Gory photos at the end.

     It was my last night on call, the night before leaving my job and house to return to Scotland. Weeknights tended to be pretty quiet and I had an evening of packing ahead of me, cardboard boxes liberally scattered across the living room. I had decided that when I moved home, Millie the cat was not coming with me – she loved it here. She could go out if she wanted to, sit on the windowsill watching people walking past, have stairs to run up and down at 3am, all the things a cat should do. Taking her back to a second story flat in Glasgow just wasn’t fair. Jill next door had fallen in love with her over the course of a weekend when I was away and she was chief Whiskas disher-outer, and it seemed the perfect solution. She would move in with Jill and enjoy being an only cat with the undivided attention of a single lady lavished upon her. A single lady with a sun room where a lazycat could bask all day

     I packed up all her effects and took her round to Jill’s. We stopped for a cup of tea and chat as usual, putting off the packing as long as possible before I surrendered to the inevitable and headed home for a jolly time of labeling boxes. I hadn’t got my foot through the door before Bill called.

“Where are you? Got a stitch up for you, said you’d be there in 15 minutes. A dog that ripped itself out lamping rabbits. Just needs a few stitches. They don’t have much money” I grabbed my keys and headed out.

     They were waiting for me at the surgery in a rough looking van, two young guys and a wee black dog. I opened up the surgery and got them inside. The whippet was wrapped in a jumper soaked with blood. “Is that all his?” I asked them.

“Aye, it was pissin all ower an all I could think like to do was put pressure on – I’ve had my fist in there all the way.” I peeled the hoodie back to reveal a substantial gash with a fist rammed in it..

“What’s his name?” I asked, just as the second lad went in for a closer look, turned green and staggered out of the consult room to throw up in the car park. His mate took over. “It’s Ronnie. Sorry about him like, it was dark an we couldn’t see and we ran all the way back carryin him an..” “Don’t worry pal, go get your mate some water and I’ll take a look at this.” The wound was deep, the muscles were ripped all down the front of his chest. There was a clear entry wound where he had run on to a stick at full pelt. I flicked some splinters off the edge. “Right guys, you’re going to have to leave him with me, I’ll see what I can do. I’ll call you when I’m done.”

“Will he be able to work again?”

“Let’s worry about that later, right now we need to save his life. This is really serious. I’ll call you.” 

I sedated him immediately and gave him some hefty pain relief. The poor dog hadn’t made a noise yet, despite me prodding at a gaping hole in his chest. I left him to get sleepy whilst I gathered a few things I thought I would need – an operating kit with drapes, suture materials, swabs, a tray to keep everything sterile, gloves and anything else I could think of. But first I had to clean it up. With Ronnie asleep I was able to examine the wound properly. I pushed the general anaesthetic into his bloodstream and turned him on his back into a cradle to keep him propped with his legs in the air. For the first time I appreciated the full horror of his wound. The stick had pierced the skin, plunged into the muscle and been deflected by the breastbone so it ran parallel to the ribcage, cleaving the muscle off the bone and leaving a large tear. When the dog tried to reverse off the stick, the tip it had caught on the muscle fibres, and the rip had made a right angled flap. You couldn’t see the extent of his injuries at first, but making a slit in the hollow skin above revealed something akin to a butchers shop window. I took a couple of pictures so I could show his owners the extent of the damage.

     Using warmed saline I flushed the wound time and time again, removing as many splinters as I could with my fine forceps, chanting “Dilution is the solution to pollution”. It was a painstaking job, I knew that any foreign material left in there could potentially cause an abscess and stop the wound healing, or worse, set up life threatening infection. When I thought I had removed everything I could, I started the repair job.

     I was on my own at the surgery so I had to try to think ahead to everything I might need, then have it ready and laid out as once I was scrubbed up I couldn’t break sterility by touching anything and risking further contamination of the wound. Satisfied that I had everything within easy reach, I started to reconstruct his chest. It was cold in the building, midnight in the North in January, but I was sweating. First I had to establish which bit went where, which muscle belonged to which ripped end, then try to stick them back together as seamlessly as possible without leaving any little air pockets. It took a couple of hours and dozens of little stitches, but I was making good progress when his paws started to twitch. He was waking up. I was alone, unable to tend to anaesthetic gas and was doing the surgery under a ketamine general anaesthetic – very effective and cheap, but with a time limit. I stopped stitching, drew up some more drugs and tried to get a vein, but he had been laying on his back with his feet in the air for and hour and a half by this time, and the veins in his forelegs were collapsed. I started to scrabble about in desperation as he came ever more awake. With the certain knowledge that it was medically a very bad idea, but the only hope I had, I stuck the needle into the femoral vein and pushed the plunger. He settled and slid back into deep anaesthesia. I took a second to breathe, sort myself out, scrub my hands again and reapply myself to the gory jigsaw. Eventually I reached the point where I thought I had done the best I could, and put my instruments down. The dog was starting to come round and fight against the anaesthetic. It was 2.30am.

