I am at my favourite vets Mike Martins Heart Referral for 3 days. Tuesday, Wednesday and Thursday. The worst part has been the heat, as much as l like hot l hate the stickyness.
The only problem with the here at the moment is that the bedroom is on the 3rd floor and all the heat has gone straight up and set up a home in the bedroom, l have the wondows open but the heat is holding tight screaming "no chance l aint going out there l like it here".
I have suddenly realised that there is sound on 2 of the computers so it has widened my options of reading and internet to listening to podcasts on the bbc, and looking at various freeview programmes. I had a look at the new channel4 programme that l missed on Monday night, autopsies on various large mammals that have died. Inside Natures Giants amazing, but l kept feeling sorry for the elephant keeper who l am sure was told what was going to happen and all l could think of was how upset he would probably be at her being an item for a tv programme.
Wibs had her heart scanned yesterday to see how it is doing. Great news is that the preassure is down slightly it was 4 and now it is down to an average of 3.5 so the kamagra is working.
She is still on her Asprin but l cut her from 1 1/4 2xs a day to 1. She put her back out (again) and a vet friend said put her up to 1 1/2 tablets 2xs a day for a few days she had a bad stomach reaction within 2 doses and ended up not having any for several days while the D+ settled down. It took such a small amount to tip her over l decided to cut her down slightly.
I buy her kamagra online 24/100mg tablets are £28. I decided to see how much the genuine viagra would cost and nearly fell off my pearch. 16/100mg tablets are between £230 to £290. She is staying on Kamagra. I crush the Viagra into some doggie chocs rollthem into a sausage and cut them into 8. So long as l wipe a bit of butter onto the doggie choc she eats them.
For those of you who are puzzled by the above and why Wibble would be on Kamagra (generic Viagra) this will explain
I was having a read of one of Mikes human heart magazines today and an article caught my eye. A study is beinng carried out for the best treatment for Myocardial infarction The first english patient to be signed up was done so by an ambulanceman.
Wow what a job it had to have been dreamed up by experts. I don't envy the ambulance crews having to get the people to agree.
Ahh well l am going to sign off and try and have a sleep if l can without cooking.
Showing posts with label Heart. Show all posts
Showing posts with label Heart. Show all posts
Wednesday, 1 July 2009
Tuesday, 20 January 2009
Viagra and D-Dimers
The D-Dimers are back Mike says that The D dimers are normal. This means that any embolism was likely not too recent and that fibrinolysis is not ongoing. So she can go onto asprin as there are no clots to breakdown.
Wibble and l are awaiting the order of viagra l sent off for last night. The active ingredient Sildenafil has been found to be excellent in treating Pulmonary Arterial Hypertension (PAH) which Wibble has, probably from her thrombus.
I have seen viagra in action over the last couple of weeks. We had a poodle in 2 weeks ago with very high pulmonary pressures and at retest last week, after one week of viagra the pressure had dropped by half.
There is no guarantee that the tablets will work as well or at all on Wib but without trying we won’t know. I was a bit worried when Mike J said viagra as it is horrendously expensive but the generic is fine.
My other problem will be to break a 100mg tablet into small pieces as they are to big but l could not get smaller ones, ahh well l have a tablet cutter and glasses.
I will get her started on the viagra first and let her get used to that check that there are no side effects then the asprin after a week or two if all goes well with the viagra.
Wibble and l are awaiting the order of viagra l sent off for last night. The active ingredient Sildenafil has been found to be excellent in treating Pulmonary Arterial Hypertension (PAH) which Wibble has, probably from her thrombus.
I have seen viagra in action over the last couple of weeks. We had a poodle in 2 weeks ago with very high pulmonary pressures and at retest last week, after one week of viagra the pressure had dropped by half.
There is no guarantee that the tablets will work as well or at all on Wib but without trying we won’t know. I was a bit worried when Mike J said viagra as it is horrendously expensive but the generic is fine.
My other problem will be to break a 100mg tablet into small pieces as they are to big but l could not get smaller ones, ahh well l have a tablet cutter and glasses.
I will get her started on the viagra first and let her get used to that check that there are no side effects then the asprin after a week or two if all goes well with the viagra.
Thursday, 15 January 2009
A.T.E (Aortic Thromboembolism)
Well you learn something new every day. I am very used, thanks to the emergency work, to dealing with cats that have had an ATE (Aortic Thromboembolism) In other words the clot of blood that breaks free and lodges, generally speaking at the branch of the where the Aorta separates down the cats back legs.
It is intensely painful and a very high percentage of cats die. If they do recover it is a very guarded prognosis.
Sometimes the clot travels round and lodges in the lungs. Usually this is less painful as blood is still circulating past it but it still causes a lot of problems. And again a guarded prognosis.
When we did the pacemaker on the cat Mike explained that one of the risks is that cats blood clots very easily, like a humans does. A dog’s blood is different so they were able to do a lot more heart operations on dogs.
I never though to ask about thrombus in dog's. I did not think l had seen (as far as l knew) any in dogs and we were discussing a cat and a very big operation on it.
Today was one of those rude awakening days. Wibble has been a bit puffy for about 3 weeks but l thought with central heating being up, l did not want to be a paranoid owner, would just keep an eye and if l was still not 100% happy l would speak to the 2 Mikes today.
The problem is working, especially like l do, with a major part of my work emergencys you get paranoid that every little thing is a major 'thing'. The animal suffers endless needles and exams to go to the other extreme of dismissing everything as paranoia. So l tend to end up on a bit of a tightrope and often the vets check my dogs and find nothing, but l try and withold endless tests and needles etc.
Mike J beat me to it. Last night he stayed behind to chat about Wibs and that they had been worried about her breathing, he did not remember her being like that before. I agreed and asked if he could check her. He was happy to, so today we put her through the heart and respiratory ‘book’.
First was auscultation (listening with a stethoscope) not a quick listen but very involved, different areas for several minutes per area. There was just a slight grade 2 murmur lots have that and l was not worried.
Then onto fluoroscopy, live moving x-ray of how her breathing was, anything obvious like collapsing airway, or nasty looking areas.
She was settled for a few minutes then went into freak panic mode just because Mike not me was holding her head, l was holding her legs but oh no not good enough. After she settled Mike and l swapped places and he finished the flouro, nothing showed up.
Then a heart scan. Now we were headed towards the problem. She had a minor bit of valve disease and a bit of ‘regurg’ (swirly blood going back and forwards instead of just one way through the valve) but considering she is 15 nothing to worry about.
