The Gift of Pets: Stories Only a Vet Could Tell (31 page)

Yet there was more than fear in her eyes. Registered in them was also a knowing that I cannot express. There was a knowledge, I presume, that soon the battle would be over, and perhaps there was gratitude for that. A knowledge that the enemy, Cancer, had finally won, a hollow victory for him at this point. There was acknowledgment that her influence in this world would soon cease, that her ability to intercede for her loved ones and to intervene in their affairs was gone. And there was an awareness that despite the attendant pain and loss and parting, life is worth it; that hers had been spent in valuable pursuits that would outlive her.

*   *   *

It is tempting to spend pages drawing life-altering lessons from the story I have unfolded. And I know there are some. I have certainly learned many from it myself. But who am I to point out to you anything other than how the tale has impacted me? I am not learned. I am not a sage or a philosopher. I am only a scribe, the simple teller of the tale and a witness to its truthfulness, though tears even now trace their way from my eyes to your heart. I can write the words with careful craft, but I cannot read them aloud without once more spilling tears. Interpretation is not my task. It is for you to apply the blood to your own doorposts.

Lisa was my friend. And if I could say anything to her now, it would be this. “Your influence did not cease the day your breathing did. You influence me still. I sense it when I take advantage of the training and skills of my present-day technicians. I honor it by recognizing the value of the Gift, the import of the bonds of the fragile circle between my clients and their pets, like the one between you and Grizzly. It is evident even now when Steven brings his children to the office to meet me—your grandchildren. Perhaps it will be disseminated widely with this telling, to impact many more people, unknown to you or me.

“I have kept my promises to you. Zepp, now a senior citizen, still comes to me, brought in by your aging mother, Amelia, her eyes still bearing the weight and sadness of your absence. I have faithfully provided Zepp’s veterinary care all these years, cheerfully without charge, in memory of both you and Steve. With tears in my eyes, I personally injected into Grizzly’s vein the solution that slipped him through the portal of the fragile circle to join you, figuratively and permanently. I carried him myself into the funeral home, where his remains would join yours, as your hearts had been joined for years.

“And I have done more than I promised. I went to your house, with your mother’s permission, and took Tillie’s stone from there to the office building, where I placed it under a tree planted in her memory. And if ever I build a new office, I will carry Tillie’s stone there, too, placing it under another tree, perhaps outside my office window, where I will be able to see it with just a glance when I think of you, which I still so often do.”

The Nutty Case of Gumbo

Mrs. Adler was a kind white-haired woman about sixty years of age who presented her little poodle, Gumbo, for evaluation of an ongoing problem. She was a thin, proper, and thoroughly pleasant woman who always dressed in smart, fashionable clothes. Though she was reserved and rather shy, it was obvious that Gumbo was the apple of her eye.

She told me how she had adopted Gumbo from a rescue organization as a young adult dog. The two had bonded right away, their close relationship cemented when her husband had passed unexpectedly, leaving her beloved dog as her only companion. She had recently moved with Gumbo from the crush of the northern Virginia population and very much enjoyed the more relaxed atmosphere in the valley.

Because they were new residents in town, I had seen Gumbo and Mrs. Adler on only one or two occasions. Gumbo had been well cared for at his former veterinarian’s office. I could follow the course of his medical history in the records that Mrs. Adler brought with her on her first visit. Fortunately for Mrs. Adler, he had already been neutered when she had adopted him years ago, saving her the added expense of the procedure. Since his adoption, Gumbo had been a boringly healthy patient, seen only annually for his routine vaccinations. Mrs. Adler had been religious about making sure Gumbo received his heartworm-preventive medications each month and kept flea and tick medications on him to prevent the many tick-borne diseases.

Gumbo was the epitome of the patient I had always sworn that I would not treat. In high school and college, when asked what my career aspirations were, I would proudly describe my ideal job as that of an equine veterinarian spending my days outdoors or in a truck, working exclusively with horses. “I’d never want to spend my days stuck in some office, working on poodles with painted nails that belong to some little old lady with blue hair,” I’d proclaim.

