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.

Friday night consults

Note to all animal owners out there - if you really want to get to the bottom of your animal's skin or ear condition that's been going on for the past four years - do NOT book a 10 minute consult on a Friday night at 6:45pm before the bank holiday weekend. After 20 morning consults, 4 surgeries, 2 dentals, countless phone calls & referrals, 30 minutes on the phone fighting with the red tape that is banking bureaucracy and 10 evening consults...this is NOT the time to try to address your animal's chronic poorly managed skin condition.

In an ideal world several skin scrapings and hair pluckings would be taken, along with extensive history including all food eaten in the past 6 months, and a thorough physical exam possibly including blood tests. In the real world on a Friday night you will get steroids, a medicated shampoo and a flea treatment and told to come back in a week. NEXT!!!

VAVs

My sympathy goes out to all the VAVs (Victim's of Volcanic Ash) who are trying to get home, and even more so to all the poor people working at the airport and copping all the flack from angry passengers.

On the other hand, having just booked a flight to Newcastle for the bank holiday and another to Egypt for the near future, all I can say is...THEY BETTER NOT BUMP ME NOW!

It's not the size that counts

I had a "giant" of a dog brought in for his first puppy vaccination today. After seeing the name "Zeus" on the clipboard, I was naturally expecting a Great Dane, Mastiff or similar sized pup. Instead, I was greeted by a ball of energy in the form of a Mini-Foxy. Should've seen it coming really.

The owner pointed out a spot on its back that was shaped like a duck and I exclaimed without thinking (one of my poorer habits), "Oh, why didn't you call him Ducky?" (which I thought was more appropriate).
"Well," she replied, "I wanted to, but my grandson decided he needed a STRONG name."

Since most foxies seem to think they are just big dogs trapped in a small dog's body (the classic dog version of "small man's syndrome") I suppose it was appropriate after all!

Chocolate Labradors

Ah Easter...the time of bunnies, Easter eggs, chocolate, and of course, chocolate poisonings in dogs...usually labradors, the food addicts of the dog world. We often get phone-calls from panicked owners about dogs having eaten one or two Easter eggs. These are usually false alarms as the eggs are mostly milk chocolate, and it takes a lot more chocolate than people realise to poison a dog.

That was, however, until a one year old Lab was brought in as he had managed to polish off an A4 sized one inch deep container FULL of chocolate (including one of those dark rabbit chocs) sometime during the night. The kids were not happy at having lost all their Easter treats and their mother was not happy at having grumpy kids and a hyperactive lab on her hands.

Now the active ingredient, theobromine, causes hyperactivity, increased heart rate, vomiting & diarrhoea, heart irregularities and seizures resulting in death. Essentially it's the equivalent of giving a kid a whole lot of sugar mixed in with caffeine and energy drinks, and then releasing it into a funpark.
So when the lab arrived bouncing off the walls, it was understandably difficult to examine. He had already vomited a couple of times, purging some of the chocolate, but now needed further treatment to ensure he wouldn't absorb any more toxin. I sedated him so that he wouldn't be ricocheting off the walls of his cage and, once he had calmed down a bit, re-examined him. Even his breath smelled of chocolate as he happily panted in my face! He was doing well so we decided to give him a small feed containing activated charcoal (just in case). Unfortunately this stimulated the gastrocolic reflex...i.e. he suddenly needed to poo. ALL OVER THE PREP ROOM FLOOR. All I can say is that I have NEVER smelt anything like it - it was like pure chocolate! We frantically scrambled to prevent him from treading in it as he spun around depositing his little chocolate surprises all over the floor, trying not to fall over laughing as we did so.

I suppose it could have been worse as he could have eaten fish or something equally horrible, but it was enough to put us off chocolate for a while. Which meant that no one was interested in the chocolates dropped off by a client that morning...well, not until the smell of chocolate had been cleared from the air...

To the pub!

After a rough week last week (and it was only four days!) a few of the girls from work & I decided to hit the local pub on Friday night. It was only a few yards away down the lane so was nice and close to home.