The pulmonary artery was the problem it was greatly enlarged and had a high pressure. Normally the dog and cat pressures are up to 3 meters Wibble is 4 so why and what caused this?
Well she had had heart worm years ago so possibly a hangover of damage but unlikely as it was an acute cause. She did not appear to have lung worm, so more working out.
The thought is that she has had an ATE. And it has lodged in her lungs. Apparently in dogs although rare they get 2 sorts. An acute ATE that causes extreme pain and the animal dies within about 2 hours (very rare) The dog gets a lesser clot, it shows no signs other than the breathlessness on exercise and if active possibly intermittent collapse. Wibs is not active so that didn’t show but the breathlessness does.
After lunch we took x-rays. Mike J asked if l thought we should sedate her perfect timing as at the same time l was saying we need to sedate her. It was to much hassle to do conscious she would have been kicking and getting annoyed at being positioned. So a break while the dozey juice kicked in and several x-rays later. Again nothing showed. Heart size was fine, no lung worm patterns, no nasty shadows.
Mike J then did an abdominal scan to check spleen and liver and kidneys for anything that looked wrong to see if the clot was as a result of that, all was clear. This scan was great she was nicely sedated and did not care who held what or did what to her.
Final test was blood, and yes, Mike J held her while l shoved a needle into her jugular and pulled out 5ml.
Blood smears and various tubes have gone to the labs to measure the levels of a by-product of clotting material called D-dimer, a tube of blood for a general haematology and a couple of blood smears.
Treatment for pulmonary arterial hypertension is on hold until results are back next week probably Tuesday. If it is an ATE she will go onto aspirin and a heparin drug to help thin her blood down and Mike says that it is a pretty good diagnosis and should more or less clear her up. So we will see how she does. (on the link scroll down to Pathogenesis it explains things well)
She is so lucky that we are at the top Cardio Respiratory Referral Centre, in Europe and one of the best in the world. We (Wibble and l) owe a big thank you to every one here.
Sitting in the fridge is 2 very very chocolate cakes and l have planned a couple of other personal gifts but as l can not get to the shops till Saturday l am not saying in case one of the Mikes reads this.
l have the fluoroscopy on DVD l may try and upload some when l get home and work out how. I have clips of the heart scan again may try an upload. Finally l have her x-rays.
Wibs - "WTF hit me" recovering post sedation. I threw my jersey over her so she could snuggle.
It is intensely painful and a very high percentage of cats die. If they do recover it is a very guarded prognosis.
Sometimes the clot travels round and lodges in the lungs. Usually this is less painful as blood is still circulating past it but it still causes a lot of problems. And again a guarded prognosis.
When we did the pacemaker on the cat Mike explained that one of the risks is that cats blood clots very easily, like a humans does. A dog’s blood is different so they were able to do a lot more heart operations on dogs.
I never though to ask about thrombus in dog's. I did not think l had seen (as far as l knew) any in dogs and we were discussing a cat and a very big operation on it.
Today was one of those rude awakening days. Wibble has been a bit puffy for about 3 weeks but l thought with central heating being up, l did not want to be a paranoid owner, would just keep an eye and if l was still not 100% happy l would speak to the 2 Mikes today.
The problem is working, especially like l do, with a major part of my work emergencys you get paranoid that every little thing is a major 'thing'. The animal suffers endless needles and exams to go to the other extreme of dismissing everything as paranoia. So l tend to end up on a bit of a tightrope and often the vets check my dogs and find nothing, but l try and withold endless tests and needles etc.
Mike J beat me to it. Last night he stayed behind to chat about Wibs and that they had been worried about her breathing, he did not remember her being like that before. I agreed and asked if he could check her. He was happy to, so today we put her through the heart and respiratory ‘book’.
First was auscultation (listening with a stethoscope) not a quick listen but very involved, different areas for several minutes per area. There was just a slight grade 2 murmur lots have that and l was not worried.
Then onto fluoroscopy, live moving x-ray of how her breathing was, anything obvious like collapsing airway, or nasty looking areas.
She was settled for a few minutes then went into freak panic mode just because Mike not me was holding her head, l was holding her legs but oh no not good enough. After she settled Mike and l swapped places and he finished the flouro, nothing showed up.
Then a heart scan. Now we were headed towards the problem. She had a minor bit of valve disease and a bit of ‘regurg’ (swirly blood going back and forwards instead of just one way through the valve) but considering she is 15 nothing to worry about.
The pulmonary artery was the problem it was greatly enlarged and had a high pressure. Normally the dog and cat pressures are up to 3 meters Wibble is 4 so why and what caused this?
Well she had had heart worm years ago so possibly a hangover of damage but unlikely as it was an acute cause. She did not appear to have lung worm, so more working out.
The thought is that she has had an ATE. And it has lodged in her lungs. Apparently in dogs although rare they get 2 sorts. An acute ATE that causes extreme pain and the animal dies within about 2 hours (very rare) The dog gets a lesser clot, it shows no signs other than the breathlessness on exercise and if active possibly intermittent collapse. Wibs is not active so that didn’t show but the breathlessness does.
After lunch we took x-rays. Mike J asked if l thought we should sedate her perfect timing as at the same time l was saying we need to sedate her. It was to much hassle to do conscious she would have been kicking and getting annoyed at being positioned. So a break while the dozey juice kicked in and several x-rays later. Again nothing showed. Heart size was fine, no lung worm patterns, no nasty shadows.
Mike J then did an abdominal scan to check spleen and liver and kidneys for anything that looked wrong to see if the clot was as a result of that, all was clear. This scan was great she was nicely sedated and did not care who held what or did what to her.
Final test was blood, and yes, Mike J held her while l shoved a needle into her jugular and pulled out 5ml.
Blood smears and various tubes have gone to the labs to measure the levels of a by-product of clotting material called D-dimer, a tube of blood for a general haematology and a couple of blood smears.
Treatment for pulmonary arterial hypertension is on hold until results are back next week probably Tuesday. If it is an ATE she will go onto aspirin and a heparin drug to help thin her blood down and Mike says that it is a pretty good diagnosis and should more or less clear her up. So we will see how she does. (on the link scroll down to Pathogenesis it explains things well)
She is so lucky that we are at the top Cardio Respiratory Referral Centre, in Europe and one of the best in the world. We (Wibble and l) owe a big thank you to every one here.
Sitting in the fridge is 2 very very chocolate cakes and l have planned a couple of other personal gifts but as l can not get to the shops till Saturday l am not saying in case one of the Mikes reads this.
l have the fluoroscopy on DVD l may try and upload some when l get home and work out how. I have clips of the heart scan again may try an upload. Finally l have her x-rays.
