Some cases stay with you.
Tofu came to us in October 2024: a sweet, cooperative gray cat with a belly full of fluid and a very worried family. His owner, Matt, suspected heart disease. We ran the workup: echocardiogram showed a normal heart. FIP panel came back negative. A CT scan revealed something far less common, a narrowing of the vena cava, the major vein responsible for returning blood to the heart.
It was the kind of finding that raises more questions than it answers.
Dr. Derek Nestor, our board-certified ACVIM Diplomate in Small Animal Internal Medicine, had seen complicated before. And he happened to know exactly who to call.
Dr. Nestor completed his residency in Small Animal Internal Medicine at Michigan State University. It was the same institution where CSU cardiologist Dr. Brian Scansen trained as a veterinary student, back when Nestor was a resident there. That relationship, built years before Tofu was even born,turned out to matter enormously.
Dr. Nestor reached out to Dr. Scansen, now head of the Cardiology service at the CSU Veterinary Teaching Hospital in Fort Collins. Tofu had a blockage in the vena cava that was causing fluid to accumulate in his abdomen, requiring taps to drain that fluid every one to two weeks. Dr. Scansen felt it was worth attempting to open the obstructed vessel, and Matt made the trip to Colorado in January 2025.
We'll let CSU tell that part of the story, and they do, beautifully, in their own write up here.
The short version: it was one of the most complex feline vascular cases the CSU team had ever taken on. The obstruction was complete, nothing was getting through, and it took multiple attempts across several procedures before Dr. Scansen was able to cross the blockage and place two metallic stents to hold the vessel open. Tofu also needed a surgical bypass graft, developed a hernia requiring a fourth procedure, needed a rare blood type transfusion, ands pent weeks in the Critical Care Unit.
To Dr. Scansen's knowledge, this was the first time a completely obstructed vena cava had ever been opened by catheterization in a cat.
Tofu, because he is Tofu, spent his recovery purring and charming the cardiology residents who cared for him.
Why This Story Matters to Us
We didn't perform the surgeries. We didn't place the stents. The CSU team, Dr. Scansen, residents Dr. Cassidy Coats and Dr. Riley Ellis-Reis, the Critical Care Unit, and the Veterinary Blood Bank, did the extraordinary work that brought Tofu home.
What we did was recognize the limits of what we knew, pick up the phone,and make sure Tofu got to the people who could actually help him.
That's what referral medicine is supposed to look like.
Matt put it simply: he'd forgotten what healthy Tofu looked like by the time they made it to Colorado. The difference afterward was remarkable. A year and a half and three stents later, Tofu is doing well, still navigating some lingering liver questions, but happier and healthier than he would have been,with plenty of good days ahead.
Cases like this remind us why we do this work. The diagnostic puzzle, the collaborative medicine, the moment a family gets their pet back. It doesn't get better than that.
If your pet is showing symptoms that don't have easy answers, we're hereto help figure out the next right step. Sometimes that step is us. Sometimes it's a phone call to someone we trust. Either way, we're in your corner.
Oklahoma Veterinary Specialists delivers 24-hour emergency care and board-certified specialty services with advanced technology and compassionate treatment.
