Sometimes as a vet, we see things that make our blood boil. We see things that make us shake our heads in disgust. Sometimes, we just have to shrug our shoulders and walk away. (And thus its no wonder that veterinarians have one of the highest suicide rates of professionals.)
We have people that own animals that have no business doing so. As vets, we try to make people understand our concerns and our passion.
A few weeks ago, I saw one of those cases that make me so very sad. It's not very often that I get upset about a case to the point of tears, get so passionate about a case. Luckily, Joe knows this and to his credit in the very rare event that this happens, he gives me free range to do what I need to.
In this case, what I needed to was adopt a fourth dog. At least temporarily.
Unfortunately, it didn't work out that way.
A few weeks ago, I was finishing up something at the office and was told that there were a handful of emergencies coming in. Could I see some of them? Sure. (Then a horse emergency came in. Of course.)
One of the first emergencies was a chihuahua with a broken leg. She had be accidentally ran over. The owners had previously been written off which wasn't realized till they got there. They were told that they needed to pay the previous balance (less than $100) in addition to whatever the charges were. They were given a rough estimate. When I saw the dog, she was pretty shocky but had an obviously fractured femur. A couple of x-rays told the extent and revealed a broken pelvis. I returned to discuss the dog's options: referral for orthopedic repair of the limb, amputation of the limb or euthanasia.
And I was pretty much shot down. For everything. I had estimates prepared for amputation and even allowed for a cuteness factor discount. (Who says vets are just in it for the money?) Eventually, I convinced them to let me hospitalize the little dog for the night to stabilize her. I hoped that overnight they would see the light and allow me to amputate the leg in the morning rather than their plan: take the dog home.
Then there was a money issue. (Did I mention that they had been written off for non-payment before?)
So the sweet little dog spent the night at the clinic. In the morning, the owners came and took the dog AMA (against medical advice). They thought it was cruel to amputate the dog's leg. I told them point blank that I thought it was cruel to take the dog home with a broken leg.
I even suggested that they could surrender the dog to me. (If money was an issue, that way she could have the leg amputated and then find a good home. Also to wear little pink tutus!)
Luckily, the dog found her way to another clinic and had her leg amputated. I'm glad it got done for her. But it still makes me mad that these people even considered taking that dog home with a broken bone. (That being said, today we had a dog come in for an x ray. They only wanted an x ray but we told them they had to have an exam since it had been four years!! The dog was holding up its leg and an X-ray showed a broken leg and pelvis. The big problem with this? The dog was ran over a week or two ago and the own didn't think that him holding up the leg was an issue until now. They got essentially the same speech and the receptionist had to beg them to take pain medicine home for the poor old dog.)
Wednesday, June 19, 2013
Monday, June 17, 2013
Lawyers
For reasons I can't really get into, we've recently had to hire a lawyer. It really sort of sucked.
As an adult, I'm not sure the proper procedure for hiring a lawyer. I'm sure the method that Joe employed-Google-isn't the approved method. I guess it can have some role in it but ultimately you probably should do more research than 'I saw your commercial'. Anyway, we ended up with one of those lawyers with the commercials on TV. Luckily not one of the generic ones with Captain Kirk.
So after a meeting or two, Joe wasn't satisfied that his lawyer was going to do a whole lot. It was disappointing. He pretty much said that Joe was screwed. Then the court date was moved without asking us first.
Luckily, we found out that this lawyer was not actually the lawyer. It was an investigator. It sort of made me feel a little bit better. But just a little.
Today, we went to court. We waited on the lawyer to show up longer than we were actually in the courtroom.
While the end result was favorable, it left a bad taste in my mouth. I guess I expected something more along the lines of Law And Order. Something more exciting. And when I didn't get it I decided our lawyer was a shyster.
I understand that he probably does hundreds of these a year. That we aren't anything special. That really, its in and out sort of case but I still want to stand up and scream that we are not your typical dumb fuck Pennsylvanians! I'm a fucking doctor! And Joe is an intelligent guy. Mistakes were made. Lessons learned.
It would have been nice if this guy had introduced himself to both of us. To one of us. I guess I should be glad that he knew Joe's name...
The lesson that I've learned? Make friends with a lawyer. Not so much to be council for us but to tell us who to hire.
(EDIT: this was written several weeks ago. Also I might edit it to include some links.)
