Adventures in Veterinary Medicine – Ingrid

Yes, you read right.   This Adventures in Veterinary Medicine post is about me, not one of the animals I encountered in my years of working in the profession. 

In Buckley’s Story, I share my story of how Buckley helped me take the leap to start my own business.  But this wasn’t the first step on my journey toward finding my bliss.  Prior to starting my Healing Hands business, I worked in various facets of the veterinary profession for twelve years. 

It took me a while to figure out what I wanted to be when I grew up.  I started my professional life by translating manuals for a computer manufacturer.  Then I wrote and translated ad copy for a magazine about diesel and gas turbines.  After that, I worked as a travel agent for a while.  Eventually, I ended up at a financial services corporation, beginning as a receptionist and working my way up into middle management.  After fifteen years in corporate America, I had enough.  At that point in my life, I was looking for purpose and meaning in all areas of my life, including my work.  That’s where veterinary medicine came in. 

Feebee, my first cat and the love of my life for almost sixteen years, who got me through a period of great upheaval in my life in the mid-90’s when my marriage of thirteen years ended and my mother died, all within a four month period, developed bladder stones (most likely, as a result of trying to absorb some of my stress).  We ended up spending a lot of time at various veterinary hospitals while he was going through treatment, and ultimately surgery (he fully recovered and lived for many more years).  One afternoon, I was sitting in the waiting room of an animal hospital while they were taking x-rays of Feebee in the back, and I looked around and found myself wondering what it might be like to work in an environment like that.  The thought wouldn’t let go.  I started to do some research, and saw an ad for an office manager position at a nearby vet clinic.  I knew I was well-qualified for the position from a business perspective, even though I knew very little about the inner workings of a veterinary practice at the time.  I applied, and was invited for an interview.  The clinic’s owner offered me the position.    Sadly, I couldn’t afford to take it at the time.  The one aspect of veterinary medicine I hadn’t researched very well ahead of time was the pay – the salary offered was not enough to support myself.   So, instead, I asked whether I could volunteer at the clinic .  The clinic’s owner laughed and said sure, why not!

My first day as a volunteer at the clinic arrived.  I was so excited.  I didn’t really know what to expect.  I was introduced to the head technician, who I was going to be shadowing all day.  I was told that, due to insurance restrictions, I wasn’t allowed to touch any of the animals there, which was a bit of a disappointment.  I had sort of figured that if I was going to be allowed to do anything, it wouldn’t be too terribly glamorous.  I was prepared to do lowly things like cleaning cages and emptying trash if that’s what it took.  I just wanted to be in a clinic environment and learn as much as I could through observation and by osmosis.  

The first thing the technician showed me how to do was to set up a fecal test.  In retrospect, I think it was a test on her part to see how dedicated I was to this volunteering gig.  She showed me how to separate out a small amount of stool from the (giant! smelly!) sample the dog’s owner had dropped off, and how to set it up in a small plastic vial with a solution that would allow any parasites that might be in the sample to float to the top.  Icky, stinky, nasty work.  I was in heaven.  That’s when I realized it – I had found my bliss.  If I could feel this happy playing with a fecal sample, surely I had found my calling!  

It was the beginning of a twelve year journey.  I was eventually hired as a part-time receptionist at this clinic, then went to work part-time at my own vet’s clinic, where I was trained as a veterinary assistant.  I did everything from cleaning cages to answering phones to giving injections and monitoring anesthesia.   I reduced my hours at the day job as a business analyst at a financial services corporation to part-time status, and for the next three years, I worked pretty much seven days a week at either the day job or the vet clinic.  Being at the vet clinic never felt like work, no matter how many hours I spent there – another sign that I had found my passion.  In 1998, I quit the day job and took a hospital manager position at a vet clinic, in essence combining my business background with my newfound love for veterinary medicine.   It was the beginning of my adventures in veterinary medicine.

You really can find your bliss in the most unexpected places.

Allegra’s World: Big Girl

It’s been a while since I last wrote here, and I need to catch you up on what’s been happening in my world.  Yesterday was my almost birthday – I’m eleven months old now!  I’m almost a big girl!  I don’t really know what birthday means, but Mom says next month, when it’s my real birthday, we’ll have a little celebration and there will be presents.  I think I know what presents are – I think it’s the new toys that have been appearing here occasionally.  I can’t believe there might be more!  Wee!!!

Since I am a big girl now, I’ve been trying to act more grown up, too.  Well, maybe not quite grown up, but I am trying to be a good girl.  Mom says I’ve been doing really well with some of the things we’ve been working on together . I didn’t realize we were working on them together, but whatever – let her think that!  I may just be a kitten, but I’m still the one who decides what I do, make no mistake about that!  Anyway, I let her pet me for longer and longer periods of time now, and I don’t nip at her near as much.  I really don’t know why I even still do it, but it’s like I have all this extra energy that needs to be discharged somehow, and nipping is a way for me to do that.  It’s like I don’t really want to do it, it just happens.  I think Mom understands that, and she knows I’m not nipping at her to hurt her.  I love that she gets that.  I love her a lot, and I’d hate for her to think that I’m doing it on purpose.  I also don’t like that she simply walks away from me when I do nip at her, so I’m starting to put two and two together.  I’m a smart kitten!

