Not What You Want At The End of The Day

Generally we don't like to see sick patients at the END of the day for various reasons: a work up is just going to extend the day that much longer, if they need monitoring/observation or testing that goes on over time they will need to be referred or deferred to the following work day and then there's tonight's example:


A 14yr old cat that hasn't seen a veterinarian much in his fortunately healthy life comes in for weight loss and not eating much despite seeming to be interested in food. He's lost about 1/2 his body weight in ??? amount of time (no good answer to this one). During his exam I discover three things: 
1. he has an oral mass (most likely cancer)
2. he has a very short kitty window to work with - in other words, he became fractious
3. he's a bit "yellow" - gum, skin and sclera color - indicating liver issues


So the owner quickly understands we need blood work and may need to follow up with setting up a biopsy on this oral mass.  We take him to get blood and he is NOT going to let us. We don't want to stress him out OR have a staff member get bitten or hurt so we recommend using some gas anesthesia to lightly sedate him to get the blood. This stuff is VERY safe - and is handled by the lungs alone - no liver/kidney involvement at all. Once they are off the gas, they are quickly awake. Well, our little old kitty decided that after he was fighting for a bit...to suddenly go into cardiac and respiratory arrest (in other words - die!). I had this feeling he wasn't "right" all of a sudden and it happened THAT quickly. So we intubated him and did CPR on him and got him back!! Yeah!! New clients, end of day, sick cat..not where I wanted to go with this case..but fortunately he is doing fine..for now. I explained what happened because frankly, he is NOT a surgical candidate at all now. His blood work will tell us more and I won't be surprised if his liver values are way off but there is every chance this poor kitty's day are numbered.