[Author's note: Okay, you guys, I admit it: I've been cheating. Some of these stories are ones I wrote in previous years, to entertain my sister or my BF. I'm re-printing them here because most of you haven't had a chance to hear them, and some of them still make me laugh. Besides, I'm getting ready to travel; that means I have 2 zillion things to do in a very short period of time, so for a little while I won't have time to write new stories. So.... I hope you don't mind if I go to my archives to keep you entertained for a little while. If not, read on for one that happened in late February of 2003...]
It was one of those days today, lots of interesting events - too many for one story, though, so I'll start at the end and work backwards as I have the time.
The day ended with two just-before-closing emergencies. Since I'm on call, we told them both to come in. One is an Iditarod leader who just got bitten by another dog and has a one-inch laceration on its wrist. There are a select few clients from whom I will believe this assessment; it seems to be quite difficult for people to accurately report the size of lacerations on their animals. Unless it is a client who has proven their accuracy in this regard, I read "one-inch laceration" as "some kinda cut, which could be anything from a degloving injury to a puncture wound - on the owner".
Since Iditarod is starting this weekend, this dog needs to be seen ASAP. The dog is in Willow, though, and it's just started to sleet in earnest, so the owners estimate they might get in by 6:30 if the roads are passable. I elect not to try to make it home and back in 30 minutes (I can make the round trip in 23 minutes, traffic permitting, but it isn't worth it for the 7 minutes at home.)
As it happens, just a few minutes after this call someone rings in with a cat laying around and crying as if his stomach hurts. My receptionist quite rightly suspects an obstructed tomcat and tells them to bop on in lickety split. They arrive at six on the dot and I spend the approximately 22 seconds it takes to diagnose a blocked tomcat (this includes the time it takes to take the crate apart to get the cat out... it's isn't a tough diagnosis in general, and Zeke's bladder is approximately the size and hardness of a softball, in any case.)
Fortunately as I walk into the treatment area with my (eighteen pound) patient, I note that not only has JG not left yet, but M has stopped by for some reason and is chatting with her, so I have TWO nurses available. This turns out to be a fortunate event, as all three of us are ultimately necessary to pass Zeke's catheter, a procedure I can usually do alone. We clear away the surgery laundry that JG was folding on the treatment table and replace it with poor Zeke, who is purring madly despite his extreme discomfort - his owner says he purrs when he's nervous, which he has every reason to be about now; his life is on the line and I am all that stands between him and death. Fortunately we have a neat little toy to help unblock tomcats, an ultrasonic device which is supposed to break up the crystal plug so you can catheterise the cat, and I am keen to try it out. M gets out the dental machine, to which it attaches, and JG and I anesthetise the cat.
Now the fun begins.
Zeke, like the majority of my obstructed toms, is a bit (read: rather a lot, really) on the portly side. In addition, he isn't the "manliest man" I've ever encountered. I can find his prepuce amidst his chubby and luxuriantly furred thighs, but exteriorising his penis is another matter entirely. He is so fat (and admittedly he's remarkably under-endowed to boot) that I can't get more than the tip of his little Johnson to peer out of the sheath (although considering that I'm about to clip a hemostat onto it and run a catheter up it, this may indicate a certain degree of reasonable caution). It is impossible to catheterise a cat unless you exteriorise their little weenie first, and since Zeke's life quite literally depends on me catheterising him - and right now - I have to find a way. With JG holding Zeke's substantial thighs out of the way and M applying pressure to Zeke's peri-genital tissues I finally am able to get a bit more of him to extrude itself, like a snail emerging cautiously from its shell in fear of small boys with salt. I make a lucky grab with my hemostats (although about this time I bet Zeke's Johnson wasn't feeling especially lucky). It's not in the ideal position, but I am unlikely to get a better one; the minute you let go or try to hold it in place with your fingers while you move the hemostat, it slips through your grasp like a bar of wet soap and has to be laboriously fished out again (which, as you might suspect, I am reporting from personal experience with Zeke's very own penis, which is already a deep reddish purple from the strain of trying to pass his urethral obstruction, and would surely rather not be pinched any more with the hemostats than is absolutely necessary).
M has hooked up our ultrasonic toy and I manage to get the slender tip of it into the (tiny) urethral orifice. It is a SLICK little device and zips through the gritty crystal plug in Zeke's urethra like a hot knife through butter. Zeke's distended bladder, under considerable pressure until now, gratefully sends a high-velocity jet of cat urine geyserlike into the air, arcing gracefully above his prostrate form and onto my neck (liberally dousing of my nice long hair and my clinic coat). M and JG are frozen for a microsecond of dismay, but I start laughing, which leads them to conclude (correctly) that none of it went in my mouth, no matter what it looked like. The front of my shirt is generously sprinkled with Zeke pee, but while I will say I don't love the smell of cat urine in the evening (or any other time), I'm just as glad to be doused in it this time: it means I've just saved Zeke's life, which goes some way to making a shirtful of cat pee seem like a minor deal. All part of the glamorous world of Veterinary Medicine.
