D. E. Larsen, DVM
The mouth was wide open, and salvia dripped from the gleaming white teeth. The snarl could have come from a timber wolf. As I reached around to his rear end, the mouth snapped viciously at my arm. My arm would have been chewed to pieces if Joleen hadn’t had a death grip around Paco’s neck.
Once Joleen was able to get a grip on Paco, we were committed to complete the procedure. There would be fooling him a second time.
Paco was in for a much needed and overdue, neuter. He was one of our most unmanageable patients. His black color made with white teeth more obvious. Paco was a Chihuahua. Soaking wet, he maybe weighed four pounds. Joleen, who is no small girl, needs most of her strength to direct Paco’s slashing teeth away from my hands.
I applied a rubber band tourniquet to his forearm as Joleen continue to struggle, directing his bites away from me. I slipped a small needle into his cephalic vein, and the effects of a low dose of Pentathol was rapid. Joleen turned Paco to his side and relaxed her grip. I could feel myself relax as we inserted the endotracheal tube and moved Paco toward the surgery room.
With Paco clipped and prepped for surgery, I placed sterile towels around the surgery site and covered those with a sterile drape. I pushed one testicle forward out of the scrotum. Then because we didn’t want to have to see Paco back to remove sutures, I made a short midline incision over the testicle. I squeezed the testicle out of this small incision. The second testicle was externalized similarly.
I generally opened the tunic covering the testicles and ligated the vessels separately. With a small dog, like Paco, I placed a couple hemostats on the cord and ligated the cord without opening the tunic. Now with Paco’s jewels on the tray, I could rest assured that there were going to be no little Pacos running around to eat my fingers.
I closed the skin incision with a single mattress suture placed under the skin. I did not want to have to see Paco for suture removal.
Pat was happy to be able to pick up Paco that evening. Paco was wagging his tail rapidly when Pat opened the cage door. Paco jumped on her shoulder. It is hard to believe this was the same dog we had on the exam table this morning.
As I watched Pat and Paco walk out the door, I couldn’t help but remember one of my calls to Pat’s farm on the top of Scott Mountain Road.
It was a warm afternoon in August when Pat had called about her old horse, Dan.
“Doctor, I am hoping you can get a look at Dan today,” Pat said into the phone. “He has not been his self for some time now, but today he is out in the pasture just wandering in circles. I am worried sick that there is something terribly wrong with him.”
“Pat, I can get up there in the early afternoon. That will give me time to get any lab samples ready for the courier this evening.”
Pat was waiting for me in the front yard. I could see her wringing her hands and wiping a tear from her cheek.
“I am so glad you could come this afternoon,” Pat said.
“Your old horse is not doing well?” I said.
“Yes, it is Dan,” Pat said. “He is old, but there is something terribly wrong with him. Look at him.” Pat points to Dan, who is slowly walking in a wide circle in the middle of the pasture.
“Let’s go get a look at him,” I suggested.
We walked around the small shingled farmhouse to the gate into the pasture. As we walked out to Dan, I scanned the small farm. Pat had several horses, a small flock of about 40 sheep, a couple of pigs in a pen by the old barn with ducks and chickens scattered everywhere. The pasture was dotted with Tansy plants. Tansy is a poisonous weed that seemed to be everywhere in the 1970s. It was bitter tasting, and most grazing animals would not touch it. However, for some reason, an occasional horse would develop a liking for it and seek it out. It was toxic to the liver, and the toxicity was cumulative. A nibble here or there, over time, became a lethal dose.
When we got to Dan, Pat stepped in front of him. He stood there, pressing his head into her chest and grinding his teeth. As I worked through an exam, Dan did not move. His mucus membranes and the whites of his eyes were noticeably yellow. To me, the diagnosis was Tansy toxicity. Pat was going to need some time to come to grips with the finality of that diagnosis. I drew some blood to send to the lab.
“Pat, Dan is probably in liver failure,” I said. “You can see how yellow his membranes are by looking at the whites of his eyes.” I lifted Dan’s head to a level that Pat could see his eyes a little better.
“What does that mean for him?” Pat asked.
“It is seldom good,” I said. “I will send in this blood, and they can tell us how advanced things are. This is likely Tansy poisoning. If that is the case, Dan is going to die.”
“I was so afraid of that. I knew he was very sick. When will you hear on the blood results?”
“I will hear in the morning,” I said.
“Is he suffering?” Pat asked.
“If this is Tansy, there is nothing we can do for him,” I said. “It would be best to consider putting him to sleep. I will give him a couple of injections to make him more comfortable for tonight.”
I had no hope of helping Dan with any injection. I could just remember a couple of mentors admonishing me to always give an injection, even if it is sterile water. That way, if the patient dies, at least you tried in the eyes of the client. And then, if there is a miracle recovery, you get all the credit. And in school, they always said no patient should die without the benefit of a steroid.
“I will give you a call as soon as I get the results,” I told Pat as I was leaving.
There were no miracles, the blood showed Dan had advanced liver failure. His days were numbered. I took a deep breath and called Pat.
“Thank you for the call and for your efforts,” Pat said. “I need to spend some time with the old boy. We have been through a lot together over the years. I will call when I am ready.”
“That is fine, I know it is never easy,” I said. “If you wait too long, Dan is going to go down and have an awful death struggle.”
It was a few days later when Pat called. I again made the trip to the top of Scott Mountain and quietly put Dan to sleep while Pat waited in the house.
It would be another dozen years before the imported Cinnabar moth would give Western Oregon some relief from the losses associated with Tansy ragwort.
As I sat down to fill out Paco’s surgery record, I scanned through the old records. Dan’s file was still there. Pat had sent me a poem after that event. I looked for it, but it apparently did not survive the years. Probably not clinical enough, I guess.
Photo credit: https://www.pexels.com/@pixabay