I would say that I don’t gamble, but really I am constantly asked to play the odds. People ask me what I think or what I would do. I have a very mathematical brain and I am very good at knowing and remembering the chances of something happening. But we had a week recently where the odds didn’t seem to matter.
It started with Flowrr. Flowrr was a rabbit that the family dog had done a beautiful amputation of a front leg. Flowrr had emergency treatment at the ER. They were careful to not make the situation worse. We saw it the next morning and shaved up the wound, dressed it and medicated Flowrr. Over the next few weeks, Flowrr healed and did very well, but a week after she was doing well, she came back in extremis.
This time Flowrr was in very bad shape. Her temperature was 92 degrees. (Normal in a rabbit is between 100.4°F and 103.8°F. Studies have been done on prognosis of rabbit survival vs their presenting temperature. Rabbits with that low of a temp are not supposed to survive. Ever! I advised the owners of this and discussed euthanasia. They did not want to euthanize and we went to work on Flowrr. Lindsay is quite good at IV catheters, but declined to try the tiny lateral ear vein on Flowrr.
To everyone’s amazement and using a tiny needle, I put warm IV fluids in Flowrr’s ear vein twice. Intraperitoneal fluids were also used before Flowrr was put in an incubator with oxygen.
Within an hour Flowrr was up and eating. I still counseled the owners that there could a fatal bacterial overgrowth from the cecum. But Flowrr continued to eat and did well and went home.
Likewise, Oscar went home. Oscar was never expected to go home. Oscar was an older white cat with a few black patches that came in showing respiratory distress. Oscar could not breathe enough to get oxygen to his tissues. Emergency oxygen while we got some diagnostics. Blood work didn’t look too bad, but there was a lot of fluid in the chest outside the lungs. A chest tap removed over 100 ml or about half a cup. Reducing the amount of air by 4 ounces every breath is a lot. I explained that cancer was probably the most likely cause and the prognosis was poor. They wanted to treat. We treated.
Oscar defied the odds and went home with totally clear pleural space. To be totally fair, he did return ten days later and we drained accumulated fluid off his chest again. We discussed referral and chemotherapy. They will have a family discussion and get back to me.
Fonzo looked bad when he came in. He could not stand. He was older. He barely could lift his head. Many owners would have elected euthanasia while he was still on the gurney that was needed to get him into the exam room. He had a very high white blood cell count due to prostatitis and had to go through surgery, but he was up, walking and wagging within 48 hours. He did have damage to his kidneys and stayed for several days on IV fluids, but he was a happy, waggy pup (of advanced age).
Woody was a stray in the neighborhood. He was matted, nasty teeth, pus running out of his ears. His white blood cells were sky high and he was anemic. E2L2 did an excellent job getting the mats, ticks and fleas off him. IV fluids, IV antibiotics and surgery made him feel better. He still has a high white blood cell count and anemia, but he is doing better and feeling better at home.
Bubba presented in severe respiratory distress. The little pug was working so hard to breathe that his temperature was over 105. Even on IV fluids, meds and oxygen, he looked bad. Michelle, who has a bit of ER experience came and asked if we could talk to the owners about euthanasia. I explained that a Chordae tendineae rupture (the little fibrous cords that hold the valves in place) can cause a lot of havoc before the other muscles learn their new way to make the valve work. By morning Bubba could visit with his dad off oxygen. I made sure to seek out Michelle to point out how well Bubba was doing.
Not everything even stayed in the hospital that did well. Spice’s parents declined hospitalization and treated him at home. Twenty-four year old cockatiels that are bleeding all over the place statistically do not do well. We stopped the bleeding. The owners listened and set up an incubator at home and worked to hand feed Spice even though he tried just as hard to bite them. I saw him back on a recheck and he has gained weight and doing well enough that we can start his treatment for his respiratory infection.
Banjo had stones in his urethra and could not pee. From the time that you block until you are dead is 24 to 36 hours. He had been blocked for a while. We passed a catheter with some difficulty, but got the bladder emptied. He was on IV fluids and his blood work looked good. He reblocked. We recatherized. We got brown-grey-red pus out of the catheter. Surgery was performed to remove the testosterone effect on the prostate. Banjo wasn’t blocked but he wouldn’t/couldn’t pee. The nerves sometimes lose the ability to contract the bladder if the bladder has been extended for too long. We drained and expressed until the nerves took back over. Banjo did well, but he certainly took longer than I wanted for him to recover.
And then, the streak was over. At 3pm on Friday, we saw an emergency. A sugar glider had been missed while the owners were on vacation. He was comatose: unable to stand, lift his head or move. Although I had him up and playing within 30 minutes, he was dead within a couple of hours.
There is a saying that it is better to be lucky than to be good. I think reality is that it pays to be both. If you don’t have the ability to make the best of a situation, it doesn’t work out well when there is a chance.
We needed that week. The morning that all this started, a wonderful pitbull, Lyken, had died of liver and splenic cancer. I necropsied him and the cancer was so far advanced that it was the best thing for Lyken, but we did not like it.
This week will be remembered. Staff and I will say, “remember that week when nothing died? Even the ones that were supposed to die? Let’s have that week again!” May the odds ever be in your favor. And I wish in retrospect, I had enough time to buy a lottery ticket that week. Or maybe not. I would rather use the luck on the patients who should have died.