One Wrong Step

D. E. Larsen, DVM

It was almost 8:30, and Debbie hadn’t come through the door yet. This was most unusual for her. I was mostly relaxed on arrival times for work unless someone took advantage of the fact. But Debbie had been working here since her senior year, and she was never late. We were concerned for her safety more than worried about her being tardy.

It was somewhat of a relief when she pulled up to the front door, another thing not allowed. But she got out of her car and reached into the back seat and pulled out a cat carrier. Her hair was not combed, and she was still in her barn clothes.

“I’m sorry, but Simba got stepped on by Dad’s horse, Rocket,” Debbie said while trying to catch her breath. “I have been all morning trying to get him into this carrier. He is still walking, but I think it is a bad injury.”

I took the carrier from Debbie and set it on the exam table. “I will get a look at him and get a set of x-rays,” I said. “You can go home and get cleaned up and relax a little. By the time you get back, I should have things figured out.”

“Thanks,” Debbie said as she opened the carrier door to give Simba a soothing pat on the head. “He is terrified and pretty painful, don’t let him bite you.”

“I will give him a little Ketamine,” I said. “That will give him some pain relief and allow us to get a set of pictures without a struggle. You hurry along now, we have a slow morning and will be able to get him taken care of without changing too much in the appointment book.”

Simba was a big cat. He was a Siamese cross, and like my Charlie cat, hunted all the time. This was an unfortunate accident. I drew up a small dose of Ketamine and gave it by IM injection. Then waited a few minutes for it to take effect. It was easy to tell when it was taking effect because the cat’s pupils would dilate completely.

When I was able to pull Simba out of the carrier, I ran my hand down his spine. It was fine until I reached his tail. Rocket must have stepped on him right at the base of his tail. His tailbone was completely depressed into the floor of his pelvis. He would probably have nerve damage to the tail and maybe to his rectum, but my primary concern was with his colon and his pelvic urethra.

We got a set of x-rays, and while they were developing, I did a rectal exam on Simba. With my finger in the colon, I could push the tail bone up into a normal position. That would need to be wired into place. I have seen some tails return to function after a few weeks or months following such an injury, but most are paralyzed. It was not worth the wait unless a client was really hung up about not taking the tail off. The colon seemed to be intact on the digital exam. We would wait to see what the x-rays said.

Debbie popped back through the front door just about the time I put the x-rays on the viewer. No fractures, only the displaced tail bone. The colon looked okay. Then the problem came into view. The bladder was lying in the ventral abdomen, with no attachment to the pelvic urethra. The tail bone had been pressed down against the pelvic floor, and it amputated the bladder from the pelvic urethra.

“Can you fix that?” Debbie asked, with some tears welling up in her eyes. She had seen enough surgery to know this would be difficult, if not impossible, repair.

“I can try,” I said. “But to be honest, it is probably not going to be something I can do. I am not even sure that Dr. Slocum could do this.”

“Taking him somewhere else is not an option,” Debbie said as a tear spilled over and ran down her cheek.

“I will open him up and take a look,” I said. “There might be another way to fix him. When cats are plugged, we sometimes need to do a perineal urethrostomy. Looking at this picture, that might not be possible. We could maybe do a prepubic urethrostomy. Just bring the bladder neck out through the abdominal wall on his posterior abdomen.”

“Would he be able to pee okay?” Debbie asked.

“That will depend on what is left on the end of his bladder,” I said. “If we were to get lucky, he could even have control of his urine. If not, he might just dribble urine all the time. But it will give him a chance at survival. We can always put him to sleep at another time if it becomes obvious that he is not going do well.”

“Okay, let’s go ahead and do what we can to save this guy,” Debbie said.

When multiple surgeries are going to be needed, the rule of thumb is to do the procedure that will do the most good first. In Simba’s case, that meant we would fix the bladder first, then worry about securing the tail bone and the amputation later. Probably, that would mean tomorrow.

