VetInfo Digest    March 1999 

This issue

Abbreviations and Acronyms Used in Veterinary Medicine
When Should You Just Do Nothing?
New Stuff:
Medications -- From Your Pharmacy or From Your Vet?
Quick Differentials
What Dental Disorder Do 48% of Cats Have?
Baggy
 

Abbreviations and Acronyms Used in Veterinary Medicine

We encourage our clients to ask for copies of their pet's medical records when they are traveling or seeking a second opinion. Sometimes when this happens we have to explain the abbreviations that we have used on the record. Other times, clients read articles or check our site on the Internet and find abbreviations or acronyms that they don't recognize. The following lists may help you if you try to read your pet's medical record or research health concerns about your pet in magazines or on the Internet.

abd = abdomen

ADR = "ain't doing right" (used to describe ill pets whose owners can't describe specific symptoms)

AAFCO = Association of American Feed Control Officials

ARF = acute renal failure

 

BAR = bright, alert & responsive

BARH = above + hydrated

BID = twice a day

CHF = congestive heart failure

CC = chief complaint

CRF = chronic renal failure

 

DCM = dilated cardiomyopathy

DJD = degenerative joint disease

DSH = domestic short hair (cat)

DLH = domestic long hair (cat)

DDX = differential diagnoses

 

EVC = emergency veterinary clinic

 

FDA = Food and Drug Administration

GDV = gastric dilitation and volvulus (bloat)

HBC = Hit by car HBT= hit by truck

H/L = heart and lungs

HR = heart rate

Hx = history

 

LN = lymph node LNs= lymph nodes

LDDS = low dose dexamethasone suppression test

LSA = lymphosarcoma (lymphoma)

LVT = licensed veterinary technician

 

MI = mitral insufficiency (not to be confused with myocardial infarction, which MI is used for in humans)

MR = mitral regurgitation

 

NAF = no abnormal findings

NPO = nothing per os (nothing orally)

NSA= normal sinus arrhythmia (heartbeat)

NSF = no significant findings

NVL = no visible lesions

 

PCV = packed cell volume

PDH = pituitary dependent hyperadrenocorticism

PE = physical examination

PO = per os (give orally)

PRN = as needed

Px = prognosis

 

QID = four times a day

 

RDVM = referring veterinarian / regular vet

R/O = rule out

Rx = prescription

 

SIBO = small intestinal bacterial overgrowth

SID = once a day

Sx = surgery

 

TID = three times a day

TP = total protein

Tx = treatment

 

USDA = United States Department of Agriculture

UTI = urinary tract infection

URI = upper respiratory infection

V/D = vomiting and diarrhea

WNL = within normal limits
 

When Should You Just Do Nothing?

Most pet owners come to the vet with the expectation that their pet's problem will be diagnosed and an appropriate treatment prescribed. It is difficult for veterinarians to resist the urge to provide some type of treatment for pets who come to the office. If a veterinarian provides treatment and the pet does not improve the perception exists that the client will be less upset than if treatment is withheld. Sometimes, though, doing nothing is the best treatment. If your vet suggests doing nothing, or suggests minimal treatment, there is probably a good reason.

There are many conditions for which the currently available treatments are minimally effective. One example is vomiting. While there are medications that have label claims for control of vomiting, none of them work really well. The best treatment for vomiting, in most cases, is simply to stop feeding a pet and to give water or an oral rehydration solution in small quantities at one time but to try not to restrict the total amount of water available to the pet. An easy way to restrict the amount of water a pet drinks at one time is to put ice cubes in the water bowl instead of water. As it melts, small amounts of water are available to the pet. Vomiting that is severe or lasts more than 24 hours may require intravenous or subcutaneous fluid therapy, so keep your vet informed of your pet's progress.

