Memorable Cases- Finn, who never retired

     Finn, a Springer Spaniel came in to see me one morning. He had seen Bill a day or two earlier for vomiting and lethargy, and he hadn't gotten any better. I read through his notes and gave him a quick check over before deciding we needed to x-ray him to see if anything was stuck. His owner was quite teary and gave him a very sad, lingering goodbye. 

     I injected him with some sedatives and set up the x-ray machine ready to take some images of his abdomen. Within minutes I had a picture of his insides with a very sinister looking lump in it. Flynn was 14, and not a good candidate for surgery. Old dogs don't heal very well, run a higher risk of anaesthetic complications and, sad as it is, financially it doesn't stack up. It's also a lot to put an old man through just to get you another few months. I called and spoke to his owner and she decided the best option was to put him to sleep. It was what she had expected. She said herself and her daughter would be down shortly.

     Finn was still very sleepy when they arrived, I had to carry him through to the consulting room so they could spend a few minutes with him and say goodbye. As soon as he heard their voices, his tail started to wag, despite being so groggy he couldn’t lift his head. Everybody braced themselves as I started to gather the equipment I needed. And then they started to talk. A lot of owners faced with the imminent loss of their friend, companion and family member start to tell you about their personality and escapades. Finn it seems was no ordinary spaniel. He was a working dog. I asked if he was trained to the gun? No no they said – he's a sniffer dog from Ireland. That's why he's called Finn. It turned out that with the new-found peace in Northern Ireland there was a surplus of army dogs. He was retired off and rehomed to the McCarthys. But the thing was that nobody ever told Finn he had retired, so every time they carried a rucksack or a bag, he had to give it the all clear. As soon as the shopping had been brought into the house he unpacked it all over the kitchen floor, then sat in the middle of the debris, wagging his tail, signalling that they hadn't accidently brought home any Semtex today. He was fascinated by lights and would follow a searchlight or a torchbeam anywhere. He was particularly pleased when a neighbour fitted a motion sensor security light. Every time it clicked on Finn would jump to attention, ready to go! Wherever he walked it was always in a straight line. They couldn’t go on a circular walk, it had to be a square. 

     I stroked his ears whilst they told me of his efforts to keep their family safe over the past few years, then, with a lump in my throat, started to push the fatal injection into his vein. I stepped back to let them hold him whilst he slept away.

     Four months later a woman came into the surgery asking to put up a poster on one of our notice boards. I recognised her as a client, but wasn't sure which dog she belonged to. She showed me her poster and immediately I recognised the picture of a confident eager looking Springer Spaniel. The poster was advertising a reward for the return of a lost mobile phone, probably dropped along the side of the river at the end of August. “It's not the phone I'm bothered about” said Mrs McCarthy, swallowing to keep her breaking voice under control- “all my pictures of Finn are on that phone. I just want to see my boy”.

     Later in the year I was in the middle of a busy morning surgery when I was greeted by two shining happy faces and a small puppy. Mrs McCarthy and her daughter were bursting with pride in their latest acquisition – a sandy coloured cairn terrier. This wee tearaway was a bundle of joy and mischief, undaunted by a trip to the big bad vets. She introduced herself to me by clambering up my front and licking my face, biting my nose in the process. I gave her a thorough check over, and satisfied that she was the very picture of health except for a very small fatty hernia at her belly button, gave her the second part of her puppy vaccinations.

     It was late on a winter afternoon when we got the phone call. Bonnie was throwing up. Her owner had seen it all before and was terrified, it seemed like history was repeating itself. The dog was still bright and happy but decidedly out of sorts and unable to keep anything down. I told them to come straight to the surgery. 

    Bonnie greeted me in her usual fashion, all tail, enthusiasm and licks. I started to gently feel her belly, and just at my fingertips thought I felt something hard. She winced.

“I think we’d better get an x-ray” I said. “I’m worried Bonnie has swallowed something”. 

“It’s a stone out of the drive” Mrs McCarthy said “I’m pretty sure of it.”