With Simba under anesthesia and on the surgery table, I opened the abdomen with a posterior midline incision. Looking at the bladder, I am not sure one could have done a nicer amputation with a scalpel. It was severed right at the prostate, we could probably expect urinary control with a prepubic urethrostomy. The pelvic urethra was far enough into the pelvis that reattachment was not going to be an option.

So I brought the neck of the bladder out through the abdominal wall and made a nice stoma to prevent scar tissue closing the stoma. After closing the abdomen, we had ample time to turn Simba over and do the surgery to wire his tail bone in place, and amputate is tail.

Now it only remained to see how his bladder would work and if he could deal with peeing out his belly wall. Some animals could have a problem with urine scald with his urine soiling the skin around the stoma. But the cat is fastidious enough that we should not have that problem.

Debbie was pleased with the fact that Simba had a new lease on life. Simba recovered well and went home with Debbie that evening. When he returned in two weeks for suture removal. The stoma was healed well, and Simba was keeping himself clean.

“Does he have an awareness of where he is peeing?” I asked.

“I think he has learned already,” Debbie said. “At first, he was a little surprised when he would squat to pee, and it would come out his belly. But now, he just lowers his belly down and lets it go. He seems to have complete control. We have not noticed him leaking urine anywhere. Mom is pleased as can be. So are Simba and I.”

Simba went on to live a long life. I had worried and warned Debbie about chronic bladder infections. Still, Simba must have had enough urethral structure to prevent that problem.

Photo by Janko Ferlic from Pexels

The Taint That Ain’t

D. E. Larsen, DVM

It was 12:30 on Thursday, and we were mostly closed. Thursday afternoon was reserved for golf. But the phone kept ringing, Sandy had stepped into the back, and I was tempted to not answer. But duty calls.

“Good afternoon, this is Doctor Larsen,” I say as I picked up the receiver.

“Oh, Doctor Larsen, I am so happy I caught you,” the lady said. “I know you close early on Thursday.”

I recognized the voice. It was one of the sisters who lived on a small farm not far out of Sweet Home. They were older, maybe spinsters, but I did not know much about them. They were Edith and Elsie, it was almost impossible to tell apart in person. On the phone, I had no chance of knowing which sister I was talking to. Most of the time, their emergencies were minor problems or no problem at all.

“Yes, we are closed, I was just about to switch the phone over to the answering service,” I said. “Is there something I could help you with briefly.”

“This is Edith, I know that you probably have a golf game scheduled this afternoon,” Edith said. “But we were feeding our pig just now and noticed that he has some large swellings on his rear end. He doesn’t act sick, but if he has a large abscess, I would hate to have to leave it for another day.”

“Tell me about this pig,” I said. “How old and how big is he?”

“He is young, I think we got him in February as a weaner pig,” Edith said. “He is growing fast. He is getting big enough that we are going to have him slaughtered sometime in October.”

“Has he been castrated?” I asked.

“Castrated, will I guess. Don’t they usually do that to weaner pigs?” Edith said.

“Just where on the rear end are these swellings?” I asked. I was convinced now that they had just noticed the testicles on this pig.

“They on just below his butt, they are just bulging out,” Edith said. “They can’t be normal, Doctor. We would really like you to check them.”

“It sounds to me like you are looking at his testicles,” I said.

There was a long pause on the phone. Then I could hear the sisters talking to each other.

“He thinks they are testicles,” Edith says. 

“Testicles?” Elsie says. “I don’t think they could possibly be testicles. They are way too large.”

Now I remembered, Edith always did the phone calls and most of the talking. Elsie just seemed to disagree with everything that was said.

“Doctor, we don’t think they could be testicles,” Edith says into the phone. “These swellings are larger than a grapefruit. Each one of them.”

This discussion was going nowhere fast. And it was not going to be resolved over the phone.

“I’ll tell what,” I said. “I will be going right by your place on my way to the golf course. I will stop and just get a look at this pig. If it looks like something that won’t wait until tomorrow, I will stop by on my home and take care of it tonight.”

