I felt a wonderful sense of anticipation when meeting new clients and their cats. Being professional meant that I had to be ready for the diversity of all who entrusted me with the care of their feline friends. It was like Forrest Gump’s box of chocolates. I never knew what I was going to get.
I always enjoyed seeing guys come into my clinic by themselves. Manliness was the order of the day, especially when the guy in question was the owner of the cat. People often think of women having cats and men having dogs, just as they think dogs are masculine and cats are feminine. This is not necessarily true.
One scruffy college student named Finn brought in his tiny four-month-old jet-black kitten, Kitty Monster. Kitty Monster was adorned with a wide black leather collar with silver-colored spikes sticking out of it. That collar really complemented Finn’s Goth look of hair dyed black and styled bristly with lots of gel, black jeans, a torn black T-shirt, and black boots. Teenage Finn may have thought his style was fierce and intimidating; I thought they were both totally adorable. I insisted on taking a picture of them for the clinic bulletin board before I gave Kitty Monster his exam, deworming, and shots.
Another client, Max, was a huge motor-head, complete with a long ponytail, scraggly beard, tattoos, and Harley. Max owned an adult brown tabby cat called Slash, named, I presume, for the potential damage the cat could inflict. But Slash was no vet killer, despite the mental images that whirred through my mind of a kitty sidecar on Max’s Harley for the annual Sturgis roundup. He was a pussycat, one of the sweetest patients I ever had.
I expected clients to bring their cats safely to the clinic. My staff and I discussed this with new clients on the phone before their appointment rolled around. I once had a client bring two cats to the clinic in the trunk of his old beater, without the safety of pet carriers inside the car. The instant he opened the trunk, out flew the terrified cats. I normally won’t chase cats, but my clinic was on a busy street, and the cats ran away after fleeing the trunk. We did eventually capture them, but when I insisted that the owner buy two cardboard cat carriers from me to go home, his attitude made it clear that he wasn’t interested in safer transportation for his terrified pets. I declined to take him on as a client after that first visit.
Fortunately, Max drove Slash to the clinic safely in a cat carrier in his car, not strapped to the back of his Harley. He was such a charming man—one of the tattoos on his forearm was a likeness of Slash within a heart—and so careful with Slash and mindful of his proper care.
I have also done many sex changes in the office, often during that first visit.
Sex changes?
Yes, really!
It’s not as difficult as you think. Bonny’s a good example of the procedure.
Bonny’s older owner, David, brought her in. When David left a short time later, Bonny had become Sir Bonny, no muss, no fuss. Well, not much fuss.
How is this possible, you ask?
The exam began simply enough. I positioned the cat on my exam table. Cats were pretty comfortable on my table, because instead of the usual cold stainless steel surface, my beautiful cat-sized exam table was a converted antique Singer sewing machine stand. Its oak tabletop was covered with a pad and towel so my patients wouldn’t slip or slide.
I rolled the friendly adult cat over so it was belly-side up. And there, right where you’d expect it to be, was a scrotum containing two testes.
Bonny was definitely a male. Instant sex change!
As politely as I could, I asked David if he had looked for the scrotal sac. He turned bright red and stammered, “I didn’t see anything hanging.” This is a pretty common scenario, and I always imagine myself replying, “Cats don’t hang, sir.” But I know better; my clients are already uncomfortable enough as it is.
So, very gently, I pointed out Bonny’s male genitalia and explained that cats, even lions and tigers, have scrotal sacs very close to their abdomens, which can make them difficult to recognize. Bulls hang, rams and buck goats hang, dogs hang a little, but not cats, nor horses for that matter.
Talking about testicles to a guy is dicey. To ease the embarrassment, I often shared the story of El Toro, the Brave Black Bull.
El Toro is a life-sized anatomically correct sculpture of a bull and matador outside a Mexican restaurant in Tucson, Arizona. El Toro is amazingly well endowed—so well endowed, in fact, that it has become a tradition to paint the hanging scrotum in a seasonal theme, such as Santa and his reindeer at Christmastime, shamrocks for St. Patrick’s Day, or the University of Arizona’s signature A during basketball playoffs, depending on the time of the year. There is a long waiting list to be allowed to paint that bull’s huge privates. There is no vandalism on this statue—it is art. This story is true and ridiculous enough that my clients can laugh about hanging versus not hanging and girl cats suddenly becoming boy cats.
Owners are not allowed in the surgery room, but they are welcome to stay in the exam room for treatments. Some clients walk out of the room when their cats get vaccination shots; others are fine no matter what procedure needs to be done. No one is required to stay, of course, but guys like me to know that they can handle observation of medical treatments.
