I Have A Curse

Maybe it's "beginner's luck," but my cases all turn into wacky, that-never-happens, no-one-has-seen-anything-like-it sagas. I'm not complaining, but it's uncanny. I've had to research things that the other vets have hardly seen a handful of times in thirty years of practice. I've had straightforward cases develop bizarre crazyland complications. Last year, my boss told me I'd seen more weird stuff in two months than he'd seen in two years.

Here's a selection of the weird and wonderfuls I've seen...

• Great Dane with Lyme disease who came back a week later with a severe immune-mediated vasculitis (his leg was a water balloon).
• The same week, a cat came in for a recent "swollen foot." Sounds like a cat bite abscess, right? Nope. Huge elbow mass full of joint fluid. Maybe a synovial sarcoma?
• Also that week, a young cat brought in because he was having trouble breathing. Turns out he had acute anuric renal failure, for absolutely no reason we could figure out, and didn't respond to treatment. Died that day, nothing to do with the breathing.
• My first month in practice I encountered a dog with megaoesophagus, which is a rare condition.
• My first month, I also prescribed routine ear drops for an ear infection--a situation that happens on an almost daily basis. But this dog went death in both ears immediately after starting the drops. The owners were so mad at me I could barely talk to them. Has never happened before in this practice with any ear medication for any of the other vets.
• My boss saw a cat for a cat bite abscess and I ended up with the recheck the next week on his day off. He assured me it would be routine. Turned out to be in massive acute liver failure and spent the day on oxygen support because it could barely breathe.
• My first blocked bladder cat was a female with five struvite stones at least the size of your thumbnail. My boss has never seen as many large stones in a cat in his whole career.
• I saw a cat with nice owners a few times for small issues, then he came in a month later, on death's door, with a stomach full of blood. He was an indoor, only cat with no medications and no access to anything unsavory that we knew of.
• I had an ongoing saga with a cat that wouldn't really eat for weeks to months for no discernable reason. The owner is a little batty, and wouldn't let us do the full nine yards with regard to treatment, but still cicled around with this cat for ages. Weekly rechecks, repeat blood work and imaging, no response to any medication--and we must have tried the whole pharmacy.

I'm sure many more are on the horizon. They especially like coming in when I'm by myself, like Saturdays or in the evening on my late day. There have been a lot of panic texts to my boss these past six months.

First Bird In-Patient - Patched Up A Macaw

Our first injured bird came in, and it went well! There is a nearby bird rescue, and one of their Military Macaws got attacked by his cage mate. He was missing a piece of his eyelid and all the feathers over his tail, plus had some various cuts and bruises. He was quite gentle to work with, however, and I daringly admitted him to the hospital. Our first avian admit!

I'm not great at wound management in general, even in dogs and cats. I tend to fumble through, with lots of direction from the other vets. For some reason I have a difficult time understanding the concepts, even though wound healing was drilled into me in vet school. Something about making the connection between lecture material and physically working with a wound right the hell in front of me has a hard time inside my brain. So, naturally, our first "sick bird" was a wound. But hey, could have been way worse!

I've read plenty about intranasal sedation, but when I was on Wildbase, I never saw it done. So I cruised VIN, checked my Avian textbooks, picked a dose, and went for it. Boom, midazolam and butorphanol right in the nostrils. No one else had seen it done before, either, so then we stood around with the lights dimmed waiting to see what happened. After about five minutes, we had a pretty snoozy parrot! The other vets were impressed.

I flushed out his wounds, applied some silver sulfadiazine and some Tegaderm, and that was pretty much it. It turned out I couldn't do much with the eyelid, though I wasn't sure until we sedated him (and the owner didn't care about cosmetics). Sent him home on antibiotics and meloxicam, and he's doing great.

Here's his good side.

You Have A Cold? Time For GDV Dog To Come In When You're By Yourself.

Yesterday, when I left the house, I felt normal. By the time I got to work, I had one of those, "Oh, the air is a bit dry" sore throats. Then I proceeded to get sicker by the hour. Since I hadn't been sick in the morning, I wasn't prepared. At home I have a cornucopia of cold and flu remedies, but at work all I had was tea. Lots and lots of tea.

It figures this would happen on my late day, when the clinic closes at 8pm. Things went pretty well, considering. Most of my exams were new pets adopted from the shelter, getting their free exam. I speyed a shelter cat. Dental on a dog that didn't need any extractions. For the evening appointments, one showed up super early, one was just a booster with no exam, and we knocked it out of the park.

Yay, maybe I can get home somewhat early and then take some NyQuil and pass out!

Ten minutes to seven, phone call. Young dog that has been severely vomiting all day. May have eaten sewing fabric or needles. Hmm, doesn't really sound like something that I want to wait overnight.

I knew it was going to be a long haul as soon as they arrived, because this dog was a big labby thing that was going crazy. All over the place, jumping, panting, anxious, wouldn't sit still. There were only three of us in the whole clinic, and one of the technicians is recovering from broken ribs so can't handle any animals. So it was two tiny young women against big anxious dog. When we finally managed to get an xray... Oh shit, that looks like GDV.

I decided to call the emergency clinic to see what they recommended. I had the brilliant plan to email them the xrays. Turns out none of us knew how to actually log in to the email account.

Long story short, it wasn't actually GDV, gave it some meds, and the dog got better overnight. They canceled their recheck appointment today, along with the other... three or so appointments I had. So after the handful of morning appointments, everyone kind of shuffled me out the door to go home and rest.

My First Day On The Job Involved A Proptosed Eye

One of the reasons I took the job that I did was that they were interested in hiring a new grad, and willing to give me training wheels for my transition from vet student to actual vet. For my first month, I was never alone in the clinic, so no evenings or weekends, and I was paired with the most experienced senior vet techs. My appointments were all scheduled for 30 minutes instead of twenty, and I was given extra "block off" time for work-ins. My first few days, I didn't have any scheduled appointments at all. I was meant to observe, familiarise myself with where everything is, and maybe jump in on work-ins or walk-ins.

As life would have it, there was a work-in at 8am that first Monday. A dog that had gotten into a fight with its larger friend, and may have gotten a laceration above one eye. "Redness" above the eye, they said. Perfect first case for the new grad, they said.

So in I go and as soon as I lay eyes on the dog, I know exactly what happened, and that I have no idea what to do about it. It wasn't a laceration. It was a proptosed eye.

Small, buggy-eyed dogs like pugs and shih-tzus already have their eyes halfway out of their heads. Therefore, it's pretty easy to pop them the rest of the way out. A solid squeeze or bang on the head could do it. If you catch them straightaway, you can push them right back in. Naturally, this happened the previous afternoon, so the eye had been bulging out exposed to the world for more than 12 hours.

In typical new grad fashion, I gave an excuse to bring the dog out back ("have a look at it under the bright lamp in treatment"), found my boss, and promptly went, "What do I do, what do I do!"

Long story short, we admitted her to the hospital for mini surgery to put the eye back in and suture the eyelids together to hold it. All went well, and I saw her every week for a month or two. The eye retained some function to it and time will tell what happens to it in the long run.

It turns out this was a prelude to the theme of my career. Nothing normal happens to me. It's only the wacky, you-don't-see-that-every-day cases, time and time again.