I’m learning to be brave, too.  When I first came to live here, loud noises, especially the big trash trucks that go by our house every day, would send me running for safety under the sofa.  Now, I just watch them go by from the window – I know they can’t hurt me.  I still don’t like the noise of the lawn mowers that come every other week.  Why do humans need to have their lawns mowed anyway?  Don’t they know it scares little kittens like me?  Last week, I discovered a cool new spot to hide when scary noises happen (I still haven’t been able to make Mom stop what she calls thunderstorms – she keeps explaining to me that she has no control over the weather, but she seems to control so much else in our house, I’m not sure I believe her – after all, she can open cans!).  Anyway, I went behind the shower curtain in the downstairs bathroom.  It was nice and dark and I couldn’t hear the loud noise from the thunder as much down there.  When Mom found me there, she started to cry.  Turns out that this was Amber‘s safe place, too, and I guess seeing me there made her miss Amber a lot right then.

I can tell that Mom still gets sad a lot.  I don’t really know what to do when that happens, I’m just a kitten, but I want to help her!  So sometimes when she’s sad, I curl up next to her and just sit with her, even though that much closeness is still a little bit overwhelming for me, but I do it for my Mom, because I know it makes her feel better.  I know she’d like me to do more of it, and I will, but on my own time.  I love that Mom understands that.

Anyway, that’s all.   It’s time for a nap now, and maybe I’ll dream about this birthday that’s going to happen next month!  More toys!  Wee!!!

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Allegra’s World: Chewing

Things have been really interesting around here!  My mom and I are still getting to know each other, and I love how she wants to make sure I’m happy.  I want her to be happy, too!   But sometimes, I think the things I do to try and make her happy actually aren’t such bright ideas.  I don’t really understand why she doesn’t think it’s totally cool when I stalk her when she walks down the hall and attack her ankles.  I also don’t understand why she doesn’t think it’s fun when I nip at her hands to let her know that I’ve had enough petting.  Doing those things is soooo fun!  But I’m starting to get a clue that maybe it’s not okay to do these things, because when I do, Mom stops talking to me, won’t even look at me, and just walks away from me.  I don’t like that at all!

The other day, I did something so amazingly cool, I couldn’t wait for Mom to see!  I chewed off the edge of the big dresser in the bedroom!  It was so much fun to nibble on it, and it felt really good on my teeth!  Wee!  I worked at it really really hard, and managed to make it look like a work of art, if I do say so myself.  But when Mom saw it, she wasn’t impressed at all.  In fact, she got pretty mad.  I could tell when she said “Oh no, Allegra!” in a voice that didn’t sound loving to me at all – and believe me, I can tell the difference, because Mom sounds loving almost all the time, so when her voice changes like that, I kind of know I’m in trouble.   She told me I shouldn’t be doing that, and then she sprayed some stuff on it that she says is called Bitter Yuck.  She said I might not want to chew on that spot again, or I’d be sorry.  Okay fine, whatever!  Well, I waited a little while before going back to chew on the dresser some more – I’m not stupid, I’m not going to do it right in front of her!  It tasted a bit odd – but the chewing was so much fun, it was worth the weird taste in my mouth.  Mom got really exasperated with me and taped some stuff called Sticky Paws around the corner I’d worked so hard to chew off.  Again, she told me I might not want to chew on it again, as the stuff would stick to my mouth and feel really awful.  Hmmm.  Okay.  Whatever!  Of course I tried again.  Did you really think I wouldn’t?  It was really interesting, I managed to pull the sticky stuff off, spit it out, and then proceded to chew on the wood some more.  I was pretty pleased with the result – but Mom wasn’t ready to give up on making me stop.  You have to give her this – she is persistent.  I watched her rub a lemon on the area I’d chewed so nicely.  Some of the juice dribbled on the floor, so I investigated.  YUCK!!!  Major yuck!!!  I’m sad to say my work of art will not be completed – that stuff just tastes too nasty even for me to persevere.

Then, the other night, Mom was on the phone for a long time.  I heard my name mentioned a lot during that time.  After she got off the phone, she told me that we’d be making some changes to cure me of some of my “undesirable behavior.”  I have no idea what that means. It sounded very grown up and something humans would say when they’re trying to sound important.  I wasn’t too worried about it.  That night, Mom spent a longer than usual time playing with me, and then, she fed me an extra meal just before she went to bed.  How cool was that!  If that’s the kind of change she was talking about, I’m on board with that!  The next day, I got new toys!  Wee!!!  Now mind you, when I first got here, I thought for sure that I had landed in kitty paradise.  There were so many toys!  But now, there are even more!  How lucky can one kitten get!  I got a new play house, and a Kong Kickeroo.  I also saw her stash a bag of stuff in the closet, so I’m thinking there may be more new toys!  And I was right.  Last night, she brought out a really fun toy that has me somewhat puzzled – I just can’t get the little mouse out of it, but I’m going to keep trying!  I know there’s more in that closet, I just know it.  One of these days, I’ll figure out how to open those big closet doors….  but you’ll have to excuse me, I have to go play in my new playhouse now!  Wee!!!