One young man, Callum, brought in his adult long-haired cat, Lionel, who had an abscess on his back from the bite of another cat, a common reason for a trip to the vet. I diagnosed this before the cat ever got to the examination room. The feline mouth is a cesspool of bacteria, one species in particular, Pasteurella multocida, which is instantly identifiable by the putrid smell the moment the cat comes through the clinic door.
Fortunately, Lionel’s abscess still had a scab. This could be treated in the exam room and not compromise the antiseptic cleanliness of my operating room. I could just pull the scab off and squeeze the pus to the outside, thus avoiding general anesthesia, a surgical incision, and a drainage tube stitched in.
I gave Callum the option of waiting in the reception area if he wished. Callum said no, he was a pre-vet student, and he’d like to stay in the exam room and watch.
I told him that it might be unpleasant for him and warned him that it’s different when it’s your own cat on the table, but he insisted he’d be fine and he could handle it.
He was a nice guy, but I wondered if he could take what was coming.
When I pulled the scab off Lionel’s side and started gently squeezing the swelling, pus oozed out everywhere—I mean on my gloves, down the side of the cat, onto the exam table and my lab coat, overflowing to the floor, and splattering onto my shoes. That small, lumpy abscess turned out to be a volcano of infection that yielded over a cup of stinking, gooey yellowish pus mixing in with Lionel’s long fur. Good grief! Half that cat’s weight must have been pus.
As I milked the abscess, I glanced at Callum. He was as white as a sheet. His mouth hung open. His face was sweaty, and he was breathing hard. Then his complexion turned green, a portent of sickness to come. I told him quickly to lean over, put his head between his knees, and take slow, deep breaths. I couldn’t catch him if he fell over; I had a patient on the table and was covered with pus. Besides, I’d rather smell cat abscess than human vomit any day of the week and twice on Sundays. I told Callum he would be okay; it’s just that some inexperienced people can handle watching treatments and some can’t. Not to worry, nothing to be embarrassed about.
As I finished treating Lionel, Callum still needed a few minutes to recover. It was a while before my next appointment, so I let him hang out in the chair, head down, while my staff cleaned up the room around him. Eventually, he was stable enough to stand up and no longer looked as though he had been run over by a truck. After taking care of the bill, he shook his head, grinned sheepishly, and said, “Jeez, what a gross and disgusting way to earn a living.”
Indeed. Being a vet isn’t all about cute and cuddly; some days, it’s about having pus pour down your lab coat and praying that no one, human or animal, throws up on your shoes. I knew that Callum’s queasiness that day might—or might not—matter by the time he got through the rigors of undergraduate work.
“Pre-vet” isn’t an actual major; it’s more of a declaration of intent. Vet school prerequisites—medical-level organic chemistry, genetics, and calculus, for example—can be part of any major and many career paths. Once he finished these courses and others, he could apply to vet school, or he could pursue any one of the hundreds of other science-based careers out there. Add a teaching licensure program, and he could have a great career as a teacher.
I’d begun as a physical education teacher and returned to college to take the veterinary prerequisites during summer semesters and, when my teaching job was part time, in my free time during the school year. I loved my new career, but it’s not for everyone.
Even those who are confident in their career choice will succumb to the “green around the gills” phenomenon in the right circumstances. It’s a physiological reaction, biology at its most basic. The remedies we learn address that.
One of my best employees was a freshman pre-vet student. Steve, who was a big kid, first started with me as a teenaged member of a high school project in business class. Steve later told me he’d felt embarrassed when he’d held cats for me because his hands were so huge they’d covered the entire cat. He was worried that clients thought he was hurting their cats. I found that concern charming. Steve made it into vet school and continued to be a caring, gentle employee.
While Steve was assisting me in surgery and learning how to monitor the patients, he kept excusing himself to leave the room. He almost fainted several times.
I told Steve not to lock his knees, which almost every rookie in the OR does. I told him to breathe slowly and deeply and to move around a little while being mindful not to touch me or the table, which could compromise the sterile technique we were using. For weeks, he jogged gently in place during surgery in my small OR, training his body to tolerate the sights, smells, and sounds that are routine in surgical procedures. It worked, and he ultimately completed vet school. After graduation, he became a feline practitioner in Utah.
