Ongoing care easier with calm patients

In last week’s column, I introduced Sherman, a cat who did fine in the doctor’s office as a youngster, but later became frightened and reactive/ aggressive. This turned into a big problem when he got truly sick.

His folks had thought that cats needed little, if any, medical care. It’s a common mistake.

Sherman had lost his appetite and significant weight. A thorough exam and blood and urine tests would be essential to an accurate diagnosis, but any kind of restraint had historically caused him to panic and fight. Cats who struggle, especially those who are already sick, are at risk of sudden death.

I prescribed a safe antianxiety medication, called gabapentin, at a generous enough dose that Sherman would be relaxed and a bit sedated. A couple of hours later on my exam table, he didn’t have a care in the world. With his folks close by, I removed the top half of his carrier and then covered Sherman’s head with a towel. Touching him gently and speaking quietly, I conducted an exam.

Sherman’s kidneys palpated smaller than normal. He was 11 years old, raising the statistical risk of kidney failure. With our patient’s newly cooperative mindset, we also went ahead with x-rays and an ultrasound evaluation.

The diagnostic process proved valuable, but sobering. Sherman had stage 3 kidney failure. This was not a minor problem, but the prognosis was good with consistent at-home treatment and follow-up monitoring. Oral medication to control Sherman’s blood pressure, a special kidney-sparing diet and daily at-home fluid injections bought him several more good years.

We cared for Sherman, but I’ve always wondered how much more life he could have enjoyed had he gotten routine annual evaluations.

Sherman’s folks loved him intensely. They certainly would have brought him in for annual exams but for that one serious scare in a veterinary clinic. Cats are masters of “one-event learning.” Had this boy lived to be 30, his terror in this context would never fade.

Now veterinarians and their staffs can get training in Fear Free handling of cats and dogs. I’ll explain more about how we set scared pets up for long and healthy lives next week.