Shooting Up the Cat
I had a very interesting day yesterday. The Mighty Hunter, who had been walking a little funny the day before, refused to put weight on his right front paw.
I tried my best to figure out what was wrong: I palpated the whole limb very carefully but didn't elicit any reaction from him. He wasn't particularly in the mood to be handled, though, so I wasn't sure I hadn't missed something. By the time I had showered and dressed, Darling Spouse was really worried about him. Our regular vet didn't have any appointments available so we decided to try a local emergency vet place we'd heard about.
TMH went into the carrier easily, something else that really scared the shit out of us. I drove; Darling Spouse held the carrier, crooning to TMH as we tried to find the place. The cat was crying; it's the only word for the sounds he was making. Then he started panting. Very uncharacteristic for this guy. Needless to say, we were getting more and more scared.
The logical, clinical part of me wasn't really worried. The overwhelming likelihood was that it was something musculoskeletal, and that we'd be sent home with anti-inflammatories instead of having to leave the dude there for surgery. I doubted trauma, even though he insists on going outdoors, because I would have expected an injury to start with symptoms at their most severe instead of the progression -- albeit fairly rapid -- that we observed. But the part of me that wasn't a vet thought, "What if it's something serious, like in his lungs?" I didn't know if an apical lung lesion could produce referred pain to a front limb or something like that.
We found the place after only a few wrong turns. Let me just say this: I'm in the wrong business. The facility was absolutely gorgeous; huge waiting room; coffee and cookies -- for the humans; a basket of doggie treats on the counter. The receptionist was awesome: friendly and attentive. I filled out the shortest form I've ever seen in a medical office. A nurse came out to triage TMH; making sure he didn't have something immediately limb-threatening like a clot, we were told later, but then we had to wait while another woman's critically ill dog was cared for.
Eventually we were taken back where TMH had his vitals taken. I have to say one thing for this cat: at least he's cooperative with medical care. He wasn't crying or panting anymore. In retrospect, I'd have to say he was taking his emotional cues from us, and we were feeling better about him now that we were doing something for him. The nurse set him down on the floor and sure enough, he began walking around on three legs, confirming that he was lame. (At first we were worried he'd walk perfectly normally and were reassured that that actually happens all the time. Not this time though. Definitely something wrong.) We left him on the floor while we waited for the doctor. After cruising the room he came back over to where I was sitting on a small bench next to the exam table. He carefully jumped up onto my lap and then back up onto the table; definitely guarding his right front limb, but we were encouraged.
The vet was great; young; very cool. Seemed to appreciate TMH's dudeliness. Did a complete exam. (Totally cracked me up later to read the documentation: "Neuro: cranial nn intact; proprioception intact; mentation good." WTF? He never asked TMH what his name was or if he knew the date or where he was.)
In order to do a very thorough exam of the right front limb we held the cat for him: on his back, cradled in my arms instead of right against the cold metal table; rubbing his belly. Once again, TMH cooperated beautifully. (Anything for a belly rub.) The vet was pretty sure the dark marks on the right paw pad were specks of dirt and not dried blood, but he said he couldn't be sure there wasn't something in there. He thought the metatarsal pad was a tiny bit swollen and a bit warmer than the other one. Darling Spouse and I looked at each other, suddenly remembering the broken glass in the street next to the driveway left by the garbage men. Had TMH stepped on some and gotten a piece stuck? I would have expected it to hurt a great deal more than TMH was letting on if that was the case. Still, x-rays were definitely indicated.
Off we went to the waiting room while TMH was radiated, but then we were invited back to view the films on a monitor in a gorgeous wood-paneled office area. The glimpses we got on the walk back showed that the rest of the facility was just as impressive as the waiting and exam areas. There on the monitor was an enlarged x-ray of a cat's paw. (Now, of course, I regret not taking him up on his offer to burn me a CD of the images. I wasn't thinking of blogging at the time.) "Right there," he pointed. Sure enough, the base of the fifth metacarpal had a small but definite non-displaced chip fracture.
How the hell had he done it? No idea. What to do? Let it heal. No cast or anything. Just three days of an anti-inflammatory. (It turns out cats' livers don't tolerate NSAIDs very well, hence the very short course.) Which one? Meloxicam; Mobic, for humans. Metacam for animals. Same stuff, of course.
TMH had already received a dose SQ (subcutaneously.) They were going to send us home with two more oral doses for him for the next two days. I looked at TMH. He was actually much better about letting vets handle him than us. The idea of catching him, immobilizing him (I couldn't squirt something into his mouth while rubbing his belly) and forcing something into his mouth that he didn't want filled me with something between trepidation and terror.
"Can I give it to him sub-Q?" I asked. I've had cats all my life and have seen all of them get shots. It really did look ridiculously easy.
I said the vet was cool. "No problem. They have so much skin, it's ridiculously easy." He showed me how to lift the skin of the back and inject into the V formed by pulling it up. "He won't even know you're doing it."
Back home, TMH looked almost stoned. I wasn't sure if it was the drug or the relief of being home. He slept very well all day.
This morning it was shot time. I took one of the two syringes they'd given me ($14 apiece; I told you I'm in the wrong business) each containing 0.1 cc of Metacam, then found TMH upstairs on our bed. I lifted the skin with my left hand and went to pull the cap off the needle with my teeth. The needle came off the syringe; it wasn't a Luer lock. I let the cat go, shoved the needle back onto the syringe and pulled the cap off.
Let me interject here that I give shots all the time; immunizations and allergy shots; obviously this is flu shot season. I usually use needles that are 5/8" long, going in at a 45 degree angle for SQ and a 90 degree angle for IM. (Yes yes yes; I've been told a million times I need to use longer ones; but I've hit bone going into a small toddler's arm with the 5/8", and I've also read that there's no difference in efficacy if it doesn't get into the muscle, so that's what I do.) This was a tiny little 1 cc syringe; I was expecting a similar sized needle.
So imagine my surprise at having uncapped a one inch, twenty gauge weapon I was supposed to stick into my cat! Ok; they have a lot of skin; the skin on the back -- where I was injecting -- is probably the thickest skin on their body (like humans; only place thicker is the soles of the feet.) Here goes nothing.
I lift up the skin on the back and poke the needle into the V, inject as quickly as I can (one whole whopping tenth of a cc) and get it the hell out.
The cat doesn't even notice. In fact, he rolls back over and waits for me to rub his belly. Which I did. Interestingly, within five minutes he's fast asleep. I go in to shower and when I come out of the bathroom, he's still passed out, spread-eagled on his back.
That meloxicam must be some great shit.