ER vet

Apologies for being a bit out of the loop lately. What with traveling and working at an emergency centre doing night-work it's been pretty flat out. Emergency work is both exciting and terrifying. Exciting because I might finally have the toys I need to actually treat some emergency cases, terrifying because I probably won't know how to use them! 

As if in response to my future as an ER vet, the past couple of weeks have kept me busy with common emergencies, almost as if to prepare me for my new job. I've had a C-section, dogfight stitch-up, poisoning, GDV (twisted stomach in a large dog) and removal of a splenic tumour the size of a rock-melon from the abdomen of an Alsation. Phew!

GDV's are particularly nasty and I always warn owners that it's a 50:50 chance as you never know how much damage has already been done. What added to the pressure this time was that it was one of our nurses' dogs, and my favorite dog of the bunch! Luckily she got the dog to us at the first sign of trouble and I am convinced that the timing of presentation is the most critical factor in the survival of these cases. That, and having three vets and two nurses involved in the operation!

Look into my eyes!

The best thing about this job is that just when you've had enough at the end of a long day, someone comes along and makes you laugh. My favorite consult of the day - the woman who insisted on staring into her rabbits eyes for a full minute before putting it on the table in order to 'calm him down'. Which was when my nurse walked in and stood there wondering what the hell we were doing standing silently staring at a rabbit cradled in its owner's arms.

I've heard of chickens being hypnotised but this was the first time I'd seen it tried on a rabbit!

(Oh, and it lasted all of ten seconds until the vaccination needle hit the skin.)

VET not snake-catcher!

So I had someone call me after 8pm on the emergency line last night about an adder that was caught up in some packing tape and they were worried that it might be dehydrated. Now I will see someone's pet snake IF I HAVE TO and only if they can guarantee that the snake is not poisonous. Unravelling a wild poisonous adder from packing tape however is NOT part of my job description. 

I asked the client if he as able to catch it safely. 

"Well, we have caught it," he replied. "It's in the packing tape."

"And you can't safely release it?" I asked.

"No, that's why I'm calling the vet. It's only a small one!"

So if it's so small and safe then why don't you do it!? I wanted to ask. Instead I replied that I was did not have the gear to deal with snakes safely and nicely suggested that he look in the yellow pages to call a qualified snake catcher. And yes, you probably will have to pay for their services!

Ticked off

There are many things I miss about Australia but the one thing I certainly don't miss is tick paralysis. The Australian Paralysis Tick causes progressive ascending paralysis that starts with weakness in the back end leading to a wobbly gait which progresses to paralysis that can eventually involve the respiratory system, resulting in death due to asphyxiation (not a nice way to go). We also found that smaller dogs would more often present with a history of coughing and 'vomiting', often before any signs of leg weakness. This is actually regurgitation caused by paralysis of the muscles responsible for swallowing and can often result in pneumonia even once the initial toxicity is treated. In the US, removing the tick will often prevent further toxin release and the animal should recover. Unfortunately in Australia an anti-toxin is required to mop up any toxin in the system before it binds to receptors and causes further damage, resulting in further deterioration despite having removed the tick, which is why it is so important to administer it as early as possible.

Now it was easy enough to know what to do if the owner was aware of the high risk area in which we lived or brought the tick in to be identified, but often we would have visitors from other states who had no idea about the prevalence of tick paralysis on the east coast. Although it is relatively safe to give the anti-toxin to an animal who is not suffering tick paralysis, it is also pretty expensive and one has to think twice before giving it to a large dog. So I had to become pretty adept at spotting the difference between a 'lame' animal and one that was in the early stages of paralysis. Luckily these ticks like to hang around in specific spots on the animal, and with a bit of practice one can become pretty quick at finding the little suckers.

