Monday, 29 September 2008


I was on the mid shift last night which means l finished at 22:00. We were pretty busy most wards dog, cat and critical full with a suspect lepto in isolation. Still overflow and small furries was empty so it was not to bad.

Last night was the first time l have seen a cat bloat. Dogs bloats for us on nights are fairly common. Roughly one every couple of weeks. Cat bloats are pretty much unknown, in 7 years l have never seen one. This one presented as collapsed and screaming when it came in. At first the thought was it was a thrombus (a blood clot) but no the feet were all warm. A dose of our strongest pain relief was administered and when it started to take effect it would also sedate the cat slightly.

As soon as he was injected with pain relief a quick x-ray was taken and the classic elbow showing of bloat and the chest in a bad way. We had a locum vet on who is not used to bloats as they are very rare in general practice. I set up for him to do an emergency decompress.
With the first decompress we took about 80ml air out. The cat was more settled and iv catheter was placed. Normally one would be placed first but we had not been able to as the cat was in so much pain keeping it still long enough was impossible.
The second decompress removed roughly another 80ml of air. A final x-ray showed that the bloat was much reduced.
We did not want to do any more gas removal in case we caused more problems than we solved by adding holes into the stomach with a large bore needle and possible leakage.

The assessment of the night vet who came on duty later in the evening was that the chest was in a bad state, this lead to mouth breathing and to much air diverting to the stomach, the stomach filled with air and somehow it moved enough to trap the air. Withdrawing the air allowed it to settle back to normal position and expel the remaining air, thankfully, as the cat would never have survived an operation.

When l left the cat was sitting in his incubator purring away. He still has a long haul to go the heart and lungs are not good and he is over 10years old but he came through step one.

We had an unusual patient in, a goose. He had a bad leg cut 4 days before. It was felt that dressing and strict rest would do the job. He had been in overnight, then home for 3 days. Wonderful blue eyes he had and was very well behaved as he was a pet not a wild goose. The vet undressed the wound and BANG! out poured blood. Sods law a dressing was not going to work we would have to do an op. He reapplied a tight pressure dressing while l tried to not get attached into said dressing while holding the leg out.
I took goosy to an empty walk in kennel and he was a bit rude when placed in it. He had been wrapped up in a duvet for some time with just his head out so he needed a good wing swing. Trouble was l was clobbered by him but it was not personal as wild geese are this was more the lines of.
"Well it was your fault for not getting out my way"
Once he was happy he had both of them and they were working he allowed me to pick him up and place him on his newly made bed.

It seems to be Diabetic season at the moment and we have at least one animal in a day on a glucose curve.
This means glucose taken every hour or two hours for 24hours. Last nights one was a sweetie, allowing us to take blood and stats etc. as though it was an everyday occurrence. I took her general stats but her drip had stopped and wouldn't unblock when l adjusted her leg position and tried to flush it this did not work either.

I undid the drip line, bunged her (iv) catheter blasted the drip and reattached her line, went to tape it in and her teeth missed me by mm's, she made it clear l was on her dinner list, and sweet doggie was not playing ball any more.
Great, the drip line disconnected and blood decided to descend as it had a lovely open hole. While l could not get near my patient. My cussing drew a vet who asked if he could help. I legged it passed him for a muzzle and yelled yes stay there. I got back with vet and dog gazing at each other warily and thrust a muzzle on my patient before the teeth could move. While saying to the vet right get that iv in while l secure her.

Do you mean this he said holding drip line up and (iv) catheter attached to it. He reattached the drip line, she had moved and bingo... it had come out. Oh well so much for a sweet patient, she would have to have a redrip later, l was going off duty and she needed to settle down.

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