Hank. Cervical Disc Disease Management When Surgical Treatment is NOT an Option. His journey and recovery blog.

Hank was a statistic no one wanted to happen.

He is a beagle who is middle aged, lazy and overweight. He also spends his time outdoors with a hyperactive over exuberant nut case of a brother, Moe. Moe has everything going for him. He is active, lean, muscular, and full of energy. This lifestyle has made him a powerhouse, it has also made him a liability to his brother, fat, old, slothy Hank.

Moe, Caleb, Hank

Hank was found laying on his side unable to stand, move, or walk on a Friday afternoon. He was shaking, trembling, and crying in pain. His family brought him to see me on a Sunday after it was apparent he was not recovering on his own.

Now I am just like you. I heard his story, looked at his pitiful pathetic desperate self and thought, "Oh God! why did they wait to bring him in?"

This is what I saw when I entered the exam room the first time I met Hank and Caleb.
I will never forget seeing them.
I feared the worst...

I have been wearing a white coat for a while. It has provided me some important life lessons. One is to not assume or rush to judgement. Hank's family was overwhelmed with caretaking for their son, Caleb, who has spina bifada. Caleb is 8 years old and preparing for his 6th surgery this year. It was very clear very quickly that this family was taxed beyond what many of us could handle on a routine basis and now Hank was down and out. When I discussed my concerns for Hank, how he needed to be transferred immediately to a neurologist and how the optimal care for his current condition would require an MRI and decompression surgery with its $8,000 to $10,000 price tag, his family went white with anguish.

Hank was Caleb's best friend. His lifeline, and his inspiration for all of his surgeries. At every surgery Caleb carried in a stuffed version of his beloved Hank to keep him company.

My bright idea of publicly posting Hank's condition in an effort to gain social media assistance to cover some, or all, of Hanks medical costs was abandoned when Caleb's mom quietly mentioned that they already had a GoFund me site set up to help pay for Caleb's next surgery. How could I ask for help with Hank's medical needs when Caleb's were in competition for those dollars? There was no way I was going to ask, or beg, for help and have it cost Caleb. So I did what I believed was the only option left. I took Hank's case on as my own. No advertising, no reimbursement, no discussion of anything except to say to his mom "You worry about Caleb and yourself, and I will worry about Hank."

And so it was. After two nights in the clinic Hank came home with me. I arrived at home late Wednesday evening with a paralyzed Hank and an almost absent ambivalent husband who now expects that I take the critical cases home with me. A few minutes of basic technician training and my husband was enlisted in Hank's care and understanding that verbal protests would only damage our relationship and fail at discouraging my maternal veterinary compulsions.

After 14 days with us, including a week of almost completely sleepless nights because Hank refused to sleep on a dog bed at the end of our bed, and would only stop crying, whining and bellowing when I put him in our bed. Which is a ridiculously dangerous place to be because who wants a paralyzed dog to fall out of bed? AND he is peeing and pooping at unforeseen intervals.

Hank required 24/7 care. Multiple baths at 2 am because had to go to the bathroom, multiple times getting up to try to figure out if the whimpering and discontent meant he needed something like, perhaps,, food?, water?, pain medication?, to go outside?, to sit up?, to get more attention?, to see the cat who believed she also belonged on the bed?, to cool him off?, warm him up?, etc. etc. There is no exception to these pups being an intensive amount of work with an unknown amount of recovery time.

There were days I went to work exhausted and cranky. There were nights my husband hated me for inflicting these restless nights upon our bedroom. And, there were the endless questions of whether this was all for naught? Would he ever get better? Would his family take him back? Would that be best for Hank? What would the rest of Hank's life look like? Would he relapse in a week? A month? A year? Would he recover the next time?

Here is Hank's YouTube diary.

There are a few critical things I hope that everyone leaves this blog with;

1. These cases are difficult.

2. There is no rule book for time and prognosis.

3. These cases need affordable options provided to clients,

4. Never surrender hope.

5. Or let anyone steal your faith.

6. These cases deserve an opportunity to provide and offer the fertile ground of miracles a chance. If any vet tells to you surrender your hope IF YOU DON'T have a couple grand available immediately walk out and find another vet. 

7. Managing pain is possible, and these cases have a chance at recovery. Hank was trembling and panting for a week in discomfort. It was hard to watch, and I tried very hard to keep him as comfortable as possible, BUT, I did not out him in a drug induced coma. 

