It is curious the things we accept as true without pausing to ask whether they match what we know to actually be true, often without even noticing that we are doing it.
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Challenges
Favorite client. Favorite dog.
DAYS after diagnosis, we are gathered to say good bye. Dad had opted to treat with steroids, and the dog's poor body did not handle them well.
We loved this guy and his dog. Kelly has a Boxer dog. This was a seven (seven!) year old Boxer dog. I have a three year old dog with lymphoma. This dog had lymphoma. Some euthanasias are even harder than others.
Why have I been given eight good months so far and this guy two good days? Why are they both so young? Why do I have to be punched RIGHT in the heart? Why did this guy? He did adopt a tiny Boxer puppy, which is just asking for heartache. Who am I kidding? I adopted a goofy mutt puppy, and that too is just asking for heartache...eventually.
"I will be back with a puppy, but it won't be soon," he said.
"I know," I said.
I walked Joy and Luna up to Beals Elementary. I walked until I was exhausted, then much to Luna's annoyance, picked her up for the walk home. She was exhausted too. Joy happily panted along next to us.
I have no more answers than I did when we started our walk, but I am tired enough that it is difficult to think, and that is good. I try to get into Joy's state of mind, and step back into the house. I need to call it a night early. Tomorrow is another busy day.
In the midst of their own grief, her Moms made the sweetest care packages for us. They were filled with things that reminded us...and them...of Whiskey, including...whiskey : ) ...and a lavender candle because that was Whiskey's favorite scent.
Thank you Pamela. Thank you Christian. You are among the best of the best, and we love you <3
Kelly and I were finishing a cystotomy. This is a surgery in which the urinary bladder is opened to remove urinary stones. I must have removed 99 stones. The dog was only three years old, and she had impressively made more stones than I had ever seen at once.
After stone removal surgery, we always take an x-ray to assure all the stones have been removed. Almost a formality. I always fret a bit though between the surgery room and the x-ray table.
The x-ray appeared on the screen, and one lone stone remained in the trigone of the bladder. I was mortified. This happens in a reported 20% of stone removal surgeries in which x-rays are taken afterwards, but it had never happened to ME.
Back to surgery we went, Kelly reminding me, as she often does, to BREATHE. I sure love that friend. As basic as it sounds, I was NOT breathing, and needed to in order to complete surgery.
We reopened the surgery site, I removed the stone with a hemostat and returned to take another x-ray. The stone was out, and I was glad I had returned for the one last stone.
Luke 15
or something
My eyes once went two years without crying. I would cry, but there would be no tears. It was at a time in my career when I was burned out, and I think my eyes just had nothing to give.
I only told Trey, a vet tech I worked with at the time, because I thought everyone else would think it was weird. “That’s not weird,” Trey said.
Now my eyes cry again, and they get carried away. When Huckleberry died, my eyes cried for a day. The day after Huckleberry died, as my eyes were recovering, a client came in to tell us thank you for taking care of her dog who had recently passed, and my eyes started crying again. They stopped long enough for another client to come in to show us her engagement ring, and my eyes started up again. It could have been the glare from the beautiful ring, but I am pretty sure they were real life tears.
So if I seem overwhelmed with emotion by the sight of your beautiful, healthy dog...I am...but my eyes may also be still crying over a sad (or happy) thing. Give me a minute...or a day. I always pull it together eventually.
She was a gorgeous grey Standard Poodle who was anything but standard.
She didn't board with us. Rather, she sat in the front area with Hannah or Stephanie or Nicole and greeted everyone who came in. If it was Russ, she barked at him. If it was a client she didn't know, she held back. Everyone else was a friend.
Her hair was crazy, the good and wild kind. She often had it up in clips or a scrunchy, and other times had it out in curls and waves all over the place.
She was living well with an impressive list of conditions. Until she wasn't. Then she was just done.
Whiskey is survived by her Moms, her Standard Poodle friend and her kitty. And she leaves behind a heartbroken veterinary team.
We sure loved you Whiskey Girl. Rest well sweet friend. Until we meet again.
Have you ever loved a patient so much that you know his last day will be your last day in medicine? So you decide that day just can't come. You know if it does, you will set your stethoscope down and walk out the door, never looking back.
