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

https://www.google.com/search?rls=en&sxsrf=ALeKk01ZkATWBbb2NSQIBcqQ3Bms4Xe57g:1597031150836&source=univ&tbm=isch&q=al+martin+napoletano&client=safari&sa=X&ved=2ahUKEwid_sLT3I_rAhUKHzQIHa_UCvoQsAR6BAgKEAE&biw=1343&bih=854

The Missed Quill

D. E. Larsen, DVM

Bob had already lifted Rex onto the exam table by the time I entered the exam room. Rex was an Australian Shepherd. At one time, he had been a cow dog, but Bob sold the cows. Now Rex had little to do except to patrol his property.

“Hi, Bob, what brings you and Rex in today?” I asked as I shook hands with Bob.

Rex is really painful this morning,” Bob said. “Something around his head really hurts.”

I raised Rex’s head with my hand under his chin. I could sense a reluctance for him to allow this. I looked close and could only see a slight swelling around his left eye.

Rex pulled away when I reached to feel the area.

“He is really painful, Doc,” Bob said. “He really yipped when I just brushed the side of his face this morning.”

I tried to feel the eye again, Rex recoiled and growled this time. He was not going to tolerate any palpation around the left side of his face.

The pupil of the left eye was constricted to a pinpoint. I instilled a couple of drops of medication to dilate the pupil.

“Do you know of anything that could have injured this eye?” I asked Bob.

“No, he was in the house last night and doing fine,” Bob said. “Then this morning, he is really painful.”

With the pupil dilated, I carefully held Rex by the chin and looked at the back of the eye with my ophthalmoscope. Starting from a distance and then slowly closing in close to his face to avoid alarming him.

It took me a couple of seconds to figure out what I was looking at. Projecting from the back of the eye, near the optic disc (that spot where the optic nerve connects with the retina), was a porcupine quill. It was probably penetrating over a centimeter into the eye.

“Bob, has Rex ever had porcupine quills?” I asked.

“Oh, yes,” Bob said. “We had quite a struggle pulling a mouthful of quills out of him a couple of months ago.”

“Will, it looks like you must have missed one,” I said. “It has entered his eye through the back of the eye. This one is for the books. I always hear stories of the quills that are left in the tissues migrating to odd places. But I have never read of one puncturing the eye from behind.”

“Can you get it out?” Bob asked. 

“I can’t, and I don’t know if a specialist could or not,” I replied. “Getting to that area behind the eye would be extremely difficult. And after removing the quill, you might lose the eye anyway.”

“I don’t have the cows anymore,” Bob said, “And old Rex doesn’t have much to do. He just lays around the house and chases a stick once in a while. I don’t think a specialist is in the cards for him.”

“I think the best thing to do is to remove this eye,” I said. “He will do fine with one eye. We will get rid of the pain.”

With that, we set up to remove Rex’s left eye. Enucleation of an eye in the dog was relatively straightforward surgery. I incised around the margin of the eyelids and dissected to the surface of the globe behind the conjunctiva. Then working around the globe, I severed the ocular muscle at their attachment to the globe. I was able to keep bleeding to a minimum this way. Finally, ligating the optic stalk and removing the eye. This was complicated just a bit by the presence of the quill.

Once the eye was removed, I closed the dense fascia over the eye socket so the socket would remain smooth, rather than sinking back into the head when the muscles atrophied. The skin was then closed, and if you didn’t look twice, you might not notice the missing eye.

Rex recovered uneventfully and immediately felt better. Opening the eyeball after it was removed, the quill was halfway into the eye. The track was infected, I doubt if the eyeball could have been saved under any circumstances.

Late that afternoon, Rex bounced out of the clinic with Bob and the kids, acting like nothing was wrong.

Photo by Alana Sousa from Pexels

Medicine and Surgery, According to the Moon

D. E. Larsen, DVM

Mr. Hansen was leaning on the corral fence when I pulled into the barnyard. He had a half dozen young bulls in the corral. 

“Doc, I hope you are ready for these guys,” Mr. Hansen said. “They might be a handful.”

“We can handle them quickly with the chute,” I said.

Mr. Hansen, a Norwegian farmer outside of Enumclaw, had called to have these bulls castrated. I had wondered why he didn’t do it when they were small calves.

