Seraphina. Lip Avulsion in a Hit By Car Cat. How to, why it is so imperative to do early, and cost of care. Warning surgery photos!

Serafina

This is Serafina. Serafina was brought to me one afternoon by a client who witnessed her, minutes before, dragging herself across the road as numerous other drivers passed her by. That single act by this brave woman to stop her car, pull over, and go out into the road to get to her saved Serafina's life.  

Seraphina was a wisp of a kitten. Barely three pounds in all, mostly fluff and wide green eyes. When she came to me, just a few minutes after being the victim of a hit and run, (although this wasn't witnessed by the finder I deduced it by the severity of her injuries), she was being cradled in a towel. Her face was obviously injured. Her chin had been detached from the bottom row of teeth and lay flapping midway down her mandible. Her pupils were different sizes, (indicating head trauma), and a left back leg just sort of lifelessly dangling. She was adorably and unabashedly obviously cute, but, also crunchy. Crunching is broken bones. She was crunching from the bottom of her sacrum, because her tail was pulled off of her pelvis, which, by the way was broken in multiple places, and there was a long list of worries I had just on my very quick preliminary over view of her. 

The first few hours were about assessment, observation and pain management. She didn't have much going for her. She didn't seem to be able to feel or recognize her broken left leg. We weren't sure that the head trauma wouldn't cause hemorrhage in her brain which could kill her. With little more than a warm bed, food, an opioid to place inside her cheek she was left for 12 hours to see if she would survive overnight. I wouldn't have suspected that she would have survived her injuries. Life is like that. Chance, fate, luck, it is often little more than this. 

It is important to pause the story here. There is a knee jerk reaction to protest the black and whiteness of this particular case at this specific moment in time. There are spectators among the readers who wanted me to start fixing her. On. The. Spot. Life in medicine in the world of severe trauma isn't like this. In many cases we have to wait to collect information before attempting to repair the obvious that is not life threatening. Serafina's injuries; skull fracture, leg fracture, tail avulsion and lip avulsion are not life threatening unless severe hemorrhage or nerve loss is occurring concurrent with them. She also did not have a parent to provide consent to our care so we have to be careful about what we can and cannot do for her. Many (too many I fear) would see this list of injuries, no discernible home to provide financial assistance or care for. The list of all of the "worst case scenarios" is long, ominous, and foreboding. Many just shrug that they are sparing her further suffering and would have put her down right here, right now. My personal plea is to not give up. These are almost always savable. Maybe not "perfect" anatomically, but perfectly happy and functional, able to live a long happy, healthy life.

When she first arrived at the clinic we tried to find her home. We hope each and every time an unknown pet is brought to us that there is some worried parent out searching for them that we can locate and notify for a tear filled reunion. Some small semblance of extending the compassion we inherently feel when we see some little thing so fragile hurting yet alone and at the mercy of the world. We spent days searching to see if she belonged to someone near where she was found. She was so young, only about 3 months old, but she was affectionate and trusting. She knew people and she wasn't afraid of them. She had no microchip, and no person came forward to claim her even after her finder canvassed the area where she had been found. She was one of the too many who gets overlooked, forgotten especially when trauma with a big price tag presents. She is one of too many unwanted, which makes her disposable and easily replaceable. 

The next morning she was still brightly enthusiastic to see her breakfast and made herself very quickly yet sheepishly at home. The first 12 hours are critical. The first two days reveal almost everything you need to know from where you are and how far is needed to get to fly the coop. 

It was two days before I was convinced that she had any nerve function to her broken leg. This was the first hope to save it. She also was beginning to drag herself to the litter box to go to the bathroom. 

For cats, in my opinion, for a trauma patient to be able to survive they need to be able to do the most basic of things, this includes; eat, drink, pee, poop and ambulate. These things must be intact to allow them a reasonable chance at being adopted and cared for adequately to allow them a safe and comfortable life for many years to come. (This is a general rule. Not a hard and fast rule.. ask me about Dora someday).

Within a week Seraphina was beating all the odds. She was alive. She was improving miraculously and at an alarming speed. The injuries that might have been life ending were being crossed out like a bucket list to live.

The last item to resolve, the only one I really felt compelled to correct, the one that would get worse over time, (unlike all the others who were correcting themselves on their own), was her lip. It needed to be reattached to her mandible. It had come in damaged and ripped off the chin of her face, but it was contracting with scar tissue and pulling the chin off of her face at an alarm quick pace daily. Scar tissue is designed by the body to close wounds, pull tissue together, but if the anchor is released the pulling of the tissue can worsen an injury. 

The edge of the front of her lip was being pulled down her chin. Food, hair, and debris was collecting in this pocket. She was uncomfortable with her non-functional chin in the wrong place. 