Wibs - "WTF hit me" recovering post sedation. I threw my jersey over her so she could snuggle.
Monday, 5 January 2009
Hearts and Rascals
I am back at my favourite practice for the next 2 weeks the Heart Referral. I wish they were closer l would have applied for full time work. The only place l would consider doing that for. I like my freedom as locum so it says a lot about the place.
Driving down in the pitch black at 5am was not much fun. I envied Wibble snoring in the back in her bed all snuggled under the blanket. As l got to Warrington there was snow on the sides of the roads and quite a bit down here.
It reminded me of when we arrived in UK. During the early 80s the winters were much colder and we lived down south.
I worked for 7 years with racing greyhounds at a kennels based at Biggin Hill, for a trainer called John Horsefall. We were licensed to Catford now sadly closed.
One very bad winter l was on the way to work at the Greyhound Kennels at about 05:30 and going along Layhams Road where the kennels were based. In winter a cold and miserable trip, the road runs alongside the Met Police Dog Training estab. One section of the road glided under bare, overhanging trees, which made a dark tunnel, the road covered with dead slippery leaves into a sharp bend that ran alongside the graveyard of police dogs killed in action.
In summer it is very different, wildflowers grew around the graves and a green canopy overhead it was very peaceful.
Layhams Rd then swept up past the main training section. The rest of Layhams rd runs between either steep banks or open windswept fields.
A small van, l call a “scallywagon”, the Rascal came towards me. Three men walked by it’s side. Every few paces the van would slip and fall onto its side and they would skurry round to whichever side was lying either on the floor or snowbank and push it back upright.
l stopped, tucked myself and Honda tight into a snow bank and watched them. It seemed a bit unsafe to try and ride past them as the road was very narrow with high snow banks either side. They were chatting away having a good gossip as though this was a normal job for anyone.
They gave me a cheerful hello and l wish l had got the courage to ask where they were going from, too but l was shy back then.
It was so cheering to meet them on a freezing morning when l was cold and miserable. I often think of them if the roads are snowy and l am driving. l never saw them again l hope they got to where they were going, in one piece.
Driving down in the pitch black at 5am was not much fun. I envied Wibble snoring in the back in her bed all snuggled under the blanket. As l got to Warrington there was snow on the sides of the roads and quite a bit down here.
It reminded me of when we arrived in UK. During the early 80s the winters were much colder and we lived down south.
I worked for 7 years with racing greyhounds at a kennels based at Biggin Hill, for a trainer called John Horsefall. We were licensed to Catford now sadly closed.
One very bad winter l was on the way to work at the Greyhound Kennels at about 05:30 and going along Layhams Road where the kennels were based. In winter a cold and miserable trip, the road runs alongside the Met Police Dog Training estab. One section of the road glided under bare, overhanging trees, which made a dark tunnel, the road covered with dead slippery leaves into a sharp bend that ran alongside the graveyard of police dogs killed in action.
In summer it is very different, wildflowers grew around the graves and a green canopy overhead it was very peaceful.
Layhams Rd then swept up past the main training section. The rest of Layhams rd runs between either steep banks or open windswept fields.
A small van, l call a “scallywagon”, the Rascal came towards me. Three men walked by it’s side. Every few paces the van would slip and fall onto its side and they would skurry round to whichever side was lying either on the floor or snowbank and push it back upright.
l stopped, tucked myself and Honda tight into a snow bank and watched them. It seemed a bit unsafe to try and ride past them as the road was very narrow with high snow banks either side. They were chatting away having a good gossip as though this was a normal job for anyone.
They gave me a cheerful hello and l wish l had got the courage to ask where they were going from, too but l was shy back then.
It was so cheering to meet them on a freezing morning when l was cold and miserable. I often think of them if the roads are snowy and l am driving. l never saw them again l hope they got to where they were going, in one piece.
Saturday, 22 November 2008
Lung Foreign Body
The English springer spaniel bounced into us last week. He had a bad cough and was coming in for a heart lung check-up. His breath was like a charnel house but his teeth were clean.
Mike well experienced with what may be the problem took a couple of x-rays which tipped the diagnosis more in favour with his idea. There was a fuzzy area on the chest x-ray in the lungs which was suspicious.
A general anaesthetic and a scope down the trachea into the lungs confirmed what was happening. Springer’s and apparently Labradors are the main culprits for “foreign bodies” being inhaled into the lungs. They generally cause a cough and can be well tolerated. Often just the cough and no slow down in their lifestyle, oh and the bad breath. Do not mistake it for doggie bad breath. This is putrid and bad teeth/tooth smell is not even on the scale it is so tame.
A set of graspers was pushed down the instrument channel in the scope and the item was caught. It was fairly difficult and at first a few single grains were pulled up. This moved the main plug a bit into a better position and a 5th go the grasper's managed to get a good grip on the full plug. It was slowly lifted all the way out the lung.
If l thought the smell was bad before it got a whole lot worse as the plug arrived in what had been fresh air. The whole lot was shoved in a bottle ASAP so that we could get some more un-putrid air circulating, the plug was put to one side for the owner to see.
The lung was red and spots of pus still remained but would soon settle down.
An hour later the Springer was back to his bouncy self. There was still a bit of a cough but that would go pretty quickly. The plug was an awl of barley. The cough had started in about august which was cropping time (roughly) so that was about a 3 month window of how long it had been down in the lung.
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Better photos views in thePhoto album
Mike well experienced with what may be the problem took a couple of x-rays which tipped the diagnosis more in favour with his idea. There was a fuzzy area on the chest x-ray in the lungs which was suspicious.
A general anaesthetic and a scope down the trachea into the lungs confirmed what was happening. Springer’s and apparently Labradors are the main culprits for “foreign bodies” being inhaled into the lungs. They generally cause a cough and can be well tolerated. Often just the cough and no slow down in their lifestyle, oh and the bad breath. Do not mistake it for doggie bad breath. This is putrid and bad teeth/tooth smell is not even on the scale it is so tame.
A set of graspers was pushed down the instrument channel in the scope and the item was caught. It was fairly difficult and at first a few single grains were pulled up. This moved the main plug a bit into a better position and a 5th go the grasper's managed to get a good grip on the full plug. It was slowly lifted all the way out the lung.
If l thought the smell was bad before it got a whole lot worse as the plug arrived in what had been fresh air. The whole lot was shoved in a bottle ASAP so that we could get some more un-putrid air circulating, the plug was put to one side for the owner to see.
The lung was red and spots of pus still remained but would soon settle down.
