“Just keep him up and keep the wound clean,” I told Waltham. “After tomorrow, if it gets dirty, just wipe it off, gently with a clean, damp cloth. We want the scab to stay on. I’ll be back in a couple of days to check on him.”
It was approaching two in the morning when we got home. Rosalie insisted on examining my chest while I was in the shower. With her forefinger, she traced the perfect imprint of a horseshoe.
“We could save time if you got in here with me,” I smiled.
She poked my sternum with the same forefinger, and I winced.
“Oh, I’m very impressed with how tough you are,” she said, still serious and concerned.
I lifted her, fully clothed, over the edge of the tub and into the shower. She leaned her head, very gently, against my chest.
“I was so scared when that horse kicked you,” she murmured.
I wrapped my arms around her. “I know. It was stupid. It never should have happened. I just got distracted. Tired, I guess. I promise to be more careful.”
I started unbuttoning her wet blouse, fumbling.
“For an athlete, you certainly are a klutz,” she giggled, helping me.
Chapter 21: Frick and Frack and Wilma the Cat
It was mid-May. I left the basement at six in the morning to get an early start on an assortment of routine calls. By ten, I finished the farm calls and was occupied with an ovariohistorectomy on a dog when a client brought in two bluetick hounds. Both the hounds’ faces were unrecognizable, their muzzles full of porcupine quills.
Their owner was Tim Gervis, a gentleman in his mid-sixties, tall, loose limbed, lanky, with gnarled arthritic hands and graying hair. Later Dick explained to me that Gervis owned the ranch just north of Frank Tompkins’s old place.
Frank Tompkins was a local legend. He was a famous rodeo cowboy in his early days, and he was a supporting character to Buffalo Bill in the later years of the Wild West Show. He was also a decorated pilot in World War I, an ace with ten verified kills. After the war, he returned to take over his family’s ranch north and west of Sidney.
Gervis waited patiently, as did the two hounds, until I finished and came into the waiting room peeling off my surgical gown and cap. He got to his feet and extended his hand.
“Glad to meet you, Doc. Frick and Frack here never seem to learn about porcupines. Usually they only get one or two quills stuck, and I just pull them out with pliers, but this is a bit much.”
“Frick and Frack, how did those names come about?”
“Hell, I don’t know. They’re brothers, about eight years old now. My youngest, Sadie, was ten when I brought ’em home. She named ’em. She turned eighteen a couple of months ago. I think she just liked the way the names sound together.”
“Which one is Frick, and which one is Frack?” I asked.
“Hell, they’re identical, even when their heads aren’t all swelled up, and they’re always together. I can’t tell which is which. Sadie can. They’re pretty much useless, just kinda hang around on the porch, except when they decide to hunt porcupines. If it were up to me, I’d just tell you to put ’em to sleep and be done with it, but Sadie would have a fit, and her mom would kick me out of the house.”
How many poets have eulogized the relationships between people and their dogs? Why can’t he just admit he’s attached to them and that he wants me to relieve them of their pain and discomfort? He’s just as attached to the two hounds as are his daughter and wife. What is it about our culture that does not permit him to admit it?
“No problem, Mr. Gervis. I’ll anesthetize them, pull out the quills, treat them with some anti-inflammatory drugs and antibiotics, and they’ll be ready to hunt porcupines again in no time. However, there’s one hell of a lot of quills in each of them, and it’s going to take some time to get ’em all out. I have to tell you I’ve never seen that many quills in an animal before.”
“Is there any hope that these two have learned their lesson and will leave off these encounters?” Gervis asked.
“Sometimes they learn. This time, they obviously got close enough to both get smacked with the tail, or maybe there was more than one porcupine since they both seemed to have caught a full load. They’re certainly old enough to learn that porcupines need to be left alone. We can hope for the best.”
Gervis shook his head. “I don’t know, Doc. I hope you’re right and they learned their lesson this time.”
After he left, I consulted with Dick. “Which one has the most quills?” I asked.