A note from Allegra’s Mom:  I was becoming increasingly frustrated with watching Allegra be a sweet little kitten 80% of the time and then turn into devil kitten the remaining 20%.  She’s a little play aggressive, and she tends to bite when she gets overstimulated.  I knew the basics of how to respond to this type of behavior, but I wasn’t making much headway, so I decided to consult The Cat Coach.  Marilyn Krieger is a nationally recognized and Certified Cat Behavior Consultant and has been successfully solving cat behavior problems since 1990. Offering both on-site and phone consultation sessions, Marilyn’s expert advice solves diverse cat behavior problems.  Marilyn is the resident cat behaviorist for Cat Fancy Magazine and their web site, catchannel.com.  I’m sure Allegra will keep you posted on future developments as a result of Marilyn’s recommendations!

Adventures in Veterinary Medicine – Oliver

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This is an excerpt from Adventures in Veterinary Medicine: What Working in Veterinary Medicine: What Working in Veterinary Hospitals Taught Me About Life, Love and Myself

When I first began working in veterinary hospitals, I did a little bit of everything.  I worked as a receptionist, veterinary assistant, and kennel attendant.  Being a kennel attendant involved taking care of animals that were boarding at the hospital, which included everything from cleaning their cages, making sure they had fresh food and water, walking them, and giving them medications if needed. Continue Reading

Happy Father’s Day 2010

Happy Father’s Day to all the dads out there! 

My dad passed away more than six years ago.   This Father’s Day, I miss him a little more than I normally do.  My grief over Amber is still fresh and raw.  One aspect of the grieving process that often catches people by surprise is that frequently, it causes us to relive all the other losses we’ve previously suffered.  Holidays like Father’s Day always intensify the emotions.

Last year, I wrote a piece titled Father’s Day Reflections, and I thought I’d share it again here today:

My relationship with my dad was complicated at times, but I always knew that he loved me, and I have many wonderful memories of him.  His life was shaped to a great extent by his experiences during World War II in Germany, and as a result of suffering so much loss at such a young age, he held those he loved close to him – at times, too close for a daughter who wanted to spread her wings and fly from the nest!   He instilled in me my love of nature – some of my earliest and fondest memories are of long walks in the woods and parks near our home.  He taught me the names of all the flowers, trees, butterflies and animals we’d encounter on those walks.

He worked hard at a job he didn’t enjoy all that much to provide for my mother and me.  We were by no means rich, but he always made me feel like we were.  He fell in love with the Alps after first catching a glimpse of them as an American POW in Bavaria after the end of World War II.  The story he told was of being held captive in a basement with a very small window, through which he could see these beautiful mountains, and even in the darkest days of his captivity, looking at the mountains would give him hope.  He vowed that he would come back to these mountains someday, and he did.  Some of his happiest times were vacations spent hiking those magestic mountains.  He loved to travel, and after taking early retirement, for the next nine years, he and my mother traveled extensively.  He especially enjoyed his travels in the Western part of the United States – every Western movie he’d ever seen came to life for him there.  He would talk about those trips for years to come.

He had a difficult time dealing with my mother’s death in 1994, and his life contracted again.  He didn’t enjoy traveling by himself, and other than his annual visit to the United States, he stayed close to home.  When he became ill with prostate cancer, I wasn’t sure he would want to fight – but he surprised me.  He wanted to live, and he survived.  Then he decided that it was time to make a lifelong dream come true.  He sold his home of forty years almost overnight, and bought a condo in the Black Forest, where he spent the last two years of his life in an environment that he loved.   Having been a life-long worrier, he learned to live in the moment and “appreciate each flower and each butterfly,” as he once told me.  He passed away after a short illness, and knowing how happy he was the last two years of his life was a great comfort to me.

If you still have your father, tell him that you love him today.  My dad had a long, sometimes difficult, but ultimately good life, and I miss his physical presence in my life.  However, his spirit is never far from me.

Allegra’s World: Loud Noises

Wee!  Mom is letting me write a blog again!  Mom keeps telling me that I’m a good little kitten, and I guess this is my reward.  I have been very good, if I do say so myself.

I’m continuing to learn stuff about my new home, and I still discover new things every day.  Some are fun – like when I discovered that I can climb on top of the dining room cabinet.  Wee!  That was so cool!  It’s the highest spot in the house (short of the curtain rods – I haven’t figured out how to get up there yet, but I’m not giving up….psst, don’t tell Mom!), and I can see everything from up there.  And the most fun part is that if I lie down and make myself really flat, Mom can’t see me!  One time when I was up there, I heard her calling my name all throughout the  house, but I wasn’t going to move or let her know where I was.  But then her voice got kind of panicky, and I realized that she was worried because she couldn’t find me, and that’s when the game stopped being fun, so I popped my head up to show her where I was.