An hour later the Springer was back to his bouncy self. There was still a bit of a cough but that would go pretty quickly. The plug was an awl of barley. The cough had started in about august which was cropping time (roughly) so that was about a 3 month window of how long it had been down in the lung.
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Better photos views in thePhoto album
Monday, 10 November 2008
The Cat Pacemaker
Before l start a disclaimer...Sorry if anyone is looking for correct medical terms and words to describe operations or conditions. I am not into those and rarely use them. I like simple talk that anyone can understand, and anyhow, my spelling and grammar (better add word that before Curley pulls me up yet again) is bad enough as it is
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We had the cat in today for his pacemaker. It is very rare for cats to have a pacemaker fitted. If they are at the stage they need a pacemaker then their hearts are usually to badly damaged to have one fitted.
Cats also clot very easily and throw thrombus (blood clots) a condition that is often critical in them.
Only a few cat pacemakers have been fitted in the USA and this was a rare one for the UK.
Dogs have pacers fitted fairly regularly and generally do very well on them. They have different type of blood (yes it is still red though)that does not clot as easily, and a better heart physiology to tolerate pacemakers.
This appeared to be one of the rare cat hearts that was suitable for a pacemaker. His exact age is unknown as he was rescued but possibly about 10-12years old. The owner was given a very guarded prognosis and all the possible options covered but she elected to go ahead.
Despite the initial worry from the vet about how puss would react being sedated, as opposed to full anaesthetic, to have his temporary pace lead placed via the jugular he was a star, just lay quietly.
It was a bit fiddley as the jugular is so small but Mike (The vet) is very experienced and with fluoroscopy to guide, it went smoothly.
Once the temporary lead was in place he was given propoflo for his anaesthetic and surgery began.
Surgery took about 2.5hrs (including prep). The surgeon made a midline incision in the abdomen and entered the chest through the diaphragm. He attached l believe it is called a unipolar lead (single pad lead) to the heart. This lead fed from the heart back through the diaphragm to the pacer. In cats this is placed in the abdomen. Puss had steady stats all the way through. It was one of those near perfect anaesthetics that you wish for and do not always get.
Recovery was uneventful and within about 3 hours he was awake and having some food. He had a swipe at me at one point when l was trying to sort his food bowl out.
I was giving him another check when the secretary came in, to see how things were going.
I shut his kennel door and was saying “He is…”
At this point puss gave a half mewy cry and crashed. I bellowed for back up as l got him out the kennel and he was being worked on within about 40 seconds of the initial crash, despite about 20 to 30mins of attempted resus we lost him.
A very s**ty end to what started out as a positive day. Why Puss crashed is unknown. The vet came up with a couple of ideas but with no autopsy there is no way of knowing.
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We had the cat in today for his pacemaker. It is very rare for cats to have a pacemaker fitted. If they are at the stage they need a pacemaker then their hearts are usually to badly damaged to have one fitted.
Cats also clot very easily and throw thrombus (blood clots) a condition that is often critical in them.
Only a few cat pacemakers have been fitted in the USA and this was a rare one for the UK.
Dogs have pacers fitted fairly regularly and generally do very well on them. They have different type of blood (yes it is still red though)that does not clot as easily, and a better heart physiology to tolerate pacemakers.
This appeared to be one of the rare cat hearts that was suitable for a pacemaker. His exact age is unknown as he was rescued but possibly about 10-12years old. The owner was given a very guarded prognosis and all the possible options covered but she elected to go ahead.
Despite the initial worry from the vet about how puss would react being sedated, as opposed to full anaesthetic, to have his temporary pace lead placed via the jugular he was a star, just lay quietly.
It was a bit fiddley as the jugular is so small but Mike (The vet) is very experienced and with fluoroscopy to guide, it went smoothly.
Once the temporary lead was in place he was given propoflo for his anaesthetic and surgery began.
Surgery took about 2.5hrs (including prep). The surgeon made a midline incision in the abdomen and entered the chest through the diaphragm. He attached l believe it is called a unipolar lead (single pad lead) to the heart. This lead fed from the heart back through the diaphragm to the pacer. In cats this is placed in the abdomen. Puss had steady stats all the way through. It was one of those near perfect anaesthetics that you wish for and do not always get.
Recovery was uneventful and within about 3 hours he was awake and having some food. He had a swipe at me at one point when l was trying to sort his food bowl out.
I was giving him another check when the secretary came in, to see how things were going.
I shut his kennel door and was saying “He is…”
At this point puss gave a half mewy cry and crashed. I bellowed for back up as l got him out the kennel and he was being worked on within about 40 seconds of the initial crash, despite about 20 to 30mins of attempted resus we lost him.
A very s**ty end to what started out as a positive day. Why Puss crashed is unknown. The vet came up with a couple of ideas but with no autopsy there is no way of knowing.
Saturday, 8 November 2008
Pacemakers and Strange Goings On
I got a phone call yesterday (Friday) at 10am. My old practice (one that wanted me for this Saturday night) it was 2 nurses down 1 on the 13:00-23:00 shift and the other for 15:00 – 22:00 that night.
As l was half way down the country, and wouldn’t be back till late. I was able to cheerfully say nope no can do.
Had a lovely but insane dog in for clinic Friday morning, going through to the consult room it pulled so hard it was walking on its back legs. The front paws swept the brochures, cards and bell off the reception desk in one sweep. The room had a blizzard of business cards fluttering about.
A little terrier stood under a chair with a look of distaste at such manners.
It was a busy interesting afternoon. We had a clinic for dogs due their annual pacemaker check for any developments or changes in heart rhythm as well as pacemaker function and battery depletion. The pacemakers have an average life of 10years.
During a break while we awaited traffic hold ups to spit out clients, we had a great slide show. Well had a great, from a morbid point of view.The pacemakers that are used in dogs and cats are human ones and the people that run the clinic are human nurses. They had a slides of problems that humans with pacemakers have encountered over the years.
I am crossing fingers we may have a cat in on Monday to have a pacemaker implant, won't say more in case it doesn't come off.
A Pacer implanted in a dog and A Pre Implant Pacer
Had an interesting experience Thursday night and while some may scoff others may understand so I decided l would put it up anyhow.
One of the vets brought up about the spirit (ghost) if or if there isn’t one here as it is an old Victorian house. He said that other nurses had sworn there was and was very noisy.
Now l figured there may or may not be something having a few feelings but you have too allow for imagination.
It is an old house and so l expect it to be noisy at night, there is not the normal daily bustle and noise to cover it. ‘Spooky’ feelings are bound to apply, in an old Victorian house, that’s how the horror and docutripe TV programmes (most haunted type) work.
