Monday, June 21, 2010

Tragic twists and turns

Last week one of my best clients said he was sending his dad's cats in to see me.  One of the cats had teeth trouble, and his parents' regular vet just kept giving steroids and antibiotics with no improvement, stating he was unwilling to anesthetize and take care of the cats teeth.  Since I am unafraid of anesthetizing older cats with our very safe protocol, and I love taking care of teeth, I encouraged him to send them in.

His sister ended up bringing in her very elderly father to the appointment, with the old cat, and the old cat's mother.  The cats had belonged to some neighbors who moved about 2 years ago, leaving the cats behind.  The old man had the cat in question sitting on his lap, and seemed delighted to meet me.  He grabbed my hand with both of his and smiled warmly when I introduced myself.  He was terribly hard of hearing, and seemed not to know exactly what was going on, but still enjoyed meeting people and connecting with them, especially if they were interested in his cats.

The cat in question was very friendly, but dried drool was all around his mouth.  His teeth weren't terrible, but there was a large mass under his tongue, with a necrotic center.  I relayed this information to the man and his daughter, continuing my exam.  The old man said, "Oh,"  and the daughter came close to me, and whispered, "His wife just died two weeks ago.  I don't know if he can handle this."

I finished my exam, reeling from this information.  Well, I'd better examine the cat's even older mother.  She weighed only 4 lbs (!), and had a pronounced heart murmur.  She seemed to have some labored breathing.  Oh, great.   The daughter and I left the old man with his cats to confer in the adjacent exam room.

"I am 95% sure that is a tumor under the cat's tongue," I told her.  "The only way I can be 100% sure is if we do a biopsy, but it will come back something bad like squamous cell carcinoma."  How I wished it was just a dental infection, something I could fix!  After conferring with me and her brother, we decided to euthanize the cat.  We sent off labwork on the older mother cat, and took a chest Xray, which showed an enlarged heart but no problems in the lungs.

The daughter thought it would be best to just leave the cat with us for euthanasia, and she would take her dad and the mother cat home, and let him know later what happened.  I brought her the permission form for euthanasia.  "Just initial here that he hasn't bitten anyone in the last 10 days," I said.

"But he has!" she said.  "He bit my dad last week, really bad, on the arm."

Oh no.  I checked the records faxed from their previous vet.  No history of a rabies vaccinations.  This was not good.

"Could you just look at his arm, and tell me what you think?" she asked.

"No," I said, "but here's what we're going to do.  After the euthanasia, I'll have to send the head to the state lab for rabies testing.  We can send the rest of the body for cremation."  Truly, since I am not a physician, I cannot give my opinion on a human's condition, and no one can tell by looking whether a bite has rabies or not.  But I do have to help protect public health, and by law this cat's brain had to be tested.

"What will I tell my father?" she asked.  I told her not to say anything; likely this cat had been vaccinated at some point in his lifetime, and in 24 hours we would have the rabies testing results.  If it came back positive, we'd let him know and deal with it then.

While the poor overwhelmed daughter finished the paperwork (remember, she'd just lost her mother two weeks ago, too), I went back into the room with the old man.  "You're going to go home with L. (the mama cat), and I'm going to take care of this one here," I told him.  "Okay," he said, "what was your name again?"  "I'm Jennifer," I said, dispensing with the dr. title, and we shook hands again.  He was so sweet and kind, and I felt terrible for him, but I knew it was the right thing for his poor cat.

Then, I humanely euthanized the cat and had the gruesome task of cutting off its head, and double bagging it for the lab.  Fortunately for us the lab is here in Austin; other parts of the state have to put it on  ice and send it via Greyhound.

The next day the results came back negative, and the mom's bloodwork showed some hyperthyroidism, a disease that is relatively easy to control with oral medication.  And there is talk of getting the old man a new cat, perhaps an adult cat from the shelter, one that also likes to sit in laps.

Tuesday, June 15, 2010

Summertime, the livin' is easy?

So apparently life is not getting less crowded now that school is out.  At least there isn't any homework, though!  The weekend after school finally let out, we had our first swim meet (5 am! yuk!) followed by the annual Danskin Triathlon.  Emily and I have been doing it annually for some time now.  It is a great way to make yourself get in shape for the summer.  This year we followed it with some spa pampering and massage.  That's the way to relax!

Last weekend was another super-birthday weekend.  My nieces and nephews and Anthony's birthdays are all in May.  Anna had choir camp all week.  She is such a little song bird, always singing in the shower, car, dinner table, hallway....  Also her parents met in college choir.  This was her first formal choral experience and she loved it.  Of course, she's a first soprano, and has been singing at the top of her new-found range ever since.

Anthony has been out of town a lot, and so has Wesley, our usual babysitter (he deserves a brief summer vacation, too).  This makes juggling the schedule extra complicated for me, with pinch-hitter babysitters and friends to the rescue.  Don't forget we are also doing daily swim team practices (not at the same time), ballet and piano.  Next weekend is another swim meet, another triathlon.

Don't worry, we are going to take a vacation.  In July, we run off to South America.  Hopefully I'll catch my breath before then, and the next post won't be a catch-up-here's-what-I-did-when-I-wasn't-blogging.

Tuesday, June 01, 2010

That was May

So my birthday weekend was enormous, amazing, overflowing with celebration and feasting.  Nearly everyone I invited came to my party (a few key people were there in spirit).  It was great to turn 40 and feel surrounded by love.

There was some singing, which I had not planned on but made me deleriously happy.

I made a vast 80s playlist for the party, and some guests went beyond the call of duty, dressing in vintage 80s clothes!  I loved it.  Unfortunately, there aren't tons of pictures because Anthony was doing an amazing job hosting the thing.  My entire family pitched in to put on an amazing event for me.

The next day we had to get up for Colin's birthday party.  Luckily for me he wanted a Harry Potter party just like Anna.  Therefore it required very brain effort or preparation.  However, Colin wanted to "Slay the Basilisk" with the sword of Godric Griffindor - and I lucked into getting a chinese dragon basilisk pinata two days before.

Also he chose to have a "Quaffle" cake instead of the Golden Snitch, which was pretty simple for Anthony once he got the color mixed.
Then my dad deserved a celebration befitting his septuagenarian status, and we had a 3rd rousing good time.

Anna performed well the next weekend in the ballet extravaganza, earning a Gold medal in Performance Awards and shining as usual on stage in the recital.  Hopefully I'll get links to videos of her Vocal Solo at school and the piano recital.  They both performed so well, even on their duet.  Anna is one of those rare souls who does better in performance than she ever does in rehearsal!

I also spoke at career day at a friend's school.  I am so lucky because my vocation is always the most popular.  Anna and Colin were jealous, so I also spoke to their classrooms last week.  I tell them about how important math is, how I use it every day, and writing, and reading, etc.  Then I show some Xrays, pass around some bones, and gross them out with the dog heart with worms in it.  Its really fun to do, and I love all the predictable and surprising questions.

This is our last week of school, then a full summer starts, bolting out of the starting gate this weekend:  first swim team meet Saturday morning, Danskin Triathlon Sunday, Choir camp for Anna starting Monday, another birthday weekend after that.

And its already wayyyyy too hot.