“Okay, lets get a look and see what we find. If there’s something there I’m going to have to take it out as soon as possible before it can cause any more damage. I need you to sign…” I was cut off mid flow

“Whatever you think. Do whatever you need to do, I trust you.”

“That’s great, but I need you to sign a form for me”

“Whatever you want, Heather, just fix her.”

     I got the consent forms signed and picked Bonnie up with one arm to put her in the kennel that the nurses had already set up for her. “See to get the stone, you’ll have to cut her open? When you’re in there, can you fix her hernia?” I smiled. 

“Not a problem, I’d have to stitch it all back up anyway.” 

“And do you think you could spay her? We were going to get it done next month anyway.

     The surgery was a great success, the lump was indeed a stone from the driveway, and I was able to perform three operations in one, spaying her and repairing the hernia at the same time. Bonnie went home that night with a neat row of stitches, a basket muzzle and a bill for £350. Her owners pledged their undying gratitude. I went home for my tea, pleased to be able to give the family a happy ending this time.

Morbid advertising

Most folk have a plain mug at work, or maybe a pretty patterned 99p Tesco mug, or a present from their kids that says No.1 Dad or something. 

Vets? We have adverts for pet crematoriums, or drugs for treating diarrhoea. Lucky we're not squeamish! 

Puja

     Breakfast time down on the ghat, we performed the sacred rituals of the puja ceremony. A few people were performing their own morning rites, alone or in small clusters on the marble steps surrounding the holy lake. Some were washing clothes, others having a dip themselves. We walked slowly and found a quiet spot on our own. I found it moving being part of the ebb and flow of Indian life, chanting cross-legged and barefoot with my Brahmin friend. We offered up gifts in memory of departed family and friends, praying for their souls in the bright early morning light and sending paper boats out onto the lake. I choked up at one point and had to croak my way through the next prayer, pleased to offer my rice to the water and see it devoured by the catfish sucking at the surface. Ceremony finished, red dot and grain of rice stuck on my forehead, coloured string tied around my wrist, we retreated up the steps and sat in the sun. 

     You, he said. You carry a shadow. Sometime in the past, you were like fire, always fire. Now like water, but sometimes fire still. But I see shadow, is always with you.  Is in your eyes. Find peace, my friend. It is passed.

Timeless

   I picked up my old Volkswagon saloon on the Wednesday night, and drove back down South, down the motorway to Carlisle and across the country following the Tyne, the route of the old marches of Elizabethan times when the border had to be defended from reivers. It was a bitter night, and as I passed Haltwhistle it started snowing. When I got home I went through the usual routine – call to say I’m home safe, make a cup of tea and a fuss of the cat, then up to bed. 

   I awoke early with a bright light pressing into the room, squeezing past the curtains. Looking out of the window I could see that we’d had a substantial dump of snow overnight, the ground was perfectly white and smooth all over the village. Snow clung to the branches of the trees and the tops of fences, a sparkling beautiful sight. I got myself together hastily and headed out for work. 

   It took me five tries to get up the hill and out of the lane. The first time I made it, ready to pull out, but a car coming the other way made me retreat. After that the car didn’t want to climb the slight rise up out on to the road, and instead would slither around looking for some purchase on the now compacted snow. Eventually I took a good run at it and succeeded in scrambling over the top of the street and out on to the main road.

   I arrived at work surprisingly punctually, having allowed extra time to dig myself out, however all of my operations for the day had cancelled. Nobody could reach us. The only thing on the diary now was my evening appointments and they were already getting rapidly dropped. 

   “You got any work to do?” Bill asked hopefully. Days like this are always good for catching up on paperwork. Unfortunately I’d had an efficiency drive/crisis of conscience a week before and caught up on my reports, histories and mail in my own time during lunchtimes and after hours.

“Well you might as well go home then, just stay on call – any farm calls I’ll have to take the pick up and you’ll be on surgery. By the way, is it your birthday?” 

