Dixie came in on the first day we were open after Christmas. She was normally a very lively little Cairn terrier - lively even by the peppy standards of the breed - but that day she was quiet. Normally she would run up to me and cock her head with that so, are you giving me a treat? facial expression if I went anywhere near the treat jar, but that day she just lay by Mrs Pawluk's feet and did not look up at me at all. Mrs Pawluk was a widow and none of her children lived in Winnipeg anymore. Apparently she had some friends who she played poker with every Friday night, but otherwise Dixie was by far her best friend and closest companion. She had had a succession of Cairns over the years, but she told me more than once that Dixie was the best of the lot. She often wore sweaters with pictures of Cairns on them. She had a new red one on that day sporting a large tartan applique Cairn.
"So, Dixie's not looking too well today. When did this start?" I asked.
"The day before yesterday, on Christmas Day, she did not want to eat, not even her favourite treat. I thought maybe she just ate too much on Christmas Eve so I didn't really worry, but yesterday it was the same thing." Mrs Pawluk had Parkinson's and her hands were shaking as it was always worse when she was anxious.
"Ok. Has she vomited at all?"
"No, but she does this." Mrs Pawluk mimed a dog opening its mouth open wide, as if to yawn, while stretching her neck out. "There's no sound at first and then a little gag at the end. Do you think something could be stuck in her throat doctor?"
"It's not likely, but it's possible. Did you feed her anything unusual on Christmas Eve?"
I know that a few of my colleagues read this blog and that most of them will immediately recognize my error. Perhaps they're even sticking their arms in the air and saying "oh, oh, oh" like Horshack on Welcome Back Kotter when he knows the answer to a question. In my defense I will remind them that this was a very long time ago and assure them that I definitely learned from my mistake. But back to Dixie.
I was about to ask a few more questions when Dixie stood up and retched a couple times in very much the fashion that Mrs Pawluk described, although the sound at the end was louder, wetter and more violent than I expected. I picked her up and put her on the exam table. Her lungs sounded clear and her belly felt soft and empty, but she had a slight fever. The only other abnormality was that by palpating her windpipe I could get her to cough a little. To allay Mrs Pawluk's worry about something being stuck I opened Dixie's mouth and looked in as far as I could, which was not very far. I put her back on the floor and then sat down on my stool to deliver the verdict.
"I'm pretty sure Dixie has a form of kennel cough. It's unusual for them to go off their food with this, but she has a bit of a fever too so she may have some bacterial complications. It will clear up with time and antibiotics."
"Thank you doctor, I'm so relieved it's nothing more serious!"
Cue ominous music.
I saw Dixie again four days later on New Year's Eve. She still hadn't eaten and she had become increasingly depressed, hardly moving at all now. Mrs Pawluk would have come in sooner, but the weekend had intervened and she wanted to wait for me rather than go to the emergency clinic. Now I was worried too. This was obviously not kennel cough, or any other sort of respiratory infection. We ran blood and took x-rays. One of the nurses grabbed me and said, "Philipp, come and look at this x-ray. There's something weird in there."
Indeed there was. In Dixie's chest, slightly ahead of and above the heart, was a very dense, irregularly shaped object, perhaps half an inch across. It was a piece of bone and it was lodged deep in her esophagus, the tube that leads from the mouth to the stomach. Mrs Pawluk had been right, sort of. Certainly more right than me.
As we were closing for New Year's, and in any case are not set up to provide the overnight care she needed, we transferred Dixie to the emergency clinic. I don't think enough of you are interested in the gory medical details to warrant a complete telling, so I'll summarize what happened next by saying that they ultimately decided to try to remove the bone with a scope. They got the bone, but unfortunately they found a large tear in the lining of the esophagus that could not be repaired. Poor Dixie struggled along for another couple of days, but it was hopeless and Mrs Pawluk had to make the heartbreaking decision to let her go.
A week or two later Mrs Pawluk came in with a thank-you card, that I was not sure I deserved, and to talk. I felt terrible that I had missed the diagnosis initially and she felt terrible that she had fed Dixie pork ribs as a treat. She said that Dixie got rib bones regularly. It was her usual treat for special occasions. She never had a problem before. She had told the truth when I had asked her whether she had given Dixie anything unusual to eat.
Before she left she handed me a small object wrapped in brown paper. It was the bone. I put it in a jar and set it up on the shelf in room two, beside the giant stone that had filled Guido the tiny Pomeranian's entire bladder, and beside the rogue's gallery of pickled parasites. Dixie's bone was there to remind me that I should always ask, "Could she have eaten anything other than dog food?" rather that "Did you feed her something unusual?" It was also there to remind me to tell people that Charles Schultz, bless his soul, did the dog owning public a grave disservice by depicting Snoopy powering through a stack of bones like they were Pringles. But then Snoopy is clearly a magical dog. When your dog starts fighting the Red Barron and decorating Christmas trees we can talk about feeding him bones. Until then, know this: bones can be so dangerous, especially pork and poultry.
To be honest, the bone in the jar was kind of gross, so I understand why it's gone. And I remember these things anyway.
p.s.
Some of you reading this will protest that the dog you had growing up on the farm ate nothing but bones and lived to be 103. Or something like that. This was likely the same dog who never saw a vet, not even once in his unnaturally long life, and the same dog who ran twenty miles through a blizzard to get help when grandpa got his arm stuck in the snowblower. All I can say to you is that I guess they don't make dogs like they used to.
p.p.s.
A small but measurable percentage of you will now have the Welcome Back Kotter theme looping through your brain for the next two days. No, there's really no need to thank me.
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