The Whispers of Three Brothers

D. E. Larsen, DVM

I was in the back room cleaning up from my morning farm calls. I had been in Enumclaw for a little over a year, and my portion of the practice was steadily growing. Today was a fairly typical Monday. The morning was spent on herd health work with two or three dairy herds, followed by a full afternoon schedule of office calls at the clinic.

I was hoping to have time today to run home for a quick lunch with Sandy and the girls. Sandy was over seven months pregnant, and I liked to be able to check on her during the day.

Just as I was pulling my shirt back on, Kathy popped her head through the door from the front of the clinic.

“Oh, good,” She said. “I see you’re ready to go to work.”

“I was hoping I had time to get a quick lunch,” I said.

“No such luck, Cheryl is on her way with her young tomcat,” Kathy said. “You should remember her. She is the one you tried to convince to have her cat neutered. He was that young orange tomcat you gave vaccines to a few months ago.”

“Yes, I remember, she was a pleasant young gal,” I said. “But sort of stubborn, I guess the cat still isn’t neutered.”

“That’s the one,” Kathy said. “She is pretty excited. I think Leo must be pretty sick.”

Kathy was right. Just as I stepped into the front of the clinic, Cheryl pulled into the parking lot. I watched as she rushed around and wrestled a large cardboard box out of the back seat. Plastic cat carriers were not common in 1976.

Cheryl was out of breath when she pushed through the front door.

“I think he is almost gone,” Cheryl said, as Kathy took the box from her. She followed us into the exam room.

Kathy placed a fleece pad on the exam table, and I lifted Leo out of the box and placed him on the padded table top. He was limp as a dishrag.

The instant he hit the table, he went into a seizure, and then he was gone.

Cheryl watched, horrified. “Oh, my gosh, what could have happened to him?” Cheryl asked. “He seemed fine yesterday.”

I raised Leo’s lip and then opened his mouth. His membranes were ghost white. Running my hands over his body, there was no evidence of any trauma.

“He has been in the house the last few days,” Cheryl said. “He couldn’t have been injured.”

“Give me a few minutes,” I said. “I will get a drop or two of blood and get a look at it. You can wait out front if you like.”

The Clinic in Enumclaw was not really set up to accommodate small animal clients. Historically, it was a dairy practice that took care of dogs and cats as an afterthought. After my arrival, the small animal practice began to expand a bit. Some of that was because I made an effort to be available in the afternoons. Being part of a younger generation in veterinary medicine may have also influenced the practice’s growth.

As soon as Cheryl left the exam room, I drew a small sample of blood from Leo’s jugular vein. It looked like red water. I was certain this was a Feline Leukemia death.

Sure enough, Leo’s blood showed a packed cell volume (PCV) of 6%, not compatible with life, and the blood slide was covered with abnormal lymphocytes. Quick chair-side diagnostics for feline leukemia were not available in 1976, but this was all I needed for the diagnosis in a dead cat.

I stepped out and motioned for Cheryl to return to the exam room.

“Leo died of Feline Leukemia,” I said.

“I feel so guilty,” Cheryl said. “Could we have done something for him if I had gotten him here earlier?”

“Cheryl, this disease is killing a lot of cats these days,” I said. “We lose cats every week. Had we seen him yesterday or the day before, we might have bought him some time with a blood transfusion and some medication. But the outcome would not have changed, and the transfusion only would have bought him a few weeks or a month or two at best.”

Cheryl carefully loaded Leo back into his box.

“At least I can take him home and bury him under his favorite tree,” Cheryl said as she headed out the door.

“That’s so sad,” Kathy said. “I wish there was something that could be done for these cats.”

“They’re working on it,” I said. “But it will be while.”

***

It was late in the day on Wednesday when I noticed Kathy hang up the phone and look at me with concern all over her face.

“That was a new client,” Kathy said. “She is on her way, she said five minutes. It sounds just like another Leo.”

It was less than three minutes when Marie came through the door with a cat carrier. She was in tears.

“I think he just died,” Marie said, the tears streaming down her face. “It happened so fast. He seemed fine this morning, and when I got home from work, he was stretched out on the front steps, unable to move. He had a seizure or something just as I pulled into the parking lot. There was a terrible ruckus in the carrier. And he looks dead to me.”

Kathy placed the carrier on the exam table, and I removed the cat.  A young orange tomcat. Sure enough, he was dead. One didn’t need a degree to determine that. I opened his mouth; no color to his membranes. There was no evidence of any other injury.

“He even looks just like Leo,” Kathy said.

“What do you think happened to Nacho, Doctor?” Marie asked.

“I could do some blood tests if you want, just to be more accurate in my guess, but I would I would guess he has feline leukemia,” I said.