After nattering away over a couple of drinks telling disaster work stories & comparing crazy clients (as vets & nurses & I'm sure many other professions do), we bundled out into the dark to stagger home. As I passed a couple of guys propping up the bar I heard one of them remark, "Those are some of the girls from '_______ Vets'.

Hmmm, perhaps our local is a bit too local! In the future I guess we will have to be a bit more careful about our conversations or else find a pub a little further away. Ah small towns.

My Little Pony

During my first week on the job I had to rush out to an early morning horse colic as the on-call vet was already at another call. Upon arrival I drove past several very flash cars parked outside a mansion of a house, stables that were more impressive than most houses in NZ, and a horse truck that I would be happy to call home. The horse in question was a stunning animal with a long history of colic episodes that had been treated surgically in the past. Luckily he wasn't too bad and responded well to the pain relief medication administered.

I had an inkling that there was a bit of money involved (wonder what gave it away?), but was glad that it wasn't until I returned from the call that the vet chose to inform me of how much the horse was really worth. Let's just say it's more than I would spend on a house...or two. So much for the "country hacks and pleasure horses" I was told I'd be treating!

It's the UK baby!

I apologise for the long delay on blog updates. I have recently moved to the UK to do the mandatory "Overseas Experience" all Kiwis and Aussies need to do at least once in their lifetimes. In the past month or so I've been rushing around organising my new job, bank account, insurance against angry clients and roof over my head. Then I had to get used to all the new drug names, procedures and, worst of all, COMPUTER SYSTEMS in my new clinic. It's been three weeks and I'm finally starting to get the hang of it.

Things I've discovered during my first three weeks in the UK:
- Just because some people speak "English" doesn't mean I will necessarily understand a word they're saying.
- When two kiwi vets go out to a farm together, we WILL be compared to the cast of "Neighbours"...they are AUSTRALIAN, people!
- UK TV is as rubbish as Kiwi & Aussie - same crap reality shows, different accents
- DO NOT wear a bright red ski jacket in central London unless you want to stand out like Rudolph's nose.
- Catching the tube is a piece of piss, just make sure you know how to get through the turnstiles when you get off.
- Cops are not amused when you take photos of their machine guns because "it's like being back in Africa".
- The cost of food is inversely proportional to the number of calories in it.
- Even teeny tiny towns will have so much traffic that at 5pm you will need a traffic light just to cross the road.
- It is possible to get stuck in a four-storey shop and not be able to find the exit...like a rat in a trap...
- I miss the sun, sea and surf already BUT the pubs are AWESOME and on a cold, wet day I now understand why everyone can be found in one of these warm sanctuaries of beer and pies...

So just in case animals weren't scared enough of the clinic, we found this on the door recently:

And to top it all off, we discovered this when we got back from a weekend away:


I guess geckos are not as quick as they think...

Doctor Death

The other morning I had to rush out to pick up a dog that had collapsed and whose owners were unable to bring it to the clinic as they didn't own a car. When I arrived, expecting to see a dog flat on the floor, I was greeted by the most overweight 2 year old Staffie-cross that I had ever seen. It waddled up to me, tail wagging and gasping for breath (not unusual for obese dogs). The owners were now rethinking their decision to have him taken to the clinic.
"Oh, he seems fine now!"
I had a quick look at the dog's gums, which were WHITE.
"Um, no, I think I'd better get him to the clinic. There is something wrong here."
That was when they mentioned that he had been off his food for the past THREE WEEKS - and for this dog to be off his food there must have been something SERIOUSLY wrong. The owner had been forcing food down his throat for the past three days as he had gone completely anorexic - never a good sign. They then also mentioned that "oh, and he's been having intermittent seizures since he's been a pup" but they'd never had it looked into. Great.

