Your Pet's Best Friend

Diabetic Cat Surprise

Here's Mimo. He and his house-mate Perry are boarding at the clinic for a few days.  "While they're here I want to get their vaccines up to date, and Mimo needs his teeth cleaned.  He has really bad breath."  The admitting staff asked if he had any other problems.  "Well, he vomits a lot, but he seems to feel good. He eats really well." The owner okayed pre-anesthetic blood-work before the dental, signed the release forms, and headed off on vacation.

When I did Mimo's physical exam, he did look pretty good, except for the periodontal disease.  Several teeth have been lost and the gums are really inflamed around those that remain.  Here's a funny thing: the last time we saw him (two years ago), he weighed over 15 pounds.  Today, 11.9 pounds.  That's a 20% weight loss... and he vomits a lot...(but "he feels good"). Maybe we ought to do that lab-work right now.

I've had a surprise diabetic patient before, and here's another one.  His blood glucose was 460mg/dl.  It shouldn't be over 150.  Let's check a little urine, and it's not only full of sugar, it's full of ketones, as well.  That's those two really dark pads at the bottom of the dipstick.  They ought to be the same color as the pads on the left, rather than dark brown.  Full of ketones is bad. 

When you can't utilize sugar for energy, you lose it in the urine.  You also have to have something else to use for energy.   So you break down body fat and use fatty acids for energy.  That works, but if you do too much, too fast, the waste products from that process (the ketones)can make you really sick.  Fortunately, Mimo still "feels good", still eating well, so we're not in the crisis that we could be in.

We've started Mimo on insulin injections and his prognosis for a normal quality of life is great.  I've got to talk to his owner about something, though. 

My notes in the record say that Mimo never goes outside.  I've got to wonder about who's changing the litter box.  This cat put out four ounces of urine during the night.  He has to have been soaking the litter-box.  I would think somebody would have been concerned over the fact that the cat is peeing like a race-horse. The owner must have a maid.

That excessive water-drinking and urination completes the classical picture of the diabetic patient: big appetite, weight loss, excessive water-drinking and urination (usually the first thing you see).

Oddly, in obese cats who develop diabetes, sometimes the first thing we see is vomiting when the ketones go crazy.  The cat hasn't lost weight, no change in the water intake/output.

Mimo is a little more on the classic lines.  Me, too.  I look like Michaelangelo's "David" (only not so muscular and good-looking).

Her nipples are too big for her puppies.

You know, there are many times when the description you get over the telephone doesn't convey an accurate picture.  Maybe the owner doesn't have the scientific vocabulary.  Maybe they are in distress about their pet's condition, and they exaggerate.  Something that looks terrible to them may not look so bad to me -- after all, it just stands to reason that after thirty years as a veterinarian, I will have seen more pet medical problems than they have.

Then there are times when, as weird as it sounds, what the owner says is exactly how it is. Even though it sounds like they must be exaggerating, and you just can't believe it until you see it for yourself, by gosh, that's how it is.  One example would be "the horse with a motor stuck in his back".  Another would be Shelby.  "Her nipples are bigger than my thumb, and she lost her last litter because they couldn't nurse."  Than your thumb?!  Come on, now.

And here she is, heavily pregnant, with nipples that are pretty doggone big.   According to what her owners remember, she was bred 5 or 6 weeks ago, yet she already has an udder full of milk, and how.  The milk looks normal, and she seems to feel okay, but if these faucets have three more weeks to grow, it does seem unlikely that the pups will be able to latch on.  Most of her last litter were born dead, and the rest died within days, so I suspect there may have been other factors involved (canine herpesvirus, for instance).  Still, this is a little unusual... okay, a lot unusual.

When you look at this close-up, it is really hard for a guy not to lapse into some kind of politically incorrect remark.  Some of these nipples are 3cm in diameter (my own thumb maxes out at 2cm through the knuckle).  They say you can't have too much of a good thing and you've heard the one about  Whoops!

The follow-up is one of those good news/bad news things.  The breeding date was much earlier, so the puppies showed up much sooner than expected.  Thus, her udder didn't get much bigger before she gave birth.  She had some complications in late pregnancy and wound up in the hospital (the bad news), but whelped normally the next day (the good news).  The other good news is that most of the pups were able to grab on to most of the nipples.  Since there are nine of them, the owners will still need to do supplemental feedings (and they would need to even if all the nipples were regulation size -- that's a lot of puppies, and mom needs the help).  Prognosis is good.

Snakes...why did it have to be snakes?

So said Indiana Jones in "Raiders of the Lost Ark" (and we see why in "Last Crusade").  My own feeling about snakes is that I have no problem with them as long as they are not poisonous.  I'm not a great naturalist, though, so I'm unlikely to make a positive identification in the field.  Fellow Scouter John McDonough stops to take a picture when he encountered a timber rattler at Camp Lewallen.  If I encounter one in the wild, I just try to avoid them.  "What kind of snake was it?"   It was a snake kind of snake.  It had no legs: "Mr. No-Shoulders".  "What shape were its eyes?" I was avoiding it, not kissing it.  "Get the hoe, maw!"

