Friday, March 4, 2011

Two types of everything...

Grey hair falling over her lovely (hazel)eyes...curvaceous figure..she watched me come close and made a step backwards as I reached out a hand to stroke her back.
This is Kenza, 13 yrs old female "Griffon" upon her first visit in January (and not, as you thought, some hot chick playing shy with Dr Sam!)Owner brought her for a "fourth" opinion after being told that she had cancer and was terminal. Kenza had been spayed 6 years ago and the next year she was having vaginal bleeding again and since then has been with vaginal discharges of various colour and "consistency". Owner has been around, been prescribed numerous antibiotics, antihaemorraghics, hormonal suppressors and last vet told him that there was no hope..that she had to be euthanised.

First thing I noted was that she was smelling bad...and that she was having brown vaginal discharges.So straight to some "between-legs" inspection and gosh that was gross! Full blown abscess on upper aspect of vulva...packed with...wriggling maggots! 1 hr of anaesthesia and fun maggot-fishing later she went home with a medicated gauze drain. It took several wet to dry debriding sessions to get that wound clean and healed. Was happy to hear that she was doing ok and eating etc...until last week Mr Ramos called for an appointment - Kenza was again bleeding per vagina!
Okay...clouds of doubt in my head now...Have I missed something? Did my sutures block her urinary meatus and now she is having a bladder infection? Could it be that she is having an "ascending" infection that moved from vagina to bladder?Bladder Stones? I saw her last week with my head full of biased "convictions"...and guess what? I did palpate a 5 x 5 mass in her abdomen..roughly where bladder lies! See....Dr Sam knew it! It is a bladder infection!!Some Citrosoda,Fluoroquinolones and antiinflammatories would do the trick. Except that Kenza came back on Wednesday in worse situation and with more evidenced by the matted fur in her genital area! Pfffff!

"Ok! Mr Ramos! I am going in!" I heard myself say! Poor owner...he was distressed when he came but the thought of having her old 13yr old friend go through anaeasthesia and a major surgery was not appealing at all.
I made him understand that the point of going inside is to actually see what was going on and if I could fix it. If, on the other hand I cannot do anything, we would at least know and take a decision on whether to prolong her sufferings or put an end to all this.
It was with a slightly shaking hand that I drove the anaeasthesia needle into her vein and later opened her abdomen...You know that feeling when you are hypnotised by something evil? Torn between fear and curiosity? Well...that entangled mass staring at me from under her bladder made me feel like that! Under the bladder of a female there can only be one thing...the uterus...but Kenza was spayed and a uterus could not look that big and round!At this point of time, Mr Ramos, who must have seen the sweat dribbling down my forehead, was pacing around, all nervous and panicked.
"Ooookayyy! Mr Ramos, we are in control here...we got it...we know what it is" I said to calm him down...but geeeeez this mass was hard to have a hold on in all this mess! I tried to detach but in vain!I kept talking to the owner whilst I tried to locate the cervical part of what I had now identified as a uterine stump. Finally made it after some 30 minutes; ligated and excised the mass. You know us vets!!! I had to cut it open! loool! And yes it was full of bloody purulent foul smelling material! The stench!!! All that I needed in a closed poorly ventilated surgery area! Hahaha!
So Dr X, did not remove all the uterus 6 years ago and left enough inside to be a "party zone" for bacteria! She's been with a practically chronic metritis that could have killed her!

Whilst talking to Mr Ramos throughout all this episode, I confirmed a few things to myself; There are 2 types of vets:
The ones who are very comfortably ensconsed on their pedestal; who enjoy crushing you into submission and don't you dare come challenge their diagnosis, as they are always right. These are the ones who prescribe pills and give shots ad the secret hope that one of them will work.
And there are the ones who think about the case with you and empowers you to be a good "nurse" at home; taking time to explain because he knows that the rest of the 23 hrs 30 mins of the day the animal is going to be in your care. They are the ones to take straightforward decisions with the owner and be frank and sincere about the feasibility of things.

Kenza has seen them all...and I was so glad to receive a text from Mr Ramos today asking me if she can be on solid food already...because she is making a big fuss with her bowl...asking for food!!

Kenza the Warrior!


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