“You got to be kidding me. I’ve never seen so many quills in a dog before. Both of their heads are as swollen as basketballs. It’s amazing they didn’t get hit in the eyes and get blinded too.”
“Well, they both have a few quills around the eyes. They must have squinted very tight just before being hit. This is liable to take a while. Let’s start with Frick, or are you Frack?” I asked one of the dogs.
Both dogs cocked their heads listening, silently pleading for me to stop talking and get busy relieving them of their painful burden.
“OK, OK,” I said, brandishing two syringes. “Here’s some tranquilizer for each of you. That should take some of the hurt away until I get you anesthetized and get rid of the quills.”
I spent the following three hours pulling quills, one by one, out of the hounds’ faces. When I finished, each of the two dogs resembled bluetick hounds again but still with significantly swollen faces. I gave each an injection of prednisolone and antibiotics and then put them next to each other in separate large cages on the bottom of the three-cage tier. Since I had used a short-acting anesthetic for induction and the gas anesthesia machine, they were both up and about in short order, except they were howling. Imagine, if you can, the sound those two hounds made howling in unison, each inside a stainless steel cage in a closed room with a wall full of reverberating stainless steel cages! The howling caused all the other animals in the hospital—several dogs and cats with a variety of conditions and a bull in the barn that Dr. Schultz was treating for a ruptured penis—to add their voices to the pandemonium.
Dick covered his ears and gave me a look. “Do something, Doc, or I’ll go shut those two up permanently.”
It finally occurred to me that these dogs, like Skipper Jones, had never been inside a house or been locked in a cage. First, I made certain the barn door was closed and latched. Next, I took out Frick and Frack, one at a time, and put them in a stall together. A wave of silence engulfed the hospital. All was good with the world.
Dick handed me a couple of call slips.
“When I finish with these, I’m going home. Call me on the two-way if something else comes in before I get home.”
***
Ike Williams and Jon Wilkins were partners, owners of Williams & Wilkins Blacksmiths and Mechanics. Theirs was a large, dirty shop occupying the property in front of the small, immaculate frame house they shared. The shop blocked the house from sight on the main road leading north and east from Sidney. Their considerable skills shielded them from the necessity of acknowledging who and what they were. What the community considered important was that they were able to repair, and if necessary fabricate, a part for any type of agricultural implement.
They had lived and worked together in Sidney for twenty-five years before my new bride and I arrived. Like an old married couple, Ike and Jon finished each other’s thoughts, knew how to avoid conflict, and were comfortable in their own skin and with each other. They had made all the necessary accommodations years previously.
They both loved cats. I was never able to determine exactly, or even approximately, how many cats they cared for. There were shop cats, outside cats, and house cats, all seemingly equally loved.
They made certain their cats received all necessary vaccinations. From time to time, one or both would bring in a male for castration or a female for spaying. Those animals were destined for the house or shop. I guess they had a method for making that decision. The outside cats were apparently free to reproduce, but each new litt
er of kittens was brought in for vaccinations, and caring homes were found for them.
This day they were both in the waiting room when I returned from doing pregnancy exams on twenty-five head of half-wild range cattle. I rubbed my sore left arm as I greeted them.
“Mr. Williams, Mr. Wilkins, what have you got for us today?”
They stood up as if joined at the hip, Wilkins holding a huge tabby in his arms. The cat was meowing, whimpering actually, and obviously hurting.
“This is Wilma. She’s a house cat. Dr. Schultz spayed her for us several years ago, and she’s had all her shots every year. Today when we went to the house for lunch, we found her crying in pain. I think she’s paralyzed.”
Tears welled up in Wilkins’s eyes.
Ike put his arm over his partner’s shoulders. “It will be OK, Jon. Young Doc is good; everyone says so. He’ll take care of Wilma for us, won’t you, Doc?”
I held out my hands. “Here, let me take her. Let’s go into the exam room and see what we can figure out.”
