by Laurie Hess
“Mommy?”
I turned around to find five-year-old Brett standing in his pajamas, wearing an astonished expression.
“Why is there a dinosaur in the garage?”
“This is Hugo,” I said. “He’s a snapping turtle who was in an accident, but Mommy put him back together again.”
His eyes widened further. “Can I bring him to school for show and tell?”
Hugo spent one night in a safe and secure plastic tub filled with a few inches of water inside our garage. I rigged up a heat lamp to ensure that he would be warm enough overnight and also to allow his skin to soak up some ultraviolet light, necessary for turtles and tortoises to make enough vitamin D to enable them to absorb calcium from their food. Brett accompanied me to check on Hugo several times before I declared it “bedtime” for both little boys and turtles.
The next morning I drove Hugo to Katonah and turned him over to a seasoned team of reptile rehabilitators for rest and rehab. After several months, the hardware was removed from Hugo’s face and shell, and he was returned to the Central Park Turtle Pond. His recovery was even celebrated in the New York Post. The headline read, “Prehistoric Central Park Turtle Rescued and Repaired!”
I hadn’t thought about Hugo for years, but now the memory filled me with renewed strength to open my eyes and face the day. Mathilda’s death had been devastating, and the thought of Marnie leaving filled me with a dreaded sense of finality. We’d been there for each other through the births of our kids and the deaths of pets and relatives. We’d supported each other unquestioningly for over a decade. What would I do without her? Over the years I’ve consoled countless pet owners who’ve lost their closest and most cherished companions. In the heart of their grief, many have told me that their years with their pets outweighed their suffering now. I knew this was true, having loved and lost pets of my own. The risk of developing deep bonds that may one day be stretched, compromised, or even broken is worth the hurt and the pain. I took a deep breath and sat up in bed. I’ll get through this. I’ll put myself back together again. Just like Hugo. Piece by piece.
And anyway, Marnie was only going to LA.
I threw on my favorite yoga pants and a T-shirt and plodded downstairs. After a bowl of chicken noodle soup and a cup of green tea, I gave in and took a cold tablet. The recommended dose is two, but I usually take the child’s dosage of one on account of my small size. Peter likes to tease me about that, and I always make the point, “Hey, this way the bottle lasts us twice as long.”
I positioned myself at the kitchen table and opened my laptop. A stack of unopened mail was waiting for me, mostly more disgruntled protests in response to my statements online. I groaned. Just wait until news of Mathilda’s death gets out, I thought, and then I recoiled at the thought of the same TV reporter from the Johnson Valley Mall showing up at my hospital for an interview. What would I tell him? How long could I continue to defend Sugar Buddies? How many more of Simon’s gliders would fall sick before I identified the source of illness? I was praying for a miracle when my hospital cell phone rang. It was Marnie.
“Why aren’t you here? Are you okay?” She sounded both frustrated and concerned.
“I’m not avoiding you, if that’s what you’re wondering. I overslept, and I’m not feeling so hot, but I’m on my way.”
“Well, you better get in here. Quickly. I think we may finally have a break in the case.”
“What? How?” I quickened and suddenly revived.
“An Amazon parrot arrived at the hospital about an hour ago. He’s thirty-five years old, and his owner brought him in weak and shaking. I initially thought he was suffering from gout, as we see so often in older birds, so Colette and I ran an in-hospital blood test to check his kidneys. Since he also has dark red urine”—the telltale sign of lead poisoning in parrots—“we decided to check his lead level too.”
We often have to test and treat parrots for lead toxicity, as they have a habit of chewing on anything they can sink their beaks into.
“And?”
“The lead reading came back high.”
I wasn’t following. “What does any of this have to do with the sick gliders?”
“Laurie, the symptoms the Amazon is exhibiting are exactly the same as what we’ve seen in the gliders—weakness, tremors and shaking, dehydration, decreased appetite, inability to climb.”