Lip avulsions happen most commonly, (I have seen it twice, both times with a cat, both times when they had been hit by a car), because the skin of the chin is pulled off the bone of the  mandible when the face is pushed into the ground as the body is pushed forward. Serafina was very, very lucky. Her mandible was not broken, just the skin torn away.

There are reasons I waited a week to do this surgery. She had worse injuries to heal from. Possible internal trauma that would have  made surgery more dangerous and tenuous. The lip had to wait for her to be well enough to survive anesthesia. 

Serafina is lying on her back. Her jaw is clipped,
scrubbed and draped out of the surgery field. 

Serafina went under anesthesia to have the lip replaced and secured to her jaw. This is not a surgery we do every year. Maybe once in a decade. 

Cleaning the tissue, (there was an immense amount of hair, food, debris stuck between her lip and jaw was done under anesthesia. It was the only way it could be done. This is delicate sensitive tissue. You can't clean it well with her awake.

Once the tissue is cleaned it was loosened. We call it undermining. The tissue, her jaw and lower lip was shortening as it was being pulled toward her neck. It is scar tissue contracting. To relieve the tension you have to break down this fibrotic tissue and pull the flap back into place.

Stents (small pieces of surgical i.v. tubing) are used to go through the mandible skin and then looped around her canine teeth. It was the most exciting, aesthetically transforming surgery, (and quickest meets easiest), I have done in a long time. If I could do this surgery every day I would! It was that fulfilling.

A better close up of the closure and stents.

 Waking up her new chin,, just as it is supposed to be.

Serafina was lucky. Incredibly lucky. This case will have a happy ending because someone intervened immediately. She also had her internal organs intact. Bones will heal, especially in young animals. They need time, patience, containment, and monitoring from someone who knows what to look for and what to worry about. 

The cost of the surgery to repair her lip was about $200. It was that quick and easy. Our internal Good Samaritan Fund will cover it.

I have read posts where veterinarians are too afraid, tentative, reluctant to do this surgery. I want to send out a personal plea to all of you looking at a kitten, cat, dog, puppy who has this injury; if the mandible is intact, the canine teeth are anchored, then please try. It is so simple and easy. I'll help in anyway I can.

If you are a pet lover, pet parent, or pet expert I hope that you will join me on Pawbly.com to lend a helping hand for others who need us. If you are interested in more informative cases you can follow me on YouTube, or you can follow our amazing Jarrettsville Vet Facebook page.

Here is another blog about Serafina. The WHY In Who I Am.

Serafina. The WHY In Who I Am.

I have been a veterinarian for about 15 years. The best moments of these years are those I call 'dwelling within my calling'. The cases that remind of the WHY I am here. WHY I worked so doggedly and determinedly hard, for over a decade, just to get into vet school. Never mind the hard work it was to actually get through those 4 years. I was never blessed with blissfully finding, or even fortunately stumbling, upon the road to professional salvation to that destined path toward my perfect future. I could not ever find it among the tangled brush of my day to day life. I suppose I would have been better served by looking toward the horizon in place of the daily clutter that clouds all good decisions. The WHY of me within my little veterinary life exists in the moments of the day that prove to serve my purpose. These minutes of veterinary medicine that mean so much to me are the ones no one else has time for. The cast away felines to be specific. It has become increasingly more imperative for me to look for, recognize, and live within the WHY.

Serafina. Our first meeting.

There are more cats in U.S. homes than dogs. Felines are smaller, require less effort to care for. Less walking with leashes and poop baggies on those cold early mornings. Cats can eliminate in a small box hidden in some remote corner of the home. Cats are just easier; less time, energy and even expense. Cats may be in homes across the USA in greater numbers, but they visit the vet in minuscule proportions when it comes to their canine counterparts. Cats, in our current society, are provided a fraction of the investment in both time and financial resources than their canine cohorts get.

Life is not fair, we all know this, but, life for a cat is exceptionally more complicated, difficult, and cumbersome when compared to a dog.

How many stray dogs do we routinely see roaming my area of the country? Almost none, ever. We are conditioned from the love of our own bedroom occupant pups to stop, call for them, try to recapture them with the leashes we all always have awaiting in our cars. We will take the time to call the authorities as a last act to intervene on their behalf when we see a pup running loose without a leashed parent attached to them. A cat, we all pass by cats trying to survive on the most primitive and basic levels, routinely. Cats get a call to intervene as considered more "pest removal" than missing persons. Cats are omnipresent, replaceable, disposable. It is tragic that so many humans will never know the immense intelligence, kindness, adoring affection and abundant joy that they inherently inhabit. Cats are just as, (if not more so), wonderful than dogs. If you don't know this it is simply because you haven't opened your heart enough to see their magic. Why, (back to the WHY?), why, don't more people extend the same compassion to cats as they do to dogs? I have an answer; it is the failing of humans. Cats make you earn their trust. They take effort. People are inherently impatient and too many have convinced themselves that they are allergic. Milk, milk they will push themselves through tolerating milk in tiny sips, eaten in small icy spoonful quantities of Ben loves Jerry, until the body accepts it as permissible. (Did you know the huge majority of people are born allergic to milk?). Cats, they are wily, coy, cunning, and people dismiss the effort from initial rejection with excuses to dismiss their magic preemptively. "I'm allergic." People you don't know what you are missing.

