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Saturday, 13 December 2008

Vet schools.

Lord help me.

'Wednesday Addams' is seeing practice at the moment. She is super bright but with very poor communication skills. She scares the living shit out of me because every time I turn round she is stood silently behind me.

Watching.

Those students amongst you will have little trouble deducting which vet school she is attending.

I hear on the grapevine however that the students entering their clinical rotations at Nottingham are quite exceptional.

In part due to the standard of teaching but also because when the school opened it was uncertain whether they would be accredited by the RCVS. Therefore Nottingham has naturally selected a crop of risk takers, likely to be more extroverted and motivated.

Each vet school is perhaps unknowingly fingerprinting their own students through the selection and education process. Vet schools must learn to compete with the new wave of private referral clinics that have set up in the last ten years and some are failing miserably. Students do not need to know about referral procedures, basic veterinary skills are far more important but often overlooked...unless you are at Nottingham.

I can't wait to meet the risk takers.

Who knows, perhaps they will change the face of veterinary medicine and give us all a well timed kick up the *rse!

Thursday, 11 December 2008

Pincer movement.

'My friends have one of those Birman kittens. Amazing blue eyes. Almost as blue as yours.' Daniel Craig tells me in his deep soft voice as he looks into my eyes across my consulting room table.

Meanwhile his charming dog rests his head gently on my knee, brown eyes also connecting with mine.

Suddenly I realise what a fool I have been.

Daniel Craig is not naieve.

He knows that the way to a vet's heart is through his dog.....

Wednesday, 10 December 2008

Deception

Sophie, the pug is dangerously ill with a nasty infection in her uterus which requires an urgent hysterectomy but Mrs Frobisher thinks her mother who lives in a nursing home, cannot afford the operation.

A real shame because I know that Mrs Frobisher would easily be able to afford it.

'I have to make lots of phone calls to find out what is best.' She tells me.

I leave her to get on with this while I examine my next patient.

I overhear Mrs Frobisher inflating the quote I have given for the operation and I know Sophie's days are numbered.

Then she phones a friend. 'I'll be leaving in ten minutes, I promise I wont be late for lunch.'

Meanwhile I am still busy with a longstanding patient of mine.

Immediately she has ended the phone call Mrs Frobisher lets out a wail. 'Help me! She's dying.' She lies.

I am forced to stop what I am doing and attend. The crocodile tears role and Mrs Frobisher leaves on time. Sadly Sophie is euthanased.

I hope I never see Mrs Frobisher again.

Tuesday, 9 December 2008

White Lies.

When Billy the terrier was sick with diabetic ketoacidosis (very bad diabetes) Mr Homes sat by his kennel every day for one week. Ten years previously Billy had belonged to Mr Homes' daughter. When she was killed in a car accident Billy became his last remaining link to her.

We got to know a lot about Mr Homes. About his wife, his own diabetes, about what his daughter was like. Everyday he returned without fail, limping in through the surgery doors on his walking stick.

'What are his chances today?' He would ask me in his west country accent.

On the first day I told him 50/50.

On the second day 60/30.

'Is he 80/20 yet?' He asked me on the fourth day.

After a week Billy went home. Two years later he is still doing well.

Yesterday Mr Homes picked up Billy's insulin. As he waited in reception he was privy to a conversation the receptionist was having on the phone.

'No I am afraid LittleVet isn't at the surgery at the moment, she's out on a visit.'

The receptionist replaced the receiver.

'That's not strictly true is it?' Mr Homes said raising his eyebrows. 'Because I've just seen her shopping in Sainsbury's.'

Well... we can't all be as virtuous as Mr Homes.

Sunday, 30 November 2008

Girl's weekend.

Having just returned from a weekend away with members of our branch surgery it occurred to me that the one thing that unites women in the profession is a sharp sense of humour.

Perhaps this is true of all professions but some of the situations we find ourselves in can be so traumatic that laughter is the best coping strategy. Each of us has our own style of story telling.

Take for example my colleague recounting the tale of an impending euthanasia. As she approached the dog's kennel she chatted quietly with the owner.

'I know it's a hard decision.' She told her.

'I've known for some time.' The owner replied.

'I think you always know.' My colleague nodded.

'It's just not my dog.'

'Yes, they just stop being the pet you know and love.' She tried to comfort her.

'No.' The owner continued. 'I mean that is not my dog.' She said pointing at the dog in the kennel they had arrived at.


Thursday, 27 November 2008

Redirection.

The floor in our entrance porch caved in rather dramatically this morning.

People and their pets were then redirected treasure hunt style via sheets of A4 paper with hand written messages urging them to 'Enter' into the side door leading directly into the grotty kitchen/stationery cupboard. After passing the rubbish bin they set foot through a door festooned with many coats and bags, sadly it was not Narnia that greeted them but the chaos of the vets office.

Here a further notice told them to 'keep going' passed the table strewn with sandwiches half eaten, unfinished cold tea, various thoracic drainage kits, magazines and a mountain of byros and lab results.

Finally after negotiating a large pile of cardboard boxes and empty crates they were directed to 'Turn left' into reception.

I'm not sure what people thought of their little behind the scenes tour. Sadly, I for one forgot on occasion that the vet's office was no longer a 'safe haven'. I can only hope the rather plump old lady who for some minutes remained wedged with her cat basket between the filing cabinet, photocopier and the recycling bin was hard of hearing. Otherwise she probably would not have appreciated my candid phone conversation with a colleague where I may have used the 'f' word more than once in reference to 'that twat of a client'.

Friday, 21 November 2008

Student life.

The house is just as it was ten years ago, dirty and unloved.

Yet this is the house where I spent my third year at vetschool and I loved every moment.

I walk the streets I once trod as a student over ten years ago and for the first time I am totally sober.

It worries me that the vetstudent blogs I read today are full of angst and worry because the five years I spent at vetschool were the best five years of my life.

I attended every lecture, every party, every annual veterinary sports and in my final year when life was altogether far more serious I was to be found oftentimes dancing on the tables in the vet school bar. I put more effort into the final year pantomime than any of my studies and never worried about a thing...apart from the last two weeks when I realised I probably should pass my finals.

When I left vetschool I knew a reasonable amount about animals but absolutely nothing about the one species that would challenge me the most, their human owners.

I find it ironic that vetschools specifically select candidates with excellent communication skills and then neglect these skills for the next five years. No-one teaches you how to tell a client their pet has a terminal disease or how to ascertain what the client actually wants.

Even now I'm still learning about humans, and I don't think that will ever stop.....

Wednesday, 19 November 2008

Life after death.

There are times when a deceased pet will do a very good impression of being otherwise.

The animal is dead, the owner upset, tissues are in abundance....

...and then the beloved pet will produce a sudden gasp of breath...a repeated twitch of muscle...a stretch of the limbs and inevitably the mother of all wees, a lake of urine slowly creeping ever closer like molten lava to the edge of the table and my shoes.

Worse, far worse the eyelids that refuse to close however many times I press them shut when the owner isn't looking.

The intensity of this entirely normal post mortem activity is always somehow directly proportional to the distress of the owner.

It's horrible.

Really horrible.

It necessitates a cold scientific explanation on my part at a time when utmost sensitivity is required.

'Are you sure he is dead?' They cry in anguish.

'Yes it's a muscular reflex.' I reply.'I've emptied both barrels of the syringe, he aint coming back.' I want to continue.

If anyone has a cure for 'life after death' I would love to know?

Or perhaps I just need to try keeping more of them alive....

Sunday, 9 November 2008

Defra.

The depratment for Food, the Environment and Rural Affairs.

The typo was actually unintentional...but if the cap fits...

And so at last, the general public has come to learn what the veterinary profession have known for a long time....DEFRA are a complete bunch of fuckwits.

Firstly they insist on using lower case letters in their title which makes it hard to take them seriously.

Secondly they are always giving us the wrong advice.  When I phoned them regarding the PETS travel scheme because a microchip had stopped working in a dog that was due to go to Spain the next day I was advised to risk it and allow the pet to travel because it would probably get picked up on an alternative reader on the way back to the UK, I had used four different ones already.  Thankfully I ignored this advice, I don't think the owner or the dog would have been chuffed with a six month stint in quarantine.

It would appear they have now excelled themselves by setting out some very patronising guide lines on how to keep pets working largely on the assumption that we are all numptys

I mean really, telling us not to overfeed our pets...does the government not realise we are in the middle of a recession?



Saturday, 8 November 2008

Firework phobia.

It always amazes me how unprepared owners can be about an event that comes around every year at the same time.

