Client Conversations #5

My, she’s a big cat! 

“Yes, I’m her feeder”  

*awkward silence*

You for whom I have cared

After your owners have gone

And the light has left your eyes

I lift you up

Cradle your head in the crook of my arm

Gaze softly upon your brow

and say

You were a good boy.

Making it up as you go along.

Sometimes you are faced with things that they don’t tell you about in Vet School and you just have to wing it. When I was called out at 1am to a cat which had unexpectedly had kittens, I realized this was one of those times. She had prolapsed her whole uterus, it was swollen and engorged, an angry looking mass of flesh. I had never heard of a cat prolapsing before, normally we only see it in ruminants. She had five new kittens, mewling and squirming in a washing basket beside her, still damp. Although I didn’t know how I was going to do it, I knew I had to help her. I called my nurse, and rushed back to the surgery, the cat beside me on the passenger seat in a washing basket with a towel on the top, my dog relegated to the back of the car.

I anaesthetised her and to the surprise and horror of my nurse, liberally dusted the uterus with sugar.  Sugar draws the water out of the swollen organ, reducing its size and making it more pliable. Despite my old fashioned tricks however there was no way that this one was going to go back inside the cat; when I pushed one horn in it simply involuted and folded itself up inside the other horn. There was no choice, I had to open her up. I looked at the nurse, bleary eyed and already convinced that this was fatal. “I have to go in. I’ve never heard of anyone doing it, I don’t know what to do, but we’ll work it out – we have to or these kittens are dead.” She nodded. The owner was already braced for the worst so it was do or die.

I made a midline incision and tried to orientate myself. The guts were all in order, the bladder slightly skewiff but identifiable. I hunted the ovaries and eventually found one down in the groin region. I tried to lift it but it was strung taught like a piano wire, and as I touched it I could feel it starting to give under the strain. If it ripped off it would leave a major artery loose in the abdomen, spouting blood. I had to try something different. By this time it was 3.30am and I was feeling a little desperate. But my patience was rewarded, a deeper hold, some gentle traction and miraculously the uterus was suddenly the right way round again, in my hand, inside the cat. I quickly tied off the ovaries, then took great care with the cervix – if I tied it too low she could have bladder problems for the rest of her life. It was flabby and misshapen, but it did close. Suddenly fearing that the final section might somehow fall out again, I tacked it to the inside of her abdominal wall securing it in place. I fell back against the wall and wiped my forehead whilst she got cleaned up and started to come round.

I texted the owner to say she was through the surgery and we would have to await the outcome, and waited with the cat until she woke up, snuggled in beside her kittens. I staggered off to the mattress on the floor for a few hours rest. It was 4.15am and I started work again at 8.30. I lay awake unable to sleep for another hour, high on the adrenaline, wondering how it was going down there.

When I arose in the morning she was up and feeding her kittens. The operation was a success and she went home the next day once I was sure she had suffered no ill effects. I have a friend who says that when you drive through the dark, you can’t see the whole journey, just the little bit ahead of you lit up by the headlights, but nevertheless you can make the whole journey that way.

The Doctor will see you now.

Last week the RCVS decided that vets can now call themselves "Dr" if they wish. Don't get me started on what a pointless ego stroking waste of funds I think this is. The main point is - I was against it, in an eye-rolling "it's not very British" sort of fashion.

Today I was in a supermarket, and I was waylaid by a chirpy young man with an ipad who was doing a survey about all sorts of seemingly unrelated things. I think the main drive was to get your details so they can cold call you. Anyway, he was being annoyingly cheerful whilst I was feeling slightly put upon, and so when he said - "Is it Miss or Mrs?" I heard myself say "It's Doctor."
"Right, of course Doctor, sorry" he said.

Everyone loves a good power trip, but in half a second I turned into the very sort of arsehole I had been complaining about. It will be interesting to see how this pans out!

Tales of Bill

I returned from a weekend in Scotland to find my boss bleary eyed in the surgery on Monday morning. 

“Hard weekend?”

“Five bloody horses kicked each other one after the other, all needed stitched, and one was bloody mental, I gave it 50mls ketamine and it was still standing. In the end I put a rope on it, tied it's head to its feet and sat on the bugger, just bloody stitched it from there.”

I grinned and went to put the kettle on. There was always a shaggy dog story with Bill. Unlike me he didn't have to report when he was going out on a call and when he was back safely, so he could make up any story on a Monday and I couldn't say otherwise. My on-call weekends were usually fairly steady, a couple of call outs, maybe a colic would involve visiting every four hours but otherwise it was manageable the most part of the time. Speak to Bill on a Mon morning and you would think he'd been sent to a war zone.

He followed me to the kettle. 