The most effective medications for controlling itching are corticosteroids, such as prednisone. Some dogs will respond to therapy for itching using antihistamines such as clemastine (Tavist Tm) or diphenhydramine (Benedryl Tm) but most will not. When a pet is itchy, but not damaging its skin and not responsive to antihistamines, it may be better to do nothing than to use prednisone. The corticosteroids have a number of side effects, including increased thirst, increased urination, weight gain, water retention and decreased immune function. They should not be withheld when it is clear that their use will stop self-trauma or when a pet is miserable but they should be used judiciously. Sometimes it is better to live with minor itchiness in pets than to use powerful medications to stop the itch.

With a hundred miles or so of beaches strewn with oyster shells and the occasional shard of glass, we commonly see cut foot pads. For several years I carefully sutured these foot pads, following the directions in surgical books and from surgical seminars as carefully as possible. Most of the time the sutures were gone in a few days and the foot pad was opened up again. Sometimes we would try to suture the foot pad again. Sometimes we just let them heal. After a while, it became obvious that both sets of patients were experiencing full recovery and there wasn't all that much difference in the time it was taking. So we decided not to suture foot pads unless the wound extended into the surrounding skin or split the pad completely in two. A lot of clients are skeptical of this advice at first but usually they are happy after the pad heals. If your vet thinks that a footpad is best left unsutured, it is reasonable to follow this advice. There are other times when doing surgery may not be a good idea, even though it seems like it should be. When your vet tells you that leaving a wound alone is best, there is a good chance your vet is right.

We see a lot of cats who are sneezing and have slightly runny eyes. Usually these are cats who had upper respiratory infections as kittens and then have recurrent bouts of slight upper respiratory disease. There is a strong temptation in these cases to use oral antibiotics when relapses occur or to use antibiotic or antibiotic/cortisone combination eye drops. The most common cause of this problem is rhinotracheitis virus infection (feline herpes virus). Like most viral illnesses, antibiotics are not very helpful unless a secondary infection is present. We send a lot of cats home with instructions to watch them for signs of secondary illness such as inappetance, lethargy or worsening of respiratory signs. If your vet suggests this course for a cat with upper respiratory signs he or she isn't ignoring your worries. It is just best not to treat some conditions.

When your vet suggests doing less than you think is necessary, ask questions. If your vet explains the decision in a logical manner think the situation over. It really is better not to do anything -- or at least to do less, sometimes.

 
 

Heartworm Season is Approaching

Heartworms are carried by mosquitoes. During the seasons in which mosquitoes and warm weather occur simultaneously, transmission of heartworms from an infected dog to your dog or cat is possible. This time period varies from region to region, so be sure that you know the recommendation for the best times to give heartworm prevention in your area.

We still have clients who use daily heartworm preventative medications, despite the fact that we are firmly convinced that the monthly preventatives are better. Staying with a product that is working well is understandable but to give you some idea of the advantage of using the monthly medications, consider these points:

1) Daily heartworm preventatives may not work if a single pill is missed. Monthly heartworm preventatives work for at least 45 days. Forgetting to give the pill on the proper day is less likely to cause problems with monthly heartworm pills.

2) Ivermectin based monthly heartworm medications (Heartgard Rx) can actually be used to "cover" a missed month, simply by giving them on time for at least several months after a pill is missed.

3) The monthly heartworm medications are safe. They kill the heartworms the dog or cat was exposed to in the month preceding administration of the pill, so they are not time released or retained in the body for a month.

Recently, new research into the way heartworms are spread has led to a theory on when to give heartworm prevention medications that may be confusing. The research suggests that the length of time a heartworm must develop in the mosquito is dependent on the temperature the mosquito is exposed to. In warm temperatures, baby heartworms develop into infective larvae in mosquitoes in just a few days. In colder temperatures it may take weeks or months for the juvenile heartworm to make the change. With this information in mind, it is possible to predict when it is necessary to give heartworm prevention medications. For most areas of the country, the recommended time of administration is less than one year. Despite this, a number of veterinarians recommend giving monthly heartworm prevention medications all year. There are three good reasons to do this even though the medication may not be necessary every month if it is given properly during the months heartworm transmission is possible.

