This week: Luck Lucky or unlucky, you be the judge. It is hard to define the quality we call 'luck'. It can be as unfathomable as any mystery in the universe or as predictable as those formulas on a physics professor's blackboard. I have always thought of luck as a word that you should use to describe some event in the past rather than the future. When I have won at the mahjong table or made a great investment, I would describe myself as lucky. To use luck to describe the future, such as 'I am going to be lucky tonight at the mahjong table', is just wishful thinking. In my profession there is certainly a great deal of science involved. Science allows us to predict nature, or at least try, and it helps me predict the course of diseases and to stop them in their tracks. But there is always a certain degree of luck involved, where science as it stands at the moment cannot predict all that nature throws at it. For example, when I give an annual vaccination to an animal, I cannot predict whether this animal will have an adverse reaction to the vaccine. And I cannot predict that if an adverse reaction does occur, whether it will be life threatening or just a mild swelling around the face. This is where risk management comes into play. In this example I would compare the risk of the vaccination reaction with the risk of not receiving the vaccination. I see cases of lethal distemper or parvovirus, for which dogs can be vaccinated almost weekly, while I only see a mild vaccine reaction once every two years, and I have not yet seen a death. So, statistically speaking, it is an easy decision. I had two recent experiences that highlight how unpredictable luck can be. The first case was a cat that hadn't eaten for a few days and had vomited a few times. It took some time for the owners to realise the cat was sick because it was left home with a carer every day while the owners were at work. So when the cat arrived at the clinic it was pretty sick. I performed an X-ray, which revealed an odd square object in its intestines. It was very hard to see among the rest of the gut, but it was there and we were lucky to have seen it. It was an open-and-shut case - the cat needed to be stabilised, then we needed to surgically explore its abdomen under anaesthetic. As most people who have had an anaesthetic would know, you need at least half a day of fasting before surgery. The reason is that during the induction phase and the recovery phase of the anaesthetic, the muscles of the voice box are relaxed and insensitive, which could allow vomit to enter the airways. So fasting is to minimise the chance of breathing vomit. This cat supposedly had an empty stomach because it had had no appetite for four days. But during the induction phase of the anaesthetic, it amazingly vomited voluminous amounts of a foul-smelling green fluid. It turned out the gut, blocked by the square object, had started to rot, which had led to this buildup of pus-filled fluid. Unfortunately for the cat, some of this fluid made its way into its lungs during induction. The subsequent surgery successfully removed what turned out to be an ear-plug from the small intestine. But the cat died from aspiration pneumonia a couple of days later. What was a textbook scenario turned out for the worse despite following a perfect set of procedures; if that isn't bad luck I don't know what is. The second case occurred with a cat brought in with difficulty breathing. During the short wait in reception, the owner noticed it was getting worse by the minute. So we immediately took it out the back and put it on oxygen before we started to work out what was going on. We took a full body blood exam, which turned out to be normal, and chest X-rays. The lungs were slightly cloudy on the X-rays in certain areas, which explained the breathing problem, but didn't explain why it was getting worse. A few minutes later the cat started to turn blue, its breathing got even more laboured and it collapsed. At first the only reasonable prognosis I could give for this cat was grave. And I mean 'the grave'. I took another chest X-ray and this time the cloudiness had spread throughout its lungs. It was the clue I needed to save him. The only reasonable explanation for this sudden deterioration was an extreme and sudden allergic episode. I gave the cat a dose of steroids, an antihistamine and adrenaline, and within moments the breathing was more relaxed. It seemed like a miracle. The cat went home 24 hours later after it started eating normally. Lady luck can be paradoxical; in most instances, an animal with such extreme symptoms and with such a short period for me to act upon, should have died. But it didn't. If that isn't good luck, I don't know what is.