answers.

More on Jekyll here;
The Little Things.

Losing My Beloved Jekyll-Pup

there are dozens more stories on him.. he was my muse,,

Jekyll Arrives

Pets Are Not Property. The Case of Bela. Whose deceased owner requested he be euthanized at her death so they can be buried together.

Bigfoot was brought to us after his dad died
and the rest of the family decided they didn't want him.
Do you believe in second chances?

There are many aspects to being a veterinarian that are difficult. I have talked about a few of them before. The stress of compassion fatigue. The difficulty of dealing with clients who can be shallow and selfish. Those who view their pets as disposable whims of fancy by dumping them when they no longer match the house decor. (Yes, I actually had a client request a euthanasia because her black cat no longer matched her new white furniture). Or, those who abandon the middle aged, older, or ill pet for a cheaper new edition. (See Levi's story). The list goes on and on. It can be depressing and bleed your soul dry as you try to be a doctor for a patient someone else is supposed to be both emotionally and financially responsible for. It can be extremely difficult to maintain a genuine degree of care and compassion when a client seems to lack the same. You get stuck in the middle.

But what do you do when a seemingly loyal pet parent wants their healthy pet destroyed upon their death? Is it possible to love so much that it is detrimental to your pet?

In the news recently is the case of Bela, a healthy 9 year old German Shepherd whose owner died and left a request in her will to euthanize him so their ashes could be buried together. Bela's story here.

There has been an uproar on social media and a band of highly charged outspoken animal advocates have gathered to try to save him. He has been offered refuge, homes, and sanctuary. BUT, he is property and that leaves his fate up to a court. To make matters worse for him the lawyer in charge of his fate states that his owner feared his aggression and lack of socialization were reasons enough to not seek a home for him after her death.

Do you think that this is uncommon? It isn't. Over the last years I have had one client ask me to honor her wish of euthanizing her two dogs should anything happen to her. She believed that no one could love them, or care for them to her standards, and that it wouldn't be fair to the dogs for them to be left to someone else. She lacked faith in her family, her friends, our society, and believed with her whole heart that their lives were better off if they were ended when hers was. It was a conversation I will remember my whole life. I told her that I understood her concerns, and that I knew she loved them, but that I had seen soo many pets find a second home, and go onto to live a second life with another family. Yes, for some pets it took time, and yes, for some they might miss their original life, BUT, every single pet was alive. Pets live in the moment. They love again, they forgive, they don't feel sorry for themselves, and they adapt. For every pet we have declined to euthanize we have seen new lives grow, new chances, and new miracles. They happen, they take faith, devotion, and time, but they happen.

j

Sunshine,
Bigfoot's brother arrives for me to  examine, update vaccines, and find him a new home.
His dad's father sits next  to him, still grieving the loss of his son.

Here is a story of pets that we didn't put to sleep when their owners passed away;

Pheobe. Her family brought her to us to put to sleep because her mom went into hospice and none of the remaining family wanted her. She became the companion to a dog who suffered from severe seperation anxiety. She also went from an obese, lethargic, withdrawn dog, to a bubbly, happy, energetic dog. Her life changed so dynamically that I would not have known her to be the same dog if I hadn't witnessed the transformation firsthand. Pheobe's Story here.

There have also been a handful of clients who died and left no plan for their pets. ALL, yes, ALL have been housed with us, adopted out, and gone on to live the rest of their happy life. What will happen to the pets you leave behind blog.

Bigfoot celebrates Pets With Santa 2014 with us at the clinic.
He was with us three weeks before he found his new home.

So, where do I stand?

On Bela's case, as with every pet, I stand with Bela. But, I also recognize the complexities of his case. Bela's mom made the most common  mistake I see with German Shepherd's. Bela was inadequately socialized and trained at a young age and this has made him into a socially hesitant member of our society. The only dog I have euthanized due to aggression was a young German Shepherd who almost killed his own owner after he surprised him when he was walking into his own house. BUT,  I  do not believe that every aggression behavior case should  be given up on. Bela is in a sanctuary now and they should be the a part of this discussion.

Pets are not property. Until this archaic, incongruous notion is redefined into something more consistent with they way we love, honor, respect and treat our pets situations like these will occur, pets will be disposed of without consideration, consequence, or voice.  Our pets, our four legged-furry children enrich our lives, save them, protect them, and yet we deny them rights and protection worthy of their contributions.