Meanwhile, my other emergency has arrived and the dog-handler is watching the circus with bright-eyed interest. I go to change my shirt - which, I notice, is dotted with tiny domes of sand, courtesy of the incredibly high crystal content of Zeke's urine - while we manage to express the rest of Zeke's bladder (primarily into the sink). The treatment area reeks of cat urine, and there is bloody urine and a visible sediment of sand on the treatment table, but I am feeling cheerful about this; Zeke is way better off than he was 10 minutes ago. The dog handler wants to know how it happened, what we're doing, how we'll prevent it recurring, whether the cat is anesthetized and so on. I answer absently, concentrating on getting Zeke emptied out and setting up to pass our catheter, but when I get to the part about prescription diets, she says sagely, "Just as long as you stay away from Science Diet," nodding firmly to underscore her point. This rather irritates me (in actuality, in my hands at least, it's the best on the market for this problem; I've had all other prescription and non-prescription crystal control diets fail at least once, but so far Hill's hasn't let me down.)
"Actually, in my opinion, that's the best diet on the market for this problem," I tell her, still working over Zeke's slumbering form; we've pretty well emptied him but we still have to place a urinary catheter that will stay in place until at least morning.
"It has soy in it," she argues. "That's really bad for them." I suddenly suspect she has Internet access. Sigh.
"Be that as it may, if this cat is going to recover, it'll be on that diet. Nothing else is as good for this problem," I reply, rather shortly, as I tease the catheter into the still-gritty opening of Zeke's urethra. After a little stutter, it passes into his bladder. Ahh. Success. Until it is pulled, the catheter will keep Zeke's bladder empty. This is important not only to prevent re-obstruction, but also because the bladder, having been stretched well beyond its normal limits, has lost its tone temporarily. In nearly all cases the bladder will regain its contractility, but it needs to stay small for a while to re-establish the tight connections between the smooth muscle cells that are responsible for contracting the bladder. Until this happens, the muscle cannot contract in synchrony to empty the bladder, and not only will bladder tone not re-establish, but re-obstruction is a risk. But I have hopes that Zeke will be peeing on his own in 24 to 36 hours.
Zeke having been stashed away in a cage, we get to Butch, who, it is revealed, actually has TWO lacerations, neither of them an inch long (sigh). By great good fortune, both have missed all the rather important tendons and ligaments and joint capsules and vessels in their vicinity. I will need to repair this without benefit of shaving (since this dog is intended to run the Iditarod in a few days and the dog can't have bare skin exposed in that kind of cold). Luckily it looks do-able. I spend a few minutes tracking down the record (the reception staff had pulled the handler's record, not the owner's). We anesthetize our lacerated leader and prep the wound without shaving it. I begin suturing, pleased to see that the wounds are coming together nicely. Meanwhile, the dog handler (who has ceased annoying me, mainly by dint of her genuine and sympathetic concern for poor Zeke), asks me, "Did you vaccinate Raymie's dogs for rabies?"
"Hmmm, I'm not sure," I say, wondering which "Raymie" she might mean. Ramie Reddington? Raymie Smyth? Some other Raymie I have never heard of? Apart from which, I have no idea how many Iditarod dogs I have vaccinated for rabies in the last 2 months, but it was somewhere between "a lot" and "REALLY a lot". I am only half listening as she burbles happily on, but suddenly JG recalls that I DID vaccinate Raymie Smyth's team, because she recalls M helping me, in a slick little tag-team. Now I recall it too... we counted out 17 vaccines (for the 17 dogs we were told he brought) but ended up one short. Raymie and his assistant, another musher, are counting and re-counting dogs and insisting there are only 17, but I am counting 18 - did they remember to count the one in the cab with them? Nope. That's it.
"Yeah, he [does she mean Raymie or his musher assistant?] said the shorter woman who was vaccinating was really good - very efficient. So I thought, I have to see who this woman is," says Raymie's handler now. Well, that would be me - the shorter woman: M and JG are rather taller than I am, as is nearly everyone else at the clinic. But now (apart from being rather abashed that I was short in correcting her on the diet issue, since she really is very well-meaning and clearly loves animals) I am wondering: just HOW does one vaccinate a dog for rabies in such a way as to impress someone enough to mention it? There's really not much to it: grab 'em and stab 'em, basically. Maybe they were just impressed that I was able to count to 18.... Just part of the outstanding service at the clinic, where amongst other things we are all smarter than we look.