Wednesday, 30 September 2009

Nights With a Difference

Well it has been a 4night shift of cases that we normally see in singles coming in in pairs or triples unconnected to each other.

2 cats in needing back legs amputated due to damage from cars, both damage to the right hind and both long haired dark tortoiseshell cats.
1 dog in that needed it’s front leg amputated. Running around in the woods it had somehow ripped the whole lower section of it’s front leg off. Apparently only 1 bit of skin held it on. When l got in the leg was all padded up prior to the op the next day once he was nice and stable. I am told that even the vets and nurses looked ill when they saw the damage, the dog was dark brindle. A doggie version of dark tortoiseshell in cats

3 dogs in attacked by other dogs and a lot of damage done to all of them. One of the dog attack dogs was a stray. Severe bite wounds to her front legs and shoulders. When she was under GA for clip and clean they pulled some scabs off and a fountain of pus erupted.
She was very flat for 2 nights, then at about 5am the third night had an “ok no more malingering” moment and started to eat and try to stand. It took till the end of the 4th night before she could walk without falling over.
Her tail never stopped wagging although we muzzled her to inject her as she was so sore and some of the injections sting, even then all she did was cry.
I had a word with the collection driver and he is going to arrange for her to go to a friend of his with an animal rescue to be rehomed. She is a very sweet dog and l am crossing fingers for her.

2 bitches in unable to urinate and blocked solid with bladder stones. Both needed operations, very unusual for bitches to get blocked.

2 animals brought in by police, made a change normally we have to send the collection van.
1 cat that 3 police brought in the back of their van after 2 cars had hit it [cat]. This cat needs to choose a lottery ticket. Apart from bruising it was unhurt.
The second was a dog whose owner had been arrested for being stupidly drunk and abusive. It was a very sweet dog the copper wanted to adopt it and was upset that it was owned.

2 dogs with ear damage that needed head dressings on. One was one of the dog attack dogs with neck and ear wounds. Usually we only get the odd head dressing animal through.

2 jaw cases one a stray dog. His mouth wouldn’t shut, thinking it was a broken jaw he was given a GA. Nope his teeth were so rotted he couldn’t shut his mouth. All teeth removed and about 8hours post op he tucked into a bowl of sloppy food. If anyone wants to rehome a grey grizzle lurcher about 6 or 7 years old let me know, he is great with other animals. This one will also go to rescue.
The other jaw case a young cat with facial damage including a fractured lower jaw according to the owners they have no carpet and the cat was having a mad half hour, couldn’t stop, slid and smacked into the wall.

1 hard talk with police control and badgered an inspector at "Someplace Police" into giving us a fwin for collection of a dangerous dog, and rspca giving a log to have it put down. The Inspector was reluctant as it was a put down at owners request and not police request but the owner couldn't get the dog to us.
I found out afterwards that the law has changed about a month ago and neither police, rspca or us knew. The collections driver did and told me when he brought the dog in and said we couldn't put it down and why.

Now if a dog bites someone and the police are informed it is not allowed to be put straight down, even at the owners request, the police have to prosecute. And they can not prosecute an owner if the dog is dead. So it goes to special holding kennels until post court case, then it is put down. A wonderful waste of police time and money and added stress for the dog.
So l could have trumped the inspectors reluctance without horse trading damm. At least l know for next time because the will be one, Inspectors are tight with their fwins.

This does not take into account the usual post op recovery cases, heart and kidney failure cases, isolation dogs with diahorea and vomiting, RTA pets, general medical cases, and bunny with gut stasis.
The bunny we had in was evil and although not eating normal food was partial to human fingers which made syringe feeding and giving bolus fluids fun.

Ahh well l have just agreed to another load of nights. I wish l could say l liked days as much as nights but for all my moaning about nights and the lack of sleep it is my favourite because you never know what will come through the door next.

Sunday, 27 September 2009

World Rabies Day '09

September 28th is World Rabies Day Organisations around the world will be aiming to raise awareness and understanding about the importance of rabies prevention on the third annual World Rabies Day on 28 September.

Having had to go through the injections after my brush with a bat in UK behaving strangely that l was handling at work, there is rabies in some bats in the UK, and seen a dog shot back in Rhodesia when l was growing up. The dog was unknown on the tea plantation and so it’s was a risk. I am aware of the risks involved with rabies and they scare me.

What shocked me was the statistics of human deaths over 55000/year. At least 100 of the 150+ death a day are children.
Here are some personal stories of those who have had contact with rabies some died and others survived after post exposure treatment.

The following is from the BVA website.

