lesson learned...

one thing that is scary for the new graduate veterinarian is being faced with cases that are outside the scope of our experience. now - come on! you've just graduated from vet school, you're surely thinking - so you should be ready for anything, should have seen EVERYTHING - coming, as we do, from the ivory tower of vet school, with all the bells and whistles of diagnostics available to us. if you think about it though - you'll realize that we rarely see run-of-the-mill emergencies in vet school. that's because the vets out "in the trenches" see them all the time and handle them on a routine basis: snakebites, hit by cars, rodenticide poisoning, HGE...all of these things emergency and referring veterinarians handle on a daily basis. as a result, i have an idea (in the back of my head) how to treat these things. in practice - i don't always recognize them and have to consult my plunkett emergency book to get a handle on what i'm dealing with and how to treat it.

that's where technicians are crucial - good technicians. luckily, the practice in which i work has excellent techs who are self-motivated, competent, and comfortable starting triage treatments such as fluids and apomorphine (to induce vomiting).

i learned an important lesson on my second official day as an intern. i walked in to find 3 emergencies waiting for care. i opted for the seizuring cat with blood pouring from his mouth on the table. the technician looked at me and said, "the owner bought over-the-counter flea medicine and applied it. this is a pyrethrin toxicity. we've already administered robaxin and valium" (muscle relaxants and sedatives). naturally, in vet school we learned about these things, but i had never actually seen a case. the patient in front of me was completely obtunded, seizing. the owners had no idea how long he'd been seizing. based on his condition and the suspicion of long-term brain damage due to hypoxia, i discussed with the owners his poor prognosis. i did also tell them that sometimes animals (and people) make amazing recoveries and that treating him overnight would at least give him a shot. the owner was torn but elected to try therapy.

i was extremely skeptical about this cat's chances. he was blind - one eye was already clouded by what looked like anterior uveitis. the other eye was now blind - due to hypoxia, i could only surmise. but i tried very hard not to give the owners an indication one way or the other, besides saying that i thought there was absolutely nothing wrong with trying overnight and postponing a decision till the morning. in my head though - i thought the cat was toast.

pressing on, we treated this little kitty. by 3am, he was purring, throwing himself into my arms (valium makes kitties very affectionate), and generally making a pest of himself. it was nothing short of amazing (to me anyway).

my lesson: appearances can be deceiving. even the most hopeless looking case has a shot...