Dandelions in a meadow outside Thunder Bay, ON

Dandelions in a meadow outside Thunder Bay, ON

Saturday, March 19, 2011

Brachial plexus injury, and a big spot of doubt.

Last Saturday I had the honour of meeting a young marmalade cat who'd been hit by a car and found his way home a couple of days later (judging by the dried blood on his chin and the degree of dehydration). He had a broken lower jaw, a broken upper canine tooth (fang), and an injury of the front leg that made it impossible for him to use it. A fracture would have been much better, medically speaking. But this cat had a brachial plexus avulsion (torn or badly stretched nerves that run through the armpit to the front leg) which happens when the arm is suddenly and violently thrown sideways. With this injury there is almost no hope of meaningful recovery. In the best case scenario, the animal 1. is a dog, 2. has a calm and patient temperament, and 3. has undamaged nerves running from the back to the muscles above the elbow. Then they may learn to throw their leg forward to unfold the wrist onto the ground. If they are not so fortunate, the wrist buckles under and is dragged along, making it necessary to amputate the leg. Either way, they are unable to actively move the wrist and position the foot. This cat had two major disadvantages going against him: his injury was bad, making amputation necessary, and he was an inveterate outdoor cat.

I explained the injuries to the owners and said that physically the cat would recover just fine after a leg amputation - he was a robust young cat with the will to live, and ate a whole plate of food after the painkillers had kicked in. (He would also have needed dental surgery to remove the root of the broken fang and to wire the lower jaw together.) I told them that he would have to be an indoor cat for the rest of his life, as it is not safe to let a three-legged cat outdoors - he can neither run fast enough nor climb to get out of harm's way. Then I asked the owner about this cat's day - what he does, what he likes to do. The answer I got told me he was a dedicated outdoorsman, and would probably be miserable if confined. Unless he was frightened off the outdoors by his experience. My broaching of the subject, and asking the owner about his lifestyle, may have sealed his fate. Because an hour later, after we'd given the owners a financial estimate of the surgeries and hospital stay, they called back to tell us they'd made the decision to euthanize.

The things I've learned since starting in this career are the tip of the iceberg of what I want to know and be able to do. Yet one thing that came naturally (and perhaps too easily, given other veterinarians' typical reaction to the issue) was reluctance - or inability - to judge most people for life-and-death decisions relating to their animals. Of the things we do, passing judgment has to be one of the most exhausting procedures. I know this from the times when I was unable to resist. I'm actually quite easily annoyed by people, but this is different from feeling morally indignant at their choices. In this case, I did not feel the cat was being done a gross injustice. I needed to know his lifestyle, and I needed to tell the owners that the only safe life for a three-legged cat would be an indoor one. The God complex that afflicts many veterinarians made me feel responsible for the owners' decision - even now I can't help thinking the cat might still be alive if I hadn't stressed indoor lifestyle or if I'd been more forceful with the possibility that he might not even want to go outside from now on. Alive and recovering from a major surgery to see if his new life was livable to him as a cat as opposed to feline patient. He spent his last hours free of pain, ate a hearty meal, and dozed off slowly as the barbiturate I injected into his belly took effect. Then the receptionist told us that she got a vibe from the owner when he first brought the cat in that morning - he would not go ahead with any involved procedures. She has enough experience with people for this to be believable. And enough kindness to say things that would make us feel better. I still think I may have swayed their decision, but it must have been ready to be swayed.

5 comments:

  1. About a year ago we adopted a cat that our Vet had saved. He had been dropped off at her clinic by 2 men. He was in pretty rough shape. It took two months of care including multiple surgeries to get him back on his feet. The last surgery was a leg amputation. She named him Simon. Once home with us we did our best to get him used to staying inside but he would have none of it and let us know. After two weeks I finally relented and let him outside. We live in a rural area and I know it is better to keep a cat indoors. Simon runs like the wind, climbs trees, catches moles and digs holes like he was looking for gold. He loves being outside. But he loves being inside with us too, sleeping on our bed at night. He is not allowed out all night and is fine with that. He has the best of both worlds.

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  2. Thanks for sharing your story, Elizabeth. Which leg is Simon missing? How long did it take him to re-learn to climb?
    Cats will indeed do as they please :-)

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  3. He is missing his left front leg. He was jumping up to counter height one week post amputation. It was about 3 months post amputation that we noticed he was making runs at the trees and jumping at them.. It was a funny sight at first but he quickly learned to get up that tree. Coming down was actually harder for him and we had to get him down a few times that first few months but no longer.

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  4. Charming and hilarious! :-) How fortunate that you were there to help him and he was safe from the cars in the streets.

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  5. Sadly the injuries to Simon were inflicted by humans (and I use that term loosely). Even with all he has been through he still trusts people.. Last week he got to visit the Vet that saved him for a routine dental and while she was very happy to see him he was less than thrilled with the experience :)
    Thank you for all you do for the Simon's of the world!

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