My patients, My life

It was seven days after Dusty, in part one of “A Tail of Two Kitties” allowed me to remove his sutures and assured me he was fine. As I walked to my lab Alison, my very understanding receptionist, snagged me like an arresting wire on an aircraft carrier to tell me that our county animal control officers were on the way over with a cat that was reportedly “shot”.  I paused and looked at her with the look that meant “more information please.”

Trust me, she knows that look, but seemed reluctant to offer more as I continued on my way to my microscope with a slide to study. I sat on my stool, inserted the slide onto the stage of the microscope, turned on the light and peered in, focusing the lens on the blood cells.

 Alison, still standing in the same spot behind me, started to speak but then paused.

“They said that it has an arrow sticking all the way through it,” not quite sure that she believed what she was saying.

“An arrow?”, I half asked, as that thought stumbled through my mind which was currently considering the contents of the slide. I immediately surmised that the cat was dead and that this was some sort of criminal investigation needing an opinion and not an actual medical crisis for the cat. Back to the slide went my focus.

She answered, “Yes, and the cat appears to be in a great deal of pain.”

Great composure for the situation he's in

Now, it doesn’t take a medical professional to understand that pain is one of those special senses reserved for the living.  I removed my slide and placed it in my “to be continued” pile. I turned off the microscope and turned about on my stool to make eye contact with my receptionist. She plainly had the “I’m not kidding” look on her face.

Without a word, Kathy, my faithful technician, made a ninety degree turn from her current undertaking and began to prepare for what was about to come through the door. She had just laid a towel on the treatment table when a commotion in the lobby was followed by a small contingent of animal control staff headed for the treatment room where we stood.

I stood in shocked disbelief at what I saw.  There, hunkered down on the towel, was a fully grown,  black and white kitty with the fletched end of an arrow shaft protruding from one side of his body and the other end of the arrow sticking about two inches outside the other side.

The room was stone silent. I searched for words. All of my questions were left without answers.  They basically knew nothing about how, why or who. In retrospect, it is better that way.  There are times when I am ashamed to be a member of the same species as the instigator of such a deed and this was shaping up to be one of those times. I sent them all on their way so Kathy and I could form a plan of action. I sat back down on my stool and stared in disbelief.

About six weeks have passed since the events that I am sharing transpired. Even the passage of so many days has not diminished my memory of the pain in my heart as I imagined what this young cat must be going through. That image and feeling persists with crystal clarity in my mind as I struggle to share this story.

Perhaps an accident I considered, but highly doubtful. Some kids being mean and malicious perhaps?  Maybe someone with an ax to grind with the neighbors cat I thought. Who knows? But the end result was sitting peacefully in front of me waiting patiently for the next card that fate was going to deal him.

 We began to offer some assistance to this pitiful creature.  We started an IV, gave him antibiotics and medication for pain, all the while working around this arrow protruding from both sides of his body.I must admit that I was a bit overwhelmed by it all. My voice was breaking and a tear was on my face as I apologized to this innocent creature. I cradled his head in my hands and finished my thoughts in silence as I swore to him that I would make him well again.  My anger and frustration began to focus with razor edge precision on my determination to fix this cat.  It did not matter to me if this was just another stray cat or the beloved pet of some sweet granny. I planned to do whatever I possibly could to get him out of this predicament. I made up my mind that when this ordeal was over, he was walking out and he was going without the god awful pain that he was currently enduring. To that end he owned every resource that I could muster. I left the treatment area and sat at my desk to work out an anesthetic and surgical scenario that would take me and this little no-name kitty to the place where I had just promised he would awaken.

His IV fluid pump purred with a quiet hum as I carefully escorted him into surgery. As I slowly injected the anesthetic into the IV line he nodded off to sleep. I placed the endotracheal tube down his windpipe and hooked him to the circuit of the anesthetic machine to maintain his anesthesia throughout the long surgery. Without delay we placed him on his back on the padded surgery table and tied him gently in that position. Kathy prepped him for the surgery which would start with a midline abdominal incision to assess the track of the arrow. Where we went from there depended on the damage that the arrow had caused. Based on the position of the arrow, I was extremely concerned for his kidney and liver.

 I scrubbed up with a bit of dread.  I still wore my game face however. This had somehow become very personal.

