A day at the vet takes you inside Dr. Kim Kendall's personal diary. As well as being a world leader in feline medicine, Kim is a full time feline veterinary practitioner.
Gotta fire up the computers and the coffee pot, and say hello to all the cats in boarding. We do not usually have cats stay overnight for medical or surgical reason. I do as much as possible on an outpatient basis for them.
The nurses have already cleaned the trays and fed the cats, and there are no nasty smells to irritate them or us - “all is quiet on the western front”.
By now, at least one cat and owner combo is arriving.
Our owners are pretty clued up about transporting their kitty friends and have the cats in carriers. I can recognise people by their cat and carrier combo. If you are unsure of how to make transporting your kitty stress free, read my article on cat travel anxiety.
There are usually a couple of consultations or cats needing operations that arrive early so I examine the cats and discuss the next stages of treatment with the owner.
Most cats I see are under a coordinated care plan, so I rarely see emergencies arise. In fact, ‘“going well” or “going as to plan” is what I aim for.
Last time I saw him he’d lost weight.
He was on a pretty strict diet and had one loose tooth which I removed, so we increased his calories and he gained weight, so all is well.
If he had not gained weight, we would have to delve deeper into his metabolic processes. Each appointment is 30 minutes so if I do need samples of blood or urine, I can do that immediately, without bringing him into hospital for the day.
The cats appreciate that, and owners prefer not to have to come back. I can do a lot of follow up by telephone which is just one of the ways we create an owner-friendly clinic. Read more about the importance of cat weight charts and checks by the cat vet.
Coffee by my side, and I'm ready to go. We have lots of geriatrics and ‘special needs’ cats boarding with us. In fact, that is our specific niche. So most are on medications and special diets.
It can be quite complex keeping all the routines straight, and the people who work with me are meticulous about getting the right thing to the right cat.
No special problems today, so I just say hi to each of the cats and get ready for the next consult.
Consultations may be done but there is one cat in for a major dental procedure today.
It is quite a young cat, only 4 years old, but already the periodontal ligament - the elastic sling around the tooth that allows it to move when eating - has deteriorated and the jaw bone is trying to patch things together by growing bone into the tooth.
This is periodontal osteitis and is irreversible. Most of the damage is microscopic, and all the back teeth will eventually be affected, so I just take them all out at the one time.
A day in hospital is not a cat’s favourite pastime, and since I know that repair is not possible, plus the other teeth will be in the same state soon, the best solution for the cat is a ‘caudal clearance’ - all the teeth behind the canines are removed - rather than just remove the visibly damaged or even the ones that show up damaged on dental xray.
Research on homeless people’s general health showed that if they had all their teeth taken out (become ‘edentulus’) then they spend less time in hospital. since a cat’s oral hygiene is about the same as a homeless persons, I figured I'd take the same approach.
It works. However, it is a big deal, and up to 90 minutes under anaesthetic, so the cat has to be in pretty good shape to do the procedure. There are rarely long term problems, though the first week can be a bit up-and-down. It is more like having 4 wisdom teeth out for us than anything like a routine dental trip for the kids. And there is always an anaesthetic risk.
I watch while the nurse washes a cat. I am finding that many cats are suffering from eczema - we call it atopy in cats and dogs.
The dust and pollen, moulds grease and diesel fumes get onto their coats and makes their skin itch. The more they lick, the worse it gets, and some cats can get quite sore throats from ingesting that stuff off themselves.
When I first saw a regular cat (as opposed to a show cat) being washed in a Texas Cat Hospital, I asked whether they were ever able to wash the same cat twice! they said yes - and you’d be surprised at how many cats enjoy their bath (after the first one where they just think you are nuts).
Must be like washing your hair after a week camping without water to wash in! We don’t blow dry them always - especially if the cat has a sore throat, licking clean water off themselves is very soothing.
There is usually paperwork and follow up phone calls to attend to, though the nurses, again, do most of the follow up. When there is the slightest doubt, I review the case and either contact the owner or clarify the question so the nurse can follow up again.
Often there are questions left over from clients who have visited the specialists or the emergency clinic. I like to review those and make sure everyone is on the same page.
After all, the cat can’t pipe up for themselves and these things can get complex!
Two out of three are rechecks, the third - a euthanasia. I know it is hard to bring a cat back to the clinic for a recheck, but there are some I just like to look over again, in case they are not going to plan...
The owner calls the shots - like what level of treatment they want for their pet.
Sometimes it is a financial problem to do a full investigation, but sometimes is is just an inability to manage a complex solution.
There are not many drugs around for cats, really, and most cats are a bit resistant to medication, so I try to customise a treatment that will help the cat and that will fit the owner’s budget and capabilities. It can be a bit of a juggling act, but I always put the cat’s comfort and health first.
If either the cat or the condition is impossible for that owner to manage or treat, then I view euthanasia as a considerate form of preventing suffering. You can’t get a perfect life, and sometimes, the bigger picture is brutal.
I remember watching a friend of mine who had terminal cancer, and there was lots of probing and testing. The doctors knew they couldn’t make a difference, but still they felt obliged to do things. What struck me was that, for all the sympathy in the world I could feel, my friend was the one suffering every minute till she died. It was a pivotal realisation.
Today, the cat had just run out of reserves. Kidneys and liver failing, lost a great deal of weight. Any time from now on was for the owner, not the cat, and I think they did the right thing. Everyone is different, and I accept that animals and people have individual karmic journeys. I am a lot less proscriptive than I used to be - not so much of ‘thou shalt’ as ‘may I help you and your cat this way ..’
Social skills I have had to learn one at a time, but the key is that I can only influence the welfare of any animal through an owner. I’d better listen to what they can and want to do.
The cat comes first though. I even had a client say (in a focus group) that they understood all the cats were Dr Kim’s and I just let them look after them!
Well, we were a foster home for 5,000 cats and kittens over the 20 years. There is a kernel of truth.
He was still a bit sedated from the anaesthetic, but well able to travel.
The pain relievers will last till morning, and by then the gums should have settled after all those extractions. The cats always look a bit Frankenstienish, but they recover very quickly, and I expect this one to eat a couple of hours after she gets home.
She would be unlikely to eat in here, so unless I am worried about the gums still bleeding or the cat being too sedated and falling over at home, I do send them back to be in their familiar environment.
I take every opportunity to catch up with paper work and research before a consultation. But it's back to work and this cat has cystitis, which is recognised now as a behavioural (mental) problem more than a medical one.
Much as I’d like to be able to ‘fix it with a pill’, I know it is going to need some complex medication as well as some environmental adjustment. Some cats are not particularly good at communicating in a crowded environment (usually other cats are the problem, but sometimes just a household disruption will tip the balance for a ‘worried’ cat), and get a bladder spasm as a result.
In males, this can result in a ‘blocked bladder’ which is a medical and surgical emergency. I like to keep owners informed enough to prevent the crisis escalating. The good news is that for females, while uncomfortable, it is not going to escalate to an emergency. We also have better medications to help them than we had years ago.
Last round to check all the boarders and make sure the ioniser is on. The triple ioniser cleans the air of the dust and pollen, as well as cat viruses. We see a lot less flu among the boarders since using it, and it keeps the smells - of excreta AND other cats down - so the cats are more relaxed.
8.00 pm Time to go home, lights out and lock up.