During my final year, the teaching hospital at my university was a bustling place that saw 60 to 70 cases on an average every day. We students were divided into five groups, with each group moving by rotation through the Out Patient Department (OPD), the intensive care unit (ICU), the Continuous Monitoring Unit (CMU), the pharmacy, and the kennels.

The kennels were in a building to one side of the hospital and were quite basic in construction and facilities. Two rooms had a series of lengthwise enclosures, each about six feet by four feet in dimension with concrete floors and walls. Each kennel had a wire mesh door in front and each had a drain to wash away the mess if the wards urinated or defecated inside, which happened regularly and continuously. The house had a wall in the middle that divided it into two—one portion was the designated Isolation Ward that received patients with suspected infectious diseases, the most common one being puppies with parvoviral infections. On the other side were non-infectious patients.

The kennel rotation was the most physically demanding rotation of all, because it meant working outside in all weather conditions, walking back and forth multiple times between the hospital and the kennels. It also involved a lot of fetching, lifting, and restraining of the patients from their enclosures. In addition, the patients had to be fed and walked.

Sadly, to me, it also felt that the kennels were where all the delinquents and discards of the animal world came. It was mostly filled with dogs—there was a separate cat ward in the hospital, so it was rare to see cats in the kennels. Of course, some of the kennel cases were awaiting surgery or recovering from it, and were put there if there was no space in the recovery room. Others showed all signs of contagious diseases and it made sense to isolate them at least temporarily. But the kennels were equally full of the most heart-breaking cases—stray dogs that had been hit by a car or a train, dogs and cats with terminal illnesses, and several patients who didn’t need to spend long lonely days shut up there with the smells, sounds and energy from a dozen other dogs to endure. Some of the dogs adapted well while others just couldn’t handle it and would withdraw deep into themselves.

It was this last category of pedigreed, maladjusted dogs that distressed me the most. The strays seemed anyway moulded and cast in fires for having been born and bred on the streets where surviving each day was a triumph. They were there because some Good Samaritan had dropped them off after seeing them injured—many of them stayed on at the hospital grounds after recovery and joined the local pack.

The parvo and gastroenteritis pups were too young to really show any reaction to the kennels—if they were too sick, they became quiet and miserable due to the fever raging inside them and the diarrhoea leaking away all their energy. If they were generally of a sunny disposition and not too sick, they’d take their isolation without thinking about it—sleeping most of the time, wagging their tails when they saw a student and enjoying their short walks.

But the pets that came from homes were the most difficult to handle. Away from their families, they expressed their pain in different ways. The majority of them would show signs of depression, becoming quiet and sitting in a corner of their cages. Some became unnaturally aggressive. A few didn’t show any ill effects and remained cheerful and active in spite of their stay in the kennels. There were some owners who cared about their pets and visited the kennels once, some of them twice a day, to talk to their pets and ask us how they were progressing. Many owners, however, never came, and these were the saddest cases, because it seemed like those dogs were unwanted and uncared for. They were left in the wards for weeks on end when they might have had a much quicker recovery at home, because the owner wanted to go on vacation, or didn’t care enough to provide the pet with minimal care at home and would rather pay a hospital to do it.

It was in the kennels that I met three individuals who inspired, cheered and churned me.

His name was Duke and it was an apt name for what he must have once been—a beautiful black and tan German Shepherd in the prime of his life.

When I first got the case and saw him, I felt like I had been dropped into a deep ocean with a heavy stone tied to me.

He was recumbent on his left side on the floor of his kennel, staring straight ahead with an empty gaze at the concrete wall a few inches away. His coat, or what remained of it, was a dull matted mess with large pressure sores at his cheek bones, shoulder, and hip, showing how long he had been sick and unable to stand. He had stopped eating and drinking for several days, and although his coat still covered the worst of it, I was shocked when I placed a hand on his side—the ribs could hardly have felt more prominent on a skeleton. He had distemper with all the tell-tale, classic signs—the hyper-keratinised pads, the frequent paddling of the limbs, and the thick mucous discharges from the eyes that had crusted so that his eyes were half shut. And over everything was the smell—the stink of the diarrhoea that had pasted his rectum and soiled his tail and hind quarters, of the festering sores on his body, of the stale breath coming out of his mouth, the smell of impending death.

The clinician who was there gave me my instructions. “Poor dog,” he said. “There is nothing much we can do for him other than supportive treatment. Try to keep him as comfortable as possible.”

It was clear that he expected the patient to die soon.

“In such cases, isn’t it better that we euthanise the patient and put him out of this suffering?” I asked.

“Yes, we also recommended the same thing, but the owners aren’t willing to let us put him down,” came the answer.

And that was pretty much that. I squared my shoulders and took a deep breath before getting down to the task. Donning my gloves, I pushed my hands under Duke and lifted him onto the wooden tables placed outside to give medications to the kennel dogs. Down as he was to skin and bones, he couldn’t have weighed more than 15 kilogrammes.