“Thank you, Doctor,” Edith says. “We were hoping you could get a look at him.”

“You be ready, I am leaving here shortly, and I won’t have much time,” I said. “I am just going to glance at him for now.”

“We will be waiting for you,” Edith said. “He is in a small pen, so it won’t be any problem looking at him.”

I pulled into the driveway, and both sisters were waiting for me. It was just a short walk to pigpen out beside the small barn. The thought occurred to me that I might not be acceptable on the golf course if I got splattered with pig manure, but I didn’t have time to put on coveralls and boots just to glance over the fence.

I could see the pig through the slats in the fence of the pigpen as we approached. This was a good looking young pig, probably over 200 pounds. He had a long body and black and white in color.

I approach the pen so I could get a good look at the rear end of this pig. One glance and I stepped away. 

“Those swellings are testicles,” I said.

“But Doctor, they are so large,” Elsie said. “Are you certain, I mean, I have seen lots of testicles but nothing like these?”

“I didn’t make the design, that is just way pigs are put together,” I said. “I am certain, and I have seen a few testicles also. Now you probably have a couple of choices to make with this guy.”

“What do you mean by choices?” Edith said.

“When pigs are not castrated, their testicles will produce products that can flavor the meat when they reach sexual maturity. This guy is close to market weight but has obviously gone through puberty. You may be okay if you slaughter him now rather than waiting until fall. Otherwise, castrating him now would be a good idea.”

“What do you mean when you say flavor the meat?” Elsie asked.

“It is called boar taint,” I said. “It is in the fat, and in bad cases, it will run you out of the house when you put sausage in the frying pan. Some people say it tastes like piss. It probably occurs in 20 to 30 percent of boars slaughtered. The larger he gets, the more the chances that his meat will be tainted.”

“We were hoping to get him bigger,” Edith said. “I mean, he is growing so well.”

“It might be a good idea to talk with the place you are going to have him slaughtered,” I said. “Some of those places won’t even consider hanging a boar in their cooler.”

“A boar, I have been told you can’t eat a boar,” Elsie asked. “When do you start calling him a boar?”

“I would say about when those testicles start hanging there, so they are noticed. That is why I would suggest you either slaughter him now or have him castrated.”

“And I suppose that castrating him is going to cost some money,” Edith said. “That will sort of change the economics of this whole project.”

“At this age, if I castrate him, it will require anesthesia,” I said. “And yes, it will cost a little money. Actually, there will be more expenses than just the surgery and anesthesia. The procedure always comes with some risks, and he will lose some of his growth. That is why it is so much easier to do it when they are a few days old.”

“We will give it some thought,” Elsie said. “But I think we will go ahead and slaughter him on our original schedule. The odds are in our favor.”

It was sometime in November when Edith stopped by the clinic to let me know that I was probably correct.

“Elsie still is determined to eat that pork, but I make her cook it outside on the barbecue,” Edith said. “It is just like you said it would be when it hits the frying pan, it runs me out of the house. I won’t touch the stuff, but Elsie isn’t going to admit that she was wrong in her decision. She says it ain’t too bad.”

Photo by Leah Kelley from Pexels

The Battle of Ping-Li

D. E. Larsen, DVM

It was the end of a busy afternoon when I leaned into the reception desk to check on what remained of the day.

“I’m beat, how close to being done are we?” I asked.

“You poor man,” Sandy replied. She seldom gave me any sympathy. “Your last appointment is in the exam room. It is just a nail trim on a cat, you should be able to handle it okay.”

I stepped into the exam room and met Al and Vivian. They were new clients, but I had met Al when I was on a farm call out on Upper Berlin Road some weeks before. Al was a short guy, stocky, and with white hair and mustache. Vivian was taller than Al by several inches. 

