A Fearless Heart

Laurie Ross and her family have been PAWS foster care providers since July 2009, raising and preparing 25 kittens for adoption. She's admittedly a soft touch, "Each of these little fur-balls has wiggled their way into my heart." So when a family of seven Siamese-mixes showed up at PAWS, Laurie couldn't say no. The kittens were discovered in a woodpile, steps away from their deceased mother. They were beautiful, and the smallest of the litter was tugging hardest on Laurie's heart.

It was clear that Icicle (as she would become known), was taking longer to put on weight and grow into her gangly legs than the other kittens. Even so, Laurie's neighbors fell in love with her and her sibling, Thea. The Brown family decided to adopt them both, not knowing that Icicle was facing a lifethreatening medical condition.

Prior to adoption, cats and dogs who have been in foster care return to the PAWS shelter for a final medical examination and are spayed or neutered. On the day Icicle and Thea were scheduled for their spay surgeries, PAWS Veterinarian Dr. Darlene DeGhetto performed the pre-surgical examination. "Right away I knew something wasn't right. Icicle's breathing patterns were rapid and shallow, and she seemed lethargic." Dr. DeGhetto was concerned that the kitten might be suffering from pneumonia, so she decided to take radiographs of her chest. The spay surgery was postponed.

The medical team managed to take radiographs of Icicle's tiny chest, even though the kitten only weighed about 2½ pounds. The results showed signs that her ribs had been fractured at a young age and fortunately had healed. But what concerned Dr. DeGhetto is what she saw beneath Icicle's ribcage. The images were so unusual that she immediately consulted with Dr. John Huckabee, PAWS Wildlife Veterinarian.

The veterinarians performed an ultrasound that revealed grim news. Icicle didn't have any signs of pneumonia, nor did her heart appear enlarged. "That would have been more straightforward," sighs Dr. Huckabee. Instead, Icicle's liver was pushed upward in the abdominal cavity and had actually wrapped around her heart. A situation the doctors decided was most likely caused by a small congenital defect in the diaphragm that had allowed the cranial portion of the liver to enter the sac around the heart (called the pericardium). Icicle's prognosis was grim. She needed surgery, but removing a liver from around the heart is risky.

PAWS veterinarian Dr. Keiko Young performed the surgery a week later. Using small, delicate instruments, she carefully manipulated the kitten's organs. "I was able to gently tease the liver out of the pericardium, repair the hole in the diaphragm while leaving the liver intact." Dr. Young then placed a tube into Icicle's chest to re-inflate her lungs and drain any excess fluid or air from her chest cavity. For the next 24 hours the doctor stayed at Icicle's side, watching for complications like respiratory distress, lung collapse, or excessive pain.

The next day, Icicle returned to her foster home to recuperate. The operation was behind her, and a new family was on the horizon. Exactly one month later she was finally spayed. The Browns completed the adoption soon after and Icicle was finally reunited with Thea. Two sisters once abandoned, now living a life full of love and companionship. Thanks to a heart that dared to survive, inside the delicate body of a kitten who was waiting for love.

Inside the Medicine: The Radiograph

PAWS veterinarians use a radiograph to visualize tissue, organs and bones that lie beneath the skin. This abdominal x-ray procedure is very helpful in discovering organ abnormalities and defects that may show up in an examination as unexplained fever, lethargy and weight loss. These are all symptoms that Icicle presented to PAWS veterinarians. By using the radiograph procedure, they were able to visually identify the liver/heart issue, and create a strategy for the surgery that followed. The radiograph is non-invasive, and causes no pain for the animal. In fact, in most cases, the animals don't even require sedation.

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