Lead poisoning? Could it be that lead was the cause of all the glider deaths? I took a moment and turned this over in my mind. The signs and symptoms of the sick gliders were in fact similar to those we see in birds with lead toxicity. But lead poisoning doesn’t spread from animal to animal, and Simon’s gliders were sick all over the country. At what point would all of the sick gliders have been exposed to toxic lead? I still couldn’t connect the dots. Where was the lead coming from?
As I considered this, I asked Marnie, “Any ideas how the Amazon parrot was exposed?”
“His owner thinks it may have been from an old metal bell in his cage. Possibly lead in the paint. The bell’s been in the cage for years, he said, but the bird never bothered with it until about two weeks ago when the Amazon took a sudden interest, and his owner says he’s been chewing on it night and day. You should see it. The parrot’s scraped all the outer coating off the outside of the bell, and the clapper is nearly gone.”
Lead poisoning from the metal bell was entirely plausible. Some of the older metal toys, especially those manufactured overseas, contain toxic lead in the paint and sometimes in the metal itself, which can slowly chip off or leach out if an animal repeatedly chews on it. My mind flipped back to the sick gliders. When would any of Simon’s young gliders have been exposed to old metal toys? Most all of the new pet toys on the market are lead-free and also BPA-, PVC-, and phthalate-free. The pet toy aisle in PetSmart or Petco these days looks similar to the newborn section in Babies“R”Us. Nearly everything is marked with a safety sticker. Still, I couldn’t dispute the connection Marnie had made—there was no denying their shared symptoms. All of the gliders I’d lost had exhibited similar signs to the hundreds of birds I’d treated for lead toxicity over the course of my career. Although a very low level of lead in the blood is generally not harmful, when the lead concentration reaches a critical threshold, the metal can start to interfere with organ function and can cause anemia, weakness, and ultimately death.
“I’ll be there in ten minutes.” I threw on my jacket and practically ran out the door.
ON THE DRIVE to the hospital I recalled the last time I’d treated an Amazon parrot for lead poisoning. It was 11:30 p.m. on a Sunday night, and my phone went off. It was a text message from the answering service: “Mrs. Hurvitz in Peekskill, NY, calling about her 26-year-old Amazon parrot, Morris. Please call ASAP.” I dialed her number and heard a frantic woman at the other end crying. “Dr. Hess, Dr. Hess . . . it’s Morris. He got his foot stuck in the metal chain of a toy hanging in his cage when I was out, and I came home to find him dangling by his toes. He must have been hanging there for hours trying to free himself, because I found him upside down, having chewed one of his toes off. He also seems to have bitten off parts of the metal chain. I freed him from the toy, but he has lost a lot of blood.”
“I’ll meet you at the hospital in fifteen minutes,” I said.
As I zoomed into the parking lot, I spotted Debra Hurvitz already standing outside the hospital waiting for me. I unlocked the door, disarmed the alarm, and showed her immediately into an exam room. I took Morris, a big green-and-yellow Amazon parrot, out of his carrier. Indeed, he had a bloody stump where one of his toes should have been. It was no longer actively bleeding, but Morris was pale and lethargic. Normally, he was an active and noisy bird, often squawking and flapping his wings as I examined him.
Morris had been a patient of mine for years, and I loved seeing Debra as we always had something in common to chat about. The last time I had seen the pair, about a year before, Debra had shared with me her excitement that she’d finally left the
corporate world in New York City to follow her dream of opening her own ice cream store in a nearby town in my area of upstate New York. I’d just read an article in the local paper about how successful her artisan ice creamery had become.
I cleaned and bandaged Morris’s mangled toe as Debra attempted to hold him steady for me. I administered a painkiller and an antibiotic injection, as well as a shot of iron and some fluids underneath his skin. I told Debra that he would be okay and to keep him quiet in his cage overnight and come back in Monday morning. Debra hugged me profusely and promised to be on my doorstep first thing in the morning. Sure enough, like clockwork, she was there at the stroke of 9 a.m., as Marnie and I simultaneously pulled into the parking lot to open the hospital for the day.