When you deal with death, abandonment, grieving, medical mysteries, angry clients, fearful pets, and the mixed bag of grief and joy that being a veterinarian involves you learn to trust that life has a reason, you are a small part of a big picture that will keep you humble, curious, and believing in something  more

Sunshine found his home in 1 week.

There are amazing people, just as there are amazing animals in this world. You just have to open your eyes, your heart, and have faith that they will meet. I know anything is possible if you try.

We have a great deal to learn from our pets. They forgive, they love, and they can adapt. Life is about second chances, and loving one another. Are our pets the only ones who intuitively remember this?

If you have a pet question please visit Pawbly.com. We are an open pet centered community dedicated to helping pets by exchanging pet care information and support. You can also find me on Twitter @FreePetAdvice. Or, in person, with some other pet in need of a home, at Jarrettsville Vet, in Jarrettsville Maryland.

Merry Christmas to all!

Update;
Bela Is Saved! He will be moving into Best Friends Animal Sanctuary soon! Is it a miracle? Yes, of course, but it is more a testament to how much we love our pets, how much power lies in the hearts of people, and how anything can happen if you believe AND you try. His story here.

Death and Those You Leave Behind

There are a few die hard animal rescuers, guardian angels, and tireless animal advocates in Harford County, Maryland, where my clinic resides. They are the backbone of how Harford County, (a very rural farming community at the Northern most part of Maryland), keeps the feral cats from outnumbering the squirrels. These  few women generously dedicate their time and considerable amount of personal expense to help the four legged domestic pets of our community that no one else seems to care about. To say I admire and am inspired by them is a gross understatement. Whenever they come to see me at the clinic it is always with another cat or dog with another sad tale and another long road to a happy ending. It is my standard practice to not charge them for my time and to go to whatever lengths possible to assisting them care for their latest do-good-subject. 

Last Sunday Julia came in with a cat in a carrier and a visibly heavy heart. With the opening of the exam room door, a quick "hello" and the cursory "how are you?" introduction I knew that she had an especially troublesome story to share.

"Did you know that my neighbors passed away?" she began.

"Yes, I had heard that the Mrs. G passed about a year ago." I replied. I knew that her neighbors, longtime clients of Jarrettsville Vet, had a few dogs, a mix of poodles and German Shepherds, and some cats. I also knew that Mrs was ill and had passed. "But what about Mr. G?" 

"Yes, he just died too." Julia gave her shy smile and lowered her head out of respect.

"Oh, I'm sorry, I hadn't heard." I answered slowly and softly. 

"Yes, Mr. G died and wasn't found for a week. His other neighbors found him after they noticed there wasn't any footprints in the snow around his house for a few days. There were four dogs in the house, one had died and been eaten, and four cats. Most of the cats have never been seen by a vet and two of the poodles were so matted we had to shave them down to be sure they were poodles." She took a long pause....."Thankfully the little dogs are very sweet and I think I can find them a home easily. The cats....well, I'm not sure they will acclimate well, or be suitable house cats. I'm going too try to find them a home, but if worse comes to worse I suppose I will just keep them as barn cats.

"Oh, god, I'm so sorry." I was having a tough time processing all of the details, trying to skip over mental images, and feeling that sour mix of disbelief, disgust, and dismay. It is at these times that we struggle to remember those little details that make each person an individual. I remember them coming in together as a couple. He was tall, quiet, looming, and she was short boisterous and demanding. They were a colorful couple who most people cowered to, but they loved their animals. Blindly they loved them. 

To think that they were gone. 

To think that their pets, who they loved so very much were at the mercy of us. People they didn't know, who didn't care for them and who would likely split them up, or worse. It is hard for us to imagine that we are going to pass on, and it's even harder to think about planning for those that depend on us. But for our pets it is something they need us to do for them.

I asked Julia if she would allow me to write about this. 

She did one better, (as she always does), she wrote me her account.

She sent me these two photos of the cats that are still in search of a new home. If you can help her, or any of the pets that were left behind you can reach me here. 