“While we are used to discussing the risks of rabies to pets, most vets probably know much less about the risks of rabies to humans,” says Zoe Belshaw, a member of the BVA Overseas Group. “World Rabies Day is an ideal time to promote understanding of this devastating but preventable disease.”
It aims to dispel some common misconceptions – such as that a deep bite is necessary for the disease to be contracted. ‘A lick on broken skin or mucous membranes or a scratch from an infected animal is sufficient,’ it points out.

Rabies kills at least 55,000 people each year, half of whom are children under the age of 15. “Rabies is primarily a disease of children, who are particularly at risk from this terrible disease, due to their close contact with dogs, the major global source,” said Dr Deborah Briggs, Executive Director of the Alliance for Rabies Control. “Children are more likely to suffer multiple bites and scratches to the face and head, both of which carry a higher risk of contracting rabies. Children are often unaware of the danger that dogs transmit rabies and may not tell their parents when a bite, lick or scratch has occurred from an infected animal.” Many animals carry rabies not just dogs but it is dogs that people tend to focus on.

The World Rabies Day Alliance for Rabies Control initiative aims to bring together relevant partners in an effort to address rabies prevention and control. “This is a coordinated effort to let the world know that this disease can be readily prevented through education, pet vaccination and increased human awareness of proper wound management and administration of rabies vaccination after an exposure has occurred,” added Dr Briggs.

Very scary just how prevalent rabies is. The sites give info on how to deal with suspected contact and on just how it affects lives daily around the world. If you do not get post exposure treatment, rabies has a single outcome once it has manifested, and to get there is hell.

Remember that your family and friends are often jetting off to affected countries on trips and volunteer programmes, it may just affect you.

The gentleman depicted died from rabies in 1959, soon after the photo (courtesy of US CDC ) was taken.

Friday, 25 September 2009

Governmentium (Gv)

Lawrence Livermore Laboratories has discovered the heaviest element yet known to science.

The new element, Governmentium (Gv), has one neutron,
25 assistant neutrons,
88 deputy neutrons,
and 198 assistant deputy neutrons, giving it an atomic mass of 312.

These 312 particles are held together by forces called morons, which are surrounded by vast quantities of lepton-like particles called peons.

Since Governmentium has no electrons, it is inert; however, it can be detected, because it impedes every reaction with which it comes into contact. A tiny amount of Governmentium can cause a reaction that would normally take less than a second, to take from 4 days to 4 years to complete.

Governmentium has a normal half-life of 2- 4 years. It does not decay, but instead undergoes a reorganization in which a portion of the assistant neutrons and deputy neutrons exchange places.
In fact, Governmentium's mass will actually increase over time, since each reorganization will cause more morons to become neutrons, forming isodopes.

This characteristic of moron promotion leads some scientists to believe that Governmentium is formed whenever morons reach a critical concentration. This hypothetical quantity is referred to as critical morass.

When catalyzed with money, Governmentium becomes Administratium, an element that radiates just as much energy as Governmentium since it has half as many peons but twice as many morons.

Tuesday, 22 September 2009


I spent last week at a lovely practice. They have taken on a rabbit with a problem back leg and named him “Carrots”. The leg wound broke down and so the decision was taken to remove it instead of messing about.

Carrots isn‘t kept in his kennel during the day but has the floor area of small furry’s to walk around in. He has taken to the place like a duck to water. If the main room door is left open by mistake then you suddenly have a rabbit appear round the corner as if he is on a shopping trip, unconcerned about barking dogs or hissing cats.
At night he has to be locked up or he sets the alarm off. Apparently he is not too amused about the locking up idea and throws a foot stamping tantrum when he is shut in.

I was dealing with a rabbit in a bottom kennel in the furry ward. It was at the very back of the kennel so with a lot of groaning as my knees objected to the floor as l bent down. I ended up lying flat out to reach my patient. Carrots suddenly jumped up onto my back and starts walking up and down. I was unable to do anything except threaten him if he used me as his loo. Thankfully he got down but only to stick his head in the kennel then jumped back up and made himself at home until my upright movement as l groaned up warned him l was about to grab him and evict him so he jumped off and went to look for another comfy spot to sit.

About 30mins later l popped in to get something from the room and he was sitting on top of a cat carrier stored in the room and ripping the plastic bags to get to the dill, and other titbits that were on top of them them. Needless to say l was not popular with him when l removed the bags and put them out of reach.

There is a big wrangle going on at the moment as several vet nurses want to adopt Carrots, once the dust settles he will be off to a good new home.