As an adult, I'm not sure the proper procedure for hiring a lawyer. I'm sure the method that Joe employed-Google-isn't the approved method. I guess it can have some role in it but ultimately you probably should do more research than 'I saw your commercial'. Anyway, we ended up with one of those lawyers with the commercials on TV. Luckily not one of the generic ones with Captain Kirk.
So after a meeting or two, Joe wasn't satisfied that his lawyer was going to do a whole lot. It was disappointing. He pretty much said that Joe was screwed. Then the court date was moved without asking us first.
Luckily, we found out that this lawyer was not actually the lawyer. It was an investigator. It sort of made me feel a little bit better. But just a little.
Today, we went to court. We waited on the lawyer to show up longer than we were actually in the courtroom.
While the end result was favorable, it left a bad taste in my mouth. I guess I expected something more along the lines of Law And Order. Something more exciting. And when I didn't get it I decided our lawyer was a shyster.
I understand that he probably does hundreds of these a year. That we aren't anything special. That really, its in and out sort of case but I still want to stand up and scream that we are not your typical dumb fuck Pennsylvanians! I'm a fucking doctor! And Joe is an intelligent guy. Mistakes were made. Lessons learned.
It would have been nice if this guy had introduced himself to both of us. To one of us. I guess I should be glad that he knew Joe's name...
The lesson that I've learned? Make friends with a lawyer. Not so much to be council for us but to tell us who to hire.
(EDIT: this was written several weeks ago. Also I might edit it to include some links.)
Saturday, June 15, 2013
Devistation
This week we were pretty swamped. CB was out of town until Wednesday night and we were down three techs-one was with her husband who was getting surgery in Philly, one was recovering from post-op complications and the last was in the hospital with MRSA.
Tuesday, I was on call. I had finished up a vaccination visit with several horses and rushed back to the office to see a dog with a cut on its head. Then I rushed back out the direction I came to see a choking horse. Then I rushed back to see two horses that were sick.
These two horses belonged to an Amish gentleman who I had seen about a year ago with his goats. He had one small pony stallion that was down in his stall. The pony had an elevated heart rate and respiratory rate. Every breath was labored though his lungs sounded clear. Temperature was low normal. Some gut sounds and mucous membranes were normal color. He couldn't raise himself and pawed crazily in his stall. The other horse was a Haflinger gelding. He was down in his stall but could stand and walk normally. When standing, the gelding had some muscle twitches and was very gaunt in his flanks. His respiratory pattern was much better than the down horse's. The gelding's heart rate was normal and temperature was low normal. Gut sounds were good. It was pretty evident that though the gelding wanted to eat, he could not. All the hay kept balling up in his mouth.
The Dutchman informed me that he had lost his buggy horse Monday morning. The horse was a little off after being driven to church but they didn't think much of it-maybe a mild colic. By Monday morning, he was down like the pony and dead after breakfast.
A fourth horse-a small pony mare-didn't show any signs of an issue at all.
I was thinking toxin-some trees had been blown down into the pasture-but didn't know where to start. I was also thinking listeria since he had mentioned that it was possible that all the horses had gotten into some hayledge that he had for the goats. Listeria can cause neurological signs and inability to swallow in cattle. It also comes from improperly cured silage.
I called DE to get advice and he suggested supportive care-NG tubes of oil and water, banamine to bind toxins, broad spectrum antibiotics. He also suggested calling the local equine referral hospital to see if they had any better advice.
I decided that I still wasn't sure what to do and that I still wasn't sure what the cause was so I called the local equine referral hospital. I filled them in and instantly the clinician that answered the phone gave me the answer-BOTULISM. Apparently, I had classic cases on my hands.
While a diagnosis is good news normally, in this instance, it was not. In this instance, it was a death sentence for these horses. I explained everything I had learned: botulism spores form in improperly cured hayledge and silage. There is no diagnositic test. Its all based on clinical signs. There is no treatment short of antitoxin. Even with antitoxin and supportive care (fluids), there are no promises that health can be restored. Essentially, I was screwed.
The pony down in the stall was a lost cause and would need to be euthanized (which I did) and that short of a miracle and several thousand dollars getting antitoxin into the Haflinger that he too was likely a goner. For the lone pony that wasn't showing signs, she probably would make it but also should probably get antitoxins just in case.
It wasn't feasible for this farmer and honestly, short of my pony, Nell, wouldn't be feasible for me either.
I hoped that the gelding wouldn't get progressively worse but in the morning I received the phone call that I was dreading. The Haflinger was down and needed euthanized. He left this world with the quiet dignity that is becoming of his breed.