Overnight at the house doors clunk shut. Despite the fact that l go round and made sure all the doors are shut every night, doors still clunk shut, bangs and creaks, pipes knocking and all types of noises. I reason it as the house settling.
I told the vet that there is a great (nice) spirit at my old place who was really helpful on nights. I had also asked him (spirit) to please not slam doors or have talking going on as l am happy for spirit to be about but it is the thought of strange humans on the premises that worries me.
Since l asked that, l never had another door bang or hear strange voices but others do still hear all of that.
I have had help, like flashing lights in ICU when a critical patient needed me and a few other happenings that were to strange to pass for normal.
Thursday night after we had our chat there was NOT a sound. No doors clunking shut, no creaking, no bangs, no rattles, nothing, nada grave quiet.
In the morning I said a thanks to whomever, it was a lovely peaceful night. You may scoff, but what other reason there could be?
As l was half way down the country, and wouldn’t be back till late. I was able to cheerfully say nope no can do.
Had a lovely but insane dog in for clinic Friday morning, going through to the consult room it pulled so hard it was walking on its back legs. The front paws swept the brochures, cards and bell off the reception desk in one sweep. The room had a blizzard of business cards fluttering about.
A little terrier stood under a chair with a look of distaste at such manners.
It was a busy interesting afternoon. We had a clinic for dogs due their annual pacemaker check for any developments or changes in heart rhythm as well as pacemaker function and battery depletion. The pacemakers have an average life of 10years.
During a break while we awaited traffic hold ups to spit out clients, we had a great slide show. Well had a great, from a morbid point of view.The pacemakers that are used in dogs and cats are human ones and the people that run the clinic are human nurses. They had a slides of problems that humans with pacemakers have encountered over the years.
I am crossing fingers we may have a cat in on Monday to have a pacemaker implant, won't say more in case it doesn't come off.
A Pacer implanted in a dog and A Pre Implant Pacer
Had an interesting experience Thursday night and while some may scoff others may understand so I decided l would put it up anyhow.
One of the vets brought up about the spirit (ghost) if or if there isn’t one here as it is an old Victorian house. He said that other nurses had sworn there was and was very noisy.
Now l figured there may or may not be something having a few feelings but you have too allow for imagination.
It is an old house and so l expect it to be noisy at night, there is not the normal daily bustle and noise to cover it. ‘Spooky’ feelings are bound to apply, in an old Victorian house, that’s how the horror and docutripe TV programmes (most haunted type) work.
Overnight at the house doors clunk shut. Despite the fact that l go round and made sure all the doors are shut every night, doors still clunk shut, bangs and creaks, pipes knocking and all types of noises. I reason it as the house settling.
I told the vet that there is a great (nice) spirit at my old place who was really helpful on nights. I had also asked him (spirit) to please not slam doors or have talking going on as l am happy for spirit to be about but it is the thought of strange humans on the premises that worries me.
Since l asked that, l never had another door bang or hear strange voices but others do still hear all of that.
I have had help, like flashing lights in ICU when a critical patient needed me and a few other happenings that were to strange to pass for normal.
Thursday night after we had our chat there was NOT a sound. No doors clunking shut, no creaking, no bangs, no rattles, nothing, nada grave quiet.
In the morning I said a thanks to whomever, it was a lovely peaceful night. You may scoff, but what other reason there could be?
Wednesday, 29 October 2008
The Referral Practice (Part2)
When the locum job was confirmed I was scared stiff. Being nervous when going into a new placement is common but this is not common practice. The practice is a cardiac referral practice, the best in Europe, ok let’s not beat about the bush, the best in the world.
This practice does not follow some ones else’s animal cardiac textbook, they wrote it, literally. Small animal cardio/ respiratory work done elsewhere in the world was pioneered and perfected here. They still write major scientific papers that change the course of thinking and treatment of small animal cardiology, world-wide.
As it turns out l need not have worried. I felt at ease from the start. One thing that did it was the relaxed atmosphere, the other is that much of the work is standard veterinary nursing work.
Looking after inpatients, reception, phone calls, anaesthesia, x rays (although machines do vary they are fairly easy to get to grips with) topping up, checking what to order, general cleaning.
With equipment l haven’t used, or procedures l haven’t done, or not sure on everyone is great at explaining how to do/use whatever. I just wish l could learn faster, l guess it is me getting old.
A lot of ultrasound scanning is done. Before now an ultrasound tended to be a shifting mass of grainy images to me. Now lm getting good at spotting things. I can recognise a heart valve when l look at it, don’t know which one it is in the heart, but hey, it is a start.
Both vets are great at explaining what is showing on the screen, how it works/isn’t working and why it may be like that (so often genetic), and what may need to be done, if anything is possible to correct the problem.
We had one very sweet little bitch having her scan done and she was hooked up with 3clips to her legs to check her basic ECG. Initially her tail kept doing gentle intermittent little wags, but she was totally still otherwise.
“Ahhh said the vet, l think l know what’s going on” He undid the clips and taped them to her feet.
The waggy tail stopped and she did not move till we turned her round to scan the other side of her heart, when she immediately lay down and totally still.
The clips had been a bit to much for her but she was such a sweet little lady she did not wriggle, howl, cry or use any other rude way to explain the problem. Just a gentle intermittent wag of the tail, Her polite way to say “excuse me please they hurt”
Unlike the young nutty hooligan dog who did not want to lie down when there was so many exciting things going on.
He felt that it was the height of insult to have jelly stuff on him that he was not allowed to eat. He only had the humans word for it that ultra sound gel is not tasty he wanted proof.
Then there was all the new stuff that he wanted to sniff, and given the chance pee on, to prove he had been there!
I have what looks like another fine set scars forming from his nails on my arm to remind me of him.
When animals are like that then they are sedated lightly to settle them. Mind you that behaviour and effect is normal in all practices not nasty just overexcited.
It is safe to say that several operations here have “blown my little mind” as the well known saying goes. I am used to major operations in animals but these are major delicate operations. Using equipment that you just do not see in general or even general referral practice.
The effects so far are also very different. Instead of often intense nursing and several days recovery these patients scoffed a good meal that night and were home the next day.
Operations here are often done guided by fluoroscopy. These are x-ray pictures that allow you to see internal organs or procedures live and in real time. The fluoroscopy has quite a few uses.
We used it on a dog that was drinking liquid barium and eating barium mixed with dog food. This was to observe the swallowing action to try and determine where the problem was, and what caused/contributed to the patients cough.
