The Dart’s Glance

D. E. Larsen, DVM

Fred Briggs waited patiently while I was finishing up on my office calls. He always came at the end of the day, maybe because we were close to his home in Albany, but I liked to think because he knew he would have more time to talk with me.

Fred was a salesman for one of the drug companies that supplied our clinic. He was older and had been in the business for many years. I enjoyed his monthly visits, not only for the information he provided and the orders he took but because of the stories he would tell.

Fred knew all the veterinarians on his route. I would guess he had a little card on all of us. What we liked to talk about, what drugs we favored, and what we wanted to do in our spare time.

When the last client left, Fred showed himself back to the pharmacy area and opened his briefcase on the counter.

“Have a story to tell you, Fred,” I said. “I will be with you in a couple of minutes after I finish up in the back.”

Sandy was there to place our order and place the flyers on the new products in a stack to transfer to my desk later.

“I will take them, and he will glance at them,” Sandy said. “I can never tell how much he absorbs with a simple glance, but it must be a bunch. He always seems to know what it’s all about.

“I think a lot of these vets just absorb things by osmosis,” Fred said. “They are always too busy to sit down and read anything.”

“How are you doing this evening,” I said as I shook Fred’s hand. “I have been wanting to tell you about using that new capture drug that you got for me.”

“How did that work out for you?” Fred asked.

“Worked like a charm,” I said. “We darted a bull elk. We have captured him every year for the last couple of years. He gets sort of ornery during the rut, so we saw his antlers off just to keep his pasture mates safe. He killed a little Sika buck a couple of years ago. It was always such a struggle just using Rompun.”

“The sad news is, I hear that they are probably going to pull it off the market,” Fred said. “It’s ten times the concentration of Ketamine and Ketamine is becoming so popular as a street drug, they don’t want it out there.”

“That’s too bad, just when you find something that works and you don’t have to keep it in a safe deposit box, and they pull it off the market,” I said.

“You know when they first started using those capture guns, they used Nicotine Sulfate for the drug,” Fred said.

“That was not a very safe drug,” I said.

“Let me tell you a little story,” Fred said. “One of the Albany vets bought one of those capture guns. I walked into his clinic just as he got ready to go out on a farm call to castrate a 600-pound boar hog. He asked if I wanted to ride along and watch. I figured it would be a good show.”

“A 600-pound dose of Nicotine Sulfate loaded into one of those darts would be dangerous if it misfired,” I said.

“Let me finish. We got to the place, and they had this boar in a small shed. The vet stood at one doorway and sent me around to stand at the other doorway. They had a couple of boards tacked across the doorways, but if this boar wanted to go through them, the boards wouldn’t even slow him down.”

“So here I am, standing in the doorway,” Fred continued. “And this vet aims at the rump of the boar and pulls the trigger. This dart glances off the boar’s butt and sticks in the top of my Wellingtons. Probably would have got me if I hadn’t had on those leather boots.”

“While, a 600 pounds dose of Nicotine Sulfate, you would not have even survived for the ambulance to get to you,” I said. “Would not have made much of a difference. There is no antidote. You would have been a dead man.”

“The face of the old vet was pretty pale as he was looking at that dart stuck in my pants leg,” Fred said. “He thought it was in my leg. That sort of brought that farm call to a conclusion. He was just getting some color back into his face by the time we got back to town. He stopped at the back of the old T&R truck stop and threw that capture gun into their dumpster.”

“And I thought I was the one who would be telling the story this evening,” I said.

“What are you going to be doing this weekend?” Fred asked. 

“I don’t have anything planned,” I said. “If this place doesn’t tie me down, I am probably free.”

“I am putting together a float trip down the Molalla River. I thought I would see if I could get you and another vet hooked up with a steelhead.”

The fishing trip was a soaker. No fish, just a lot of rain. But it was a good time. Free time away from the practice was precious in those early days.

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Blood Please, Fill Her Up

D. E. Larsen, DVM

She came through the door in a rush, a young girl, probably in her early twenties, with a very limp, pale orange tabby cat in her arms. 

She stopped at the counter. “I need to see the vet. This is an emergency,” she said, visibly trying to maintain her self control.

Under a lot of financial stress for a new clinic, this was one of our most difficult situations to handle. This patient was an obvious need for emergency care. Still, we were not in a place where we could provide a lot of expensive medical care without some assurance that we would get paid.

Sandy escorted her to the exam room, and Ruth was right there to check her status. 

“I’ll get the Doctor,” Ruth said.

“We require payment at the time of service,” Sandy said.

“I have a credit card,” Valarie said.