Thursday, 17 September 2009

Reast in Peace Wibble

Wibble (left), Santa (middle), Poca (right)

Last night l rang B when l left the cpd. He was worried about Wibble. I got back and she was very mauve and gasping and coughing. I took her to the animal emerg. hosp. where we (me working, Wib's snoozing) spend most of our lives. I was thinking frusamide, pain relief and 02 for a few hours and see how it went.

As l drove into the car park it hit hit me, Wib's sore front leg on Sunday. It was a strange soreness but l figured it was her spondylosis playing up again. It eased up by Monday. The pain was was a thrombus again but a severe one, the clot had moved through and hit hard into her lungs this collapse was irreversible.

I got Wib's onto 02 and rang B l felt awful l had not insisted he came, l told him the outlook. He was staggered he said she was very poorly all day and didn't realise she was so bad but agreed it was fairest and best for her.
A last word with the vet l asked her knowing the reply especially when l told her what l believed. Then l nodded my head at her to start the injection. The staff left us to have our goodbyes.
I wanted to stop the vet and say "no no she will be ok" but l didn't. The same way l didn't when the decision had been taken with the other members of the family that have passed through our lives. What l was doing was my final gift to Wibble that hub and l (and everyone who knew her) loved. To have stopped the vet would have been for me not for Wibble.

Today work was hell and everyone was wonderful.

Last night l needed something positive l pulled my Angel cards out upside down (so l couldn't see them) l was giving them a good shuffle and a card fell out l turned it over and have taken that as my special meaning, Yvonne is one of the Angels.

Wibble is with her Aunties, Santa and Poca and Ginger the cat and all our other animals.

Sunday, 13 September 2009

Could You Just.....

The owners were new to the area and booked the dog in for a routine castration. So it was slotted in with the normal set of ops and the day was fully op and consult booked. One vet was off ill on the day but all was planned and doable, just, without the duty vet needing a stress break (hit of double strength coffee and several bars of chocolate)

Alas the best laid plans of mice and men…

On pre-op check it was discovered that the owner of the dog for castration had neglected to mention the dog was cryptorchid. In other words only one testicle was descended. This is a potently dangerous situation for the animal. Testicles are supposed to be outside the body to be kept cool, trapped inside they can mutate into tumours. Sometimes it is a major hunt for the reclusive testi. It may be felt it may not. It may be in the abdomen, or in the groin almost “home” or any point between the 2 areas. It may be tiny and easily confused with other bits of muscle or fat or a fair size. The vet can spend over an hour chasing it down thinking they have found it every few minutes leaving a large area to suture up post find of the errant testicle.

The owner continued with her shopping list. While the patient is asleep, could we just remove both hind dew claws, the dog had badly ripped a hind dew claw a couple of times in the past year, and the nail was growing back in strange shapes. The owner was worried it may happen again, oh and clip all the nails.

The dog had an umbilical hernia. It was tiny, there was no lump, just a small hole that his old vet had once felt, could we just repair it.

Could we just give him a nice deep ear clean, the dog had recurrent ear problems so while he was asleep, a clean would be ideal.

Oh and an identichip would be the icing on the cake, or by now to be precise, the straw that broke the camels back.

Post unavoidable “vet stress break” the hn called a vet to help from one of the practices quieter neighbouring branches. The op’s were started and I landed the above fun job as the hn had the dental to do, she pointed out l hate dental machines.

I placed the identichip as soon as he was asleep. With how much there was to do sods law said something would make us forget it. Yes it was on my anaesthetic op sheet, ops board and consent form but with the way the day was going, l was taking no chances.

The hidden testicle was possibly felt in the groin and after a lot of groping and going a lot deeper than originally thought would be needed the errant article was found. The dog got lucky only 2 abdominal and 1 prepuce wounds, main testicle, hidden one and hernia repair.

Hind dew claws were simple to snip as only skin held them on. All that was needed was a couple of stitches a side and a dressing. I took over the dressings and ear clean as they were at the end of the op and the vet wanted the “powder room” She dragged the hn away from her coffee and gossip. Sorry, “work based discussion” to cover the anaesthetic for me.
The hn and call in vet’s 4 ops of dental, that had potential to turn into a nasty job, had turned into a short scale and polish, and the 3 cat castrates were pretty quick only minutes. She and the call in vet had a nice hot mug of coffee and a chat, making sure we saw them.

His ears were not too bad. I got a bit annoyed looking for the chunk of gunk that l couldn’t clean and realised it was stuck in the otoscope end. As I pulled the scope out the ear l caught the gunk and it pushed to the side so when l looked down in case it was inside the scope nothing was there, pushed back into the ear it pushed the gunk back into view.