Thankfully I was not in work today but I can only imagine how many last minute requests for valium were made.  Unfortunately people also fail to remember their pets have to have been examined by a vet within 6 months in order to obtain the medication. A lot of last minutes trips to the vets too.

To be honest though, they may as well stay at home because in my opinion nothing really works...not the firework CD's nor the expensive dog pheremones or any amount of drugs.

In fact, I've got news for all those pet owners, all you can do is wait.....around 12 years and finally your pet will stop when he or she becomes too deaf to notice any more. 

Thursday, 6 November 2008

The cold vet.

'I don't do fawning over people's pets.' Says the city vet matter of fact 'I mean just because I work with pets doesn't mean I would actually want one of my own. People tell me all the time that they can't believe I'm a vet. It really annoys me when doctors think what they do is more difficult.'

I find this sort of vet intensely irritating. Primarily because they think they are too cool to be a vet but also because someone this cold and clinical should have become a doctor, a fact they are acutely aware of and in desperate denial of. Besides which they won't even own a pet for fear of becoming too soft.

I've never been one to be ashamed of the reasons I became the vet.

'I fawn.' I say proudly. 'In fact I fawn all the time and to be honest I couldn't give a shit about what doctors or anyone else think of me.'

City vet frowns. 'Just because people become primary school teachers doesn't mean they want to have lots of children.'

'Oh please.' I want to tell her.'You are talking to someone who owns two cats and a giant rabbit.'

Friday, 31 October 2008

'Still'

'Still' is the word no vet wants to see on the waiting list when used in conjunction with the animal's presenting complaint.

Here are a few examples:

'Still vomiting.'
'Still itching.'
'Still lame.'
'Still weeing everywhere.'
'Still lethargic.'

and my favourite...

....'Still not right.'

In other words the first vet to see this animal 'still hasn't a fucking clue whats wrong with it.'

None the less it is 'still going to be your job to sort it out' and if you can't the owner is 'still going to complain about it' because their pet is 'still no better'.

Who would have thought after all this time that this one little word would 'still have me hiding in the toilet' in the vague hope my colleague will take them off the waiting list first.

As it turns out, I'm 'still a very bad girl.'

Thursday, 30 October 2008

Priorities.

Basil the Bassett hound's owners have just spent £3000 on spinal surgery at a specialist vets. Basil is barely able to urinate by himself, he still can't walk and it has been three weeks since the surgery.

'Do you think we can get him booked in to have his teeth cleaned under anaesthetic next week?' His owner asks me.

After I pick myself up off the floor my facial expression is enough to answer them.

Sunday, 26 October 2008

Biting the hand that feeds.
















Having recently finished my bathroom, I got slightly sentimental when I found this picture in a shop and decided to hang it above the toilet. It reminds me of Mavis, a dog I saved after diagnosing her with a large but operable tumour. It is the only piece of veterinary memorabilia in my home.

Exactly one week after I hung the picture Mavis also became the only dog who has ever bitten me.

In fairness she was aiming for the Jack Russell terrier across the waiting room but connected with my hand instead.

Now when I reach for the toilet role I am reminded of the large bruise which still marks my hand and not my remarkable heroism.

I am going to keep Mavis as a valuable lesson in humility.

Friday, 24 October 2008

Veterinary Vocabulary.

As one of the worlds worst at spelling I find great comfort when others (namely receptionists) make veterinary vocabulary clangers. Here are some examples, those of you involved in the profession will no doubt spot straight away.

Appointment:

Timmy Shaw : Annual gland evacuation.

Mungo and Milly Fisher: Lebanon Dwarf rabbits in for neutering.

Message:

Please phone Mr Smith about Billy's Cushions disease.

Monday, 20 October 2008

Pet hates.

I can tell a lot about an emergency client as I drive into work in the early hours of the morning, simply by noting the way they have parked outside the surgery.

Parking sensibly in the allocated slot means they will behave sensibly and be very grateful for my attendance in their hour of need.

Parking like a suicide bomber across the lawn and virtually in the porch with all doors open screams 'Nob'. Those driving Chelsea Tractors will be 'Complete Nobheads.' This is my number one pet hate.

Second are the clients who choose to arrive without a cat basket, carrying their wounded pet like a trophy of mangled limbs and blood, usually in a filthy, damp towel that they found in the back of the garage (in the cat basket they failed to use). Expecting me to examine their broken pet whilst it is lolling over their shoulder.

Finally the mobile phone. I don't ever want to hear it in my room. If I do I will ignore it and double your bill for wasting veterinary time.

Last night at 1.30 am I scored my first hat-trick.

Tuesday, 14 October 2008

Ferrets.

Think of the smell of the worst body odour you have ever encountered, now double it.

Add some acid and ground up smelly socks.

A sprinkling of garlic and onions.

Now turn the volume of this odour up a hundred times and add a distinct feeling of nausea.

THAT is the smell I have been walking around with ALL day on my hands after castrating a ferret this morning and unleashing the wrath of both it's anal glands during the proceedings.

In case you are wondering.....

...yes I did wear gloves,

two pairs!

Sunday, 12 October 2008

Holding the baby.

A few weeks ago a young boy of about five tried drinking form a surgical spirit bottle whilst in a consulting room with his mother, dog and one of our veterinary nurses.

Last week when a nurse was about to administer a premed to an animal in a similar situation a boy of eight swiped a syringe containing methadone off the table before she could administer it to the dog.

Neither of these children came to any harm.

What this illustrates is a lack of control on behalf of the parents, a lack of experience as far as our nurses are concerned in dealing with badly behaved children but more seriously a failure of our nursing staff to realise under RCVS rules they are now just as culpable as we are in the eyes of the law.

Quite frankly because I know I am responsible for the health and welfare of every person in that room and don't wish to have my arse sued off, I don't allow that sort of situation to arise.

Nurses traditionally have accepted no responsibility for their actions. But times are changing and they need to become more savy. They cant lay responsibility at the feet of the vets any more.

When a woman came alone with her boisterous, badly behaved two year old son and requested I euthanase her dog. I asked her to leave the dog with me because I felt it inappropriate and quite frankly a liability for her son to be present whilst administering an overdose of very powerful barbiturate to the dog.

The senior nurse frowned at me with a look that said 'Hard bitch.'

'Would you have held that baby?' I asked her.

'No.' Came her reply.

Friday, 10 October 2008

Old men.

'She's scratching all the time.' Announces Mr Derbyshire. He's an elderly gentleman who speaks very loudly because he is deaf. The sort of chap with a 1940's war effort accent who still wears a cravat.

The Norfolk puppy terrier roles on her back and allows me to tickle her.

'Have you bought any flea treatment for her?' I ask.

'Yes, I've bought that very expensive frontline stuff from you. Cost me an arm and a leg!' He shouts at me.

'OK.' I pause. 'Well if it hasn't worked perhaps we will need to do a few tests.' I tell him.

'Oh, I haven't put it on yet.' He replies.

Friday, 19 September 2008

Flowers.

At work.

Always the cause of great excitement amongst female employees.


Today they were for me.

One day I'll get flowers at work and they won't be from a dead dog.

Tuesday, 9 September 2008

What has happened to me?

Today I wore red shoes and a sky blue jumper.

I knew they didn't match, worse still I didn't care.

I am starting to look like a primary school teacher, I may even be starting to look like a vet.

I have also taken to wearing a Kagool. I look like one of those middle aged people who buy everything from Millets camping store. Only I never go camping.

I never stay out late on a school night because I am frightened I will be tired for work.

I never stay out late on a weekend either for that matter.

In fact I never stay out ever anymore.

I am officially boring.

Gok Wan, come and rescue me please!

At least I am still thin.

Monday, 8 September 2008

On Call.

There is a common misconception that vets work shifts.

The reality is that we work on average 70 hours a week. We do on call, nights and weekends as a routine as well as the normal day hours. We do not work shifts. We work all the time.

To give you a little taster here is a diary of my weekend on call. Remember I have worked a normal week prior to starting my weekend on call, and I will work a normal week afterward. I finished work on friday at 7pm, I finished work at 6.30 pm today (monday) after my on call weekend. There are two of us covering the weekend, during the week there would be nine.

Saturday morning.

8 am: Arrive at work, check the inpatients and call owners. I discuss treatment plans for the day, only the last client wants to talk for ever and ever but I need to start consulting soon....

9am- 11.30 am I consult, during this time I take an X-ray, a blood sample, vaccinate various animals, discuss lamenesses and admit a Bulldog for a C-section.