1) It is easy to miss a heartworm pill. If this happens, there is research that suggests that giving the pills on a regular schedule for at least one year afterwards will prevent any heartworms acquired during the lapse from developing.

2) Heartgard (Rx) and Interceptor (Rx) also kill intestinal worms. Sentinel (Rx) kills intestinal worms and prevents flea infestation. These benefits may be important even when it is not necessary to give heartworm preventative.

3) The last point has more to do with people's habits than with medical needs. We have noticed that clients that stop heartworm prevention medications often forget to start again. It is simply easier to give the pills each month all year than to stop and start again. Our practice area requires heartworm prevention be used for 8 months of the year, so giving it all year does not seem too excessive. That is not the case in all areas where heartworm disease is a problem, so this argument is not as valid in places where the pills only need to be given for 6 months or less.

Cats get heartworms, too. In areas in which heartworms are common it is best to put cats on heartworm prevention medications. At present, Heartgard (Tm) is the only preventative approved for cats. When cats are infected with heartworms the damage to their lungs is usually more severe than is typical in dogs and cats may start coughing very early in heartworm disease. In addition, cats are more likely to die within the first year to eighteen months of infection. Approximately 50% of cats die once they are infected with heartworms during this period. There is not a safe and effective treatment for heartworms in cats at this time but heartworms do not live long in cats and infections are often resolved within eighteen months. If a cat tests positive for heartworms it is usually advisable to put them on heartworm preventative medications to keep them from acquiring more heartworms while the ones they have age and die. Some universities are trying surgical removal of heartworms in cats as a method of treatment but at present this is still considered to be experimental surgery.

Heartworms are a preventable disease. Keep your pet from getting them.
 

New Stuff:

Meriel has introduced a new line of rabies vaccinations (Purevax Rx) made with recombinant gene technology. This makes it possible for the vaccines to work without needing adjuvents, which should theoretically reduce the risk of vaccine associated sarcoma (cancer). At present these vaccines are only approved for one year use. They may be used in eight week old kittens, which is a month earlier than other rabies vaccines.

If your pet needs a medical alert tag, Save-A-Pet, P.O. Box 912, Chesire, CT 06410 makes them. They make them for several medical conditions, including diabetes, allergies, anesthestic sensitivity, seizure disorders and others.
 
 

Medications -- From Your Pharmacy or From Your Vet?

Veterinary clients are used to having their pet examined, a diagnosis made and then purchasing the medications their pet needs all at the same place. This has been the model that veterinary practice was built on in the U.S. Receiving a prescription for a medication to be purchased elsewhere has been unusual prior to the last few years. It is increasingly common for veterinary clients to ask for, or be given, a prescription to purchase medications from a pharmacy. Is this a good thing?

The number of pharmaceutical agents available has increased tremendously over the last twenty years. It is increasing difficult for a veterinary hospital to stock all of the medications that may be useful for all of the conditions that affect dogs and cats. Some medications that are approved for use in humans are valuable in the treatment of pets but hard for the veterinary hospital to acquire, even if they want to. There is a growing tendency to rely on pharmacies to supply the medications that veterinarians can not easily obtain through their suppliers and medications that may be costly to keep on hand for a small number of patients. Many veterinarians who are reluctant to keep the records necessary to stock and dispense controlled substances rely on prescriptions for those medications as well. Veterinary clients sometimes are surprised when they are given a prescription instead of a bottle of pills, but it is a growing trend.

Sometimes clients are the reason for a prescription. In a cost-concious world people often shop around for the lowest price on many things. Pharmaceuticals are no exception. There are mail-order pharmacies that will supply medications to pet owners. If a veterinarian's prescription is necessary in order to utilize these services it is necessary to get one from your veterinarian. In many states it is illegal for a veterinarian to refuse to write a prescription for a medication as long as there is a doctor/client/patient relationship and prudent medical examinations, such as heartworm checks, are current. I think that mail order pharmacies will eventually lead to increases in the prices of services in veterinary practices that offset any savings from buying through them but that doesn't appear to diminish their current popularity among some veterinary clients. It is illogical to think that adding a third person to a transaction will make it less expensive, overall, but it does save some money right now on the prescription price if that is the major consideration.

