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

So I Am Told...

I am told quite frequently that I talk more than most vets.

How do I give advice and help a pet and a family if there isn't talking involved?

Isn't it my job to give a voice to my patients?

Isn't that why people bring their pets to me? To help them understand what they need?

 

I take the "chattiness" quality as a compliment. It's not like I am going to change this late in the game, and I think asking me to talk less is asking me to care less.

 

My job is a mix of appointments, some are routine annual physical examinations with shots and others are emergencies, (or some degree of such), or I am in surgery,( these too run the gamut of routine spays and neuters to emergencies).

 

Tuesday nights are my usual weekly exam appointment times. It is one of the best parts of my job. Every room is another story, another pet, and another chance to meet a new case, a new challenge, and make a new or even re-meet an old friend. As I walked into what appeared to be a "normal annual exam" a few weeks ago I was met by a high spirited, frenetic black lab-ish dog, which appeared older than his demeanor was making him out to be.

I expect that over the age of 6 most dogs will have been through the veterinary examination process enough times to have learned one of two ways to manage getting through without incident. They either decide to just embrace and enjoy the change of scenery and make friends with everyone in the building, or they just sit and wait for the fate to befall them and then make for the exit door as soon as possible. I don't tend to see 8 year old middle sized dogs that dart back and forth like a newly caged captive wild animal. This exam was for Beau, a 60 pound male neutered Lab-ish boy. He was owned by a laid back placid couple who apologized for his lack of polite salutations and sputtered their disbelief that "he has never grown out of his fear of everything."

They went on to explain to me that Beau had just lost his lifelong Beagle companion who kept his fears grounded and chaperoned him every moment of his every day. Beau's only coping mechanism was his beagle brother, and since his passing Beau had unleashed his fears and anxieties onto every other being in the home. He was unmanageable to the point that his parents feared for his safety.

As they described his outbursts I was reminded of the ads for Clomicalm when it first was released to the veterinary industry. The ad featured a sad looking dog sitting dejected next to a room in shambles.

http://www.reconcile.com/

Beau's dad pulled his phone out to present me with Exhibit A and B in the Prosecution’s evidence file. Exhibit A and B were irrefutable evidence to a dog in a dark desperate place.

 

Exhibit A. Day 1 in the laundry room.

Exhibit B. Day 2 in the laundry room.

"Lordy! Beau! You are stressed out!" I said after closing my gaping disbelief mouth. Beau's destruction wave had led them to trying every method of containment, restraint, training, and counseling. They had failed at every intervention.

When I see a dog who destroys a home, or living area, or when I hear about a dog that is constantly whining, crying, barking, or mis-behaving I start to ask questions. I live by the adage "a barking dog is a dog who needs something." Trying to figure out what they are pleading for requires a bit of a detective work, but if you keep listening, keep asking yourself questions, and most of all if you can be patient, (and ask for help if you can't seem to make sense of their pleas) you can figure out the root of their problems and then fix them. In an act of frustration and have known people resort to yelling, scolding, or banishing their pet instead of trying to address the underlying causes.

Lucky for Beau his parents understood how the change in the household was affecting him. He was grieving the loss of both his best friend and his entire support system. He needed help immediately.

OK, here's where the great veterinary debate begins. Drugs or no drugs?

I will admit that I am not a big "drugs cure everything" practitioner. I think they have great benefit in many, many, cases, and I prescribe lots and lots of them, but Beau's problem stems from his loneliness, and not a chemical imbalance in his brain.

As Beau's owners talked about his outbursts they collectively agreed that although they weren't quite ready for a new dog, they recognized Beau's mental health, (and theirs too), were going to have to accept that a trip to the shelter was looming and inevitable.

(It is such an incredible relief to be a spectator in a pet behavior session where the answer is concluded without your having to coerce, beg, or plea for the life of a pet).