11.30 am: I start the C-section. Meanwhile a collapsed dog arrives, my colleague is resuscitating this but it dies. He then sees another collapsed dog (only it's actually ok) He has to head straight to the branch surgery to consult immediately, he will be late. We normally do this together but I have to continue with my C-section. He sees nine people, I deliver nine puppies.

1.30 pm I phone the Bulldog owner and ask her to come and collect the bitch and puppies. She tells me she wants to have a spot of lunch first. Lucky for some, I still havent eaten and nor have the nurses who are tending to her dog.

1.45 pm I drink a glass of water and get on with anaesthetising and X-raying a dog who turns out to have and infection in his intervertebral disc.

2.30 pm- 4.30pm, I consult again.

4.30 pm I manage to have lunch, a piece of toast. I am told a lame cat is coming down.

5pm I see three further emergencies.

7pm I go home.

10 pm I am called to be told an old cat that has had a fit is coming down to the surgery.

'I'll be there straight away.' I tell the nurses.

What I actually say is 'For fucks sake! With a bit of luck it will be decrepid and dying of renal failure and they'll want it put to sleep!'

When I arrive I find the cat is a pretty cool old fella who looks great for his age and is much loved, he's also absolutely fine now.

10.45 pm I contemplate what a bitch I am.

11pm I go to bed.

Sunday

I arrive 9 am and check inpatients

10 am- 12pm I consult again, seeing 'urgent cases'. Ranging from diarrhoea to cystitis.

The day continues much the same, with the addition of a seventy five kilo Mastiff that requires an emergency hysterectomy as a result of an infected uterus, various non emergencies (a fractured nail and a bee sting) and two pigeons and one hedgehog deposited at the front door by members of the public. All of which look like they've been through a washing machine.

My last call out is at 9pm that night to see a not very lame dog who has been 'shivering' and is absolutely fine when he arrives.

This was actually a pretty quiet weekend for me in comparison to the norm.

European working time directive you say....what's that?

Saturday, 6 September 2008

Freaks of nature.

This morning I performed a caesarian section on a Bulldog.

Bulldogs can't mate, nor can they give birth naturally. They spend their whole lives suboptimally oxygenated because their airways are half the size they should be and the shape of their faces don't help either. In fact they are the commonest breed to suffer from cancer of the cells on the heart responsible for sampling the oxygen content of the blood or a chemodectoma, simply because these cells have to work overtime. They also suffer bad skin as a result of their wrinkles and orthopaedic problems due to their bendy legs.

A third of the litter I delivered had congenital defects including cleft pallate and hernias, these died shortly after birth or were euthanased. I advised the breeder not to breed again from this bitch but I know she will be back because the veterinary profession has facilitated the perpetuation of such problems by medical intervention. Quite simply if it were down to mother nature they would not be here.

A recent programme by the BBC highlighted the plight of pedigree dogs. This has caused mild hysteria amongst Cavalier King Charles owners, but personally I think the Cavalier has it pretty easy compared to the Bulldog. Syringomyelia is not that common amongst the breed and although they suffer with faulty heart valves we can often help with medication, at least for a while.

The Bulldog is buggered right from day one.

'This little puppy is quite snuffly.' The nurse tells me from across the theatre as I am stitching up the bitch.

'Yep, and so he will be for the rest of his life.' I reply.

Pretty much nothing will stop these breeders, until now.

Thankfully Britain's recession appears to be slowing the trade as people are reluctant to spend a thousand pounds on a dog that's also going to need a hefty insurance policy.

Thursday, 28 August 2008

Sum of all parts.

'What was wrong with William in October Mrs Brown?' I ask. I am concerned about William the cats inability to walk, urinate, eat groom and pretty much be a cat. I am searching for clues in his history.

'Well that cost me a hundred pounds.' She says matter of fact.

'Can you remember what was wrong with him?' I persist.

'I don't know love but in June that year it cost me six hundred pounds and in March it was another two hundred, so I really want you to make him better.' She grins.

Mrs Brown fails to realise that a William is not like a 'souped up car' and that because she has spent nine hundred pounds already this will not automatically guarantee a green card for recovery, on the contrary his previous mystery illness is likely to worsen his chances.

If only veterinary medicine was that simple.

Wednesday, 6 August 2008

Gratitude.

Today I received a large box of chocolates with a note attached.

Dear Littlevet,

I am not sure that you have been told that on Sunday our 'Big Man' Sebastian was put to sleep by your colleague.

Things started to become difficult for him and he took a turn for the worst, I could not see my boy suffer anymore.

At nearly 13 and four months he has put up a 'Good Fight'.

Even though it is an extremely difficult time for us all, we wanted to give you a token of our immense gratitude for the care and help that you have personally shown Sebastian since we have known you at the vets.

I recall the time that Sebastian went in for a dental and even though, it was different people doing the treatment you made a point of telling them 'To be careful with him because of his neck.'

You are a 'Fantastic Vet' and those animals out there need you, so on behalf of Sebastian and the animal world we 'Thank! You!'


Sebastian was a much loved guide dog.

At a time when my morale has been at it's lowest I am so touched that a blind man found the time to write the words I so desperately needed to hear, leading me out from the darkness and back into the light.

Tuesday, 5 August 2008

Emotions.

The papers are signed and consent has been given.

But what has really happened is that I have struck a bargain, in other words I will run the tests if she will just 'shut the fuck up'.

In a climate of ever increasing litigation sadly it sometimes does not matter whether you feel the tests are appropriate or not. Since our patients can't talk, if the client thinks there is something wrong with the dog then it is better to assume there is because if you are wrong the consequences may be serious for your career.

Before she hands the lead to me she strokes Dudley's head.

'He doesn't like you.' She says to me with acid conviction.

I have no idea how she can tell because Bassett hounds always look miserable.

'You are the only vet he runs away from because you hurt him once.' She continues.

I glance at the notes, the last time I saw the dog was 1999.

I wonder whether dogs really do feel emotions, if they do Dudley hasn't made his clear because he hasn't attempted to run away once.

I take the lead from her hand.

'I'm sure he doesn't remember.' I assure her

He follows me willingly, tail wagging out of the room.

Sunday, 3 August 2008

Unknown territory...

The wounds are bleeding again. They are small and superficial but they trickle persistently because the heparin medication makes it difficult for the blood to clot.

'I think we need more plasters.' My Uncle says to me.

I want to tell him that some things simply can't be patched back together with plasters, but I know he will not listen so I fetch some more.

'I think she needs more pain relief.' I tell him gently.

I sleep in the room above hers, in the night I hear her crying often. Her breathing is also not good.

'She must eat.' He says as he tries to force bread to my Aunt's mouth.

For me, this is unknown territory. A place somewhere between this life and the next where my patients are rarely permitted to linger.

The cancer is advanced and my Uncle's atempts at palliative homecare are less than adequate. He still believes she will get better. He will not listen to the advice of the doctors but strangely he will listen to me, because I am not a doctor and I do not try to tell him what he does not want to hear.

Whilst I cannot fix my Aunt, I deal with death on a daily basis and I have some small understanding of the complex and mixed emotions that people experience. Sometimes when someone does not want to listen you have to find a way round.
He is obsessed with her food intake because this is the only thing he has any control over so I use this to my advantage.

'Perhaps if her pain relief were better she might begin to eat again and get stronger.' I tell him.
I avoid use of the word morphine because I know that it has a strong association with the dying.

He agrees. Eventually, but far too late, she is admitted to hospital. He is overjoyed that she feels well enough again to eat some cake.

Before now I have found health care professionals and those who have lost relatives to cancer to be strongly pro-euthanasia amongst their pets. They often have a surprisingly low tolerance to any degree of suffering.

Now sadly, I understand so completely. I only wish my Uncle would too.

To quote the words of a song,

'If you love someone, set them free.'

Friday, 25 July 2008

The special case.

The sombre gentlemen sits quietly in the corner of the waiting room. On his lap is a tightly bound black plastic bin liner, the contents approximating the dimensions of a medium size cat.

A quite clearly deceased, medium sized cat.

An odd looking gentleman standing at the counter glances over at him. He smiles broadly.
'She's good isn't she?' He says nodding at the bound bin liner. 'My Sooty would have been off your lap and out that door by now.' He continues chuckling.

'Actually she's dead.' The sombre man replies.

'What's her name then?' The odd man persists, quite clearly oblivious.

'Amber, her name was Amber.' The sombre man sadly pats the motionless cat parcel.

'That's a pretty name, how old is she?'

'She was seventeen.'

