Some Days…

Some days as a vet tech are difficult. You assist in preforming 5 euthanasias in a row, just to go into the next room and it’s a terminal cancer diagnosis with a dog that you have seen since they were a puppy. Some days the patient dies in your arms for no apparent reason. Some days you have more than one hit by car and you can see the suffering on their faces. Some days you cry in your car during lunch, just to make the rest of the day bearable. Some days a client cries on your shoulder as they say goodbye or realize that this is the end of the road. Some days you meet a puppy with parvo, suffering badly, and the owners cannot afford any treatment. Some days break you. Some days take you to the point where you aren’t sure you can take any more.

Then, there are some days that are amazing. You assist with a C-section and a puppy comes to life in your hands. Some days it really is all puppies and kittens. Some days you know you helped that animal. You comforted a client and let them know there was more we could do. Some days, a client gives you a hug and thanks you for your hard work. Some days a dog’s kiss is the best kind of thanks. Some days an animal recovers from a terrible illness or injury. Some days, those parvo puppies find the will and we gave them a way to survive and thrive. Some days are the best days I have ever had.

Being a vet tech is a lot of things. For the most part, we are unseen and in the background. However, it’s the times where we know we made a difference that keep us going. So keep those heads up, techs. Smile, work hard, and enjoy the puppy kisses when you can!

Oh, Basset Hound

Oh, the blight of the Basset Hound. His body is low and his ears drag the ground. Running is rare, but the hound doesn’t care. Give him a comfortable place to sleep, and his owners he will keep.

Rufus was only a few years old and had been adopted about 8 months prior to us seeing him for the first time. He was a handsome baying hound with a long rolling gait and happy demeanor. The owners had just moved to the area and we were preforming his semi-annual exam with preventive care. He was due for his heartworm test and a few vaccines. He had been on one type of heartworm prevention for the first 6 months they had owned him and then they had switched him to a more inclusive prevention that also killed fleas. It turns out the initial prevention he had been on was being recalled for inadequate amounts of the drug that prevented heartworms.  He had tested negative for heartworms when they first adopted him from the rescue 8 months prior. His test that day showed he was positive.

The owners were upset, but not deterred. They offered to pay for his treatment, but we promised them the company with the recalled medication would cover the cost of his treatment. Next came the flurry of tests. We repeated an in-house heartworm test. Again, it was positive. We drew more blood and prepared it to be sent off to an independent laboratory for yet more testing to triple check the diagnosis. We used some of the blood we drew to run an in-house superchem/cbc. Luckily, everything checked out normal. Then, we took chest radiographs. Those, thankfully, showed no obvious changes to his heart.

While the doctor was speaking to the owners, I called the company who had manufactured the ineffective medication and got the list of things the owners needed to provide, plus had them fax the forms we were going to have to fill out. Next, I called the only drug company who was still carrying the medication to kill the heartworms. It had been on back order for so long there was a wait list to get it and only clinics with heartworm positive animals were at the top of the list. Luckily they had some in stock and got the order out to us.

When Rufus returned for his first treatment a few weeks later, he was his drooly, floppy self. We weren’t exceptionally busy, so we got to him first. After placing his iv catheter, we gave him some preemptive pain and anti-inflammatory medications. Next, we administered his deep-muscle injections to rid him of the heartworms. He was patient with us and was fairly well behaved for the first few hours, then the boredom hit. The baying began. And the whining. And the pacing in his cage. By the 3rd hour, one of us was having to sit with him at all times to keep him quiet. You see, once the injections start, the dog must be kept as quiet as possible to keep their heart rate down. If the medication had killed a group of the heartworms and they got pushed out into the veins, they could cause an embolus and kill the dog. It is imperative that he stayed calm and quiet. So, we took shifts sitting on the floor, half in the cage, doting on him. We needed to keep him for the entire day to make sure he didn’t react poorly to the injection, so there was no going home early for him.

When we scheduled his next appointment for a month later, we made sure it was on a quieter day so that we could sit with him again if needed. When he came in for the second treatment, he was keen to the routine. He was suddenly unhappy about the iv catheter and would try to flail when we picked him up to put him on the treatment table. Then he tried to bite when I was placing his catheter. For his, and my, protection, I muzzled him to place the catheter and he quieted right down. We left him muzzled for his pain medications and the heartworm treatment, since that was the most painful part.