   I went home, but couldn’t relax. I was anxious, knowing that if we got any more snow I could be stuck immobile until the pick up came to drag me out. I got my boots on and starting to shovel the street clear, at least I’d only have to contend with any new snowfall. As evening fell I moved the car again, up to the main road where I was sure I’d be able to get out.

   The next morning I was called out early to a dog with chronic diarrhoea in need of some medication. They were able to meet me at the surgery so I packed the snow shovel into the boot of the car on top of my drugs cabinet and set off. The building was freezing cold and I was glad this was a quick visit. As I tried to put my equipment back into the car, I found that the boot lock had frozen. I skooshed some de-icer into the slit, but it wouldn’t budge. I tried harder and suddenly it gave way, the key spinning uselessly in the lock. The only way into the boot now was by crawling through the hole when you fold down the back seat! I was getting pretty fed up, and went home for some hot tea in front of the coal fire. 

   At 3 o’clock the phone rang. It was a familiar number, one of the local horse dealers who was a friend. 

“Cathy’s Horsus got a ridge” he said. 

“Sorry?"

“A ridge! Doon is belly! He’s na pissin!”

“I’d better take a look. How’s the road, will I get down the hill okay? 

“Wey aye, man! Gerron with it!”

   I was sure I could get down to the allotments behind the terrace of houses by the river where this wee horse lived, but I wasn’t so sure I could get back out again. Nevertheless, duty called, so I was off. I slid all the way down the hill at 10mph, touching neither accelerator nor brake, and arrived safely by the red brick houses. I wasn’t quite sure what I was coming to see, so I just grabbed my basic toolbox and stumbled into the knee-deep snow of the allotments.

“HELLO? CATHY? JOHNNIE?"

“Ower here, pet”

   They were in a knocktogether shelter of corrugated iron, a 7ft cube with a stable door at one corner, bedded with damp sawdust. Johnnie had been called upon to help out, Harry the pony belonged to a very nice local lady, the wife of the dentist, and Johnnie the traveler was chief advisor to this village in all things horse. He was a good solid guy, if a bit rogueish. I sometimes slipped him rehydration tablets for calves when he expected a bad hangover was imminent. They were both in the tiny shelter with a very sad looking little pony. He did indeed have a ridge running along his abdomen, an excess of fluid building up. His back feet were placed apart, he shifted from side to side and was straining and grunting. He needed to pee, but couldn’t let go. He was also so uncomfortable he was dancing about, and wouldn’t let me examine him properly. His heart was racing, a sign of pain in horses, and he was starting to sweat. Sedation was the next step. I drew up what I thought would be the right dose for his size, a combination of sedative, pain relief and muscle relaxant, slipped it into his vein and watched him start to settle. 

   “Right, I’m going to need to try to pass a catheter. But I don’t have a horse catheter, so we will have to improvise, okay? He needs relief or his bladder could burst, or his kidneys suffer irreparable damage. That jab should help drop his willy and allow him to pee easier”

   I trotted off back to the car to collect some gear. I had forgotten about the boot breaking, and swore under my breath as I climbed into the back seat and reached through into the boot space, grappling for the equipment I though I might need. It was dusk, pretty dark already and to make things even better, it had started to snow again. I was getting cold, and needed to keep moving.

   As I jogged back across the uneven ground of the allotment I saw a warm glow coming from the stable. My shout stirred a cheery yell back – he’s dropped it! The drugs had worked, Harry’s considerable manhood was now hanging loosely between his legs. I got my makeshift urinary catheters out and went in to the horse box. Johnnie had found his paraffin lamp and was lighting the stable with it. The smell it gave off was lovely and homely, like remembering something which you had never known. I got down on one damp knee, got hold of his penis with my left hand and started to pass the urinary catheter with the right. Something was dripping on me. 

“Is it raining in here?”

