10/12/2025
Below is the next excerpt of my upcoming novel, A Company of Paws, due out next Summer/Fall. In the meantime, if you haven't read it yet, look for my first novel about veterinary medicine, Red Barn Tales, available on Amazon and at other retailers.
A Will To Live
Boris Weaver stood anxiously on the other side of the cold metal exam table, his gaze nervously shifting from me to his little dog, Cargo, who lay unmoving and lifeless on the table. It was a dreary Monday morning and drops of water from the soft rain falling outside clung to the brim of the worn fishing hat that Boris clutched tightly in his hands. Boris was an elderly gentleman, in his late seventies, and he and his family had been bringing their animals to the clinic for as long as I could remember. As I lifted the dog’s lips, I was stunned by the cold gray mucous membranes. I listened to his heart in silence as Cargo’s owner watched. Each breath was accompanied by an ominous rattle, and his heart rate was painfully slow, its rhythm irregular and skipping the occasional beat. The skin along his back stood in a defined ridge when lifted, only gradually sinking back after it was released, all elasticity gone. I gently palpated Cargo’s abdomen, which was difficult because the dog was extremely overweight. He grunted softly in response but continued to stare vacantly ahead. Watery hemorrhagic stool leaked from his rear end when I raised his tail and gently inserted my glass thermometer into the a**s. The strong, putrid odor of bloody diarrhea wafted through the air.
“How bad is he, Doc?” Boris asked, on the verge of tears, his large, calloused hand resting lovingly atop Cargo’s head. He already suspected the worst.
“He’s in shock, Boris.” I wiped one end of the thermometer clear of lingering black organic matter and studied the mercury column. “His body temperature is barely 98 degrees, which is way below what it should be. Dogs in shock normally have a really fast heart rate. It’s the body’s way of trying to compensate. But in the most severe cases, the heart slows down as death nears. Cargo’s rate is very slow and irregular, which is a bad sign.”
I looked across the table at the sad owner before reiterating what I’d just said. “He’s in shock and his body is cooling off and shutting down, his circulatory system collapsing. I’m afraid he’s trying to die.”
As the words sank in, registering with the full import of what I was saying, several tears slid down the big man’s face one at a time, glistening on the end of his mottled red nose. After a minute, Boris managed to regain some his composure. “Can you save him?” he pleaded. “Is there anything you can do? I love this dog so much.” His breath caught in his throat as he tried to continue. “I don’t want to lose him. I just can’t lose my boy.” His voice jumped an octave at the end.
I passed Boris a box of tissues before I attempted to respond. The truth was that I didn’t really know how to answer his question. Cargo was actively dying, and even if we did everything humanly possible, it was likely the dog still wouldn’t survive. Boris had lost his beloved wife of fifty-two years, Blanche, only a few months before. Dr. Hitchcock and I had taken the afternoon off to go to Blanche’s funeral, and I could still feel the raw emotion of that day. My heart ached for Boris, for what the additional loss of this dog would mean to the old man, so soon following the death of his wife.
Cargo had all the classic signs of pancreatitis. He was middle-aged, morbidly obese, and had developed acute vomiting and diarrhea in the past 24 hours. When I questioned Boris closely, he admitted a large part of Cargo’s diet consisted of table food. And in the weeks since his wife had passed away, both he and the dog ate a lot of take out. It was just too much effort to try to fix meals alone that his wife had always cooked for the three of them before. But this wasn’t really anything new; for years, they had consumed a diet rich in fats that wasn’t healthy for the humans in the household, let alone the dog. Boris’ wife prepared large country spreads at each meal that featured fried foods in abundance. Breakfast always included healthy portions of bacon, and Cargo partook of about as much as Boris did.
In dogs, pancreatitis is frequently caused by consumption of the type of human foods that made up a large portion of Cargo’s diet. The pancreas, which normally secretes digestive enzymes into the small intestine, becomes overstimulated and inflamed. The digestive enzymes began to leak out into the peritoneal cavity, damaging not only the pancreas but the surrounding organs, too. Some chronic cases lead to mild vomiting and diarrhea, but the acute episodes can be life-threatening. The liver and even the kidneys are severely affected, and I had seen some dogs with pancreatitis develop secondary renal failure as a result. Sometimes, in acute cases, the pancreas becomes necrotic, an abscess develops, and the dog becomes septic. I suspected that this was what was happening to Cargo, and his prognosis was very grave. Even when dogs survived, they could become diabetic due to the permanent damage to the pancreas.
