My holiday

so far has been lovely, absolutely lovely. Two Christmas dinners - one with my family and one with my husband's, some very thoughtful gifts, and relaxation and sleep! Lots of sleep. Tonight, we are going to watch the UT bowl game with my husband's grandfather (as well as celebrate my husband's 35th birthday!), and tomorrow night, we are seeing the Avett Brothers in Asheville to ring in the New Year (with friends).

I can't wait!

The happy Christmas story!

MTWaggin - I HAVE IT! A happy Christmas story!

On Christmas Eve, a very nice woman and her daughter showed up at our clinic. In tow, they brought a yellow labrador. Based on his teeth, he appeared to be about 1-2 years old. He should have weighed a good 60 pounds. Instead, he weighed in at 31.7 pounds. He'd been outside a trailer and left to die without food. The lady that brought him in had thought he was being fed, but she kept noticing him outside the trailer without food, no cars in the driveway. Finally, one day as she drove by, the Lab happened to stand up, and she saw how shockingly thin he was. She banged on the trailer door and realized it was empty. She took the dog then and there (Christmas Eve).

For being half-starved, he was remarkably chipper. I was assuming the lady had come to turn him over to our clinic (and I likely would have been forced to euthanize him...). Instead, she wanted to take financial responsibility. I explained how expensive it could be, especially given that he was completely starved. He would have to be fed VERY carefully to avoid refeeding syndrome (a killer of concentration camp victims, first recognized in WWII). We would have to monitor his electrolytes and hydration status.

Further, as it turned out, he was heartworm positive.

I was sure he would be euthanized.

Nope. The lady wanted to do what he needed, regardless. And despite his starving, the Lab was in good spirits and relatively healthy condition. We started treatment for his starvation and he did amazingly through the weekend. She picked him up this morning, did not complain about the $850 bill (I knocked off $200 due to my cheery Christmas spirit), and is taking him to a day veterinarian to discuss heartworm treatment, vaccinations, and other preventative care.

My good cheer is fully restored this morning. I've been cooking in preparation to go home for Christmas dinner (one with my family, one with my husbands), although me + punch drunk/slap happy + knives and hot cooking oil...maybe not such a good idea. Only one small bleeder so far and that came from a sharp can.

Snow...and idiot awards

It snowed in earnest here last night, necessitating that I stay 2.5 hours beyond the end of my shift. Really I should be sleeping, not blogging. Our night was steady but not crazy. The morning, on the other hand, was turning into a CRAZY day. I'm glad I left when I did. I'd just admitted a female dog with a urinary obstruction, an older dog with abdominal pain and free abdominal fluid, and euthanized a laterally recumbent, severely hypoglycemic cat. There were 3 or 4 patients waiting to be seen by the day doctor when I evacuated.

There was about 4 inches of snow on the windshield of my car, so I turned it on to warm it up. I also flipped on the windshield wipers, not thinking anything of it. I came back out about 15 minutes later to find the windshield wipers not moving. When I got in the car, the overwhelming smell of burning plastic/melting car parts almost made me vomit. It was then that I realized that I'd burned the motor out on my windshield wipers.

I win the idiot award for the week - as in retrospect, DUH!!!!!

It's a Mercedes SUV (my freebie, hand-me-down), and I love that car...but fixing anything costs a fortune! Plus, it's the day after Christmas, it's Sunday, and it's snowing. There is no way in Hades it's getting fixed by a mechanic. Luckily, my husband is quite talented with automobile repair. The Mercedes always presents a special challenge, but I'm confident in his capabilities.

Here's hoping desperately, as we are supposed to leave and go home for Christmas with the families tomorrow. We likely can't make the drive without windshield wipers...(although there are other options - rent a car, fly, etc).

On a brighter note, my wonderful husband surprised me at work last night. He brought me a roasted and stuffed duck (he made himself), homemade mashed potatoes, dressing, gravy, broccoli, hot rolls, and sweet tea. He also brought me a few, smaller presents. How wonderful is that? I didn't even feel sad to be working on Christmas.

Ok, to bed with my tired self.

Merry Christmas (Eve)

My night consisted of the following:

Arriving at 5:30pm to a mostly quiet ER with some inpatients but nothing waiting to be seen.