“Naw hinny – it’s the sweat affa him”

The poor pony was running with sweat, it was dripping off his long shaggy hair and falling on my arms as I guddled around under his belly. I got the whole length of tube to pass, but nothing came out. I flushed it with saline solution but the only thing that ran out was what I put in. It wasn’t reaching the blockage; I had to come up with a new plan. I took out my pocket knife and cut a length of drip line – I only had the coiled ones that I use for dogs so they can move around the kennel and not pull their IV line out. I straightened it as much as I could, lubricated it and slowly, gently corkscrewed it up through his urethra. I got it in as far as I could, but still no joy. I was going to have to rectal him, and see if I could fix this from the other end. 

   I sighed, took a deep breath and started to strip. It was -5C, dark and snowing. I took off my jacket and handed it to Cathy, then my hat and jumper which I threw into the corner of the box, followed by my shirt. I was standing in my vest, ready for action with a shoulder length glove on. I stopped and grinned for a moment, this truly was the stuff of the James Herriot books I had read so avidly as a youngster – stripping in the snow to rectal a sick horse, lit by a paraffin lamp held by a gypsy.

   The cunning plan was to apply some gentle pressure to his bladder whilst he was catheterized to try and force the issue a little. So up past my elbow in horse I gently drew his bladder back toward the pelvis and gave it a little squeeze. Johnnie put his hand under the pipeline to feel for any drips, but we weren’t getting anywhere. After a couple of goes I decided we’d all had enough. I called my boss. 

“Bill, I’m down at the yards, this horse can’t pee. I’ve passed the longest catheter we have, but it didn’t work, I gave him ACP, I’ve put pressure on the bladder, I’ve done everything I can think of but I’m not further forward. I think I’ll have to refer him to the local equine specialist unless you have a plan?”

“Nae point sending him there, wor Alex is covering for them this weekend wi my pickup – they don’t have owt you don’t, and you’ve done everything already. Just have to try again in the morning. Nowt for it”

   I would have to give him an anti-inflammatory and come back later. This did not please me at all, I was really concerned about him and wanted him seen by a more experienced vet with better kit, but there wasn’t one – I was it. I pulled on my shirt, drew up a hefty dose of the drug and gave it to him IV, then started to get my stuff together. I grabbed the jumper, now covered in sawdust and pulled it over my head. The hurricane lamp was burning low and guttering on the last few drips of paraffin.

“Cathy, can I get my coat please?” 

She made one of those little “Oh dear” sounds as she picked it up from the stable door. It had been lovingly placed on top of the door out of harms way and off the wet floor, but by accident the wrong way up, so the snow had fallen inside the fleece lining of my jacket. With the temperature still dropping outside I didn’t really have a choice, I needed the extra layer. I shook it out, and with a grimace I put on my snow lined coat, shuddering.

   I was just putting the last of my equipment in my toolbox outside when a cry came out from the box. I jumped over to the door with the head torch and was delighted to see a stream of hot urine spouting forth. Henry had let go, and judging by the noises Johnnie was making it was a couple of days worth – strong smelling and thick. There was a chance for this wee guy, and we would all sleep tonight.

Monkey business

It's inevitable when you work closely with animals that certain cases or characters will interest you more than others, and some will steal your heart. It was a post-monsoon day like any other in India when the rescue vehicle pulled up at the hospital and unloaded a few dogs with maggot infested bite wounds, a calf who had been lying down in a gutter for four days and a baby langur monkey. He was in a sorry state having been hit by a vehicle on what the locals call Snake Mountain, named after the twisting road that winds it’s way over the hill between Pushkar and Ajmer. There were no visible wounds but he was paralysed from the waist down, confused and very depressed. He was still quite young, and could easily be cradled in my left arm whilst I worked. 

We gave him steroids to reduce the inflammation, and some pain relief. As there were no obvious fractures to treat it was a case of hoping and praying that the paralysis was a temporary disability caused by swelling and bruising around the spinal cord rather than trauma to the nerves themselves. 

