Crap Cases

The last few weeks have been highly stressful for many reasons, most of which I intend to ignore for the moment.  I felt inclined to share about two crap cases that really frustrated me and made me sad and tell a short client story complete with the one-liner on which I bit my tongue but rather wish I had the nerve to have said...

First is Ellie, a nine month old MinPin who came in for bad breath.  Her exam was pretty unremarkable but two things bothered me.  First, while she had more tartar than expected for a nine month old and a single retained baby tooth, the breath seemed too bad; but, the owner had used antibiotics they had at home (grrrrr!!) and reported improvement...  Second, even for a young MinPin, she seemed kinda thin.  We scheduled her for a dental the following week.  Her owners declined blood work but I used my powers of persuasion (okay, so I just ignored them, did it anyway, then asked forgiveness) and got it done.  She was in severe renal failure.  Although we could not get an immediate ultrasound, I felt sure it was a congenital issue given her age and how well she was doing.  We started antibiotics pending a urine culture since there was a mildly elevated white count.  Sadly, Ellie died within the week...

Second is Betty, an aged female English Bulldog who likely came from a puppy mill.  She was a sweet, sweet soul that a local rescue obtained.  Heartworm negative (shocker!) but with a respiratory infection, horribly thin, and huge mammary tumors in all except two glands.  We gave her a few weeks to recuperate and gain strength then tackled the spay / tumor issue.  In her case, I opted to remove all the mammary tissue from both sides in one go primarily because there were palpable nodules running in the connecting blood vessels traveling across midline and because she was thin enough to have extra skin for closure.  Her spay went without a hitch, she had a softball sized lumpy ovary on the right, then her mastectomy also went smoothly.   We kept her hospitalized for observation, initially on IV fluids.  Her owner wanted her to stay through the weekend and I checked her over Friday, looked great.  It was not my weekend but I've been kicking my rear ever since for not going by...apparently, at some point Sunday, she chewed her stitches out causing complete dehiscence with intestine becoming strangulated and contaminated.  Back to surgery she went, this time for a resection and anastomosis.  The surgery went well but apparently Betty's kidneys were on the brink and the second anesthesia pushed her over the edge.

And my last story for now.  There's a guy that has been bringing his two little dogs to our clinic for years.  I remember him, his dogs, and his previous wife from when I was here before vet school.  At some point since then, he has remarried.  His new wife brought the dogs in to have their chronic allergy skin dealt with and commented that she did not understand why he even kept the dogs around (they are 17 and 19, by the way).  How I wish I had said "Well, what I don't understand is why he keeps you around..."