September 2008 - The Parklander Magazine

PET TALK
The Perils of Rocky
By Glenn Kalick, DVM
urinalysis. Strike three. He said he still had the prescription for the
Amoxicillin and would start him on the meds.
When he brought Rocky in this time, he told me that he had not
realized that I was no longer practicing in Ft. Lauderdale. He couldn’t
believe that the veterinarian there wanted to do all of this expensive
bloodwork, i.e., x-rays, urinalysis, etc. (I have been in my present
practice for six years, so that means Rocky had not been seen by a
veterinarian in six years). Rocky was skin and bones. The owner said he
tried everything to get him to eat, but he refused everything. He had
been gradually losing weight over the years but the weight loss had been
most dramatic over the past two weeks. Rocky was probably six pounds
now and in his youth, was a 17-pound cat. The owner wanted the cat
“fixed”. I went over my diagnostic plan, and per his usual response, he
quickly shot it down. At that point, I told him that I could not help the
cat without the tests, that I left my magic wand at Disney World and, for
the cat’s sake, he needed to have the tests performed. If it wasn’t for his
daughter next to him, crying, he probably would have taken Rocky
home. He told me I could run the tests, but not the x-rays.
Recently I ran into a gentleman in Publix who almost ran me down with
his cart when he recognized me. He was so excited to see me and
claimed that he used to bring his cat to me when I practiced in Ft.
Lauderdale and that I “fixed” his cat without performing any diagnostic
tests. He told me that he still lived in Davie, but would like me to look at
Rocky. I told him to have his records faxed over to the hospital and then
I would be happy to see him.
By the time I got back to the animal hospital the records were already
there— on one page. Eleven years of medical history was on one page of
paper. It seems that eleven years ago, I gave one set of vaccines to a threepound
stray cat that had intestinal parasites.The owner never finished the
vaccines and never came in for follow up dewormings.Two years later, the
cat came in for vomiting and I recommended a full work up including
bloodwork and x-rays, a fecal parasite exam and a check for Feline Aids
and leukemia. He refused the work up and told me that his last cat used to
have hairballs and that he still had some hairball medication left.
Three years later Rocky was brought in with a fight wound. It was
superficial but there was a central aspect of the swelling that might later
have caused him problems. I told him that the bite wound penetrated the
skin and that we could be looking at an abscess. I recommended we
aggressively clean the wound and start antibiotics to potentially avoid
abscess surgery. Once again, he refused treatment. He said that he had
Neosporin at home and he would call me if he needed me. I did get him to
at least take a prescription for Amoxicillin for Rocky.
One year later, Rocky’s owner called to report that he was urinating all
over the house. I told him that Rocky might have a urinary tract
infection; possible bladder crystals in the urine, or the inappropriate
urination might be behavioral, so I suggested he bring him in for a
Amazingly, Rocky is a medical wonder. He tested positive for Feline
Aids (outdoor fighting cat) and had hookworms (makes you wonder if
he ever didn’t have worms). Rocky was severely anemic and in desperate
need of a transfusion. He had a dramatically elevated liver and
pancreatic enzymes signifying probable liver disease and pancreatitis.
Rocky was in kidney failure and was hypothermic. He also was
hyperthyroid (when a cat has a tumor on the thyroid gland causing it to
lose weight and vomit). All of these problems could cause vomiting and
all of the treatments included a long hospital stay, IV fluids, medications
and repeated bloodwork to monitor the success of the treatment.
I called the owner and his teenage daughter picked up the phone. I told
her that Rocky was very sick and to please have her dad come in so we
could go over the treatment plan. She wanted to know if Rocky would be
okay and I told her that we were trying, but we needed to know all of
Rocky’s problems before we started any treatment. She told me that she
knew Rocky better than anyone did and to take the x-ray, but not to tell
her dad because he would get mad. In the meantime, she would talk to
him. I took the x-ray and there it was— a foreign body in the stomach.
When father and daughter came in, they took one look at the x-ray and
knew exactly what it was, a cap from a tube of lip balm. It seemed Rocky
loved chapstick, especially the fruity ones.
Rocky was transferred to the emergency referral hospital close to his
home and received a blood transfusion and 24 hours of IV fluids. He then
had the gastric foreign body removed. Afterwards, his bloodwork
improved, he regained his appetite and was given subcutaneous fluids
every other day for his kidneys and medication daily for his thyroid tumor.
There are three important facts in this story: The power of a
daughter’s tears; never stop insisting on the importance of good
medicine; and, in order to treat a condition, complete diagnostic
workups need to be completed.
104 SEPTEMBER 2008