Don’t worry, I know I still haven’t posted my last dental sequel and I will definitely be doing that soon. I just had to share this unbelievable case with you first. This will also give you a brief break from the gory dental pictures.
We have endured a very chaotic working schedule in the past two weeks. We have seen a huge and interesting case load and been swamped with emergencies and so I haven’t had time to blog.
Last week, my colleague Liz had just examined a stray kitten that was picked up the night before. It was found next to the bacon factory and a very compassionate man had caught her after his late night shift. She hissed and carried on but he knew she was too tiny and weak to fend for herself.
Liz was concerned the kitten was suffering from a very serious umbilical infection.
She wanted my second opinion. I had never seen such a bad case of an umbilical stump infection. Palpation revealed the infection was protruding deep into the abdomen. We jointly decided to trim the stump that was poking out and treat her supportively.
The poor little critter had very pale white gums and was quite hypothermic. While Liz held her, I clamped the base of the umbilical stump. It felt like I was snapping a twig. I was still in the mindset that I’m dealing with dead tissue when Liz yelled out: ‘Oh my God Rayya, I think that’s a stick!’
The kitten became more reactive and meowed in pain as I tried to grab the remaining bits of the stick poking out of its abdomen. The local anesthetic we infused into her wound was still not enough to keep her still. Liz went back into the consultation room to notify the clients about the progress of the kitten.
She informed them that it required urgent surgery and her prognosis was very poor.
Given it was a stray rescue kitten, Liz offered to do the surgery free of charge on the condition that the clients will cover the costs of the medication. The kitten was immediately anesthetized We had both secretly hoped that the rest of the stick was merely lodged into the abdominal muscle wall and so we could avoid a massive surgery and anesthetic on a much debilitated patient. We quickly discovered that an exploratory laparotomy was inevitable.
There was no obvious sign of peritonitis. The rest of the stick was found to be poking out of the stomach.
A raging and brewing peritonitis secondary to contamination from the foreign body was now a serious cause of concern.
In that moment, I said: ‘let’s press on and see what happens. What’s the worst that can happen! She dies but at least we can say we did our best to save her.’
And so we did not pull the plug on her and continued with the surgery. Mind you, this was all being conducted after-hours free of charge just because we knew deep down, this kitten deserved a chance. Our vet nurse Jayde also stayed behind and did a terrific job monitoring the critical anesthetic. I scrubbed in to assist Liz with the gastrotomy. We placed stay sutures and I held the stomach up while Liz extended the incision into the stomach wall and pulled out the stick.
The poor baby was obviously starving and binging on the bacon factory’s waste bin.
Her stomach was emptied and stitched back together. Liz then quickly removed her barely formed uterus as she was still fairly stable. She then closed up her abdomen and her very paper thin skin was stapled together. The moment of truth had arrived, most anesthetic deaths in our patients occur during the post-operative recovery period.
We were focused on warming the patient up. Liz even managed to pop in an intravenous catheter so she could be given intravenous fluid therapy which will help increase the patient’s blood pressure. The odds were still against her and we waited anxiously for her to recover. She was very drowsy and unresponsive after the surgery.
I went home with a heavy heart wondering if it was indeed the right decision to put her through all that if we couldn’t guarantee saving her life.
The next morning, I ran up to her cage as soon as I arrived at the clinic and she managed to give me a very weak meow. She was barely moving but was feeling much warmer and had a slightly pinkish tinge to her gums. Judy, our groomer, had even bought her a cat igloo that she was comfortably nestling into.
The poor little kitten looked so runty and weighed less than a half a kg. She was so malnourished and needed energy to enable her to start healing. However, we were flustered and knew it was too soon to feed her.
In theory, we are trained to withhold food from our patients for 48 hours after a gastrotomy surgery.
This time is needed to allow the stomach to heal. Otherwise, you risk stretching the sutures and predisposing the patient to a peritonitis secondary to leakage.
We weighed out the pros and cons of not feeding her and Liz decided we could start her on a small amount of nutrigel (vitamin B paste). She quickly regretted feeding her. Why? Well the little kitten sparked up and almost took Liz’s finger off when she smelt the paste. I’ve never seen a kitten so psyched about nutrigel.
A few hours later, she was offered a slurry of Hill’s a/d (liquid high energy food) and she hawed into it. She instantaneously looked much livelier.
We crossed our fingers and toes and preyed the early feed won’t come back to haunt us.
The next 24 hours were quite critical and so she remained in the vet hospital.
I was scheduled to head to Sydney the next day but I made sure to call the clinic to get a progress report on the kitten. I was flabbergasted to hear she was full of life, eating well and even managed to pass a well formed stool. Never did I think I would stand and rejoice at being informed about the successful passing of a stinky kitten poo. Here are photos Jayde messaged me upon my incessant demand showing the huge surge of energy and miraculous recovery of this very stoic kitten. She was demanding to be fed :)
And finally, our nameless stray kitten was named ‘Cleo’ and picked up by her saviors and new loving owners.
A few days after being discharged, Liz called to check up on ‘Cleo’ and was informed she was doing really well. We are scheduled to see her this week and we are all super excited!!!!! I simply can’t wait to see her and cuddle her.
This case should inspire veterinarians to never lose hope. It never hurts to try and there is nothing worse than giving up too soon.This kitten defeated all the odds and managed to survive.
It definitely now makes me a firm believer that cats must have nine lives.
- Fetching a stick turns ugly… (rayyathevet.com)