From Julia;

On December 19 my neighbor was found dead in his house.  He owned a horse farm and lived by himself with his six dogs, five cats, and four horses.  Apparently he had been dead for over a week before he was found.  None of the animals had food or water, and one of the Poodles in the house was found dead.  Thanks to Officer Stacy Rawlings from Harford County Animal Control who came in and took care of everyone and made sure that their conditions were not critical.  Stacy also had the pleasure of dealing with a German Shepherd who was extremely protective of her property and was able to safely move her. 

The dogs and cats were transported to the Humane Society of Harford County where they were each given an extensive examination and food and water.  The shelter cared for the pets for almost a week until they were picked up on Christmas Eve and returned to the farm.  Thanks to Mary Leavens, Blaine Lang, and the staff at the shelter for giving everyone such great care. 

None of the dogs and cats appeared to be up to date on inoculations, and the Harford County Humane Society generously tested the cats for leukemia and FIV, gave everyone all of their vaccines, and a flea preventative.  This was a huge cost savings for the man’s son who is very appreciative.

I’ve have been helping to take care of the horses along with Emily Cavanaugh, and Jim Nooft.   The man’s son is a horse trainer so he will move the horses and sell them.  The dogs have all been placed in their new homes, and at this time I have possibly two cats that still need a home (pictures attached).  One older cat became very sick after she returned to the farm, and Animal Rescue, Inc. has been caring for Clarice.  Their vet diagnosed her with possible pneumonia, and she is being treated with fluids and is being fed every two hours.  She appears to be getting better so hopefully one day she will be able to go to a forever home.

After this experience I cannot say enough about having a designated care giver for your pets.  Since your pets cannot take care of themselves and make their own decisions, it is extremely important to have an advocate for them.  Also please keep an eye out for your neighbors who live alone, and if you do not see them every few days check on them since their life can depend on it.

A big thank you to Julia for sharing her story, her time, and for always being such a beacon of kindness and generosity to others.

As fate would have it another client died unexpectedly and left their pets alone in their home until his body was discovered. Their story follows next, and I will try to provide some guidelines to help us all take care of our pets should we depart before them.

If you have a pet question, or would like to help others with their pets, I hope you will join the conversation at Pawbly. Or you can find me on Twitter @FreePetAdvice.

Death By Accident

Yesterday our evening appointments were interrupted by a woman rushing into the clinc carrying in a white collie mix who was flat out. She was hysterical and her three young half-clothed boys followed like ducklings in tow.

When she erupted into the front doors her shrieking turned into a full exam room of screaming. The receptionists were frantically yelling, the waiting clients were awestruck, and then joined the bellowing, and even though I was only half-way through my examination with a client I too joined in on the hysteria. I literally dropped my papers, ditched the exam, and high tailed it (despite the receptionists screams to "RUN!") behind the congo line parade of delirium. It was pandemonium, and all the neighbors knew.

A very young, intact, long white haired Shepherd mix was placed on the surgery table. He was lifeless, but still breathing. He seemed to be entering a comatose state and I knew the minute that I saw his bright red-purple gums and the slightly watered down blood pouring from his rectum that he was a heat stroke victim. As I started to take his temperature the first number that flashed onto the digital read-out was 106. Within 2 seconds it beeped at its max read out of 108 degrees. I told the 3 techs scrambling for equipment that he was a hyperthermia and that he was likely going to die.

Terrible, cold, short, words to hear. But I knew that surviving 108 plus degrees internal body temp was physiologically impossible.

We immediately transferred him to the dental table so we could start hosing him off with water. I reminded the staff to use "cool" vs "cold" water because ice-cold water on an already way over heated animal causes the vasculature on the skin's surface to vaso-constrict and stop blood flow, therefore arresting the cooling process.

I then knew that I had to very quickly go out to talk to the family.

Three boys under age 10 flocked to me like I was some sort of relief aid worker. They were all in summer shorts, no shoes, and no shirts. It appeared that their dogs discovery had occurred mid- afternoon summer play time. Their mom, also in summer pool attire, was crying uncontrollably and kept asking me.

I asked the receptionist to sit in the exam room with the boys while I took mom across the hall to discuss Rudy's condition.

"How did this happen?" she asked.