I came into the exam room and lifted the lip on the cat, a year old female named Sissy, lying almost lifeless on the exam table.

“We have to be very gentle right now,” I said. “This kitty is hanging onto life with by thin straw.”

“This has happened before,” Valarie said. “She is positive for Feline Leukemia Virus. All she needs is a blood transfusion.”

“I wish it was that simple,” I said. “A transfusion will be like magic for her right now. But it will buy her very little time. She will be back here again, in the same condition. And one time, she will not survive the trip.”

“She does just fine after getting a transfusion,” Valarie said.

“That’s why she is here in this condition,” I said. “When was her last transfusion?”

“It was about 3 weeks ago,” Valarie said.

“The virus crowds out her normal bone marrow cells so she can’t make her own blood. These FeLV positive cats have a short time to live once we start to see symptoms. Sometimes it is dysfunctional bone marrow like this. Sometimes it is leukemia. Sometimes it is a nonfunctional immune system, and sometimes it is a lymphatic tumor in the chest or abdomen.”

“Can we just get some blood into her?” Valarie asked.

“Sure, we just happen to have a donor cat in the back today,” I said. “I just want you to know that this is not as simple as you seem to think. Any undue stress on this cat right now, and she will seizure and die, just like that.”

I wish I could say this case was unusual. But in the late 1970s and early 1980s, we would see cats in this condition often, maybe 2 or 3 times a week. The only thing unusual about this case was the cat was still alive.

Often, the client would storm through the door with a cat in a kennel. Throw the kennel on the exam table, and drag the cat out for an exam. With the trip’s stress and a PCV of about 6%, the cat would have a seizure and die right before their eyes.

We took Sissy into the back and placed an IV catheter. Her PCV (packed cell volume) was 6%. Low normal is 25%. I had only seen a handful of cats survive with a 6% PCV.

I sedated our donor cat with a small anesthetic dose and collected 60 ccs of blood into a syringe. Then I turned around and administered this out of the syringe into Sissy’s catheter. Sissy was back to life before half the syringe was administered.

When I sent Sissy home later that day, I again tried to caution Valarie that Sissy was a lucky cat today. And that this may not happen next time or the next.

“Valarie, Sissy looks good right now,” I said. “But she is running on borrowed time and borrowed blood. Likely, her bone marrow is not producing blood like it should. Two weeks from now, she will be in the same situation, and one time she will not survive.”

“She looks so good. I can’t thank you enough,” Valarie said as she picked Sissy out of the kennel and held her against her chest.

I am not sure if she didn’t hear me or just chose to ignore my thoughts. But she went out the door happy.

It was just like clockwork when Valarie rushed through the door two weeks to the day later.

This time we ran a PCV first. It was 4%.

“Valarie, I have never seen a cat that was alive with PCV of 4%,” I said.

“All she needs is some blood,” Valarie responded.

“Yes, some blood and some functional bone marrow,” I said. “We will try, but I have no confidence that she will live through the process.”

We took Sissy to the back treatment table. As predicted, she died while we were placing an IV catheter.

To say that Valarie left the clinic unhappy this time would be an understatement. Valarie left the clinic pissed off.

To her credit, Valarie came in the next day and apologized for her behavior. 

“I was pretty unhappy yesterday,” She said. “I realize that you had warned me of Sissy’s status several times. I am sorry I acted the way I did.”

“We all get upset at times of stress,” I said. “Losing a pet is a hard thing. This Feline Leukemia Virus is tough. It is very prevalent around here.”

It was half a dozen years later when a vaccine for Feline Leukemia Virus became available. The vaccine immediately changed the landscape for Feline Leukemia Virus associated diseases. 

Today that vaccine has fallen in use and in favor. It does have some problems. Those problems do not begin to compare with what was seen in the cat population before 1984. Those veterinarians who fail to endorse that vaccine were not practicing before 1984.

Photo by M Ruslan from Pexels

The Turpentine Compress

D. E. Larsen, DVM

I carefully started removing the wrap on the hindfoot of Lady, a large Golden Retriever. This wrap was composed of a couple of rags and what looked like an old tee shirt. 

I recoiled from the odor.

“When did this happen,” I asked Ralph.

“She got ran over yesterday afternoon. The foot looked so bad, and she was licking it so much, so I put a turpentine compress on it last night.”

“Turpentine!” I said. “What made you think turpentine would be helpful.”

“My grandfather always used turpentine on a wound on his cattle,” Ralph said with no hesitation.

I pulled the final pieces of cloth off the wound. Lady just laid her head down on the table, obviously resigned to the misery she was suffering.

This wound was a total loss of the skin from the hock down to the footpads. The skin was totally gone. The bare tissue looked almost cooked from the turpentine. I can only imagine how that must have felt when it was applied.