I was delighted to see that Morris’s color had returned and he was back to his usual squawky self. He’d chewed a little on his bandage, but his toe was still covered, and the inside of his mouth was no longer pale. Debra pulled an old, rusty, chipped metal chain from her purse. “I forgot to show you this last night,” she commented.
I examined the chain: all the links were intact, but Morris had chewed through the outer coating on the metal, likely as he tried to free his toes from the toy.
“Wow, he must have been really frustrated,” I responded, turning the chain over in my hand. “I’m a little concerned, based on the age of this toy and the amount Morris chewed, that he may have ingested lead or zinc. I think we should test him for these metals.”
Marnie and I took blood from Morris and loaded it into the lead machine in our lab. A few minutes later, out came the report: high. We immediately started treatment with an injectable metal chelation medication, and I gave Debra the oral version to administer to Morris at home.
Debra replaced all of the old toys in his cage with new, lead-free toys and brought Morris back for a follow-up measurement of his lead level a week later. That time, the reading came back normal. Before leaving the hospital, she presented Marnie and me with an insulated cooler bag containing three pints of homemade ice cream—Birdie Banana, Pineapple Parrot, and Raspberry Rabbit, the fruity flavors in her store named for the types of pets she kept. To this day, this thank-you gesture stands out as one of the more delicious gifts I’ve ever received.
11:12 A.M., ANIMAL HOSPITAL
I THREW OPEN the hospital doors and made a beeline through the waiting room. I greeted Colette with a rushed “Morning.”
“Good morning,” she said, looking me up and down. “Did you run here?”
“Huh?” I looked down and realized that in my mad dash to leave the house, I’d forgotten to change out of my Athleta wear and Nike sneakers. Instead of stopping to explain, I said, “Sure.” Sometimes the best answer is the simplest one, even if it’s not necessarily the truth.
I found Marnie in the emergency care area treating the lead-poisoned Amazon parrot with calcium EDTA injections while simultaneously trying to run a blood test on Lily.
“Just in time,” she said. “Colette’s been busy up at the front desk, and I need help restraining Lily so I can get a blood sample from her leg. I tried to do it alone, but I’m just not that coordinated, and I don’t want to make her any more uncomfortable than she already is.”
Without a specific blood test, it’s impossible to confirm the presence of lead in the body, let alone lead poisoning. I hadn’t ordered the test or performed anything other than a broad blood panel on any of the sick gliders because I’d never once treated, or ever even heard of, an instance of a sugar glider being poisoned with the neurotoxic metal. The routine blood count and chemistry tests I had performed on each animal had revealed mild anemia and slight elevation in kidney function values, which are consistent with the presence of lead, but those irregularities can also be attributed to any number of diseases. The possibility that the sugar gliders were suffering from lead poisoning never entered my mind.
I cradled Lily’s tiny, frail body in a towel on the treatment table as Marnie extended her back leg to identify the hairlike vein that ran just above her ankle. She dabbed Lily’s leg with an alcohol-soaked cotton ball to make the vein more visible, and as I held pressure on her leg above the vein to make it stand up, Marnie gently inserted the almost invisibly thin 33-gauge needle—the kind I use to administer insulin to myself—into the vein. We needed just a drop or two of blood to check for lead; in fact, that’s often all we can get from our small patients. Marnie got the sample, and we whisked it to our lab and loaded it into the lead analyzer.
Blood lead levels are measured on analyzers that detect the concentration of lead in the bloodstream. Many veterinary hospitals don’t have these special machines and must send blood samples out to laboratories for analysis. But given how often we see lead poisoning in birds, I had bitten the lead bullet, so to speak, and bought an in-hospital machine. Having to wait days to get lead test results back can sometimes mean the difference between life and death for a bird, so having the in-hospital lead-testing machine, which gave us results within minutes, had saved many lives.
I held my breath for what seemed like an eternity until the lead analyzer whirred to a stop.
Marnie said, “Take a look at this.”
The word “high” appeared on the machine’s screen, indicating that Lily’s blood contained lead at a level too high for the machine to actually measure.