What really sucks about this situation is that this Amish family lost so much. Nothing I can do can fix that. They were a nice family with nice horses and a sucky situation. Botulism is bad news.
Tuesday, I was on call. I had finished up a vaccination visit with several horses and rushed back to the office to see a dog with a cut on its head. Then I rushed back out the direction I came to see a choking horse. Then I rushed back to see two horses that were sick.
These two horses belonged to an Amish gentleman who I had seen about a year ago with his goats. He had one small pony stallion that was down in his stall. The pony had an elevated heart rate and respiratory rate. Every breath was labored though his lungs sounded clear. Temperature was low normal. Some gut sounds and mucous membranes were normal color. He couldn't raise himself and pawed crazily in his stall. The other horse was a Haflinger gelding. He was down in his stall but could stand and walk normally. When standing, the gelding had some muscle twitches and was very gaunt in his flanks. His respiratory pattern was much better than the down horse's. The gelding's heart rate was normal and temperature was low normal. Gut sounds were good. It was pretty evident that though the gelding wanted to eat, he could not. All the hay kept balling up in his mouth.
The Dutchman informed me that he had lost his buggy horse Monday morning. The horse was a little off after being driven to church but they didn't think much of it-maybe a mild colic. By Monday morning, he was down like the pony and dead after breakfast.
A fourth horse-a small pony mare-didn't show any signs of an issue at all.
I was thinking toxin-some trees had been blown down into the pasture-but didn't know where to start. I was also thinking listeria since he had mentioned that it was possible that all the horses had gotten into some hayledge that he had for the goats. Listeria can cause neurological signs and inability to swallow in cattle. It also comes from improperly cured silage.
I called DE to get advice and he suggested supportive care-NG tubes of oil and water, banamine to bind toxins, broad spectrum antibiotics. He also suggested calling the local equine referral hospital to see if they had any better advice.
I decided that I still wasn't sure what to do and that I still wasn't sure what the cause was so I called the local equine referral hospital. I filled them in and instantly the clinician that answered the phone gave me the answer-BOTULISM. Apparently, I had classic cases on my hands.
While a diagnosis is good news normally, in this instance, it was not. In this instance, it was a death sentence for these horses. I explained everything I had learned: botulism spores form in improperly cured hayledge and silage. There is no diagnositic test. Its all based on clinical signs. There is no treatment short of antitoxin. Even with antitoxin and supportive care (fluids), there are no promises that health can be restored. Essentially, I was screwed.
The pony down in the stall was a lost cause and would need to be euthanized (which I did) and that short of a miracle and several thousand dollars getting antitoxin into the Haflinger that he too was likely a goner. For the lone pony that wasn't showing signs, she probably would make it but also should probably get antitoxins just in case.
It wasn't feasible for this farmer and honestly, short of my pony, Nell, wouldn't be feasible for me either.
I hoped that the gelding wouldn't get progressively worse but in the morning I received the phone call that I was dreading. The Haflinger was down and needed euthanized. He left this world with the quiet dignity that is becoming of his breed.
What really sucks about this situation is that this Amish family lost so much. Nothing I can do can fix that. They were a nice family with nice horses and a sucky situation. Botulism is bad news.
Wednesday, June 12, 2013
As a rule, we don't sleep with our dogs. There's barely room in bed for two of us much less including some dogs. Plus, where would the cats sleep? And it wouldn't be fair to Riley who can't make it up the stairs.
Occasionally, I've been allowing a dog to sleep with me when Joe's not home. Mary has also taken to seeking out the bed when one of us is in it-when we're napping or only one is sleeping.
Last night, Mary came to bed with me. Joe said he came up to put her away and she was snuggling so hard he thought about sleeping on the couch. Then he decided it was dumb. He literally had to drag Mary from the bed while I pushed her out. Mary was determine to stay and before eviction kept laying in smaller and smaller balls closer to me. Ultimately, being on my pillow. Poor girl just wants a comfy bed.
Occasionally, I've been allowing a dog to sleep with me when Joe's not home. Mary has also taken to seeking out the bed when one of us is in it-when we're napping or only one is sleeping.
Last night, Mary came to bed with me. Joe said he came up to put her away and she was snuggling so hard he thought about sleeping on the couch. Then he decided it was dumb. He literally had to drag Mary from the bed while I pushed her out. Mary was determine to stay and before eviction kept laying in smaller and smaller balls closer to me. Ultimately, being on my pillow. Poor girl just wants a comfy bed.