So I hefted (and I mean HEFTED) the dog into the boot of my car and drive the five minute trip back to the clinic. I ran into the clinic to get a nurse to give me a hand bringing the dog in as there was no way I would be able to lift it out of my car again, but it was already too late. The poor bugger had died on the way to the clinic and it was too late to try CPR or adrenalin or any of those last ditch attempts at clawing an animal back from the edge of life. It was only then that I realised that these were the clients whose bird had died during a nail clip (Oct 2009 - Ornithophobia).

And to them I will now forever be known as "Doctor Death."

Not such a sweetie

We had a cute little baby possum brought in today. Well, it was cute, until you tried to touch it, when it hissed like a rattlesnake and attempted to savage anything that came near it. I quickly pronounced it "fine" and the wildlife carers were called. I asked the woman who brought it in where she'd found it.
"Attached to the cat's neck," she replied, "by it's teeth!"
That poor cat must have go the fright of its nine lives when this seemingly innocuous "mouse" turned into a tiny toothed terror! I had to laugh.

For the birds

You may have noticed in past posts a reference to my slight aversion to birds and may be wondering where it all started. Or not, but I am going to tell you anyway.

It all began at the tender age of six, when I was in some sort of zoo or park (the mind dims with old age) and was mugged by a goose which bit my finger and stole my toy block (ah the days before gameboy or PSP or whatever they are now).

I tried to get over it by owning a budgie, but in hindsight probably should have splurged the $10 at the pet store buying a tame one instead of catching one from the roof of the neighbour's house. She turned out to be the most vicious, psychotic bird I've met and would hang upside down from her perch screeching like a banshee. That and the fact that she regularly drew blood from any unwary fingers coming too close to her cage as well as living for what felt like forever (6 years is a long time to have a devil-bird in your room watching you sleep through the cracks in the sheet over the cage and making ominous low chirping noises) convinced me that she was half budgie-half vampire.

Then I arrived at University to discover that there were swans living around the pond outside the vet block and, at certain times of the year when the males were, lets call it "frisky", we would have have to run the gauntlet to get to and from class. This consisted of waiting until a small group of people had arrived at one end of the bridge and then making a dash for the other side with a hissing, flapping black male swan flying out from nowhere to challenge the unwanted intruders. It was not long until he was "relocated". I never did check if the on-campus students were served "chicken" for dinner that week.

But my tale cannot end without mentioning why I am especially nervous around chickens, apart from their beady little eyes and ominous "quaaarrrrkkk..." emerging from the bushes as you walk obliviously past their jealously guarded nests, before your ankles are attacked by a furiously windmilling ball of feathers, beak and clawed feet. No, this tale begins at an ex-boyfriend's place where his parents owned bantam chickens. One of the chickens had a habit of jumping on the windowsill and tapping on the window demanding to be fed. Now, I've never been a fan of being at the beck and call of any animal, let alone an animal that might well be my dinner one day, and it was even worse when she trained her little male chicken to do exactly the same thing. He was even tamer than his mother, to the point where he would to sit on my boyfriend's mother's shoulder. She would then bring the bird into the house and plop him on my shoulder like a parrot, where he would sit staring at me with his sharp little beak inches away from my unprotected eyeball.
"Haha, very cute," I would say, whilst shooting meaningful glances in the direction of my boyfriend that said, "Get this bloody bird off my shoulder before I lose an eye!"
One day I was sitting on the deck and our fluffy half-grown little friend jumped onto a small table next to me. I looked at it warily as it eyed my shoulder.
"Careful!" smiled my boyfriend from the steps, "He'll try to jump on your shoulder!"
"What?" I said, taking my eyes of the bantam chick for ONE SECOND. With a feral squawk that shot terror into my heart it FLEW at my head and landed with one foot in my hair and one clawed foot firmly embedded in my shoulder.
"Get it off, get it OFF!" I screeched, grabbing the madly flapping bird and throwing it to the ground, where it shook the dust out of its feathers and glowered at me with its beady little eyes while my loving partner rolled around on the ground laughing his arse off.
"Oh shut up and chase him away before he tries it again," I said grumpily as the cheeky beggar started hopping up the stairs towards me (they must be like cats, the less you want them around the more attention they seek).
He grabbed a coal scuttle and tried to shoo it away but, instead of running off like a NORMAL chicken, it ATTACKED THE COAL SCUTTLE. My brave boyfriend actually backed away from it for a few steps until he heard me laughing at him running away from a chicken (what does that make him then?) and gave it a small whack with the scuttle, whereby it finally realised that he was actually bigger and stronger than it and took off with a angry squawk.