8. We got through it together! Me, Hank, my husband, and the staff at the clinic. Provide a supportive network or encouraging helpful people. Death is not an option I considered. I understand this is on a case by case basis, BUT, I was prepared for a cart and a dog who needed help for as long as Hank needed help.

What does Hanks future hold? I am not sure. He is home with his family. We talk often and we will continue to do so. Caleb has his next surgery next week. Our best wishes and thoughts are with him. We have faith,,,, sometimes that is enough.

Caleb comes to visit Hank, day 3.

Hank and his family day 10

There is a whole lot more information on IVDD on my other blogs. Please visit them. I think they answer every question I have ever had on managing this disease.

Hank goes home, day 17

IVDD. The Days Immediately Following the Diagnosis.

IVDD. Dr Kelcourse's Advice.

IVDD. A Tale Of Two Outcomes.

If you have a pet in need, or a pet question you would like to ask, please find the helpful people at Pawbly.com. It is a free and open community for anyone and everyone who loves pets.

I am also available via Facebook, Twitter @FreePetAdvice, and YouTube. 

IVDD A tale of two outcomes

We have these weeks where the storm clouds swirl above you and the seas rise around you and your boat gets rocked hard. It is in the middle of the looming disaster that you test your abilities, and truly get a sense of where your strengths lie and where the weaknesses are cracking your hull. There was a time a few years ago where we literally did 12 splenectomies in a 2 month period. Before that first splenectomy I had been out of vet school for two years and not seen one. In the four years since I haven’t seen 2. So weird, but completely true.

In the last week we have seen two dogs with acute intervertebral disc disease cases. I thought their cases would be a good story to help you understand this disease and how easily an outcome can sway in the balance.

Today is Wednesday the 21^st of September. It is the day that Porter had the disc that was putting pressure on his spinal cord at Lumbar vertebrae 2 and 3 removed. The intervertebral disc in the spine can best be described like a jelly filled donut. Those little jelly filled donuts are the pillows between the vertebrae that protect your lifeline; the spinal cord. The bones that makes up the vertebrae, (your backbone), are like the cars of a train. Once one of those cars gets loose in the track the rest of the cars are more vulnerable. It is an amazing framework of engineering, but one small problem has devastating consequences. If you injure your back to the point that the jelly is extruded from the donut the jelly can only go into your spinal cord space.  Any tiny amount of jelly in this very narrow place is painful and causes pressure and damage to the very sensitive electric wires that are your spinal cord. Too much pressure for too long causes paralysis of these fibers and then the messages your brain is trying to send to the body get slowed down or stop completely. It’s like losing your power to your house because a tree fell on the electric lines between the power plant (your brain) and your house (or say your leg). IVDD (intervertebral disc disease) is common in the dogs with the long backs. The most common dogs we see suffering from this disease are the dachshunds. I also see it a lot in beagles. The obese dogs seem to also have weaker backs.

In some cases we see this disease as a result of dogs playing to hard, or from trauma, like being hit by a car. And in some cases it just creeps in slowly and silently and persistently. Clients will walk in with their pet complaining of not wanting to walk up or down stairs, or not wanting to jump up on the bed, or not able to urinate or defecate. Sometimes it is that they aren’t eating. All of these complaints areyour dog telling you that they are in pain. I have had owners tell me that they think their dog has a belly ache because when they tried to pick them up they screamed. A dog with a “slipped disc” is painful. Sometimes they are painful everywhere, sometimes they are very good at hiding their pain. There have been a few patients that make me have to search hard to get them to elicit where their sore spot is. IVDD can happen in the neck (cervical) or lower back (lumbar). When it happens in the neck I see these dogs reluctant to walk, unwilling to move their head, (think whiplash) and then scream in pain when you try to move their head while holding the rest of them still. Sometimes we also see the four legs not responding normally to basic functions. A dog with lumbar disc disease will not want to jump, or walk up or down stairs, or not wanting to get their butt off the ground. In the end stages of this disease the disc cuts off the spinal cords ability to talk to the limbs ability to ambulate (move), and the body’s ability to urinate or defecate voluntarily.

The tale of Porter and Daymin is about lumbar IVDD.