We then discussed Beau’s options for immediate peace of mind. The list included things like;

1. Thundershirt. I have many clients using them and testifying to its "miraculous" calming effect.

2. DAP, (Dog Appeasing Pheromone). This resembles a plug-in room scent, but it releases calming dog pheromones. I have had very mixed reviews on this product because it isn’t a drug I offer it as something to try. There are published studies to testify to its benefit, but my clients have mixed mediocre reviews.

3. Drugs. These include TCA's (Tricyclic Antidepressants) like clomipramine and SSRI's (Serotonin Reuptake Inhibitors) like fluoxetine (generic for Prozac). I heard a statistic not too long ago that 1 in 3 women over 40 are on one of these drugs. Goodness, we all need more dogs! The concern with these for me is that they take about 30 days to work, if they work, and then you are on them for life. So I don't want to start someone unless I think we have exhausted all other options. I also think that in general many of us aren't so great at remembering to give medications everyday. So don't start down a path you can't follow through on.

Just a few last points to mention; I think a huge number of the behavioral problems we see are plain old boredom. If you are not keeping your pet active and mentally stimulated (some breeds literally cannot function without a job, for example, have you ever met a bored Border collie? They go crazy). I also think that in general we underuse the SSRI's and TCA's medications. I have started to prescribe them to some of my patients over the last few years and had the most incredibly beneficial results. There are patients out there that benefit from anti-depressants, they should be offered, and we shouldn't be afraid to try them. Ask your vet about them if you think your pet's quality of life might benefit from a trial.

I finished Beau's exam (he is the perfect picture of physical health) and wished them all well in their pet finder endeavor.

To read more about separation anxiety; http://www.petmd.com/dog/conditions/behavioral/c_dg_separation_anxiety

More on Beau's story next time..

A Kitten Cures What Ails Me

I was having a record breaking terrible week.

I was at the point of wanting to throw in the towel, like permanently, forever, moving to an island, wearing ragged clothes, sitting on a stoop, and drowning myself in cheap rum made from fermented cow saliva. It was bad. It happens.

I was emotionally, physically, and mentally spent, running below the red line, and coasting to an all stop.

I tried to sleep more, exercise more, and tried a last ditch effort impromptu date night to see if I could bail my bad attitude out. Nothing worked.

So I did what any normal level-headed animal lover would do.

I opened a cage, picked up a (partially broken) kitten who had been brought to us by the wonderful people at Animal Rescue Inc to repair a fractured dislocated ankle. We sat down together, two broken souls in a place that too often houses sad beginnings, a few unfinished tales, and occasionally a miracle or two. I needed her to cuddle and purr in my neck as I smothered her with my own self-pity.

Low and behold! It worked!! I felt better!

I put her back after my self esteem had picked up past the drown myself in tears point, and I went back to work.

I visited her cage at least ten more times that day.

By 8 pm, the lights were being turned out and I was headed out the door, I stopped by her cage to give her one last kiss goodbye and good night.

As I said my thanks to her for helping me get through the day she kissed my chin and purred herself into a roar.

It was settled. She was coming home to see how she did with Wren. After all Wren was as lonely as I was. It made perfect sense.

I took her home, broke it to my husband, and waited to see if there was any other unrest from the family.

Lucky for us all, she ignored my old kitties, and let Wren stalk her.

It has been a week, and she is officially ours.

Here she is.

Wren checking out the new kid.

Here is our new baby Magpie..

Bug? Was that a BUG??

Wren wondering what the heck that crazy kitten is doing now?



New Kitten ROAR!!!

Sprout's name was officially changed about 6 months later. When we collectively decided that we were adopting a little orange kitten. The cats seemed to fit better as a group when we stuck to the bird theme. So Sprout became Magpie, and that little orange kitten became Oriole.

Update;
September 2014.
Magpie is her own cat. She is officially in charge of the new wing of the house. She much prefers her own space and the defined parameters of a restraining order on the more playful kitties. If you are on her side of the border you adhere to her rules. It works, she has her space and we have the afternoon shift on her turf.