Cats need help, and I always root for the underdog. It is the badge of honor for considering yourself an advocate. It is also the one species that I can make the most impactful and meaningful difference for. This is important in a profession ripe and replete with immense emotional turmoil. It is important to protect your soul as you try to navigate in the black through the business of hocking your service bespoken wares. I have had to learn this. I have had to figure out how to be a veterinarian who cares and wants to keep trying to care, in a world with tenuous intentions seeming to force you into caring less as the best option to lifelong soul preserving survival.

Serafina, pre-surgical chin repair prep.

Kittens, the ones no one wants, those that everyone else overlooks, the ones with deficiencies, disfigurements, the ones so easily removed as so many others who meet the standard of "perfect" can replace them. Not sure what I am talking about, ask a shelter employee in the middle of March who they feed and care for when there are dozens in need of round the clock feeding every 2 hours. Which ones get the best chance? Which ones do you try to save when you fear that you cannot save them all? You save the ones people will adopt. It is that simple, that linear. There are too many cats. This isn't my opinion, it isn't even my belief, it is the numbers of those who are set to fend for themselves. Those cats who are labeled "feral" are not descendants of cougars or lions, they are the children of humans who gave up on them.

I am going to be honest about my reasons and intentions for defending and publicizing my why. The motivation to intervening on these cases. It is a vulnerability that most won't confess to and never would embrace. It leaves you open to eating your words. Made especially poignant when the world of pets, the business of pet care, and the current environment of hiding that compassion as it leaves you open to dumping (even more) problems on your lap if you admit to caring when no one else either does, or, wants to be financially responsible for, if they do. It's a predicament. Price over empathy. It is a web of disaster I navigate daily. It is the reason many people just close their doors to appearing as if they care about anybody or anything when those lives appear at your doorstep without a checkbook attached to them.

It is also a place of opportunity with little liability. It is where I have found my purpose again and again. These unwanted, unowned, broken, needy felines are the best place to fulfill my WHY.

Serafina is a perfect example. She is the why behind the longing I have to maintain a desire to keep practicing. She is the fuel to burn my continual passion for caring. For reasons beyond her control, she just doesn't have a mom. Well, she has me. That's all either of us need. I am lucky in that way. I have isolated myself so that this is the reality of my veterinary practice. She isn't about being profitable. She is more important to me than that. She is about my safe place.

Serafina was brought into my clinic by a client. This is the only way we will receive them in almost all cases. She has to be assumed to be an owned cat, before she is assumed to be an unwanted cat. Even though the later is far more likely than the former. It may sound that I am pessimistic about so many unwanted cats living among us, but people will feign and deny ownership if a fee for services is looming. We always scan for a microchip when an unknown pet lands at our doorstep. A tiny clue to help find a worried mom. Some small token of adoration the huge majority of pets are denied. In cases of emergencies I have some leverage due to my credentials to provide care to the injured, albeit unknown, pet. Many vets would just send her to the ER, or, the shelter (who without a veterinarian on staff is woefully inept to manage even the mildly sick pets of our community), or, they would just tell the finder to act as the owner and assume financial responsibility for this patient as it is not uncommon for a pet parent to claim the pet "isn't theirs" to avoid having to pay the tab. You can begin to see the landmine of pitfalls we walk among. There is no human equivalent to this. You walk yourself, or someone else, into a human ER, broken and bleeding due to skull, pelvis, leg, and tail fractures and they start helping immediately as someone else starts asking the questions. There is not an internal pause of delay to figure out who is paying first as someone is possibly dying next to them.

In veterinary medicine helping/intervening/providing even basic care isn't so compulsory. In fact it isn't even marginally compulsory. Pets are considered "property". The whole single solitary reason injustice, cruelty, and blind eyes are commonplace. I took Serafina and offered to help her, based on a few things: I knew the person who brought her in. The person who found Serafina, a speck at two pounds, dragging herself across the road, smashed from the waist down, as many other cars passed her by, wasn't lying about her story. This wasn't her cat. Serafina in the first minutes that I examined her had a chance of surviving. It was a slim, tiny chance. But enough for me to know she was best off here, and better off  trying to stay alive instead of giving up on her with a small pink needle of fluid into her vein. This is a little bit of skill and just as much gut. I could eat the cost of her care because I have had cases like hers before. The first time you jump into pro bono is scary. The tenth-plus is not.