Some things about my new home are not so fun.  I really don’t like loud noises, and every morning, these big, noisy things go by the house.  Mom says they’re called “trash trucks” and “school buses” – all I know is that they scare me and I run and hide under the sofa when they come.  Sometimes, I’m really brave and just watch them from the top of the stairs through the window – but I’m always ready to run, just in case.  Every other week, there’s an even scarier loud noise.  It sneaks up on me, because at first, all I hear is some rattling in front of our house, and some men talking, and then, all of a sudden, this deafening noise starts!  Mom says it’s called “lawn service” and that it will come every other week all through the summer and fall, and that she hopes I’ll get used to it.  Maybe I will in time, but for now, I’m under the sofa when they come!  Thankfully, they don’t stay very long, but I still won’t come out unless Mom tells me it’s safe.

And then the other night, there was the scariest loud noise of all.  It woke me from a deep sleep on Mom’s bed (I know she loves it when I sleep on the bed with her, and most nights, I try to spend at least part of the night with her.  I know she wished I stayed all night, but there are things a kitten must do in the middle of the night that she couldn’t possibly understand!).  Anyway, that night, these horrible loud noises kept coming, one after the other.  There were also really weird flashing lights along with the noise, and sometimes it felt like the whole house shook.  I was so scared!  Mom tried to calm me down, but even though she talked to me in a quiet, soothing voice, it didn’t help.  I hid under the bed, but it wasn’t any less scary down there, so I decided to run from the noise.  I dashed all over the house trying to find a place where the awful noise wouldn’t follow me, but it was everywhere!  Finally, I ran back under the bed, and that’s where I stayed until after what seemed like forever, it finally stopped.  It took me a while to trust that it was safe to come out from under the bed, though, despite Mom reassuring me that it was over.  Mom said the loud noise was what’s called a “thunderstorm,” and that we’ll have them all summer long.  She said she’ll give me Rescue Remedy from now on whenever they’re in the forecast, and she said it would help calm me down.   She also said to tell you to read her article Thunderstorm Anxiety in Your Pets for more on how you can help your pets during those scary loud things.

Other than that, I’m just loving life.  I know Mom wishes I’d mellow out a little bit more and sit in her lap or let her hold me, but I can’t help being who I am – I’ve got to be me!  I’m not just a kitten, I’m a tortie kitten!  It’s a good thing that Mom understands about “tortitude,” because she says I have it in spades!

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What Not to Say to Someone Who Is Grieving The Loss of a Pet

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As a society, we are not equipped to handle grief and loss, and many people don’t know what to say to someone who is grieving.  This can be compounded when the loss is that of a pet.  Even people who are genuinely sorry and want to express their sympathy often don’t know what to say to comfort the grieving person.

It is difficult to know what to say, and as a result, people often, without meaning to, say the wrong things that, rather than providing comfort, only serve to upset the grieving person even more.   Sometimes, the best thing to say is to simply acknowledge the loss – because the only thing worse than saying the wrong thing is to not say anything at all.   As I’m dealing with my own grief about Amber, I’m once again reminded of how much some of the things people say hurt, even though they’re offered with the best intentions.Continue Reading

Allegra’s World: Amber is Gone

A lot of things have changed around here since I last got to write on here.  It’s been very confusing.  I’m just a kitten, and I’m not sure I understand it all.  I knew my sister Amber wasn’t feeling well.  The way I knew that was that she didn’t hiss and growl at me when I harassed her.  Mom said to leave her alone, but I kept trying – I just wanted her to play with me!   I thought she’d feel better for sure if she would just play with me!

Then one morning, Mom put Amber in a carrier, and took her away.  Mom was gone all day, too, and when she finally came home that evening, Amber wasn’t with her, and Mom was really upset.    I didn’t understand why Amber didn’t come back with her.  Mom said something about Amber being very sick, and having to be in the hospital so she could get better.  I didn’t really understand what any of that meant, I just knew Mom was upset, and I wanted her to be happy.  So I did the best I could to amuse her, doing my usual kitten things, and that night, I stayed in bed with her all night long for the first time.  I think she liked that.

Amber didn’t come back the next day and the next, and I got used to having Mom to myself.  I actually kind of liked it.  Even though it was a little boring not having Amber here to taunt and harass, it was nice to have Mom’s undivided attention.  I showed Mom that I liked it by purring for her, and rolling around on the floor so she’d pet me.  I could tell that it pleased Mom when I did that, for those moments, it seemed like she felt a little better.  But I could tell that most of the time, she was really worried  and scared.  I wish she’d explained more to me what was going on, but I guess it was just too hard for her.  I just tried to be my normal kitten self, and tried to make her smile.

Then Amber finally came home. I was excited!  But something wasn’t right.  Amber wasn’t in a carrier, Mom was just carrying her in a blanket.  I thought Mom would be happy to have Amber home, but she seemed really sad.  I may just be a kitten, but I do pick up on Mom’s energy.  Amber walked around the house a bit, and when she got close enough to me so I could catch a whiff of her scent, I couldn’t believe my nose.  Pew, did she stink!    She didn’t smell like the Amber I remembered!  She had a really weird smell, like she’d been to a place where bad things happen to kitties.  I hissed and growled at her.  That upset Mom so badly that she put me in a separate room with my toys, litter box and water bowl.  I didn’t understand at all.  I hadn’t done anything wrong!  But it was okay, the room had big windows and I spent my time in there watching the birds and squirrels outside.   Even though I’m just a kitten, I knew something was really wrong, or else Mom wouldn’t have locked me away, and so I made the most of it.