     I took him back to my house and slept beside him all night, waking briefly to top up his pain relief.

     When morning came, I opened my eyes and was greeted by the sight of a pair of soft dark eyes staring back at me. When I groaned and sat up, his tail tip flipped.

     He went home later that morning, his young owner so pleased and grateful that he brought me a present.

“Some pork chops for you missus, I 'ad a pig.”

I laid the chops on top of my already rammed car, and set off for Scotland.

     I phoned down to the surgery a week later for an update, and was delighted to hear that he made a full recovery. In time he returned to work to live out the life of the poachers dog, wild and happy.

The chops were delicious.

**DISCLAIMER** 

If this were to happen today I would handle it very differently, but I did the best with what I had at the time.

Nursing her wrath to keep it warm

“I’m sorry but this canna gan on, you’re no getting anywhere and the dog is suffering and I canna cope any more and I divven want to but I think we are gonna have to pit her doon and it’s a shame anna but we canna gan on like this and I canna keep payin’ these bills it’s not that I divven want to pay for the dog like but its not making nowt of a difference, is it.”

     A large, clearly frustrated and quite angry woman was crowding out the consult room, a tall long haired German Shepherd dog at her side, markedly underweight.
“Okay, lets back up a bit and take this a bit slower – you said I’m not getting anywhere – I’ve never met your dog, so let’s start at the start, what exactly is the problem?”

“What do you mean you’ve never met the dog like? My husband’s been bringing her doon fer weeks to try and sort oot the diarrhoea man, it’s running oot o’ her! Look at the state o’ her, aal scrawny, mekkin me look bad! All them jabs haven’t made a bit o’ difference.”

“I understand, that must be very frustrating for you and difficult to watch her like that, but the thing is, we’ve really never seen your dog here before. You registered her by phone a couple of months ago, but this is the first time she’s actually come in. Might she have been seen somewhere else?”

The woman stopped, stared at me, blinked twice then shouted

“BASTARD!!” 

She wasn’t finished. “I told him to take her and gan to the vet. He’s been tekkin her away oot every week and asking for the money for the vets bills. But that useless bloody bastard husband of mine has gone to the bloody pub again! Spending my money on beer and those waster mates of his. Well I’ll bloody show him!”

“Okay, meantime, maybe we can see about helping your dog?”

     I examined the bewildered dog gave it a jab, a combination of a couple of drugs I thought might help. The owner left with some special sensitive food, a few tablets, a set of instructions and a murderous rage.

One week later they were back for a follow up.

“It’s amazin, hinny. She cleared right up and has been fine evva since. That’s a few months she’s had this, and it couldda been fixed, but that useless bastard drank the money for hissel. I nearly had the poor dog put down!”

I was just pleased we got a result, I wouldn’t like to have faced that lady’s wrath!

Mrs Walker's Pussy

     One of the things they don’t tell you about much in vet school is that you are going to end up having to deal with your clients mental health issues. Some times that’s easier than others. Sometimes we end up doing a version of care in the community, for free. I regard that as a privilege.

     Mrs Walker was a long standing client, with an outrageously obese cat. She would always say with a twinkle in her eye, “He’s a very hungry pussy!”. He was such a hungry boy that he ended up with diabetes. There was no chance of managing him with insulin, so we did our best to get on top of his issues with a combination of diet and oral medication. As Mrs Walker was increasingly frail, rather than giving her large bags of heavy cat food she would come in and buy one or two small packs every couple of days. A sparrow like wee woman with stick legs and a cheery nature, we were very fond of her and always took a little time to speak with her, knowing that her family had all moved away and could only visit at weekends, which they did. In the wintertime she would come in with freezing hands, and we would always try to stall her and share some tea together so we could get her warmed up again before heading out into the harsh Scottish winter.

     Over time, it became increasingly noticeable that Mrs Walker was losing her marbles. Whilst this was very sad and a source of some worry for all of us, she bore it with such good cheer that we couldn’t feel too awful about it. Her visits became more frequent, at least every day and sometimes more often. We noticed that she was asking for more and more cat food, insisting that she had none. She knew she was right because she had written it down. The staff were uncomfortable about this, so one of the team offered to go round and check on her food supplies. When they arrived in her kitchen they discovered a litter tray full of kibble, and a food dish with cat litter. We started labeling the packets. 

     It was around coffee break one morning on a freezing day and I was at the reception, chatting. Mrs Walker came up to the desk and smiled at me.

“Good Morning Mrs Walker, what can I do for you today?”
“Well now, I need a comb, and my feet”
“Your feet?”
“Yes, I have an appointment. I wrote it down, see?” I looked at the proffered note.
“I think that might be an appointment for you at the hospital with the nurse?”
“Oh. Where is this?”
“The vets. I’m the vet who looks after Oscar”
She looked crestfallen for half a second, then the impish grin started to reappear.
“Of course! Never mind, I’ll just take the hot water bottle and a comb please.”

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.