So, it seems that while many birds seem to have a tendency to freak out and die when I handle them; the remainder seem to have one purpose in life, and that is to freak ME out. I rest my case.

Paranoid rantings

Last weekend I went for a walk along the "Tanglewood Track" in Noosa National Park. My parents were worried about me wandering around the park on my own as a woman had been raped in the past in a remote area of the park. Now this didn't deter me since if I didn't go to places just because they "might" have rapists lurking around every corner, I would be stuck in my room watching reruns of "Buffy the Vampire Slayer" and drinking rum and coke.

So I went for the walk during a busy time of day on a popular track, constantly aware of the ever-present danger of potential rapists hiding behind every rock and tree. I scoped out escape routes and made sure I had enough energy in reserve to knee someone in the groin and run away (which is about the extent of my self-defense knowledge). All completely unnecessary as the only guy I saw that looked like a potential rapist turned out to have a baby strapped to his back and his partner lagging behind. That's the last time I listen to my mum's paranoid rantings.

Who needs a degree?

Now I've heard it all.

A woman rang up today to ask for some advice. She had "diagnosed" a heart "arrhythmia" in her dog (the nurse forgot to ask if she had a stethoscope or had just pressed her ear against the poor animals chest) and had been treating it with her father's medication (goodness knows what he now had to use). But wait, there's more. Now the dog was bleeding from its nose and she wanted to know if it was related to the medication!

As you have probably figured out by the fact that she had self-diagnosed and self-treated the dog, she was NOT a client of ours and was probably a few sandwiches short of a picnic. As she was using a human drug that we had never heard of before, we told her that she would need to ring the pharmacist who had prescribed the medication and ask them. The receptionist also suggested she try Googling the drug (which is what I do all the time). "Oh no!" she replied, "the Internet is full of rubbish!" She then proceeded to lecture the poor receptionist on a book called "MIMS" which is a drug book used by medical personnel and which I have sitting on my bookshelf. The receptionist refrained from asking her where she had got her medical degree (this is why I don't deal with the "difficult" clients) and said, "That's nice, we suggest you call the pharmacist or bring the dog in for us to check out." Now I could do a bit of research and find out but to be honest I had a busy morning clinic full of people who had bothered to take the time to bring their animals to the vet and I really did not have time to waste on someone who thought they knew best.

The receptionist later came in to tell me that the woman was on the phone again, having ascertained from the pharmacist that the drug in question would indeed have an anti-coagulant effect (i.e. it can cause BLEEDING!!) BUT, and here's the kicker, she thought that the dog may also have an "aneurysm" in its nose. By now I realised that we were dealing with a level 5 crazy person and told the nurse that unless we EXAMINED the dog, there was nothing we could do and I was not prepared to give advice over the phone because if anything else went wrong it would be my arse on the line. She came back to tell me that the woman did not want to bring the dog in, she just wanted to know what she could do at home. Surprise, surprise.
Apparently the chemist had told her to "hold the dog's nose shut."
Oh for the love of all that is small and furry! How long are you planning on sitting around blocking the poor animals nose shut? Not to mention the fact that the blood can just go down the OTHER WAY into the throat and you're not actually dealing with the fact that there is something potentially serious going on to cause the bleeding!

The nurse had already advised the woman that this was not going to deal with the underling problem (which was HER, I commented), but she still refused to bring the dog in to see us. I thought that was the end of it when the nurse said that before she could hang up the woman just had one more question and I was going to love it.
"Sooo, should I skip her dose tonight then?"

I....GIVE...UP!!!