Afterwards, we settled him into his cage, which was located in the center of the room, so he wasn’t alone and we could sit with him if needed. His owners had brought one of his beds so he was more comfortable. He would be returning the next day for his final treatment, so we were just going to leave his cage set up for him. He didn’t even let us get an hour after the treatment before he started his protesting. One of the techs sat with him first while I finished up the surgeries we had to do. Then, we rotated to lunch, but we sat with him while we were eating. We had to think of something for the afternoon since our appointment schedule was busy. After tying two leashed together, we were able to attach them to the front of the cage and place his bed out in front of it, so he wasn’t caged at all. This seemed to appease him and he was much quieter that afternoon.

The next morning, I was opening and was waiting for Rufus and his mom to arrive. I thought I had spotted her car, but she hadn’t come in after a few minutes. Before I knew it, in came the owner, carrying 60lb Rufus. He wouldn’t walk in the building. When I saw her, I ran to help her, but she was laughing. She said she had been standing outside, tying to reason with him, but it wasn’t happening.

Treatment that day went the same as the day before, but Rufus wasn’t even happy with the leash and bed situation. Again, one of us was having to sit with him most of the day. We discovered a brush that he thoroughly enjoyed and it would put him to sleep after we used it for a while. That allowed me to get some notes typed and cleaning done in the area. Once he woke, the baying began again and I sat with him while I ate my lunch. He offered to help me eat it, but I declined.

We had some adventures that day trying to get him in and out of the clinic to pee, but we ended up carrying his highness in and out each time. I got to know Rufus well over those two days. He and I became buds and, even though he hated me for poking him with needles, he was a lovey guy.

We saw him again a few months later for injuring his back, oh the blight of the basset hound, and he ended up traveling to a spinal specialist and needing surgery to fix his injury. His owners were beyond patent and only wanted the best for him. Rufus left a lasting impact on me, both because of his houndy personality and by the love his owners showed for him.

Doctors

I realized today that I am doing a terrible job blogging lately and have only posted one story in the last 3 weeks. I apologize and I would say I have been incredibly busy, which I have, but I can usually find 30 minutes to write. Except I have been devoting that writing time to 2 different books and a vet tech series for the online magazine Rider Fitness. So I apologize. I am going to do a better job dividing my writing time.

This post is about the large variety of doctors I have worked with; the great through the ugly. It may get candid and I will be as honest as I can be. Some doctors are absolutely amazing. They appreciate their staff and are always willing to share their knowledge with their staff and clients. Others, well let’s just say I wondered how they got through school and passed their boards. Some are decent diagnosticians and terrible surgeons, while others wish to stay behind the mask and never actually see a client. Some treat staff like they are the “help” while others tell us “thank you” and that they appreciate our hard work. I have had some listen to me when I give my opinion, and others completely ignore it because I am “just a tech”.

I have had to stop doctors from prescribing medications that would have caused harm to a pet if given together. I have known more about what to do in emergency situations and have had to talk a doctor through CPR and the emergency drugs to give. I have had to calm more than one down and tell them to go update an owner while I preformed CPR on the pet. In stark contrast, I have taken direction from fantastic vets in emergencies and have learned proper protocols and techniques to save lives. I have seen a great vet sit on a bench with a client and cry with them, as they told the owner that there was nothing more we could do.

Some veterinarians just prefer to be behind the mask. They love surgery and I commend them for it. Surgery is a difficult aspect of the industry and some are just better and enjoy it more than others. Most vets are required to perform surgery at least a few times a week, regardless if they enjoy it or if they are proficient at it. I have seen more than one surgery fail, meaning a routine spay turns into a disaster post-op and sutures come undone, resulting in the need for sedation and re-suturing. I have seen vets give terrible post-op advice, in which after they left the room, I told the client NOT to do that. I have then seen vets preform miracles. I have assisted with a splenectomy for a very cancerous spleen, in which I held the 6lb spleen of a 20lb dog for fifteen minutes while the doctor ligated it and removed it from the body. She then went in and told the owner we brought the pet more time, but there was no guarantee how much. Others have walked in, spat out medical jargon and left the room. I then would translate what the doctor had told them and answer the dozens of questions the owners had, but the doctor couldn’t be bothered to answer.

On more than one occasion, I checked on a hospitalized pet and reported abnormalities to the doctor. They brushed off my concerns and in almost every case, the pet declined and died within 24 hours. I know how terrible that sounds, but again, at the time, I was working for a doctor who only saw me as “just a tech”. On the opposite note, I have had doctors listen to my concerns or suggestions and take them into serious consideration.