'That's such a good age, fancy that she hasn't moved a muscle, she's being so good, not like my Sooty.' The odd man smiles. 'Out that door I tell you!' He laughs.

Four days later we are still waiting for Sooty to be collected from the surgery.

Hardly surprising.

Thursday, 24 July 2008

Leaving the flock.

We lost one of our sheep on Monday but by Wednesday she had returned.

It is not unusual to have a high turn over of veterinary nurses, sadly once they are trained the good ones move on, usually for more money and less hours.

I find it hard to see them go because I have watched most of them turn from awkward teenage girls into competent professionals.

But this one came back. She came back because the standard of care in her new place of work was poor, because animals were neglected when they should have been nursed. She decided she couldn't take the money and turn a blind eye.

I am so proud of her for standing up for her principles. Mostly there has been talk of why she came back, but the important question is, why did she leave in the first place?

Sadly the veterinary nurse continues to be undervalued and underpaid, not least because most are young women who do not have the privilege of the middle class upbringing that their employers will have enjoyed. They never complain, they just move on.

Until there are more female partners including both vets and nurses, sadly the cycle will continue.

Saturday, 19 July 2008

A flea in the ear.

'I've been coming here for seven years and no-one has ever told me that Co-Co has fleas!' Says the rather irrate lady with large gaps in her teeth.

Right on cue Co-Co starts scratching her abdomen with her hindleg.

Had I been a man I suspect the reaction would have been a little less violent.
For this particular client such a diagnosis from a female clinician is equivalent to accusing her of being a slut who lives in a filthy house.

Ten minutes later my clinical judgement is still being questioned because she has taken it upon herself to disagree with everything I say in order to prove that I am not fit to be a vet.
I remain calm and reasonable, I never raise my voice.

Finally she leaves the surgery declaring rather dramatically that 'She has never been spoken to like this in all her life.' Crocodile tears rolling down her face.

The next day she phones the sugery to enquire about the bill.

The receptionist reveals that I have not charged her.

'Does she think I am some sort of charity case?!' She rants, demanding a bill immediately.

As a vet passive aggression is the only way to get even with a client, yet remain professional.

I decide not to fulfill her request, afterall it's a lot harder to complain about a service you haven't paid for.

Thursday, 17 July 2008

Dangerous wild animals.



Every so often an injured wild animal will be brought to the surgery.

As a vet you learn to read your patients, it is something that comes with experience from having examined thousands of animals and of course learning from your mistakes.

You can tell which will be dangerous within seconds, subtle changes in body posture, facial expression and a sixth sense that comes with time.

When faced with a species you are not accustomed to this becomes harder.

In hindsight the muzzle and gauntlets we used for this 5 kg fox were admittedly overkill.

But we saved him, nobody got hurt and that's what counts.

Saturday, 12 July 2008

Inappropriate behaviour.

Bertie and Jasper bound into my room, they each weigh thirty two kilos. That translates into sixty four kilos of Labradoodle jumping up and punching me in the breasts simultaneously.

Josh and James, eight year old twin boys weighing approximately the same are giving them encouragement with a Ben Hur style use of the leash.

The adult that has accompanied them asks,

'Do you think castration will help?'

'For your sons or the dogs?' I want to ask.

Thursday, 10 July 2008

Sometimes it's hard...

....to be a socialist.

Because poor people are just plain stupid.

'My cat's got a cut.' Says the lady on the phone. 'But I can't afford to pay nothing today.'

'How big is it?' I ask.

'Quite big.'

'In centimeters.' I clarify.

'How big is a centimeter?' She asks.

'OK, how big is it compared to the length of a ruler?'

'Oh, it's at least as long as a ruler.' She replies.

'I think we had better see him then.' I say rather concerned.

'In fact if you include his tail he's probably longer than what a ruler is.' She says with added gravity.

These are the people I vote Labour for.

Thankfully Mr Brown is making it a little less easy these days.

Friday, 4 July 2008

Guilt.

People handle it in different ways.

Take for example the couple in their sixties who insisted I pull all the stops out for their critically injured, very elderly eighteen year old cat. They wanted Sooty to die of old age not as a result of being reversed over on the driveway.

The woman whose dog sustained fatal injuries as a result of a fight with four of her other dogs, now taking legal action against her landlord.

When an animal is injured or dies as a direct result of our own actions the guilt can make us behave irrationally, but what we must really ask is whether this is in the animal's interest?

Thursday, 26 June 2008

Conveyor belt....

.....sometimes my life feels like one.

I live from one weekend on call, to the next night on call to the blissful recovery period in between and then the dread of the impending cycle repeating again. A cycle of exhaustion followed by recovery with peaks and troughs in between.

Sometimes when I step into my car and make the journey between surgeries a feeling of immense sorrow falls over me. In these quiet times of reflection I remember the people who are no longer here through tragedy or timely end and those whose lives now hang in the balance.

It's been a difficult year.

When I reach my destination, I wipe away the tears, step back onto the conveyor belt and continue on.

Because at times like this, much as we might resent it, the conveyor belt will carry us through.

Saturday, 21 June 2008

Geriatrics.

Miss Marple sits quietly in the waiting room.

She really is a sweet old dear. Complete with sparkly blue eyes, a few missing teeth probably as a result of sucking too many toffees and her much doted upon companion, Susie the tortoiseshell cat.

She rests her wooden walking stick upon one chair, while Susie sits quietly under another in her wire basket.

I help Miss Marple up and we walk, very very slowly into my room. I carry Susie in one hand and prop Miss Marple up with the other.

Miss Marple sits down in a chair and the nurse helps me with Susie. We chat about things that old people worry about, like whether to get Susie insured or whether to just put some savings away in case she gets sick.

When we have finished I help Miss Marple to her feet and carry Susie out to reception.

'Is someone coming to pick you up?' I ask her.

'Oh no dear.' She says smiling. 'I came by car.'

As I am placing Susie on the front seat of the small blue corsa, mosty parked on the lawn and fractionally parked in the carpark, I say a little prayer.

Tuesday, 17 June 2008

A different world.

'Mr Jones what is your appointment for?' Asks the receptionist.

'I can't remember.' Says the elderly Mr Jones, who looks like he is dressed in his best Sunday suit.

Next up Mr Humble.

'Your appointment was yesterday.' She explains to him. He scratches his balding head and says nothing. 'I'm sure we can fit you in though.' She smiles.

Meanwhile the old woman next to me is continuously scratching her hands. It's a horrible noise. Nails on rubbery skin, repeated over and over again.

Mr Johnstone has arrived for a health check, but forgotten his paperwork.

As I sit in the doctor's waiting room I thank God that old people rarely have pets.

'If your balance problem returns you'll have to see the 'Giddy Doctor' at the hospital.' My GP explains slowly. Obviously being around old people all day is starting to where off on him too.

'You mean I'll have to line up with all the old people twice my age who are falling over?' I ask him with some trepidation.

'Actually, probably three times your age.' Is the reply.

Saturday, 7 June 2008

Euro pets.

As I sit in the restaurant at the arrivals lounge at Hamburg airport I am vaguely aware of a wet, licking sensation somewhere around my left ankle.


The Jack Russell terrier sniffs my shoe and carries on about it's business, dragging it's well sodden toy ball passed the sandwich counter and back to it's owners who are enjoying a meal at the neighbouring table.


A Giant Schnauzer saunters by with it's owner.


Euro pets go everywhere, restaurants, airports, shops.

We don't take our pets to the airport or the restaurant because we are afraid of germs but we do let them crap all over our streets and in our children's parks.


We don't go in for nudity or porn yet we have the highest rate of teenage pregnancy.


We don't let our kids drink wine yet we binge at the weekends.


Quite simply, the British are repressed and so are their pets.

Our island existence together and two world wars has made us different to our European counterparts. In fact the British don't even consider themselves to be European.

Lord knows how our little lambs will cope on the continent?


Thursday, 5 June 2008

Executioner's tea party.

'I thought we might have a cup of tea first.' Says Mrs Bridger.

Oh how I loathe euthanasia visits.

The pressure to ensure a good clean kill is felt nowhere more than when positioned between the sofa, the dog basket, two neighbours (assembled to offer support/stories of pets gone by) and the mantle piece upon which Grannie's ashes sit.

Invariably poor lighting will make the visualisation of the vein impossible. Hindered yet further by the pet's shrinking circulation as a result of at least four consecutive days of collapse after the owner's sad yet optimistic hope that their pet will be 'gone by morning'.

When 'gone by morning' becomes still not 'gone by Friday' the vet is called.