Serafina's finder also offered to help. This is a key component. Being a savior for another life is a step into unknown waters. Having someone else to help you through the journey empowers you immeasurably. It helps immensely to not want to feel alone. It's a way to share the load even if the ending is tragic. It takes a village to save both sides. We are all victims to the pressure and chillness of society. I have learned this too. Serafina's finder canvassed the area she was picked up in to see if she had a home. Nothing. Someone knew her, no one would claim her. She also reported her as found to the local authorities. I waited as Serafina got better in my clinic and no one came, or even came to check to see if she was possibly theirs. I was not in the least surprised.

Serafina has been a many months long journey. She has resilience. She is gentle and affectionate, and she is the example to why I am vocal in being proudly compassionate. Even if all I end up is a good story. There enough of the others to need washing and leveraging. I will stick to Serafina for as long as I need to. She completes my why. Fulfills my ever emptying internal soul sucking public pleas for taking everyone else's problems as my own. At least for today she is the WHY. She is the who I am. She is also the reason I don't feel alone, or even oddly vulnerable, lost in a profession with so many others struggling every single day to remember, and maybe even re-embrace their own WHY?

Serafina is a small piece of my tortuous and twisted journey. She is currently residing at my clinic, Jarrettsville Veterinary Center, in bucolic Harford County. She is looking for a home. A home where her love for people can be mirrored by someone's love for her. She deserves this. We all deserve this.

Serafina's recovery story is my next blog.

Thank you to all who help me, the staff, the people who aren't afraid, nor ridiculed, when they care. We take care of each other, two, four legged, furred and skin alike.

For more information on me, the clinic, and our WHY please follow this blog, our Facebook page, and my YouTube channel.

Hit By My Own Car

Being a veterinarian means you wear a lot of hats, everyday.

Most of us vets are what we call "general practitioners."  A quaint little way of saying "jack of all trades, master of none."

Truth be told, I enjoy having a broad spectrum of basic knowledge. But every vet has their own particular strengths, weaknesses and areas of interest. I am lucky to work with 5 other veterinarians who all have their own honed skills and resume of experiences. We often work together collectively and will tackle the cases that require multiple brains with our multiple own perspectives and this ultimately always benefits our patients.

At Jarrettsville Vet I am the surgeon. It suits me just fine. I enjoy the tedious challenge, the never-the-same-problem twice individuality of every case, and the cosmetic aspect. I like to take the puzzle pieces and put them back neatly, and prettily in order, not losing site of function, of course.

Sometimes the surgeries are what we term "routine." A spay, neuter, or a small skin mass removal, these are the daily bread and butter. The surgeries we don't think much about, get too excited about, or fret over.

The once in a while trauma cases, those are the toughies.

Trauma, when I talk about this in veterinary medicine I separate them into two categories;

1. Motor vehicle meets pet. 

OR,

2. Mammal meets mammal. Whether it be BDLD, (our acronym for big dog vs little dog), or wildlife meets pet, or human being is abusive to pet.

Let's discuss category number one today.

Twenty years ago HBC (hit by car) was a more frequent, more likely to be fatal event. 

In my opinion a few things have happened to change the once grim statistics.

• More people spay and neuter, and therefore, fewer pets wander.
• More people use home containment devices (invisible fence, etc) to keep their pet within their own property.
• Almost every municipality have shelters and actively pick up roaming pets.
• Many people will stop and try to help a wandering or injured pet.
• Veterinarians who specialize in surgery and can correct almost every broken bone in the body.

But here's the trauma that I do see happening now more often these days.

Household-induced trauma.Specifically, I see more and more pets being injured by automobiles that belong to the pets own family. These are tough cases on many levels. The family feels guilty, they feel terrible about inflicting pain and suffering on their own pet, and they have to be clear headed enough to be able to make decisions about their pets care.

If there is one wish I could make with today's blog it would be to be diligent and careful and not to assume that your pet understands that a moving car, or lawn mower, or piece of farm equipment, or anything that moves, or has moving parts, is a threat. No matter how slow or how fast it moves your pet is curious and unable to comprehend circumstances, I don't care if they have "been hit before, and you think they have learned their lesson." They haven't and they will be hurt again, or worse yet, maimed or killed.

This is the story of Mac. He was seen lying on the driveway as his family started the car and began to back out. They heard him yelp! and they stopped the car to find they they had run over his tail and ankle.