“I think Cargo has pancreatitis, but we can radiograph his abdomen to try to rule out other causes. He could have ingested a foreign body and have an intestinal obstruction, maybe a bowel perforation, or he could even have cancer. His abdomen is so large that it’s difficult to palpate it completely. We need to start an IV and take blood samples to send to the lab in Anderson, but we won’t have those results back until tomorrow. The most important thing right now is to try to reverse the shock with fluid therapy, because otherwise he won’t live much longer.”
In those days, as a small rural clinic, we didn’t have the capability to perform in-house bloodwork. If a case required it, blood samples must be submitted to the hospital lab over in Anderson, South Carolina. Fortunately, they would send a courier by the clinic each morning if we requested it, but that still meant results would not be delivered, either by telephone or fax, until the following morning at the earliest.
“Do everything you can, Doc,” Boris said. “I know he’s suffering, and if it’s hopeless I, I guess I’ll have to let him go.” He paused and gulped, overcome with grief at the prospect of losing his dog. Leaning down, he kissed Cargo on the head, and the little dog managed a soft whimper as he tried to look up at Boris. But his strength was almost gone, although his tail thumped the table once or twice at the sound of his owner’s voice.
It was an emotional scene, and in these situations, I didn’t always know the best thing to say. But I needed to give Boris some sort of encouragement. He would go back home to a very empty house with the knowledge that Cargo might never come home weighing heavily on his mind. “I know you don’t want to have to do that, Boris. We’ll do everything we can to save him.”
Boris looked across the table at me one more time and managed a feeble smile. “I trust you. Do what you can, and I’ll just have to accept whatever happens.” He kissed the dog once more, lingering by the animal’s face and patting him briefly on the head. Then he turned and left. My gut clenched at the sound of muted sobs trailing behind him as he headed up to the front. Cargo watched with sad eyes as his owner left.
F***y, one of our assistants, laid a towel on the table that she’d brought from the kennel and heated in the microwave. Both F***y and Cozy were a team who traded responsibilities between the front desk and the exam and surgery rooms. Today F***y was helping me take care of patients.
“Let’s take him back to the surgery room. He’s extremely dehydrated and it’s going to be tough to get a catheter in him. At least the light is better there.” I lifted Cargo while F***y slid the clean, warm towel underneath him. Then we carried him gently back and laid him on the surgery table.
While F***y warmed up a bag of fluid in the microwave, I set up the intravenous line and extension set and prepared several lengths of tape to secure the catheter once it was in place. When F***y returned, she held Cargo with his right foreleg extended while I shaved a patch of hair over his cephalic vein. Cargo was some sort of mixture of Chihuahua and Dachshund. Unfortunately for the dog, he’d inherited the short stubby legs of the latter breed. Dachshunds are achondroplastic dwarves with short, crooked legs. Cargo’ forearm was malformed and splayed laterally at the carpus, and the cephalic vein could be difficult to catheterize under normal circumstances. In a hydrated animal, it tended to roll about beneath the overlying skin, and due to the compromised length of Cargo’s forelimb, the size of the catheter was almost longer than the span of the forearm itself. But Cargo was severely dehydrated, and I couldn’t even see the elusive vein I was searching for.
When animals suffer from shock, the cardiovascular system collapses. In survival mode, peripheral circulation is shunted to the most vital body organs, such as the heart and brain. Sure enough, when we tried to distend the cephalic, there was no filling of the vein. With the hair shaved, I thought I could detect its faint blue shadow coursing along under the pale skin, buried deep in the fat below. But it was difficult to tell for certain. Because the vein didn’t fill, palpation was pretty much useless.
“Okay, here goes nothing,” I said to F***y as I took a deep breath. I carefully inserted the thin, teflon catheter through the skin and into what I thought was the blood vessel. Cargo ignored what I was doing, totally indifferent to something that is sometimes painful to the animal. He simply continued his blank, mindless stare, gazing straight ahead, not even lifting his head or whimpering. I would have rather he protested a little. Just show a little bit of a fight, I thought. That would be something.