I have been a technician for over 12 years now, and have seen a lot regarding diseases and injuries. I certainly never elevate my opinion or knowledge above the veterinarians, however I feel that it is my duty to double check and speak up when something isn’t correct. Like when a dosage doesn’t seem quite right. Or when medications being prescribed might have negative interactions with each other. Or when a veterinarian is preforming a declaw and I only counted 9 toes as they are bandaging the paws. Or when the bloodwork is not ok for surgery, but the doctor wants to preform one anyway. Or when they are preforming a tooth extraction for over an hour on one tooth, in which the doctor continued to think they were taking out the root, but had started digging into the mandible.

Those are just a few examples. The good ones, however, are there to better the knowledge of the client and of their staff. I had the privilege of working with one doctor who never acted like a question was a bother. Rather, they would take the time to answer and explain until I understood. I have learned more from the doctors I have worked with than from the classes I took in vet tech school. And I mean that. Every word. One of the fantastic things about this field is that it is ever growing and expanding with studies and knowledge. Most of that knowledge is freely given and encouraged. Being able to tell a doctor about a study you read the other day about a new flea/tick prevention being used off label to treat demodex, then seeing them prescribe it to a couple of particularly difficult demodex cases a few weeks later, is a wonderful feeling of pride. The doctor listened and because of that, we were able to help pets.

In the long run, most veterinarians are good. They all have your pets health as their top priority. Some are just better than others, just like human doctors. For the most part, I have enjoyed working the vets I was with and learned which ones would take my questions and comments, and which ones wouldn’t. My one take away for technicians is to never give up learning and asking questions. Being in the moment when you are preforming a procedure, looking at an x-ray or ultrasound, or recording notes for the doctor is the best time to ask the questions! Find out the what, why, and how! The more knowledge we have as techs, the more we can help our patients and educate our clients.

Clients Can Be A Bit Crazy Sometimes

Let me preface this with the knowledge that not all pet owners are crazy, but all crazy people own pets. That was a common saying in multiple practices I have worked in. From people demanding that we do things for free, to those saying we are just in it for the money, finances drive some a little nutty. Or when we are told interesting things that I really didn’t need to know. I called them “exam room confessions”. I am not sure why people feel the need to tell a complete stranger very personal things.

One story that comes to mind was a woman with a 3 year old boxer. She had just moved up from Florida and was sure there was something wrong with her dog. I took a thorough history and tried to keep the owner on topic. She kept trying to tell me personal details about her life. I managed to find out that the dog had been itching a lot since they moved a month ago. I did my mini-exam and saw a few patches of erythema and hair loss. I also managed to find out the dog was not on a flea prevention. I say managed because every question I asked was about a 3 minute answer that has almost nothing to do with the dog. The veterinarian went in and did her exam. She was in the room twice as long as she normally was for a skin problem and I raised my eyebrows at her when she exited the room. She had had the same battle I had experienced. Lots of redirecting. The owner consented to having the areas clipped and cleaned with an antibacterial scrub and take home antibiotics, an oral steriod, and flea prevention. I had no clue what I was in for when I went back in to go over medication. I managed to finish explaining the directions of the medication before she told me that her ex-husband had been stalking her. Not just stalking her, but before she left Florida, he had beaten her and broken her jaw. I didn’t really know what to say. She said she moved to get away from him and bought the dog for protection. I guessed the physical abuse had been a year or so prior, as she was fully healed. She told me all about the restraining order, the medications she had take, the changes she had to make in order to drink her meals, and the moving without his knowing. Then she proceeded to tell me she had been having terrible gastrointestinal upset over the past few days and told me all about the diarrhea she had been having. In exquisite detail. Things that I never need to know. Ever. I did manage to walk her to the front lobby, still telling me about her confinement to the bathroom over the past few days.

A woman with a physical disability had adopted a new kitten and had brought him in for his first exam. He was about 5 months old and the shelter had given him most of his vaccines, but he needed two more visits to complete his kitten series. The exam was routine, and he was a healthy, albeit feisty, adorable ball of fluff. The visit was over and I was wrapping up with my usual asking if there were any other questions when the owner got quiet. She looked down, then straight at me and asked if marijuana smoke would hurt the kitten. I told her that the smoke would have the same negative effects as cigarette smoke, but because the marijuana smoke can still effect the mental state of a being, I wouldn’t recommend smoking it around the kitten. She nodded slowly. She explained that she smoked medical marijuana to help with her pain from her disability, even though it wasn’t legal in our state yet. Then she thought for a moment. She decided to sit in the doorway of her back porch so that most of the smoke went outside. She seemed satisfied with her solution, so I helped her carry the kittens carrier and the paperwork from the visit out to her car. She then gave me a hug and thanked me for the advice. I saw her the other few times she came in for the kittens check ups. He turned into a wonderful companion for her.