I was not immune to this challenge. My first experience with it in animal care was one summer long before I went to vet school, when I was helping Earl in his clinic. It was a hot day, and I was wearing a cap, mask, gown, and gloves for the first time. I was standing—knees locked, of course, since I didn’t know any better—under the light of Earl’s towering surgical lamp, becoming increasingly hot and uncomfortable. I started to feel light-headed, and then everything went black.
I didn’t faint—I didn’t collapse, and I was fully conscious—but I was blind. I recognized this as something I’d experienced before, once as an undergraduate and once in high school.
I fumbled my way out of the OR, sat down, and lowered my head until I recovered. I realized later that it wasn’t looking at guts that triggered this reaction; it was wearing a mask over my nose and mouth and standing with knees locked under a hot light on a hot day.
During junior year in vet school, learning to cope with a mask was part of our training. A surgery professor gave each of us a mask and encouraged us to wear it as much as possible at home and in the hospital, just to get used to it before ever going into an operating room. Even with practice, each year at least one junior surgery student fainted dead away to the floor in the student OR. Unfortunately there’s no one to catch them—everyone is in sterile clothing, busy with procedures, and can’t break sterile technique.
Of course, vet students and wannabes aren’t the only ones who get queasy when it comes to procedures. Many otherwise responsible and intelligent men turned interesting shades of green or flushed red when the subject of neutering their cats came up. Often, on their first visit, they refused to discuss the topic at all. When I finally could get them to talk, we’d have to wade through a lot of misinformation.
More than one client relayed that they’d heard you weren’t supposed to neuter cats until they “knew everything.” Knew what? How sex worked? Where kittens came from? What tomcat urine smelled like?
Kittens reach sexual maturity at about eight months of age. It may be tough to look at that little furball and think, It’s time, but delaying or avoiding the procedure is never a good idea. The kitten’s urine starts to reek of the horrible, beyond-pungent odor of the mature tom. And the cat starts using this substance to mark its territory, spraying it to tell other toms that there’s a new sheriff in town. It doesn’t matter if there aren’t any other toms; the territorial marking behavior is hardwired into the intact male cat. One-half regular Listerine mouthwash to one-half water in a spray bottle can help with the odor when cleaning surfaces such as a cage a tom has occupied, but in homes that have an adult intact male cat, the house and cat reek horribly of tomcat urine.
A beautiful tomcat named Mikey, who lived in a rural area not far from my home, was a classic: huge tomcat shape to the head, muscular physique, and massive testes in his large scrotum. He was kept outside to deal with the rodent population. However, looking for a feline girlfriend is pretty much all that toms want to do. Eating is secondary.
Add that to the problem of pet overpopulation and the number of unwanted cats that fill up animal shelters, not to mention the decline in the songbird population thanks to outdoor cats hunting birds, and there is a real problem with having outdoor intact toms.
When I broached the topic of neutering their cats, I think men involuntarily projected an imagined experience of their own castration onto their cat. I never used the word “castration” with them; it was just too close to their virility, and I didn’t want them to collapse on the floor, moaning about losing their own manhood. I also knew that I couldn’t just say, “Hey! We aren’t talking of neutering you, just your kitten.”
I had to be very diplomatic on such a touchy subject. I learned early on that everything would work out as long as I could educate the guys about their cats. That included taking their reluctance regarding neutering seriously, thus lessening their self-induced trauma. Once they realized that their own manliness would be intact—and so would their cat’s, except for the cat’s ability to breed—the light bulb would go on in their heads, and they’d understand the importance of having the procedure done, and done correctly.
I recommend all feline males be neutered at five months, or sooner if there is something there for me to grasp. If I can’t palpate the testis—if I can’t feel it in the scrotal sac—I have to hunt for it.
Cats are born with two testes. If only one or none are palpable, the cat is termed cryptorchid, and you wait a little longer to see if the testes will continue on their journey out of the abdomen, under the skin and other tissues, and drop into the scrotum. If they don’t descend, they still have to be removed, which can involve major surgery. It’s important not just because you want to be a responsible pet owner; retained testicles can also lead in later life to a cancer called Sertoli cell carcinoma.
Kirk, a brilliant English teacher and good friend, brought his cat in for routine dental care but mentioned that his previous vet had told him that three-year-old Tigger had been born with only one testicle. Kirk thought Tigger was special because Tigger had only one, which the vet had removed. But Tigger was not special, medically speaking.
Cryptorchidism is fairly common among male cats. I’m sorry, but God gives the male cat two testes. Having only one is so rare as to be unheard of. If you can’t find the missing testis, you have to go hunting for it. The veterinarian has to know this and know how to resolve the problem.
