The Gift of Pets: Stories Only a Vet Could Tell (3 page)

I stared at him blankly. I had never encountered a syllylogy before, patented or otherwise, and my mind immediately veered dangerously into wondering with which government agency one would patent a syllylogy—or why.

“I have invented a language in which each syllable represents a discreet meaning. Words are then assembled which convey specific meaning by their very construction.”

“So what does Dahmun mean, then?” I asked.

“Well, the syllables represent … I mean ‘dah’ is a … uh … a large landmass, especially one with lots of altitude. Combine that with the syllable ‘mun,’ which signifies deep affection and fondness. See?”

He looked at me, apparently to watch the light of meaning dawn in my foggy eyes. The fog persisted.

“No, I don’t quite get your drift.”

He clicked his tongue again, clearly impatient with the obvious dullness of the pupil before him.

“Dah-mun. Dah-mun. Get it? It literally means ‘Mountain of Love.’”

“Oh, I see now.” And I really did begin at that moment to understand Mr. Johnston.

“Tell me what’s been going on with Dahmun. Start at the very beginning, please.”

“About four or five months ago, we were hiking on my property in the Fort.”

Fort Valley is a blind valley with an open mouth on the north end. It is contained by two ridges that run along the east and west flanks of its fifteen- or twenty-mile length. The floor of the valley is no more than two or three miles at its widest and is choked off as the ridges squeeze together and finally join at the southern end. It’s said that George Washington had scouted out this “fort valley” as a place to hide had the Revolutionary War gone badly. The valley would probably be missed if scouted either from the east or the west, and the mouth could be easily defended against intruders from the north. Over time, Fort Valley became the accepted name of the valley. It also became a place where lots of people settled who liked to hide their homes from prying eyes. It is occupied today by folks for whom Woodstock is too populated and occupied by weekenders escaping from the rush of the nation’s capital. Locals call it simply “the Fort.”

“Dahmun loves to go hiking with me. That day, we were going up a rather steep hill with loose gravel. She slipped and fell down on her poobus. I—”

“Excuse me.” I interrupted him. I was carefully writing down the history in the record and was sure I had been concentrating too hard on this task to have heard him correctly. “What was it that she hit when she fell?”

“Her poobus!” He waited for me to catch up. My face was apparently broadcasting that I was helplessly clawing for clarity.

“Poobus. Poo-bus,” he said again for me, more slowly this time and louder. I suspected another patented syllylogy, until he clapped his hand over the lower reaches of his right fanny and repeated again, “Poobus.”

“Got it. Go on,” I said, finally recognizing that he had just badly mangled the anatomical term
pubis.

“So after she fell, she displayed some dysmobility for a few days. It might have lasted as long as a couple of weeks. Then it seemed to improve again. I wasn’t too worried at that point. I just assumed she had pulled a muscular infraction or something. But then I noticed that the muscles in the right rear were beginning to atrophatize.”

The linguistic license Mr. Johnston displayed began to tickle me. It seemed important to him that I recognize the mastery he possessed over nearly correct medical terminology. The oddities of the syntax and the reinvention of the words were so strange that I knew I would never remember them or be believed when I related them again. So I discreetly slid the record over and began to jot down on a sheet of paper towel the words he was inventing—
dysmobility, atrophatize.
This was good!

“Please go on, Mr. Johnston.”

“About that time, I noticed that a lump was beginning to form at the top of the leg. It didn’t really seem painful at the time. But over a period of several months, it’s gotten bigger and bigger, until I thought I ought to have it checked out. It has also begun to cause her some pain. I’m sure it’s just an abcleft. How much will you charge to have it lanceted?”

“I think it’s a little early to talk about treatment,” I responded. “I haven’t even examined her yet. Let’s take a look.”

Dahmun was much too large to place on the examination table, so I began my exam by getting down on the floor with her. I started at the head and examined her eyes, ears, and nose. I then opened her cavernous mouth and inspected her bear-size teeth, tonsils, and tongue. My hands traced the lines of her neck, carefully outlining the lymph nodes, salivary glands, and trachea. All looked and felt normal. I heard an audible sigh again and looked up at Mr. Johnston.

“Doctor, the problem is not up there. The problem is back in the hind leg, see?” He rolled his eyes, as if I was too simple to recognize his unmistakable disdain.