On Thursday the 15^th of September Daymin was brought to the clinic to be evaluated.  His chart read simply, “Exam, can’t get up, has $ issues.” That was written by the receptionist as was stated by the client to them at check-in.  The technician then wrote the following; “ owner thought he was constipated,  so they gave him an enema. Was fine, normal, all day, sat back, then fell over, urinating on himself.” I was not the vet that Daymin saw that day, but as I read his chart I am once again dumbfounded how many times clients think that their pets are constipated. I know that I shouldn’t make these broad sweeping general statements, but here I go.., “People! Dogs are hardly ever constipated!” As I think back, I have only ever seen one or two constipated dogs. (Now constipation in cats is a real problem, so my statement doesn’t apply to cats!) Perhaps constipation is a big problem in people?, so that’s why they think their dog is constipated? I don’t know? But darn it, don’t give anyone an enema without a Dr’s ok. Enemas can cause big big problems. The veterinarian who saw Daymin stated in her physical examination findings that Daymin was panting, painful, and unable to use his hind legs. Daymin was also very obese. Daymin is a Labrador Retriever and these guys don't typically get this disease, BUT, the fat ones are all susceptible. He had urine and feces on his hind end. The owners had enough money to run blood work and take x-rays. After these were run his preliminary diagnosis was IVDD. Based on the severity of his clinical signs the veterinarian recommended he immediately be sent to a veterinary neurologist specialist. Based on the cost (estimates range from 1700-8000+) the owners declined and sought conservative medical treatment. Based on my experience if deep pain is still present in their back legs (a test your vet will check) and strict cage rest for 8 weeks I would say that 40 to 50% of patients will have a return to function. For dogs without deep pain present this conservative approach has a poorer prognosis, and little chance of return to function. (When I say return to function I mean able to ambulate on four legs.) If the disc material can be taken out quickly the spinal cord can heal and I have seen many dogs go down (paralysis) and be looking normal a few weeks later. Daymin was given a barrage of medicines to try to stop the swelling, protect his stomach from the steroids he was being given, pain relief medications (opioids are the only thing with any chance of relieving this kind of pain) and strict orders to bring him back tomorrow for a re-check.

On the 16^th Daymin was dropped off for the day for us to observe him. his medical record stated; “able to sit up, ate a little, unable to support his weight. No proprioception in the back legs, (this is a test that we do to see if his feet can talk to his brain and then his brain tell his feet that they are in the wrong position to stand). Does have superficial and deep pain present (this means his feet can feel a tickle and a hard pinch, or the nerves in the feet feel a sensation and tell the brain that they can feel something. Deep pain is one of the most primitive functions and the last thing the nerves let go of).  When this is gone there is complete paralysis and without relieving the cause little hope the nerves will talk to the leg again.  At the end of the day his progress report read “eating and drinking normally, leaking urine, but seems more comfortable.” The owners were given directions to keep him in a small confined enclosure, continue the treatment plan provided the day before, re-check on  Monday, or sooner if worsens, owner was told there is a 50% chance of recovery. Owner declined referral to neurologist.”

9/19 entry, “patient here for observation, seems painful.  Unable to support weight on hind legs, no superficial or deep pain. Prognosis poor.” Daymin was not getting better and he needed a neurologist. The owner also gave the Vet a handwritten letter. Dr. E held the letter up to me and gave me her “I don’t know what to do about this, and the guilt is crippling me” look. She summarized that the letter was written to her, because they liked her and trusted her.  “Dear Dr.  Daymin did good over the weekend, he peed and pooped and we kept him clean, like you asked us to. He drug himself around with his front legs. I’m not asking you, I’m literally begging you to please see if you think acupuncture is worth a shot. I just don’t wanna give up yet…please let’s just try a little longer. Please. Thank you..”  I don’t know how the acupuncture thought came into play, but this poor dog was waaay beyond the point of this helping. I am a big supporter of alternative therapies but he needed emergency veterinary care NOW!

Daymin stayed in his cage heavily medicated all day. At the end of the day the owner sent two friends to come pick Daymin up. The owner had made an appointment at the neurologists on Wednesday. He would have to wait until then. When we tried to move Daymin out of his cage he tried to bite the technicians, he also urinated and defected everywhere, despite being medicated, having a morphine patch on, and really no sensation to his whole back half he was in excruciating pain. I went outside to the friends of the owner here to pick him up and explained just how bad Daymin was. Medical management was not working in spite of every effort to provide him relief. His suffering was too great and I knew it wasn’t fair to him to wait and get even worse. The owner elected to euthanize him. it is a hard terrible thing to put down a sweet dog who may have had another outcome if the expense wasn’t so great.  I am in no way trying to pass judgement or assume that his outcome may have been different. It may not have regardless of finances or circumstances. There are many cases whose outcomes are decided by some intangible force no vet, no human, and no amount of money will change. It is the lesson your learn in medicine if you stick around long enough to not grow frustrated or indifferent no matter how hard you pray and want a patient to walk out with a "happily ever after."

