A Veterinary Journal by Claire Poole
March
Chapter 3 - Page 6
Chapter 1
Chapter 2
Chapter 3
Saturday 14th March
Saturday 14th March
Saturday surgeries seem more relaxed than those on weekdays, probably as there is no ops list or evening surgery to follow. However they are often very busy and today is no exception. It is a typical surgery this morning, lots of variety but thankfully no unhappy situations or nasty surprises. First in is Tammy McTavish for routine weighing. Tammy is a rotund little cairn terrier who is a frequent visitor. Two years ago, this little fat barrel rolled into the surgery, coughing badly and wetting wherever she stood. Her owner bought up the rear, armed with a box of tissues to mop up the damage. Tammy demonstrates well the value of slimming - after 1 kilogram loss, her cough disappeared; after losing 2 kilos the indiscriminate wetting stopped and her attempts to jump onto the settee were finally successful. In all she lost a third of her body weight and became a new dog. Unfortunately, her owner died, things slipped and we are now back where we started. Happily re-homed with a neighbour, a coughing, weeing Tammy is again on a diet, and early results are promising. The cough is fading and she only wets if excited. A good start.
Next is Guinevere our diabetic cat, doing well on her new insulin regime; then Chatsworth, a 12-year-old Labrador with arthritis. I dispense anti-inflammatory drugs and make an appointment to see him in a week, telling his owner to restrict him to gentle exercise. Like our Kippen, Chatsworth loves to chase his ball but the extra forces on his old legs make the arthritis worse. If an owner is observant, they can predict when more medication is required - perhaps after a longer walk, or a play with a friend or a soaking in rain or river. Hopefully, better weather is on the way and our arthritic patients will soon have some relief.
Two booster vaccinations follow, then a stitch removal for a cat spayed last week. Just Ricky Marsh to go. Ricky is a Scottie with more than his share of problems. Although only 6, he suffers from bad skin, bad legs and colitis. This can make management tricky as treatment for one condition can worsen another. Luck is with us today as Ricky has improved from last time. A different diet and more frequent, smaller walks, dips in water and topical antiseptics applied directly to the affected areas of skin all seem to be helping, although inevitably we will need drugs when one or other condition flares up. Just as in humans, simple lifestyle changes can often reap large benefits.
We have a late arrival - a shot ferret. The ferret was being used to flush rabbits from a burrow and was accidently winged. Only one small hole is visible on her flank but no shot can be felt below it. The ideal approach would be to take x-rays to locate the shot. If it is in the abdomen, the ferret will probably die unless it is removed. The ferret is a little tender by her back bone and I suspect the shot is lodged there. She does not seem particularly distressed, and the owner does not want to spend much money so we have to compromise. I dispense antibiotics for the next few days and insist that the surgery is contacted if the ferret becomes ill. The embedded shot will not cause any problems through lead poisoning where it is - a popular fallacy, only ingested lead will produce symptoms of poisoning. As many ferret owners would not seek veterinary advice at all, the pragmatic approach adopted in this case is better than nothing.
Finished at last. Gillian and I exit at speed, both with the same thought - what a great day for a walk with the dogs. In a week that has seen its share of snow and ice, spring seems to be winning today. In the woods, small young nettles are appearing through the undergrowth, and I know that soon the woods will be off limits until late autumn - these innocent baby nettles will shortly turn into 3 foot triffids with a savage sting. Birds are singing their hearts out in courtship rituals and overhead a rook labours to carry a large twig back for nest construction. We pause at the top of the hill for the first sunbathe of the year, listening lazily to the skylark’s sweet song before heading homeward to embark on the weekly shopping expedition. It comes as a surprise to some customers that even vets need to perform such mundane tasks albeit on sufferance that the pager does not summon us home post haste. All vets in practice have an ear perpetually pricked for the sounds of bleeping pagers or trilling phones. When this happens at veterinary meetings, it is quite comical to see everyone else reaching automatically for their own communicators. Even pelican crossings or ringing tills can have similar effects. My shopping trip is undisturbed, and I arrive home with happy thoughts of a relaxing meal and an evening spent vegetating in front of the television. While unpacking the shopping, such dreams are rudely shattered; a frantic banging at the door announces alternative plans for the evening. Jude, a young German Shepherd dog has been hit by a car and her owner has rushed straight here in a panic. ‘This looks serious’, I think as we stretcher her into the surgery and I automatically fall into emergency routine. Thank goodness Jay is not working today and is able to help. We need to deal with life-threatening conditions first, broken legs and skin tears can wait till later. A quick examination shows Jude to be deep in shock - a situation where the circulation is in imminent danger of irreversible collapse. The body’s initial response to severe trauma is to shut down the blood circulation to the extremities, concentrating on supplying vital areas such as brain and kidneys. This initially helpful response can be fatal if it continues for too long. Jude’s gums are white as a sheet and her ears and feet are frigid. Her heart is indistinct, very fast and weak, and her breathing is laboured. This is going to be touch and go. Fast action is necessary. We wrap her in blankets and position an oxygen mask by her face, then insert an intravenous catheter, inject anti-shock drugs and rapidly run in blood volume expander (the nearest substitute for blood that we have). She is very frightened and struggles at first until weakness overcomes her and she flops back on the table. Her owner Cath helps by trying to keep her calm. Once everything is connected or administered, I try to examine Jude further. This is not easy as she is a big dog. All of us think privately that we are going to lose her. I have met Jude’s owner before and like her very much. First appearances were deceptive, as she is a fully fledged punk, but a kinder, more committed pet owner is hard to find. We got to know each other quite well while treating Jude’s mother Jenny. Jenny died, and I want so much to save Jude for her.
We are now stuck in suspended animation, drugs running in and oxygen hissing while we wait for any change. Cath has to collect her toddler from a neighbour so bids a semi-conscious Jude a tearful goodbye. We have been working on Jude for over an hour. Jay remains in the surgery while I monitor our patient, checking and re-checking colour, temperature, heart etc. I try to connect a pulse oximeter to her lip. The device measures the oxygen concentration in a peripheral blood vessel - no reading - poor peripheral circulation. Yet another bag of fluid is heated and attached to the drip. Feeling her ears again - ‘Are they slightly warmer - or is it just wishful thinking?’ I agonise. Jay agrees ... her feet are also slightly better. Her colour is still awful but is there the merest hint of pink? Ten minutes later, there is no doubt that things are improving and we get a reading on the pulse ox. - 95% - not bad at all. Twenty minutes later, her ears and feet are warm and her gums are pale pink. Her breathing is less laboured though still far from right. After a further 20 minutes we remove the plastic clips running oxygen into her nostrils and observe her closely for 10 minutes - no deterioration. At 8.40 p.m. we transfer her into a warm kennel. At last she appears stable, and we risk going into the house for supper. Jude gets checked every 15 minutes initially, graduating to every half hour. She remains warm and her colour is improved, but her heart and breathing are still fast and I detect occasional irregularities in her heart rhythm. The drip is closed off at 11 p.m. She accepts a drink of water. I finally go to bed at midnight, setting the alarm for 2 a.m.
Copyright Claire Poole 2005