'Milk?' She asks me. 'I thought we might like Rosie to settle first.'

I've never had tea under these circumstances, I'm usually in and out like an efficient yet compassionate assassin, with just the right mix of 'It was the kindest thing for her' and 'please can you open the boot to my car'.

But I have formed an attachment to Mrs Bridger and Rosie. I know that Mrs Bridger's husband has recently died and that Rosie is the last in a long line of boxers that Mrs Bridger has bred herself. I know that Rosie likes tea and biscuits too.

I sip my tea and Rosie settles down in front of the fireplace after her initial excitement to see me.

Mrs Bridger's assembled friend is listing a long line of Corgis that she has kept over the last thirty years, Rosie is snoring and I am wondering just how much of my tea it is polite to drink before I get on with the task in hand.

Rosie passes peacefully whilst chomping on a chocolate digestive biscuit.

It is hard for me not to get upset. Contrary to popular belief vets cry too sometimes.

I am glad that I made time for Mrs Bridger and Rosie. I only wish I could do it more often.

Wednesday, 4 June 2008

A boneo.....



.....is a vet's best friend.
Poor Ebony has terrible ear disease. They have been flushed under anaesthetic but they require daily cleaning. Ebony is a very reluctant patient. She wears her muzzle and gives me that glare, the one where the whites of her eyes are clearly visible.
Until we come to an understanding.
Ear cleaning = 1 x boneo
Ebony's ears are now perfect.
But she has gained 3 kgs.
No doubt I'll be seeing her for her arthritis shortly.

Tuesday, 27 May 2008

Incognito....


...no more.

Alas my poor broken Ford Focus lies ailing at the garage.

Leaving me with the only alternative means of transport available- the practice van.

A postman pat van with big green crosses and advertising sloguns.

Worse still because my garage is jam packed full of giant rabbit and giant rabbit accessories I am having to park it on the driveway, leaving my neighbours in no doubt as to my profession, place of work, daytime contact numbers and emergency night time contact numbers.

I am waiting for the doorstep consultations to begin.

Maybe I just won't answer the door....

Monday, 26 May 2008

When you lose something you can't replace....

As I enter the back door a desperate scene unfolds.

Three small children under the age of ten huddled in a dog basket in the corner of the room, tears streaming and cries of 'No! You can't take Bessie, you can't!' The oldest girl has her arms wrapped around Bessie's neck and the youngest boy is lying across her back.

Underneath them poor Bessie the Labrador looks tired, very tired in deed.

The children are torn away one by one. Bessie passes peacefully and I warn the parents not to allow the children back into the room for a few moments in case there should be any reflex movement after death. They ignore my advice. The children return and Bessie's body gasps several times.

'She's not dead.' Says the five year old boy. He has the biggest saddest brown eyes I have ever seen.

I say nothing, I am the executioner. The one that took Bessie away. The parents can lay the responsibilty and the torment at my feet.

The children are grief stricken because Bessie was part of their family, she was there every day to be fed, played with or ignored. Bessie was just there. Now Bessie will never be there again and she can never ever be replaced.

But how do we feel when we lose something we never really had in the first place?

I remember being cradled in her lap and comforted whilst watching the small black and white TV, it was a cowboy film. I was two years old and my mother was in hospital giving birth to my brother. My german Grandmother was visiting from Hamburg to look after me. I can feel her pearl necklace against my forehead and the way her bracelets caught the hair on my arms as I slipped them over my tiny wrist.

Whenever I smell clementines in the supermarket I think of her. She used to store them in crates in the cool cellar, I can still hear the knocking sound of her stilletto heels on the hard red wooden staircase. She refused to take them off as she walked down the pricarious steps. She would rather break her neck than be found at the bottom of the staircase without them.

The mirror in the hallway where she put on her make-up and carefully combed her bright red hair. Always red. We never knew what colour really lay beneath the hair dye, now we will never know.

The reality is that our paths rarely crossed. Although I know she loved me, she is gone and I mourn the person I barely got to know.

But slowly I realise there are many things that will remain. The german nursery rhymes that she taught my mother, I somehow know off by heart and instinctively sing to my godchildren. The decorations we hang on the trees at Easter and Christmas. The crooked nose and high cheek bones I see when I look in the mirror. An obsessive admiration for auburn hair. The prohibition of jam sandwiches because jam is for breakfast only.  The way my mother soothes me when I am down, the way my grandmother would soothe me when I was sick or tired. The cold flannels placed around my calves as a child to bring down a fever. The fennel tea. 
The impulse to do what is right, to speak our mind regardless of what others think. Courage.

When we lose a member of our human family it is never the same as losing a pet. To some the sadness may be comparable, to others incomparable.  

But there will always be something however small or insignificant that remains, an imprint that will be passed on to the next generation.  You just need to know where to look and when you find it you must never let it go.

Sunday, 11 May 2008

Broke Back Cats...

It's that time of year again.

The time of year when an inexperienced nurse will phone you and tell you that someone is bringing their cat in as an emergency because she can't walk and is howling but rather mysteriously is still eating and rather bright.

This is the behaviour of a cat in season not a cat with a broken back.

Every spring/summer owners who fail to get their cats neutered will be bewildered by their pet's behaviour. Crying, rolling, crawling on their tummy with their tail to one side is all part of their 'come and get me' behaviour.

This behaviour continues for seven days and is repeated every three weeks until she is pregnant.

Thank God humans are different.

Saturday, 3 May 2008

Standing at the cross roads.

It is hard for female clinicians my age.

No husband, children or prospects of partnership at work.

I am left wondering, where next?

I can't afford to go back to school and become a specialist because I have no-one to support me financially. If I could go back, would I be able to have a family should the opportunity finally arise?

I am afraid of failure too.

I realise after my week with the supervets that their expertise may be greater but underneath it all we are not so different.

The women are not icey they are harassed and stressed because they are running the show.

The vets may have many letters after their names but they often show a touching level of affection towards their patients suggesting they care deeply about what happens to them.

At the end of the day we are all doing the best we can whether we be standing at the crossroads or at our final destination.

Tuesday, 29 April 2008

Supervets

This week I am seeing practice with a group of specialist vets in order to improve my knowledge and clinical skills.

There are supervets and there are superbitches.

It's not the first time I have recieved an icey reception from female clinicians. They just don't like another woman on their patch, certainly not a blonde.

The men are a piece of cake. Maybe that's the problem.

Everyone eats healthily, ricecakes, fruit and whole carrots. I suspect the sort of people that get to their level of expertise are generally pretty obsessive about every aspect of their life. On friday I'll bring in chocolate cake and then we'll see just how strong willed they really are.

There are animals with tubes coming out of every part of their anatomy. Very, very sick animals being kept alive. It's quite depressing.

Today during rounds I found it hard to watch four incredibly bright people with Phds and many many letters after their names discussing the fate of Princess the cat and Nobby the terrier. It just seemed wrong, almost unethical because Princess is just a cat and Nobby is just a dog.

I wondered, had they become doctors just how many lives they would have saved by now.

Wednesday, 23 April 2008

Staff pets.

When the partners are in the pets are out.

But when the partners are out the pets are in.

This evening I had to trip my way over three staff dogs and one extra large fuffy dog bed to get to the reception computer, intercept two from being attacked by dogs in the waiting room and continuously shut the door to the tea room to avoid one from escaping and making his way to the cattery in order to eat his way through its occupants.

They are all without exception rescued which automatically gives them the right to be badly behaved and spoilt.

Worse still, I have to pretend to enjoy their company, even when they jump up at me for the sixth time with their muddy paws or growl when I won't share my food.

Lets get one thing straight now readers, something I've kept from you for a little while now.

I am a cat person.

I am not a dog person.

Dogs smell. I mean it, they really smell.

When you pet a dog. You get dog smell on your hand.

With a patient this is no problem, once the dog has left the room I can wash my hands.

I have to carry staff pet dog smell about with me all day to avoid causing offense to my colleagues.

One day I'm gonna get a dog, a big smelly, badly behaved, domineering, shaggy dog and boy will they suffer.......

Thursday, 17 April 2008

Obsessive compulsive learner.




























It's getting out of hand. I just can't stop.

As the deadline for my small animal internal medicine certficate approaches I have become feverish in my attempt to gain knowledge.

Purchasing books is an obsession.

If only I had time to actually read them.

I find it a comfort knowing they are there, just waiting.....

Tuesday, 15 April 2008

The chime of the bell.

Out at the branch surgery life moves at a slower pace.