She still has the magic cat ability to cure whatever ails me. If you don't have a cat in your life you just might be missing out on some purr-poseful enchantment.

If you see these eyes you'd better keep you toes under cover!

 The photo gallery of the last 2 years.

A favorite spot.

Can you guess who is in charge?

She monitors and surveys all fronts!

Who says there isn't enough room for a small cat nap?

Head shot for the agencies.

So not her bed!
(Note the dog theme!)

This morning, (9/19/14) coffee and therapy session in pj's,
what else could right your wrongs?

If you have a cat that rules your life, our who provides you a place to unwind and remind you how incredibly beautiful life is please share your stories, photos, and pet experiences with us at Pawbly.com. Pawbly is a community built by and for pet lovers to help pets around the globe live longer, happier, healthier lives. It is free for everyone to use.

You can also find me at the clinic, occasionally snuggling and cat-napping kittens between appointments at Jarrettsville Vet, in Harford County, Maryland.

I am also on Facebook and Twitter @FreePetAdvice.

Many BIG HUGE THANKS to the compassionate people at Animal Rescue Inc., in New Freedom Pa who tirelessly save lives big, small, broken, abandoned, and desperate every single day of every single year. You all inspire me everyday to give more and ask less. And, most of all, Thank You for saving Magpie I would be lost without her in my life.

Animal Rescue's website.

The REAL value of the annual exam

I was running with my very good friend the other morning and we were talking shop as we always do. You see I live about 5 minutes away from a veterinary hospital, and that hospital is owned by my very good friend Amy. We run together at least 4 times a week and those 4 miles blow by when you have a comrade to commiserate with. We swap stories, gossip, medicine, and go over the hard cases together. We also bring our dogs. We both agree that the dogs love the run more than we do. For all 5 of us its usually the best part of our day.

We were discussing how the face of veterinary medicine has changed over the years and venting a little. I know that for both of us it’s nice to have an understanding shoulder to lean on and ear to chew at. It’s a great combination of cardiovascular exercise and psychotherapy.

I was telling her about a case I had just seen of a 6 year old Chihuahua male neutered dog named Nacho. He had come in for his yearly physical examination and shots. He was brought in by his very caring concerned involved parents and their late teenage daughter.

Nacho, unlike many of his small counterparts is a gentle calm trusting patient. He was a tiny bit nervous but not aggressive or excited. After I said my “Hello’s!” to everyone in the room and especially to my patient (tip to vets: always greet your patient!) I asked my usual list of questions. I am a big believer in the question and answer part of the exam. I get very concerned when a client requests a “drop-off appointment” because your pet can’t tell me the things I need you to answer for on their behalf. Therefore, in my opinion, if you are dropping your pet off and not getting a dialog with your veterinarian you are not getting the full value of what you are paying for.

This gets me back to my point on my run with Amy. We were discussing how many of our clients don’t want to pay for an exam, they just want to get the “shots their pet needs.” We were discussing how frustrating it is to try to impress upon our clients that the most important part of the annual examination and vaccines is the annual examination and probably less the vaccines. She reminded me that as a profession we drilled into our clients head that “they needed to return every year to get their shots,” and that we “sort of did this to ourselves.” 

I said “I agree, and now that so many of the shots are available as tri-annual we are finding it even harder and harder to convince owners to bring their pets in to see us.”

Ten years ago when there weren’t three year shots available, and so many more pets died of diseases that we don’t see much of anymore, like distemper and parvovirus we were right in pleading for annual shots. But these days the diseases are less prevelant in household pets that get their initial series of shots, so the importance of vet care has shifted from disease prevention through vaccination to disease prevention through veterinary care and intervention. 

We started talking about how many annual exams that we have done on pets that were apparently healthy in the eyes of their owners where we inadvertently found major issues. I have found splenic tumors, diagnosed thyroid disease, Cushings disease, and all sorts of cancers.