Wilma was too soft, too fat, and too much in pain. Both hind limbs were flaccid. She was meowing louder now that Jon was no longer holding her. She was also hyperventilating. I examined her carefully, noting that the white nails on her hind paws were tinged blue and the paws were cold to the touch. I was unable to palpate a pulse in either femoral artery. I checked again and made certain there was no pulse.
I tapped on both patellar tendons with the handle of a bandage scissors. There was a delayed reflex response.
“This is not good,” I told them. “I’m pretty certain she has what we call a saddle thrombus. It’s a blood clot blocking the two main arteries to her legs. I’ve never seen a case before, but I remember the description from vet school. All the signs are there. She is partially paralyzed in the hind legs, in obvious pain, and there is little, if any, blood circulating to her hind legs.”
“Is there something you can do to fix her?” asked Ike.
“Well, theoretically I could operate and remove the clot. However, I’ve never seen nor done anything even remotely like that before, never opened an artery on purpose and then tried to suture it closed afterwards. I don’t think we even have any suture material small enough to do that kind of thing. We have no idea what causes this, and it could come right back. I’m sorry. I hate to say this. My job is to help animals, not kill them. In this case, I think the best thing I can do to help Wilma is to put her out of her misery.”
They were devastated.
“Are you sure you don’t want to even try?” pleaded Jon. “Cost is not a problem, you know. We’ll pay whatever it costs.” He looked to Ike for confirmation.
Ike nodded in agreement.
“OK, I’m willing to try anything, but I have to make certain you know this could be a disaster. I’ve only read about this kind of operation in a textbook. First let me look to see if we have any suture material small enough to suture an artery closed.”
I was apprehensive as I searched through the cabinet of surgical supplies. I found one packet of 4-0 silk, with a needle attached. It looked to be several years old. I had no idea where it had come from or what Dr. Schultz had intended for it when he had bought it. I came back into the exam room and held up the packet.
“This might work; it might be fine enough, but it’s old, and I’ll need to sterilize it again. I have no idea how long it’s been around. You are certain you want me to try? I’ll have to dissect down to the end of the aorta, that’s the main artery coming from the heart, where it branches to supply blood to both hind legs and the tail. Then I have to find the blockage, try to put a tourniquet around the artery above the obstruction, open the artery, remove the clot, and suture the artery back together. Chances are Wilma will bleed to death while I’m fumbling around.”
“But she’ll be anesthetized, right, Doc? She won’t feel anything?” Ike asked.
“That’s true. As soon as I anesthetize her, she’ll feel no more pain until and unless we remove the clot and get everything repaired and let her wake up again. She could still be in a lot of pain after I’m done with the surgery. I don’t know.”
“But you can give her something for post-operative pain, right?” Jon pleaded.
“Sure, we can treat post-op pain, to some extent at least.”
Ike spoke up. “OK, Doc. Go for it. Is it OK if we wait here? We already put a sign on the shop door saying we wouldn’t be back until tomorrow.”
“Sure, you’re welcome to wait here. It will take me some time to put a surgical pack together to sterilize with the suture material. I have to think about what I might need by way of instruments. I know we don’t have any specialized vascular surgical instruments, so I’ll have to improvise. I’ll let you know before I get started. Let me give her just a touch of tranquilizer to see if we can make her more comfortable. I’m afraid to give her anywhere near a full dose because her heart rate is so fast. The tranquilizer will slow her heart rate, and the high heart rate may be the only thing keeping her alive. There’s too much I don’t know about this.”
It went about as I had anticipated. I got Wilma anesthetized, hooked up an intravenous drip, opened up her abdomen, packed off her abdominal organs, and gained access to the distal aorta. When I tried to dissect around the aorta, I managed to break off some small branches, and the abdomen quickly filled with arterial blood. The turkey baster I added to the pack was not an adequate suction device, and Wilma bled out in short order. The experience was the unmitigated disaster I had feared.