When Mom let me out of the room a couple of hours later, Amber was just lying on the loveseat and not moving at all, not even when I bopped her on the head.  Mom was crying.  She said something about Amber being gone, but I didn’t understand what that meant.  I’m just a kitten.  All I knew was that Mom was really really sad, and I hated that.  The next day, Amber disappeared again.  She hasn’t come back, and Mom has been sad ever since.

I guess it’s up to me now to take care of Mom.  That’s a pretty big job for a kitten who still needs to be taken care of herself, but I think I’m up for it.  I’m managing to coax smiles out of her every once in a while.  I like it when Mom smiles!  I’ve heard her say to someone that I’ve become “much more affectionate” since Amber left.  I don’t really know what that means, all I know is that I’m starting to get more comfortable in my new home, and around my Mom, and it’s easier for me to let her pet me for longer periods of time, and to sleep with her in bed all night long.  I think she likes that.

One thing I really love is all the different names Mom has for me.  She calls me Allie, Allegrina, Legra-Girl, Leggy and more.  One name she calls me a lot is “Allegrano.”  Her voice always gets louder than normal when she calls me that.  Whenever she calls me all the other names, she sounds really sweet and loving.  I’m a pretty smart kitten, and I don’t think it’s a good thing when she calls me “Allegrano” in that tone of voice.  It makes no sense to me, though.  I really don’t understand why it’s not okay for me to eat stuff off of Mom’s plate, or to bite her hand when I’ve had enough of her petting me, or to attack her ankles when she walks down the hall.  I’m just being a kitten – those things are fun!  But I’m trying to learn – I want to make Mom happy.  And she’s a really cool Mom – she plays lots of games with me!

Anyway – that’s what’s happening in my world and….oh – sorry, gotta go.  Big squirrel sitting on the deck outside.  BIG squirrel.  Really  huge.  Wow!  I could take him!!!  I know I could!

Virulent Systemic Feline Calicivirus

Guest Post by Dr. Fern Crist

Virulent Systemic Feline Calicivirus – What Do We Really Know?

When Ingrid called me to tell me that Amber was making occasional odd gagging noises as if something was stuck in her throat, but that she seemed fine otherwise, I was certainly not expecting Amber to die within ten days.

Two days later, Ingrid told me Amber’s appetite was decreased, and she was throwing up a little bit, gagging a little more but still seemed generally fine.  My brain went on yellow alert, but not red.  After all, Amber was still eating and keeping nearly all of it down.  Her abdomen was not painful.  Most such events resolve on their own, and since Amber gets very stressed with hospital visits, the benefits of getting her checked out had to be weighed against the stress of the hospital visit.  It seemed wiser to “just watch” for a little longer.

Non-specific symptoms

But after a few more days of “she’s not worse but she’s not better either,” I hit my limit of “let’s keep an eye on it,” so into the hospital we went.

I didn’t think of calicivirus right away when I first examined her.  I could hear that her airway was narrowed at some point in her throat, and like Ingrid, I thought she might have a foreign body stuck there.  Cats will sometimes vomit a little if they cough hard enough, so the occasional little “urp” didn’t concern me too much at the time.  She had no fever, and her labwork and x-rays showed nothing significant.  We decided to look down her throat and hope we could pull out an offending object.

It wasn’t until I saw her larynx that I first thought, fleetingly, of calici.  The edges of her larynx were very swollen and her air passage narrowed at that point.  We passed tubes down her trachea and esophagus anyway to be sure, and found no foreign body.  The only real finding we had was laryngeal edema (swelling around the larynx), which can be caused by allergic reactions, many viruses, and a host of other things.  Laryngeal edema is quite often a transient problem in the cat, for which a cause is never identified, but in nearly all cases the cats recover as long as the edema is treated.  We treat strenuous breathing when present because it can lead to the potentially fatal development of lung edema.  So we gave her steroids and fluids, the standard approach for acute laryngitis.  Having seen such cases before, I fully expected her to be much better the next day.

When she wasn’t, I began to seriously consider other possibilities.  And here’s where the calici comes in.

Felin calicivirus (FCV)

Feline calicivirus (FCV) is an important and largely preventable respiratory disease in cats.  It is included in what we consider the “core” vaccination protocol for every cat.  If you’ve ever seen the inside of the mouth of a cat with regular old calici, you’ll understand why.  It’s nasty, very difficult to treat, and some cats are even euthanized because of the terrible pain it causes them.  And that’s the “good” calicivirus.

