Friday, August 12, 2011

What, is that Smell?

I love mentoring because I usually learn as much as the mentored. Yesterday I was discussing a case with Dr. Berning, our new associate. My patient, an elderly cat had presented with decreased appetite and lethargy. With a history of hyperthyroidism, multiple missing teeth and several strokes that had resulted in hearing loss, there were many possible causes. In addition, through x-rays and ultrasound, we had discovered a large cyst in front of his heart.

We decided to tap the fluid off the cyst using ultrasound guidance, hoping that, if this was the main problem, we'd see immediate improvement. We also temporarily stopped the thyroid medication since long term use can result in toxicity in some cats. Dr. Berning suggested that another factor might be loss of sense of smell due to the strokes. This made sense since he seemed to prefer fish based foods. With this in mind, we recommended offering these foods, either alone or on top of the regular diet, warming the food, and continued use of an appetite stimulant. Thanks Dr, Berning!

(Interestingly, this patient was exposed to debris from 9-11. Living a mile downwind, he was outside when much of the debris permeated this neighborhood. I don't know that the cyst is related, but cysts are unusual enough that the link must be considered.)

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