As much as I didn't have a spare second to try to console her in her grief-ridden confusion I tried to explain hurriedly that Rudy was very hot, and that I needed to know if she wanted me to start emergency treatment measures on him.  although his internal core temperature was above what I could record and that I feared he was too hot to be saved.

She replied "Yes," in a momentary lapse of tears gurgling and incomprehensible babble.

She asked me, "What happened?" and I wanted to pick her up and shake her. It was my honest first response. How could she not know what happened? How did she expect me to know?

I replied back to her, "Ruby has gotten too hot. His internal body temperature does not even register. He is above 108 degrees and I am afraid he is going to die." I had no time for platitudes, and there were 3 techs in the back treatment area and her dying dog who needed me immediately.

She started to mutter something to the effect of "we only left him tied out for two hours..."

It was a 100 plus degrees outside and I was going to say things I would regret and Ruby was going to die if I didn't leave.

I ran to the back and we started to try to reverse the series of life-ending steps that his body had already started.

One tech was still hosing him down. To the touch he was almost completely soaked now.

The other two techs were trying to place peripheral i.v. catheters in his front leg.

I barked out orders as fast as I could. Ruby needed an i.v. catheter in each front leg and fluids as fast as we could deliver them.

My staff is incredibly competent and every technician in the building can place an i.v. catheter within seconds. Multiple attempts at light speed and they still didn't have one catheter in. They stopped their attempts and moved over so I could jump in.

He had no blood pressure, no palpable veins, and hence they had had no success in placing the catheter.

Because he was so hot his blood had already started to condense. They were expecting to see a "flashback" of blood when the catheter entered the vein, but he was too hot for the blood to "flash."  He was a patient with blood vessels like they hadn't seen before and their idea of normal was prohibiting them from believing that their catheters were in the vein. As I advanced the catheter there was only a teeny tiny drop of blood to flash. They were expecting his vein to be the normal tube like liquid-blood filled structure that healthy pets have. But he was no longer a normal healthy pet. I quickly taped the first i.v. in and moved to the other leg.

The other leg was so difficult that I had to do what we call a "cut-down." The vein was so small, so obscure, and so damaged that I had to cut through the skin to dissect the vein out so I could then try to place the i.v. catheter. It is a procedure we only do when everything else has failed and we are up against a wall. I placed the second i.v. and we started to push fluids as fast as we could.

"The fluids won't run," they reported to me as quickly as they started to squeeze the i.v. bags.

The veins were blowing because the "tube" of the vein had been heated up to a point where the tube broke down. Not only were the walls of the tubes breaking down, but the liquid-blood inside of them was no a jello-like consistency. He had essentially evaporated off the liquid and congealed his own blood. Both legs i.v. catheters were blown as quickly as we had started to push the i.v. fluids.

Within minutes of cool water cooling his temperature registered at 106.5. It was better than >108, but he was failing, and all of our attempts to save him were too.

He then started to seize. I tried to give an emergency valium dose to stop the seizure but seconds after the seizure started his heart started to beat irregularly.

At this point I looked at my staff. They were begging me to save him, and gazing at me as if I had some magical powers to stop and reverse time.

I said to them again "I am sorry, I think he is going to die."

I looked at Ruby and I said, "I am sorry."

His heart changed from too slow, during his seizure, to wildly erratically irregularly fast. He was in atrial fibrillation now. I grabbed for more drugs. His eyes opened, his head flew back, the pupils went fixed and dilated, and his mouth gaped open as if to release a harboring demon.

The techs begged me to put him down. One grabbed for the euthanasia solution as I wrapped my hand around the area of his chest where I could feel his dying bewildered heart take its last few beats.

As he took his last breath I pierced his heart with the pink fluid to relieve his struggle. He died before the fluid could assist him.

It had been less than 20 minutes and we had all witnessed what we all collectively agreed was the most excruciatingly horrible death.

I returned to the family to notify them of Ruby's passing. The boys, who had not seemed upset before, now screamed in a charged guttural grief stricken cry. Their mom held them and tried to comfort them. I could tell that she wasn't going to let herself cry while she stayed strong for her children.

The rest of the family arrived a little while later. I spoke to all of the adults together.