The other diagnostic aids had not been very clear and were of limited use in diagnosing this patients problem.
Amazing to see what you have learnt happens via a textbook about the body’s mechanisms when something is swallowed, actually happening live.
I know l have seen it in documentaries but that is remote, this was not.
Operations wise, for the following 2 especially, there are both of us veterinary nurses. I do what l know for anaesthetics and leave the complex assist parts and equipment to the head nurse. With her in throat clearing distance if l needed anything.
People could learn a hell of a lot from her, she is calm, cheerful, knowledgeable and helpful. In this profession more are needed like that behind the scenes.
Fluoroscopy was used in 2 different types of heart operations this time the patients were under general anaesthetic.
PDA
The first, a large dog about 35kgs in weight, had a PDA or “hole in the heart” repaired.
**Patent ductus arteriosus (PDA) is a when a vessel connecting the two major cardiac vessels (the aorta and the pulmonary artery) fails to close at birth as it should. Uncorrected, a PDA leads to progressive heart enlargement and heart failure. If left untreated, approximately 50% of dogs with a PDA die in the first year of life.
The closure involved passing catheters via the artery in the hind leg (‘keyhole’ surgery) and ‘plugging’ the vessel with devices to stop or minimise flow through it. This was also assisted with angiographic studies*
Visually post operation there was a small wound where the incision and that was it. There is minimal pain compared to traditional surgery (which involves cutting open the chest between the ribs).
That evening l was walking the dog and trying to stop her bouncing about and jumping up for kisses with me, not easy she could see no reason to keep calm. She went home the next day.
**In some cases where traditional “open chest” is needed here, patients are hospitalised for 3 - 5 days to provide pain relief and to monitor for complications that can arise following open chest surgery. After discharge dogs must be rested for 3 or 4 weeks so as not to pull any of the sutures, especially those between the ribs. After that, exercise can be gradually introduced over a period of a couple of weeks.
A huge contrast to the method l witnessed.
BV
The second operation was a Balloon Valvuloplasty on a small cross breed about 10kgs in weight.
She had Pulmonic Stenosis. **This congenital heart condition restricts blood flow through to the pulmonary artery, which takes blood to the lungs for oxygenation. As a consequence of this narrowing, blood flows through the valve at an increased velocity. This results in a ‘squirt’ of blood flow with each heart beat, which creates a sound called a murmur. The obstruction caused by the narrowed valve leads to an increased pressure in the right heart, and potentially heart failure
The operation to repair it “Balloon valvuloplasty” involved passing a specially designed balloon-tipped catheter via the vein in the neck (‘keyhole’ surgery) into the heart and through the narrowed valve.
This is catheter is visually guided by fluoroscopy and then after *angiographic studies. A sausage-shaped balloon was momentarily inflated to stretch the defective valve, allowing it to open more normally.
Again post op all she had to show for this major operation was a small wound on her neck and a clipped area of her coat.
That night the she out for a walk. She was not to happy, it was dark, windy and wet, who want’s to walk in that? Again she went home the day after her operation.
They also carry out pacemaker operations here as well, although l have not seen any, yet.
*====*====*====*====*====*====*====*====*====*====*====*====*
*An angiogram is a radiographic technique used to visualise blood vessels (the fluoroscopy can not show these). A dye is injected into the heart arteries with a special catheter. This dye enables the fluoroscopy to contrast the arteries with the surrounding body tissue. The cardiologist can then see the artery even the smallest blood vessels. (The angiogram was another first for me)
**Explanations of PDA and Pulmonic Stenosis were 'borrowed' from the practice website. My words are mixed in with them.
This practice does not follow some ones else’s animal cardiac textbook, they wrote it, literally. Small animal cardio/ respiratory work done elsewhere in the world was pioneered and perfected here. They still write major scientific papers that change the course of thinking and treatment of small animal cardiology, world-wide.
As it turns out l need not have worried. I felt at ease from the start. One thing that did it was the relaxed atmosphere, the other is that much of the work is standard veterinary nursing work.
Looking after inpatients, reception, phone calls, anaesthesia, x rays (although machines do vary they are fairly easy to get to grips with) topping up, checking what to order, general cleaning.
With equipment l haven’t used, or procedures l haven’t done, or not sure on everyone is great at explaining how to do/use whatever. I just wish l could learn faster, l guess it is me getting old.
A lot of ultrasound scanning is done. Before now an ultrasound tended to be a shifting mass of grainy images to me. Now lm getting good at spotting things. I can recognise a heart valve when l look at it, don’t know which one it is in the heart, but hey, it is a start.
Both vets are great at explaining what is showing on the screen, how it works/isn’t working and why it may be like that (so often genetic), and what may need to be done, if anything is possible to correct the problem.
We had one very sweet little bitch having her scan done and she was hooked up with 3clips to her legs to check her basic ECG. Initially her tail kept doing gentle intermittent little wags, but she was totally still otherwise.
“Ahhh said the vet, l think l know what’s going on” He undid the clips and taped them to her feet.
The waggy tail stopped and she did not move till we turned her round to scan the other side of her heart, when she immediately lay down and totally still.
The clips had been a bit to much for her but she was such a sweet little lady she did not wriggle, howl, cry or use any other rude way to explain the problem. Just a gentle intermittent wag of the tail, Her polite way to say “excuse me please they hurt”
Unlike the young nutty hooligan dog who did not want to lie down when there was so many exciting things going on.
He felt that it was the height of insult to have jelly stuff on him that he was not allowed to eat. He only had the humans word for it that ultra sound gel is not tasty he wanted proof.
Then there was all the new stuff that he wanted to sniff, and given the chance pee on, to prove he had been there!
I have what looks like another fine set scars forming from his nails on my arm to remind me of him.
When animals are like that then they are sedated lightly to settle them. Mind you that behaviour and effect is normal in all practices not nasty just overexcited.
It is safe to say that several operations here have “blown my little mind” as the well known saying goes. I am used to major operations in animals but these are major delicate operations. Using equipment that you just do not see in general or even general referral practice.
The effects so far are also very different. Instead of often intense nursing and several days recovery these patients scoffed a good meal that night and were home the next day.
Operations here are often done guided by fluoroscopy. These are x-ray pictures that allow you to see internal organs or procedures live and in real time. The fluoroscopy has quite a few uses.
We used it on a dog that was drinking liquid barium and eating barium mixed with dog food. This was to observe the swallowing action to try and determine where the problem was, and what caused/contributed to the patients cough.
The other diagnostic aids had not been very clear and were of limited use in diagnosing this patients problem.