He was an instant hit, everybody wanted to come and see him. I drip fed him water from a syringe to keep his fluid balance stable and left him overnight to rest as much as possible. It’s very tempting to continually visit the cute patients and see how they are doing, but this wee guy needed rest more that than anything else. 

The next day he was still off balance and face down, badly concussed but if he was held upright and supported he would eat a very little banana if it was squashed and put in his mouth. I took him outside and gave him a gentle bath, cleaner his soiled hindquarters, drying him in the sun and lightly grooming him to keep the tactile contact that baby monkeys thrive on. By the next day he would lick food when you smeared it on his lips. Another day later and he opened his mouth ready for it. Little by little he was trying to move, becoming aware of his surroundings. On day five he put his hand out to try and grab at the fruit I was feeding him whilst he was bathed.

As he began to bite and chew we were able to feed him apples and papaya as well as bananas. I made a special feeder for him to encourage his co-ordination and reduce his dependence on humans. It was a dangling bottle with holes cut in it – he had to put his hands in the holes and pick out what he wanted to eat. As he got stronger and more independent we pulled back from handling him so that he did not regard us as his family. His recovery was going well. 

My own less so – I was struck down by a virus that knocked me off my feet and had me hallucinating and fevered for two days. I was brought to by a phone call from the compounders – Monkey wasn't eating. I was worried, he had been doing so well when I left, but perhaps he did not like being cared for by the male nurses? I peeled myself off the sweat dampened sheets, got washed and dressed, and called for a driver – I was in no fit state to make my own way 7 miles into the desert. On the way I stopped at the fruit stall to buy fresh apple, banana, bitter melons and the local biscuit – Parle G (like Nice biscuits) I arrived at the compound in a cloud of red dust, and using a stick for support made my way to his kennel. The men were sad, shaking their heads and telling me that they had tried but he would not eat for them and monkey love only me. I tried to ask what they had tried to feed him and he had responded. After some painstaking translation by Siteram, it turned out that the hospital had run out of apple and banana and the monkey had only been offered papaya for two days. He considered this unacceptable, and had gone in the huff! I sat down beside him on the concrete floor, and opened the Parle G biscuits. A small black hand came up through the bars, trying to grab hold of the sweet biscuit. He ate two, and then made a start on the fruit. 

After a two week stay at the compound the monkey was fit, healthy, and ready to be released, much to the dismay of the volunteers who had fallen in love with him! I made myself busy elsewhere so I didn’t see him leave. The rescue vehicle took him back to the exact spot where he was found and released him back into the jungle. His family came bounding down out of the trees to greet him, and carried him home.

Client Conversations #8

A client phoned the surgery. They had left their dog with us for the day to be examined and treated as required. We ran some blood tests which all looked good, and performed an eye exam which revealed that the dog wasn’t making enough tears in her right eye and as a result the eye was tacky and sticky, the eyelid painfully rubbing on the eyeball with every blink. We prescribed lubricating drops to help keep the surface of the eye slippy and recommended they be applied every 2 hours, which was explained by the nurse at discharge.

“ You didn’t write on the bottle which eye I’ve to put the drops in, it just says the right eye. How do I know which is the right eye?”

Sorry, I’m not sure what you mean? It’s her right eye.

“But which is the right eye?”

“Well, you know how you’ve got a right and a left eye? So does your dog. It’s the one on her right side.”

“Is that the right one?”

“Right. The right one is on the right, right?”

“Ooooohhhhhh you mean like left and right? Not like right and wrong”

Up late

Vacantly sitting in bed, checking my phone again and again. Looking for a new update, something happening, someone saying hello, an email maybe.

I know what I am really waiting for. A message from him. 

It will never be from him again. 

Veterinary Medicine loses another extraordinary colleague.

You were the brightest and best and I am shattered into a thousand shards of sharp black grief. 

Client Conversations #7

A guy came in with his cat and an anxious expression on his face. He said  

"She’s not good with people who aren’t me."

"Not good aggressive or not good timid?" 