Ordinarily, as the catheter threads the vessel, there is an accompanying flash of blood in the hub to signal that the vein has been successfully entered. As the catheter is advanced and the metal stylet inside withdrawn, the blood wells up in the end of the catheter, and the intravenous fluid line can be attached and turned on. But at this moment, there was no rewarding flicker of blood, no encouraging spot of red flowing out. A few minutes later, after multiple disappointing attempts, we moved to Cargo’s left arm. But it was the same there, too. I couldn’t hit the vein, let alone catheterize it. And if we didn’t get fluid going soon, Cargo would die. That was a grim fact, and the clock was ticking down, his time rapidly running out.
One try after another failed. Dogs have a lateral saphenous vein on the outside of each lower rear limb, and although it can be more difficult to catheterize, it became our next option. But there again, I was unable to hit anything in either leg. Cargo’s blood pressure had bottomed out, and it all seemed so useless. My anger was rising at both my inability to start an IV and at the seemingly hopeless condition of my patient.
“What about his neck?” F***y asked as I leaned back against the counter in frustration.
I shook my head. “Probably not in this case.” It is possible to catheterize one of the large jugular veins in the neck, but the teflon catheters we used were difficult to secure to the neck region, and Cargo’s short, fat, neck would make venipuncture there even harder to achieve, let alone maintain in place if we were successful.
“Can you give him subcutaneous fluid?” F***y suggested as she stared down in discouragement at our lifeless patient lying on the table before us. Fluid can be administered under the skin in small amounts, but it is very slowly absorbed, so for a patient in critical condition like Cargo, it isn’t the best route. Cargo needed the immediate fluid expansion of his cardiovascular system that only IV fluids could provide, if he were to have any chance to live.
“No, he needs intravenous fluid. Subcutaneous fluid would only be like pi***ng in the wind.” That was a phrase I’d heard Dr. Hitchcock say time and again over the course of many years of working at the clinic as a young boy. “If we don’t get this line started soon, it’s all going to be a moot point,” I said, sighing. “Let’s go back to the front leg. I can try to do a venous cutdown. That might work.”
A venous cutdown is a procedure where the skin and subcutaneous tissue over a major superficial vessel is incised. By dissecting down to the vessel itself, it can be easier to thread a catheter into the vein. It would obviously be painful, but Cargo was in no condition to be sedated, let alone anesthetized. It was rare that this had to be done, but I was all out of other options, and it might mean the difference between life and death for the dog. But as I prepped the leg, I didn’t really have much hope.
I shaved as much hair along the length of Cargo’s forearm as I could, and then quickly prepped the skin with surgical scrub and a layer of disinfectant. Donning a pair of gloves, I opened a sterile surgical pack and removed the scalpel handle. Holding it up before me, I snapped a new number ten blade into place on the end of the handle. While F***y positioned the forearm and blocked the cephalic vein again near the elbow, I waited a few moments for it to fill. All I was rewarded with was that same faint blue line deep under the cool waxy skin. Cargo simply didn’t have much blood flowing peripherally.
Taking a deep breath, I incised just above where I thought the vein was, being careful not to go too deeply into the tissue. Cargo made not the slightest response as the shiny blade did its work. As the skin parted, I advanced the incision a little deeper, and the shadowy blue vein came into better view. Setting the scalpel aside, I took a new catheter, said a quick prayer, and inserted the bevel of the needle directly into the now visible vein. Almost immediately, a flash of impossibly thick, tenacious blood oozed into the hub of the catheter. Holding my breath, I simultaneously advanced the flexible catheter while withdrawing the stylet. Amazingly, the catheter threaded its way up the vein with relative ease.
“Thank the Lord!” I shouted, my outburst startling both Fannie and Cargo, who for the first time lifted his head. “We got it!”