Amazing to see what you have learnt happens via a textbook about the body’s mechanisms when something is swallowed, actually happening live.
I know l have seen it in documentaries but that is remote, this was not.
Operations wise, for the following 2 especially, there are both of us veterinary nurses. I do what l know for anaesthetics and leave the complex assist parts and equipment to the head nurse. With her in throat clearing distance if l needed anything.
People could learn a hell of a lot from her, she is calm, cheerful, knowledgeable and helpful. In this profession more are needed like that behind the scenes.
Fluoroscopy was used in 2 different types of heart operations this time the patients were under general anaesthetic.
PDA
The first, a large dog about 35kgs in weight, had a PDA or “hole in the heart” repaired.
**Patent ductus arteriosus (PDA) is a when a vessel connecting the two major cardiac vessels (the aorta and the pulmonary artery) fails to close at birth as it should. Uncorrected, a PDA leads to progressive heart enlargement and heart failure. If left untreated, approximately 50% of dogs with a PDA die in the first year of life.
The closure involved passing catheters via the artery in the hind leg (‘keyhole’ surgery) and ‘plugging’ the vessel with devices to stop or minimise flow through it. This was also assisted with angiographic studies*
Visually post operation there was a small wound where the incision and that was it. There is minimal pain compared to traditional surgery (which involves cutting open the chest between the ribs).
That evening l was walking the dog and trying to stop her bouncing about and jumping up for kisses with me, not easy she could see no reason to keep calm. She went home the next day.
**In some cases where traditional “open chest” is needed here, patients are hospitalised for 3 - 5 days to provide pain relief and to monitor for complications that can arise following open chest surgery. After discharge dogs must be rested for 3 or 4 weeks so as not to pull any of the sutures, especially those between the ribs. After that, exercise can be gradually introduced over a period of a couple of weeks.
A huge contrast to the method l witnessed.
BV
The second operation was a Balloon Valvuloplasty on a small cross breed about 10kgs in weight.
She had Pulmonic Stenosis. **This congenital heart condition restricts blood flow through to the pulmonary artery, which takes blood to the lungs for oxygenation. As a consequence of this narrowing, blood flows through the valve at an increased velocity. This results in a ‘squirt’ of blood flow with each heart beat, which creates a sound called a murmur. The obstruction caused by the narrowed valve leads to an increased pressure in the right heart, and potentially heart failure
The operation to repair it “Balloon valvuloplasty” involved passing a specially designed balloon-tipped catheter via the vein in the neck (‘keyhole’ surgery) into the heart and through the narrowed valve.
This is catheter is visually guided by fluoroscopy and then after *angiographic studies. A sausage-shaped balloon was momentarily inflated to stretch the defective valve, allowing it to open more normally.
Again post op all she had to show for this major operation was a small wound on her neck and a clipped area of her coat.
That night the she out for a walk. She was not to happy, it was dark, windy and wet, who want’s to walk in that? Again she went home the day after her operation.
They also carry out pacemaker operations here as well, although l have not seen any, yet.
*====*====*====*====*====*====*====*====*====*====*====*====*
*An angiogram is a radiographic technique used to visualise blood vessels (the fluoroscopy can not show these). A dye is injected into the heart arteries with a special catheter. This dye enables the fluoroscopy to contrast the arteries with the surrounding body tissue. The cardiologist can then see the artery even the smallest blood vessels. (The angiogram was another first for me)
**Explanations of PDA and Pulmonic Stenosis were 'borrowed' from the practice website. My words are mixed in with them.
Wednesday, 1 October 2008
Forked Tongues and Buffets
I am up suffering indigestion. One of the drug companies held a CPD meeting at our place and had a pre talk buffet, most of the food was uneaten. Bliss for those of us on late shift we get the left overs. Trouble was l did my usual and overate and am now waiting for the antacids to kick in, so thought l may as well do something constructive and write.
Heart cat went home today with enough pills to keep him rattling.
The Siamese is out of the incubator it was needed for other patients. As his red blood cell count is rising, his temper is shortening.
He has won the battle of the litter tray, knew he would. We just keep piling the washing up. He and l have got on fine all day. True l have not needed to inject him that helped, and early evening we had a lovely chat and cuddle.
Tonight on change over l was explaining this to the night nurse while my fingers were resting through the kennel door on his bed.
Next thing l have 2 holes in my hand and am swapping glares at the cat who is looking arrogantly at me and the night nurse who is creased up laughing.
We had an op tonight on a cat that somehow bit his tongue and had a lovely fork in it. He had not eaten since yesterday so it needed a fix. A quick GA some suture material and surgical glue and the vet had made it almost as good as new. It is a bit crinkled and a piece had to be trimmed but hey, beggars can not be choosers and at least his good looks are not affected. By the time l left tonight his stomach was enjoying the return of food as sloppy AD (mushy convalescent food) slid down it.
The RTA dog is doing well. She had her femur repaired yesterday, the one side of her pelvis done today. The other side of the pelvis the vet will see how she does, it may be possible to get it settled with strict cage rest and no 3rd op.
The diabetic dog is still not settling on her glucose, it is swinging all over and things do not look good. She has other health problems that complicate it but the vets may win yet and get her home. Poor lass it is understandable why she is fed up of us with having to get so many drops of blood. It is yet another needle hole and to do that we have to muzzle her and she hates muzzles.
We have 2 sad strays in, neither are microchipped. We all had our usual snarl about "wish that people would microchip their pets and make sure that they have lodged the details. And if any of their phone numbers or addresses change they notify the chip company".
There is one thing worse than an animal that doesn't have a microchip, one that does and the details are out of date and we can not reunite the family.
One stray is an old dog, blind, senile and confused. He circles the walk-in kennel banging into walls and occasionally ramming the door when the rattle tells him it is not solid like the walls. We tried him in a small kennel but he became even more stressed in that.
He has eaten but not drunk just tripped over the water bowl and squelched through it. So he will be fed food mixed with water, to get round the drinking problem.
Trying to calm him doesn't work, we may as well not exist, and if we try and restrain him he gets snappy and even more distressed. Tonight we sedated him to settle him down and allow him some sleep.
The other stray is a lovely cat who has been in an RTA. She has a severely fractured pelvis, a fractured hock and deglove injury. She has eaten a bit and is heavily dosed with pain killers and antibiotics.
Both are in as short stay, end of days. If they are not claimed within a few days they will be put down on humane grounds.
With stray patients such as these it is veterinary discretion some are put to sleep immediately on humane grounds, others will stay a few days like these two but unless owners come forward they will be put down on humane grounds.
