And then what happened?


One of the fun parts of writing my column is naming the animals. For hypothetical cases, I might choose something silly. Sweetie Pie, the diabetic cat. Polly Dipsia, the dog who drinks excessive water. When reporting about actual pets, I use pseudonyms to protect the privacy of the owners. Dogs don’t seem to care much. Cats like to read about themselves in the paper, but they know my pseudonym choice is irrelevant as it is never their true “deep and inscrutable singular name.”

Sometimes I go obvious. Tom, the cat, becomes Dick or Harry. The dog Grover becomes Elmo. Sometimes I take a more circuitous route. Leopold becomes Kinshasa. (Know your African history?) Charlotte becomes Currer. (Check out pen names of the Bronte sisters.)

When I write about patients, it is often in the midst of caring for them. Researching the latest helps me keep current medically while simultaneously gathering information for the column. The upshot, however, is that I often don’t know how things are going to turn out when we go to press. A gentleman recently left me a message inquiring about the outcome of one story. “What happened to Thunderbolt? Please call back.”

I was happy to reply, but being a pseudonym, I had no idea who Thunderbolt was or what problem he had. I racked my brain. I checked my old articles about thunderstorms. I thought about dogs named Zeus or Thor. I searched my data base for various terms. I finally gave up. I couldn’t remember. Here at the office we have computerized reminders for follow-up calls. I plug in data when a pet goes home, and later my staff calls owners and gets updates. You don’t have that option, so today here are progress reports about some cases you may have read about in these pages.

Isaac, the overweight golden retriever who went acutely blind soon after starting weight loss medication was diagnosed by MRI with immune-mediated meningitis of unknown cause. The neurologist does not think it was related to the diet medication, though we opted not to use it again with him. He has been on corticosteroids for a year. His vision returned quickly, though when we first tried to lower his cortisone dose he relapsed slightly until we bumped it back up. He’s doing great now, though still plump, and we are very, very slowly weaning down his medication.

Tunny, the border collie cross with autoimmune hemolytic anemia received multiple blood transfusions and other treatment at the specialists but then had to come home a little before the doctors would have liked. He’s doing well on a variety of long-term immunosuppressants as well as medications to protect his gastrointestinal tract from side effects and anticoagulants to lower the risk of blood clots. I was a little concerned about how long it has been taking for

his blood counts to normalize. In my 30 years of practice, all the AIHA cases I have seen either got completely better or passed away by this point, but I check in with the specialists regularly and they reassure me everything is on track.

Don Quixote, the big lab with neck pain who was collapsing and virtually unable to walk, had an MRI that revealed a large lesion in his spine. At first we thought it might be cancer, but it turned out to be a ruptured disc that was removed surgically. Don is dancing around now almost as though nothing ever happened.

Sylvester, the diabetic Maine coon cat, had less definitive results. The special diet did not get his blood sugar under control. Before starting insulin, we decided to send him to the neurologist, who noticed abnormalities in his front legs as well as his hind. She is concerned he may have a primary problem with his muscles or nerves, unrelated to his diabetes, but recommended regulating his blood sugar with insulin first. If he doesn’t improve, the next steps may be MRI, muscle biopsies, or other specialized tests to evaluate his neuromuscular function.

Piglet was the cat with the recurrent urinary tract blockage who needed the penile amputation surgery called a perineal urethrostomy. Surgery went well, after which, on the advice of some specialists, I stopped his antibiotics. Big mistake. Piglet’s kidney failure worsened dramatically soon thereafter. We obtained a urine sample, and cultured a nasty bacteria that turned out to be susceptible to only a very limited number of antibiotics. I prescribed one available at the local human pharmacy. His owners gave it to him faithfully, as well as daily subcutaneous fluids at home. The renal failure turned out to be completely the result of bacterial pyelonephritis, i.e., a kidney infection, which resolved with a month of treatment. He has gained two pounds, his kidney function is normal, and he’s peeing beautifully. It’s funny the things that make me happy.

Maya, the rottie who I was afraid might have the uterine infection called pyometra that is life-threatening without emergency surgery, happily survived to bark another day with just oral antibiotics. But her problem is likely to recur with each heat so her owner is thinking about having her spayed despite her senior age.

Blanche, the cat with feline infectious anemia, and Coal, the kitten with anaplasmosis, both recovered completely with antibiotics, though sadly Coal passed away from other causes. Zev was the cockapoo with the cardiac problem called AV block. The cardiologists suggested a pacemaker, but Zev was not a young dog, so his owner decided to just enjoy whatever time he had left. We had hoped he might live for many months, but he passed away peacefully in his sleep soon after his diagnosis.

I’ve scanned back through years of articles to glean these follow-ups. Still haven’t found Thunderbolt. And now I’ve misplaced the message slip with the caller’s name and number. Perhaps it will come to me, suddenly, like a bolt of lightening. Or maybe you will call and remind me. Please. I promise to report how things turned out.