“Your grandfather maybe used it on some minor abrasions of the skin. That was maybe done in those days. Using it on a wound like this was nothing less than torture for Lady.”

“Gee, I am sorry, Doc,” Ralph said. “I was just trying to do something helpful.”

“This wound was probably not repairable last night. It is definitely not repairable at this point. This leg is going to have to be amputated.”

“When are you going to be able to do that surgery?” Ralph asked.

“We have a busy schedule, but I can’t allow Lady to sit in a kennel and suffer waiting for surgery. We will move things around and get her into surgery right away.”

“I don’t know, Doc,” Ralph said. “I am not sure she will be able to get along with only 3 legs. Maybe we should just put her to sleep.”

“Dogs wake up in the morning and evaluate their situation. They just get up and go with what they have. They make do. People worry more about amputations than the dog. You will probably have to count legs to know that she only has 3 legs.”

“What do you think it is going to cost?” Ralph asked.

“After what you put this dog through for the last 12 hours, you owe her whatever it cost. You owe her another few years.”

“Doc, I was just asking to make sure I can pay the bill,” Ralph said. “But if I decide to put her to sleep, that is the way it will be.”

“Ralph, there is not a judge in the county who will not believe me if I say this is a case of animal abuse,” I said. “Now, I don’t believe in reporting any charges of abuse when it was done out of ignorance, and the person seeks care. That applies in this case. Especially since you are here this morning and not next week. But if you want to put her to sleep, my opinion might change.”

“I am just trying to see where I stand,” Ralph said. “You do the surgery. I will leave a deposit at the front desk. When do you think Lady will be able to go home?”

“Going home will depend on how well she is doing in the morning. If she is up and about, I will probably send her home. She will need a few pain pills, but she is probably going to feel so much better with this foot gone that she will be bouncing around.”

“Where do you take the leg off, Doc?” Ralph asked.

“We could save you a little money by just taking it off at the hock joint. But Lady will do a whole lot better if we take it off in the middle of her thigh.”

“Let’s do what is best for her,” Ralph said. “You have me feeling bad enough already.”

We hurried Lady to surgery. The stench of the turpentine was nearly overwhelming in the surgery room. The surgical prep on the leg did little to lessen the odor or fumes.

I did a standard mid femur amputation. This started with a bivalve incision through the skin to provide big enough flaps for closure over the stump. Extra skin can always be trimmed off the flaps as needed, but if the flaps were cut too short, it would be a significant problem to shorten the stump.

I isolated the major vessels first. Double ligating the femoral artery to reduce any significant blood loss as the surgery progressed. After the vessels were ligated and severed, I separated the muscles quickly. I wanted to get this leg off and out of the surgery room as soon as possible, so everyone could breathe again.

When I finally had dissected down to the femur, I severed it with a Gigli wire saw. Once free from the body, I handed the leg off to be removed from the room.

At this point, I could take a deep breath and start closing the muscles over the bone to provide a well-padded stump. Then the skin was trimmed and closed. I had been a little faster than usual because I wanted that stinky foot out of the surgery room. It was a pretty brief surgery, less than an hour.

Lady recovered with some pain medication aid, but she had to feel so much better with that foot being gone. She was up and around by the early afternoon. Being a little older, it took her a few tries before Lady could handle getting up and down with only one hind leg. After those first few tries, she was acting like she didn’t miss the leg much.

When I could feel confident that Lady would be ready to go home in the morning, I gave Ralph a call.

“Ralph, you can pick up Lady any time in the morning,” I said. “She is feeling much better and is getting around on the one leg just fine.”

“That sounds good, Doc,” Ralph said. “I will be there first thing in the morning.”

When morning came, Lady ate a good breakfast and walked on a leash well. 

Ralph took care of the account and lead Lady out to his pickup. He lowered the tailgate, and Lady started to jump into the back. She made a jump but did not have the strength in the one hind leg to make it up to the pickup bed. Ralph was quick to catch her before Lady fell. Then she jumped up with her front feet on the tailgate and looked to Ralph for a boost. One little boost from Ralph and Lady was in the bed.

“She will do just fine,” I said to Sandy as I watched from the office. “Just give her a couple of weeks.”

Lady continued to do well. As predicted, one had to count legs to make sure she only had three legs when she returned for suture removal a couple of weeks later.

After the sutures were removed, I never saw Lady or Ralph again. That was not a surprise. I had been stern with Ralph, and for him to find another clinic was almost expected. Perhaps it was from embarrassment for his actions, but more likely, it was from the veiled threat of reporting his abuse.

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