The IV cannula had already been placed in the cephalic vein of his foreleg. So I got the saline running and gave him his shots of antibiotics against secondary infections. I clipped the long, matted hair around the body sores, flipping him over to make sure the sores on both sides were covered. They had to be thoroughly washed out with saline and a diluted solution of povidone iodine. Finally, the wounds had to be wrapped in padding and bandage. The next task was to clean him up as best as I could. The perineal area had to be cleaned of the diarrhoeal remains and his eyes washed. I took a piece of cloth and soaked it in water before using it to give him a rub down.

The whole procedure had taken close to 90 minutes and I was tired and depressed at the end of it.

In my teens, one of my favourite authors had been James Herriot, the world famous and much-loved veterinarian from Yorkshire. His stories about patients that he had to euthanise came back to me. I remembered his words, about how he tried to talk to his patients and gently stroke them as he injected the overdose of the anaesthetic drug so that as they faded away, the last thing they would know and feel would be a gentle voice or a touch.

I decided I would adopt his method. As I placed Duke down back in his kennel and gave him some water in his mouth through a syringe, I stroked his head and ears and spoke to him for a minute. As I spoke his name, there was the slightest flicker of response in his eyes. “Good dog, Duke,” I said. “Go in peace.”

For the first time in my brief veterinary career, I prayed that the patient would die.

But it was not to be. Over the course of the next week to ten days, I had to repeat the same protocol morning and evening. I began to think of Duke as the dog that simply would not die. By day two, he had become so dehydrated in spite of the IV fluids that his veins had collapsed and inserting a new cannula became impossible. So, any fluids he was getting from that point on went in subcutaneously. He did not eat a morsel of food or drink any water other than what was forced down his throat.

Every day, I’d open the bandages to find that the sores had become just a bit worse than the day before, driving me to new depths of despair. And yet, Duke carried on, lying there, feet paddling, staring at the wall in front of him. Dying, but not going.

Each time, I’d say the same words. “Good dog, Duke. Nice dog. Go in peace.”

Duke’s family never came to see him. I wondered at this family that would not allow us to put him to sleep, but would also not come to visit. There was nothing we could do to save him and it would have been better for Duke to die in his home, rather than in a concrete cell. Surely, they knew that? Perhaps they could not bear to see him in this condition and could not provide the daily nursing care that we were giving him. It was not my place to judge. But one thing I knew: Duke needed them around him during these final days when he was suffering. I was a poor, poor substitute.

Duke took ten days to die. By that time, I had moved on to my next rotation, and my classmate who had taken over his case from me told me one morning that Duke had gone. I said a silent prayer for him, glad that his suffering had finally come to an end.

It was a case that swallowed me, twisted me around, digested a part of me, and then spat me out like a much-chewed up paan. If only the owners had given Duke his standard vaccination shots when he was a puppy, he may have lived a full life. Why did the hospital agree to hospitalise Duke when there was clearly no chance of saving the patient’s life? And if it did admit him, why was the owner’s consent required for what was clearly a medical decision to alleviate suffering? As veterinarians, what were we genuinely able to do to save a life? Had we provided some comfort to that poor dog, or just prolonged his suffering before he finally passed on? All these questions ran round and round inside me and I had no answers.

***

Roxy was a growler. When I got the case, the others in the group told me to be careful because “she’s a biter.” I walked into the kennel to see this new patient, and there she was, sitting silently on one side of her cage, looking up sullenly at me.

At first sight, she looked like a Yorkshire terrier with the classic Yorkie moustache, the black and tan colouration, the hairy body and short tail. But Roxy’s ears were strange-looking and she was a little too tall for a Yorkie. Roxy was a mutt. And she had attitude.

“Hi Roxyyy…” I called out before entering her enclosure.

“Grrrr…grrrr…” was her reply.

I tentatively held out my closed fist in front of her while looking a little to the side. I could feel her breath on my fist, but the growling emerging from the depths of her abdomen did not stop even for a second. Without making any sudden moves, I gently eased the chain off her neck, allowing her to get used to my presence. I moved about the kennel a little, then squatted down again beside my patient, looking at the hind legs that were spread out in a strange way. Gently, I ran my hand over Roxy’s back, and while talking in a low voice to her, lifted her slowly to my side, to take her to the benches outside.

The growling abated a little and I soon realised that it was all an elaborate act. Roxy was harmless. Some dogs reacted to being in the kennel by barking madly when we worked with them. Others wagged their tails in joy at the human contact. Some of them would shrink in terror and some of them would take our prodding and handling with total equanimity.

