Friday, July 28, 2006

The Nurse as Vet

I was visiting a patient today to follow up on a finger lesion that we biospied in the office on Wednesday. Although my patient was moderately concerned with her finger---which, by the way, looked considerably better---her main concerns rested with her cat (pictured here) who apparently has a upper respiratory infection.

Said cat---"Timmy"---has been sneezing and anorexic for days, and only today began taking azithromycin. My patient was mostly concerned with ongoing anorexia on Timmy's part.

Being a nurse who likes to please, I performed a cursory exam of the surprisingly cooperative feline, felt his belly, palpated his nose and throat and sinuses, checked out his nose and mouth and ears, and concluded that he had no acute GI symptoms and was most likely not eating due to a combination of the antibiotics and a cold. I urged my patient to relax, keep plenty of fluids and cat food available to him at all times, and recommended she follow up with her vet if Tommy isn't better by Monday.

As for the finger, the wound culture has so far grown out gram-negative rods and we're waiting to see if the herpes culture is positive or negative. While my patient has already had one lung removed due to adenocarcinoma, I don't think the finger will be killing her any time soon. (Interestingly, she reports having had a colonoscopy recently and thinks that the finger with the lesion was the one that they had in a pulse oximeter. Could she have picked up an infection from poorly cleaned medical equipment? It wouldn't be the first time.)

As for Timmy, I expect a full recovery and give him a prognosis of a very long and happy life, along with the occasional URI.
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