I put Tigger on his back and pushed my finger over his abdomen on one side, where the testis leaves the inguinal canal via the cord that takes it out of the abdomen and under the skin to go into the scrotum. As I moved my finger over the abdomen, I saw and felt a large lump. It was the testis, right under the skin. It just hadn’t made it all the way to the scrotum, missing it by two inches.
It’s common to see in practice and, in this case, was easy to remedy. I anesthetized Tigger as planned for his dental work, popped out the misplaced testicle, put in a couple of sutures, and then cleaned his teeth.
Other times, the hunt for missing testes isn’t so easy. Jason brought in a new patient, a drop-dead gorgeous purebred Birman kitten named Jasper, which his parents had bought him to have as a companion at college.
The Birman, also called the “Sacred Cat of Burma,” is a longhaired, color-pointed cat typified by a silky, fluffy coat, deep blue eyes, and white “gloves” or “socks” on each color-pointed paw. It looks similar to the Siamese, but there are no longhaired coats or white socks on Siamese cats.
I confess that my first reaction when a client brings in a purebred cat is to insist that the client not tell me how much the cat cost. While I love to see beautiful purebred cats, I’ve never owned one. I’m a firm believer in adopting cats from the animal shelter. However, I had to admit that while my three tabbies were beautiful cats, Jasper was breathtaking.
Different people have different wishes and needs, which quality breeders fulfill. And Jason was a good kid. He loved Jasper and was a topnotch cat owner. He listened to what I said and followed all my advice about his fluffy Birman buddy.
Jasper, as it turned out, was bilaterally cryptorchid. Cryptorchid cats can’t be used for breeding, as the trait of undescended testes can be passed along to male offspring. That should be pointed out to the buyer, who shouldn’t have to pay such a high price for a purebred cat that won’t be able or allowed to breed.
At six months of age, when I should have been able to find the two testes in Jasper’s scrotum, there were none. I told Jason that sometimes purebred kittens need a little more time. We would give Jasper until eight months to see if the testes would descend.
A few months later, at nine months, Jasper came in for a checkup and a second round of vaccinations. There was still no sign of the testes. I’ve seen purebred cats with undescended testes at eighteen months of age, but I didn’t want to wait that long. The results would be the same. Wherever they were, it was time for Jasper’s testes to go. We scheduled the operation.
And so Jasper went to surgery. For the life of me, I couldn’t find his gonads. But God still gives them two, so they had to be there somewhere.
First, I tried the usual way to find testes, opening the scrotum by making an incision on each side, then exploring the inside. Nada.
The next step is to explore the area where the testes leave the abdomen to be under the skin and fat on their way to the scrotum. Now Jasper had four incisions: the original two in the scrotum, plus one on each side of the lower abdomen, running diagonally from the inguinal ring area to the scrotum. I explored the path the testes are supposed to take on their migration from the abdomen to the entrance of the scrotum. Nope.
I reviewed in my mind the absolute last thing you do if you can’t find the testes: a very long incision, similar to the short spay incision on a female cat, midabdomen, straight down to the genitalia. A cat spay incision is maybe an inch long for me unless the cat is pregnant or infection is present. Jasper’s incision was five inches long. I reminded myself of the pearl of wisdom a surgery professor had once given me, “Incisions heal from side to side, not end to end.”
Eureka! There they were, two little squashed, alien-looking structures right next to the bladder on either side. Victory was mine!
These testes would clearly be nonfunctional with that structure combined with the heat of the abdomen. Temperature control is why the testes are outside of the body cavity.
A couple of sutures to the mashed testes’ attachments, then closure of the long incision, and Jasper was officially neutered. Although his suture-covered abdomen looked like a road map, his long, luxurious fur would cover the scars as soon as it grew back. He would again look beautiful.
I kept Jasper overnight to observe him and administer pain medicine if needed. That’s the benefit of having an in-house clinic.
Jason and Jasper had a happy reunion the next day. Jason took him home, no worse for the wear. I had no doubt that Jasper would be in good hands with his best buddy.
Summertime is kitten time, and my appointment book fills with new patients and their humans. I grinned as Gil, the electrician who’d rewired our house the previous year, made his way carefully from the waiting room to the exam room. A snoozing white-and-gray kitten nestled entirely in Gil’s massive left hand. The kitten woke and yawned wider than wide, as if practicing for future leonine roars.
Gil, as concerned as any new father, gently handed the kitten to me for its first exam.
Boy or girl?
Almost time for the talk.