The REAL value we agreed these days is not so much in the vaccines, but in many cases it is in the question and answer period, the review of diet and lifestyle, and the behavioral issues many pet owners deal with. As an example these days I  prescribe many annual exam pets Thundershirts, Prozac, and “more exercise less treats” and give fewer vaccines.

To all of you pet parents out there overdue, or questioning the importance of calling the vet to schedule the list on the post card stuck on the fridge I encourage you to call and schedule your pets exam. 

When you are scheduling and get there think about the following;

1.       Avoid the drop-off examinations at all costs. If you do have to drop-off, make sure you have a lengthy conversation with the vet first, so that you can both discuss your concerns and costs.

2.       Discuss the vaccine protocol that the vet is suggesting for your pet. Ask if there are 3-year vaccine options available for your pet? And whether they are appropriate.

3.       Discuss food/diet, and treats.

4.       Discuss activity level and exercise regimen.

5.       Discuss any and all behavioral issues, and remember that behavioral issues tend to worsen and magnify over time. So if it doesn’t seem like a big deal now, will it be if it is twice as often as it is now? Or more?

6.       Stress plays a role in your pet’s lives and health. So if there are any different members of the family (kids, parents, other new pets), noisy activities in the house, or changes to the household, etc. mention them. Things that we see as being a minor change (like moving furniture, redecorating, etc) can really stress out your pets.

7.       Anything that you feed your pet (be honest!), or your pet chooses to eat, or gets into (stealing food) are also important pieces of information. I currently have a client who is using homeopathic herbs and additives and I suspect is causing kidney diseasein her 6 year old house cat. It took 20 minutes of Q & A to get this information because she thinks “homeopathic is equivalent to harmless.” In some cases it is and in others it isn’t.

8.       Leave the appointment with a good list of things to think about, remember to-do (monthly heartworm and flea & tick preventative), upcoming future appointments and re-checks, etc. At our clinic we give out report cards for each visit. It really helps go over all of the information we discussed, and provides a good overall summary of our PE findings.

Last week at Nacho’s appointment I immediately noticed that his hair is very thin, sparse, and flaky, especially around the top of his head and ears. When I inquired about this his owners told me that “he has been like this for years.” I was shocked! Why would this be disregarded? A skin issue can be a health issue, especially if it is a chronic problem. We began our exam with a lengthy discussion of Nacho’s diet, lifestyle, and history of this condition. I asked them to start a long term plan with me to try to get to the bottom of what the skin issue might be caused by. We decided to start with the easy things like a good diet, an omega-3 supplement, and taking a picture of his head every month.  I also reminded them that hair re-growth is a slow process. It took years to get to this point, it will take some time, like months, to start to resolve.

Base of the ear. Note the sparse hair and big flakes of dead skin.

Thickened ear pinna (flap), lots of dead crusty skin flaking off.

I ask clients to take pictures/document their pets because in the day to day progress of a disease (or response to a treatment plan to identify a disease) the owners doesn’t often notice the subtle changes. So I either have them come in for regularly scheduled visits over set intervals of time (like every 1, 2, 3 weeks, or monthly, etc.) so I can help them monitor. I also take a picture of the pet every visit to keep in my phone, or on a hard drive. Or we print a picture out in the clinic and staple it into the chart that way no matter which vet does the follow-up we know where we were at the last visit.

I am notorious for assigning homework to my clients. It helps get everyone involved and provides a much more consistent patient monitoring.

I will keep you posted on little Nacho.

His initial treatment plan is as follows;

1.   Better food. No little gravy cans with funky colors and junk food ingredients. Very hard for small dogs, they get used to junk food, they want to keep eating junk food, so a transition to a better food takes time, patience, and persistence.

2.   Start Welactin daily, the omega-3 fatty acid supplement from Nutrimax.

3.   Use monthly flea & tick prevention. We switched him from intermittent to almost negligible to monthly revolution.

4.   Re-check in 1 month.

July 1st, Sunday's Folly

It was a very busy two hours today.