“Went to see Marg’ret Cook yes'day, one of her granddaughters’ dogs, that bulldog thing, went for Foxy” Foxy was an old one eyed mongrel with big pointed ears that suggested German Shepherd ancestry somewhere along the line. “ She had a big rip doon her side an needed stitched up. So I went up to the house 'cause you allus get a good feed up there. Well, I goes inta the livin room and there was this coffin laid out, an wor Andy was in it! After Auwl Andra died he went tae bits an drank hissel tae death. It's taken him a coupla year like, he looked rough as hell last I saw. There was no tellin him like. So Young Andra’s in this coffin, an Foxy's lyin underneath it, an poor Ma’gret's there wi aw the family roon. And I had to knock it oot and stitch it up right under the coffin. So I flattened it an got into it wi the needle and there's this big bang ootside. An Ma’gret's sons all come back in wi the gun an say – he'll no dae that again. The granddaughter starts greetin an twistin on. Wild like.”

A stitch in time

I got a call at 7am

“Heather! It’s Willum! Blood everywhere, it won’t stop, come quick!”

I’m not at my sparkiest at that time of day, I usually consider early morning to be my lowest ebb. So it was a flap to try and get myself together and bundled into the car. I flew up the road as fast as I legally could, rattling my teeth as I battered across the potholes.  The farmer heard me grinding up the drive and came running round to fetch me. “Wild bitch jumped the fence and ripped hersin on the barbed wire, it’s running like a tap and winna stop!

Right enough, the tall dairy cow had a gash in front of her teat which had clearly torn the vein and the blood was pouring out. She was a great big German beast, a new breeding line that was starting to appear in dairy herds and gave great yields but could be a little stroppy. “Right lads – you get a halter on and tie her to the post, Davie, you get a rope on that back leg and tie it to the gate so she can’t kick me. I’ll get some stuff.” The cattle crush was the wrong shape with the holes in all the wrong place for this job. I reckoned it would be safer, quicker and easier in a pen.

I ran back to the car and came back with suture material and my operating tools. They were still getting her into the pen and trying to get a hold of her. After the wild chase across the field she was pretty full of adrenaline and difficult to handle. Eventually she was secured and I opened my toolbox. I swithered before drawing up the local anaesthetic – it tends to sting when you inject it and the cows don’t like it, but it was better than her going nuts every time I tried to get a stitch in – and this was going to take a few. I touched the needle to the skin and braced myself to push it in, but before I could she suddenly reversed, snapped the halter in half, and ran off taking the gate with her – and the farmer who was still standing on the gate. They took off down the yard leaving a strip of clean concrete where the gate scrapped the muck away, liberally splashed with scarlet blood.

I'd never seen a cow that strong. I needed back up.

I phoned one of my professors from Vet School. 

“David? It’s Heather, I’m on a farm and I need to sedate a cow to stitch her up.” “Sounds fun” he said, “No bother, give her a bit of Rompun, what strength do you have?”

“None, the boss doesn’t like it so I’ve only got Sedivet or Ketamine”

“Oh, I wouldn’t know about that then. Good luck!” and he hung up, leaving me standing in the yard blankly.

At that, a yell heralded the return of the bucking bronco. They had chased her down, turned her round and she was heading into the parlour at top speed. We managed to fix the gates to channel her into our normal treatment area and, after some argy bargy, into the crush. As I thought, the central upright pillar in this machine was in exactly the wrong place and every time I approached the wound I risked breaking my arm – one kick in the wrong direction and the bones would be shattered against the steel frame. “Come on lads, we need to get this leg back again”. I lassoed the foot and tied it up where I thought it would do least damage. There was nothing for it but to go for it, the blood was pumping out of her at a great rate. I threaded a needle and blindly dived into the sea of red. I felt the hot splash across my face and heard it spatter on my collar as I tried to isolate the source of the bleeding. Her foot flailed past me several times but couldn’t connect due to the rope, only flinging muck at my cheek as I turned away. Time and again I tried to bring the edges together, large clumsy stitches trying to stem the flow. And then, it slowed, dripped rather than poured, and another stitch stopped the tide. We had won. We looked at each other and laughed. I was red and brown, caked in filth with aching fingers.

“Breakfast?” they laughed

“I’m late for surgery lads, I’d better go”

“You might want a wash first.”

I did my best to scrub off the worst with a twisted old nailbrush and gritty cracked lump of Imperial Leather. When I thought I looked half presentable, I stripped, put on the clean shirt I always carried in the car, and headed down to the surgery.

“What happened to you?” said the head nurse. “You’ve got blood everywhere”.

A month later the farmer called me to say that the cow had come in for milking that morning and a huge ball of suture material had come away in his hand “like a massive spider web”.