Porter and I at Jarrettsville Vets Pets with Santa 2013

That evening my good friend Janet called me to tell me that her 13 year  old mixed Dachsund-ey looking dog was having trouble and reluctant to go up stairs. (Remember how I explained the splenectomy cluster we saw a few years ago? this week was disc disease bonanza).  I told her to bring him in right away. She arrived a short time later. Sure enough Porter was painful in his spine and his radiographs showed some narrowing in the spine at the level of L1 to L3 and L5 to L6, (top and bottom of his lumbar vertebrae). Because it was late in the evening I gave him some pain relief medications, told her to keep him calm and quiet and call me if he worsened overnight. If he wasn’t better by morning she was to bring him back in. at 10:30 pm I received an email saying that he was no longer walking. I told her I would see her first thing the next morning . Before I left for work that next morning I advised her to have a “worst case scenario” talk with her husband. I was pretty sure that Porter had ruptured a disc in his back and based on the fast progression and worsening of his clinical signs he needed to be transferred to a neurologist ASAP. When I saw Porter that next morning he was significantly more painful and would not support his own weight. We started calling to transfer him.

The next day he was examined by a Veterinary Neurologist and then was given an MRI which confirmed everyone’s suspicions. He has ruptured a lumbar disc. He immediately went into surgery. In the 48 hours between him being reluctant to walk up the stairs, he lost deep pain in his back legs. It was the worst case scenario. Luckily for Porter he received all of the care he needed in almost the shortest time possible. He is recovering at the neurologists over the weekend, but so far he is eating, comfortable, and has regained some sensation in his back feet.

I expect, and hope for, Porters full recovery. I will keep you all posted. His final bill will be somewhere in the range of $7000. I jokingly told his mom that they can check off the box that says “Most expensive thing that can happen to your dog”, box now.

Here are some post-op pictures of Porter with his mom giving him his post-op PT.He is doing great! He is a strong, determined, stubborn dog, and I have no doubt he will make a full recovery.

My expert general practitioner advice is to have pet insurance, especially for the predisposed IVDD breeds like dachshunds, Shih Tzus, and beagles. IVDD is uncommon in other breeds as long as they maintain an optimal weight and refrain from dare devil activities. 

For anyone in a financial predicament DO NOT GIVE UP ON YOUR DOG! Follow the vets conservative management guidelines. The most important of which is;

• ABSOLUTE CRATE/CAGE REST FOR 4-8 WEEKS.
• Leash walk only to go to the bathroom.
• Use the pain medications prescribed.
• Don't freak out in the first 3-5 days. They are the worst, but, things will get better.
• Monitor for eating, drinking, urination, defecation. Call the vet with questions. You will need a helping experienced hand. They can help.
• Be strong, be brave, have faith, and try. Your pet is an amazing soul who can beat almost the most impossible of things, IF, you give them a chance and a helping hand of love.

If you would like to learn more about IVDD please see the links below;

The leading source for IVDD help online; Dodgerslist.com

Dr Kelcourse's advice for IVDD patients.

IVDD. Getting a diagnosis. What to do once you have it and associated costs with each option. Encouragement for the first few days (hardest days) after the diagnosis is made. 

Update; Porter did very well with his slight stagger, and somewhat torticollis-sway back stagger for his remaining 4 years! He needed carpet to help him keep his feet from slipping, and he could not climb up stairs, but he never seemed to be in pain or distress and loved his walks with his mom up until his last days at the end of 2015. He lived to be 19. He will always be missed.

In an ideal world resources, financial stability, and access to experts is reality. For the rest  of us lean on your vet, get help where possible, follow directions explicitly, and be patient. There is the other side of this disease, and many pets will shock you at their degree of recovery. I never, ever give up on a disc disease pet. It may be hard to watch, difficult to manage and heart wrenching, but it will pass, and most will dramatically improve IF you can get through the first few days.

If you have a question about your dog with IVDD please find me on Pawbly.com. I am happy to offer assistance and encouragement. Pawbly is free to use and open to all pet lovers across the globe.

If you have a pet that you would like me to see you can find me at Jarrettsville Vet in Harford County Maryland.

I am also on Twitter @FreePetAdvice, and I have a YouTube channel with lots of helpful videos.

A day in the life, (a bad day)

This is supposed to be about my real-life. But sometimes my real-life gets so out of control crazy busy that there is nothing else in my life. It is part of the reason I love what I do. But it is also part of the reason that I have no children, few hobbies, and a diet no one should be proud of.