The last reason that veterinarians and clients alike sometimes favor a prescription over receiving a medication at the vet's is convenience. Sometimes it is easier to have your vet call in a prescription to the pharmacy next to where you work than to make a special trip to the vet's. In addition, compounding pharmacies can produce medications in formulations that allow for easier administration. A very small cat or dog may need a medication in quantities such as one-sixth of a pill or may need a liquid medication for ease of administration when only a tablet is made. Some eye medications have to be formulated from injectable or oral forms of the medication because an approved version of the eye drop just doesn't exist. In these situations, a prescription from your vet to a compounding pharmacist can literally be a life-saver. Due to the pressure of big pharmaceutical chains on small independent pharmacies there is an increase in interest among pharmacists in compounding. It is very likely that you can find a compounding pharmacy near your home. If you are struggling to give a medication that must be given chronically, it may be worth asking your vet about a prescription to have it compounded into a tasty gel or liquid. It isn't always possible but it can be very helpful at times.

The mail order pharmaceutical companies and big pet store chains are currently fighting for a bigger piece of the veterinary pharmaceutical market. It is likely that this trend will continue because there is the perception among clients that money can be saved. In the short term, this is actually true. Veterinarians have traditionally used the mark-up of pharmaceuticals to fund a large part of their operating expenses. The high mark-ups associated with some medications made it inevitable that someone would step in and compete on price. For a few more years, there will be a competition between veterinarians and pharmacists (or veterinarians who own mail-order veterinary pharmaceutical companies). Mail order pharmacies will always be able to advertise a cheaper price. Veterinarians will accept this and just make their income from services provided instead of a mix of services and pharmaceuticals. The consumer will pay more, overall. While I am not sure that is the best for all concerned, I am pretty sure it is what will happen.
 

Quick Differentials

If your vet thinks that your pet has allergic skin disease but it isn't responding well to treatment, what else could be wrong?

Parasites - Demodectic mange (cats and dogs), sarcoptic mange (dogs), notoedric mange (cats), cheyletiella mange (dogs and cats), lice and fleas. Do not underestimate the potential damage done by fleas -- in any pet with skin disease use a good flea control product on a regular basis. Skin scrapings are the best way to identify most of the mange mites, but direct examination of dandruff (or "scotch tape"testing) works best for cheyletiella mites.

Bacterial, fungal and yeast skin infections --- while these often occur as secondary problems when allergies are present, either one can be a primary cause of skin itchiness all by itself. Ringworm in cats can also be confused with allergic skin disease sometimes.

Immune mediated skin disease -- discoid lupus and phemphigus can be confused with allergic skin disease in some cases. Discoid lupus causes skin irritation around the nose most of the time and phemphigus may affect the face, feet, ears or any area in which normal haired skin meets a specialized skin such as the nasal planum or eyelids.

Allergic skin disease can be hard to treat, whether it is due to food allergy, atopy (inhaled allergy), flea allergy or contact allergies. It is a good idea to eliminate all the other possible diseases when skin is not responding well to treatment, though. How do you know if this was done? Think back over your pet's case. Were skin scrapings done for mites? Did your vet examine the dander on the haircoat for cheyletiella mites? Was a ringworm culture done on cats? Was an antibiotic used for at least three weeks if bacterial skin disease was present? Did impression smears or skin biopsies show yeast infection?. In the case of sarcoptic mange the best approach to diagnosis is often just to treat for the mite. It can be very hard to find on skin scrapings.

