Wednesday, January 23, 2008

Why did he die?

Last week I had to do a necropsy. (Dissecting a dead human is an AUTOPSY, since it is like cutting yourself. For animals we say NECROPSY, cutting the dead, a species other than ours). A new client called and said her healthy 4 year old cat was found suddenly dead, and she wanted to know why.

I don't really enjoy doing necropsies, I must admit. It's not the squeamish factor, or the smell (which is daunting). It's just that I don't get a thrill from figuring out what went wrong. People who do this for a living - they're called pathologists - have a real passion for figuring out the reason the patient died, the progression of disease, the cascade that happened after injury. They have so much passion for it they will spend all their days with dead patients that they never met alive, surrounded by tissues pickled in formaldehyde, cutting up pristine bodies getting down to the answer.

It's not for me. My mission is to relieve animal suffering. I also like interacting with the people who love these animals enough to seek good care for them. Dead animals are gross, but I do lots of gross things everyday. Already dead animals just leave me cold.

My least favorite thing about necropsies, though, is that I can do them and still not know why the animal died. Anthony was shocked by this when we were first married. "You mean you can't figure it out, like Quincy always did?" Yeah, Quincy always figured out the one toxin that caused everything, and within 50 minutes. I'm sure CSI is doing similar damage to today's audiences.

If a dog dies of a toxin, I'm not likely to see it on a gross dissection, and it costs a lot of money to test randomly for all the toxins you can think of. Subtle lesions are likely to get past me, since I am not a trained pathologist (thank God).

So, my dead patient this day was a robust black Persian. Externally, he was male, he had big yellow eyes, he had a shiny coat, and he was quite stiff.

His abdomen was pretty normal, except for the kidneys. The left one was completely normal, but I couldn't find the right one. I found the bladder, found the ureter, and followed it up to a tiny shriveled pea of an organ. This was the hypoplastic kidney, smaller than a lymph node. It had never developed.

However, this was not the cause of death. Anyone can live with just one kidney. It was really interesting, but not the culprit.

I cracked his chest. Lungs looked good. The heart looked a little large nestled in the lungs, but it was beautiful. Hearts are so complex, so amazing how they generate their own electrical charge. This one was a little iridescent, a marvel to me. I cut it open. The valves were pristine, crisp webs. The muscle was meaty and thick. Too thick. I measured the ventricular wall thickness. It should be 5.5 - 6 mm at the most. This kitty's heart measured 11 mm.

I had a diagnosis: hypertrophic cardiomyopathy. This cat's heart muscle was pathologically sick. It had to work harder, and any muscle that works harder gets pumped up. This cat probably died from a blood clot that formed in the abnormal heart or developed a fatal arrhythmia.

I called the owner. I expressed my sympathies, and told her my findings. She was relieved to know what had happened, and that she had not done anything to lead to his death. She was still a little in shock that her friend was suddenly gone.

She called this week to make an appointment to see me with her new kitten. I am glad I will finally get to meet her and her new living pet.


mr man said...

Quincy was always one of my favorites. The opening segment where the cops quickly start disappearing to the floor was always funny. I appreciated his diligence and problem solving, but I never really wanted to be a pathologist. Helping the living is more rewarding and less stinky; I can't imagine any speed of fan helping. It is fascinating to the layman, though, in any case.

Emily said...

Although the smell would probably get to me, I'm fascinated by the idea that you can (almost all the time) determine the cause of death. I think it is comforting to the owner. (Remember Enrique?)
Cool story, even if it leaves you a bit squeamish. You're amazing!

peevish said...

Wow, that was really interesting. Thanks for the good read!

EdamameMommy said...

It's strangreading this today because on NPR they reminded us that this is the anniversary of the shuttle Challenger going down. And I remember I was at G.E.M. that day disecting a stinky formaldehyde yellow rat when we watched the launch. Disection is intriguing but not enthralling to me. I much prefer the satisfaction of your Dr.Jenn-saves-the-day work, too. But this was a great post.