***
Today we know that saddle thrombus is usually associated with a disease called dilated cardiomyopathy, a condition that probably has a genetic predisposition. Cats with cardiomyopathy have an enlarged and dilated heart that doesn’t function properly.
Normally blood circulates continuously inside the heart, like swirling a drink in a glass. Even when the heart is in diastole, resting between beats, the blood is in constant motion, so clots do not form. With cardiomyopathy, the heart is unable to beat strong enough to maintain the constant motion of the blood, and areas of flow stasis develop within the heart chambers. Areas of flow stasis allow clots to develop.
These areas of flow stasis are like eddies in a creek. When a leaf falls into the water, it can get trapped in an eddy. If enough leaves collect in the eddy, they will bunch together and eventually wash downstream. When the clot grows enough, it eventually washes out of the heart. The clot then flows through one of the arteries until it lodges at a location too small for the size of the clot. In cats, the most common location for it to lodge is at the terminal trifurcation of the aorta. Today veterinary surgeons are prepared to do this surgery. If the diagnosis is made early enough and if the underlying heart disease is controlled, many of these animals can be saved and go on to live a reasonably normal life.
In 1961, saving Wilma would have been a miracle, especially in my hands. If I had a time machine and I could go back with the knowledge and skills I have now... wishful thinking.
***
Jon cradled Wilma in his arms, rocking her gently while Ike handed me a greasy ten and two crisp fives. He sniffed and then turned to Jon.
“You want me to carry her to the truck, or do you want to hold her?”
“I’ll hold her; you drive.”
Jon reached up with his right hand to remove his glasses. Wilma started to slip, and he squeezed her to his chest. He wiped his eyes with first his left and then his right upper arm.
“Do you want to bury her tonight?” asked Ike. “Or should we wait till morning?”
“I think tonight,” Jon answered, replacing his glasses. “We can put her next to Tom and the others under the walnut tree.”
“Yeah, we’ll put up a marker for her, like we did for Tom,” said Ike, holding the door to the waiting room open.
Their pickup roared to life, and the headlights came on. As the truck pulled onto the road, I waved at them through the window.
Part V: Summer 1961
Chapter 22: The Elkhorn Ranch
I was back in the Badlands, this time called to Bill Dow’s ranch. I drove over the cattle guard and approached a group of scattered buildings about two hundred yards from the north bank of the Little Missouri River. The house was long, low, and narrow, built halfway up with hand-hewed logs and then finished with unpainted, rough-cut, horizontal planks. The roof was made of sapling poles covered with galvanized tin, covered with tarpaper, covered with sod. The front of the house and one side were festooned with elk, antelope, and deer racks. The barn and other buildings were sided with vertical, twelve-inch-wide, rough-cut planks, also unpainted.
Bill Dow fit John Jones’s description, huge and hairy. His beard, midnight black, flecked with gray, covered his face, save his eyes and forehead. Long black hair, also flecked with gray, covered his ears. He extended a gnarled, callused, and weathered hand. His fingernails were broken fragments.
John Jones told me that Bill was the son of Wilmot Dow, who had died in the summer of 1891 when Bill was only five years old. When he was growing up, young Bill listened to the stories of his family’s Badlands adventures as told by his great-uncle, Bill Seward. Seward and Wilmot Dow were partners with Theodore Roosevelt in the original Elkhorn Ranch.
After serving in World War I, Bill Dow decided to see the Badlands for himself. In 1921, only twenty-five years old, he put everything he had managed to save and borrow into an abandoned homestead and a few head of cattle. The place he purchased was not far from where his great-uncle and father had helped Roosevelt capture the notorious Redhead Finnegan gang.
Dow was sixty-five years old when I drove onto his place. The old bachelor followed his father and great-uncle’s passion for hunting, fishing, and the outdoors. Ranching was the way he earned enough to feed his passion.
“Howdy, Doc. Glad you could come out. I usually manage to take care of m’ own cattle, but I did the Coke bottle trick on these heifers, and they just popped out again.”
Animals Don't Blush Page 20
