D. E. Larsen, DVM
Manure piles were (and still are to some extent) standard fare on Oregon farms. They were located around the barn somewhere and served multiple uses. They came in many shapes and sizes. Smaller places had a simple pile outside a doorway where the barn was cleaned. Larger farms had more elaborate piles. In my experience their edges were the easiest place to collect a can of worms for a day’s fishing. They also were used to dispose of small animals that were casualties during the year on the farm. They were the ultimate compost piles.
Gus was a typical barn cat. Well past middle age when I first met him when I came to Sweet Home in 1976. Gus was lucky to have been neutered early in his life, but still had his share of scraps defending his turf. He was nothing special, gray tabby in color and not large, maybe 8 pounds. He lived with his extended family on a small acreage on a hill outside of Sweet Home. Grandma and Grandpa lived on the “farm”. Not much of a farm, but enough for a few cows and sheep and a small barn. The son and his family lived about a quarter mile up the road on a neighboring taxlot. When Gus came to the clinic he came with Carol, the daughter-in-law.
Over the first few years of practice in Sweet Home Gus was approaching his golden year. In those times I didn’t see neutered male cats over 15 years of age. This was before the advent of the feline leukemia vaccine, and diets did not address urinary tract and heart issues. For barns cats to reach that age was truly exceptional.
One cold winter morning Grandpa hurried into his pickup truck in the carport on the side of the barn. It was cold and he was anxious to get the truck started. “Thump, thump” came from under the hood. Gus had sought the warmest spot he knew of to sleep the night before. The warm engine block was one of his favorites. Usually able to scramble out before the engine started, this morning it didn’t work.
Grandpa knew what the noise meant, he had seen more than one cat caught in a fan belt on cold mornings. He was disappointed when he found Gus, he had been such a good cat. Gus was a mess, broken leg with bone poking out, left eye hanging out of the socket, several large lacerations and bleeding from his mouth. In Grandpa’s mind there was only one thing to do. Picking up a hammer, he made a quick whack to the back of Gus’ head. Disposal was easy. Gus’ final resting place was the manure pile on the other side of the barn.
In most cases that would be the end of the story, but remember, cats have 9 lives. Gus had already used several of his just surviving to this advanced age. Now he would need to cash in all the others.
Carol had noticed that Gus had not been to his dish on the back porch for several days. She mentioned his unusual absence to Grandpa. Grandpa was quiet, knowing the she would have rushed Gus to clinic and spent a lot of money on an old cat.
The next morning, she heard a noise on the porch. She opened the door and was aghast at the scene. There was Gus. Covered with manure, left eye hanging out, broken and torn. How had he managed to make it to the door? How had he known which door was the one to provide him help? She carefully boxed Gus and headed for the clinic. Grandpa was outside as she drove by so she stopped to show him what she had found. Grandpa had no choice but to confess. He said that the vet could do a better job than him, assuming that Gus would be put to sleep. In those years, in Sweet Home, if a cat couldn’t be fixed for $100.00 it probably was not going to be fixed. Gus would surely be well over that figure.
Carol laid Gus on the exam table and related the story. Gus looked hopeless to me. She wanted to know her options. Gus was a pitiful sight as he lay on the table, looking cautiously at me out of his one good eye.
“What are your options, Gus?” I thought to myself as I pondered the situation.
My initial thought that Grandpa had Gus’ best interest at heart, he just didn’t do the job very well. I’m not sure that was what his owner wanted to hear.
“We have a lot problems here” I started. “Contaminated compound fracture of the tibia, fracture of mandible, eye that needs to be removed, broken teeth and multiple lacerations that are very contaminated. The first question we need to discuss is do we want to put him through all this over the next few weeks?”
Carol was quick to respond, “We are not going to put him to sleep, not until we don’t have any other option. I don’t care what it costs. If we have to, Grandpa can log a few trees. That’s the least he can do after what he did to this cat.”
I knew Grandpa. He would log his trees for his family or for the Grandkids. I wasn’t so sure about a cat.
Now we were on to option number 2. Referral was out of the question. There were no specialty clinics around at that period of time. If Gus was going to survive it was going to be by my hands only.
“We have several things to do, first we need to sedate him and get him cleaned up, get him on some fluids and antibiotics.”
“The wounds are too contaminated to close; if we clean them up and remove the grossly contaminated tissues, they will heal if he lives long enough.”
“I can probably wire the jaw and remove the broken teeth. The eye is toast and has to go.”