If your vet took all these steps and then confirmed atopy, flea allergy or atopy with specific testing it may be necessary to do some or all of the testing again. Just because your pet didn't have these problems a year ago doesn't mean one of them hasn't cropped up since!
 

What Dental Disorder Do 48% of Cats Have?

If you have two cats, chances are good that one of them has odontoclastic resorption lesions affecting one or more teeth. This problem was previously referred to as "neck lesions" or feline erosive neck lesions. Like many conditions with long names, this one is usually shortened -- currently to the acronym FORL, for feline odontoclastic resorption lesions.

FORL is a disorder in which the enamel of the tooth erodes away, eventually leading to exposure of the nerve and loss of the tooth. Many cats lose teeth mysteriously and this is probably the leading cause of those loses. The tooth is weakened and stress on it will cause it to fracture. The lesions tend to occur right at or just below the gumline so the tooth fractures at this point. The remaining root may be reabsorbed completely or may in some cases lead to periodontal disease.

At the present time the cause for feline odontoclastic resorption lesions is not known. There is a definite connection to feline immunodeficiency virus (FIV). Cats with FIV are about twice as likely to have FORLs than cats that do not have FIV. In addition, there seems to be a correlation between low magnesium diets and odontoclastic lesions, although the importance of this is not known for certain at this time, since wild cats do have odontoclastic lesions, although at a lower rate than domestic cats.

A recent study (Lund, et al, Feb. 1998 Journal of the American Veterinary Medical Association) found odontoclastic lesions in 48% of cats studied at random during anesthetic procedures. Other studies have found these lesions at lower rates but they are undeniably common in cats. Despite this, most cat owners are probably unaware of this disorder.

There are two reasons why veterinarians do not routinely diagnose FORLs in cats. The first is that they can be hard to find without intra-oral X-rays. Most veterinary hospitals are not equipped with dental X-ray machines, dental film and dental film processors. Dental X-rays need to be taken under anesthesia in pets because it is hard to talk a cat into holding a bite wing film between its teeth while an X-ray is taken. The second reason that vets don't look for these lesions more vigorously is that the currently advocated treatment for odontoclastic lesions is removal of the tooth and its entire root. It is hard to remove a tooth with an odontoclastic lesion and get the entire root because the damaged tooth root is very prone to fracturing. Finding the little pieces of the root can be very difficult. In some cases the root caused enough reaction that it has become part of the bone (anklyosed).

Treatment for FORLs is somewhat controversial right now. Some vets feel that it is acceptable to simply remove the part of the tooth above the gumline and leave the small root fragments that remain. Other veterinarians (including most dental specialists) feel that this approach is unacceptable. Dental specialists usually advise removal of teeth affected with odontoclastic lesions. The majority of veterinarians in general practice probably just leave these teeth alone, which specialists virtually unanimously believe to be unacceptable. Dental fillings do not work for FORLs because the tooth continues to erode and the filling falls out.

When cats have odontoclastic lesions they react to stimulation of the tooth just like they do to a fractured tooth with nerve exposure. There is almost no question that these lesions are painful, at least until the time the tooth fractures. Removal of affected teeth is almost certainly the best course of action. This has to be done carefully and is often more expensive than removing teeth for other reasons, due to the difficulties in dealing with damaged tooth roots. It does involve anesthetizing the cat. Often, cats with FORLs in one tooth will develop the problem in other teeth later. It is a frustrating situation but if you have ever had one of the nerves in your teeth get exposed due to cavities or tooth fracture then you can imagine how your cat feels.

Examination of the teeth should be part of the yearly exam for cats. When feline odontoclastic resorptive lesions are found, the teeth should be removed if there is any evidence of pain when the lesion is stimulated with a dental explorer or Q-tip. If not, it is harder to figure out what to do, since there is significant cost and slight anesthetic risk in removing the teeth. Realistically, it is hard to argue that almost all of these lesions have to hurt. Veterinarians and pet owners may both wish to avoid dealing with this problem but cats probably feel much better when these teeth are removed.
 