They didn't understand that 2 hours was likely an hour and 50 minutes longer than any dog could tolerate in 100 plus degree very high humidity heat. They told me that they never tie him up, but because the kids were out playing, and because Ruby was trying to corral them up, they had tied him to a bush. He had been jumping and barking and when they found him he was collapsed under the bush.

I tried to explain that dogs are about 2 degrees warmer than humans are, they wear a fur coat all year around, and that they have a very limited ability to sweat.

Ruby's death was a terrible tragic accident and my only hope is that his story will save other pets out there somewhere.

Please never leave your pets outside in hot weather. NEVER EVER leave them in a car. And if they start to pant its time to get them wet and cool them off.

Any pet over 103 degrees needs to go to a vet immediately!

My thoughts and prayers are with Rudy's family.



I saw this online recently. It is a petition at change.org.

It’s a sight that makes Dorothy Hearst desperately worried every summer: a car parked at a shopping center, a dog looking anxiously out the window, and no owner in sight.
Dorothy never leaves Emmi, a 3-year-old Labrador whom she adores, in her Subaru -- as a lifelong dog lover, she knows that in the few minutes it takes to run an errand, the temperature in a car can soar to almost 110 degrees. But many people don’t realize that even a 15 minute errand can be fatal for their beloved pets. For Dorothy, it’s heartbreaking. And what’s worse is knowing it can happen to even the most loving owners -- people simply don’t realize the danger. Dorothy knows that educating people would save the lives of countless dogs. That’s why she’s started a petition asking Subaru, which prides itself on its dog-friendly image, to make an ad warning drivers not to leave their dogs in the car during the summer.
As a Subaru driver, Dorothy appreciates all the ways the company has already shown it cares about dogs -- and she loves its popular "Dog Tested, Dog Approved" ads showing dogs test driving its cars with hilarious results. This summer, she thinks Subaru can use these creative ads to send an important message about the dangers of hot cars -- and save the lives of hundreds of dogs.
Subaru says 70% of its customers are pet owners, and Dorothy thinks this makes them the ideal voice for such an important, dog-friendly message. She's convinced that Subaru will jump at the chance to appeal not only to its own customers, but to dog lovers everywhere -- and she knows that this is one of the most powerful ways to make sure this summer, more dogs don’t die needlessly.** ask Subaru to save dogs’ lives by making an ad warning owners not to leave their dogs in the car this summer.
Thanks for being a change-maker, via Change.org see Dorothies petition.

The signing period for this petition has closed. You can notify Subaru yourself via their link at  https://www.subaru.com/shopping-tools/contact-us.html. Wouldn't it be nice if there was a way for automobiles to detect if a pet or person was in the car? It will happen someday.


For more information on the dangers of pets in cars see; http://www.petmd.com/dog/emergency/common-emergencies/e_dg_heat_stroke

Moe's gentle heart

I am a veterinarian. I usually don’t believe that your job should define you, but sometimes it is the most accurate summary descriptor I can use to characterize myself. I, like most of the rest of my colleges went into veterinary medicine because we like animals better than people. Not really an admirable quality, but honest. Of my many memorable veterinary experiences it is usually the pets that burn a place in my heart and head. This time it was the clients more so than my patient that made this case so memorable.

Any seasoned versed veterinarian will tell you that there are many important qualities to put in your holster on your way to becoming a great practitioner. You have to remember all of that stuff you were taught, tested on, and were supposed to have read, absorbed and understood while in veterinary school, then you graduate and have to learn how to integrate what you learned into what you are seeing, and on top of that, and probably the most challenging, you need to learn how to build a strong trusted relationship with your patients’ owners. Here is where the cavernous juxtaposition lies. We go into veterinary medicine because we like animals then we have to learn how to relate to people so we can help their pets. If a veterinarian can’t master this skill they may be able to practice great medicine but they will never feel as if they made a difference in a life. You see we have the ability to heal but without that human connection you can’t feel the difference you may have made in someone’s life. The longer I practice medicine the more I understand that it is the human’s lives I am impacting through the healthcare of their pets.

