Secret Second Opinions sought by Mr. Nomad's clandestine city tour

I found Mrs. Clueless anxiously awaiting my return to the exam room as I entered with the bad news.

It seemed that her cat, Boulder, had a large bladder stone and would require surgery to have it removed.

"You know, doctor," she said. "I have a medical background and some knowledge of radiography. Would you mind showing me the X-ray?"

I placed Boulder's film on the viewer and waited a minute while she studied the image. Her next words were exactly what I had expected.

"What am I looking at, doctor?"

I gave her a quick tour of the X-ray, going out of my way to name most of the important structures and points of reference.

"Thank you, doctor," she said. "You know, I have a working knowledge of anatomy. So, I understand perfectly what you are showing me. Are those the stones?"

With her finger, she was pointing to the lumbar vertebrae.

"No, that's the back bone." I said, and traced for her the outline of the calculus in the urinary bladder.

She felt that the stone looked pretty small and questioned whether a little thing like that could actually be making the cat sick. (It was likely the largest stone I had ever seen in a cat. In fact, during surgery I would have to remember to be careful not to drop it on my foot.)

Between a rock and a hard place

Well, I gave my recommendations. Boulder would definitely need bladder surgery, followed by analysis of the stone to determine what had caused it to form in the first place.

"You know, doctor," she said. "I know a little about physiognomy, and I already know what caused the stone. So there won't be any reason to have it analyzed. You see, I've been using that clumping cat litter, and I'll bet he got some inside and it clumped into that stone in his bladder. Don't you think we should try giving him an enema to get it out of there?" (Wrong again.)

I explained the surgical procedure. Due to her "working knowledge" of surgery, she claimed to understand me perfectly. The truth is, however, that the cat probably understood better than his owner did. Surgery was scheduled for the next day.

Mrs. Clueless was my last appointment that day. So, as she was leaving the office, my thoughts turned to visions of my dinner waiting at home. Unfortunately, there was a hitch in the gitalong.

The great horse jumper

It seems that Mr. Nomad was rushing over with his dog, Pencil.

The pooch had not eaten in three weeks, and now it was an "emergency." We would have to squeeze him in before we left.

The dog looked terrible. He was literally skin and bones. In fact, he bore an uncanny resemblance to a bag of wrenches. The only facts that Mr. Nomad could give me were that pencil had not eaten in three weeks and was getting terribly weak and thin. There was no other history.

I recommended some blood tests that would be necessary combined with fluid therapy and nourishment to keep the pooch going while we figured out how to make him well.

"They already did that at the last vet," he said. "Why don't you call them and get the test results?"

(You guessed it. This was one of those secret second opinion cases. I hate those.)

His explanation continued, "My regular vet wasn't available two weeks ago when this started, so I took him to a place near my house. They ran tests, but it didn't help. Then, the next week, my regular vet did the same thing. I don't see any reason to run the same tests again."

(Now it was a third opinion case. Mr. Nomad was jumping from horse to horse in the middle of the stream.)

I devised a plan. Since this guy was always looking for new opinions, I would stabilize the dog and send him to see some specialists. I was half tempted though to send him a real expert, Mrs. Clueless.

Dr. Obenski owns Allentown Clinic for Cats in Allentown, Pa.