Within 30 minutes, I had 7 rooms waiting on me as follows:

1) A 1 year old Shepherd mix with a swollen eye (turned out to be conjunctivitis of unknown cause)

2) A dog that had been (likely) attacked by another dog, non-weightbearing on one leg, with puncture wounds.

3) Another dog that tussled with the neighbor's dog and now had a flap of skin dangling that needed to be cleaned and sutured up.

4) A hit by car Labrador puppy that wouldn't walk (nasty femoral fracture)

5) An emaciated (30 pounds at 1.5 years old) Yellow labrador that had been tied outside an abandoned house for 2 weeks without food, brought in by Good Samaritans that wanted to take responsibility for him (he has heartworms and is starved - but is in good cheer - currently refeeding him slowly to make sure he doesn't die from refeeding syndrome).

6) A Shih-Tzu with severe back pain.

7) A dog that ate a large quantity of semi-sweet, milk, and white chocolate.

The night continued to be interesting from there on...3 euthanasias (an ancient Great Dane with dilated cardiomyopathy that chose to BLOAT, of all things), a HBC Boxer with the worst pulmonary contusions I've seen in a long, long time, and a 7 year old mixed breed dog with a history of seizures that presented in status epilepticus (owner had not a SINGLE penny to his name - but it being Christmas, we did some treatments until he could make a decision).

I should rest now...because there are 2 more nights of holiday madness to come...then 9 days off to rest, recuperate, have Christmas with the husband's family, then my family, then celebrate his birthday, then see the Avett Brothers in concert on NYE.

Merry Christmas everyone!

Thank you for all the thoughts. It has made me feel a lot better. That and the final cessation of a 72 hour headache, some sleep, and the presence of my husband back from meeting his PhD advisor. It is a beautiful, though chilly day here. We're going to have dinner and see a movie together, and I'm going to remember all the good things I have to be thankful for. I'm also going to re-read my stack of thank you cards one more time.

Angry kitten gods

I must have angered the kitten gods. A nice young man showed up yesterday morning at work, holding a little black fuzz ball to his chest. It was a beautiful black kitten (with silver frosted fur). His eyes were caked shut with snot, and so was his poor little nose. He was about 8 weeks old. Both eyes were ulcerated, but as soon as you cuddled him under your chin, he made biscuits on your face and cheeks, and purred.

So...guess where he now resides? Yes. Yes. Yes. The bathroom. At least this one is not a bottle baby. He's big enough to eat kitten food. He's also very sick, so I'm not sure if he's going to pull through, although he does purr and make biscuits.

Worse yet, a woman brought in her puggle puppy tonight (pug/beagle cross). It's so ugly, it's adorable. He was picked up by his nose and shaken by a much larger dog. As a result, he developed some serious pulmonary bruising. The owner had not a single cent to her name, not even the money to come into the ER. I offered CareCredit, she did not want to apply. She called people. No money. Finally, I confided to her that I was fairly sure the puppy would pull through. I told her that I thought if she took the dog home and kept him quiet and calm for the night, he would likely survive. No, she didn't want to do that. She couldn't stand the thought of waking up and finding him dead. They just wanted him euthanized!

Exasperated, I went back to this cute little 5 month old puggle (who has a great prognosis). I couldn't stand the thought of euthanizing him. So now courtesy of some quick paperwork, he belongs to the clinic (i.e. me). Anybody want the world's cutest puggle??

Want some wine with that cheese?

The last 2 nights have been significantly less than stellar. SIGNIFICANTLY.

7:00pm Wednesday night, an owner calls. Her large breed dog has had 2 puppies, both dead. The third one was born alive, but the bitch accidentally eviscerated the puppy while chewing the umbilical cord. Further, the bitch has stopped pushing and produced no more puppies in over 8 hours.

My technician recommends bringing BOTH mom and the eviscerated puppy in ASAP. The owner declines to do so and hangs up. At 11:30pm, she calls back. The puppy with its intestines hanging out is dead (there's a real shocker), and the bitch has not been pushing. Should she bring her in? My technician counsels her AGAIN that bringing in the dog is imperative. The owner demures.

