GOING INTO THE LION'S DEN
Dr
Sing Kong Yuen, BVMS (Glasgow), MRCVS
Saturday
20 July, 2010 |
 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
 Going to an apartment
to treat a ferocious cat with a needle and thread inside
his mouth can send shivers down a vet's spine. It is
like going to a lion's den. "I can't get my cat into the
carrier," Mr Hall said when I requested him to the Surgery.
So I had to make a
house-call on this fine weekday
evening.
I drove to the Grand Hyatt, Singapore in less than 15
minutes and such prompt attendance impressed Mr Hall. I
presumed his vet was not available. I saved time as I
was allowed to park outside the hotel entrance as I told the valet I was
going to treat Mr Hall's cat and handed him my car's key.
In the semi-darkened glowing lights of the lobby, I met
my two assistants, Mr Aung and Mr Saw at the lobby. Mr
Saw was off-duty but he did not mind attending to this
emergency. The hotel
receptionist, dressed in smart black jackets and well groomed
ushered us into a lift, pressed the lift button and took us up to Mr Hall's
apartment.
I knew what to do as I am an old vet and would finish
the job in 20 minutes. But it would be best for my two
assistants to get hands-on experience as they wanted to
open their own practice in Myanmar next year. They are
veterinarians if they practise in Myanmar but they are
veterinary technicians when they work in
Singapore.
PREPARATION FOR THE BATTLE
"What will you bring to this case?" I had phoned Mr Aung
earlier. "Domitor and swabs to stop bleeding," he said.
I packed my bag with Domitor, Antisedan, Xylazine,
Ketamine, antibiotics, swabs, a pair of forceps, needles
21G and one-ml syringes. I forgot to pack 23G needles
for use in the femoral vein injection as the cat has
fine veins which bled in front of the Mrs Hall when
Antisedan was injected IV using the bigger 21G needle.
Experience is usually gathered after a case handled. I
envisaged that this case would be full of surprises and
dangers but since I could not get the owner to bring the
cat to the Surgery, I had to make a house-call
reluctantly.
AT THE SCENE
Mr Aung is a hands-on man and he went for the cat. This
cat was crouched tightly inside the master bathroom
between the water closet and the wall. Mr Aung grabbed
the scruff and got him out and placed him on the cat's
white towel on the bed in the master bedroom. I had not
briefed my assistants and was therefore surprised.
"It is best to prepare the sedative before catching the
cat," I said to Mr Aung. "Look at the cat to estimate
his weight and prepare the correct dose."
The cat was displeased and pawed Mr Aung vigorously. Mr
Aung released him. The cat bounced off the bed and went
under the master bed, exactly in the middle of the
sanctuary. There was a moment of indecision as Mr and
Mrs Hall and I did not know what to do.
"Maybe Mrs Hall should under the bed to get the cat
out," I said like a General who bark orders from the
safety of an army headquarters fall from the battle
scene. Nobody moved.
"Let's lift up the bed," Mr Hall suggested
intelligently. Mr Hall and my two assistants lifted up
one end. I helped. It was surprisingly a very light bed
but there were four of us. Mrs Hall looked on.
Being exposed, the cat sprang to hide behind the day
curtains. The room has two sets of curtains. The day
curtains are the translucent type. Mr Aung walked
quickly towards the curtains to make friends with the
cat. What he does normally is to talk to the cat and
slowly let the cat (or dog) get used to the smell of his
hand. The cat was ready to scratch him as he had
scratched Mr Hall's hand a few times when Mr Hall tried
to open the mouth to take out the needle.
ARMING THE TROOPS FOR BATTLE
"Prepare the sedative first," I said to Mr Aung. That
would be what I would do before touching the cat. I
estimated the cat to weigh 3 kg. Though he was adopted
as a local cat, he certainly was bigger and fatter than
the stray cats we see around the neighbourhood. Mr Aung
got 0.1 ml Domitor and 0.1 ml Ketamine in one syringe
and gave it to me. He realised that this cat would never
accept an IV injection. IV injections at the Surgery
could be done because the cat would be in foreign
territory and would not be so ferocious usually. Here,
the cat was on home ground.
FRONTLINE DANGERS
Being a hands-on man, Mr Aung never hesitate from feline
dangers. He walked on his tip toes and squatted swiftly
in front of the day curtains. In one speedy grab, his
right hand lifted the cat's scruff. He placed the cat on
the white blanket on the master bed. I was ready with my
weapon (syringe) and in less than one second, I had
injected the cat's backside muscle with 0.2 ml IM of the
combined sedative. Mr Aung let go of the cat.
UNDER-DOSED
It is always safe to under-dose a frightened cat. I knew
the dose was insufficient. For the next 5 minutes, the
cat ambled out of the master bedroom, dashed across the
living cum dining room with the open concept kitchen and
disappeared into Bedroom 2 at the other end of this
apartment. Another 5 minutes passed. The cat was as
fresh as a daisy.
REINFORCEMENTS
In a losing battle, the commander must call for
reinforcements. "Give the cat Domitor IV," Mr Aung
proposed catching the cat as he was one never afraid of
getting cat scratches. "All three of us are veterans
with cat scars on our hands" I had said to assure Mr
Hall who must be wondering what was going on. The
sedative seemed to be dud. A dud missile that fell and
did not explode.