Abrasion wound to the inside of the ankle.

Mac was brought in immediately after his family injured him. He was examined, x-rays were taken and he was started on pain medications and antibiotics. Luckily nothing was broken. He had a few abrasions, some with open wounds, a moderate amount of soft tissue damage, which included bruising and a few small areas of bleeding. All of his wounds were cleaned and dressed and he was scheduled for surgery the next morning.

The end of the tail is filleted open and there is damage to the fibers that surround the tail vertebrae.

There was some concern that we would have to amputate the end of Mac's tail. We would have had to do this if the end of the tail was necrotic (not viable or dead tissue). Thankfully, Mac's tail tip was still pink and he had feeling when you pinched it.

I have had many discussions over the years about how best to treat tail tip problems. There is a condition in dogs that we call "happy tail." This happens when a dog wags their tail so much, and in close enough proximity to a hard wall, that they break the blood vessels in the end of their tail. Or they hit it hard enough and often enough to cause the skin on the end of the tail to open. It can be a very frustrating ordeal to treat. Try asking a happy dog to stop wagging? Or try affixing anything that can, or will, stay on to the end of a wagging tail..not easy tasks.

Every vet has had to deal with this problem, and just about every one of us has had to amputate a tail or two because we either can't get that tail to heal, or the client loses the ability to try any longer.

The first vet Mac saw on the day of his trauma thought that maybe his tail would need to be amputated. She had forewarned his parents. It has been my experience to always try to keep from amputating a tail because I know how hard it is to manage them long term. If you ever think that this is the easier option please have a long talk with your vet before cutting..any happy dog with happy tail will keep wagging and keep busting open those sutures. Not only do you have to think about dehiscence of a suture, you also have to try to figure out a way to keep it bandaged..

When Mac came in the next day we removed his bandages to see how things were progressing.

The first big clue that Mac needed surgery was the smell that removing the ankle bandage produced. The bouquet of a simmering infection is a definable as the pus that it emits. Sometimes you only smell infection and Mac smelled of infection. Oddly I didn't see a wound that made sense with the putrid pungent aroma I smelled.

I knew right then that Mac would need surgery to find the source of the smell.

Mac's wound was very small..About half an inch long, and there wasn't any signs of bleeding, or the ever easy to identify pus. To an untrained eye (and nose) the ankle wound was small and unimpressive. But when Mac was placed under anesthesia we were able to make a very large pocket of fluid, about 6 inches long with the surgical scrub. The pocket was infection and it lay not beneath the skin where the small wound was obvious, but rather below the layer of muscle that appeared to be wound free.

Half of the drain has been placed. The drain must enter and exit at an area outside of the pocket of infection, but be in communication with it.The drains function is to keep the infection from remaining walled off under the muscle and allow a tunnel for both draining and flushing of an antibiotic solution.

Mac.
Under general anesthesia as we prep his wounds for surgery.

The drain in above and below the infection.

His tail looked jagged and swollen but it was healthy tissue and I thought that a few simple sutures to keep the edges opposed were the first step. The next was just to keep it clean, protected, and watch and wait to see if it would heal on its own.

After surgery. 

Mac's tail stayed bandaged for a week. We checked it daily for the first four days, and then the owners changed it at home for the remainder of the week. The tail healed quickly and looks like brand new.

The ankle was flushed twice daily with a chlorhexidine solution. It is important to remind clients that we are flushing around the drain and not through it. The drain is a flexible latex material that keeps an opening around the infection. We want to keep the entry and exit hole open so that the wound can drain, and so that you can flush a cleaner around the drain and into the infections pocket.

A few last notes on drains;

• Drains need to be removed within 7 to 10 days or the latex starts to break down.
• Be very diligent in keeping your pet away from the drain, and never cut it on your own. Every once in a while the ends get cut, or chewed off and I have to go back into that wound that we have worked so hard to get to heal and fish out a piece of shrunken latex..frustrating and annoying, for everyone.

If you have any questions, or any story to share please share them.

For any pet question you can find me, and many other helpful people with many other skills, at Pawbly

If you are a pet person please visit us at pawbly and share your skills, thoughts, and help other pets and their people. We are a place for all things pet, always free. Or visit us on facebook, Many thanks for reading.

krista

Tread-ing Lightly

It usually starts with a call..

"Dr. Mag!" I heard the receptionist yell. 

She came to the treatment area to find me, in the traditional 'yell first, walk to find later' method. Somewhere along the eight years I have owned JVC the last 3 syllables of my name got dropped. I know I never signed a consent for informality form, but none the less it disappeared and non of my staff take the time anymore to complete my name. It gets difficult when clients call and ask for me by my nickname, like I adopted it as an alias.