“Yes, I noticed that when you came in the door. But you don’t want me to miss something else important because I focused in too quickly on what was blatantly obvious, do you?”

He didn’t answer. Apparently, he didn’t care what I might miss. I continued my examination by listening intently to the dog’s heart and the lungs. Then carefully, using both hands on her prodigious belly, I palpated the urinary bladder, the intestines, the kidneys, the spleen, and a bit of the liver poking beyond the arches of the last ribs. All seemed fine.

I then turned my attention to the leg. As Dahmun stood patiently, the toes on her right foot turned under and her leg was stocked in a taut straight line. The skin over her knees and toes bulged with swelling. At the top of her leg, by the hip, a huge mass, larger than a cantaloupe and as firm, encased the bone. The slightest pressure on this mass caused Dahmun to whine and squeal in pain. A little more pressure induced her to turn and nip at my hand apologetically.

I shook my head absently. This wasn’t good. I turned and began to write my findings in the record, using this time to organize my thoughts around how I was going to discuss the problem with Mr. Johnston. Apparently, I was taking too long for him.

“So, now that you’ve had a chance to examine her, how much will you charge to lancet the abcleft?”

“I’m afraid lancing an abscess is not what we need to do here, Mr. Johnston.” I sighed. I dislike being the bearer of bad news. But in this case, there was no other option. “The lump is not an abscess. Dahmun has a tumor in her leg. It entirely encases the femur just below the hip. It also apparently has the sciatic nerve entrapped within it, too. That’s why she can’t bend her leg, and why she knuckles over on her toes like that.”

Mr. Johnston processed this for a moment. It was clear that he did not want to believe me.

“What is the causality of this problem?”

“I wish I could answer that question, Mr. Johnston. If we had the answer to why cancer occurs, we would be far along the road to its cure. But for most cancer types, we really haven’t identified any specific cause-and-effect relationships. It’s just one of those things that happen.”

“Could it be the initial injury? Or is it unexpectable for an injury like that to cause tumors?”

“No. I suspect the injury was a result of the cancer, not the other way around. The tumor in its early stages may have made her unstable and led to the fall.”

“And the swelling? Is that just the phlebum that can’t reticulate back up the leg?”

“Exactly,” I agreed. “Because of the poor lymphatic return, extracellular fluid accumulates and causes that type of swelling. It’s called ‘pitting edema,’ and it’s a common consequence of such an invasive growth.”

“I’m sure you’re a good vet and all, Doctor. But I’m still not convinced this isn’t just an abcleft. Can’t you do some tests or something to find out?”

“Of course, Mr. Johnston. I’ll do an aspiration cytology. I’ll stick a needle into the tumor and draw some cells out that I can look at under the microscope. If this is just an abscess, what we’ll get is pus. X-rays will also be very helpful in this case. But…” I shook my head to underscore my pessimism. “I’d love to be wrong here, Mr. Johnston. But I really don’t think it’s reasonable to expect that.”

“You’ll forgive me for this, but I’m eternally optometric.”

I plunged a needle deep into the mass and could feel grating against the tip of the needle as I did so. The tumor had begun to incorporate calcium deposits into its structure—not a good sign. I then sprayed the contents of the needle onto a glass slide and took it to the laboratory. While the technicians took Dahmun to get X-rays of the swollen leg, I placed the slide under the microscope’s lens. Peering through the eyepieces, I examined the cells I had collected. They were grossly abnormal.

Soon I was called into the radiology room to evaluate the X-rays. The films were classic for bone cancer. Feeling defeated, I trailed back into the exam room.

I came right to the point. “I’m afraid there is really no question about it.” “The cells that I collected show all the telltale signs of cancer. And judging by the cellular characteristics, it looks to be quite an aggressive tumor at that. When we combine that with the textbook pattern I see on the X-rays, I’d say I’m more than ninety-five percent sure it’s bone cancer. I’m so sorry. A definitive diagnosis can only be made by a pathologist examining a tissue section, but a biopsy confirmation wouldn’t change our treatments much.”

Mr. Johnston was quiet for a moment, absorbing the impact of my findings.

“It’s my own fault. I should have brought her in earlier. I shouldn’t have been so delaysive in getting her some help. What do we do now?”

