December 21, 2011
Heartwarming stories of healing boost spirits of veterinarians
Good news welcomed in profession
By: Phyllis DeGioia
For The VIN News Service
"Fabulous day so far," announced Dr. Susanne Heartsill in a post on Veterinary Information Network (VIN), recounting the story of how a cat that fell five stories made a miraculous recovery with the help of extensive medical care.
A cat in Memphis, Tenn., sustained extensive injuries after falling from a fifth-story window.
Photo courtesy of Dr. Susanne Heartsill
"He had a hard palate fracture, mandibular fracture, fractured femoral neck, severe pulmonary trauma and anemia secondary to internal bleeding. He has had multiple surgeries including femoral head ostectomy/mandible/hard palate/etc., and esophagostomy tube. The final step today was removing a fractured premolar and his lower canine which was causing issues due to his new, crooked face/malocclusion.
"Awesome owner, pissy cat but, really, who wouldn't be?” she added.
Heartsill's colleagues — veterinarians who are members of VIN, a professional online community — broke out in virtual applause. It seems that in the midst of a sagging economy, high educational indebtedness and an uncertain job market, veterinarians are looking to each other to boost their spirits with stories of surprising, happy medical outcomes.
Heartsill, based in Memphis, Tenn., relayed how the cat's owner rushed barefoot into the clinic on a morning in May, wearing worn, mismatched pajamas and reeking of booze and cigarettes. Her husband also was disheveled. The cat slept under the bed frequently so they didn't notice he was gone. She found the cat after he'd fallen out of an open window and was outside for 12 hours during a cold night. Upon arrival at the clinic, the cat's body temperature was less than 97 degrees Fahrenheit.
A feline's normal body temperature is 100.5 to 102.5 degrees Fahrenheit.
"He almost didn’t survive," Heartsill recalled in an interview with the VIN News Service.
Looking at the clients, Heartsill's first assumption was that they couldn't afford the extensive care the cat needed to survive. But the owners' reaction to a $500 initial estimate served as a powerful reminder to not make judgments based on physical appearances.
"She said fine, money wasn’t a concern, which is usually an indicator for me that money isn’t a concern because they don’t have any," Heartsill said. "As it turns out, money really wasn’t a concern. I have had enough cases like this in the past to know better than to judge ability to pay based on how someone looks or even how they smell. Some of my best cases/clients have been the ones who I would have sworn couldn’t afford it. I just love that lesson."
Bills for the cat's care totaled approximately $7,000 with Heartsill, plus the veterinary dentist and three overnight stays in an emergency hospital while Heartsill's clinic was closed.
Unlike the cat's five-month treatment for a nearly fatal fall, some cases have amazing results with little expense and medical care.
A 10-year-old Lhasa Apso mix with chronic neck and back pain appeared to be in significant discomfort one October weekend. The dog, Maggie, was yelping, biting her owner and unable to walk or eat. The owner was distraught not only because the dog was in severe pain, but because he could not afford surgery.
Dr. Megan Tremelling of Port Washington, Wisc., deduced that if medication and rest didn't take care of the dog's neck and spinal lumbar pain, euthanasia would be necessary. Maggie hadn't walked or eaten in two days.
However, Tremelling's surprise diagnosis of the dog's condition allowed her to quickly alleviate the animal's suffering.
"Seems those full anal glands were WAAAAAY more painful than a bad back ever was," Tremelling wrote on the message board. "You should have seen the owner's face when I brought the dog back to him and she WALKED over to him wagging her tail. He kept saying, 'She's walking... She can walk now!"
Maggie had no history of anal sac problems or neurologic deficits and showed no sign of having any spinal pain during Tremelling's physical exam. The fact that such a simple, quick procedure helped the dog stunned everyone in the practice.
"For my next act, I will turn water into wine," joked Tremelling.
In some cases, the joy of practicing veterinary medicine comes from helping an owner overcome her fears to manage a pet's chronic illness.
Dr. Danelle Griswold of Kansas City, Mo., diagnosed diabetes in a seriously ill cat. The cat came in with significant weight loss and a blood glucose level of more than 450. The owner was willing to learn how to administer insulin shots, and after being shown how to give subcutaneous injections, tried practicing on her cat.
"She was extremely nervous (to the point that she was trembling), and we found out not only had she never given any kind of injection, but she also hated needles," Griswold said. "The first time she tried to stick the cat, the cat jumped a little and the owner screamed and jumped a foot in the air. After many failed attempts, we decided the owner needed a break, and we gave her some ideas such as practicing on oranges and coming in the next day to practice on the cat."
