My Cat has Asthma!

I arrived home from work around midnight to two hungry cats pacing in circles for their dinner.  After giving them each a scoop of food and fixing myself some trader joe’s pancakes for my own dinner, i settled down with a glass of red wine and TLC’s Trading Spaces to help unwind from the day.  But a strange noise caught my ear.  I looked down to see Louise staring at me, grunting and sniffling.  What’s wrong, Squeezie? I cooed.  She didn’t answer me, just kept making those funny breathing noises.

You’d think that as an ER doctor I could figure out what was wrong.  Sure, if she was a newborn, or a toddler, or even a full grown adult I could have examined her nose, her throat, her lungs, etc and try to isolate the problem. But she’s a cat…a very tiny body compared to a full grown adult.  I peered up her nostrils to see if her nose was running.  I pried open her teeth to see if there were any furballs in the back of her throat. Nope, none.  I cut her nails…I knew this was going to get hairy and decided to protect myself.

I grabbed my stethescope and began listening to her lungs, her heart, her throat…but I had no clue what I was hearing.  it sounded like she was purring.  Did she have stridor?  The noise she made reminded me of a 2 year old with croup.  Should I take her into the steamy bathroom and then out into the cold air?  No…she’s a cat, I reminded myself.

I was getting concerned. It was now 2 AM and her symptoms were worse, not better.  I had no idea what was wrong, and felt a little silly.  I had to work the next day, could I afford to be up all night at the veterinary clinic?  I realized I didn’t have a choice.  her breathing was getting worse, and as a people doctor, I knew that the type of noise she was making was potentially a sign of airway obstruction….this was a kitty emergency!

So I wrapped her up in a blanket and off we went.  Fortunately there is a clinic about 5 miles from my house that is open all night. I rehearsed my chief complaint on the way over.   I knew a long winded explanation was not necessary.  if she were a people, we’d bring her right back to the treatment area for urgent evaluation before wasting time asking questions in  triage.

I rang the bell and entered the animal hospital.

“What’s wrong?”

“She’s having trouble breathing”

She was immediately taken back to the treatment area and placed in an oxygen cage.

I have to admit that I was more than a little worried.  I imagined all the things that I do when I see a patient with trouble breathing. I imagined that I knew what they were doing with her in the back.  I hoped that they could figure it out and wouldn’t need to do a kitty intubation.  Eternal moments later, the veterinarian came out to ask me some questions. I tried to assess how concerned she was…or was she just being matter of fact?

Has she been sick?
Does she take any medicines?
Has she had any illnesses in the past?

I asked how Louise was doing, and the vet told me that they had given her a shot of terbutaline, a medicine related to adrenaline to help with her breathing.  She was pretty certain that it was an asthma attack.

Asthma.

Asthma???

Cats get asthma?????   Well it’s no wonder, they GIVE asthma to plenty of people.

So they gave her steroids, terbutaline, a kitty chest x-ray (2 views!), prescriptions for flovent & albuterol, and sheet of paper with a website with videos and information about giving cats aerosol treatments.  Little kitty breathing masks and little kitty spacers.

Poor kitty.  They gave her a sedative as well…she looks kind of stoned now, she’s been staring at the same spot on the wall since we got home about 20 minutes ago, but at least her breathing is better.  She’s still a little wheezy.  Weesie.  That’s her nickname, who would have ever guessed it would be prophetic?

Just like parents who have kids with peanut allergies have to educate their friends, the childs teachers, and other parents about treatment of allergic reactions with medications, I’ll have to teach all my friends how to check a kitty respiratory rate (should be less than 30), and give kitty albuterol in case of an acute asthma attack.

So…who wants to watch my cat for me next time I’m on vacation?

Creative Expansion

In the field of earth sciences, the phenomenon of “rebound” of the tundra and arctic crusts is well known.  As overlying glaciers, surface ice & snow and tundra melt away, the weight of the water in its various phases is removed.  The underlying soil & earth undergoes what is called “rebound”.  The elevation of the land actually increases as the ground “bounces back”.  This occurs over a time span of centuries if I recall, and the arctic lands are still rebounding from the last little ice age.

I often feel this own phenomenon in my own mind.  When I get away from the stress and hassle of work, there is a creative part of my brain that undergoes rebound.  It has spent so much time slumbering under the weight of grown-up responsibilties and actions that it nearly reached a point of “learned helplessness.”

But I couldn’t let that happen…

While many people who are not mathmatically inclined would argue that order and calcuation is not a creative process, I know for certain that it is the creative part of my brain that processes patterns, order, differences, and integrated solutions to problems.

Some creative things that are trying to escape from my head…

  • Web page Design
  • web page programming
  • Computer illustration
  • Pen & ink drawings
  • marketing campaign for my race team

Hopefully enough rebound will occur on my mini-vacation that several of these things can escape from my head over the next few days…

Shazam on Vacation

Hello from sunny, shiney California.  Since ER docs work in shifts, and typically are contracted for # of hours or # of shifts in a month, it’s not unusual to end up with a block of days off, just as we end up with a block of days working.  When I spotted 7 days off in a row for my busy winter schedule, I didn’t hesitate to schedule a mini-vacation.

I’ve been working pretty much non-stop since mid December, and had just about the worst holiday schedule one could get, save for the fact that I didn’t work on Christmas day.

I worked Thanksgiving eve, Thanksgiving Day, Christmas eve, New Years Eve and New Years day…all of them evening shifts, so I was unable to get together with friends or family on any of those days.  Often times in order for everyone to see all the in-laws at holidays, we will have a family gathering on Thanksgiving eve or Christmas eve, rather on the day of the holiday itself.  So I missed it all.  I basically had no real holiday, at least nothing that felt like a holiday.

So these days off were long in coming and well deserved.

I have had a handful of patient experiences that I’d like to blog about and apologize for not doing so more often…I’m trying to stay on the brighter side of life while working in a hellish neighborhood.  So I reserve my posts for those encounters that truly inspire me or reach me deep inside.  Somehow treating my umpteenth STD of the week, watching a drunken idiot sober up or calling a code on (yet another) 25 year old who has OD’d on who knows what does not inspire great posting for me anymore.  It did when it was new, but not anymore.

So instead, here I sit in the sun at a coffee shop in California.  Warm, green trees, blooming rosemary bushes & birds of paradise surround me along with palms and happy people.  Beach sand in my shoes and the slight odor of sunscreen reminds me that yes, it’s real… I’m on vacation!

More soon…