I was greeted at 12:30 by a oung couple carrying their beloved Corgi. She was in severe pain, unable to stand, and had refused all food and water for the last 2 days. She had been involved in a dog fight a few weeks ago, and from there things had taken many turns for the worse. Within the span of the last two weks she had become almost completely paralyzed from her waist down. She had been to all sorts of specialists and had all sorts of advanced diagnostics to try to identify the causes of her mounting ailments.

When I met her today she was obviously in an extreme amount of pain. She was also very pale. Her lymph nodes were waay too big and way to disperesed between her mouth, armpits, and legs for a simple infection to explain. I was very very concerned the minute I saw her. I was even more so after I read through their very thick very involved file.

I very quickly gave her some sedation and pain relief. She morphed from a rigid unable to move block of wood, to a calm, flaccid, relieved pup.

I repeated all of the diagnostics that I could run "in-house." I checked her blood, took x-rays, and tried to connect all of the dots of he long sad sordid clinical sign tale. Many dots remianed outside of my ability to get her very concerned emotionally fragile parents an answer. Almost nothing is as frustrating as knowing that you have a seriouslyt ill, critically fragile patient with something obviously wrong with them and not being able to put your finger on it, so you can give their parents an answer and help them figure out a treatment plan. I know that I live my whole life as a series of figuring out whats bothering me and then attacking the way to resolve it. I like to fix problems. I don't mind puzzles as long as I can make the pieces fit at the end.

After two hours of doing everything I could for her, her parents let her go. I know it was a very difficult decision to make and I know they are at home now grieving their loss.



My second patient of the day was this pitiful soul. She had just been picked up at the shelter where she was to be euthanized today. Literally she was left in a "drop box." And literally she is the most emaciated pitiful gentle soul ever. Those ears pull her already sad face to the earth and further compound her despair.

I am in love with her. How could I not want to help her? Her teeth look to be about 4 years old. And I think she has had about a dozen litters. I asked how the pups were but Cindy (her rescuer) said that just she had been "dropped." (Only a human could be so cruel!).

We ran a heartworm test, negative. And bloodwork, perfect. And I gave her a full exam, also perfect. Cindy said she was going to sneak her home and not confess to her husband that she had rescued her without consent of the rescus she works with. I told her I would help keep my lips shut. (I am sure he doesn't read this).

She will get three square meals a day of puppy food, and regain her muscle mass, and I am sure that within 1 months time she will be a beautiful happy girl. I expect that it will take her about a week to remember that she has her own personlaity. And about two weeks to start challenging the rest of the dogs for her placement on the pack. Few things marvel me more than witness a victim of neglect and abuse remember who they are. It is almost impossible to gauge any pets personality when they are in survival mode.

She spent the whole two hours that she was with us slumped in a corner. She wouldnt look around, move or respond. She is the image of an orphan forgetten in a ward 4 floors away.

I will donate the funds from SaveJade to Lilly. maybe then Cindy's husband won't reprimand her?
http://www.facebook.com/HelpSaveJade

Cindy is amazing! For more information on Lilly stay tuned.

For more information on Cindy's rescue please visit. http://www.allshepherdrescue.com/

Saving Jade

I received a tweet from someone who found me on Twitter asking “If I could, or knew of anyone who could, repair a fractured pelvis in a found kitten?”

OK, this isn’t a request I get everyday (TG). I replied back asking for more information.

Pelvic fractures, (like every other fracture) come in all sorts of sizes, shapes, and degrees of difficulty, and patient information is very important also. (Quick mention, almost every question I am asked is in dire need of significantly more information. I had a person call yesterday for an estimate on a dental? I needed a lot more information before I could give her the dollar figure she was in search of. Note to general public; don’t call for an estimate, make an appointment and go over every line item that the surgery requires. There is very rarely a “set price” for anything and every pet and every procedure should be individually customized and charged appropriately).