I looked at Marnie in disbelief, but the test was definitive. “You’re right.”
My mind rewound over the past week of events, scrambling to put the pieces of the puzzle together. Could lead exposure have caused the premature deaths of Mathilda, Georgie, Pockets, and all the other young gliders in Westchester County and across the country? I recalled Georgie’s necropsy report. On my urging, our chief pathologist in California had rushed the organ sample results back to me in two days. I hadn’t recognized anything in her report that suggested the presence of lead. But again, lead won’t be identified directly without a specific test for its presence. The pathologist had identified changes in several different organ systems, including degeneration and necrosis of liver and kidney cells, as well as segmental demyelination of nerves. Thinking about it now, demyelination is a characteristic lesion seen with lead poisoning, although it can also appear with inflammation from other causes. I’d read her full report, and not seeing anything new or that appeared inconsistent with my findings so far, I’d tossed it on top of Georgie’s paperwork to file away later.
But now, when I considered the necropsy report again, I realized Georgie might very well have suffered from lead toxicity. I reworked the case in my head: young gliders, all weak and dying, from different geographic locations, with minimal to no response to supportive treatments—and, now it appeared, all exhibiting symptoms consistent with lead poisoning.
“Start an aggressive treatment of oral dimercaptosuccinic acid with repeated calcium EDTA injections, large doses of subcutaneous fluid, oral Epsom salts to absorb lead, and syringe feeding. We need to also run a lead test on Baby G.”
Since I’d brought Baby G into the hospital, he hadn’t exhibited any signs of sickness; nor had any of the routine tests detected any abnormalities in his system. He was wide-eyed and curious, unable to sit still, actually, and climbing up and down the sides of his cage, curious to assess his new environment. Whenever I opened his cage, he did what all normal, healthy sugar gliders do: he leapt into the air, opened his arms wide, and glided onto the front of my lab coat, digging his nails into the fabric to secure a landing. For all appearances, Baby G was as healthy as he should be. And still, I acknowledged now, his display of active behavior didn’t discount exposure to or ingestion of lead. Many animals don’t start showing clinical signs of illness until their blood lead level reaches a critical threshold, which can vary from animal to animal. It was possible that he had been exposed to lead but hadn’t ingested enough of the metal to produce symptoms, or even signs, of toxicity. Only a lead test would determine if he had even a trace amount of lead in his system. I took a deep brea
th, knowing that if the baby glider had even a slightly elevated blood lead level, the source of lead exposure would again point back to Simon’s farm.
I retrieved the tiny glider from the intensive care cage and set him down on the main treatment table, under a big overhead surgical light. Getting a blood sample from this tiny animal would be even harder than it had been from Lily. I feared that the veins in his limbs were too slight and narrow to get a large enough sample to enable lead testing. We’d have to anesthetize him and use a very small needle to pull blood from his vena cava, the large blood vessel that drains into the heart. Just thinking about performing the delicate procedure made me anxious. The risk of lacerating the vena cava with the needle was considerable, and with even the least nick, Baby G could bleed to death. To avoid this dreaded outcome, we’d need to keep him perfectly still throughout the procedure.
I said to Marnie, “Let’s get set up for a vena cava stick on Baby G.”
Without hesitating, Marnie put a mask over his sweet little face to administer the anesthesia. The little glider curled up agreeably, his tiny head relaxed in the mask, and within a minute he was groggy and still enough for me to insert the hairlike 33-gauge insulin needle just above his breastbone into his chest near his heart. I said a silent prayer: Don’t move a muscle, little one; stay with me. I saw blood flow up into the hub of the needle, and when Baby G took his next small breath, I finally exhaled myself.
2:30 P.M.
THREE HOURS AFTER Marnie had begun treating Lily with a combination of oral dimercaptosuccinic acid and Epsom salts, injected calcium EDTA, and subcutaneous fluids, Bob’s longtime companion started to come back to life. With every passing minute, she showed more promising signs of improvement.