“How did he get something like that?” Marie asked.

“It is caused by a virus. It is a common problem around here,” I said. “A young tomcat like Nacho could have easily gotten it from a bite wound from an infected cat. Sometimes the virus is passed from an infected mother to her kittens, either before or after birth. Some cats will live a long time with the virus, others, like Nacho here, not so long.”

“Could you have helped him if I had brought him in this morning?” Marie asked.

“We could have bought him some time,” I said. “Not much, maybe a week or two. Do you want me to do some blood work on him now?”

“No, I don’t need to be spending any more money on a dead cat,” Marie said as she placed Nacho back into her carrier. “Thank you for your information.”

Marie paid her bill and left with Nacho. I don’t think I saw her again.

***

Early Friday afternoon, the scene repeated itself one more time. Three leukemia cats in one week seemed a bit much. This time, it was a good client, Ellen, with Sunshine, whom we had seen many times in the last year.

Ellen came flying through the door carrying Sunshine wrapped in a towel. 

“I didn’t have time to call,” Ellen said. “Sunshine was flat out on the kitchen floor when I got home a few minutes ago. I think he is dying.”

We directed Ellen and Sunshine into the surgery room where we had an open table. She carefully laid him down on the table.

“I have been sick with worry all week,” Ellen said. “I talked with Cheryl on Monday, and then Marie called me last night. Leo and Nacho are both brothers of Sunshine, all from the same litter. Then I called Mrs. Wilson. She said her momma cat seems to have kittens that don’t live very long. Cheryl said you told her Leo could have gotten the virus from his mother. I am just sick over all of this.”

I carefully looked at Sunshine. I had vaccinated him as a kitten, neutered him at six months of age, and then saw him for his annual exam. He was a friendly, neutered male cat. It was easy to recognize why Ellen was so distressed by his pending death.

I opened Sunshine’s mouth. His membranes had no color. I tried to respond as I stroked his head and back, but he did not have the strength to raise his head off the table. I was as gentle as possible, trying hard to keep from inducing a seizure that would end his life.

I clipped a foreleg and prepped it so I could place a catheter.

“Ellen, I am going to place a catheter in his leg,” I said. “That is going to allow me to collect a blood sample, and if we are lucky, we will be able to give Sunshine some blood. There is a risk here. Sunshine is very fragile right now; he could die at any moment. If he struggles at all, he could die.”

“I understand, Doctor,” Ellen said. “Cheryl told me her story. It must have been horrible to watch.”

“You are welcome to wait out front,” I said. “This is going to take some time. If I can place the catheter, and if the blood shows what I suspect, then I will collect some blood from our donor cat. This might take half an hour.”

“That’s fine, Doc,” Ellen said. “Sunshine will rest better if I am here with him.”

“If I can get some blood into him, his response will look like a miracle to you,” I said. “But you have to understand, this is only going to buy him a few weeks. Maybe a month or two if we load him up with some medication.”

“I will make those weeks the best weeks of his life,” Ellen said. “I can promise you that, Doc. Go ahead and try, we will take any time you can buy.”

With Ellen petting Sunshine and murmuring into his ear, I was able to place the catheter and collect a small sample of very watery-looking blood.

Sunshine’s PCV was 8%, which may be why he was still alive, but it was still marginal. There were many abnormal cells on the blood slide. I headed to the back to retrieve our donor cat.

I sedated the donor and collected just over a hundred ccs of blood in two heparinized syringes.

“How long is it going to take to give him that blood?” Ellen asked.

“Sunshine does have time to have it dripped into his vein,” I said. “I am going to give it out of the syringe, as a push. It will only take a few minutes. Prepare yourself for a miracle.”

I started with the smaller syringe, pushing the plunger of the thirty-five cc syringe at a slow, steady pace until it was empty. Sunshine blinked his eyes and shook his head. Then, with Ellen’s help, he righted himself to his sternum.

I started with the larger syringe of seventy ccs. By the time that syringe was empty, Sunshine was licking at his catheter and Ellen’s hands. Now the tears came, Ellen gave me a hug, and sobbed out a thank you.

I gave Sunshine a large dose of dexamethasone and removed his catheter. 

“Okay, remember what I said, this is only going to last a few weeks,” I said. “Let me look at him on Monday.

Ellen wrapped Sunshine in his towel and put him on her shoulder, wiped her tears away, and worked her way through the now crowded waiting room.

“We will see you on Monday, Doc,” Ellen said as she exited.

***

It was almost three weeks to the day when Ellen returned with Sunshine and requested euthanasia.

“He had a great three weeks,” Ellen said. “But I can tell it is time, he hasn’t moved from his bed for two days now. We want to thank you again for that extra time.”

Photo Credit: Daniil Kondrashin on Pexels.