“Well, I’m afraid there aren’t many options at this point. These types of tumors don’t respond very well to chemotherapy alone. In order to give her any chance at all, we would need to amputate the leg first, then follow with chemotherapy. This treatment has resulted in the best outcomes. One of the problems with that, though, is her size. She may not get around well at one hundred and sixty-five pounds with only three legs. It is also very likely that it has already spread to other areas.”

“You think this has already metatheclized?” Mr. Johnston gasped.

“I don’t know for sure. But it’s very likely. The odds are very much against us. In order to know, we’d need to x-ray the chest and the abdomen and consider ultrasounding the belly.” Sometimes you are beaten even before you begin the fight. And this was likely one of those cases.

“Perhaps the best thing for us to do is control her pain with medications for as long as we can. There are a number of ways we can do that.”

Mr. Johnston sadly took his big Mountain of Love home. Prescription pain medications kept Dahmun’s discomfort at bay for a few more weeks. But eventually, even those were inadequate to allay her constant suffering. As the bulbous growth enlarged ever more quickly, her ability to get up and move around declined precipitously. Soon there was nothing for us to do but ease her suffering in the most permanent of ways.

Mr. Johnston’s loss was a difficult one, and I felt bad for him. But the episode apparently bolstered his confidence in me. Though he continues to exhibit the same disgusted frustration with me that he did when I first met Dahmun, he has presented several of his animals to me since then. I’ve learned some things about dealing with him. First, I never ask for explanations of the names he gives his pets. Second, I’ll never go into the exam room again without a slip of paper under the record to write down the lingering linguistic lapses.

The Contract

Greco was an interesting mixture of canine breeds. Somewhere in his distant past, there was certainly beagle blood. That much was clear. Beyond that, breeds and bloodlines blurred. Weighing in at about forty-five pounds, Greco sported the beagle colors but displayed the body contours of a shepherd. His attitude of braggadocio was clearly independent of his questionable lineage. The set of the tail, the carriage of the proud head, and the careless, almost disdainful persona stated with clarity, “I am who I am. I don’t care who my ancestors weren’t. I am
the
Greco.” You had to like a dog like that. And Greco was quite confident that you would.

Greco’s owner, Antonio Toumopoulis, seemed equally incongruous. His jet black hair, heavy eyebrows, dark skin, and deep Greek accent were unexpected deviations from the characteristic western Virginia drawl. Nonetheless, Mr. Toumopoulis bore these Greek characteristics with obvious pride. No apologies were necessary and none was proffered. He more than compensated for his diminutive five-foot-three stature by booming out his staccato dialogue in unbelievably amplified tones. The pair was indeed an impressive duo.

The visit that morning, though still carried on at rather uncomfortable decibel levels, was relatively suppressed. Greco was sick!

“Greco … he no feela good,” Mr. Toumopoulis reported, endlessly rolling his
r
’s in ways that I can not force my tongue to imitate, much less represent in print. “Seence two day ago, he no eeta … no dreenka … no, how you say, poo.” At least half of his meaning was evident from creative use of hand, arm, and facial gestures, which, in this context, are best not described. “And he … [more expressive gesturing] “breenga ohp hees fooda meeny time.”

“Do you know of anything he could have gotten into? Any missing toys or things like that?” I queried, concerned about a possible gastrointestinal obstruction.

“Oh no, Doctohr. He no playa weeth toys. He theenka squeaky things too seessy. He more like chewa de rocks.”

Stoically, Greco stood as if planted on my examination table. Too macho to exhibit his discomfort overtly, he simply stared straight ahead, eyes fixed on the wall in front of him. In response to hearing his name, he would give three or four tentative wags of the tail before assuming once again his statuesque pose. There was a barely noticeable catch in his throat as he drew each breath. Otherwise, he masked his discomfort completely.

I carefully felt his stomach with my fingers, gently probing the bladder, the spleen, the liver, and the intestines for any abnormalities. As I did so, I felt a golf ball–size lump slip through my fingers. When I bumped up against the firm lump, Greco’s pain broke through his stoicism. He turned and snapped at my hand, barely missing, then immediately wagged his tail ingratiatingly, as if to say, “Sorry, Doc. But man, that hurt!”