This thought struck me when I first looked at my new patient. Gumbo, as pleasant and well-mannered as his owner, was approximately eleven or twelve years of age and had short-cropped curly white hair. The groomer had fashioned the characteristic topknot on his head and had decorated each ear with a blue bow, held in place with a rubber band. Like many aging poodles, Gumbo had numerous small warts dotting his skin and a hint of gray starting to shade his pupils. His hair was shaved close to the skin on his feet, allowing me to easily see the bright red polish that had been painstakingly applied to Gumbo’s nails.

And yet, though Gumbo was exactly the type of dog I’d had in mind when I’d made my pronouncement, the truth was that after almost twenty-five years in small-animal practice, he was now the type of patient I most enjoyed treating. For me, the emotional connection between owners and their pets provides the spark that ignites my work with meaning. It was clear that Gumbo was indeed an honored member of Mrs. Adler’s family.

“What seems to be Gumbo’s problem, Mrs. Adler?” I asked as I entered the examination room. My initial assessment, as I watched Gumbo circling her legs anxiously, failed to reveal any telltale symptoms. He looked fearfully from her to me and back again, his tail tucked and his ears back.

“You know, it’s hard to put my finger on it, really,” she responded. “He’s just not acting right. He seems antsy—like he’s just uneasy all the time. And it seems to be getting worse rather than better. It’s just not like him.”

“When did you first notice these changes?”

“I suppose it’s been two or three weeks.”

I nodded my head but automatically added a week or two to her estimate. People almost always underestimate the duration of a problem—especially if it is a chronic one. The more vague the guess, the more time I add. The owners don’t do this purposely to throw me off track or to justify their negligence of the problem. They simply tend to forget how long their pets have been dealing with any given issue. But unless they tell me that they first noticed the problem yesterday, I generally add about 50 percent of their guess to the time frame

“Okay, and has he cried out or shown any specific signs of pain?” I asked.

“I can’t say that he has; just a general discomfort.”

“Any squealing when you lift him or hesitancy to jump on or off the furniture or go up or down the stairs?”

“Yes, he has been hesitant to jump up on the couch recently, now that you mention it.” Mrs. Adler looked at me with a bemused look on her face, as if I had just read her palm. “How did you know that?”

“Just a hunch,” I replied. “And has he been slow to move around? Like he’s just generally sore?”

“Yeah, that’s it. Just achy like.”

A clinical picture was emerging from her vague description. It sounded like Gumbo had a sore back. With that in mind, I watched Gumbo move around the room, looking for evidence that he was guarding his back or showed a subtle deficiency of gait or a reluctance to move his back or neck normally. But as he pranced around the room, still nervous and jumpy, I saw no hint of any discomfort. This did not necessarily dissuade me from considering back pain. Often I find that back sufferers, in the stressful environs of a veterinary office, release enough adrenaline to provide temporary relief from their discomfort.

“Why don’t we take a look at the little guy, Mrs. Adler,” I said, squatting down to lift the eight-pound poodle onto the examination table. Usually I leave the task of lifting small patients to the owners, never sure how they will react. Many dogs, who usually approach me eagerly for a pat on the head or a scratch behind the ears, will react with a surprised nip at my hands when I try to lift them. Once on the table, they usually relax enough to allow me to examine them. But in Gumbo’s case, I wanted to see if I could identify any grunt or wince of discomfort at the pressure on his back while being lifted. Again, there was no noticeable reaction.

Once he was on the table, I carefully gave him a thorough examination, focusing in on his back. But despite my suspicions, I could elicit only very subtle discomfort as I pressed on the spine, moving from his pelvis and continuing forward to his neck. Neither could I identify any pain in any of his joints or in his belly. His heart and lungs sounded fine; his temperature was normal. With the exception of this vague discomfort in his back, everything seemed just fine. I turned, puzzled, to Mrs. Adler.