"Well, when we went to the Cats Protection to get a new cat, this guy was coming out of her kennel at feeding time. He was wearing a face visor, body suit and gauntlets. We looked at each other and said – if we don’t take her, who will?"

"But she’s okay with you at home?"

"Well when we arrived at the house, I got a plate of chicken ready whilst she was still in the basket. I opened the door, she came out, looked at me and started eating. It was love at first chicken."

A serious post

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I was discharging an inpatient when I heard it, and stopped mid sentence, spinning on my heel to see where it had come from.  “Vets have the highest suicide rate of any profession”.  A cocky teenaged boy showing off in front of his Mum, a client I knew fairly well due to their dogs persistent allergy problems.  I caught his eye and turned back to finish what I had to say before smiling and sending my patient on her way. Turning back to him I said “It’s not so funny when it’s your friends.”

Walking back to the consulting room they all came flooding back, a flashing show reel of those I have known and lost. The girl I grew up with who went to a different vet school, qualified, worked for a couple of years in mixed practice then took a calculated overdose one night. Her funeral was the saddest thing I have ever seen, her parents hadn’t been in a room together for over 10 years and ignored each other throughout.  The racecourse vet who was reputed to have a sixth sense with horses, kind and gentle, who had stopped drinking for a few years then one day headed off on a binge and was found dead in his house with head trauma. The one who hung himself over the back of the door, so that when they tried to get into the house they couldn’t get past his body and had to break the door down with an axe.  The vet who was a one man ambulatory practice, who took all the epilepsy tablets washed down with a bottle of coke in the back of his car. The guy who just couldn’t do it any more and overdosed on propofol in the flat above his vet surgery.

It’s a far cry from the cuddly James Herriot image that the public has, backed up by the portrayal in all those TV shows. The reality is that we are simultaneously dealing with multiple cases, often very complex, in a difficult financial climate where we are expected to fix everything within the tight time allowance. Time off is a nuisance for everyone else.  I am lucky to work in a good area, in a practice where I have colleagues who I can talk to, about cases or other stuff, and get some support. I have worked in places where that is not the case.

Be kind to your vet, you don’t know what they might be going through until it’s too late.

Exam mascots

     It was the middle of exam time,  and there was a nervous tension all over the University. You could feel it just walking up University Avenue, students brisk and urgent on their way to the library or one of the many exam halls.  I was similarly agitated, but it was a bright clear day in late early summer and my head was a mixture of pharmacology and the call of the open countryside just half an hour away. I looked to my left before stepping off the pavement to cross the street, and it was then I saw it, lying in the gutter. A squirrel. It was perfectly intact, not a spot of blood or any sign of trauma, but it was dead as a doornail and rigid with rigor mortis in a Shakespearean pose. Without pausing to think, I scooped it up and carried on to the exam hall. We filed in immediately, dropping our bags and coats against the wall, clutching our lucky pens, a packet of polos and whatever superstitious trinkets we had brought. I placed the dead squirrel on the desk for retrieval afterwards.

     The exam was rigorous and demanding, and within a couple of minutes I was fully absorbed in a panicky world of my own.  I hadn’t prepared well, and I was struggling to triumph over the negative marking system: one point for a correct answer and one point deducted for a wrong one or a pass, meaning you need to get at least 75% right. I knew about half. A further quarter I could whittle down to two possible answers. The rest were a complete guess.

     When the invigilators announced our time was up, I couldn’t get out of there quickly enough and down to the union for a sorrowful pint before going home to prep for more exams the next day.  I grabbed my bag and rocketed out the door.

     It was several hours before I realised what I had done. I had taken a dead squirrel into a vet exam, and left it there, on a desk.

Nobody ever mentioned it.  

Client Conversations #6

Whit dae ah caw you?

Sorry, what do you mean?

Weel, dae ah caw you Vet? Or are ye doactor or whit but yer no a doactor but like a doactor?

Most people just call me Heather

“Right.” (she thought for a minute) Can ah caw you hen?

*smiles* Aye, if you like.

She turned to leave. “Thanks hen”