After some additional coaching from friends, the client was able to manage her anxiety. “The owner called me today ecstatic because she just gave her first insulin injection,” Griswold announced in a VIN discussion.
Another veterinarian is happy to have acquired a new client after taming her dog's inner beast. Dr. Ebalinna Vaughn of Warrenton, Va., relayed that a new client — unsatisfied with care from her former veterinarian — came in after her dog had been injured in a fight. The dog, with a reputation for being aggressive, had been refused medical treatment.
"She was very unhappy about the other doctor," Vaughn recalled. "She kept saying how the doctor refused to even examine her dog. She maintained that the dog was not aggressive at all at home toward her or her family. He had only ever had problems at veterinary clinics. ...Apparently their doctor couldn't (owner said wouldn't) examine the dog because they couldn't get a muzzle on since that was the area that was bleeding."
When they came in, Vaughn could see the dog was likely bleeding from the left side of his face and ear. Sammy was a 65-pound beagle mix.
"I don't see the beagle, but I sure see the pit bull," Vaughn wrote in the VIN discussion.
They were able to get a gauze muzzle on with little difficulty, though the dog's ear was split and bleeding. Trying to sedate the dog wasn't as easy.
"He decided he wanted no part of the sedation and was going to leave whether we liked it or not," Vaughn said. "The muzzle was still on but there was blood everywhere — ceiling to floor and my assistant and I were covered in blood. There was even blood inside one of the drawers where I was reaching for a syringe when he shook his head."
Vaughn gave Sammy an intramuscular injection of a strong sedative and anesthetized him. "There was no way we could do this without general anesthesia," Vaughn said, having sutured the dog's two lacerations.
Vaughn sent Sammy home with acepromazine and a script for alprazolam, both anti-anxiety medications, for the suture removal. For that appointment, the dog walked in "a little drunk" but calm, Vaughn said. He was escorted directly to the treatment room instead of an exam room.
"I often do this with unhappy/aggressive dogs," Vaughn explained, noting that treatment rooms are less crowded than the reception area, offering a more relaxed environment for anxious animals.
She wrote on VIN: "He came to treatment with no fuss. Took the e-collar off and put on a real muzzle with no fuss. Took sutures out of the ear with no fuss and the dog walks out happy and takes a treat. Owner is pleased as punch and dog had a 'good' experience with no lunging, growling, biting or even any tensing."
Another veterinarian who recently made the best out of a less-than-ideal situation is Dr. Lauren Robins of Flower Mound, Texas. While working one Saturday, Robins encountered a complicated case with a new patient: a 14-year-old diabetic poodle that hadn't eaten in four days while still getting insulin. The dog, Amber, was brought in by the niece of the owner, who was on vacation. To complicate matters, the poodle's regular veterinary practice was closed, so there were no accompanying records.
Dr. Lauren Robins was surprised that geriatric Amber survived a multi-faceted illness.
Photo courtesy of Dr. Lauren Robins
"Man, did I grumble about that on the schedule," Robins recalled on VIN.
Robins discovered the diabetic dog had almost no hair and was depressed, presenting with mature cataracts and rotten teeth. Robins diagnosed the dog with severe renal failure and diabetic ketoacidosis. She warned that treatment could be costly and a survival wasn't guaranteed.
"She looked at me and said 'I don't care if it's bad for my pocketbook, if it's what's best for Amber we'll do it," Robins said of the owner's niece. "I was still skeptical but got her shipped off to the e-clinic expecting she would be euthanized."
Against overwhelming odds, Amber came back on Monday after having spent the weekend at the emergency clinic. Amber's renal values eventually stabilized, and she resumed eating. Robins started working up Amber's hypocalcemia and diagnosed the dog with pancreatitis and renal secondary hyperparathyroidism. Once they started supplementing the dog's diet with calcium, the poodle was markedly better.
"I still can't believe Amber is trucking! AND I have gained fabulous new owners," Robins exclaimed on VIN. "I am still dealing with the niece as her uncle has the beginnings of dementia. She called me a 'giant rock star' one day and basically says 'whatever she needs, doc,' which is so nice."
Amber is doing so well that the dog has resumed her favorite hobby: barking. While hospitalized, the staff never heard a peep.
"Only time I've been happy to have a barker," Robins said.
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.
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