One of the biggest magic tricks I have to perform is figuring out the real problem with someone’s ‘sick’ pet.
“Hello Doc,” the new client says as she walks in through the van door. Along with her is her husband in his fire chief jacket, and their petite and absolutely adorable Yorkshire terrier tucked underneath her arm. “Our yorkie, Bocelli , is vomiting, and we heard about you and thought you could take a quick look. Our other vet just gave us some pills and we thought maybe you could… you know… just check again.”
I sized up the family. The man was stoic and looked only vaguely interested. The woman was cheerful and confident. The dog was cute, alert and- WOW- emaciated. Hmmmm.
“How long has Bocelli been vomiting?”
“Only yesterday. After we changed his food.”
The obvious answer springs to my lips. “Maybe you need to go back to the original food.”
The couple nod in agreement, and continue to stare at me. Clearly, it is detective time. I take the dog from their hands and examine him. Boney, sunken abdomen, very tight belly, pale-pink gums…“So,” I ask casually as I cuddle the pile of bones covered in silky, well-brushed hair, “what else has been going on?”
“Oh, he has had diarrhea for awhile, and we think he has lost weight. He doesn’t eat that well- sometimes not at all. Oh, and he sometimes walks sideways. We’ve taken him to the vet several times, and the vet keeps giving us pills. He’s had several fecal and blood tests and the vet says they are all normal. This last time I called and the vet didn’t even want to check him again. He just sent a message through his receptionist to have us come and pick up some more pills.”
“How long is ‘awhile’?” I ask.
“About eight months.” A thin line of moisture springs into the woman’s eyes. She blinks quickly and stands straighter. The man is looking at me with a deceptively lazy stare, but I can tell he is listening intently.
I look back and forth between them. “Something is really wrong, isn’t it?” I ask them gently.
They both nod.
And so the relationship begins.
There are two parts to my job at this stage. One, finding out what is wrong with your pet, and two, finding out what is really wrong. In fact, there are two parts to my job at every stage- the medical aspect and the spiritual care. I believe they must go together, for one without the other is like a train without train tracks. Both are useless without the other.
Anytime I am faced with a case like this, I remind myself of a phrase I was taught by an amazing mentor at Cornell College of Veterinary Medicine. “Clients always lie.” They don’t mean to. The often don’t know they are doing it, but the fact is, they lie. They don’t know what is wrong. They misinterpret things. They forget to tell you the most important clue. They tell you things that have no bearing at all. Some even ‘know’ the answer because they read all about it on the Internet. So, my job is to wade through the words and ferret out the truth underneath the phrases, facial expressions, tales of personal tribulations, financial woes and hidden secrets and figure out what the problem and real problem is that I am dealt.
Bocelli came to be for a one-time episode of vomiting. His medical issue was undiagnosed hepatic encephalopathy and infiltrative inflammatory bowel disease, complicated with sudden onset pancreatitis and hypoglycemia. Through a beautiful friendship with his owners, I was able to diagnose and treat his multiple problems over a span of several weeks. I listened to the couple, came to their home and watched Bocelli walk in his ‘funny’ way, recommended and preformed advanced testing to decipher and treat his medical issues. I even drove my 24-foot fully equipped medical/surgical/laboratory van to their house the day after a blizzard to check on him when the owners called, worried that something seemed to be “off” but they weren’t sure they should bother me. We gained trust together as I nursed Bocelli to health once again in my home care hospital and sent the owner adorable text pics of his amazing recovery. And then Bocelli keeled over and died.
Now you tell me, what is the real problem?
I did everything right medically. I was a fantastic diagnostician. I was a thorough and comprehensive detective and I treated him caringly and completely. All of that would have meant nothing if I hadn’t taken the next step. I hugged and cried with his family. I sat in their home and talked with them about the final moments of Bocelli’s sweet life. I held the woman’s hand and squeezed her fingers, listened to her reminisce about Bocelli, the peppy puppy he had once been. I bowed my head and prayed with the family, prayed that they would find peace in their loss.
Bocelli and his family, like so many others, has a special place in my heart. Of course I wish he had lived, but ultimately, we can only do what we can and the final decision is not ours. Medically, I suspect he had an aneurysm; spiritually, I believe he was ready to move on. In the end, he did not suffer and he was well loved. In the end, the family felt vindicated that they weren’t crazy and over-reactive, and that they truly did know something very serious was wrong even though initial tests were normal. They know they did every thing they should have done, and did not just sit and watch him wither away with no answers. As the family veterinarian, I was privileged to be part of his final good-byes. His body may be gone, but his spiritual connection will endure.
That is was I was really meant to do.