1:15am, I am dog tired. Owner shows up with a ONE HUNDRED AND TWO POUND dog in tow. No puppies. Owner doesn't have finances...but she's been breeding for 20 years, and she knows all about it. She coughs up the money for xrays and an ultrasound. I see 5 puppies, 3 definitely alive on ultrasound. There is no obvious cause of fetal obstruction, so I recommend trying oxytocin to stimulate labor.

It starts to go downhill at that point. The owner complains that she doesn't want to sit around for 3 hours and wait to see if numerous doses of oxytocin work. She has to be up at 5am. However, she doesn't have money for c-section. She's not worried about live puppies. She asks me if she can get one shot of oxytocin and take the dog home. I tell her she can do that, however I would strongly advise against it. She whines some more, then she asks me what I would do.

I was thisclose to saying a) I WOULD HAVE BROUGHT THE DOG IN EITHER OF THE FIRST TWO TIMES YOU CALLED and b) I DON'T BREED SO I WOULD NEVER BE IN THIS POSITION!

It takes her an hour of more wasted time to decide to try oxytocin. Another puppy is born, but it is dead. I call to give her the news. She suddenly becomes extremely worried about the other puppies (previously she said she was not concerned with live puppies). I recommend c-section if she wants any live puppies (although I tell her that the chances of any surviving at this point are slim). She wants another ultrasound to see if any are still alive.

I'm rapidly losing my patience. Another u/s reveals live puppies still. Mom suddenly comes up with enough money to do a c-section, so to surgery we go. It is now 4:30am. Surgery is bloody, as all c-sections are. It is not routine in any fashion. The puppies are absolutely enormous. There are 4 left. The owner - OF COURSE - did not want the dog spayed, despite the fact that she was SIX YEARS old and well past good breeding age. Unfortunately, I had to make 4 uterine incisions (when normally I make ONE). The uterus was friable and tore. In the end, I had my technician call and tell her that the uterus needed to come out. I was afraid to leave it in, as I was seriously concerned about healing.

Then it got really interesting. For no discernible reason (and believe me, we exhausted the possibilities), the dog went into complete cardiac arrest. We started CPR in the operating room. Her heartbeat came back. I continued surgery. She died again. We got her back. I continued surgery. Repeat 2 more times.

Yes, she died 4 times in surgery. Amazingly, she pulled through and recovered from anesthesia. I suspect occult heart disease contributed to her cardiac arrest. We removed four puppies from the uterus, 2 alive, 2 dead. One was so huge that I realized surgery was necessitated from the start. There was no way that puppy was coming out.

I didn't leave work until well past 9am, collapsed into bed around 10am, only to get up and do it all over again last night. Last night was also a nightmare. One of my techs called in sick; the receptionist called in sick, too. So we were staffed with 2 techs and myself. Further, Everyone had a problem with money last night.

We had one couple who signed an estimate for their very ill cat, agreed to payment, then threw a fit at the register when they realized that we run our checks electronically. They accused our technician of lying to them over the phone about taking checks. It got ugly. Then there was the young, well-to-do looking lady with her 2 little dogs that ate a bottle of Rimadyl. We decontaminated them, treated them with activated charcoal. Then the perfectly nice looking young lady threw a fit (literal) that her bill was $300. She protested that she was quoted $92 for the first dog and $46 for the second (our exam fees). When we explained (again) that those were the exam room fees, she stated that since she was not told the price for treatment, she should have to pay nothing. I didn't let her get away with that.

Then there was the nice young guy with his beautiful dog that somehow managed to badly break its leg in the backyard. He had the $92 to be seen and nothing else. We discussed options: amputation, orthopedic surgery, or long-term cage rest and pain medications with questionable return of function to the leg. He could do NONE of those things. His wife hated the dog and wanted him to get rid of it. The dog was euthanized while the man held it in his arms and sobbed.

After all this, one of the only 2 technicians I had melted down in the ICU. She had been in surgery with me the night before, dealt with the stupid, thoughtless owners who were only concerned with breeding and producing puppies to sell, she'd dealt with the owners that night complaining about money, and then had to assist with euthanizing the dog with the broken leg. So, she lost it in the middle of the ICU - sobbing hysterically, asking me "why, why?? Why are people such idiots? Why do people breed? Why is it our fault that we can't fix them for free?" - tears streaming down her face.

I had to resist the urge to run screaming and crying from the building myself, but I kept it together. Thank god I have the night off.