Sunday, January 13, 2019

Day 910 to 945 of the Third Voyage: In which we explore another aspect of the Salvadoran healthcare system and end up with more than we bargained for… but in a good way.


I think it’s safe to say that between the three of us, we have had a lot of experience with Mexican/Central American healthcare. In the past three years we have darkened the doorsteps of three orthopedists as well as an internist, cardiologist, radiologist, dermatologist, ophthalmologist, otolaryngologist, audiologist, and a dentist. We nearly added a gastroenterologist to the list, but luckily that cleared up on its own.

With animals on board, we’ve also been to the vet a time or two (a petologist?) but this has always been for vaccinations and parasite prevention and never for an emergency. Cue the music because…dun dun dun…we found ourselves with a pet emergency of the feline variety. Now here’s the thing about cats—and I read this on the Internet, so you know it’s true—they will never let on that they’re not feeling well. It’s a defense mechanism going back to their pre-domestication days when it wasn’t a good idea to show weakness because that would put you at the top of the menu. Of course, with Edgrrr, he will also never let on that he’s well-fed, well-cared for, and reasonably content. His defense mechanism is that he only cops to two moods: pissed off and not pissed off. The former means that his food bowl is empty; the latter means that you filled it before he had to start bitching about it. But for all his primal instincts, even he couldn’t hide the fact that he was limping and leaving bloody pawprints everywhere. We don’t know when it happened—or how—but there was no denying that his paw was severely messed up.
Guess which paw?

It’s times like this when you can really feel helpless. You can’t just hop in a car (because you don’t have one) and scurry to the nearest vet (because who knows where that is) and even if you could, there’s the language barrier (although a messed-up paw is pretty self-explanatory.) We’d had one experience with a vet a couple months ago when we rescued a pelican from the water with a severely broken wing. An expat called in a vet that came out to the dock to examine it and through a bartender/translator advised us that the wing could not be saved, and as it was now unable to survive in the wild, the humane thing to do would be to put it down. So the vet took the pelican to a secluded part of the docks, pulled a vial out of his tackle box, and gave it an injection. He cradled the bird in a blanket until it drew its last breath, after which we gave it a burial befitting a mariner. Bummed us out for a week. Unfortunately, we couldn’t get hold of this vet, but I doubt there was anything in his tackle box that would have put a paw back together and, even though there was nothing he could have done, I still harbored a little resentment that he couldn’t save the bird I’d prematurely named “Lucky”.

So instead I called Santos who had his son come pick us up while we tried to find a vet online that wasn’t two hours away in San Salvador, and it was Freddy that suggested we go to the vet in his hometown of El Rosario that had saved his dog’s life. Forty minutes later and we’re here…

At least it's well ventilated.

It’s obviously in the construction stages, but when it’s done this will be the first animal hospital in the area. But more importantly, this facility (even in its current state) provides the community with affordable pet care. Because pet ownership in El Salvador is on the rise—for companionship, protection, and (rurally) varmint control—but “responsible pet ownership” as we know it in the States is often out of reach for the average family. Because when you’re only bringing in $600 a month, travelling (most likely by bus) to a vet in San Salvador and forking over a hundred plus dollars to have your pet neutered is not an option. Neither is $50 plus for shots and $30 for two months of parasite control meds. That’s one of the reasons why there are so many unwanted litters and high mortality rates. But here, you can get your pet fixed for $35, all their yearly shots for $10, and flea/tick/worm prevention for less than $5.  Editor’s Note: If you find yourself in the area and in need of a vet and can afford it, please consider paying a little more for their services. All extra money goes toward the building fund.

