Consulting a Specialist, Episode 2

Well, it seems like only yesterday that I was writing about the importance of consulting a specialist, and here we have a case in point.

Favorite CatJack looks a lot like the cat in one of our favorite pictures, “The Favorite Cat”.  A print hangs in our family room.  He’s an older cat, and he has been dealing with diabetes for the last couple of years, but doing pretty well for the most part.

Last week, his owner noticed that one of his eyes “looked funny”.  When she called, my receptionist asked her to come in as soon as she could (I think that always the best policy with an eye problem, but Sharon is especially sensitive to that, as she used to work in an optometrist’s office).

Indeed, his left eye did look funny, and not funny “ha ha”.  Actually both eyes looked abnormal, but his
left eye appeared to have a displaced lens.  I got on the phone with the veterinary ophthalmologists at the
University of Missouri (300 miles), and my nearest specialist in Memphis (100 miles).  Both said they really needed to see the cat to do the best job.

Well, it was Friday afternoon, and the owner was on her way to the funeral of a dear friend, and there was no way that she could take off to the ophthalmologist, even though she really loves her cat.  So, the specialists recommended some medications to use in the meantime to minimize inflammation and try to prevent
secondary glaucoma.  When the lens moves, it can block the normal fluid flow in the eye, and pressure builds up that can cause permanent blindness (and pain).

We rechecked Jack after the weekend.  He was not better.  His left eye actually felt hard, which is a not-so-subtle indicator that glaucoma is developing and to the point of being painful.  He really needs to see the ophthalmologist, because what we’re doing is not working.  “What can you do here?”  Nothing, besides what I’m doing, or going ahead and removing his eyeball so that he’s not in constant pain from an eye under pressure. 

JollyCat“If he’s going to lose his eye anyway, why should I take him to Memphis?”  Because he might not be going to lose his eye anyway.  The eye specialist may see something I don’t, and have a way out of this that doesn’t leave Jack looking like Pirate

It could hardly have been a more difficult time for Jack’s owner.  Here she is with two kids, one of whom is a two-year-old, sick with the croup.  She’s accidentally broken her $140 bottle of glargine insulin.  She is a school-teacher, and has to work the ball-game tonight.  To take Jack to the
eye-doctor early the next morning, she will have to re-arrange child-care, get a substitute teacher, pick up a cat-carrier and tranquilizers, and all this after nine o’clock at night.  The only way I can make this any easier is to meet her husband at the clinic that night and loan her the carrier and dispense the tranquilizers (Jack hates riding in the car).

She did it.  She made everything go right, and Jack was at the kitty eye-doctor early the next morning.  Sure enough, his lens was displaced, but the specialist noted the changes in both eyes, and believes that aggressive medical management may save Jack’s eyes, if not his vision.  No surgery, no Pirate Kitty.

THAT’S why it’s worth consulting the specialist, when you can.  I can do a lot over the phone, but I can’t BE the specialist.

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