The skin incision was both short and shallow, its thin margins bloodless, and I hurriedly filled the opening with an antibacterial ointment and covered it with a thin piece of sterile gauze for a light bandage. I taped the protruding end of the catheter to the overlying skin, careful not to stretch the elastic tape too tightly. Too much compression would further compromise blood flow in what was Cargo’s last remaining lifeline. Reaching across the table, I slowly opened the flow valve on the fluid line. The warm, life-saving liquid began to run into the dog’s vein, and Fannie and I anxiously watched for any sign that the fluid would infiltrate, or spill out into the surrounding tissue. The little vein was very fragile and could easily rupture. But after a few anxious moments, the IV fluid continued to flow and there was no telltale swelling farther up the leg above where the catheter was taped. I used the additional lengths of tape to fasten the looped fluid line to the foreleg and further attach it securely to Cargo’s leg. If anything happened to disrupt the catheter and fluid line, Cargo would probably die.
Breathing a sigh of relief, Fannie and I high fived across the table. Without realizing it, more than an hour had passed by while we worked on our little patient. While she held Cargo and monitored the fluid drip, I hurried to the pharmacy for medication to add to the fluid. Cargo needed dextrose for energy and b-complex vitamins. A quick check of his blood glucose had shown that it was very low. Because he likely had a serious abdominal infection, he also needed systemic antibiotics and an antiemetic to control vomiting and nausea. And he needed something for pain. Pancreatitis caused intense, unrelenting abdominal pain, and as Cargo came around, his discomfort level would likely intensify.
After administering all the medications and obtaining a blood sample to send to the outside lab, I held my patient while F***y set up a cage in the kennel with a heating pad. Once the cage was ready, we carried Cargo back and tenderly laid him in the small compartment, covering him with a blanket. We’d done all we could, and now it was up to Cargo. Once settled inside as comfortably as we could make him, he continued to lie there as listless as ever, but when I turned to go, the blanket began to shake ever so slightly. Cargo was shivering, which was a good sign. His body was trying to warm up, so he was starting to fight at some level. That was something.
I went back up to the front of the clinic and called Boris. We’d done all we could for now, and we had arranged for a courier to come pick up the blood sample and take it to the regional hospital over in Anderson. We’d get those results in the morning and go from there.
All day we anxiously watched Cargo for any sign beyond the shivering that showed he was improving. But our vigil proved disappointing. He lay unmoving in the cage, and since he was on a heating pad, we rotated him frequently to try to prevent the possibility of burns where he lay in contact with the areas heated by the underlying pad. The one good thing about his relative immobility was that the fluid ran undisturbed. Often, as animals improved, they began to move about in the cage, kinking up the fluid line or licking and chewing at the tape and the plastic tubing of the IV line. While it was encouraging to see signs of improvement, it could be challenging to maintain the fluid flow. And we had been extremely fortunate to get that IV started at all. If anything happened to dislodge the catheter, we might not be able to get another one going in its place.
I came back to the animal hospital late that night to check on Cargo and ensure that his fluid line was still intact. But there was little change. He lay still in the cage, barely responding or even moving his eyes as I adjusted his position. By now he had soaked his cage with urine, and I had to move him to clean one. It was good that his kidneys were producing urine, but that didn’t necessarily indicate the kidneys were functioning normally. We could be successful in resolving the pancreatitis only to find he had permanent kidney damage. Or he could even become a diabetic. I was relieved that at least the intravenous fluids continued to run unimpeded, and there was no swelling along his catheterized leg or in the toes of the foot. When I raised the skin along Cargo’s back, it snapped back with a little more elasticity, which told me we’d made a dent in his dehydration. But the truth was, there was minimal overall improvement in the dog’s attitude. He was still extremely depressed, and he could very well die, if not tonight, then tomorrow. It was just too early to know if our efforts would be successful, and the odds were definitely stacked against my little patient.
Cargo was still alive the next morning, but only barely, and the peculiar smell of bloody diarrhea greeted me when I approached his cage. The results of the bloodwork we’d submitted the day before lay in the paper tray of the little inkjet printer-copier-fax machine in Dr. Hitchcock’s office when we arrived at work that morning. The hospital had faxed the report over earlier, and the numbers were dire. His pancreatic amylase was over 7000, which was extremely elevated, as was another enzyme called lipase, and his renal function was compromised. Based on the clinical values, he was technically in renal failure, but I was hopeful that if we could resolve the pancreatitis and rehydrate him, Cargo’s kidney function might return to normal. But his complete blood count showed a significant elevation in his total white cells. He had a severe infection, as I had feared, very likely an abscess, and his disease was impacting his liver function, too. The large, multilobed liver sat very near the pancreas and was taking the brunt of the leaking digestive juices.