"Yes?" I replied. I could tell by the tone that I knew I didn't want to hear whatever it was she was about to report.

"There's a friend of Dr. T's on the phone. They said they found a cat in the road and that they think it was hit by a car. They have $100, but can't afford anything more." 

If I had a nickel for every time someone called with a pet that "needs to be seen immediately, and "Oh, by the way, here's my budget," I would be rich enough to be a non-profit shelter. (OK, so I am a non-profit for profit. Does that count? Please don't answer).

My response is always the same. "Tell them that it is $45 for an appointment and we can give them an estimate from there." I have learned to never believe what you hear, or what someone else thinks the diagnosis is, EVER!! Get your own eyes, hands, and ears on a pet before you ever make any decisions.

After a short chat with Dr. T I had a suspicions that my initial concerns were about to be validated.

It is hard to not get feeling like the world just keeps dumping lemons on you to see how much lemonade you can drink before the acidity tears your gut apart. (OK, this sounds a bit mello-dramatic but I really do feel this way, sometimes).

After a brief exam and an x-ray it was as bad as we thought it might be. 

Treads pelvis. The big red arrows are his fractures.

Here's what this patient had;

• Broken right leg. Femur fractured, tibia fractured, and fibula fractured. Cats have three bones in their rear leg and all were broken.
• Pelvis. Multiple fractures and luxations.
• Not neutered.
• Not owned.
• No one to jump in and take responsibility (financial or otherwise) for him.

I looked as hard as I could for a reason to say "this one is too much for us." I started the mental checklist. 

1. Cat had to be tame. (It is impossible to treat a feral cat with multiple fractures).
2. Had to be FeLV/FIV negative.
3. Had to be a stray cat or someone had to find a rescue that would take him. (Confession; I've been made to regret every person that I have helped myself. So I have learned my lesson). 
4. Everyone was going to have to accept that I might be able to fix a leg fracture but I can't fix all of these fractures. 

The technicians were very quick to return their findings;

1. "He is soo sweet."
2. "He is FeLV/FIV negative."

About this point i was confident that I was about to hear a faint "Can we keep him mom?"

I said, "Put a pain patch on him, put him in a cage, and let me make some phone calls." Head lowers, I shuffle away and internal voice of a crazy person starts whispering in code.

A day later and another vet from the clinic was calling me. She says, "I called CVRC and they will fix his leg for $900." 

Long pause, sigh, and cursing, "Umm, I had a plan for him, and I don't have $900." She replied about how incredibly generous they were being, like I didn't already know that. "I'm sorry I don't have $900." I said again.

"If I can raise it can we do it." she said. Her last pitch to influence me.

"Yes, of course, if you can raise it." Now I feel guilty, and horrible about myself for being lazy, and not trying to find a way to fix him, and for not shelling out $900, especially because it was such an incredibly generous offer from the surgeons at CVRC.

With that the frenzy of social media sharing, texts, phone calls, facebook posts, rescue reach outs, and donation bins started.

Our very good friends at No Kill Harford posted a plea for Tread. (Yes, he had a name as soon as I said OK to putting him in a cage). I'm still not to fond of his name, but I guess I should be somewhat satisfied that we are both relegated to one syllable.

Within five hours JVC and No Kill Harford had raised the $900. And by the next day Tread was slated for  surgery. 

I may have learned my lesson in helping people pay for their pet and the insane liability that comes along with it, but I should have also learned to never underestimate the generosity of my community.

Tread is a very gentle, very easy going 6 month old neutered boy. He is in need of a home to recover, and for someone to take responsibility for him. (He will reward you with lots of affection in return).

Here is the plea that No Kill Harford posted;

Tread is a cat that came to us as a surrendered stray. He was hit by a car and has a shattered pelvis and multiple fractures that have all but destroyed his leg.

As a rescue with limited funds, amputation of Treads leg was discussed … but, through the generosity and compassion of the doctors at Jarrettsville Veterinary Center we have found an orthopedic surgeon that is willing to help us save Treads leg. Normally, the surgery required to save a leg this bad would be close to or even over $4,000. We have a doctor willing to do the surgery for $900!!!!! We just need to raise the money!

Tread is SUCH A LOVE and deserves any chance we can give him. Will you please help us help Tread keep his leg???

We need to raise $900 as soon as possible to save Treads leg. Any donations we receive over $900 will go to our FixHarford fund to help animals like Tread in the future.

At last count, we were almost 1/2 way there! Even $5 will go a long way towards helping Tread!!!!

UPDATE April 1, 2013

Last week, we posted about a stray cat named Tread. Tread was brought into Jarrettville Vet Center with a crushed pelvis and a badly broken leg.

