Philipp Schott - How to Examine a Wolverine: More Tales from the Accidental Veterinarian

When Im in exam room 2 around Christmas I sometimes still think about Dixie Pawluk. I sometimes still think about her even though this was close to 20 years ago, and even though the display of odd things removed from pets that we kept in that room appears to have been thrown out, probably by staff tired of being grossed out every time they dusted the jars.

Dixie came in on the first day we were open after Christmas. She was normally a very lively little Cairn terrier lively even by the peppy standards of the breed but that day she was quiet. Normally she would run up to me and cock her head with that So, are you giving me a treat or what? facial expression if I went anywhere near the treat jar, but that day she just lay by Mrs. Pawluks feet and did not look up at me at all. Mrs. Pawluk was a widow and none of her children lived in Winnipeg anymore. Apparently, she had some friends who she played poker with every Friday night, but otherwise Dixie was by far her best friend and closest companion. She had had a succession of Cairns over the years, but she told me more than once that Dixie was the best of the lot. She often wore sweaters with pictures of Cairns on them. She had a new, red one on that day sporting a large tartan appliqu Cairn.

So, Dixies not looking too well today. When did this start? I asked.

The day before yesterday, on Christmas Day, she did not want to eat, not even her favourite treat. I thought maybe she just ate too much on Christmas Eve, so I didnt really worry, but yesterday it was the same thing. Mrs. Pawluk had Parkinsons and her hands were shaking as it was always worse when she was anxious.

OK. Has she vomited at all?

No, but she does this. Mrs. Pawluk mimed a dog opening its mouth wide, as if to yawn, while stretching her neck out. Theres no sound at first and then a little gag at the end. Do you think something could be stuck in her throat, Doctor?

Its not likely, but its possible. Did you feed her anything unusual on Christmas Eve?

I know that some of my colleagues reading this will immediately recognize my error. Perhaps theyre even sticking their arms in the air and saying oh, oh, oh like Horshack on Welcome Back, Kotter when he knows the answer to a question. In my defence I remind them that this was a very long time ago, and assure them that I definitely learned from my mistake. But back to Dixie.

I was about to ask a few more questions when Dixie stood up and retched a couple times in very much the fashion that Mrs. Pawluk had described, although the sound at the end was louder, wetter and more violent than I had expected. I picked Dixie up and put her on the exam table. Her lungs sounded clear and her belly felt soft and empty, but she had a slight fever. The only other abnormality was that by palpating her windpipe I could get her to cough a little. To allay Mrs. Pawluks worry about something being stuck I opened Dixies mouth and looked in as far as I could, which was not very far. I put her back on the floor and then sat down on my stool to deliver the verdict.

Im pretty sure Dixie has a form of kennel cough. Its unusual for them to go off their food with this, but she has a bit of a fever too, so she may have some bacterial complications. It will clear up with time and antibiotics.

Thank you, Doctor, Im so relieved its nothing more serious!

Cue ominous music.

I saw Dixie again four days later on New Years Eve. She still hadnt eaten, and she had become increasingly depressed, hardly moving at all now. Mrs. Pawluk would have come in sooner, but the weekend had intervened, and she wanted to wait for me rather than go to the emergency clinic. Now I was worried too. This was obviously not kennel cough, or any other sort of respiratory infection. We ran blood and took x-rays. One of the nurses grabbed me and said, Philipp, come and look at this x-ray. Theres something weird in there.

Indeed, there was. In Dixies chest, slightly ahead of and above the heart, was a very dense, irregularly shaped object, perhaps half an inch across. It was a piece of bone and it was lodged deep in her esophagus, the tube that leads from the mouth to the stomach. Mrs. Pawluk had been right, sort of. Certainly righter than I had been.

As we were closing for New Years, and in any case were not set up to provide the overnight care she needed, we transferred Dixie to the emergency clinic. I dont think enough of you are interested in the gory medical details to warrant a complete telling, so Ill summarize what happened next by saying that they ultimately decided to try to remove the bone with an endoscope. They got the bone, but unfortunately they found a large tear in the lining of the esophagus that could not be repaired. Poor Dixie struggled along for another couple of days, but it was hopeless, and Mrs. Pawluk had to make the heartrending decision to let her go.

A week or two later Mrs. Pawluk came in to give me a thank-you card, which I was not sure I deserved, and to talk. I felt terrible that I had missed the diagnosis initially and she felt terrible that she had fed Dixie pork ribs as a treat. She said that Dixie got rib bones regularly. It was not unusual. It was, in fact, her usual treat for special occasions. She had never had a problem before. She had told the truth when I had asked her whether she had given Dixie anything unusual to eat.