Boris came to visit Cargo later that Tuesday morning, and I hoped his owner’s presence would elicit some sort of encouraging response when Cargo saw him. But when Boris opened the cage, Cargo only watched his owner with his sad eyes. The tail thumped once or twice under the blanket and that was it, other than an occasional grunt from abdominal pain. I left Boris alone with his dog, and a few minutes later the elderly man came back up the hall, crying softly. I met him in the breezeway between the kennel and the main building and we stopped to talk.
“Should we go ahead and euthanize him?” he asked. “I don’t want him to suffer, and I think he is. His belly is hurting.”
“Pancreatitis is painful, and we’ve given medications to help. I haven’t seen the improvement I’d like, but I still think it’s too early to decide.” I patted his shoulder. “I know you’re worried about him, and I am, too. But if he were my dog, I’d give him a couple of days more. If he doesn’t improve by Thursday, then I think it’ll be time. I don’t want him to suffer needlessly if there isn’t any hope of recovery.”
Boris sniffled and took a deep breath, wiping his eyes in embarrassment. “Okay. I trust you to tell me when. Thank you for what you did for him. I went home and prayed for him yesterday.” His dejected gaze drifted down the floor. “That’s all I could do.” He wiped his face again and I noticed the old, stained handkerchief in his hand. The white square was embroidered with dark blue initials, probably a memento from his late wife.
“I know you love him, and I’m glad you prayed for him. He wouldn’t be alive otherwise. There’s a limit to what we can do, even with modern medicine.”
Boris shook my hand and left, seeming to feel a little more encouraged. But as I watched him walk back up the hall to the front door, his shoulders hunched forlornly, I had my doubts. If only Cargo would show some sign that he was improving. If he would just sit up, being to stir a little, I’d feel a lot better.
The next two days were tense, to say the least. Cargo lay in the cage, mostly unmoving, barely clinging to life. Every time I went to check on him, every night when I came back to make one last check until the next morning, I dreaded I’d find him passed away. But it was always the same. He was there, hanging on by a thread, but that was it. He had stopped vomiting and the diarrhea had slowed, but when I heated a bite of chicken to see if he might be interested in food, Cargo only turned his nose away. Miraculously, the catheter remained patent and the fluid continued to flow undisturbed, his only lifeline and the one thing that was keeping him alive.
Wednesday morning, Dr. Hitchcock examined him and shook his head, giving me his opinion in no uncertain terms. “He looks like death warmed over,” he said, lifting Cargo’s lips and examining his still very cool mouth. “We probably need to talk to Boris about letting him go.” I bit my tongue, not willing to go there yet. Surely one more day couldn’t hurt.
Late Wednesday evening, I returned to the clinic around eleven thirty. I had several patients to check on, but of them all, Cargo was in the worst shape. He still hadn’t shown any progress, and as I watched the little dog lying helpless in his cage, I was certain the end was near. I had made up my mind to give him until the next morning, but I dreaded the call I was going to have to make Thursday morning. It meant failure, it meant giving up on the little guy, it meant letting Boris down, and I was more than a little angry and depressed. I’d done everything I knew to do, but it all seemed to have no effect. Cargo’s breathing had picked up that evening, becoming more rapid, which I took as a bad omen.
As I drove to work the next morning, I mentally rehearsed what I was going to say to Boris. It would be a difficult telephone call, for sure, and I dreaded what would come later, when I had to euthanize the dog. Dr. Hitchcock had arrived a little earlier than I, and when I came in the door, I was half hoping he would tell me that Cargo had passed away on his own during the night. That would save Boris from having to make the decision himself, and it would spare us all the heartbreaking scene that was sure to follow.
When I came in the front entrance, though, Dr. Hitchcock was whistling as he came up the hall from the kennels. “That dog looks better this morning! He’s sitting up in his cage for the first time!”
