So Tuesday promised to be a long day for me. I was on surgery in the morning and then appointments in the afternoon. Then I was on call that night.
I called down on Monday to see what sort of surgeries I had scheduled and if not many, I was going to take Riley down and pull her broken tooth out too. I had a cat neuter which even I felt like I could knock out. I was slightly too aggressive about it but it went fine. Then a feral cat spay had been added on and as I got in there, I found out she was pregnant. Not super pregnant but defiantly so. I asked Dr. Sands a couple of questions about what I had to do and then went about it. There was lots of stopping and thinking but it went okay. The cat also had a cyst which didn’t make one side the easiest to exteriorize. That done, I closed with a simple continuous that ended up being supplemented with multiple simple interrupted stitches. This was my first solo surgery day, first solo spay…well, first solo everything. Even though it took a little longer than planned, the tech did complement me for not taking too much over an hour because the first new grad took over two hours for their first solo spay. From there, we cleaned Riley’s teeth and pulled the bad one. It went really well. So I had some time to go home and lay around before returning to the clinic for afternoon appointments.
My appointments went okay. I probably ended up getting behind as I normally do but eventually would get caught up. I was on call that night and had the brief run down on what I needed to do-keys, money, security codes, etc. I debated on taking home the truck or not and then decided to. As I pulled into my drive way, Lil (the neighbor across the street) stood in her doorway and then stood on her front porch for a long time as I got out of the truck and got it plugged in and everything. It was just before 8 and I changed my clothes, fed the dogs and was in the process of making a PBJ sandwich when I got a phone call. It was a client that thought her dog was bloated. Of course, she couldn’t pay my $90 initial emergency fee (which is actually $100 and $141 if I bring a tech in for one hour). So after a couple of phone calls to confirm that in fact I could get half of a payment, I was on my way back to Newville for my first emergency. I called multiple people that I felt would know more about bloat than me---pretty much everybody and called in a tech, Meg. Meg tries hard but sometimes that isn’t enough. Generally, she’s good to work with though. Luckily, when I arrived, the dog was standing though incredibly pale. I pinged the dog as I was instructed to and even though the dog didn’t look like what I felt a bloated dog should, it pinged like a gas filled organ. We took an x-ray and it didn’t look right. It looked like a normal stomach and an abdomen full of fluid. Meg and I freaked out about exposure of the x-ray and Dr. Sands came in for a second opinion. On her way in, we ran a PCV which showed that the dog had anemia. When Dr. Sands came in, she was like what do you see? An abdomen full of fluid. So what are you going to do about it? Tap it. Okay, let’s go. So we tapped the dog’s abdomen. I put the butterfly catheter in and turned to get the syringe when Dr.Sands was like stop, you don’t need that. Because pretty much pure blood was pouring out…Sigh. This dog most likely had a ruptured hemangiosarcoma. This dog was pretty much a dead dog walking. I explained the x-ray to the clients, explained the prognosis and options-surgery with a very poor outcome or euthanasia. They opted for euthanasia and we put the dog to sleep. The money situation reared its ugly head again but at this point, Meg handled it.
Dr. Sands was great to come in. Sometimes, I still need someone to bring out my own knowledge. I knew what I saw. I couldn’t believe in myself though. I’ve gotten better even in this short week. I learned a lot on Tuesday. Thursday, I felt enlarged lymph nodes on a dog and told the people that most likely it was either a tick borne disease (tested negative for Lyme disease) or lymphoma. I ran some blood work and with a super high calcium and kidneys that were starting to fail, it looked like lymphoma even without doing an FNA of the lymph nodes. I explained it to the people in addition to the fact that the dog’s kidneys were not 100%. I gave them options for treatment and diagnosis and that I didn’t think that this dog’s prognosis was very good. We euthanized that dog on Saturday. It was hard because this was the first dog that I had diagnosed and then made a decision about. I did have to have some convincing on the bloodwork but for the most part, I knew what I saw once I started looking into it. I couldn’t take it back. This dog most likely had lymphoma. If they hadn’t taken the dog home, I would have done a FNA for myself…though if I hadn’t found anything on it, I would have been second guessing myself anyway.
Friday night was another night on call. I can’t go into all of the details of that afternoon’s appointments (or some of the Saturday ones that were similar), but I had been home for a while when I got a frantic phone call from someone that thought it was time to euthanize their dog. I was on my way. I called a tech but got there first. The people showed up right away and they had thought that the dog had died on the way there. I called the tech and told her not to come in. I checked the dog and helped them package her up. While I was shutting down computers and locking doors, I got another phone call. A dog had licked chlorine tablets for a pool. I was still at the clinic and looked up some stuff. I told the people what they needed to do and I assume it all went well.
Skipping ahead with some worries for this week, I’m on call on Saturday. I assume that I’m also on for Sunday but have no way of knowing this as I don’t have August’s schedule yet. Anyway, because I’m on for Saturday, I have large animal duty solo. I could have nothing. I could have that part switched with the doctor that is doing small animal that day. But if I do large animal, I need to have all of the herd health stuff cancelled because I’m only about 75% accurate at palpating. Maybe I can use the ultrasound which would increase my % some but not all the way up to 100. Also, legally, I don’t think I’m supposed to write health certificates. We might have that finished though as I think the fair was this weekend. Worry, worry, worry…
[EDIT-Orginally published to Blogger on 7/30/11]
[EDIT-Orginally published to Blogger on 7/30/11]
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