This story is weird and uncomfortable for me to tell, so you can’t imagine how uncomfortable I was in the room when it was happening. A couple in their early 20’s had brought in their two dogs for yearly vaccines and preventive care. We had already finished their exams and vaccines and I was just chatting with them about their dogs. Then, they told me that one of their dogs pleasures herself. And not only that, she was teaching the other dog how to do it. I can’t even imagine what my face looked like at that moment. They then went into detail about how they thought this was happening, I will spare you the details, but it honestly just sounded like the dogs were cleaning themselves after using the bathroom. I think I just smiled at them and said “ok” while they explained their theory. I managed to redirect the conversation and escorted them to the lobby to check out.

The final story I will tell was uncomfortable at the time, but makes me giggle now when I remember it. A dog had come in for a routine exam and vaccines, however the owners had noticed a growth on the dog and wanted it checked out. When I was in the room initially gathering the history and doing my mini-exam, I noticed a weird tension in the room. The woman was sitting on the bench and the man was standing in the opposite corner near the door to the lobby. They never spoke to each other, just to me when answering my questions. The doctor came in and did her exam. While she was discussing diagnostic options for the growth, I snuck out and began putting together their estimate in the computer. The doctor came out of the room behind me and spoke quietly to me. She told me they were divorced and although the dog lived with the woman, they had shared custody of the dog. Awkward. So I went in to go over the treatment plan options and when it came down to discussing costs, I felt the tension increase. Then they started arguing about which option to take. I stood there, glancing back and forth, wondering if I should jump in and be a mediator. I decided against it and slid from the room. I stayed close and when the arguing quieted, I went back in. They said they would need to discuss the decision of how to diagnose the mass and would schedule it for a later date. I left the room to finalize their charges and when I went back in, only the woman was there; apparently the man had decided to leave.

Lessons learned? Keep your personal problems to yourself. The veterinary technician doesn’t need to know about your abusive husband, bowel troubles, drug habits, weird conclusions about normal dog behavior, or your marital (or ex-marital) fights. I am not licensed to be a therapist and I certainly don’t get paid enough to listen to the weirdness.

Little Bowser

Bonnie the day after her rescue.                                                                              Bonnie 2 years later.

Working in the veterinary field usually means a person acquires animals. Most or all of them are rescues of some form or another. I am no exception. This is Bonnie’s story.

I was off of work and looking through Facebook one evening when I saw posts from a veterinarian I worked with. From what I could tell by the photos, she had found a stray dog and was going to bring her to work the next day for a medical checkup. My husband and I had been seriously talking about getting another dog, so I figured I would assess her when I got to work the next day.

Her story was much more sorted than just being a stray. The veterinarian lived out in the country, with her house set back off the road. She had been outside when she saw a car slow in front of her property, let a dog out, then it drove quickly away. The dog chased the car up the road and out of sight. The vet got in her car and went to find the dog. She found her, hiding in a barn, about a mile up the road. She was limping and scared. The vet brought her to her house, gave her a dose of deworming medication, applied flea and tick prevention, and set her up in a cage for the night.

I met Little Bowser the next day. The veterinarian enjoyed giving her foster dogs odd names so she didn’t become attached to them, so this dog was no exception. We had a little free time at work, so we gave her a bath and a good check over. She was heartworm negative and we gave her the base vaccines. I inspected her thoroughly. She had a retained baby tooth that would need to be removed at the time of her spay. She also had a rear dew claw, which is not a common attribute in most dogs. That helped us narrow what breeds we thought she was. We guessed she was around 7 months old and possibly an Anatolian Shepherd mix. Her limp was better than the day before, but was still a concern for me. I took some photos of her and sent them to my husband. He told me to bring her home and we could see how she interacted with our other dog.

She was nervous when we brought her home, but our other dog tolerated her well and we decided to keep her after a single night. The next steps were to have her spayed, remove that retained baby tooth, and take off the rear dewclaw. Her surgery went well and while she was still sleepy we took x-rays of the leg she had been limping on. With her relaxed, the vet was able to palpate her knee as well. She had torn a ligament in her knee. The poor girl had been so desperate and confused as to why her previous owners had driven away without her, that she had hurt herself trying to get back to them. That fact broke my heart.