But then that day comes, and it crushes you. It crushes the team, it crushes his family and it even crushes his sweet neighbor. The little guy had a huge reach.
And you hold your dear broken client tight, and you vow to be there for her the next time and you put your stethoscope back around your neck, talks a deep breath and step into the next room, never looking back.
Later, in a happier time, you wonder, “could one little dog really have been that extraordinary?”
And you remember Huckleberry and smile. He sure was.
Rercently, Mom and Dad's little Poodles, Felix and Oscar, got into Mom's medicine. I rushed to the house to treat them.
Felix and Oscar were super happy to see me. They jumped around my knees and laughed.
I gave them both apomorphine, a medication that causes vomiting. Despite the injections, they were still having great fun. Until...
They both suddenly stopped dancing and hung their heads. Remember the story about the pie eating contest in Stand By Me? The next ten minutes were full of a parallel sort of story, only instead of people and pie, it was puppies and pills.
I called ASPCA Poison Control. THANK YOU kind team for your excellent help.* Mom cleaned up barf. THANK YOU Mom! We accounted for all the lost medication and determined, with the ASPCA Poison Control doctor that they had not had a toxic dose of any medication.
I gave both boys Cerenia, an anti-vomiting medication. They quickly returned to their happy, non-barfy selves. Dad came home and we all sat for a while holding the Poodles and enjoying, with great relief, how perfectly things had turned out.
Felix (black) and Oscar (white) Photo by Liz Middleton/Photos by Liz
*DID YOU KNOW? If your pet has a HomeAgain microchip, a consult call to ASPCA Poison Control is free!
Before Cotton died but after we learned how sick he was, Mom called me at work, frantic. Mom and Dad’s little bonded pair of Poodles, Oscar and Felix, had gotten into Mom’s vitamins and medicines and eaten some.
On the way over to meet Mom and treat the Poodles, I alternated between knowing everything would be fine to knowing that truly one or both of the pups may not be fine.
Bailey and Cotton were heavy on my heart. Bonded pairs get split up. Pets die young. Sad things happen. I pulled into the driveway and went inside.
Felix (black) and Oscar (white) Photo by Liz Middleton/Photos by Liz
Cotton and Bailey were best friends.
The two dogs boarded at the 120th and Blondo Gentle Doctor location, and we got to know them and their family well.
Cotton was blind. Bailey would walk next to Cotton’s shoulder and guide him, never letting him hit a wall or bonk a doorway (which is more than you can say for me - Sorry Cotton!)
Bailey himself recently went blind. They were both dealing with managable, age related issues, and handling them well. Then Cotton became fatally ill and had to be euthanized. It was that sudden. Cotton's family, his friends and his little partner, we were all devastated.
We humans knew we would survive the heartache, as much as it hurt, but none of us were sure if Bailey would.
He comes in to board. He sleeps with Cotton’s toys and his blanket. He is hanging in there.
We miss him too buddy. And we sure love you.
Joy has developed a fear of the wind. It took us a while to figure out what was scaring her, because she would be antsy on nice days and stormy days, then we realized it was only on windy days.
Joy staying safe on the side of our bed!
She hides on the side of our bed or on her bed next to Russ's desk or - if it is really bad - under my desk. Abby has built her forts before, and that seems to help.
Remember the beautiful light breeze this past Sunday? Joy had me close ALL the windows so we would all be safe.
We will start antianxiety medication if it worsens. Right now it seems like hiding and being comforted until the wind subsides is enough.
What fears do your pets have?
I spent an entire month with my stomach in knots over a Joy look alike with the sweetest family.
Dog had an ear hematoma from a severe ear infection. Coolest case ever, right? I love(d) ear hematomas. They are very fixable, and when the underlying issue is treated, usually allergies or an ear infection, the problem is avoided in the other ear.
We drained and wrapped the ear. We treated the double ear infection.
Six days later (as is often the case) the hematoma was back (or so we thought). It often takes a few tries at draining the ear, and about half the time, surgery, to solve the issue.
Near the tip of the ear flap was a small opening. This was unexpected. But I did not need to poke poor Dog's sore ear with a needle again, so that was a good thing (or so we thought).
*GROSSNESS WARNING* Jen had to leave twice while she was helping!
