Know when to call in specialist
I could see the problem the moment I entered the exam room, but, just for fun, I decided to wait until Mr. Obtuse pointed it out to me.
I didn't have to wait long.
"Look at this, Doc," he said. "I was petting Dakota yesterday and I found this lump."Now, normally, when a pet owner asks you to look at a lump they insist on getting their hands in the way and making it impossible for you to do your job. That didn't happen this time, though. The lump was too big to hide. Dakota had developed a growth the size of Mount Rushmore. (Not the whole thing, just Lincoln's head.)
"We're sure it wasn't there three days ago, Doctor," they said. "We are always grooming him and petting him, and he was fine on Tuesday."
Unfortunately, before I could complete my exam, we were interrupted by a knock on the door. I answered it immediately. You see, I operate on the theory that a knock on the door in the middle of an office call could mean that one of my staff is bringing me a jelly doughnut. True, this never actually happened, but I choose to cling to the hope.
In this particular instance, however, it was just one of my receptionists coming to announce that Mr. Putoff was on the phone.
"Doc, I have a problem with Old Gravid. She's real pregnant," he announced.
It was a typical Friday afternoon phone call. I could have predicted what was coming next. "I think she needs a caesarean, Doc. She has been in labor all day yesterday and today."
"There goes my chance of getting home on time," I thought to myself.
Then, in a futile effort to save a future Friday night, I tried to explain that the dog should be spayed during the surgery. She was 12 years old. Only one puppy survived from her last litter and she had two caesareans already. He wouldn't listen.
"No, I just want the pups out of her and that's all. I think I can get one more litter out of her," he argued.
I told him to bring her over and headed back to my office call where we proceeded to discuss the options for Dakota. There was no chance of a surgical cure, but there were other choices to consider.
Their next statement was quite predictable.
"You know, we can't afford to get involved with a lot of expense here."
Nonetheless, I went over our best two options. One was just to take a few pills to reduce pain and swelling until Dakota would have to be put to sleep. The other was to take X-rays, submit biopsies, consult an oncologist, and possibly proceed to chemotherapy.
They had an important question.
"Will the biopsies, X-rays and treatments cost more than the pain pills?"
I informed them that the aggressive approach was the more expensive of the two. Not surprisingly, they opted to do as little as possible.
We were interrupted by another knock. Sensing that this just might be the day, I jumped for the door only to be disappointed once again.
"Sorry to bother you, Dr. O," said a technician who was quite obviously not carrying a doughnut, "but Mr. Balming is here and he said he needs to talk to you.
M. Balming is our local taxidermist. He has been after me for years to get me to offer our clients taxidermy as an alternative to cremation when a pet dies.
"We have a whole new system that you'll be anxious to offer your patients," he announced with seemingly great pride. "We call it biological preservation. I brought in a new partner, Dee Hydrate, and we have a whole new technique. We changed the name of our company to Eternal Companion Memorials and we even have a great new motto, 'it's not your father's taxidermy.' Can I put up brochures in your office?"
I told him that I'd consider it for certain cases only and took a handful of brochures to keep on hand.
A minute later, I was back in the exam room, ready to develop a plan of action for Dakota who was essentially more tumor than cat. Several predictable questions came my way.
"Doctor, is there a university or research institute that might want to fix Dakota for free so they could learn how this happened so fast in just two days? Or would you be interested in doing experimental surgery for your own knowledge?"
I was not able to give them any encouraging answers. However, the questions continued.
"Doctor, this big lump looks so ugly that we can hardly stand to look at it. Besides, it hurts so much that the poor guy can hardly walk. Isn't there a specialist who can keep Dakota looking and feeling better?"
Luckily, I knew a specialist who could, and in fact, I had some of his brochures handy.