Wednesday, January 11, 2012

Holy cow

It's been a week since I posted? I had promised myself to do better, then the weekend came and swept away all good intentions. It was CRAZY at work. Then, I had one day to reset before driving to Florida (Tuesday) for the North American Veterinary Conference that begins on Saturday. We combined it with a family trip, so the 3 of us drove down yesterday so that Evaline could meet her aunts, uncles, cousins, and great-grandparents. It was the most perfect trip we could have hoped for with a 3 month old baby. She slept most of the way, and she only had one 20 minute fussy spell. We made it in 10.5 hours, exactly what Google predicted!

This past weekend at work had a mix of significant highs (a GDV/"bloat" that the owner caught within 5-10 minutes of occurrence and underwent almost immediate surgery, home within 24 hours) and significant lows (3 septic patients that required incredibly intensive care). We were so busy that on none of the 3 nights (Fri-Sun) did I get to lie down even for 30 minutes to nap. It was exhausting.

A typical weeknight for us in the winter can be dreadfully slow - seeing as few as 1-2 patients the entire night. The average production for a winter weeknight is somewhere around $1000. On Friday night, we made $6000!! It was quite crazed.

The first patient of the night was a cat that had been shot through the leg with an arrow! The very large arrow head and barbs went straight through the poor cat's femur, snapping it in 2. It was a horrible injury, requiring amputation. Next through the door were 2 transfer cases from local veterinarians. Both had suffered severe, severe injuries when attacked by other dogs. They'd both undergone extensive external wound cares and were transferred to me as "stable" patients for monitoring.

Unfortunately, neither of them were stable. One I suspected was suffering severe intra-abdominal trauma, and the other I suspected was rapidly developing sepsis. I was right in both cases. The first went to surgery and was found to have a hole in his intestines, torn mesentery, and a section of jejunum about 4 inches long that was totally dead (due to trauma and damaged blood supply). The second patient was septic and circling the drain. For reasons upon which I will not elaborate, the discovery of this sepsis was so delayed that by the time we knew what was happening, treatment was likely useless.

On the heels of those nightmares came a cat with a chestful of fluid, a positive feline leukemia test, and a large mass growing in his chest. This is a clinical syndrome that we see somewhat frequently in young cats - a combination of lymphoma (cancer) and feline leukemia virus. The owner wasn't prepared for euthanasia, so she elected to palliate the cancer. In the meantime, I had to tap the chest to remove the fluid.

It got so crazy that I was forced to call in the other doctor for back-up, something I haven't done in the 2.5+ years I've been working at this clinic.

By the time Monday morning rolled around, I was thrilled to be leaving! I was exhausted - physically but also emotionally. Dealing with such difficult, complicated cases (especially sepsis) drained me to the point of near tears come Sunday.

Thankfully, there's nothing that a little R&R with my family (in the form of a car trip to Florida) and some sleep can't fix.

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