Vivian was in immediate command of the conversation, Al would add a quip every now and then. They were parents of a long time client and had just moved to the area from San Francisco. Al had retired from a machine shop some years earlier but continued with his passion as a western cartoonist and illustrator. 

“Ping-Li is in the carrier,” Vivian said. “We just need his toenails clipped. I am on this blood thinner, and he doesn’t seem to understand that I can’t be his scratching post anymore.”

“And, Doc, he doesn’t really like to have his feet messed with,” Al said. “That is why we are here. We didn’t get one nail clipped last night.”

“Well, let’s get him up on the table and see what he thinks of us,” I said as I started to pick up the rather large carrier setting on the floor. 

I was surprised at the weight of the carrier. I leaned over and looked into the carrier as I set it on the exam table. 

Ping-Li was a large cat, well over 20 pounds and not fat at all. Ping-Li made his feelings known from the start, with a loud hiss at my face.

“I am not sure he wants to be friends,” Al said as Ping-Li hissed and jumped at the cage door.

“I think we will get some reinforcements before we get him out of the kennel,” I said. “You guys might want to wait out front.”

“He is pretty much a baby at home, but it is just the two of us most of the time,” Vivian said. “If anybody comes over, he generally hides. I am hoping this won’t be too traumatic for him.”

“Once we get a hand on him, we should be able to handle him okay,” I said. “I have a couple of gals here to help who are real cat ladies.”

“I don’t think I want to have him sedated for this,” Vivian said. “If it comes to that, we will rethink things.”

“He is one of the larger cats that we deal with around here,” I said. “But I think we can get him under control without sedating him.”

With that, Marilyn, Joleen, and I closed ourselves into the exam room with Ping-Li. The first task was to get him out of the kennel. He made it very clear that nobody was going to reach in and grab him. 

We opened the kennel door, and Joleen and I tipped it up to dump him onto the exam table. Good idea, but Ping-Li had himself braced against the sides of the kennel with all four feet. We shook the kennel several times before finally getting Ping-Li onto the exam table.

I attempted some soft talk and petting to calm him down. He hissed and swatted at the air close to my chest. Joleen made a quick grab for the back of his neck, and that got him a little under control. Using the extra-large cat sack, it took all three of us to get him stuffed inside and zipped up. He was almost too large.

Once secured, I did a quick once over. Everything looked okay, every time I came close to his head, I was greeted with a hiss. Using the scale on the tabletop, Ping-Li weighed in at just under 25 pounds. I looked at a couple of cats that weighed a couple of pounds more than that, but they were very obese. There was no fat on Ping-Li.

Once we had him in the sack, clipping his nails was no problem. We would just unzip a bottom opening by each foot, fight with Ping-Li to get the foot out of the sack, clip the nails and move to the next foot. By the time we were done, the hiss had become a loud growl. I think Ping-Li was indeed mad.

Marilyn checked with Al and Vivian to make sure there was nothing else. They came back to see Ping-Li in his sack before we returned him to the kennel. Vivian wanted to pet him to calm him down a little, but her efforts were met with hisses and growls.

We pointed Ping-Li into his kennel and started unzipping the cat sack. He was squirming out of it before it was half undone. He hit the back of the kennel, turned and hissed.

“Oh, I think he is mad,” Vivian said

“It will probably be more difficult next time,” Al said. “He is a pretty smart cat, and he will remember you, Doctor.”

Ping-Li became a regular visitor to the clinic. On most of the visits, he was much more manageable than he was on this first visit. But he continued to hate having his nails clipped, and it almost always required a cat sack to get the job done. 

I liked to think most cats became our friends, or they came to tolerate our invasion of their space. Ping-Li probably came to tolerate that invasion to a degree, but he never became our friend.

Some months after that battle with Ping-Li, Al came by with the cartoon at the top of this story. It still hangs in my study.

https://www.sweethomenews.com/story/2001/03/16/news/western-artist-al-martin-napoletanohas-brought-old-west-to-life-for-60-years/1384.html

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