Today was very interesting. An eccentric client came in with two male cats that were scheduled for neuters. This client is known for footing the bill for many people and has 20+ animals on his account. I brought the cats back and it was immediately apparent that they smelled of urine. They were put into the back kennel area to save our noses.
The first cat was brought to the treatment room and I induced and he was masked down for the neuter. At Sardis the DVMs do the neuters and they use the "Hemostat" technique. This is where the doctor cuts into the tunic and separates the gubernaculum from the testicle. Next they take both the vas deferens and the blood vessel with the hemostat, cuts off the testicle and ties both off with one throw. Once the doctor ensures the knot is tight enough he releases the vessel and lets it retract back into the scrotum.
The other cat was brought out and Jocelyn noticed some blood on his kennel liner. She went to set the cat on the exam table and he started to urinate but, the urine was free of blood. After we cleaned up I noticed blood on one of his paws. I had a closer look, one of his claws was missing and the toe was full of pus. Dr. Tugui looked at his other toes and there were 3 other claws on other feet in the same condition. He said we would treat them once the neuter was complete. I once again induced and the cat was masked down. The doctor performed the neuter. He then clipped the hair from the toes missing claws and he cleaned the tissues with H2O2. Dr. Tugui also asked Jocelyn to calculate a depo-cillin dose and injected it before the cat woke up.
Cosmo, the handsome yellow lab that came in the week before for rads of his swollen carpus was in today. He had a bone biopsy to confirm Dr. Powell's diagnosis of osteosarcoma. Cosmo was put under GA and Dr. Powell used an 18g needle to take the biopsies. He made 4 slides to send off to Idexx.
After my lunch break I went to check on our patients when I noticed some clotted blood in the kennel of our first neuter. Dr. Tugui happened to be in the back and he asked me to bring the cat out of the kennel. The cat's whole hind end was bloody and there was more blood in his kennel. Dr. Tugui had a look at the cat's neuter site and asked Dr. Powell to have a look. Dr. Powell suggested there may be an open vessel in the tunic or the scrotum. Jocelyn and I masked the cat down again and Dr. Tugui gathered instruments and gloved up. Dr. Tugui explored the neuter site and found that the knot he made to remove the left testicle was not tight enough. He used suture material to tie off the vessels in two different spots and released it back into the scrotum. I cleaned the cat's hind end and I put him back into his cleaned kennel to recover.
Of course Sardis' neuter protocol is different from that of TRU's. I know that there are many different ways to get the same result. What I don't know is whether something like this happens more often using the "hemostat" technique or not. I think three throws are better than just one.
Our last patient of the day was a cat coming in because the owner noticed a change in his behavior. The owner warned Dr. Tugui that the cat may bite and Dr. Tugui asked Jocelyn to accompany him into the exam room. The cat turned out to be very fractious and had to be brought back to the treatment room. The only way we were going to get blood and urine from this cat was to sedate it. It was obvious there was no way he would be masked down. The doctor drew up torb and dormitor. He managed to inject it IM into the back end of this cat and as he was doing that the cat started to urinate. We collected the urine off the table before cleaning up. The cat was still very fractious after a few minutes so Dr. Tugui gave another dose of torb and dormitor but, as he was injecting the cat got loose from Jocelyn's grip and shot off the table. She asked me to grab a fishing net from the back and I came out to the treatment room with it. I caught the cat in the net and drug him into radiology where it was dark and quiet. The fishing net is my 3rd practice tip. The worked very well in this situation. I continued to restrain the cat in the net and he seemed to get a little sedate. We pulled him up onto the table and masked him down. We pulled blood while he was under and I clipped his nails. I also assisted Dr. Tugui with taking rads of the cat's abdomen which apparently showed nothing. We had the cat recover from the anesthetic in a carrier and the owner took him home in it. We did the blood in house and there was nothing abnormal other than a neutrophilia probably caused by stress.
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