Tuesday, September 28, 2010

The Radioactive Cat, Part Two

[Quick recap: At this point, I’m neck deep in trouble, trying to recapture this cat without either of us getting injured, and keeping myself out of the Dean’s office with only 3 months left until graduation.]

If I told you that I had anything that resembled a plan at this point, I’d be lying. The first thing that came to mind was to simply run after the cat and sort things out later, which is exactly what I did.

I knew which direction Rambo had run initially, because I heard something metal crash to the floor a couple of seconds after she got out of the isolation room. Sprinting toward the sound, I was relieved to see a broom and an aluminum dustpan lying in the middle of the floor in the main radiology ward. Considering it could have been some pretty expensive equipment wrecked by an infuriated cat, I was happy. As I started to look around in the room, I heard the sound of toenails skidding on the tiles. Turning toward the sound, I caught a glimpse of her tail as she fled the radiology ward altogether and made a hard left turn into the main hall of the Small Animal Clinic. Uh-Oh.

Because it was late at night, there were almost no lights on in the Small Animal Clinic. There are all sorts of doorways, halls, and rooms in the end of the building where the chase happened, but luckily enough for me, the faculty and staff office doors were all shut. Also, some kind soul had shut the door that led to the Large Animal Clinic as well. That limited Rambo’s options.

When I caught sight of her again, she was headed up a long, sloped hallway toward the only light source in the Small Animal Clinic at night: the Critical Care Ward. This was not good news for me. CCW is one of the few areas of the Clinic that is staffed 24 hours a day, which meant that there were going to be a few of my classmates in there. They were going to be busy taking care of animals until morning... but I’m sure that they would have taken time out to cheer Rambo on as she ran laps around the ward with me in hot pursuit.

If I was seen by any students or techs, there was going to be no way to avoid getting called on the carpet for the whole thing. The thought of that happening was enough to speed me up as I chased Rambo the length of the hallway with everything I had. Just shy of where the light spilled out of the CCW doorway, someone in the room spoke loudly enough for her to hear it. She detoured under a water fountain and stopped there, wondering what to do next. Running into more people was not what she had planned. However, it was just was the opportunity that I needed.

I never slowed down. In desperation, I ran at top speed and went into a slide like a baseball player trying to get in under the tag at home plate. My shoes screeched across the floor and Rambo spun around just in time to bite down on the raptor gloves as I reached for whatever part of her I could touch. I caught her under the fountain.  In retaliation, she locked her teeth into the glove, gnawing as hard as she could. I started scrambling up to my feet with her still attached to me.

My elation over catching her was short-lived.

“What was THAT?”  It was a voice from the Critical Care Ward.  Someone had heard the ruckus I had created sliding into the wall and the muffled growls escaping around the gloved finger that Rambo was chewing on.  If another student or tech came out and caught me in the hall, I was going to have a lot of explaining to do.  With the cat in custody, I sprinted back down the hallway making as little noise as possible.  I made it back into the main ward of radiology, and had to walk past the Geiger counter again.  There was a longer burst of loud static this time, because Rambo and I came back by the machine a lot slower than she had on her exit.  I used my foot to open the cage door and put her back inside.  She took both of the gloves with her- she had her jaws welded to one and her claws dug fast into the other.  I couldn’t pry her loose from either one and had to just let her take the gloves with her. After I shut the door, she decided to give the gloves back. I opened the cage door a crack and eventually fished them out between paw swipes.

So, at this point, I’ve got the cat back in the cage safely.  I had just started to think about how lucky I was when it occurred to me that I may have irradiated something outside the isolation area.

I took the gloves over to the Geiger counter- no extra pops.  I scanned myself head to toe to be sure I wasn’t glowing.  Nothing unusual there.  Then I thought about it and decided that I was going to have to check the entire area that she had run around in for any urine she might have left behind.  If there was any, I was just going to have to suck it up and call my professor.

The Geiger counter and I made slow progress, sweeping the area for signs of wetness or an increase in the intensity of crackles from the machine.  All the way to the water fountain, it was just the occasional click of normal cosmic radiation.  Another lucky break.

A constant stream of hisses from Rambo was the last thing I heard as I replaced the Geiger counter in her room and snuck out of the radiology ward, trying to avoid being spotted on my way to the parking lot.

It was only after I got home for the night that I realized that I had successfully avoided causing a HAZMAT incident.  An incident might have meant people in white suits, a van with “Biohazard” written on the side in bright orange letters, and unwanted media attention.  I’m fairly sure that it would have gone on my permanent record.  The vet school administration tends to frown on things like that.