But back to Edgrrr’s paw. Dr. Alberto Vasquez Guardado and his assistant/wife were both caring, thorough, and genuinely dedicated to their profession (they are building a hospital after all!) They were also old school, because they had to be. As you’ve probably guessed from the photo, there’s not a lot of clinic yet. And what is there is extremely bare-bones, because this is El Salvador and little things like walls, electricity, plumbing, and anything else that requires a permit is subject to the whims of whoever is currently in charge at the planning office that day and what is a valid permit one day may not pass muster with the guy manning the desk the following day. As a result of the start/stop construction process, they currently have one room for procedures, labs, and convalescing patients while everything else (exams, vaccinations, grooming, etc.) is conducted on tables in a part of the clinic still open to the elements. There is no power (see aforementioned blurb on “permits”), but syringes, tools, and surgical items come sealed until use and whereas our vet back in the states would have probably used some knock-out gas on Edgrrr prior to any procedures, here in rural El Salvador they have “the bag” which is exactly what it sounds like. Now at first, I was taken aback—and for a split second thought it was just a weird attempt at vet humor (like “ha ha…but seriously, here’s the knock-out juice.)—but after seeing it in action, I realized it’s actually low-tech genius. Because Edgrrr is not the most cordial of cats; he has a nasty swipe and a sharp bite to go along with that “charming” personality of his.  It would normally take two people to hold him down so that the vet could do their thing, but the bag eliminated this need. It acted like a firm hug around his entire body, holding him still yet allowing him to breath comfortably. Once he was situated, the vet cut an opening and pulled his bad paw out for further examination. There was growling, but there was no carnage.

Pictured: Cat in the bag. Wonder if it comes in blue to match the boat?

Like I said before, we have no clue how he did it or what he got in to, but it took over twenty stiches to put his paw pad back together—in fact, the doctor pretty much had to remove the pad, clean out the wound, stitch the pad back together, and sew it back on. The procedure took about thirty minutes (with only the bag for containment and a local anesthesia for the pain) and then Edgrrr was returned to us with a small baggie of antibiotics and some topical cream. The vet also showed us a phone video of the procedure which was as gruesome as you can imagine, and when he asked if we wanted a copy my immediate response was, “No, gracias. I think that’ll be fueling my nightmares long enough.”

Ten days later we returned for a follow up. Edgrrr went back into the bag and Dr Vasquez took him into the back room. About five minutes later, he returned and, without saying a word, put a tiny black furball into my hand and disappeared again into the back room. As I’m standing there completely stunned, my first thought is, “Holy shit. Did Edgrrr die? Is this to lessen the blow? Is this my condolence/replacement cat?” but then my next thought was, “Oh my God! This is the cutest thing I have ever seen in my life!”

Prepare to say, “Awwwww!!!” in three, two, one…

This incredible bit of adorable was found wandering—malnourished and anemic—in the field beside the clinic. Its mother was nowhere to be found. The vet took him in and nursed him back to health, and if the kitten was once lucky to have been abandoned right next to a vet then it was twice lucky that a gringa that’s gaga for gatos should happen into the clinic right as he was ready for adoption. Not that we rushed into the decision. We do live on a boat and we are travelling (albeit at a very, very slow rate), but when you’re in our situation and you already have animals, one more (small one) really doesn’t affect your lifestyle, just so long as it doesn’t become a habit. So we talked about it, slept on it, and the next morning returned to the clinic and adopted our newest member of the crew. And we named him Cadejo.

Now at this point you’re probably wondering what the heck is a Cadejo? Well, in Central American folklore, a cadejo is a supernatural creature with glowing red eyes that looks like a dog with a little deer thrown in and comes in two colors. The white cadejo is a benevolent protector (one who, according to legend, will ensure that drunk folks get home safely), while the black one is malevolent and likes to lure people into questionable situations (like an open bar serving nothing but tequila.) The good and the evil; the dark and the light; one pushing, the other pulling. They say that the two cadejos represent the duality in us all. Pretty heady stuff, huh? Very yin/yang. But before you go thinking we got all mystical on you, the fact of the matter is that our Cadejo was named after this place…

Less yin. More yeast.