Finally done, 2 of us carried him all 50 kg of solid dog back to his kennel. Oh the joys of human nurses that have special hoists. We snuggled him under his blanket and stood up to stretch. As l pushed my hand into my pocket to pull out my packet of smint, my hand slid down though a smelly wet brown mess. It was a gift to me in my pocket from my bloody patient as we carried him back to his kennel and l hadn’t realised. So much for a nice smint. Next time l carry the front end of the patient.

Wednesday, 9 September 2009

Computers and Chocolate Biscuits

Well l have spent the last 2 weeks at a small practice and we have been wondering if the world, or the town we are in more precisely has gone mad. Every pet in the area seems to have had a need to come in and several times we have had to make appointments with one of the other branches to handle overflow.
Thankfully l was up to speed on the computers as l have been on late’s which end at 19:00 which means once ops and cleaning up is done l am on reception.

Monday l finally have an early finish as l was on mids which was a 9am start.
One of the reception computers was pulled out and looked like a computer version of rip. it had been playing up last week and looks like it finally died over the weekend.
I barely sat down on reception when l had to take the first payment of the day, l was unable to get the cash till open to get change. The computer/till system is meant to work independently so if one dies you do not have this problem, great start to the day. The client said just pop his change (pence only) into the charity box.
I had a word with the head nurse (hn) who was snarling at the back computer while trying to add histories for patients that had been to the emergency vets over the weekend. For payments l suggested we send invoices or ask for cards. She was past caring; l had enough computer problems without caring what was going on with hers.
This left me with a fist full of cash so l shoved it in an empty draw and hoped l would remember which office draw it was, the room is a bit of a tip.
Next minute the vet appears and tells me that her computer won’t print labels; quick test showed no computers would print labels. This meant hand writing labels. Money wise the clients were happy to card it or pop back to pay bills.
A practice rang up and wanted a history for a client that was leaving the area. Guess what won’t print. I read the very short history over the phone and tell them l will send the history at some point in several light years time if any of us survive the day.

The hn stomped through and rang head office told them that the reception computer seemed to have fully died after spending last week crashing all the time, this had caused overall chaos. HO said to ring the computer people they promised they would dial in and fix things. The hn and l did not query how they would do that when one of the computers was turned off at the wall. Life had enough for us to do without caring about some mythical dial in.

Finally the receptionist came in she was on late’s the hn and l fell on her like starving wolves telling of all our woes. The reply was as she knows nothing about computers except what she does what were we telling her for. Miffed and rebuffed the hn and l did what any sensible person would. Ran away down the back and got op’s ready for the vet’s, leaving the receptionist to sort the mess down the front.

Part way through the standard ops of spaying and castration the receptionist came through and said that she had sorted the computers; we must be incompetent as with no knowledge she had them all working.

I pulled the short straw with the dental. I have mentioned before one of the reasons l like nights is we do not have dentals. First get the dental machine working, these are designed by experts who do not use them. The vet cussed her way through tooth extraction, she used to do mixed work (farm animal and small pets). She hated dentals and would always swop a dental with a vet that preferred dentals to farm work and they were both happy.
Anyway the dog had lots of teeth out on both sides and a stitch a gum flap, this was needed to help extract one of the large molars.

At this point the receptionist came through again to dental/prep room. She had coffees and chocolate biscuits. I know l am trying to stop chocolate but l had to have a couple of biscuits as a stress aid. Apparently the vet from one of the other branches that was in charge of the computers was round and sorting things, l never got a chance to ask why? As she said she had fixed them.

Recovering post munch of biscuit and quick coffee hit, l took over again from the vet who was glaring at the dogs mouth, daring anything else to be wrong as she felt her part was finished and keeping an eye on the patient. The vet went to get her recovery aid and write the patient up.

I started to clean the teeth and the tooth scaler died. Water bottle full… check. Machine switched on… check. All knobs seem to be in right place…check. Dental machine kicked hard… check, nothing so look for hn. She is new and not used to the machine so repeats what l did to same effect. Then she had an idea and said hang on there is 2 bottles try and fill the other one. I did and it worked. Now what is the use of having a back up water bottle if both of them have to be full to work but the machine only takes water from one bottle at a time. To the normal mind when one bottle is empty you flick to the other and when that is empty THEN the machine stops. No not this devil you need both full even though one is back up and not in use.