“Well, I’m sure not finding anything convincing on little Gumbo. Perhaps just a tad discomfort over the lower back. But it doesn’t seem significant, at least not enough to make him show the signs you describe.” I paused, thinking carefully. “I think we should do some blood work to rule out any metabolic problems. As long as the blood work is okay, I’ll prescribe some pain medications for a couple of weeks directed at a mild back strain. If things don’t get better with that, then we should do some X-rays to see if we can find anything that explains his symptoms.”

It took just a matter of a few minutes before I had Gumbo’s test results in my hands. They were boringly normal. Early in my career, I felt apologetic if the results of some test were normal, as if I had wasted the client’s money by doing a needless test. But experience has taught me that the best news a client can hear is that their pet’s tests are normal. It means that I can cross a host of bad diseases off the list of possible diagnoses. Mrs. Adler responded with relief to the results and gladly took two weeks of pain-relieving medications home for Gumbo with instructions to enforce strict rest during that time.

Three or four days later, Mrs. Adler called to report that Gumbo seemed to be acting more like himself. She was pleased with his progress and thanked me for my assistance. Given the good report, I took Gumbo off my mental checklist.

And, of course, there were a million tiny details of practice management that demanded my constant attention. There were decisions to make about whether or not to stock a new medication. There were employee reviews to complete, checks to sign, interpersonal staff dramas to referee. Even such a seemingly insignificant detail as supplying containers large enough to accommodate large tissue samples that needed to be biopsied had to be considered. The pathology laboratory supplied small jars filled with formalin for small samples. But sometimes the growths removed from our patients were too large to fit into these small containers. So a general announcement needed to be made to the staff to bring in jars of varying sizes, in which we could submit larger tissue samples. Details, details. The devil is in the details, they say. And every day is crowded with hundreds of them, it seems.

So it was a surprise to me when a week or two later (or it could have been longer, so add a week to that if you must) I noticed a recheck appointment on the computer for Mrs. Adler and Gumbo. I had to review the record to remind myself of the details of Gumbo’s case before I entered the room where the pair had been escorted.

I found Mrs. Adler, beautifully coiffed and dressed sharply in a well-matched outfit of dress slacks and a colorful blouse, with an understated string of simple pearls around her neck and a gold bracelet around her slim wrist, sitting on the bench in the exam room. Her face was pinched and concerned. Gumbo was on the floor in front of her, still and drawn, in as odd a stance as I had seen any patient assume.

His front legs were together in front of him, stretched out, calm and serene, as if his front half was about to nod off for a nice afternoon nap. His back half, though, appeared not to have gotten the same memo. His rear legs were extended straight, raising his hips and pelvis into a position that made me think at any moment he might send his back end running off after a squirrel, leaving his front half in place, still asleep and unconcerned. The effect would have been humorous had it not been evident that this stance was the result of some significant internal discomfort.

“He looks really uncomfortable now, doesn’t he?” Mrs. Adler commented unnecessarily. “He did really well for a while after I gave him his course of pain pills. But in the last two days, this is what he does. And he does it all the time. He even does it as he stands at his bowl to eat.”

“He’s still eating, though, huh?” I observed. “Any vomiting or diarrhea?”

“No, but now he grunts a bit when I lift him. And he just stands around the house in this pose, like he’s doing the downward dog yoga position or something.”

I lifted him gently onto the table. He responded with an audible grunt and an indignant nip at my hand. My hands went first to his neck and back, where I expected a dramatically painful reaction to the manipulation along his spine. But he remained quiet. His back was not the issue.

When I encircled his tiny abdomen with my fingers and gently felt his tummy, though, a firm tangerine-size lump was immediately detectable. It took up most of the space in his belly, just in front of his back legs. Its bulk took me by surprise. But what was even more startling was Gumbo’s frantically excruciating reaction to my gentle squeezing of the mass. He turned to me, a look of surprised offense on his face, and squealed once, loudly.

“Wow, that really hurts!” I said without thinking.

“What is it?” Mrs. Adler turned anxious eyes up to me, her hands covering her ears after the awful shriek of pain.

“There is a large lump in Gumbo’s belly that hurts like anything when I squeeze it even the tiniest bit.”