Caring for Pets and Their People! October 2018

The Tale of Rumpled-Ripped-Skin

By Dr. Ann Stacker, DVM
When I was a little girl, one of my many favorite books was “The Saggy, Baggy Elephant.” Now as a grown-up veterinarian, one of my favorite cases is that of a saggy, baggy cat named Poe (for Edgar Allan).
Once upon a time, a small black kitten was dropped off with severe lacerations around his head and neck and he stunk to high heaven because of infection! Treating his “attack wounds,” we discovered his ears were full of ticks and realized his injuries were actually self-inflicted from his scratching at the itchy and painful parasites.
You might think simple enough case: remove the ticks, clean and suture the wounds, treat with antibiotics, and keep him out of pain; but Poe was not healing normally. His oddly textured, baggy skin reminded me of a disease I studied almost 40 years ago in Vet School… Out of the cobwebs in my memory I pulled Ehlers-Danlos Syndrome, a very rare genetic abnormality of the connective tissue that causes the affected patient (humans too) to have wobbly joints and skin that is weak, easily stretched, loosely attached, and as fragile as tissue paper — just like Poe!
After confirmation of this diagnosis by skin biopsies and a call to a veterinary dermatology specialist at UC Davis, we knew the condition was incurable with no real medical treatment. She strongly recommended that I declaw Poe and modify his environment to avoid any further injury, no easy task as he was now living at our hospital. Besides caution in petting and lifting him, we had to eliminate sharp corners and rough surfaces, pad his resting and sleeping areas, and watch closely for wounds that would need to be sutured.
Despite our very best attempts to “Poe-proof” the premises, Poe did re-injure himself and had to undergo anesthesia and major surgery on multiple occasions. Reconsidering options, Debbie had the idea that if we could find a human patient (maybe a child) – whose environment was already suitable, it would be a great solution: safe for Poe AND he could be a furry friend and moral support for that person. Full of newfound optimism, we reached out to Stanford, UCLA and several other medical centers, but the rarity of the disease was against us – no home could be found. At that point, we did discuss the sad but real possibility that his future might be limited if we could not ensure his quality of life…
As a PhD student in Genetics, my daughter Emily was very interested in Poe’s condition, so she (and her slightly reluctant husband) thought they could at least try to provide for his special needs in their Washington home. I discussed his diagnosis and history with a Seattle veterinarian so that they would be prepared for his case; then Debbie and I escorted him on his airline adventure – uneventful except for when they scanned him for explosives!
Well, that was over five years ago and I am able to report that Poe (aka Rumpled-Ripped-Skin) is happy and doing well, with only minor medical issues, even though he does look permanently and pitifully bedraggled. He is the official study buddy, lap warmer, entertainment and all around household stress-reliever, living HAPPILY EVER AFTER!