It's different when someone brings in a pet snake. Then I'm reasonably sure of the species, plus not very many folks will be keeping a deadly venomous serpent to cuddle with.  There used to be an old boy over at Greenway, Arkansas who brokered exotic animals.  He once brought (among other things) a gunny sack full of garter snakes.  It didn't bother me a bit to plunge my arm into the midst of them.

I'm no great snake expert, but being located in the hinterlands, I'm willing to look at whatever comes through the door.  I do have good resources to call for advice, plus the specialists on Veterinary Information Network.  As with many exotic cases (read "anything besides dogs, cats and horses") I may just be acting as eyes, ears and hands -- a remote sensing device for the faraway expert.  Still, for folks unable to travel a hundred miles, I can often get them some help.

The staff were cleaning out drawers and found some old pictures.  This particular one was certainly out of the ordinary.  "Do you work on snakes?"  Well, I'll do my best.  "How am going to bring it in?" Well, a lot of people just put them in a pillow-case if they don't want to carry them. 

I wasn't expecting a seventy-pound Burmese Python.  The thing was bigger around the middle than a two-pound coffee can.  Cool extrapolation from pillow-case to sleeping bag on the owner's part.  The owner was the Navy recruiter here (about twenty years ago?). The snake had a respiratory infection.  Dr. Mike Douglas, the Memphis Zoo veterinarian, advised me on how to treat it.  It is amazing how fast these big snakes can move.  When you see them at the zoo, you assume that they must have to just "ooze along" because of their size.  They can flip a coil faster than you can move your hand.

I made follow-up visits to the snake's home, as it was winter-time.  The owner had a two-bedroom apartment, with one bedroom devoted to the snake: a room-sized herpetarium.  Single guy, naturally. Of course, that was then, this is now.  I've seen plenty of married couples with multiple snakes.

This is why the sideshow industry has collapsed.  People have a neighbor with a houseful of snakes, seeing the "fat lady" is an everyday occurrence (not to mention that the term is politically incorrect), and as for the "Tattooed Man", tattoos are mainstream now.  My dream of a second career as a carnival barker will never come true...unless...

"Step right up, ladies and gents, see the man with no tattoos. Marvel at his milk-white skin. He's alive, they're all alive."

Incredibly great weather!

Here it is the middle of July, and this beautiful weather is like an oasis in the desert.  After a much needed rain Wednesday night, the high temps are down to 80, and the humidity is down to 40% (versus the usual mid to high 90's and 90% humidity - think "jungle", even in the midst of drought).

I hadn't been on Ol' Red for a couple of weeks, but yesterday I found time to ride for a couple of hours.  It just could not have been better.  We made a long circle, most of it on Crowley's Ridge. This upheaval created by the 1812 New Madrid earthquake gives you the experience of riding through hills, yet you can look over and see the pancake flat lands for miles on both sides of you.

The little rain and cool weather have really created a burst in the mosquito population, though.  Enjoy the beautiful day, but get inside when the sun goes down or they'll eat you alive.

Ear Tumor Problems

What's wrong with this picture?  Look closer.  Yes, Scruffy just has one ear (one ear pinna - the floppy part- anyway) .   Why, you may ask, does Scruffy just have one ear? Why, because I surgically removed it, that's why.

A few weeks before, Scruffy's owner complained that the ear was stinky and painful and she was shaking ooky-gooky all over the house.  We took a look and found that there was a nasty ear infection, with the canal full of pus.  A good cleaning revealed that there was a lumpy mass growing from the back side of her ear canal.  

I de-bulked the mass, taking it down to the level of the cartilage, and we sent off the tissue to the pathologist.  It was reported back as a benign ceruminous adenoma.  That would be a tumor of the wax glands that line the ear canal.  Since it wasn't malignant, it was unlikely to spread to other parts of the body.  However, if I didn't get it all, it would very likely grow back.

Scruffy did well for a few weeks, then got miserable again with the ooky-gooky mess in the ear.  The mass was back, as big as ever.  Because of the location of the mass, the only way to really get it all was to remove the ear canal cartilage it was attached to.  Unfortunately, this encompassed both the pinna and the vertical portion of the ear canal.

Here's what we removed.  It's not black and fuzzy because it was shaved and prepped with povidone iodine before surgery.  As in the dog, the ear canal in the cat is an "L-shaped" affair. It starts out at the eardrum, just like a person's.  At the point where you can see that hole on the side of a person's head, the cat ear canal turns 90 degrees upward, and you see the hole about an inch or so above where it makes the corner.  Unless you're Scruffy: then the hole comes out on the side, just like a person's.

Now that Scruffy's hair has grown back, you don't even notice the hole on the side of her head.  She doesn't seem to miss the ear pinna, and she sure doesn't miss the ear infection.  Her owner doesn't miss the ooky-gooky all over the living room either.

Don't miss the concert in the park!