I pressed gently on the swollen ear flap. The largest amount of purulent material I have seen since treating cat abscesses poured out of the ear flap. This was no longer a straight forward hematoma, it was a severely infected ear flap! I had seen this once in a cat. We drained her tiny triangle cat ear and she healed well. This was a big floppy dog ear. My stomach started to seize. It did not stop for the remainder of Dog's month-long treatment.
We drained and flushed the ear. We started stronger antibiotics and continued anti-inflammatories. The next week the ear flap was as infected, this time with scratches - gouge marks really - from Dog kicking her ear when her protective cone was off. (It happens.)
Every week the infection improved and the ear looked worse. I warned the family the results may not be pretty. They figured.
The second to last recheck, the tip of the ear was very firm and non-bendable. "Oh no," I thought.
Sure enough, the tip of the ear fell off - at home! "We figured," the family said. They were less mortified than I was.
On the last recheck, Dog's ear was shorter than God made it and had scratch scars, but the infection had completely cleared. Just as amazing, the double ear infection, after so many visits and treatments and oral antibiotics for the ear flap, had completely cleared as well.
I was wrong - she was as beautiful as ever.
"I am so sorry you have been through all this," I told the family (again) at their last visit.
"We are not! And thank you so much for all of your team's care. " they said (again).
And then Mr. said, "We just tell people, 'you should have seen the badger!'"
Today was the day for her spay surgery.
Not that the stakes are not infinitely high in any similar situation, but Puppy had to survive. How could it be otherwise?
No pressure, but Kelly and I had to do everything right, and pray that everything out of our control would go perfectly.
No pressure Puppy, but then you have to live a healthy, happy, very long life.
Everything went perfectly.
In fact, by faith or by folly, I am writing this the night before Puppy's surgery in the hopes and knowledge that everything will be just fine.
Puppy, have we told you lately that we love you?
It was a busy Saturday morning. Kelly ran into the treatment room carrying the tiny West Highland White Terrier puppy, the puppy that her Mom had recently adopted after her first Westie had died. Puppy was having trouble staying awake.
Puppy had ingested at least ten and - later we found out - probably closer to twenty or twenty-five ibuprofen.
We administered a medication to cause Puppy to vomit, but she lost consciousness before she was able to vomit.
Stephanie asked me if I thought she would live. "No," I said, and started to cry.
I called ASPCA Animal Poison Control Center and reached Dr. Helen Myers. Thank you Dr. Myers! She advised us on medications and supportive care and recommended we get her to the nearest 24 hour care facility as soon as possible. I asked Dr. Myers if she thought Puppy would live. "This is bad," she said.
My next calls were to Russ and his Mom to ask them to begin praying.
I then called VCA Midwest Vet to let them know Puppy was coming. Thank you VCA Midwest Vet! For being and for being there for Puppy.
Puppy's gums were blue. Her temperature was dropping, and she was still unconscious. Kelly got an IV catheter placed in a matter of seconds, her Mom got her to the emergency hospital and we waited.
The first update was promising. Puppy was awake and taking oral medications.
That evening I called again. Puppy was eating! She was also being carried everywhere and properly spoiled. Her gastrointestinal system was stable, and her kidney and liver values were normal.
And then, over two days after her ordeal began, against all odds, Puppy went home.
She is home and well with no long term damage. Everything is once again as it should be.
I keep a list of 50-100 patients with ongoing issues. I check half of the cases weekly and half of the cases monthly and update my list daily.
Losing contact with pet parents through death or healing is jarring. Also jarring is losing contact through lack of follow up.
I hate real life stories with open endings like I hate chairs not pushed in, only more deeply. That is my strange quirk to deal with. It is probably why I keep The List.
But you can help.
If your pet is cared for by our team, and we call to check on him or her, please call us back. If things change for better or for worse, please let us know.
Those of you who need advice about your pets, the only thing I ask from you in return is an update on your pet. Let me know how he or she is after we talk.
Knowing how my patients are doing brings peace of mind I can find no other way.
I was spaying a puppy. Kelly was running anesthesia. In the flickering moments between light and dark, I thought through every aspect of anesthesia. Some of the monitoring would not work, and the fluids would stop running, but the anesthesia machine, thankfully, would continue to work.
The rest of the team ran to find flashlights. I held the hemostats and the tissues between them steady in the darkness until they returned. They turned on the two flashlights and held them at the angles the surgery lights had just been.