If they are not to badly injured and are young enough to rehome then they are "repaired" generally through the inhouse stray fund and either CPL or one of the rescue groups take them on.
Even if owners came forward they would probably be put down by the owners. The cat due to severity of the injuries and cost of repair. The dog because there is lots of puppies out there and it is senile. Yes it is a harsh judgement on my part but it is the reality of the situation.
Heart cat went home today with enough pills to keep him rattling.
The Siamese is out of the incubator it was needed for other patients. As his red blood cell count is rising, his temper is shortening.
He has won the battle of the litter tray, knew he would. We just keep piling the washing up. He and l have got on fine all day. True l have not needed to inject him that helped, and early evening we had a lovely chat and cuddle.
Tonight on change over l was explaining this to the night nurse while my fingers were resting through the kennel door on his bed.
Next thing l have 2 holes in my hand and am swapping glares at the cat who is looking arrogantly at me and the night nurse who is creased up laughing.
We had an op tonight on a cat that somehow bit his tongue and had a lovely fork in it. He had not eaten since yesterday so it needed a fix. A quick GA some suture material and surgical glue and the vet had made it almost as good as new. It is a bit crinkled and a piece had to be trimmed but hey, beggars can not be choosers and at least his good looks are not affected. By the time l left tonight his stomach was enjoying the return of food as sloppy AD (mushy convalescent food) slid down it.
The RTA dog is doing well. She had her femur repaired yesterday, the one side of her pelvis done today. The other side of the pelvis the vet will see how she does, it may be possible to get it settled with strict cage rest and no 3rd op.
The diabetic dog is still not settling on her glucose, it is swinging all over and things do not look good. She has other health problems that complicate it but the vets may win yet and get her home. Poor lass it is understandable why she is fed up of us with having to get so many drops of blood. It is yet another needle hole and to do that we have to muzzle her and she hates muzzles.
We have 2 sad strays in, neither are microchipped. We all had our usual snarl about "wish that people would microchip their pets and make sure that they have lodged the details. And if any of their phone numbers or addresses change they notify the chip company".
There is one thing worse than an animal that doesn't have a microchip, one that does and the details are out of date and we can not reunite the family.
One stray is an old dog, blind, senile and confused. He circles the walk-in kennel banging into walls and occasionally ramming the door when the rattle tells him it is not solid like the walls. We tried him in a small kennel but he became even more stressed in that.
He has eaten but not drunk just tripped over the water bowl and squelched through it. So he will be fed food mixed with water, to get round the drinking problem.
Trying to calm him doesn't work, we may as well not exist, and if we try and restrain him he gets snappy and even more distressed. Tonight we sedated him to settle him down and allow him some sleep.
The other stray is a lovely cat who has been in an RTA. She has a severely fractured pelvis, a fractured hock and deglove injury. She has eaten a bit and is heavily dosed with pain killers and antibiotics.
Both are in as short stay, end of days. If they are not claimed within a few days they will be put down on humane grounds.
With stray patients such as these it is veterinary discretion some are put to sleep immediately on humane grounds, others will stay a few days like these two but unless owners come forward they will be put down on humane grounds.
If they are not to badly injured and are young enough to rehome then they are "repaired" generally through the inhouse stray fund and either CPL or one of the rescue groups take them on.
Even if owners came forward they would probably be put down by the owners. The cat due to severity of the injuries and cost of repair. The dog because there is lots of puppies out there and it is senile. Yes it is a harsh judgement on my part but it is the reality of the situation.
Tuesday, 30 September 2008
Great Bowls of Water
Well the bloat/heart cat did not get off so lucky. It did throw a clot at some point post admit. The clot is not a bad one although any clot is bad in a cat, it is now on treatment for that. The hind leg is paralysed and dragging, there is a pulse and it is not in obvious pain, he seems happy and is rolling and purring and loves a tummy tickle. Treatment has started but with the heart as it even if he does go home he stands a good chance of more clots with a less positive outcome.
I went out to triage a GSD about 8 months old who may have drunk bleach. He was a bit noisy and being a GSD l checked he was ok before l approached. To make myself less threatening l decided to sit on the table, this being the only thing handy to sit on other than the floor and my knees hurt enough.
l did not look to closely and planted my backside straight into a red bowl full of water, l did not even know we had red bowls in the place!! and had not realised it was full of water as l was concentrating on the dog. My yelp and sudden stand up did wonders for the animal's confidence. I shot off got a couple of incontinent sheets and threw them over the patch dunno where the mops were, but never to hand when wanted.
After than l got on fine with him, possibly he decided anyone that sat in a waterbowl had to be too stupid to hurt him. He was fine and after the vet checked him he bounded out the door without a backward glance.
We are having a toilet type disagreement with a Siamese at the moment. He is in for anaemia his PCV is going up nicely, however Siamese seem to have a thing about litter trays.
"Simply not for the well bred Siamese darling"
So he puts his front legs in it and goes on the bed, or leans all the way over it and goes on the bed, or pushes the tray up in the air and goes on the bed.
So l removed the tray and put the litter on an incontinence sheet. Will see if he uses that, l have a feeling that it won't be used.
Maybe we should cover the whole of the incubator floor in cat litter, somehow though he would probably still avoid that.
I went out to triage a GSD about 8 months old who may have drunk bleach. He was a bit noisy and being a GSD l checked he was ok before l approached. To make myself less threatening l decided to sit on the table, this being the only thing handy to sit on other than the floor and my knees hurt enough.
l did not look to closely and planted my backside straight into a red bowl full of water, l did not even know we had red bowls in the place!! and had not realised it was full of water as l was concentrating on the dog. My yelp and sudden stand up did wonders for the animal's confidence. I shot off got a couple of incontinent sheets and threw them over the patch dunno where the mops were, but never to hand when wanted.
After than l got on fine with him, possibly he decided anyone that sat in a waterbowl had to be too stupid to hurt him. He was fine and after the vet checked him he bounded out the door without a backward glance.
We are having a toilet type disagreement with a Siamese at the moment. He is in for anaemia his PCV is going up nicely, however Siamese seem to have a thing about litter trays.
"Simply not for the well bred Siamese darling"
So he puts his front legs in it and goes on the bed, or leans all the way over it and goes on the bed, or pushes the tray up in the air and goes on the bed.
So l removed the tray and put the litter on an incontinence sheet. Will see if he uses that, l have a feeling that it won't be used.
Maybe we should cover the whole of the incubator floor in cat litter, somehow though he would probably still avoid that.
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