So I thought I would describe what my day yesterday looked like.  Yesterday was Monday. Mondays are notoriously bad. They are insane busy from the moment the doors open. I opened the clinic for appointments on Sundays just to try to reduce the volume of bad cases that we see on Mondays. It has helped marginally.

I don’t know if people are too busy to notice that their cat hasn’t peed since Thursday night. Or that their dog that was having trouble with stairs and walking is now paralyzed and unable to control their bowels.  Or that the cat that has been crying since Wednesday and now won’t let you touch him, and has blood erupting out of a wound on its back needs to be” dropped off right now because you have to go to work.”(And, oh yeah, you can’t go near him even on his “good” days). Or the morbidly obese Shih Tzu that just walked in with his whole family because they think that the dog is having trouble breathing and they “think it’s time.” Those were some of yesterday’s cases. This is my real-life. And this is a bad day.

About a month ago I tried to cut back my work schedule so that my routine crazy insanely busy days might be more bearable. I have been scheduling my Mondays and Wednesdays for surgeries for the last couple of years. I was waking up on Mondays like the rest of the world and dreading the drive in to work. Mondays were becoming too busy to get my scheduled surgeries done, and everyone was suffering for it. So I decided that I wouldn’t schedule anything on Mondays with the hope of being less stressed and better able to provide the time and care the patients needed. I am not really sure how I can still not schedule anything, show up to work and still be here for 13 hours but it happened yesterday, and it still happens most all of my Mondays.

I woke up early like I always do, called into the clinic to see what was already on the books from the overflow of the last week and was told that I only had three cat neuters scheduled for today. I thought “Great! 3 cat neuters takes about 30 minutes, I will have no problem getting them done! I don’t need to rush into work.” Then I asked how the other Vets on the exam schedule looked and Lindsay, the receptionist, told me that they were full. That means I needed to get to work ASAP to help cover any walk-ins/disasters so the Vets on the exam schedule don’t get behind. As I was getting out of the shower Grace from Animal Rescue called. She had three small dogs that were trying to rip each other apart and all needed emergency neuters. She also had three other dogs that needed to be either spayed or neutered. I told her I would fit the emergency neuters in but the other guys would probably have to wait. She said she would meet me at the clinic in 45 minutes. I started to apply make-up faster and ditched the idea of blowing my hair dry. Another day with wet hair drying in a ponytail it was. The phone rang again. Could I come in earlier and help with the emergencies that were already calling? “Yes, I will be there soon.” Throw bag of belongings into large book bag, throw three dogs into car, remember to give Midnight her thyroid medicine, put little baby Wren in his carrier, grab coffee, and  go.  Get to the clinic unload the garbage, three dogs, one small sickly kitten (Wren) pick up my bag and trudge into building. Deep breath, good thoughts, and jump in. Open staff entrance door, survey scene. First face I see is my very well trained, lots of experience, long time Licensed Veterinary Technician. She looks up from the rubble, and the first thing out of her mouth is “why are there 3 more dogs to neuter?” I think to myself, “oh my god, I just got here, the anxiety level can’t be at a 10 already? We just got here.”  She came back at me before I could reply, “ I still have all of the treatments to do, and we don’t have enough people for all of these surgeries.” It’s hard to walk into a hard day with complaints at the onset. I put my stuff down, reminded her that they were the rescue’s dogs and we didn’t have to do them first thing, and that we would be ok and get through this. It is a hard stressful incredibly busy job and my poor techs bear the brunt of it.