We don't have all the mod cons but we offer a friendly service.

When a member of staff has a birthday there will be cake.

There are regular tea breaks, necessitating the bell:




























When the bell chimed six times in a row this morning we ran to attention.

A small child stood poised to ring again.

He was approximately five years old.

'My cat's here, he's having his balls cut off.'

Obnoxious children in the waiting room are the same wherever you are working.

Sunday, 13 April 2008

Community service.

As the nice lady in her sixties with the round glasses, hand knitted cardigan and woollen skirt hands me a cup of tea and a chocolate digestive she smiles and says 'We are definitely not WI you know.'


I am about to give a talk to the local 'wives' club.

I thought there would be four, but actually there are nearer to fourteen and as they stare at me from around the large oak table, I am very nervous.

'I think it is fair to say that veterinary medicine was not my first choice of career.' I begin 'But by the age of five I realised that I had not developed the ability to fly and lift heavy objects and it was therefore very unlikely that I would ever become Wonderwoman.'

During the next hour I try to demonstrate that there is more to a vet than being a vet.
That when I knock on a door in my street for the first time and the occupant who I have never met says 'Oh you're the vet then are you.' I want to say 'No, I'm the person who lives on the corner with a filthy ford focus and an uncut hedge.'

But that is quite clearly not what the wives want to hear. It is not what anyone wants to hear.

I labour on, getting bogged down with many questions about ropes and knots as I recount my first ever calving. I really can't remember the answers to their questions and since my first calving was a foetal monster, or an inside out calf called a 'schistosome' there wasn't much call for ropes.

What I do remember very vividly though is being very frightened at the time, not least because I had to call my male chauvinistic colleagues for help. Six hours later they had to perform a caesarian and realised what I had in the first five minutes, the calf wasn't ever going to come out because something was very wrong with it.

I finish my talk. I give them what they want. The girl that came from a grammar school, fought her way into vet school and came out the other end because she had always wanted to be a vet.

But I don't tell them the other stuff.

From a young age I was forced to give up a part of myself which I have always missed. My love for the english language, history and the arts. Cut short at the age of seventeen when I had to choose to study science.
I did love animals but I didn't love science and I endured it as a means of becoming what I had always wanted to be.
A veterinary science degree is not a challenge it is a vast array of facts, figures and principles which have to be applied and learned but never questioned.

For vets, being a vet takes up a large part of our lives. Members of our community like to define us by our profession but we are much more than a three letter word.

Some of us climb mountains, run marathons, paint, sculpture and travel,

and some of us just write blogs...

Thursday, 10 April 2008

Side effects

Most drugs have them.

Most of them we know about....or at least so I thought.

'I'm just wondering whether there are any side effects to the steroids my dog is on?' Asks Mrs Peters.

'Yes, they can cause an increase in hunger, thirst and urination.' I tell her.

'Oh.' She says. 'My husband's not going to be very happy.'

'Is there a problem?' I ask.

'We've just bought a new fridge.' She says matter of fact.

'But when that one appeared to be mysteriously leaking too, well, we did start to wonder.' She continues.

I think it's only right that I contact the publishers of the veterinary formulary to update their list of side effects for steroids, it should now read:

Excessive hunger, excessive thirst, excessive urination and replacement of white goods.

Wednesday, 9 April 2008

Country Bumpkins.

There is an unspoken prejudice against vets in rural locations.

The first time I became aware of this was when reading some notes belonging to a wealthy client's Labrador. The city vet had referred to us as the dog's 'vets in the countryside' together with the phrase 'may not be able to perform this procedure'.

If only he knew that this 'vets in the countryside' has:

A laboratory to rival most referral centres, including three fully qualified full time lab staff.
Blood gas analysis.
A digital X-ray sytem.
Three ultrasound scanners.
Four flexible endoscopes and two rigid ones.
An MRI
A ligasure machine for surgery and electrocautery.
ECG, blood pressure monitor, capnograph as standard during anaesthesia (well every numpty has that these days)
Seven drip pumps.
Two nurses overnight at the surgery.
Several vets enrolled on or having completed their certificates.

But we also know our limitations. We know when a pet needs to see a specialist.

But here too we are face prejudice.

Twice this year I have struggled to get very sick patients seen by referral centres including two Universities. When I have told them the animal needs seeing urgently they simply do not trust my judgement. 'We can see you in three days.' They tell me.

Today I phoned a referral centre four times begging them to take my patient. I was told each time someone would call me back. My patient died, only then did they take me seriously enough to return my call.

After a similar incident at Christmas, I phoned the Royal Veterinary College asking about the rules on referral centres and their obligation to take urgent cases. Apparently there are none.
They are only required to phone us with advice on case management. Since they consider me a country bumpkin unable to judge when an animal needs seeing urgently my patients have died or been too sick to travel when they have finally agreed on an appointment.

'You can always offer euthanasia.' The nice lady on the help desk at the RVC tells me.

'You try offering euthanasia to an owner whose only companion is a four year old, fully insured dog with a potentially treatable condition.' I told her.

Monday, 7 April 2008

Snow Bunny.

Every vet has one.

A pet they rescued in a moment of madness.

Mine has turned out to be quite an expense:

Cost of rabbit proof fence required to protect garden plants: £50

Cost of replacing the plants rabbit proof fence failed to protect : £100

Annual cost of most expensive low GI Burgen bread required to lure beast back into secure house at night : £50

Cost of replacing drill (wire mysteriously severed) : £40

Housing allowance: Half my garage

Annual hay,carrot and special low fat rabbit food allowance: approx £400


Watching him gamble in the snow: Priceless




Saturday, 5 April 2008

Critical care.

Meg is fitting.

Meg is fitting and I don't know why.

It's 4.30 am and I've been working on all nine kilos of her small whippet lean body for half an hour to keep her alive.

I've managed to work out the following:

1) She has septic shock.
2) An ultrasound shows she has fluid in her abdomen.
3) After wrestling with the fancy slide staining machine and then the microscope that doesn't want to illuminate I've managed to spot some familiar looking cigar shaped objects on the smear from the sample I took from her abdomen. I remember these from vet school.
They are evil bacteria.

Meg is on shock dose fluids, oxygen and intravenous antibiotics and pain killers because she is very very sore.

I'm trying to measure her blood pressure but it is too low to register on the machine. I'm also very worried because her white cell count is very low and her platelets that are important for clotting are also diminished. This means her body is not coping with the shock and the implications for her survival are grave.

Meg has a ruptured pyometra. This means her uterus has been infected with bacteria and now it has burst and the bacteria and the toxins that are now washing about in her abdominal cavity are poisoning her.

But now I can't worry about that because Meg is fitting.

Why is Meg fitting? Is it a bleed in her brain? Is it the toxins?

'Fuck!' I yell to the nurse. 'She needs glucose!'

As the realisation dawns I am sprinting to the cupboard, I blindly grab for the intravenous glucose. I inject it while I wait for the blood sugar reading on the glucometer. Her glucose is 1, this is very low.

The brain is the only organ in the body that can't make sugar and Meg's metabolic rate is very high as a result of the septic shock. Her body has greedily used up all the glucose in her blood and now her brain is running on empty like a stalling car.

I've never seen this happen before and just as I am congratulating myself for remembering in time I realise that Meg is not getting better, she's not the only one whose brain is running on empty. I have grabbed the wrong bag of saline. What a moron, two night duties in a row and the cogs are not as sharp as they should be.

Finally I get the glucose in and she stops twitching and lifts her head.

For the next three hours I do everything I can to keep her going. I just need to get her well enough to have the operation that might save her life.

When I can think of nothing more to do, I lean over her and whisper in her ear 'Don't die Meg, please don't die.' And then when the nurse isn't looking I kiss her silky forehead.

Meg made it to surgery.

She died two hours later.

It's hard.

It's hard because I willed her to live so much I truly believed she wouldn't die.

But I realise one important thing.

I gave Meg a chance.

I must never stop believing in dogs like Meg, because maybe, just maybe next time......

Thursday, 3 April 2008

Real case presentation.

Beth presented to me a week ago, she is a Staffordshire Bull terrier who had been anorexic and depressed for 4 days.