Calicivirus is an RNA virus (a virus that has ribonucleic acid as its genetic material).  RNA viruses can mutate (change) easily, which means that new strains pop up from time to time.  It likes to set up shop in cat mouths and noses, and is then passed on through pretty much any body fluid.  Calici does not die quickly when exposed to air, so it can be transmitted by such normal actions as petting one cat and then petting another.  Virus shedding is common in cats with no symptoms at all.  Cats with symptoms can have any combination of fever, conjunctivitis, ulcerations in the mouth, sneezing and snotting, and often feel totally miserable.  Some cats will develop inflammation in the joints, kidneys, or other organs.  This creates a variability of symptoms that makes diagnosis tough, and again, this is for the “good” calicivirus.

Virulent feline calicivirus

In 1998, a particularly nasty strain of calicivirus was described in California.  There have been a number of similar occurrences since, which appear to be arising independently.  What this implies about the mutating ability of the calici virus is just plain scary.  These hot strains have been designated “Virulent Systemic Feline Calici Virus” (VS-FCV), although it is misleading to give them all one name, since each is probably a new and different mutation of the virus.  They do have characteristics in common, however.  Their mortality rate is much higher than that of the usual variety, reported to be as high as 67%.  Most of the affected cats are obviously very sick.  Many develop swelling (edema) in the legs and face, because inflammation of the vessels allows circulatory fluids to escape.  Major organs can be hit hard, including the lungs, pancreas, liver, and GI tract.  Often multiple organs fail, leading to death.  Adult cats are typically hit harder than kittens.

To date, there have been fewer than 20 documented outbreaks that I am aware of.  These occurred in California, Nevada, Pennsylvania, Massachusetts, Indiana, Tennessee, North Carolina, and the United Kingdom.  They have been verified by genetic analysis, possible because these mutants are genetically different from the garden-variety calici.  In each case, the outbreak was contained and over quickly.  And to date, there have been no outbreaks reported in Virginia.  But here’s the problem: we really don’t know how many times this has happened.  We wouldn’t, because the less dramatic cases would not get the attention and research that the horrendous outbreaks have.  Most likely, a lesser problem would be treated symptomatically and never diagnosed.  Cats get sick every day with diseases that we never identify.  Most of them just get better; but some of them die.  Unless there are many victims who are simultaneously very ill, a mutant viral event probably will not be recognized for what it is.

Since a successful parasite does not kill its host, it is nearly inevitable that eventually, a less virulent form of “virulent calicivirus” will appear.  And being less fatal, it will be much harder to spot.  A quieter calici mutation might not resemble the popularly reported VS-FCV strain as much as we’d expect.  An affected cat might, for instance, have only one or two organ systems affected enough to be a problem, and may or may not have swelling of the face and limbs, and may or may not have oral ulcers.  After all, the definition of a mutation is that is different.

Could early diagnosis have made a difference?

With Amber, the unusual combination of laryngeal edema with pancreatic or GI dysfunction is what led me to ask whether calici might be the culprit.  Initially, there was no edema or fever, but we eventually saw both.  We had multiple organ failure, including cardiac; we had effusion in the chest and abdomen; evidence of pancreatic involvement; and we found no other explanation. Amber had a positive PCR (polymerase chain reaction) test for calici, but that does not necessarily mean that calici caused her disease process.  We did not do a genetic analysis.  It might have been just an ordinary calicivirus which had nothing to do with her disease.  We’ll never know for sure.

Had I considered calici sooner, could I have done more to help her?  I believe the answer is definitively yes.  There are antiviral drugs purported to help in these cases; I might have used those.  I might have hospitalized her earlier in the process, and maybe kept her from going past the point of no return with drugs to suppress immune-mediated damage.  Monitoring in the hospital would have allowed faster intervention as different systems were affected.  Her surprise development — a hidden heart condition which had never shown up on Amber’s regular bi-annual check ups, but was revealed by the combination of disease, steroids and fluid therapy — would have been detected earlier and managed better.  She might have survived, and she might not have.  But she would, perhaps, have had a better chance.

Ingrid asked me to write this article in hopes that we can help make cat owners and veterinarians alike more aware that mutant caliciviruses are capable of creating disease scenarios such as Amber’s, and that this may be more common than we realize.  Mutant caliciviruses don’t have to be the total train-wrecks reported in the news.  Having the possibility of calici in our heads earlier in the process may save some lives.

This is not an alarm call, and it is not intended to inspire fear.  You should not lock yourself in your house, nor avoid the vet, or anywhere else where another cat might be found.  You should not give up adopting kittens.  Diseases will continue to appear, as they have throughout history, and though most never affect most cats, some cats will get sick, and in rare cases, the outcome will be devastating.

But if you see symptoms similar to Amber’s, perhaps this story will encourage you to wonder whether it could possibly be a case of a more-than-commonly virulent strain of calicivirus.  If the answer is yes and you intervene early, your cat may have a better chance than Amber did.

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PS:
I should mention that there is a vaccine available labeled for protection against the virulent calicivirus.  This vaccine was developed from one of the mutant strains; however, since each mutation arises independently, there is no way to know if it would be protective against any new mutation.  It is a killed vaccine, requiring the use of an adjuvant, which we think may play a role in the rise of injection site tumors; and it is a new product, so time has not yet shown if there may be other risks with it.  We don’t even really know how prevalent virulent strains are at this time.  So – would I vaccinate my cat against VS-FCV?  Absolutely not. In my mind, the risk of vaccinating with a product as new as this, with such questionable efficacy, far outweighs any benefit likely to accrue.