I only thought I had three little quick cat neuters to do. I was sooo wrong it was soo beyond an easy day. That busy crazy Mondays cases started with Daymin. I had Daymin to look at all day. Sitting in up in his cage panting , trying to get up but unable to. Trying to get up because his brain told him that this place, this hospital, is not a safe place, so his front feet try to dig into the un-grippable stainless steel cage, and his unresponsive back end just lays there like dead weight. He cries when you try to move him and he involuntarily urinates and defecates. It is the bodies response to pain, flight or flight, and the mixed up incorrect nerve responses that happens when your spinal cord is damaged. Because he was so miserable we gave him morphine to try to ease his pain and provide some sedation. This caused him to vomit a huge amount of…stuff… I think it was eggs and chocolate? Didn’t his owners realize that his back problems were in part caused by his obesity? He was covered in poop and urine and we couldn’t clean him up without causing him more pain and thus producing more poop and urine. While we spent the day trying to convince Daymins owners that he had slid steeply downhill and needed emergency neurologic intervention we kept Daymin sedated, listened to him moan in his dysphoric morphine slumber and waited. At 6 pm I told his owner that I could no longer watch or partake in his cruel care. I told his owner that the only options left for Daymin were to refer him for the spinal surgery he desperately needed or to end his suffering with euthanasia. Daymins owners consented to letting him go and for the first time in over 3 days he wasn’t in pain.Concurrently I was trying to help Simba. A sweet purring machine of a long haired domestic tabby and white cat who had not been able to pee for days. His bladder was hard and it was painful when you touched it. He needed to pee and he needed it bad. I have seen more than one cat die in the process of trying to unblock their bladder. I went through all of the steps in my head. Remove some of the urine via cystocentesis (poke bladder with needle and pull off as much urine as possible) gosh you feel soo much better after that. Retain urine sample, (in his case very very bloody), to submit to lab, pull blood to submit to lab, place i.v. catheter to start fluids and correct electrolyte imbalance,then place under general anesthesia because its bad enough to be blocked butrtheres npo way any animal will lay still as you try to skewer their penis. (Although I have had more than a few blocked cats be soo bad off that the anesthesia wasn’t needed, and would have probably been the last nail in their own coffin). Then start the arduous process of trying to thread a small piece of plastic into a very small, and plugged up, little hole. God I can’t even explain to you how many sweaty brow hours I have spent trying to thread that hole. I have figuresd out a lot of tips. Here are some of them for you newbies; try a catheter (22 gauge minus stylet), try lidocaine in your catheter, try the ultrasonic scaler. Its like a rota-rooter on your sensitive delicate urethral lumen but it busts that cement plug up like TNT. And god bless the tomcat catheters that everyone says not to use, but damned if I can ever get one of those red rubbers in. glue tomcat in with tape and Chinese finger trap. Tape and sew collection bag to the tail and don’t forget the e-collar, or you get to do the whole process over again tomorrow.  I also think that an important tip to remember is to give the cat some SQ fluids before leaving at night and then disconnecting their i.v. fluids. I have come in the next morning to find a big birds nest of i.v. line because the cat spun around all night and twisted the lines to the point that either the i.v. or urinary catheter gets pulled out. Luckily Simba did great. And luckily for me it only took an hour to unblock him.

Then there was Mac. Mac is a big outdoor cat who hates anything that isn’t done exactly on his terms. He was brought in this morning. His owner literally passed the carrier (with him in it) over to the technician and said “he has been gone for a few days and now is bleeding on his back”. “Ok”, my technician said, “let’s take him out and take a look.” “No!,” the owner blurted, “I don’t want to see him, and he’s not a nice cat.” “Can’t I just leave him here for today?” “You can’t touch him, even on a good day.”  And for some reason he was left for me too look at when his mood changed. I called the owner and got permission to sedate him before I lost a hand or needed plastic surgery. After ten minutes with some hard core drugs surging through his veins he was placid and cooperative. I liked Mac like this. We started shaving off of the furr covered in pus and blood. The more we touched the wound the more puss erupted. And when I say FOUL smelling, I want you to think dead fish rotting in the sun. bad doesn’t make you think you are going to throw up. does it? I wanted to. But I had three other cases waiting for me, he was already under anesthesia, so you just swallow, and keep plugging along. One hour later he had a 6 inch long drain running the length of his back. I called his mom to explain what we had done, and she of course asked me “ what o you think did that?” I told her that “ I couldn’t be sure but in most cases it is another male cat trying to get him to move to another block.” He was a mean mean pistol when he was awake. We let him wake up in his carrier. He spent the rest of his day hissing and spitting and swearing at anyone and everyone who dared to come close to his cage. His mom picked him up at the end of the day still afraid to look into his carrier and see what his wound looked like. she swears he is angel at home. I hope so, he is the devil outside his house. Bon voyage and good luck Simba!

Lastly I got called out of the back surgery area to look at a walk-in client with an older Shih Tzu who they think “is having trouble breathing, and it might be his time.” Lovely. I escorted mom, dad, daughter, and obviously obese older Shih Tzu into an exam room. Turns out their dog is morbidly obese, was groomed a few days ago, and now is soo painful he won’t eat or move. To think that these owners were contemplating euthanasia due to sore back is scarey. The appointment didn’t take long and I was happy to have this bullet dodged.

I left 13 hours after I walked into the building. I watched two shifts change. And I was exhausted. Little did I know that today, Tuesday would be worse.