“The fractured tibia is too contaminated to fix, the ends of the bones are likely dead, The leg has to go.”
Carol finally spoke, ” I want to save the leg!”
“Can’t be done.” I responded.
Again Carol spoke, “I want to save the leg, we can try!”
“Okay, we can try, but if it happens it will be a miracle. And the leg will be short. We will try. He will have to stay a few days. I don’t know what this will cost.”
Carol left, convinced that Gus was going be back to his old self in a few days. Might take a little longer than that, I thought.
We sedated him with a dose of Ketamine and got him under the spray nozzle in the tub. After cleaning the manure and dirt, it looked like things were almost doable. We got him dried off and an IV started. Antibiotics on board and warmed up a little, he was ready for the first of several procedures.
Putting Gus on some gas anesthesia, we started cleaning wounds. Shaving hair from the wounds. We removed contaminated tissues and packed with Furacin Ointment (the best topical antibiotic ointment I had at the time).
I worked on the tibia next. The ends of the bone were dry and brown with debris stuffed into the ends. I cleaned the wound as best I could. Calculated that I would have to removed bone from both exposed fragments. I couldn’t make myself think this was going to be anything but a waste of time. We packed the wound with antibiotic ointment and would do the repair tomorrow.
The left eye was hanging out of the socket and did not require much to remove. Placed a single suture around the optic stalk and removed the eye. I could deal with closing the socket later.
The mouth was clean compared to the rest of the cat. Gus was missing both upper canine teeth and one lower canine tooth. His jaw was fractured on the left side and separated at the symphysis (the mid point at the front of jaw were the mandible bones join in a non movable joint).
The symphysis was repaired by passing a 20 gauge wire around the mandibles just behind the lower canine teeth, exiting on the ventral midline where I twisted the ends to tighten the ligature, cut the ends short and buried with a single suture. The fracture of the mandible was stabilized by wiring around two teeth on each side of the fracture. Probably will need to do more but later.
The next morning Gus was looking pretty good and actually was ready to get out of here and back to his barn. We gave him a few laps of gruel and continued the fluids. We were going to tackle the leg later today. I still felt this was a waste of time.
With Gus under anesthesia, I went to work on the exposed bone. To my surprise, I did not have to trim too much bone before I came to bleeding bone. The marrow cavity appeared pretty clean with the superficial debris was removed. I repaired the fracture with a threaded intramedullary pin. Inserted at the knee and threaded down the marrow cavity to the fracture site. Placed the ends of the exposed bone into normal position and seated the pin into the distal fragment. This was the common repair at that time. We will have problems due to the contamination at the fracture site. I cleaned up the wound as best we could and closed this wound.
Gus was ready to go home for a few days before we started the next round of repair and treatment.
Both Carol and Gus were happy to see each other. Gus was actually stepping on the fractured leg. Cats always make surgeons look like they know what they are doing.
Over the next few weeks, Gus became a standard visitor to the surgery room. We would clean on his open wounds, which were granulating well. We closed his eye socket and placed an additional wire in his jaw to improve the repair. On each visit I was more and more cautious on how the leg was healing. The soft tissues were looking good but I was still skeptical about the bone. Carol was in great spirits, and I think that Grandpa was getting to come out of the doghouse once in awhile.
Finally, push comes to shove. Time to x-ray the leg to see how the repair is going. Gus is still quite a sight. One eye and one lower canine tooth protruding out on the outside of his upper lip. Larges patches with no hair, but the wounds are mostly healed. Probably as good as they would have healed had they been sutured. He would purr and he was bearing weight on the fractured leg.
The x-rays were better than I expected. There was some healing but not what was needed. We would have to try something different.
So at 6 weeks from the time of injury I removed the IM pin. There was a pretty good fibrous union of the fracture, but no boney union. The next try was an external fixation device, 4 small pins driven into the bone, 2 above and 2 below the fracture site and bolted to an external pin to fix the bones in position. A tall order for a cow doctor but I got it done.
Another 4 weeks and we were done. The leg was healed, Gus was happy, Carol was happy. I don’t know about Grandpa. The total dollars are lost to a clouded memory. Anyway, it was never about the money.
The last time I saw Gus was almost a year later. Into his golden year now, and with none of 9 lives to spare, he was truly an old cat. He was in for routine stuff, an abscess on the side of face, (left side, he probably didn’t see the punch coming) and tapeworms. Still defending his turf and still able to catch a mouse or two. I always wondered about his final resting place. Was it the manure pile, again?