Monday, September 16, 2019

George



Another big orange cat. But this time not quite as big and this time a tabby, not a lion. George was one of my favourite patients and Mrs. Mackintosh was one of my favourite clients. This was many years ago, not long after I started in practice, and Mrs. Mackintosh was one of the first clients who began asking to see me specifically. My one boss had been there for over thirty years and his clientele was extremely loyal. My other boss was the first fulltime female veterinarian in the practice and she had rapidly built a following based on her more modern approach, and based on the fact that some animals are less fearful around a gentle woman than a boisterous man. Not that all women are gentle or that all men are boisterous, but that was the situation then at Birchwood. In any case, even though I was kept busy, it was not easy to attract regular clients and I was immensely pleased by the vote of confidence that Mrs. Mackintosh gave me.
            Mrs. Mackintosh was an elderly lady with a soft Scottish accent and a seemingly limitless supply of cat themed sweaters. I suspected that she had been a war bride, but in those days, I felt compelled to employ a rather narrowly defined version of professionalism and it didn’t occur to me to ask any personal questions. George was a young male orange tabby. Mrs. Mackintosh explained that he had been named George after her father. Give her age, I reasoned that George Mackintosh Senior must have been born in the 19th century back in Scotland. I smiled at the thought of how he would have reacted to know that a cat in Canada a hundred years later would be named after him.
            Orange tabbies tend to be big and they tend to be friendly. George was both, in spades. He was an enormous teddy-bear of love. Examining him was a challenge because he constantly wanted to head-butt my hand or rub against my arm, and he purred so loudly I swear the table shook from it. I loved this cat. He was perhaps the first patient I really bonded with. Consequently, it was with special concern that I listened to Mrs. Mackintosh describe his symptoms to me on the phone one grey November day.
            “The wee fellow hasn’t eaten a thing in two days! Not even his favourite – tuna from the can.”
            George was hardly a ‘wee fellow’, but I let that slide as the tone of her voice was very serious and concerned.
            “How is his drinking and urination?”
            “Terrible doctor. He’s not doing any of either.”
            “And this started suddenly two days ago? Or had you noticed any changes before?’
            “No, very sudden. What shall I do doctor?”
            “Please bring George this afternoon if you are able. We’ll probably need to run some tests. I’ll transfer you to the front desk to set up a specific time.”
            “Yes, I’ll come as soon as they let me.”

            George still purred, but he did not have the energy to head-butt or rub up against my arm. He was dehydrated and his breath was very foul. It smelled like a nasty men's urinal. I had a sinking feeling.
            “Ok, we’re going to run some blood. I’m worried about his kidneys. We’ll hook him up on intravenous fluids while we wait for the results.”
            “Please do whatever you need to do doctor.”
            The test results confirmed my suspicion. His kidneys were in appalling condition. He had something called anuric acute renal failure. This means that his kidneys had suddenly shut down and had done so so severely that they no longer were able to make urine at all. This might not surprise some readers as people often assume that a lack of urine production is a common sign of kidney failure, but in fact, it is almost always the opposite. Usually, as kidneys fail, they actually produce more urine because their ability to concentrate the urine and conserve water for the body is impaired. It is only in the very last stage that they stop making urine. Why this would happen to George, who was only five years old, baffled me. I explained this to Mrs. Mackintosh.
            “Is there anything we can do for him? Is there anything at all?” She was a tough lady, but her eyes were red, and her voice was quavering.
            “Yes, let’s keep him on the IV for 48 hours and see if we can kick start the kidneys. And let’s do a few more tests and try to find the cause.”
            I don’t know how good she was at picking up on body language, but I know that I did not really believe what I just said. I could not face telling her the truth that there was no hope and that finding the cause would not actually be helpful. George needed a kidney transplant, and that was just not possible. Certainly not in Winnipeg in the early 1990s. After saying this I talked myself into thinking that maybe there was just the slenderest hope of recovery. Maybe the tests had been wrong.
            The tests were not wrong. George stayed in hospital on aggressive IV for the two days. He purred whenever Mrs. Mackintosh visited him and whenever I handled him for examination or treatment, but he looked so sad otherwise. This was not the George we knew and he was becoming less so by the hour. By the second day, I had my answer. He had been poisoned by anti-freeze. Often, we can see the characteristic crystals anti-freeze produces on the urine test, but for some reason these were absent in the particular sample or had been missed. Instead we saw on x-ray that his kidneys had essentially turned to solid stone. There was truly no hope and he was suffering. He died peacefully in Mrs. Mackintosh’s arms as I infused an overdose of barbiturate into the IV line. We both cried.
            We never did find out whether the poisoning was deliberate or accidental. George did like to roam to the neighbours, but everybody loved him. Mrs. Mackintosh preferred to assume that it was accidental. Anti-freeze is sweet and is irresistible to cats and dogs.
            Two weeks later Mrs. Mackintosh was back in the clinic. She had a kitten with her. It was an orange one again, but this time a female. She called it Anne, after her mother.

3 comments:

  1. What a beautiful relationship. George passed with great dignity. Thank you for sharing your experience and this story. I wish Mrs. Mackintosh and Anne the absolute best.

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