Thursday, January 15, 2009

36 hours later

It started yesterday morning. A relatively light morning of appointments of which the last one was a cat who had been adopted from the Humane Society in the fall and was only supposed to be 2 years old and been left there by someone who was moving and couldn't take him. I sort of doubted the age thing but we'll come back to that. He was not eating well and lethargic and upon exam I found a huge mass in the abdomen so we kept him for radiographs and some fluids. While the techs worked on the cat I anesthetized Legend for her root canal (recall her busting her face on the concrete in the fall). Dr. B worked on the tooth while I hovered over the anesthesia as her blood pressure constantly teetered on the edge of acceptable and I had to keep upping her IV fluids and turning down her rate of anesthesia. Finally we were done and my sleepy girl woke up while I prepared to tell the cat owner of his treatment options for what was shaping up to be either a splenic or kidney tumor. The owner elected to let us perform and exploratory surgery the next day and so we got the cat settled in for the night. Just as the day was winding down a newer but really sweet client called-their 7 month old puppy was attacked by her littermates in the yard (they adopted a pregnant dog and kept mom and babies) and wanted to know if I would see her. Even though it was already after 5 the emergency clinic didn't open until 6 so I told them to come on in. She was cold-94 degrees (normal 101.5), shocky, and had several non-life threatening bite wounds. We gave her an injection for pain, placed an IV catheter and began giving her warm fluids and cleaning up her wounds. When she was stable enough to transfer I sent her to the e-clinic for further stabilization, heat, and possible surgery overnight.

Fast forward to today. I expected to see Sissy (my emergency from last night) transfer back this morning. By 8:45 when she didn't show up I called her owner. An obviously distraught and tearful woman relayed to me how Sissy did great overnight, her temp came up nicely and her surgery went very well but around 7AM she suddenly passed away during routine treatments. The doctor suspected she threw a large blood clot. There was no way anyone could have known or prevented it. Her owner felt bad for putting her out with the other dogs and also feels bad for having ill-feelings towards the other dogs. The whole thing was very sad. I tried to counsel her on the phone the best I could before heading off to other appointments. My last appointment before my big surgery was a well cared purebred cat with pet insurance (WOW!) and chronic urinary issues. Of course, he was blocked. Put cat away for now and head off to surgery.

A quick exploration of the abdomen revealed a very large and cancerous looking kidney. So I set about starting the removal of this tennis ball sized tumor. About 30 minutes into the surgery I checked with Dr. B for some advice (I've never removed a kidney before) and we came to the conclusion that it would take both of us to work on this ugly thing. Shortly thereafter we discovered that the cancer was invading nearby structures and may even have incorporated the vessels. In short, if we continued the cat may not make it through surgery and even if he did there would still be cancer left behind. Rats. The owner elected euthanasia on the table, which was the best choice given the situation. (Remember when I said we'd come back to the age thing-I was starting to wonder if someone knew this cat not only wasn't 2 but also that it had a mass and turned it in to the HS with a different story....we'll never know, but the whole thing is a little suspicious to me) Then I worked through my lunch hour to get the other cat's urinary obstruction relieved before afternoon appointments. It took forever and then the cat thanked us by spending the rest of the afternoon trying to tangle and disconnect his IV and urinary catheter lines.

Afternoon appointments seemed to mostly involve anal glands and one very sick dog that the owners had to be convinced to bring in today and not later in the week (repeated vomiting, dripping blood from rectum, barely able to stand-you know, no big deal). The poor thing was so dehydrated his blood was almost black. Labwork was run, antibiotics and IV fluids started and then he was transferred to the e-clinic for overnight care. I suspected severe GI disease or toxin.

The day wrapped up with someone who needed their "down in the back" Rottie put down but when they arrived they wanted us to either get the dog out of the car or euthanize it in the car because it was trying to bite them. Um, no. But it didn't matter because they informed us that the dog had bit several people in the last 10 days and by law if we put it down we have to submit the brain for rabies testing. Apparently they did not want to do this and left. People make unusual choices in life.

Anyway, 36 hours later I'm beat. I don't usually have so much excitement in such a short time in January-it's generally a slow month. Hopefully tomorrow will be quieter.

8 comments:

Jeni said...

Aaaaannndd...that's why I prefer my current job as a stay-at-home mom. :-)

Nicki said...

I don't if I could change diapers all day Jeni! Actually I know I couldn't :) Good for you though!

Sue said...

Wow, that's a lot of action in a short time. How's Legend doing? And how's Oreo doing?

Josh and Jess said...

No wonder you're beat after all that!! Rest up if you can... next week it starts all over again!

Greg S said...

Thats just a crazy couple of days.

Makes the day go by faster though doesn't it!

Diana said...

Its such a delemia when you have sick animals. You love them and you want to do whats best, but lets face it . Money is always in the back of our minds when making these decisions. At least it seem all those people were willing to spend what it takes. Im impressed. Good for them and you. Diana

Sara said...

Wow, that is a lot to take in. Clearly, vets play many roles, besides just being a medical doctor. You are also a social worker, psychologist, etc.....

Lauren said...

WOW - that makes my day of teacher Shakespeare to teenagers look really lame...