After a few tweets back and forth, I learned that Jade was a 5 week old kitten who was found in the middle of a very busy highway. The people who found her thought that she had “been thrown from a car.” She had been to a veterinarian already and they had been told that Jade had a fractured pelvis and would need a $3,000 surgery to fix it. The girls lacked the extra cash and  decided to hit the social media to find some help. (I’m still not sure how they found me, other than Twitter, but I was 2 hours away, and not an expert on pelvic fractures. I will take the inquiry for my services as flattery and leave it at that).

This is the highway Jade was found on.

As a matter of course I had a whole slew of questions. The first began with, “Who told you that she needed surgery?” I guessed it wasn’t a surgeon because I don’t know any reputable surgeon who would tackle a pelvic fracture in a 5 week old 1 pound kitten. I am also pretty sure that this feat is physically impossible. There aren’t even bones in a 5 week old kitten. It’s all just soft mushy stuff that eventually turns into bones. You cannot even find a bone plate that is small enough. I was happy to help this kitten but most of what I was hearing didn’t jive with reality.

I asked for the radiographs and told the girls that I would review them and pass them along to my surgeon friends.

But my second question was really the only question that mattered. “How is she doing?”

“Oh! She’s great! She is happy, playing, and eating.” Their tone had changed to a neffervescent jubilant proud parent when they explained how cute she was and how adorable every one of her kitten gesture’s was.

I reminded them that the patient dictates the treatment plan. Not the blood work, x-rays, or opinions of an “expert.”

I asked about the physical exam findings from the veterinarian that Jade had already been to. All the girls could recall was x-rays, pelvic fractures, and surgery. Not much for me to base a decision on.

We agreed that the best plan was to bring Jade to me so I could re-assess her and take more x-rays. It had been about 5 days since the first x-rays and I wanted more views if I was going to try to send them to a surgeon. I also needed to know a few key pieces of information. They included; her ability to ambulate, her nerve function to both feet, and any additional signs of trauma. I also wanted to be sure that she was disease free, (specifically FeLV/FIV). Everything hinged on these questions.

A few days later Jades foster mom drove the 2 ½ hours north, through both the DC and Balt beltways, for me to take a look at her.

As soon as I opened Jade’s carrier she leapt out and ran around the exam room. She was a little black 1 pound bucking bronco! She didn’t hesitate to investigate her surroundings, she just busted out like it was her very own coming out party!

OK, I thought, I could immediately cross almost all of my items off of her "critical information" list. She obviously had full motor function, full nerve function, full strength, and after her mom verified her negative FeLV/FIV test, and  that she was perfect in her ability to eat, drink, urinate, and defecate. I discussed my treatment suggestions.

To summarize I said “She thinks that she is perfectly fine. Listen to her. Don’t decide based on x-rays. She is too little and too comfortable just the way she is to risk an almost impossible surgery. I don’t think that you could even find someone to perform her surgery. IF you do I want to talk to them. She absolutely needs to be spayed at 5 months old, because her pelvis will likely heal crooked, and she may not be able to pass kittens through a crooked pelvic canal. But I think you saved her life, and I think she is one very lucky miraculous kitten. And as the old saying goes “put a kitten with a thousand broken bones in a bag and 2 weeks later they will heal.” (OK, skip the bag part, but the old saying in essence is that kittens and their 9 lives are amazingly resilient creatures, so don’t give up on them without giving them a chance to amaze you).

Over the last few weeks I have gotten many updates on her progress. Sure enough she is doing great and hasn’t skipped a beat!

I hope to see her in another few weeks for her spay. If I do see her (I know it’s a long drive so I won't take it personally if they decline to battle both beltways for me, although I will secretly beg and plead, and do it for free!) I will take x-rays and see just how that mangled pelvis did eventually heal.

Here is Jade’s Facebook page and information.

http://www.facebook.com/#!/HelpSaveJade

Thanks to her foster family and all of those who helped to save her life. The compassion of mankind can be found in the most common of places and I am happy to have played a part in her story. Best of luck to you all, and give her a big kiss from me and the rest of us at JVC.

XXOO!