So when an old lab who already suffered from arthritis came in with the complaint that he had 'hurt his leg' and couldn't stand up my alarm bells started ringing. As luck would have it I found a tick while playing with his ears as I was talking to the owner, which gave me an immediate diagnosis. He was duly admitted for treatment and kept overnight for monitoring (as there was always a chance of deterioration in the 12 hours following treatment). The following morning he still was unable to rise, despite being bright and alert and gobbling down his breakfast without any trouble swallowing.

I have seen cases where the muscle weakness caused by the tick paralysis exacerbates underlying arthritis, and so gave him a shot of pain relief. My boss then carried him over to the tick bath (to ensure there were no remaining nasties) and then carted him back to his cage. Where he promptly jumped off his bed and waddled over to his food bowl. Whether it was the pain relief or the fact that a potentially full food bowl was on the other side of the cage, he'd made a spectacular recovery and I was stoked. My boss however, was not impressed that he's had to carry a 40kg lab back and forth! Cheeky bugger.

9 to 5 job - what's that?

So far the comment of the week came from a pug breeder who had taken 4 hours to decide to finally allow us to take her whelping bitch to surgery. By this time it was 7pm (we closed at 6:30pm) and she asked if she could wait in the waiting room as "it will only take about half an hour won't it?"

Well, yes, the surgery itself will take about 30-45 minutes, but if you would like us to anaesthetise her first before slicing her open, clip and sterilise the site, and allow her enough time to regain consciousness, then you're looking at a minimum of 2 hours. All of this I said in my head of course, while my actual reply consisted of, "No, it will take a bit longer than that. She should be ready to go home by about 9pm."

"Oh," the unperturbed breeder replies, "well I guess I'll go home and have dinner. I suppose we've ruined your night though!" she laughs good-naturedly.

Had to grit my teeth in a grimace of a smile to avoid saying, "Well, yes, actually you have and I might have been able to have dinner tonight as well if you had just brought her in at 5pm like I advised in the first place!"

And that is what emergency after-hours surgical fees are for...now if only that money actually made its way into my pocket!

Slippery customers

I recently had my first UK snake bite victim brought in - a big boofhead of a golden retriever who had stuck his nose in the wrong place. He came bouncing in happy as larry, the only evidence of his tangle with the angry adder: a swollen nose. His owner insisted that he had done it on purpose, as he was due to be castrated the following day and now the surgery was to be put off for a couple of weeks to be on the safe side.
"Bloody men will do anything eh!"
Well, I'm sure that most guys out there would agree.
So he was sent home with anti-inflammatories & anti-histamines and a disgruntled owner.

He had the last laugh in the end. On the morning of the dreaded surgery his owner rang up.
"We're going to be a little late. My husband took him for a walk and he managed to find a bitch on heat and is currently tied!" (The dog that is, not the husband...this is not that kind of blog!)

Well, I guess you can't blame the poor guy for having one last desperate attempt to hang on to his manhood!

Traffic Jam

I was told that the English saw standing in a queue as a hobby, but didn't realise how true that was until I made the mistake of visiting a safari park on a sunny bank holiday. We knew it would be busy and made sure to put on our 'patient faces' while sitting in line in the car and slowly moving through the park. We finally cracked though, when we accidentally turned into the deer feeding paddock. Having both worked as vets in New Zealand where we routinely handled deer, we weren't really interested in seeing the deer, but didn't realise that we could skip the section until we saw the guy behind us drive straight on as we made the grave error of turning into the deer paddock. Where we proceeded to sit in a 2 lane TRAFFIC JAM for OVER AN HOUR. Bear in mind it would take about 5 minutes to drive through the paddock if there were no traffic. And we didn't even have any snacks.


The only thing that kept us sane was watching the poor family stuck in the car behind us as the father grumbled at his wife, and laughing at another father holding his little daughter up for a wee as the interminable wait had become too much for her poor little bladder to bear. I was jealous as my poor little bladder was also struggling by that time.

So the moral of the story? Never drive into an area where there are animals prancing up to the side of cars looking cute and begging for food unless you are prepared to be there for a while...or enjoy standing in line like a true Brit.