Those seasoned vets will also tell you that it is the people you help and touch and the lives on both sides of the file, owner and patient, that in the end leave you feeling as if your career, your talents, and what you give along the way are what makes this job rewarding. You also learn to not judge your clients. Sometimes the softest hearts come in the most unexpected packages. I have learned to treat every client as if they were my mom. You see my mom has a big heart but she is really bad at making healthcare decisions. Whatever her vet tells her to do she does. It isn’t an interactive experience. She cannot understand and decide what to do for her pets.  She wants her vet to decide for her. Unfortunately my dad has to pay the bills. So on many occasions the vet gets stuck in the middle of the healthcare professional and the accountant. I try very hard to present every owner with my professional findings and what treatment plan will be best for their pet. I also give estimates. Sticker shock is an unpleasant thing for all of us. But I cannot decide who gets offered the “great medical plan” and who gets offered the “discount corner cutting medical treatment” plan.

On one Sunday I met the Smitts. They were very kind, soft spoken gentle people. They didn’t dress fancy, and didn’t put on airs of being anything other than very concerned about their kitty Moe. They asked lots of great questions, were very involved in Moe’s care, and wanted nothing but the best care for their beloved kitty. They were clients that we hadn’t seen in a long while.  You see we keep tabs on our paper files that identify when the last time we saw you was. It had been so long that we didn’t have their paper file anymore. We only had a computer print out of the prior transactions they had with us. The last date in the file was the mid 90’s. Today they had brought Moe to see me because he was unable to walk, not eating well, lethargic, and had a large area of excoriation (abrasion) on the side of his head just below the right ear. I began asking for a more elaborate description as to the sequence of events with the wound to his face. They went on to explain that they believed he had ear mites and to treat them they picked up an over the counter ear mite treatment. Upon further inquiry I asked if this cat had been outside. “No, they replied, not in about 10 years or more.” I also asked if he had been vaccinated. “No, not in quite a few years.” I explained to them,( like I do to many clients), that an indoor cat still needs a rabies shot, and still benefits greatly from an annual examination.  It is a very common oversight amongst many cat owners. Veterinary medicine is just starting to get the word out to our clients, that we have been neglecting cats for too long. I understood that they didn’t intend to withhold care, they were just never told that Moe needed it.

My questions to the Smitts didn’t seem to be making my list of Moe’s possible problems shorter, but longer. I tried to politely recommend that in the future the diagnosing and prescribing be left to the vets. I had no doubt that they meant well I was just pretty sure that Moe wasn’t itching because he had ear mites, and that the well intended medication had not made him better. I was fairly certain that his problem lay in his brain, not his ear.

The inner ear lives right next door to the brain. Actually it is not so much as a neighbor but more like the other side of a duplex. There is a thin wall of bone that separates the two chambers but a problem in one side of the home can look a lot like the problem resides in the other. Because Moe was so weak, and unable to walk, I thought that he should be admitted to the hospital for fluids and aggressive treatment. I also explained to them that I had to have rabies on my list of possible diseases. I remind my client’s everyday that even indoor cats can be exposed to rabies and that it is important to have them vaccinated to protect them from this fatal disease. I use the saying “rabies kills everyone it meets” often. I have seen many rabid animals, cats especially, and I hope I don’t ever see anymore ever again. It is especially heart wrenching having to tell a family, including those with young children that they have been exposed. It is hard enough to lose my patients I don’t want to lose a person. They understood my concerns and agreed to have him hospitalized.

After 24 hours of i.v. fluids and antibiotics Moe stopped eating and was unable to get up at all. I called the owners and expressed my concern for him. They were always calm and kind and involved with his care. They came to visit him everyday. They cried over him in his cage. They offered him affection, all sorts of appetizing wet canned food. But nothing got him eating or better. Through every single poke, probe, needle, exam, and medicine he purred and cuddled. He was always so sweet. And his owners never gave up on him. They wanted him to get well despite every bleak prognosis we gave them.

Moe died a few days after he was admitted to the hospital. He purred everytime he was approached by every person in the hospital. He was a sweet, and gentle loving boy until his last breathe.

I hope that the Smitt's adopt another kitty. I can't imagine them not having a cat to share their life with.

I know that Moe was very lucky to have such kind and gentle owners, and I know he was a reflection of them. There is a part of me that truly wishes every kitty was as nice and gentle as Moe, and every client was as concerned and caring as the Smith’s.

If you would like to learn more about rabies please visit the link below;

http://tinyurl.com/3c8nh4a