We finished surgery.
It was...otherwise...uneventful. Puppy woke up fine and is living happily ever after, as are all of us who were there that day.
ONE YEAR AGO
THE KURTENBACH SERIES, PART 2 - GAMBLER
TWO YEARS AGO
THE DOWNSIDE TO KEEPING YOUR PETS SAFE THAT NO ONE IS TALKING ABOUT
The power was out. There was nothing we could do but wait. I wrote in my notebook. I comforted the dogs when they whined.
The cats didn't care. They had their sunlight.
It was quiet. We settled into the dark, the dogs and I. Maybe I needed the pause to be reminded how important writing and comforting are to my well-being. Subtly, so slowly I almost missed the transition, I shifted from waiting for the power to come back on to just being.
ONE YEAR AGO
THE KURTENBACH SERIES, PART 1 - MARCEL
TWO YEARS AGO
"I hate to see my dog in pain," she said. "And on top of personal problems we've had recently..."
I stopped my exam and looked up into her eyes.
She told me everything.
She could begin healing.
I could begin praying.
ONE YEAR AGO
TWO YEARS AGO
I try to post gross pictures here very infrequently. When I do, they are pictures I feel are cooler than they are gross, like Cutie the Cuterebra. The gross pictures I am posting today are not cool, but they are worth showing. I am posting cute (not cutereba) pictures first though so you will have to scroll down if you want to see the shock collar burns. Different patients. Not uncommon. Not cool, just sad.
Okay, are you ready? Both dogs recovered well.
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You can see where the electrodes were on the collar.
This is after cleaning and treating.
Please do not use shock collars on your dogs. At their best, they give your dog an electrical shock to provide negative reinforcement for an action. At their worst, they cause electric burns.
Training can be much more fun for everyone involved.
ONE YEAR AGO
TWO YEARS AGO
My Mom in Law Karen and Dad in Law Phill recently said good bye to their Jacy Dog. Here is Jacy's story, written by Karen.
After several years of not having a dog, we decided it was time to have another dog. Sixteen plus years ago the humane society didn't have the nice website to look on, and we lived too far away to go every day. And we didn't know about the the rescue groups or there weren't as many (and Shawn was in CO, so she couldn't help either)
I just watched the ads in the paper, now I understand the risks there! But one day there was an ad for Lhasas, so off we went with some of the grandkids in tow. There were 9 almost identical puppies in the box, all female!! All of us held them all, and we had no idea which was which!! I finally said ok this one! Cute little fluffy ball of brown and white!
Several days of trying to name her were crazy. She was outside playing when a neighbor said oh, she is Just Cute! Phill picked up on JC and thus she became Jacy!
She learned early on to sit flat on her butt and sit that way for a long time. Every one who saw her marvelled that she could do that. and since it was cute, she got treats and thus learned to be a very vocal beggar!!
She was an only dog for 9 years. Which was fine with her, she wasn't very friendly with other dogs.
We could always let her go outside on her own. She wandered around, visited the neighbors and always came back on her own.
We took her camping with us to Yellowstone and all around Nebraska. She really liked that and was very good!
Then one day her world turned upside down when we brought Lucy home. She went with us to a meet and greet, which was tense, but when they both were getting a drink from the same bowl, I took it as a yes from God that it would be ok.
Guess Jacy didn't hear God say that because she was mad for about 6 weeks. Then one day they started to play tug with a sock and it was all ok.
She got more mellow and tolerated other dogs in the house and yard including Tidus the Pit bull!!
She went with us on lots of long motorhome trips, Memphis, California, Arizona, Colorado, Texas and near home camping. But then last winter, in Texas she was really slowing down. Long walks wore her out and riding so far was uncomfortable. She was still pretty playful and would get "the terrors" around the house.
But then one day I saw some bloody spots on her pee pads. Trip to see Dr. Shawn and an ultrasound turned into sad news. Bladder cancer. Since by then she was 15 and there was no cure, we chose to love on her as long as she wasn't hurting.
But as winter was coming and our winter trip to Texas, we knew the time had come. Actually we needed the permission from Russ and Shawn that is was the right thing to do for her. Hardest decision ever! But the right one for sure. We are so thankful for Russ and Shawn who loved us and Jacy through it!