Amber’s Last Two Weeks

This past week of tributes to Amber, and all the love, support, kind words and cyber hugs you’ve offered through your comments and notes, have provided great comfort for me during this difficult time.  Thank you, all of you, from the bottom of my heart.

Throughout this past week, I’ve been getting a lot of questions about exactly what happened to Amber.  Even though it’s difficult to write about it, I’m hoping that by sharing the sequence of events of her disease process, I may help other cats who may present with the same, or similar symptoms.  I am not a vet, and I’m writing this from my vantage point of being Amber’s mom – a mom who is still grieving.  Dr. Fern Crist has promised me an article on the calici virus which we think caused Amber’s illness.  It will run here on The Conscious Cat in the next few days, again, in hopes that it may raise awareness about this virus.

I’ve also gotten a lot of questions about whether I need to worry about Allegra getting sick, too.  While there are, of course, no guarantees, the answer is almost definitely no.  The most likely scenario is that Allegra might actually have been the carrier of the virus – chances are that she had a mild form of the disease when she was younger (her medical history is a bit sketchy, and she was also over-vaccinated, so who knows), got over it, and is now immune, but was or is still shedding the virus.

On Sunday, May 2, Amber was stilll fine.  She was starting to get to know her new little sister, who, at that point, had been with us for almost a month.  She had a full breakfast, and spent the day doing all her normal, happy Amber things – napping in the sunny spots, looking out the window, cuddling with me while I was reading.  When I offered her dinner that evening, she didn’t seem very hungry, but ate about half of her meal.  Later that evening, I noticed her making some gagging noises – as if something was stuck in her throat perhaps.  She was breathing fine, and she even purred for me, so I thought maybe some hair had gotten lodged in her trachea, and that she was eventually going to be able to clear it herself.  We went to bed that night, with Amber curled up in my arms, as she had been almost every night since she came to live with me on July 29, 2000.

Unfortunately, the gagging didn’t stop overnight.  She ate a few bites of her breakfast Monday morning, and then went to one of her favorite napping spots for her morning nap.  I called Fern to run these odd symptoms by her, and we both agreed that I would just continue to keep an eye on Amber.  If things got worse, Fern would come and take a look at her.  Things didn’t change much throughout the day, but the gagging got progressively worse throughout the night (why is it that anytime a pet gets sick, things always get worse overnight?).  I didn’t want to take her to the emergency vet.  I knew that her situation wasn’t life threatening, but I also knew that she was very uncomfortable.  To compound things, she also vomited a couple of times overnight.  By Tuesday morning, it became clear that she needed to be seen by a vet.  After examining her, running bloodwork and taking a series of x-rays, we still weren’t any closer to diagnosis.  Fern was hearing high-pitched sounds in the back of her throat, like her airway was constricted or partially blocked.  She also thought she saw some redness and swelling at the back of her throat, but without getting a closer look, there was no telling what was going on.  And in order to take a closer look, Amber needed to be sedated.  There’s always a risk with sedation, but the bigger risk seemed to be to not know what was going on, so I agreed.  The good news was that the exam revealed no tumors or foreign bodies, but her larynx was severely swollen, making it tough for her to breathe.  The treatment would require steroids and supportive fluids.  Normally, I’m not a fan of using steroids because of their longterm side effects, but in this case, something was needed to knock the inflammation down and make Amber more comfortable quickly, so again, I agreed.  Thankfully, I’m able to give injections and fluids myself, so she could come home with me.

She seemed to be feeling better on Wednesday, and I started breathing a bit easier.  Meanwhile, Fern had done some research on this odd presentation of symptoms, and thought this might be a variant of a particularly nasty strain of calici virus making its way through the cat community.  This calici virus was appearing in other cats that had similar symptoms:  laryngitis, followed by inflammation and swelling in other parts of the body, including pancreatitis.  The way to treat a virus like this is with supportive care.  We thought we were on the right track, and the virus just needed to run its course and work its way out of Amber’s system.

By Friday, she wasn’t any better.  Fern stopped by my house to take another look at her, and still didn’t see anything that would lead her to think that it was anything other than a virus.  We decided to see how Amber would do through the weekend with continued supportive care.

She had a quiet weekend, but she was clearly uncomfortable.  Every afternoon, she’d rally and have a brief period of renewed energy, which gave me hope that things were starting to turn around.  She’d walk around a bit, jump up on the back of the loveseat and look out the window, and then go back to resting comfortably on her favorite sunny spot on the sofa.