The frown and cute pricked ears are as a result of:
1) Deep concentration.
2) Tetanus toxin.
3) Too much television.
Answer:
Staffies are not known for their intelligence, making 1) very, very unlikely.
2) although rare in dogs, tetanus is the correct answer,
but we can't discount 3) because the owner of the last dog I diagnosed with suspected tetanus phoned me several days later to inform me that he was fairly certain the dog's facial expression had been the result of him sitting too close to the television set after it had been moved next to the dog's bed.
Beth has tetanus because she has a wound on her foot that has become infected with Clostridium tetani, this is releasing a toxin that is affecting the function of her nerves. The correct veterinary terminology for this is:
1) Bad luck
2) Sods law
3) Both because her owner has no money.
Beth's prognosis depends upon:
1) Prompt administration of tetanus antitoxin, penicillin, diazepam and supportive treatment until she can eat again.
2) How well she wags her tail for the nice lady in the accounts department when I bring her to meet Beth because we are never going to get a penny from the owner.
3) How long I can hide her from my boss.
Beth made a good recovery.
Her bill stands at £600.
It turns out my boss is a very nice man.

Tuesday, 1 April 2008

April Fool....

....no-one likes to be one, especially when the veterinary students are in.

Every Easter they descend upon us in droves as part of their educational work experience or 'seeing practice'.

As down trodden seasoned clinicians it is our duty to impart upon them all our knowledge.

They soak it up like little sponges.

If only they new the truth.

Namely, the only reason we like teaching them is because it's a huge ego boost to realise we still know more than they do. Until of course you get a bright, switched on one that knows all the answers, I tend to avoid these like the plague, unless they bake good cakes.

In addition if I don't know the answer to one of my own questions, rather than look stupid I make it up. Usually I find the addition of the word 'itis' to the end of a condition makes it sound genuine failing this a well timed cough over the word that you can't quite remember normally works because most of them are too bored to notice.

I have to admit I've grown pretty sick of hearing my colleagues giving mini master classes on their area of expertise whilst secretly enjoying the sound of their own voices.

It was with great satisfaction therefore that I managed to trick my colleague into believing that she was required to anaesthetise a moose for surgery this morning.

'I hate it when the farm animal vet doesn't warn me in plenty of time for this sort of thing' She started telling the students.

'I wonder if he's going to want to go into theatre.' She continued. 'I wonder how big it is?'

Before her master class could continue one of the students asked.

'Do you get a lot of moose in the UK?'

Finally the penny dropped. Thankfully she believed the joke to be the work of the large animal vet.

'You're good at practical jokes.' She asked me later. 'Have you any idea how I can get him back for this?'

Student lesson number one: Vets may be clever people but even the most intelligent individuals can sometimes be very very stupid, you just have to learn how hide it, so start practicing that cough now....

Friday, 21 March 2008

Unnecessary suffering.

This week has been one of the hardest.

When you are hurting inside there is nowhere for a vet to hide.

No desk to sit behind, no computer screen or client sales.

A new face every ten minutes, a new emotional dilemma, criticism from your boss again, no time to eat, people counting on you to finish operations you barely have time to begin.

In order to stop the meltdown I have developed an emotional shell, life's too short to deal with this sort of crap. When clients make unreasonable demands and ask questions they already know the answer to, I say nothing. When no-one is willing to speak up and defend themselves during a battering from management I step forward.

I am holding it together.

Until by some cruel twist of fate, Molly Watkins is brought into my consulting room. Molly is a fourteen year old cat. She has lost the vision in her left eye and has poor use of her right fore limb and right hind limb. It is very likely that she has a left sided lesion in her brain. Molly is an old cat and I warn the owners that she might have a brain tumour.

Molly gets worse the next day and they decide to have her put to sleep.

Mr Watkins insists that their seven year old son be present whilst I give the injection.

'You've got to learn that things die son.' He tells him.

But soon the young boy is wailing, not because he is upset over the loss of his pet but because his own mother is crying and visibly distressed.

The sound they make is unbearable.

I can count the number of times my mother has cried in front of me on one hand. I remember each and every time, even from when I was a young child because it always breaks my heart. When I think of the number of times she has been my shoulder to cry on for various trivial matters and how painful this must have been for her too it makes me feel ashamed.

This week I have heard that soft but painful sound she tries so hard to keep from me twice.

Her sister has been diagnosed with a brain tumour.


'I don't know how you can do this job.' Mr Watkins says to me.

Ironically, as he watches my eyes fill with tears he looks strangely satisfied to see that perhaps sometimes I can't.

I want to scream at him, 'I don't know how you can call yourself a parent!'

But I say nothing because that is part of doing my job.

Friday, 14 March 2008

Too late.

Charlie is a large un-neutered Tom cat. I have seen him twice for cat bite infections.

Both times I have told his owner, Mrs Withers that neutering might help prevent the fights.

I have also told her that Charlie's life style is more likely to cause him to stray and get hit by a car.

Charlie is also far more likely to contract the feline immunodeficiency virus, FIV or 'cat aids'. The virus is spread amongst cats through bite wounds and it is also sexually transmited.

But Mrs Withers did not take my advice.

Charlie didn't get better from his latest war wounds and I suggested we check that his immune system was not at fault by testing him for cat aids.

Charlie tested positive.

Charlie would have to be neutered and kept in doors to prevent him infecting more cats, eventually he would not get better. Mrs Withers asked me to put Charlie to sleep.

She asked me if she could have ashes back.

Ironic that she would be prepared to pay £100 for Charlie's private cremation, approximately twice the cost of a simple neutering operation that could have saved his life.

Sadly I don't think Charlie will be the only victim here and I hate to think of the number of cats he might have infected during his short life.

When clients tell me they want to allow their female cats to have a litter of kittens, I urge them to think twice before letting the local tom cat near, you just don't know what they might be carrying.

Wednesday, 5 March 2008

Losing my footing.

The recent criticism of how I like to practise has taken it's toll and I have found myself stumbling through my work this week.

I missed a simple diagnosis today whilst another more experienced vet picked it up with ease in the blink of an eye.

If I am asked by a colleague how to manage a case I immediately ask about the clients financial situation rather than conjuring up my usual list of tests. I am more guarded and unwilling to commit to an answer.

I am left wondering whether I was really any good in the first place?

I feel fragile and unsure.

Worse still I am questioning my own judgement.

It won't be long before I'll be handing out the antibiotics like smarties and give up running any diagnostic tests at all.

I used to have a strong instinct that would usually lead me in the right direction with a case but now I just feel empty.

I have lost my way.

I only hope it's not too late to find my way home again.

Tuesday, 4 March 2008

The secret pet.

Tall, taught, athletic, well muscled, aloof and unattainable.

The mens all eight high performance rowing team strut passed. Their closely fitting Lycra emphasising every inch of their perfectly toned torsos and much, much more..

Do they look left at the boat house?

No.

Do they look right at the river?

No.

Do they look down at those beneath them?

No.

I smile, hoping to catch the attention of the biggest of the bunch who I have spoken to on one occasion.

He ignores me. They continue on in silence.

But I am not intimidated.

'How's Timmy the tortoise?' I ask him loudly and pointedly.

There is a delay of approximately ten seconds, they are not the sharpest bunch.

Finally the words sink in.

Then all eight roar with laughter.

Vengeance is sweet.

He really should have thought twice before his drunken confession to LittleVet about his love for his secret pet Timmy, currently hibernating under his staircase.

Sunday, 2 March 2008

He loves me, he loves me not?

My colleague has developed a small crush on one of her clients.

'The only problem is that he is so into his dog that I'm finding it quite a turn off.' She tells me.

'It's like it's his kid or something.' She continues.

I explain to her that the attraction is likely to be mutual.

'How do you know that?' She asks.

'Because he thinks that as a vet you will automatically love his dog too and therefore by showing a keen interest in his dog he will be gaining your affection.'

Having recently dated a man with a dog I speak from experience. We only went on two dates but during that period he asked me to examine his dog four times under fairly false pretences.

'If you like him, you must never let on that when you look at his dog you only see a dog, from now on his dog must be very special dog to you too.'

'I don't like him that much.' She replied. 'If he had a cat then we might have something to work with.'

Saturday, 1 March 2008

Dumbing it down.

I have been told by my employer that an ever increasing number of people are complaining about the cost of my investigations and veterinary care.

Since these so-called complaints have not been written, neither recorded nor recalled I cannot defend myself.

A recent study suggests that if a veterinary surgery is not receiving more that two complaints a week, they are not charging enough.

There are two paths a veterinary surgeon can decide to take throughout their career.

The first is the easy, path of least resistance. Antibiotics or steroids, minimal investigation, pattern recognition and presumptive diagnosis. Minimal effort. This will work in 80 % of cases but 20% of the time a vital diagnosis will be missed and the patient and owner will be let down.