CAUTION
Soldiers could shock and awe in battle with more
bombings to kill the enemies. But this is a cat that
must be alive at the end of the house-call. "Better not
to give another sedative," I advised Mr Aung. "The cat
may react and die. Just wrap the cat inside a towel with
his head sticking out. That would be safer. The cat
would be sedated slightly by now. 15 minutes had
passed." I asked Mr Saw to take the white towel and he
went to the bedroom to get the cat for me. I could do
everything myself but my assistants would never learn.
"SUICIDE BOMBER" ATTACK
Mr Aung went inside Bedroom 2 to risk his hands and got
the cat by the scruff of the neck. Mr Hall and Mr Saw
and possibly Mrs Hall were inside Bedroom 2. As the room
was small, I stood outside the door to supervise. Like
those consultants who talk but no action.
While Mr Aung was holding the cat for Mr Saw to wrap the
towel around, the second cat, white with grey patches
suddenly leapt up to claw either Mr Aung or the cat. I
just could not believe this suicide bomber attack from
the friendly troop. This attacking cat hissed and swung
his paws widely. He leapt up and gravity pulled him
down. From my point of view, he was attacking Mr Aung.
In cat attacks, it is wise not to interfere. Water
hosing would be ideal but not inside the apartment. Mr
Hall managed to get the attacker out of the room. He
slinked outside the room and would not go away. He was
just so furious. Was it the attention the other cat was
getting? Mr Hall said to me: "This cat is very
protective and was protecting me." Well, next time, no
other cats should be present.
The next day, I noted that Mr Saw's left hand had two
cat scratches too when we were taking blood from a dog.
So, Mr Saw had suffered.
ACTION
 After wrapping the cat in the towel, the cat seemed
quiet. I said to Mr Saw: "Put the cat on this kitchen
counter." I gave Mr Aung the forceps from my bag. He
opened the cat's mouth. "There's the needle stuck in the
hard palate!" he showed the culprit. I took some
pictures with a zoom lens inappropriately. The zoom
would not work at first until I stepped back further. Mr
Aung took the needle out. A black thread with slimy
saliva was attached to the end of the needle. I should
have put the needle onto the tissue paper as Mr Hall
seemed not too pleased when I placed it directly onto
the kitchen counter. Mrs Hall took away the needle. I
opened the cat's mouth to give a final check. "No
injuries or ulcers," I said to Mr Hall.
ANTIDOTE
 "Should give Antisedan," Mr Aung advised me. "Antisedan
is an antidote," I said to Mr Hall. "The cat will wake
up immediately. If Antisedan is not given, he would wake
up fully over a few hours. Which do you prefer?"
"It is better that the cat be sedated for a while," Mr
Hall said.
"There is a small risk that the cat may not wake up. A
very small risk. Antisedan injection ensures that the
cat's heart and lung systems are back to normal
promptly."
The cat inside the towel hissed and hissed. Mr Hall
agreed to the Antisedan injection. This was given via
the cat's femoral vein at 0.1 ml IV. "Take the cat out
of the towel and put him on the floor," I said to Mr Saw
rather urgently. Mr Saw could not understand what I
mean. In any case, he had no time to think. The cat
looked up, assessed his situation well. The cat crawled
out of the loosened towel, stood on the counter and in
one spring, he leapt onto the floor and disappeared into
the sanctuary of the master bedroom.
HAPPY ENDING
Everybody was happy that this cat was back to normal.
Most important, the cat survived an anaesthetic.
Mr
Hall asked me for my name card as he was surprised that
I was prompt in answering his house call. Mrs Hall would
be more careful with her sewing needles and threads from
now on.
CONCLUSION
Never give the frightened cat a second dose of sedatives
as the cat may just die. This case took three times as
long but the cat was alive and that was what every owner
wants. It is best to treat such cases at the Surgery.
Normally I don't even want to do it at the house as
there are so many complications and surprises. Besides,
it takes a longer time.
RE-ORGANISATION
After a battle, the soldiers will re-group and
review. In my case, I said to Mr Aung and Mr Saw that
Xylazine 20 + Ketamine 100 @ 0.1 ml + 0.4 ml
respectively in one syringe IM would be more effective
for this <3kg cat as a sedative compared to Domitor
0.1ml + Ketamine 0.1 ml IM. There are many ways to
sedate a cat and since Domitor was chosen and it was one
of the recommended sedatives, I had to respond to the
challenges involved when the cat was full of beans after
the Domitor injection and ambled off. Mr Hall must be
thinking that the vet was a dud.
We all learn from hands-on experiences and real
situations. All theories about anaesthetics are
excellent but the realities of the situation can be so
much different and in this case, quite painful for Mr
Aung and Mr Saw as they were scratched and attacked by
the suicide bomber cat.
A cat in pain and fright is as dangerous
as a lion if you had been present in Mr Hall's apartment
when I was doing the house-call. I still can't believe
that there was a suicide-bomber cat digging his claws
into Mr Aung's hands and fighting off Mr Saw's
intervention. If the case was handled at the Surgery, it
would have been much more safer for the feline patient
and the vet assistants!
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