Rambo went home uneventfully a few days later.  A couple of weeks afterward, a piece of mail showed up unexpectedly in my vet school mailbox.  It was a card from Rambo’s owner- whom I had never met, but did speak to by phone- thanking me for taking care of her during her time at Auburn.  Before you read it, you need to know two things.  First, she had another cat named Raisin that was a kind and timid soul.  Second, I never told her about the night of the Rambo Rampage.  On the front of the card, there’s a picture of a cat that looks a lot like Rambo.  Here’s what the inside said:

March 5, 2000:
Hi!  I can never say “thank you” enough for the love and care you gave Rambo during her stay at Auburn!  Rambo is doing great- just as talkative as ever. She was so obnoxious during her first day home, she pushed poor old Raisin out of my lap. Raisin wanted to know if we could send Rambo back to Auburn.   Thanks again!               

I treasure this card, and still keep it in my office 10 years later.

Tuesday, September 21, 2010

The Radioactive Cat, Part One

Here’s one from my senior year of vet school.  Since the statue of limitations has (hopefully) run out, I’ll tell you that this cat’s name really was Rambo, and she earned it.

Hyperthyroidism is a disease of older cats, and Rambo had it in spades. It does some pretty interesting things to cats that have it: increased metabolic rate, insatiable hunger, weight loss, an exceptionally high heart rate, and personality changes that most often make even the most agreeable cats turn into monsters. Rambo had all of these symptoms.

To be blunt, Rambo was 5 lbs. of pure feline hatred. To make matters worse, she was radioactive. No, that’s not a joke. 

To treat her condition, Rambo was given an injection of radioactive iodine, which kills off overactive thyroid tissue and leaves the cat with a normal thyroid.  It’s very slick technology and highly effective.  A few days after treatment, the radiation fades, and the cat goes home.  Until then, everything in contact with the cat is treated as hazardous waste- paper in the cage, leftover food, and most especially anything that hits the litterbox.

Rambo was finishing up her treatment when my rotation group moved to radiology.  She was assigned to a single student to expose as few people as possible to the radiation she was emitting. I was that student, and I was happy about it.  As a student, you always hope to get assigned cool cases that are likely to have a positive outcome.

The professor in charge of the rotation caught me on the first day and took me down to Rambo’s room in the radiology ward’s isolation area. He hadn’t told me a lot about her, but I knew that something was up when he grabbed a pair of raptor gloves (very thick, elbow-length, and used to handle hawks, eagles, and other birds of prey) and a Geiger counter to measure radiation.

On the way down to the isolation room, the Geiger counter popped occasionally, catching stray cosmic radiation that’s around us all the time.  As we got to the door it became a steadier stream of pops- a mix of cosmic radiation and the products of radioactive iodine decay coming from the cat that was now screaming and hissing at us from the corner.  Rambo got so loud, in fact, that we had to leave the room so that the professor could finish giving me safety instructions before I started in…. it was earsplitting.

My job was to feed, water, give meds, and change the litterbox.  I only had to do it for a few days until she was safe to be with her owner again.  Simple, right?  Well, it would have been except for one thing.  I had to open the cage door to do it.

For the next two days, things went about like I was told they would.  While I was working with her, she would occasionally charge across the cage and pound the raptor gloves, slapping with her paws, or gnaw on a finger until I could peel her off.  It was stunning how fast that cat could move.

Her medication schedule was pretty rigid, and on a Saturday night, I found myself going back to the school at about 10 PM to give her meds and more food.  There aren’t many people at the school at that time of night on a weekend.  I became glad about that just a few minutes later.

As I walked into Rambo’s domain wearing shorts, a tee shirt, raptor gloves, and my ever-present radiation badge, I was greeted with the customary barrage of hissing, growls and spitting I had come to expect.  When I opened the door to sneak her litterbox out, she did something I didn’t expect, and that’s where the real fun in this story begins.

Instead of chewing on me harmlessly, she grabbed the glove with her paws and started working her way up with lightning speed, pulling with the front legs, digging in with her back claws, and lunging until she reached the top of the glove.  From that point, she locked her front paws into the cuff of the glove and shoved off with her back legs.  I frantically tried to shut the cage door in what seemed like slow motion…too slow.  Moving at near supersonic speed, Rambo launched herself through the air and made a beeline for the door.

I will never forget the sound from the Geiger counter as she screamed past it.  It went from a slow, steady popping to a roar of static for about half a second.  Then she was gone, leaving only the echo of the counter alarm and a stunned veterinary student in her wake.

It was at this point that I realized two things:
  1. I wasn’t bleeding.
  2. I had just allowed a radioactive animal to escape. And I was going to have to fix it before I got busted.

I’ll finish this one up next time. Thanks for reading, and let us know what you think…


Wednesday, September 8, 2010

This Dog Did Not Belong to Robin Hood

Some of you reading this will already know that I spent a long 5 years practicing in metro Atlanta before coming to my senses and moving back to Alabama. This case is one that happened early on during that time- I was just out of grad school.  With the benefit of the experience that I have now, I’m not sure I’d have handled things the same way if I saw it again, but here’s how it happened back in 2001:

At the time, I was an associate at a practice on the North side of Atlanta.  It was mid-afternoon; I was talking to one of the techs in the back of the clinic when a pale-faced receptionist rushed in and told me that there was a dog in the lobby that had been shot. I ran up to the lobby, but instead of the horrific scene I expected, all I saw was a medium-sized fuzzy brown dog standing there. It was wheezing slightly and wagging its tail, with two distraught people looking at it. I couldn’t really see a problem with the dog until it turned its head… and that’s when I saw a snapped-off aluminum arrow shaft sticking out of the left side of its neck.