Turn patient over and start to scale that side. “Errrrrmm” clear my throat trying to think how not to make the vet want to run away. Vet looks at my face and you can see her heart sinking, then perk up “Have you done something wrong”.
“Gee thanks for that, no but you need to do something with this canine”. Her face fell. I continued “I can feel a depression in the upper canine under the gum”
She came over and felt it. “No no that is fine no….” and with a deep sigh asked me to go and get M (the other vet) and more experienced at dentals so she can check see if it needs to come out. Although she knows it does, she is hoping it is one of those cases where there may be a lifeline. M comes through and has a feel, no words needed.
Canines are difficult to get out because they have such a deep root. So more gum flap incision and a new trick taught by M to extract canines involving drilling into the base of the tooth, a nice big hole in the gum for more stitching and 2 happy vets and vetnurse.

Patient back in recover and trotting through to get Wib’s so she could go out for a pee break l walked past a strange male scowling at a computer muttering in Irish under his breath. I assumed he was the vet/computer expert. Hope he was enjoying himself because anyone that wants to fix the stupid things must have a screw loose them selves.
He was still in the same position when we came back a few minutes later and l tied Wib’s back up in reception.

Back to clean up kits, theatre and prep/dental areas. Lunch by now a distant memory, not unusual with me, I seem to miss out on lots of breaks. I must start putting my foot down as most people do and insist on taking them. Except l can not be bothered to l just grab what l can when l can, l hate starting again after l have unwound.

At least on late consults we had all the computers working and 2 vets, which was just as well because it was a busy surgery, fit in patients kept coming through the doors. I ran out the door at 17:30 relieved to let someone else play with the computers.

Tuesday l was on early l was there but no one else so l couldn’t get in. 15minutes after hanging around l rang one of the local branches as they are friendly with the staff from my place and go out partying etc so l figured they would have phone numbers, except they were still on answer machine till 08:30. So l had to ring head office asking what was going on was anyone ill. Finally at 8:30 the missing student turned up using rude language about school run and traffic.
We were as busy as Monday but thankfully the computers all worked. And l escaped as afternoon consults were starting.

Only this week there then off to another practice next week. Wonder what surprises life will treat me to there. That is the beauty of locum work. So many new routines, computer systems and staff to learn then rush off onto the next one just as you get the hang of things. I love it.

Sunday, 6 September 2009

Head Dressing's

Wibble is very good natured and often used for student practice of various bandaging techniques, much better than a doll. I managed to get some photos of her in "model mode". Bandaging is generally done by nurses vets tends to mess up they are always in a rush.

First fold the ear over the head and pad it, making sure your wound is covered by melolin or whatever dressing you want.

Then apply the first layer make sure it is not to tight especailly under the throat.

Then your next layer anchored nicely round the other ear

Finally your last layer

Now get a pen and write do not cut and a shape of the ear. Ears have been removed by people cutting through what they thought was just bandages.

Check the tightness at every stage so the patient can breath then step back and admire your work... and write in that warning!!!

Thursday, 3 September 2009

Tail Base Fracture

Possibly the cat had been jumping off a fence, a fairly simple exercise but somehow the tail had got caught, maybe in a gap in a panel. The downward body weight had fractured the cat’s tail at the base. Being caught with closing doors is another culprit.

This innocuous fracture has cost a lot of cats their lives. There is a nerve that appear in this area, it’s job is to ensure the bladder empties, and knows when to empty. If this is damaged it may take anything from weeks to never to get better.

This fracture means a long hospital stay for the cat as it has to have it’s bladder emptied every few hours. A catheter is not generally placed to empty the bladder as the vets want to see if any feeling is coming back and the cat makes any moves to urinate by it’s self.
The tail hangs down limply and if the cat recovers the tail is amputated so that it does not get caught in anything else. Tails are not repaired if they are fractured just removed.

The cats get very grumpy at having their abdomen squeezed all the time, even if they are sweethearts in between the squeezes. It can take several weeks before the vet is happy for the cat to go home. The cat may or may not be better. Sometimes they are able to take over urinating again, at least with the knowledge that the balloon in their abdomen needs the toilet, often not in litter trays though. If cats are lucky enough to get some feeling back their tails are amputated and they can resume a semblance of normal life.

Often though the urine the cat is passing is from bladder overflow. The owner may take the cat home and take over expressing the cats’ bladder, or come in two or three times a day for the nurse to do it till the owner gets the hang of it. Some people decide that they can do that for the rest of the cat’s life, this is rare.
Even with the owners doing the squeezing it is stressful and places unnatural strains on the cats body, renal failure may start or if it is an outdoor cat the change to indoor cat can be very stressful for them, sometimes the cat will go just downhill the decision is taken that the stress is to much.

The bladder is full and visible in the bottom portion of the x ray it is the large oval shape tipped at a slight upward angle.