The second is evidence based medicine. This involves a logical, methodical approach and recognition that A+B does not always equal C. It involves more effort and time which comes at a cost and there will be times when the animal just gets better by itself despite a £400 bill. But there are also times when it will save a life.

I have chosen my path and I will stick to it because I believe in providing the best quality care for my patients. I refuse to dumb down. The reason my investigations are more costly than they were four years ago is simply because I am a better clinician than I was four years ago and therefore able to provide a more thorough service. I do not purposely subject animals to procedures that are un-necessary for financial gain. I will carefully assess what is required in each case and ultimately I receive no share of the profit.

If my path is the wrong one then why do many members of staff who know how I like to approach my cases choose to bring their animals to see me?

Despite the hard work I continue to put in and the dedication I have for each and every one of my patients, I have never received a single word of praise from my employer and this recent criticism for which there is no proof is a sad attempt to knock my confidence. A sad attempt because at times it can feel quite threatening for those who have always chosen the path of least resistance to watch others mop up the mess they leave behind. To watch others who are younger and greedy for knowledge pick up a diagnosis they missed. How very English to attempt to stamp out the flame before it burns too brightly rather than nurture and respect it.

Perhaps it's time for me to tread my path elsewhere.

Somewhere I will feel appreciated rather than undervalued and demoralised just when I felt I was reaching the top of my game.

Wednesday, 27 February 2008

Wear and tear.

It's hard to look glamorous for veterinary work.

Enthusiasm for an expensive wardrobe is curbed because you never know when you might get that warm, itchy, stream of dogs piss down your pinstripe trousers whilst carrying an anaesthetised pet back to the kennels. Alternatively there are plenty of opportunities for 'blood spatter' over your expensive suede shoes or cat snot scatter over your designer shirt.

I tend to stick with practical yet bright, non vet high street clothing. You'll never catch me in the James Herriot chequered shirt warn by vets the globe over.

When I splashed out on some expensive, yet practical shoes a year ago I was dismayed to discover within 6 months they had started to fall apart. I continued to wear them believing that the clients never looked at my feet, until yesterday.

'My God, have your shoes been chewed by a dog?' Asked Mrs averagely dressed dog owner.

With that, it was off to town for some replacements.

Wednesday, 20 February 2008

Human touch.

I deliver the sad news to Mrs Matthews.

'I'm very sorry but I think it would be kinder to put Harry to sleep.'

Mrs Matthews understands.

'I'd like to have his ashes back.' She tells me. 'So they can go in with mine.'

It was only after I put the phone down that the gravity of her words hit me.

Mrs Matthews is dying.

The tears well up and I find it hard to compose myself.

I have known Mrs Matthews for several years.

I could not cry for her cat, but I could not stop the tears falling for her.

Finally I understood, the relationship I build with my clients is not a relationship with their pets. While I may be fond of their pets, in a clinical context I will never be able to relate to them in the same way that they do. It is the human relationship that becomes so important, a delicate mix of counciling, empathy and friendship and this is what makes the job worthwhile.

Sunday, 17 February 2008

Mobile disaster zone.

The mobile phone is a vital component of any modern day vet's kit.

I use mine when on call. Recently I have had a hands free system installed which means that if I am driving home, the surgery can contact me.

This nearly always happens when I get to the third roundabout, approximately two minutes from my house.

The dreaded caller identified as 'work' flashes up.

Road rage ensues 'I'm two minutes from home is this REALLY an emergency? because quite frankly I'd like to get something to eat!' I rant at the nurse as I turn the steering wheel hard right. This week, I am instructed a cat with a 'swollen eye' is coming immediately to the surgery for attention. In fact on examining the cat it is impossible to tell which eye is the bad eye and which is the normal. I charge them full price for wasting my time.

The other 90% of the time I use the phone for personal calls.

Yesterday morning before setting off for my weekly rowing session I decided to go mobile 'commando' for a variety of reasons. Firstly on rare occasions 'work' contact me when I am not on duty to ask me stuff they know I can't possibly answer without coming back in, usually of life saving magnitude stuff, which only makes me stressed. Secondly and most importantly I was awaiting a reply to a text message I had sent to a man/date/potential future husband/barer of my children. I knew he wasn't going to reply because I had an inkling he might not want to be my man/date/husband/sperm donor. The disappointment of continually checking for the little envelope signifying a received message and finding none was therefore removed.

I felt liberated and happy.

Until I discovered I was alone and locked into the boat house.

Having changed in the locker room in order to treat myself to a mobile commando shopping spree and thus prolong my new found liberty, I was the last person to leave. But I was not the last person to lock up.

As I rattled the door and nobody came, panic set in when I realised my one link to the outside world was lying on the dining room table at home. I was going to end up like the man who got stuck in the bowling club toilet for two days.

Frantic like a caged animal I made my way to the nearest fire exit and burst free. The alarm sounded and people came running. 'I didn't have my mobile' I explained.

On balance I decided maybe it was best to keep my mobile with me.

This morning I received a call from Michael from the rowing club. The only time he has ever called before now was to ask me out on a date, about two months ago. I declined but we have remained friendly.

'My girlfriend and I are looking for somewhere nice to go for a walk in the West of the county. I thought you might know somewhere?' He asked.

I proceeded to direct him to a nice pub about twenty minutes away.

'Might be a bit far.' He replied.

How ridiculous, anyone living in the East of the county who wants to get to the West would have to travel twenty minutes, unless of course that was not the true motivation for the call.

Thankfully my phone ran out of charge at that point and the line went dead.

Now my only dilemma is whether to charge it up or not?

Friday, 15 February 2008

Soften the blow.

My 6.30 pm appointment was booked in under the description ' Ebony Brown, possible PTS'

PTS in veterinary terms is short for 'Put To Sleep' or in other words 'The end of the road'.

A senior lecturer at my veterinary college once taught us that the use of the word carpet more than once during a consultation was a negative prognostic indicator.

Once the word diarrhoea and carpet had been used in conjunction more than three times during the course of Ebony's visit I knew she was doomed. A further negative prognostic indicator was the term 'Bad Debt' printed in red at the top of the notes and a history that stated 'owner does not want further investigations for chronic diarrhoea'.

It was obvious the family was divided, the teenage son felt she should live but mum and dad felt she should die.

Ebony looked pretty shitty, to pardon the pun.

So I did what I felt was best. I softened the blow.

'It sounds like Ebony's quality of life is deteriorating' I began. 'Perhaps it would be kinder to end her suffering.'

'I knew you were going to say that.' Sighed Mum, as if it was my idea.

The teenage son wailed and even switched off his Ipod.

'The vet says it would be kinder to put her to sleep.' Mum explained.

I hated to see his pain and I wanted to explain that his Mother had put the words into my mouth but I was powerless to do so without causing the family more distress.

The ordeal was worsened by Ebony's reluctance to 'go'.

A large dose of midazolam and ketamine helped soften her blow.

Now, two hours later, after a busy week including the plight of Mr and Mrs Thomas' dog yesterday (life saved thanks to my intervention) a large glass of wine now softens my blow.

I only hope the teenage son is old enough to drink.

Thursday, 14 February 2008

Breaking the bonds.

As a junior vet you get rather used to a client entering your room and pronouncing,

'Oh, I thought I was seeing 'perfect' vet, but you're not 'perfect' vet.'

From then on in you're on to a losing battle because you are not 'perfect vet'.

But more recently I have noticed an increasing demand for the services of 'LittleVet'. Perhaps it is simply because I feed dogs treats when they come to see me and play with their ears, perhaps it is because I am incredibly thorough or perhaps it is because I genuinely care about what happens to their pet.

Sometimes when I am tired after being on call for nights on end or when I am simply stuck out at a branch surgery too far for them to travel to, their loyalty becomes a bind.

Today, Mr and Mrs Thomas insisted on speaking to me on the phone during a very busy consulting period and subsequently bringing their pet to see me at the branch when it should really have gone to the main surgery for emergency treatment. They did so because 'I know their dog'. They then expected me to drop everything and treat their pet when I was booked up to the eyeballs with appointments. I know they were concerned about their pet and just wanted to see someone who knew her but the stress and the pressure I felt was enormous.

I wanted to break the bond, I wanted to send them to one of my colleagues but the truth was that I knew that they were right, I did know their dog and I did know better than anyone what should be done.

But sadly it is impossible for me to be in two places at once and so I handed her reluctantly into the care of one of my colleagues.

I hate to say it but I know exactly how they must feel because I am as anxious as they are.

Sometimes you just have to trust someone else because vets are only human and it's impossible for 'perfect vet' to do everything.