Imagine coming home to find your energetic dog suddenly paralyzed, unable to greet you at the door. This was the startling reality for the owner of a seemingly healthy German shepherd dog living high above the busy streets of San Francisco.
Saber was a beloved family pet residing in a 12th-floor apartment in downtown San Francisco. Owned by a fish market worker, Saber was regularly walked along the bustling city streets, always leashed and never mingling with other animals. His health checks were up to date, affirming his excellent condition - until one unexpected evening.
Returning from work, Saber's owner was shocked to find that his dog couldn't stand up, paralyzed and unable to move. Anxious and determined, the owner drove 90 miles to the university hospital where I was on call.
Upon examination, I diagnosed Saber with acute polyradiculoneuritis - an inflammatory condition affecting multiple nerve roots where they enter the spinal cord, often triggered by an immune-mediated response. Typically, the exact cause remains unidentified, but in the U.S. this condition has been linked to a raccoon bite and is colloquially known as "Coonhound paralysis."
Saber's condition required nothing more than patience and time for recovery. The dog bounced back within a week.
However, his paralysis recurred multiple times over the next six months, each episode more severe than the last, eventually necessitating two weeks of intensive care and ventilatory support.
Despite exhaustive questioning about Saber's potential raccoon encounters - highly improbable on the streets of San Francisco - I had missed an essential question. Driven by desperation, I asked, “Has Saber ever encountered a raccoon at any place, at any time … ever, ever, ever?”
The owner's answer was a revelation: “Oh, you mean Rocky?”
It turns out that Saber occasionally played with Rocky Raccoon, a pet raccoon living in another apartment on the same floor of the high rise … Mystery solved.
This remarkable story underscores a fundamental principle in veterinary medicine: the significance of a thorough and creative approach to history-taking. Often, the clues to resolving complex medical puzzles lie hidden in the details of an animal’s environment and interactions, which might be overlooked during routine examinations. I didn’t ask the one question I should have asked at the beginning because I assumed that it would be ridiculous to consider that Saber shared his environment on the 12th floor with a raccoon!
I learned a valuable lesson. As veterinarians, it's our duty to probe beyond the obvious, crafting questions that delve into less likely aspects of our patients' lives. By doing so, we not only enhance our ability to diagnose and treat effectively but also safeguard the well-being of our patients through proactive, informed care.
Saber's story is a compelling reminder that sometimes the key to a mystery is found simply by asking the right question.
“And Rocky Raccoon checked into his room, only to find Gideon’s Bible …”
(The Beatles 1968)
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