 

Baggy

When I started in practice, I thought that allowing a cat to roam around the clinic was an antiquated practice that really didn't have a place in "modern" medicine. I was not about to adopt a cat and keep him or her in the clinic on purpose. I worried about the cat carrying disease, about the cat getting hurt, about the cat hurting another pet or even a human. There was just no way that a cat should be allowed in a veterinary clinic.

I really do like cats. My dog at the time, Jessie, was not much of a fan, though. She was a doberman cross. Whenever a cat crossed her path she would chase it with a fury that left no doubt about her intention to kill it when she caught it. We always walked Jessie on a leash or kept her in our yard, which was well fenced in.

When we bought the house and building that our clinic is housed in the property had been unused for about two years. The previous owner had a chain saw repair store and lived in the house adjacent to it on the property. We saw this as a good place to raise children while starting and maintaining a veterinary practice despite the fact that the weeds in the yard were four or five feet tall and there were several windows in both the house and the old chain saw repair store that were broken. Everyone assured us the property would look a lot more promising after we cut the yard and cleaned up the buildings.

After we cut the lawn and cleared the trees from around the buildings we discovered that we had invaded the territory of a large yellow male cat. He didn't seem pleased. At first, he just hung around the edge of the property, where the weeds were still high and the woods instantly available to disappear in. He jumped up on the window ledges at night and seemed to be looking for the way into the house that he had previously enjoyed.

We did not try to feed him. I knew that there was just no way that Jessie was going to accept a cat in the house and it was a lot of work to keep her from attacking him outside. We had to walk her on a leash at all times. After several months of this, we had a good chain link fence put up in the yard. Thinking that the cat would have to be smart enough to avoid dogs if it had lived this long, I put Jessie in the fence and started back inside.

Almost immediately, I heard the war cry bark of my dog and the unmistakable screech of an angry cat. I turned and started running back to the fence, hoping to save the cat. I was too late. Jessie was heading full speed for the cat. He wasn't moving an inch. I knew that she was going to get to him long before I could get to her. I kept running, anyway.

I am not sure where the yellow cat had learned to fight but he was incredibly good at it. When Jessie got within a foot or so of him he leapt at her and latched onto her neck. She had too much momentum to stop suddenly so she took several steps with the cat attached to her neck, unable to bite him because he was under her chin. His rear claws were firmly dug into her shoulders. His right front foot was stuck firmly to her cheek. His left front foot was exploring the right side of her face. She stopped in confusion. His paw found what it was looking for -- her eyelids. He tore at the right eyelid and lacerated it severely. Then his left hand claws sunk into her cheek and his right paw started exploring her face. It too found an eyelid and there was another deep laceration. Jessie started to howl but now it wasn't anger, it was more like fear. The cat was smart enough not to let go and had his claws stuck in an upper eyelid now, pulling it out several inches from Jessie's face. Now I was intent on saving my dog instead of the yellow intruder.

I grabbed Jessie and as soon as I had a firm grip on her collar the cat let go and took off. I examined Jessie and decided that I was going to have to suture at least one of the lids. I took her into the building we were remodeling into a veterinary clinic and she became its first surgical patient. Fortunately, her eyes were OK. Just the lids were damaged.

I wasn't sure what was going to happen the next time the dog and cat met. I was sure that the cat was not going to let the dog displace him, though. So we started to feed him. He wasn't willing to eat if we stood around and watched but he was perfectly willing to come in the morning and night to see if food was available. After several days we tried leaving Jessie in the yard again. I was really surprised to see the cat jump back in the yard but this time just walk calmly over to Jessie and sit a few feet away. Jessie just ignored him. This pattern repeated itself daily. The cat made sure she knew he wasn't frightened and wasn't leaving. It was his yard. Jessie seemed to accept the situation.