Wednesday, June 5, 2013
A Geldin' Opportunity
I've mentioned before that I am considered the jack of all trades vet. This has its benefits (mainly being decent at most anything) and weaknesses (having to do anything and seemingly everything). The other vets in the practice have pretty well defined roles in the practice. TC does small animals. DE does all things cows and will fill in where and if needed for a random surgery or horse call. CB does all things horses and does most everything on the small animal side too. I, however, pick up the scraps a lot of the time. Its not a bad gig as it makes me fairly versatile. There are still things I'd rather not do-anything involving breeding a mare or preg checking cows. But most other things, I'll at least consider.
Fast forward to about a week ago...on the book for today was a gelding. Now geldings really need to be scheduled with a vet's approval because they can take a lot of prep work. Are the emasculators clean? Do we have a tech that can go with us? When does it have to be done? Are both nuts dropped? CB has pretty much been solely responsible for the geldings so it came a surprise to find it just placed in the book. Unfortunately, it was a miscommunication/misunderstanding with the receptionist who hopefully won't get in too much trouble. The other unfortunate part was that this horse belonged to an Amish gentleman who didn't have a phone so it couldn't be rescheduled.
So I was going to have to go geld this horse. Now I've castrated countless dogs and cats. I've assisted and done a handful of pigs. I've done about ten calves/bulls. I have castrated ONE donkey. ONE equine. But I felt pretty confident about the procedure. Sedation was my fear but with a tech and a catheter, it could be achieved. CB talked me through everything. We discussed the what-ifs and I was prepared. Except for one little snag...a horse with a cut on its chest.
So I was going to have to go geld this horse. Now I've castrated countless dogs and cats. I've assisted and done a handful of pigs. I've done about ten calves/bulls. I have castrated ONE donkey. ONE equine. But I felt pretty confident about the procedure. Sedation was my fear but with a tech and a catheter, it could be achieved. CB talked me through everything. We discussed the what-ifs and I was prepared. Except for one little snag...a horse with a cut on its chest.
After finishing surgeries-not many but they took forever!-and a hurried lunch, I went out to sew up an Amish horse that had caught his chest on a bolt. A deep but clean laceration across both pectoral muscles. I sewed it up and wished them well. I was already covered in blood.
I gathered up some supplies and a tech and headed off to the soon to be gelded Amish buggy horse. He was about 700# of cuteness. A quick exam and groping of his testicles assured me that we were going to proceed right along. I explained what the plan was, placed the catheter, gave the first sedative. Then we moved the horse into the yard, gathered supplies and extra sedation. The next round of sedation was given and I took the horse's head. He wasn't sure what I was wanting from him. He sort of stood there and I sort of pushed him by his halter until he rested back then down he went. He insisted on sitting sternal so I pushed him over, covered his eyes and got to work. About 5 minutes into removing the first testicle, the poor guy decided he wasn't super impressed so in went some more sedative, then a second round. The tech assisted with pushing extra skin out of the way and then off with the nut! The second one went routine. Now I was investigating the rings and checking for bleeding and stretching the openings when all of the sudden the horse decided he was done and sprung up! He forgot that he had legs and stumbled around falling on all of my equipment and falling towards my truck MARGIE!!! Luckily, he only nudged the truck, managed to get on his feet and take off through the yard. He headed back towards the barn but stopped before crashing into it. We caught him and surprisingly there was minimal bleeding. A slow steady countable drip of blood but nothing substantial. It actually had slowed quite a bit before we left. We gave penicillin, a tetanus vx, bute and pulled our catheter. The owner cleaned out the horse's stall and we gave a reversal for some of the sedative just so he could walk without falling over. Poor horse.
I gathered up some supplies and a tech and headed off to the soon to be gelded Amish buggy horse. He was about 700# of cuteness. A quick exam and groping of his testicles assured me that we were going to proceed right along. I explained what the plan was, placed the catheter, gave the first sedative. Then we moved the horse into the yard, gathered supplies and extra sedation. The next round of sedation was given and I took the horse's head. He wasn't sure what I was wanting from him. He sort of stood there and I sort of pushed him by his halter until he rested back then down he went. He insisted on sitting sternal so I pushed him over, covered his eyes and got to work. About 5 minutes into removing the first testicle, the poor guy decided he wasn't super impressed so in went some more sedative, then a second round. The tech assisted with pushing extra skin out of the way and then off with the nut! The second one went routine. Now I was investigating the rings and checking for bleeding and stretching the openings when all of the sudden the horse decided he was done and sprung up! He forgot that he had legs and stumbled around falling on all of my equipment and falling towards my truck MARGIE!!! Luckily, he only nudged the truck, managed to get on his feet and take off through the yard. He headed back towards the barn but stopped before crashing into it. We caught him and surprisingly there was minimal bleeding. A slow steady countable drip of blood but nothing substantial. It actually had slowed quite a bit before we left. We gave penicillin, a tetanus vx, bute and pulled our catheter. The owner cleaned out the horse's stall and we gave a reversal for some of the sedative just so he could walk without falling over. Poor horse.
