D. E. Larsen, DVM
Ann spent most of the time at the front desk while Ruth and I did an annual exam and vaccinations on Tigger. She returned to the exam room just as we put Tigger back into his kennel.
“How do things look with Tigger?” Ann asked.
“Tigger is doing fine for a twelve-year-old neutered male,” I said. “You know, these guys seldom make to fifteen. But it is pretty hard to find anything wrong with him today. The only problem I can even mention is the pellet I can feel on his upper right thigh. But looking through his record, I have noted that every year for the last five years.”
“Yes, and you always say the same thing,” Ann said. “We can take it out with no problem, but it doesn’t seem to be causing him any issues.”
“You took the words right out of my mouth,” I said. “I guess there is probably some lead exposure to his system. But he is healthy as a horse. I don’t think it is causing him any issues.”
“I do worry about the lead issue,” Ann said.
“Well, this is a twenty-two caliber pellet, and they are usually made is uncoated lead,” I said. “It would be easy to remove it. Just a short anesthetic episode, and I would make an incision around the pellet and remove it in a block of tissue surrounding it. A couple of stitches is all, not anything that will bother Tigger.”
“I will think about,” Ann said. “Obviously, it’s a very elective thing. It hasn’t caused a problem for the last five years, and I sort of think it was there for some time before you noted it.”
It was late winter of the same year when Ann again had Tigger into the clinic.
“What’s up with Tigger today?” I asked as I entered the exam room.
“I’m not sure, Doc,” Ann said. “He has just been doing a lot of vomiting lately. Nothing major. He just vomits little puddles of liquid with a little grass, but it happens several times a day, and he has never had that kind of a problem before.”
“Am I correct in thinking that Tigger is outside and does a lot of hunting?” I asked. “If that is the case, this is most likely just a parasite issue.”
“Yes, I guess I’m just a worry wort,” Ann said. “You don’t think it could be that pellet do you?”
“You have probably heard me say before, if you’re in a barn and see hoof prints, you look for a horse, not a zebra.”
“What does that mean?” Ann asked.
“You will feel foolish if you spend all your time looking for a zebra and then suddenly stumble onto a horse,” I said. “Or in Tigger’s case, if we do all the work, and the expense, to diagnose lead poisoning and then figure out that it is just a tapeworm problem.”
“I see. You’re saying that you see more tapeworm problems in cats than you see lead poisoning,” Ann said.
“Yes, that’s the thing,” I said. “I have seen one case of lead poisoning, in a cow no less. She had been chewing on a car battery left in the pasture. That was when I was in vet school, and the diagnosis was not made until the cow reached the necropsy floor. As far as pellets under pets’ skin, you should see some of the x-rays I have of bird dogs. They are usually peppered with lead shots. And they don’t have any problems. With Tigger today, let’s make sure his kidneys are okay and worm him. If problems continue after that, we can formulate a course of action. Depending on what you want to do, just removing that pellet might be the easiest first step.”
With that discussion over, we popped a worm pill down Tigger and checked his urine, which showed no problems.
“Let me hear from you in a couple of days, Ann,” I said. “If Tigger is still vomiting, we can send some sample in for lead levels, or we can remove the pellet and see what happens.”
Two days later, Ann was back with Tigger.
“The vomiting is still happening,” Ann said. “I think I would like to take that pellet out and see what happens.”
“Do you want to send in some samples for lead levels?” I asked.
“He still eats. Let’s just do the pellet today,” Ann said. “That will spare the lab expense, and if nothing else, it will give me peace of mind.”
We took Tigger to surgery, and after getting him under an anesthetic, we prepped a wide area on his right thigh. I made a wide elliptical incision around the pellet and removed it in a block of tissue. The incision was closed in two layers.
When I opened the tissue block, there was a dark discoloration of the tissues in contact with the pellet. This discoloration extended several millimeters into the tissues.
Tigger went home, utterly oblivious to his surgical wound. After several days, his vomiting resolved.
“It looks like this incision healed with no problem,” I said as I wrestled Tigger to the tabletop to take his sutures out.
“The surgery never bothered him,” Ann said. “He seems to feel so much better than he has in a long time. I think that pellet must have been causing him some problems for a long time.”
“We didn’t do any of the diagnostics, so we will never really know,” I said. “It is challenging to accurately gauge results when we want to see favorable outcomes. That is why medical studies have to be so carefully designed or our biases sneak in and influence the findings.”
“Well, Tigger doesn’t care,” Ann said. “He just feels better.”
Tigger lived to a ripe old age of sixteen years. In those years, that was almost unheard of for a male cat. Today’s life expectancy is longer, and twenty years is an attainable goal for many cats.
Photo by Yulia Ilina from Pexels.