“You could have done this surgery much easier about 6 months ago,” I said. “This procedure is okay, but if you castrate enough of these guys, you will lose one. It is just the nature of the procedure, we use a tissue crush to control bleeding. That works fine unless a calf has been on clover pasture or has some other clotting disorder.”

“Well, Doc, I do all this stuff by the moon,” Mr. Hansen said. “It is pretty hard to get you guys out here on my schedule sometimes.”

I worked through the bulls with no problems. When I was cleaning up afterward, Mr. Hansen turned the bulls, now steers, out to pasture.

“See, Doc, not a problem one, see how easy it is when you do things by the moon,” Mr. Hansen said.

That was my first experience with the moon. Growing up, I had heard several men talk about the moon having an influence on castrations and dehorning. Still, I had never paid attention to it. It was easy to allow these folks to believe what they wanted, as long it did no harm.

There were events, however, that made a person wonder if there wasn’t some outside influence.

Uterine prolapse in the cat was one of those things that were considered rare. Some said it was a once in a lifetime for most veterinarians.

Alice called on Sunday morning. This was my first weekend to take emergencies after taking a job in Enumclaw, Washington.

“Doctor, I have a momma cat who had a litter of kittens last night or this morning,” Alice said. “I am not sure what I am seeing, but something hanging out of her is not right.”

“It sounds like I should get a look at her,” I said. “When can you meet me at the clinic?”

“I was hoping that we could take care of her right away,” Alice said. “I am not really interested in hand-feeding this bunch of kittens for any length of time.”

We agreed to meet at the clinic in a few minutes. I was excited to have a genuine small animal emergency this weekend.

Alice came through the door with her momma cat and her kittens in a cardboard box. Momma was a young cat. She was mostly white, and so were the kittens. She was nursing the kittens, oblivious to her own problem.

Setting the box on the exam table, I lifted Momma out of the box. A complete prolapsed uterus hung from her vulva.

“What are we looking at, Doctor,” Alice asked. “I have never seen such a thing.

I didn’t think it would instill any confidence in me if I told Alice that I had never seen such a thing.

“It is a prolapsed uterus,” I said with confidence. “This is considered rare in the cat. It is something that we often see in cows. In cows, we replace the uterus. In this cat, the easiest thing would be to remove it. That will solve her immediate problem, and it would keep her from having more kittens.”

“Am I going to have to take care of these kittens tonight?” Alice asked.

“I think that I can get my wife to help, and I can get this surgery done this morning,” I said. “I should be able to send her home this afternoon. These kittens have been nursing well this morning, they should be fine until mom is home.”

I placed Momma in a kennel, and Alice departed with the kittens. When I got back to the house, Sandy was less than enthusiastic about the task of helping with the surgery.

“All you have to do is be there, just in case I need you to hand me something,” I explained. “The girls can come along, they might enjoy watching.”

We placed a short bench alongside the surgery table and lined the girls up to watch. They were excited, however, other than Brenda, I don’t think they had any idea what was going to happen.

I had no idea what to expect with this surgery, but it turned out to be easier than I thought it would be.  

Momma was given a small dose of IV Rompun and Ketamine for anesthesia. Opening her abdomen, I found her ovaries stretched down into the posterior abdomen. I grasped the ovarian ligaments and pulled the uterus back into a normal position with moderate traction. After that, it was just a standard spay. Sandy survived the experience well, as did the girls.

Momma recovered well, and Alice was happy to pick her up in the late afternoon.

So what about the moon business?

The odd thing about the coming week was that I had this case within weeks of getting out of school. Don, the other associate veterinarian in the practice, treated a cat with a prolapsed uterus on Tuesday of that week. That was the first prolapsed uterus in a cat that he had seen in his 8 years of practice. Then on Friday, Jack, the practice owner, had a cat with a prolapsed uterus also. It was the first time he had seen the problem in a cat is his 32 years of practice.

That was 3, once in a lifetime events, in a single week in a predominantly cattle practice.

What are the odds of that, without some outside influence? I never worried about the moon, but after that week, I never argued with anyone who did things by the moon.

Photo by freestocks.org from Pexels