I incised a generous sized hole in his midline abdominal wall.  I anticipated the need for plenty of visualization of the damaged organs. With great care and apprehension I next retracted the wall of his abdomen and stared in.  Beginning at the point where the arrow had entered his abdomen I encountered his first giant portion of good luck. The arrow had passed between the back muscles and his left kidney.  Understand that, in a cat’s abdomen, no space exists where I just described.  The arrow had wedged its way between that kidney and the muscle above it by pushing the kidney down.  The kidney is attached by a large artery, vein, nerve and the ureter which drains urine to the bladder. All of these are arranged in a single bundle which was resting against the shaft of the arrow with no apparent damage!  The kidney was a little bruised where it rested on the arrow but I was amazed the he could have been so lucky. Score one for the kitty.

As it traversed his abdomen the arrow next struck the large fundic portion of the stomach and luckily pushed it aside rather than penetrating the stomach and contaminating his abdomen with bacteria and ingesta.  Score one more for the kitty.

Next, the arrow missed by a scant 5 mm, the huge vein that drains the entire abdomen and rear end of the animal. Instant death by bleeding was dodged by the width of a pencil. It then narrowly missed the pyloric portion of the stomach and the main bile duct from the liver.  That makes three.

It was about at this point that I began to relax. This cat was obviously bulletproof, or at least arrowproof. After rearranging his abdominal contents to allow a continued inspection of the arrow, matters began to get complicated.  After having made it three fourths of the way through his belly without significant damage the arrow tore into the left lobe of his liver before disappearing into his diaphragm and into his chest cavity. Things were beginning to get a bit dicey.

I made a decision to cut the arrow where I could see it best. I planned to extract both ends outward so I could minimize contamination of his abdomen. After I cut it, Kathy gently pulled the rear end of the arrow out the way it entered while I held his kidney to prevent trauma.  That went well and the kidney looked happy. I couldn’t relax until we got the other end of the arrow out.

I asked Kathy to pull the head end of the arrow out as I watched the liver for hemorrhage. I discovered that the liver had actually torn when the arrow first penetrated it, creating a hole larger than it appeared on initial inspection. As the arrow slid out I saw very little bleeding as the liver had already sealed the vessels torn by the arrow’s entry. I placed a suture in the hole in his diaphragm and with as much haste as I could muster began to close his abdomen.

In the back of my mind, I knew that the surgery had gone too well. I knew from his radiographs that the arrow had not caused his lung to collapse after entering his chest. But, with the arrow now gone, the hole it left in his chest wall could be a big problem.

As I closed his abdomen, the monitor indicated that his oxygen sats (the percentage of oxygen saturation in his blood – the closer to 100% the better) had started to fall. His breathing went from relaxed to forced. His right lungs had begun to collapse. Air was sucking into the hole left by the arrow.  Kathy pinched the hole closed and I rushed my closure so I could address our new problem. 

The kittys oxygen saturation was in the critical 70% range when I was finally able to place a chest drain and attempt to re-inflate the collapsed lung. We augmented his breathing with the anesthetic bag while I sucked air from his chest cavity.  After removing over 120 ml of air, the lung was completely inflated and holding. His sats were 88% and climbing; heart rate 144 bpm.

 It was over. I named him “Lucky” and he most certainly was.

“Game, set and match – we win! Let’s get him recovered”, I winked to Kathy.

A short time later I looked him over as he recovered on a heating pad. He was awake but groggy.  In private, I told him one more time that I was sorry for what had happened to him and I meant it as much as any words that I have ever spoken.

Lucky’s recovery was nothing short of amazing. I advised our friends at Animal Control that he would be easy to

Breakfast, the day after surgery

place in a foster or permanent home if we moved quickly. He was just another cat in most ways but he now had a very special story. He had that special story to make him stand apart as not just another stray cat. He had survived the unthinkable, the unbelievable and he did it all with the quiet dignity of a monk. Not one utter of complaint did he ever make. 

I have not seen him since the day he left. I hope that he is happy, healthy, well fed and most especially…safe. But my biggest wish for Lucky is that he never again suffers at the hands of a human.

Please give him a deserving home.

I just learned that Lucky is still in the custody of our local adoption agency, C.H.A.T. It grieves me that this cat, like so many others, is not worthy of a permanent home.  Hopefully, some kind soul who reads my words will be moved to lend a helping hand to this very deserving little feller.