Roxy expressed herself by growling. It wasn’t even that she was irritated or scared. Whatever she was feeling, it was expressed the same way. When I greeted her and lifted her up in my arms, she would growl. When I jabbed her with a painful injection, she’d have that motorcycle engine gunning. If I fed her or rubbed her down, which was clearly a pleasurable experience, she’d still be growling non-stop. And the tone never varied. It was always the low pitched, continuous grrr…grrr…grrr…

At times I’d just laugh helplessly at her. The other students wouldn’t handle her until they put a mouth gag on her for fear of being bitten. But I saw through her facade and never felt the need to use a gag, not even the first time. Once or twice she did snap at me, when she felt more pain than usual—it was just her way of telling me that she was hurting and that I needed to be more careful.

Roxy had somehow injured her spinal cord. Her owner did not know how it had happened. When I palpated the vertebral column, I could not feel any clear fracture, but there was clearly some abnormality there. It felt more like an abnormal twist to the lumbar region than a fracture. Maybe she had wandered out of her house and some vehicle had hit her…or maybe she had got into a fight with a larger dog. Whatever the cause, the end result was that Roxy had lost control of her hind quarters. Her splayed hind legs dragged uselessly behind her, and she moved using only her forelegs. The injury had made her a paraplegic.

I had seen some terrible spinal injuries that had left dogs twisted out of shape, unable to move and in unbearable pain—Roxy was lucky. Her injuries seemed to be relatively minor because she didn’t seem to be in pain except when some especially tender spots were pressed. She could move about on her own and generally seemed in good spirits.

But the lack of control over her rear end was a problem. As she moved around continuously dragging her hind legs behind, the spiral curls of her coat would get caked with dirt. Spinal injuries often result in damage to the nerves feeding the perineal region, which in turn leads to incontinence. But Roxy didn’t seem to have that problem – an indication that the damage wasn’t too severe. I fell into a routine with Roxy. Every morning, I would start with lifting her up on the workbenches and doing the general clinical examination. She would get her antibiotic shot if it was due. Then it would be time to clean her up and give her a quick rub down with the towel. Last of all came Roxy’s favourite part – her morning and evening walks around the kennels.

I used a towel to support her hind legs for her daily walks. As I slipped the towel under her, she would sit impatiently waiting for me to start walking. Our conversation would go something like this:

“Ready for your walk, Roxy?”

“Grrr…grrr…”

“Okay, Roxy. Now go slow, otherwise the towel will slip and you’ll tip over, okay?”

“Grrr…grrrr…”

“And there’s no use running because I’m too tired to run, okay?”

“Grrr… grrr…”

It was the highlight of the day for Roxy. As soon as I stood lifting her hind quarters up with the towel, she would take off at a brisk trot—and here was a paraplegic dog that I struggled to keep up with. Any pain or discomfort was forgotten in the excitement of that daily walk. It was a relatively small area within the hospital grounds that we could walk the dogs in, but Roxy seemed to find new delights each time she walked. Every bush, every tree stump, had to be sniffed and investigated to make sure that nothing dramatic had changed in the few hours since she had last checked it.

I would take a break when we reached the grassy patch next to the surgery room—I don’t know if she ever got tired but I usually was. It was the best time to give Roxy her physiotherapy massage after the warm up walk, especially if the sun was out. And so I’d lower the towel and squat down beside my patient.

As I stroked the head and ears, the motorcycle engine would start up again.

“Grrr…grrr…” Roxy would go.

“Oh, shut up, Roxy,” I’d say as I stretched and massaged the hind legs and the pelvis.

“Grrr…grrr…” she’d reply. And so it went on.

Slowly, ever so slowly, I began to see improvement. We used to let our patients sit out in the morning sun once their medications had been given and walks completed. It was good for them to interact with their fellow inmates and get some fresh air and sunshine before going back into their kennels.

Often, going off their food is the first sign that an animal is sick. They also become dull and lethargic, often shunning company and showing no interest in play or social interaction.

Roxy was eating and drinking just fine. She was bright and alert, and as soon as she was put down, she would take off on her two fore legs and keep going until she grew tired.

Once again, I had a case that would have done much better with home care.

All I was doing was giving Roxy antibiotic shots once in three days, cleaning her coat, and massaging her hind legs. It was up to nature to cure her. The same, or better level of care, could have easily been provided by her owner. In advanced countries I had heard of paraplegic animals being fitted with prosthetic devices, but such therapeutic aids had not yet reached Sri Lanka. Some students did try to make a wheelchair for Roxy using a broken pram and other odds and ends, but it didn’t work and Roxy was not able to walk freely with it attached to her trunk. The contraption was quickly abandoned.

As I moved on from that kennel rotation, I felt that Roxy was definitely getting better. She really needed to be at home, not in the kennel.

With her zest for life and love for walking, the prognosis was bright. Even if she didn’t get the full function of her hind limbs back, she’d be fine. All she needed was a wee bit of support and daily care from her family.

Roxy was going to growl her way through life just fine.

***

“The Kennels” is an excerpt from Anand Krishnaswamy’s new memoir in progress.