After I got over my disbelief- the dog was showing no signs of distress at all- I checked things over.

There was hardly any blood from the wound. Under the fur on the right side of the dog’s neck, I could feel the point of the arrow- it had almost gone completely through. By feeling the bulge under the skin I could tell that it was a practice tip, smooth and dome-shaped, and not one of the bladed ones used for hunting. That would explain a little of why the dog wasn’t in worse condition…

But now, I had to come up with a plan. The owners didn’t have a lot of spare money, so we had to keep it simple. The idea was to knock him out as fast as possible, get the arrow out, and hope that nothing bad happened when we did it. The relief vet that I was working with at the practice had finished what she had been doing, and came to see what I was up to. Here’s how that conversation went:

Other vet: “So… what are you going to do?”
Me: “I don’t know what to do except pull it out and hope for the best. I want to get him back up as fast as we can.”
Other vet: “What about putting a catheter in so we can run fluids?”
Me: “They’re good folks, but there’s not a lot of money. Besides, if the carotid is lacerated, he’s probably going to bleed out so fast I won’t be able to do much about it. I talked to them about the possibility.”
Other vet: “You may be right.  Better you than me!”

This veterinarian, being wiser and more experienced than me, had the good sense to recognize a potential train wreck before it happened. And, just like a train wreck, it was impossible to look away while the tech and I got ready. I did note, however, that she was standing a respectful distance away when the event began. This was, I realized later, a self-preservation instinct on her part. It’s good policy to put some distance between yourself and a bad situation when you can.

We braced ourselves and injected a reversible anesthetic agent. When the dog went limp and the wheezing slowed, I grabbed the broken arrow shaft (while the tech held the head and neck still) and started slowly pulling. The arrow stuck a little at first, but then started sliding slowly out.  As I reached the halfway point of the neck, I felt the trachea slide back into place as I pulled the arrow past it. The wheezing stopped. It occurred to me that this was because the trachea had been compressed when the arrow passed by it, flexing it upward toward the spine. I pulled the arrow out the rest of the way with no problem. There wasn’t a drop of blood- just a single hole in the neck about the size of a dime.

We woke him up with the reversal injection, and sent him home with the owners the same afternoon. I saw him again a year later while I was still in Atlanta and he was doing just fine.

This one ranks as one of the strangest things I’ve ever seen.  The arrow went diagonally from one side of the neck to the other, missing both jugular veins, both carotid arteries, the trachea, the spine, the esophagus, and everything else important in the area. The only thing that had happened was a little bit of labored breathing. Incredible.

Wednesday, September 1, 2010

Diagnosis: Gluttony

Warning: There’s vomiting in this story. But it’s a neat story.

Last night, I treated an animal for ingestion of an insecticide. The dog is going to be fine, because the owners were on top of it and brought her in fast. We gave her a special medication that when administered in the eye causes vomiting (that drug seemed like magic to me the first time I saw it used when I was a kid working in a clinic). Once we got the insecticide out of the dog, the situation was much better.

Anyway, it started me thinking about one of my favorite “my dog ate something” stories.

One night, I got a call from a client that came home from work and found their dog in distress. They described him as tremendously bloated, lethargic, and unresponsive. I couldn’t get a good idea of what was up over the phone, but I was suspicious of stomach torsion.

Stomach torsion, also known as volvulus, is a condition in which the stomach rolls on its long axis and is twisted off. To better understand it, picture the way a Tootsie Roll is twisted in the wrapper, and you get a good idea. It’s a serious condition and has to be addressed quickly.

The owners arrived at the clinic, and the hugely bloated dog got out of the back seat of the car, barely able to support its massive midsection. It looked like he had swallowed a beach ball. I thought we were in real trouble. Then the owners said something that changed the whole game: “He threw up some ham in the back seat of the car on the way here.”

I knew that he shouldn’t be able to vomit if he was twisted.

After looking him over and finding him having trouble breathing from the sheer compression of his abdomen on his lungs, we took an approach similar to the dog I saw last night. We hit pay dirt.

The dog had eaten an ENTIRE spiral ham. The whole thing. It was absolutely amazing to see his belly shrink back to normal proportions. Seven and a half pounds of pork product later (Yeah… I weighed it after it came out. I just had to know.), the dog was breathing easier and feeling much better.

I have seen some impressive episodes of gluttony, but I doubt I’ll ever see a dog ingest something on the same scale again. …. But then again, you never know.