We kept remodeling and we kept feeding the cat. We decided he needed a name. He was certainly a tiger. So we named him Bagheera. But we called him Baggy. He disappeared at night and hung around the yard all day. He wasn't too interested in being touched but he did like being fed. Eventually, as male cats often do, he suffered a severe abscess. He was sick enough to let us pick him up and take him into the clinic for repair. Since it was necessary to anesthetize him to open and drain the abscess we neutered him at the same time. We also kept him in a cage for a week or so to be sure he would get antibiotics. For a cat living on his own, he took this very calmly. He even seemed to appreciate having his ears scratched.

We let him go after a week He reverted to his old self, disappearing at night and hanging out all day. We finished the clinic. People started to drift in and out all day. Baggy just sat and watched. He didn't attack any dogs and he didn't hiss at the other cats from his vantage spot in the tree next to the clinic. I was happy with the arrangement.

Baggy gradually became more and more friendly. He decided he could tolerate sleeping on the porch at night even though we were just inside the house. Even though he was neutered he didn't give up on fighting with any cat with the temerity to attempt to invade his property. For some reason he seemed to understand that it was OK for cats to be carried from cars into the clinic but he wouldn't tolerate any cat attempting to cross the property under any other circumstance. He pretty much kept the same rules for dogs but he was a little more tolerant of them.

Then he got another major abscess. We had to take him into the clinic for another week of therapy. This time, he decided it was an addition to his territory. I was worried.

Baggy became a fixture in the clinic. Every day he would wander in with one of the early appointments. He took up residence on the receptionist's counter. Most days he spent the whole day there, leaving with one of the last patients at the end of the day. Many clients would suddenly exclaim "He's REAL," when he would stretch or yawn after a long nap. He never gave up on defending his outside territory but he was incredibly good in the clinic. At least in the waiting room.

Baggy never attacked another cat in the clinic. In the waiting room he remained totally aloof and never even acknowledged that the other cats existed. He never once made an aggressive move towards a client or a child in the clinic. He seemed to have a real fondness for children and he would let them grab him without the slightest protest. He was so calm that dogs usually ignored him and he did not fear the ones that did show an interest enough to run or do anything to incite them. We did sometimes remove him from the room to quiet things down when a dog got excited, though. Why he was such a gentleman in the waiting room was always hard to understand after watching him respond to any outside cat.

In our back room, Baggy was sometimes a problem. We did try to keep him out of the hospital proper. This made him really want to check it out. He would sometimes make his way through the exam room into the room with our hospital cages. He was terrible when he made it there. He would sit just at the edge of a patient's vision through the cage door and then lean in and out, causing them to get very excited. He seemed to love teasing our patients and we usually had to push him out the door to get things calmed down. When a really excitable patient was in the clinic it would be an all day game to keep him out of the back room.

Since we had invaded his territory and since he had a real sense of when he could and couldn't get away with being difficult, we didn't try to keep Baggy out of the clinic. Only once in the fifteen years he had free rein of the clinic did he cause any trouble. Out of the blue one day he got off the reception counter, slowly walked over to a boxer and whapped him across the face. No one seemed to know what the poor dog had done to incite the attack and fortunately, he seemed to have kept his claws sheathed. We apologized and gave the boxer a free exam and treatment that day but we still had to promise to keep Baggy out of the clinic whenever the boxer returned in order to soothe the owners.

I never really got comfortable with the idea of a clinic cat and we haven't let any other cats, even Baggy's arch nemesis, Gracie, become clinic cats. I just don't know if there will ever be another cat quite like Baggy. He really seemed to understand what he could and couldn't do in the clinic, all by himself. With the exception of the one boxer, of course.

Thanks for Your Support!
TierCom, Inc.
P.O. Box 476
Cobbs Creek, VA 23035
Copyright 1999 - Michael Richards, DVM and Michal Justis, web designer.
 

Remember -- you may contact Michal about web site issues at vetinfo@vetinfo.com. To ask Dr. Richards a question, use mervet@inna.net. To see back issues of the VetInfo Digest go to www.tiercom.com/subscriber.