All in all, this gelding was a success. I got both nuts off without anyone getting injured. Horses can get really hurt under any type of anesthesia. People can get hurt. I'm glad he picked when he did to jump up. I can't imagine the fear he would have had if the emasculators had still been on when he got up.
Swift was a cute stallion but now he'll be an even cuter gelding!
Monday, June 3, 2013
First Wedding Anniversary!
As promised by my last post, here's the link on the how to for the wreath. I could have used a couple more flowers. And should have waited till everything was on sale/paid attention to what was on sale vs what was not. (Apparently, white hydrangeas from Michaels were not. The blue ones that I ended up with from Pat Catan's were but still expensive.)
So, Joe and I have been married for one year as of yesterday. Sigh.
Let's look back...
Here are some pictures...
I was going to add like a million more but it didn't want to upload them. Maybe because I removed the disc.
Anyway, we had a fantastic wedding and the first year of marriage wasn't so bad either.
We didn't have much planned for yesterday. I had told Joe that there wasn't anything that I could think of wanting for a present but then decided on a hanging basket. But not petunias. I hate petunias. I could show you a picture of my new hanging basket but somehow didn't receive one...As for Joe's present, I framed a vintage postcard of the Laughlin Mill and one of our wedding photos. Unfortunately, the one good photo of us and the mill is one that I absolutely hate. My face is all smashed up in it because of the sun.
Saturday, we went out to Red Lobster and ate way to much. We hung out that night.
Yesterday, more of hanging out and then Joe grilled some steaks for us. All in all a very uneventful weekend and anniversary. We did eat some year old cake. Joe really liked it. I regretted that it wasn't lemon. Joe is going to have to make the rest of it disappear. Which is unusual.
Today, I am making Joe a special dinner. I also made reservations at Michael Symon's restaurant Lola in Cleveland. The reservations are not for two weeks. Also, I made hotel reservations at a really fancy hotel after the idea of a Bed and Breakfast was shot down. I like the idea of it but not the actual idea of staying in a stuffy room in a small house with strangers and having to eat with them. I already had to pay for the hotel room (boo) but can cancel. I hope. I probably should have ran it all past Joe first. He's actually be a big spoil sport about this whole idea but I really think that we need some time away. Plus, I already made arrangements for the dogs to be staying at the clinic...
So, Joe and I have been married for one year as of yesterday. Sigh.
Let's look back...
Here are some pictures...
Anyway, we had a fantastic wedding and the first year of marriage wasn't so bad either.
We didn't have much planned for yesterday. I had told Joe that there wasn't anything that I could think of wanting for a present but then decided on a hanging basket. But not petunias. I hate petunias. I could show you a picture of my new hanging basket but somehow didn't receive one...As for Joe's present, I framed a vintage postcard of the Laughlin Mill and one of our wedding photos. Unfortunately, the one good photo of us and the mill is one that I absolutely hate. My face is all smashed up in it because of the sun.
Saturday, we went out to Red Lobster and ate way to much. We hung out that night.
Yesterday, more of hanging out and then Joe grilled some steaks for us. All in all a very uneventful weekend and anniversary. We did eat some year old cake. Joe really liked it. I regretted that it wasn't lemon. Joe is going to have to make the rest of it disappear. Which is unusual.
Today, I am making Joe a special dinner. I also made reservations at Michael Symon's restaurant Lola in Cleveland. The reservations are not for two weeks. Also, I made hotel reservations at a really fancy hotel after the idea of a Bed and Breakfast was shot down. I like the idea of it but not the actual idea of staying in a stuffy room in a small house with strangers and having to eat with them. I already had to pay for the hotel room (boo) but can cancel. I hope. I probably should have ran it all past Joe first. He's actually be a big spoil sport about this whole idea but I really think that we need some time away. Plus, I already made arrangements for the dogs to be staying at the clinic...
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