He could only mean Cargo, and I couldn’t believe it as I rushed back to the kennels to see for myself! The night before, I’d been sure Cargo was about to die. I hadn’t once seen him rouse from his prone position since he came in the door Monday morning.
Sure enough, the little dog was not only sitting up in the cage, but sometime in the night he’d thrown off the towel I’d covered him with. When I entered the room, he stood weakly and followed me with his head as I came up to the cage. Flooded with relief and more than a little disbelief, I opened the door and examined him. For the first time, his oral mucous membranes were warm to the touch, and instead of the ugly gray color of death, there was the faintest pink shade to his gums. He really was better, and I hurried back up to the front to call Boris and tell him the good news.
For the next couple of days, I was on pins and needles. Yes, Cargo looked stronger, but would it hold? Would he remain in renal failure, falling apart once the fluid support was removed? Would he develop diabetes?
But in the end, I needn’t have worried. Cargo had a will to live, and the little dog rapidly improved. When I came in Friday morning, he’d even chewed his IV line into during the night. This was almost always a good sign. It seemed he was done with it all! Since the dog’s hydration had been consistently normal over the last two days, I removed the catheter and offered him a bite of warmed chicken. To my surprise, he ate it readily, looking for more. With pancreatitis, animals need to be kept on a bland diet once food is reintroduced, to avoid overstimulating the pancreas again. Small frequent meals are best, so I waited a few hours before offering more chicken. Again, Cargo wolfed it down and begged for another bite, and although I didn’t give him more right away, I was elated at his interest in food and his growing appetite.
This dog had literally been snatched from the jaws of death, but I really wasn’t certain I’d done much to hasten his revival. That’s often the way it is in veterinary medicine, and you never know for sure if what you’re doing is really helping all that much. I fully believe in the power of prayer, and knowing my own limitations, I felt more inclined to underestimate my meager contributions. But the best moment came when Boris dropped by late that afternoon. Cargo excitedly stood up against the cage door and threw himself into his owner’s arms. As I watched, I felt my eyes watering a little. In the veterinary profession, we celebrate the human-animal bond and everything we do is centered around this attachment between pets and people, and it’s no different at Lavonia Animal Hospital. Clients and their pets are inseparable, and we serve them both equally. But until this incredible connection is witnessed up close and personal, it can be difficult to fully comprehend just how much a dog means to man like Boris. Boris needed Cargo as much as Cargo needed him.
As the old man gathered up his dog to take him home, he was weeping again, this time with tears of joy. He couldn’t say much to express his thanks, but I knew how he felt, and it was a wonderful feeling to know that Cargo could finally leave with his owner. Up until a couple of days earlier, that had been very much in doubt.
When Boris brought Cargo back the next Monday morning for a recheck, I couldn’t help but contrast how well the dog looked today, full of vitality as he bounced around the exam room in excitement, compared to the week before when he’d lain still on the table, at death’s door. I had seen dogs with pancreatitis that presented in better shape than Cargo still die after similar intensive treatment. But each animal is different in how they respond, and it’s not always possible to predict every individual outcome.
Boris was thrilled, too, and when he left, he took Cargo out to the car and returned carrying a plastic container with a chocolate cake inside. He’d purchased it from Dill’s, the local grocery store located within walking distance from the clinic, just a couple of blocks over on Highway 17. We often received food from grateful clients, and although the dessert might not seem like much, it meant a lot coming from Boris. Boris was a man of limited means, and Cargo’s treatment would be on the expensive side. But Dr. Hitchcock valued Boris as a friend and would have treated Cargo even if his owner couldn’t have paid anything. In fact, he heavily discounted the final bill to make it easier for Boris. It was easy to see just how much the dog meant to him, and we were happy to have helped save his life. Boris resolved to change Cargo’s diet and get his weight down, which also gave the old man a new lease on life and helped ease his depression over the recent death of his wife. Cargo thrived with the weight loss and lived to give his owner many more years of companionship. Later that day after lunch we celebrated the victory and cut the cake, savoring every delicious bite!
Excerpt from A Company of Paws © 2025 Jason K. Macomson All Rights Reserved