This is Cadejo Brewing Company, our go-to place in San Salvador for really good beer, excellent food, and the best wings outside of the States. We come here a lot. How often? Let’s just say that the servers start pouring the preferred brews as soon as we arrive in the parking lot:  El Suegra for the Captain, Belga for the Deck Boss, and Hija de Pooh for me. We have other places we like to eat in San Salvador, but it’s just so nice to go to a place where “todo el mundo sabe tu nombre.”  We’ve had a lot of good times here and that coupled with some pretty cool folklore, made it seem very fitting to name our newest family member after a brewery. That and they have the world’s most kick-ass growler…

Of course, one of their slogans translates as “Not suitable for cats” but we’ll just ignore that for now.

So obviously we are head over heals for our nuevo gato and it’s all we can do to not spend every waking moment watching him bumble around in exploration, play like it’s his job, devour his food like he’s in a pie-eating contest, and sleep like it’s his other job. We’re curious to see how big he’ll be. The vet said he was two-months old, but he was still so tiny that he fit in the palm of my hand. Over the next three weeks he grew six inches from tip of the nose to tip of the tail but seems to have stalled out since then although he has gotten slightly taller. He still doesn’t register anything on the scale. So you can imagine the spectacle of Cadejo next to Otter who easily clocks in at 85 pounds. I’d post a picture but it’s black on black in bad lighting. 

On second thought....
Awwwww!!!


In case you’re wondering, Cadejo and Otter get along just fine. Otter is curious, but he forgets how big he is and one sniff of the nose sends the little guy tumbling, but overall he’s very gentle and tolerant. Of course, Otter is the farthest from alpha as a dog can get. Edgrrr bullies him constantly—swatting when he passes by, hissing when he steps too close. When I’m feeding Otter, Edgrrr will run underneath him and between his legs to get to the bowl first leaving Otter to stand there with a hangdog look on his face. When Otter and I return from a long walk, Edgrrr immediately gets in front of him at the water bowl just to be a jerk. He sleeps in Otter’s bed, muscles in on his treats, and sticks his butt in his face (and not in a polite way.) If Otter had lunch money, Edgrrr would be waiting by the swing sets each day to take it from him. In fact, I’m pretty sure Edgrrr think’s Otter’s name is actually “Uncle.” Editor’s Note: As I’m writing this, I’m realizing that Edgrrr pretty much treats us all this way. So I guess that makes me “Patsy”.

And speaking about Edgrrr.  He responded favorably to the treatment and made a full recovery. And how does he feel about the new addition? Well, there hasn’t been too much drama. Edgrrr was still in recovery mode when we brought Cadejo home so it was a couple of days before he even realized he was there. Then one night he jumped up on the bed, saw the kitten, widened his eyes, and gave us a look that said, “WTF, dudes?! What, did you think I died? What’s with the condolence/replacement cat already?” And since then there has been some posturing, some displays of dominance and what have you on Edgrrr’s part but now that he’s established the pecking order, we have actually caught him playing (?!) with the little fuzzball. But what Edgrrr really likes about Cadejo is that he’s on a soft food diet. Edgrrr has always been a kibble cat by choice. He was never into canned food and whereas he liked the idea of treats, he would usually just lick it a couple times and call that good. But sometime during our stay in Mexico, he got a taste for pollo asada (grilled chicken) and his culinary tastes began to expand. And now, at 14 years of age, he’s decided that canned cat food is far superior to anything he's eating and insists on having some with every meal and if he doesn’t get it, he muscles Cadejo out of his. So I guess what I’m saying is, that diet he’s been on for the past year? It's pretty much gone by the wayside. Not that it seemed to do much good. From the time the vet in Barra looked at him and said, “Muy gordo!” to Dr Vasquez lifting him up a year later (and five pounds lighter) and saying, “Muy gordo!” it’s kind of become apparent that gordo is as gordo does and if you’re going to be fat, you may as well be happy or at least, in Edgrrr’s case, not pissed off.