We asked the community for help in raising the $900 needed to help repair Treads leg instead of amputating it. Our request was heard and with your help, we were able to raise all the money Tread needed.

Tread had his surgery and his leg was repaired with pins and metal rods. He did great! He’s getting better each day and is about to have his staples removed. In a few weeks, the rods will come out too.

Together, not only did we manage to save Treads leg, but we also found him a family to call his own. After hearing Treads story, a wonderful family opened there home to Tread and are in the process of adopting him.

Everyone on Team No Kill Harford is grateful to be a small part of a very large community that cares so much for animals … even the animals that they may never meet.

Thank you to everyone that asked about Tread, sent kind words of support, and donated. We couldn’t have done it without you.

Tread's new family.

Tread smiling after his surgery!

To learn more about No Kill Harford please visit them at; http://www.nokillharford.org/

For more information on Chesapeake Veterinary Referral Center (CVRC) please visit them at;

http://www.cvrc.com/


Here is Tread's post-op radiograph. Another BIG THANKS to the incredibly talented surgeons at CVRC!! We are so grateful!!!

Sadies, 3 pelvic fractures and still loves everyone

8 pm, 11/21/11
Sadie went to VOSM today for her pelvic fracture surgery repair. So she can walk again normally.

She is the sweetest most gentle girl, and we have all really fallen in love with her. I will send word about her once I have an update.

For now please keep your fingers crossed for her and send a big Thanks to VOSM and Chris for saving her. They are an incredibly generous talented bunch of people. We are all so grateful for her second chance.

I will add pictures and updates as I get them.




Sadie, 1 week ago, the night she was hit by the truck




Her radiograph from the day she arrived with us. the left side of her pelvis has the breaks, the right side is intact.


 Ok, it is 9:30 pm and Chris just texted me to say that he just finished with Sadie's surgery. What a long day for him. I feel terrible that he was working so long and late and hard for our charity case. It seems we always give him the hard, long difficulty surgeries.

He repaired Sage's fractures. See her story, (gosh that was a longtime ago). I remember me, Chris, and my very amazing tech, working on her from 7 pm to 1 am..That was a long night. I can't believe Chris still talks to me. I am a shitty friend. I would dump me.

I'll update you all as I get news. (Although I know Chris will call soon, but I will be in bed sooner) Goodnight world.

11/23/11

Sadie was brought back to us last night late. Because of very rainy weather and lots of traffic. She is a little wobbly on the three good legs and has a bandage over her right hip joint and a plastic e-collar to dissuade her from licking at her incision. But she remains optomistic and as energetic as ever to be loved. She is being cared for by one of my fabulous technicians, who told me when she got back to the clinic that she is getting attached to her already. (She has been her chauffeur for the transit back and forth to the surgeon). So my tech took her home last night to watch her, and so she wouldn't feel alone after her surgery. She wrote the following back to me this morning after I texted her to ask how she did overnight. "She's a perfect little angel. ;-) and doing well. I just keeping telling myself that she's really ugly." It is impossible to resist her big doe eyes and sweet affectionate demeanor. I think my poor tech has fallen hard. It is impossible not to with that face. I replied with the typical "lol." Because I know I can't resist her either.




The bandage over the incision of her right hip, (aka coxo-femoral joint)




Sadie and her chauffuer, (Who is beautiful but camera shy)



You can't resist that face! (My good friend sent me a facebook a message that said,,,"o, I have to squeeze her!" I know the feeling.

 Sadie will have a great Thanksgiving, and I hope you all do too! I will post her post-op radiograph when I get it, so you can see her plate. Very exciting stuff!

Blue, and His Many Miracles. His PRAA heart defect, and how his regurgitation identification was the key to his diagnosis.

We met “Blue” four weeks ago when his mom came in to try to understand why he was vomiting so much? It seemed that he was always hungry and would eat voraciously, and then a few minutes later would “vomit” up most of the food he had just eaten.

In the scary Third Year of Vet school we all take “Gastroenterology.” It, (if you go to Virginia-Maryland) is taught by the ever-challenging Dr. Leib. One of the first things he drills into our brains is that you need to distinguish “vomiting,” from “regurgitation.” “Vomiting” means that you are emptying the contents of your stomach through your mouth. This is what most of us have encountered with food poisoning, motion sickness, the "oops, I had too much to drink" episode. “Regurgitation” is expulsion of the contents that haven’t made it to your stomach yet because they are being held in your esophagus. This means the food never gets to your stomach and your stomach isn’t doing its "heave-ho-muscular-squeezing" action to force out the contents it doesn’t want. Regurgitation is a passive looking "food-just –seems-to fall-out of your mouth" action, whereas, vomiting is a muscular contraction of your stomach to expel its contents. Sometimes it takes a lot of explaining and some funny looking demonstrations to identify which of these is happening in a pet. For Blue it was the most important diagnostic key for us to uncover. For Blue it was the difference between “most likely easily treatable” and “really really bad.”

