FAIL

i know i said that i would try to post upbeat cases. for the life of me, i can't think of any that are interesting. i know that can't be the case, but it's the ones that you lose that tend to stick in your mind.

last night was a loser night. i saw a lovely chocolate lab / pit mix. he had been taken in by a good samaritan, as he was free-roaming and unloved. as i was listening to his heart, he nuzzled up between my cheek and shoulder and proceeded to lick my neck and head butt me (like a cat). his new owner of 1 month was a young girl (early 20s) excited for her upcoming marriage. as soon as i looked at the dog, my heart sank. he presented for staggering and swaying, as well as running into walls. he was also vomiting frequently. a free roaming dog with those signs means only one thing. start the antifreeze testing.

he was indeed, poisoned. antifreeze is a terrible thing. unless caught in the first 8 hours, treatment is pointless. even sometimes before 8 hours, they don't recover. 9 times out of 10, the animal will die. this guy was already showing elevations in his kidney values. the owner had no idea when he was exposed. treatment for a dog his size would have been very expensive - and perhaps fruitless. we euthanized him, needless to say.

on his heels followed a 13 year old blocked cat. fairly routine in emergency medicine. except that this guy had a quiet, very focal (1/6) heart murmur that i missed on my physical exam. when he received his fluid bolus prior to unblocking, he developed pulmonary edema secondary to his undiagnosed heart disease, started vomiting (a symptom of fluid overload), and collapsed. he recovered from that after 2 hours of oxygen, but the stone in his urethra could not be moved. neither myself, nor my senior clinician, nor the internal medicine specialist could budge the stone. despite repeated cysto (sticking a needle in the bladder to remove the urine), his potassium continued to climb (this leads to slowing of the heart and death, eventually). i talked to the owners about surgery, but his prognosis was guarded with his heart disease. they elected to euthanize the sweet little guy. his owner was a mother and her teenage daughter, both in tears and extremely grateful to me for my (i thought rather poor) care.

the icing on the cake? this morning before leaving, i ran into the students that come up from my alma mater every 2nd and 4th friday to do spays and neuters. one of them was a guy who ... honest to god, as evil as this sounds ... if he died, i'd probably throw a party. he did a terrible thing to me in vet school, and i've never quite gotten over it. of course, he would be there.

ok. i'm going to curl up in my warm bed with my husband and warm kitties and try to forget last night and its accompanying failures. for every animal i euthanize, there is are at least 2 to 4 that i send home with their owners for many more years of life.

tonight is another day.