However, by Monday morning, it was clear that not only was she not getting better, she was getting worse.  That’s when we took her to the internal medicine department at the Hope Center for Advanced Veterinary Medicine.  Ultrasound and other examinations revealed that she had fluid in her chest and abdomen.  An echocardiogram showed that she was in congestive heart failure – an underlying heart condition we were not aware of complicated matters, and the steroids and fluids she had been given had pushed her heart too far.  She spent the next three and a half days in intensive care.  She was given intravenous fluids, concentrated nutrition through a nasogastric feeding tube, and antibiotics for a complicating bacterial infection.  Thankfully, I was able to visit her twice a day.  It was hard to see her so sick, but she responded to me each and every time I came to visit, and she even purred for me at times.   I tried to cling to the hope that she was going to get better.

Ultimately, the challenge of needing to treat her with aggressive fluid therapy without pushing her heart too far proved to be too much.  On Thursday morning, after she seemingly had a good night, she took a turn for the worse, and while there was more that could have been done, her prognosis was so poor that I decided to stop treatment and take her home.   Her wonderful doctor at the Hope Center agreed that this was the right decision.

Amber and I spent the next few hours together, just soaking up every last little bit of togetherness that we could.  For most of that time, she was curled up in my arms, in our favorite spot.  Fern would come later in the afternoon to help her make the final transition.

I was still having a hard time with my decision.  I knew the decision to stop treatment was the right one, given the circumstances.  I wasn’t so sure about my decision to euthanize that afternoon.  Perhaps there was still a chance she would get better on her own?  Miracles have been known to happen.  Maybe I could have one more night with her?  Fern told me that if I waited too long, fluid would continue to accummulate in her chest, and she’d die miserably, would, in effect, be drowning in her own fluids.  Of course I could not let that happen.  But Amber seemed so happy to be home, and she seemed comfortable.  She just didn’t seem that sick!  She walked around the house, as if reclaiming her space again, then settled on her favorite spot on the loveseat.  She seemed content.  She even purred for me!  When I went into the kitchen a little while after she came  home to open a can of food for Allegra, Amber jumped off the loveseat and walked into the kitchen, tail held high in the air.  I coudn’t believe my eyes.  I offered her some food, and she even sniffed at it, but then turned away from the dish.  Still, the fact that she was interested enough to come into the kitchen….  it seemed like a glimmer of hope.  A little bit later, a friend came over to say good bye.  She brought flowers for me.  I laid the flowers on the coffee table while my friend talked to Amber.  Amber jumped off the loveseat, then up on the coffee table, to inspect the flowers.  My friend and I were speechless.  How could she show this burst of energy when she was supposedly so sick?  Seeing her so interested in what was going on around her made it really difficult to believe that her body was being ravaged from the inside and that I needed to let her go.

However, as the afternoon progressed, her breathing became a little more labored.  She was still comfortable, though.  She climbed into my lap, and curled up for another nap.  She purred some more.  And yet, her breathing continued to worsen.  At around three o’ clock, I called Fern and asked her to come in a couple of hours.  Only two more hours left together.  My heart was breaking, and yet, at that point, I knew I had no choice.

I will always treasure those last two hours.  Gradually, I began to feel more at peace.  I got a sense from Amber that she, too, was at peace.  When Fern arrived, Amber was lying on my chest, sleeping lightly, and occasionally lifting her head to look into my eyes.  Since she still had her catheter from the hospital, we didn’t even need to disturb her.  Fern gave her the final injection, and Amber passed peacefully, looking into my eyes until the last moment.

Pretty Litter

A Tribute to Amber from The Boomer Muse

Guest Post by Layla Morgan Wilde

Cat Saturday – In Memoriam
This edition of Cat Saturday is dedicated to Amber, a beloved cat born on July 29, 1998 and died on May 13, 2010. Amber lived with her human mom, Ingrid King near Washington D.C. The beautiful and wise Amber graced our pages as a Cat of the Week #55. She will be deeply missed by her many fans at her blog Amber’s Mewsings at Ingrid’s website The Conscious Cat.

Photo quote de jour

There have been several kitty deaths in both my actual and virtual families in recent months. Every death feels like a sucker punch to the gut. Nothing can prepare for the moment when a beloved four-legged friend dies. This time, the death of Amber treads a little too close for comfort. With Coco and Domino’s health scare, I’m steeling myself for a kitty funeral in my own backyard. Maybe it won’t happen for months, maybe years. In the meantime, I savor every moment and can’t take enough photos of my three. Today, when happily shooting in the garden this morning, I had no idea, Amber was dead but is it possible my cats, through some psychic cell phone knew bad news was in the wind and posed accordingly.  Merlin posed by the peace sign. Those old blue eyes knew something.

Coco was especially meditative in the herb garden. She sends condolences of a heavenly sort.

Domino, Amber’s cyber-soul mate, her long-distance Romeo will have to wait to meet and marry his Juliet. Amber loved her “tough guy”. He’s used to danger and death, and but maybe his heart is little bigger having known love.
 
Link of the Week
Lightning-strike.com – a wonderful pet loss support resource.

Time with our beloved fur friends is fleeting.  Enjoy yours.

All photographs © Layla Morgan Wilde, used by permission.

Layla Morgan Wilde is a writer, photographer, and intuitive life coach.  She shares words and images designed to inspire and amuse on her blog, The Boomer Muse.