We very quickly learned that Blue was regurgitating. He was having great difficulty getting the food, he so desperately wanted to eat, into his stomach. It is like torture. You eat and eat because you are legitimately starving. But you can’t get the food that you are devouring into your belly so that it can provide you with the nourishment you soo desperately need when you are a very young growing kitten.

At his first appointment it was very clear that he was underweight, undernourished, and desperately hungry. These are all tell-tale signs of a pet with regurgitation issues. Once we classify that you are truly regurgitating and not vomiting we can start to identify what is causing the problem. The big key is that the problem lies in front of, (or towards your mouth), and not from your stomach or below, (towards your tail). In most cases it is a problem in, or around, your esophagus.

Your esophagus is a muscular tube that pushes the food that your mouth swallows into the sac (aka your stomach) so your stomach can then churn and digest your food. If your tube (esophagus) doesn’t squeeze the food to your stomach then it just sits in the tube and the tube responds by getting wider and wider, like an over-inflated bicycle tube. The more air you try to put into your tube the more stretched it gets. This sometimes happens if you have an obstruction in your esophagus, or if something around your esophagus constricts it. This second scenario can happen if your heart doesn’t make the appropriate changes it needs to make after you are born. This is called a congenital (you are born with it) “vascular ring anomaly.” It is a malformation of the hearts vessels that entraps the esophagus and acts like a rubber band around the esophagus. The longer you keep a constrictive band around your highly dynamic muscular tube-like esophagus the more that tube will stretch and dilate in front of the tube. This is called a persistent right aortic arch, or PRAA. This anatomic “ring” occurs at the base of the heart and becomes apparent as babies switch from milk to solid foods. Affected patients become weaker and weaker and more malnourished as time goes on. You will die if it is not corrected surgically.

Back to Blue. Blue’s very unique diagnosis (this is the first any of us have ever seen), also came with a very unique story as to how he got to this point. So all the way back to the beginning we go.

Blue was brought in by his parent-mom after she witnessed his mom being hit and killed by a car. Blue was still in his mother’s mouth when she was hit with his umbilical cord still attached. He was taken home and bottle fed by his new mom. After a few weeks of being bottle fed they started to transition him from the kitten formula to solid food. It was then that he began to regurgitate. This brought him to us.

When he came into JVC we discovered that he most likely had a PRAA. The treatment for this is surgical correction ASAP. This surgery requires that we open the chest and remove the band of tissue acting like a tourniquet around the esophagus. Ok, if that doesn’t sound so incredibly difficult then please remember that Blue’s chest is about 2 inches by 2 inches, that the constrictive band is tiny, and that we have to keep his heart beating and the lungs working even while our fingers fumble around in a chest that is supposed to be a vacuum, (can’t be exposed to air, need a ventilator to do), and NONE of us Vets EVER go in the chest because very bad, scary, life ending things happen there. Without this surgery Blue will not live. Only a few Vets are qualified to perform this surgery, (or have ever done this before), and to have it done costs about $3000.

Blue’s mom realized that she couldn’t afford this and brought Blue in to have him euthanized. It is incredibly difficult, and so far for me impossible, to euthanize a treatable pet. I can’t do it. I always feel like I have to at least try. That day I told her that she could sign him over to us and we would TRY to find someone to do the surgery for him.

Jess my technician has taken over his care, and feeds him with a syringe every 2 hours. They have gotten very attached to each other. And the staff, led by Cindy has raised about $400 for his surgery.

This is an x-ray of Blue. He is lying on his side. We put some dye in his food and then had him eat it. The white is the dye. It stops at the base of the heart. then you can see it again in the stomach.

Blue’s surgery is scheduled for Monday Nov 14, 2011. Three Vets are donating their time and surgical skills to provide this. The very talented, skilled surgeons at VOSM, (Veterinary Orthopedic Sports medicine in Annapolis Junction, MD) will save his life.

It is one of the many cases that have been saved by my devoted, compassionate staff, and a few good friends.

If you would like to help contribute to Blue’s care, or any of the other pets in the care of JVC please see our website www.jarrettsvillevet.com, or call 410-692-6171, ask for Cindy and tell her that she is amazing, Jess, and Dr.H too! And if you REALLY want to make someones day call VOSM and tell them that the world is a better place because of people like them, who give even when they don't have to.

Thank-You for your generosity to those of you who have already donated and Thanks to everyone else for your well wishes.

Here is some information from Tams text book on Gastroenterology