She was small enough that if she continued to improve, we could avoid surgery on her knee, but if she got worse, we would be preforming a cruciate surgery. She fit in well with our family. She had 10x the energy of our older dog, and that took some getting used to, but she had a sweet and loving disposition. My husband and I took turns calling out names to her to see if she responded to any. When I called out Bonnie, she came running. Bonnie it was.

Less than 2 months after we adopted her, her mild limp became much worse and soon she wasn’t bearing weight on the leg. I tried anti-inflammatory medications, but after a week of no improvement, we decided she needed surgery. The procedure itself went well, but recovery after a cruciate surgery is a long process. It didn’t help that Bonnie kept figuring out how to get her knee around her e-collar and lick her incision. The length of the e-collar didn’t seem to matter, so we had to come up with some creative deterrents. Eventually, we found a baggy tee-shirt and the e-collar kept her from licking it. The next challenge was to keep her calm and quiet for a few weeks. She still had the energy f a puppy, but we needed her to give her surgery a chance to heal.

She became a wonderful addition to our family. She ended up needing 2 more surgeries to her knee, with the last removing all the hardware due to a resistant staph infection around the metal crimp. I wonder daily how a person can just dump an animal on the side of the road and drive away. Especially Bonnie. She has become my constant companion, my shadow. I am eternally grateful for the veterinarian who went searching for her and rescued her from an unknown fate.

Molly

Molly’s owners were a wonderful, caring, elderly couple. They loved her dearly, to the point of harm to Molly. You see, Molly was a Yorkie and obese. She should have weighed no more than 5lbs, but she was pushing 9. Almost double her ideal weight. She also had lived to the ripe old age of 14. She was beginning to have a myriad of old dog problems; cataracts, arthritis, and early stage renal failure.

One morning, Molly’s owners called, explaining that Molly was coughing a lot and was acting like she couldn’t catch her breath. We told them to bring her in quickly and they were at the clinic within 30 minutes. When I entered the room, I lifted Molly’s lip and saw her blue tongue and gums. I explained that a doctor would be in to talk to them, but I needed to get Molly into our oxygen cage immediately.

I ran her back and turned the oxygen on as high as it would go, then closed her in. The cage was clear plastic on all sides, so we could monitor her. Then, I found the veterinarian and explained what was going on. She told me to get Molly stable and get the rest of her vitals without exciting or stressing her. Meanwhile, the vet was headed in to talk to the owners.

It turns out that Molly had been having breathing problems for a few days, but her owners just thought it was due to the hot weather. They consented to anything and everything we thought would figure out was going on and to any treatment necessary. It took about 10  minutes, but Molly finally stopped panting. We knew it was going to be tricky to get blood and her vitals, but it needed to be done. Another technician and I moved quickly, multitasking by getting simultaneous vitals. We saved getting the blood for last. Luckily, she didn’t seem stressed and sat still while we collected three different vials of blood. Then, we placed a blanket in the oxygen cage and a small bowl of water. She settled back in to her cage, got a drink, and laid down in the middle of the blanket.

Her bloodwork didn’t look good. Her kidney values were off the charts and she also had elevated liver enzymes. We needed to get radiographs of her, but we knew it would probably stress her, so we had to move fast. I went back and had the machine and computer completely set up, while the other tech brought her into the room. We measured her with the calipers and set the machine for her size. We quickly took the first x-ray with her right side down. Once it processed, we took the second with her on her left side. Again we had to wait for the machine to process the image. The last image required her to be on her back and still, which might stress her and cause her to become cyanotic again. The second the machine was ready, we flipped her over, got her into position under the beam, and pushed the button. By the time the machine beeped, Molly was panting again and the other tech rushed her out of the room and back to her cage before the machine had even processed the image.

The news was bad: congestive heart failure. Her heart was gigantic compared to her tiny chest cavity and was obviously not pumping efficiently. The doctor was concerned that she was also retaining fluid, a combination of kidney and heart problems would cause a build-up of fluid that would also make breathing difficult. We gave her an injection of Lasix and started her on an inodilator and an ACE inhibior for her heart. Treating her was going to be tricky. We needed to start her on IV fluids to flush her kidneys, but we risked adding to the fluid retention caused by the CHE. Monitoring her closely was going to be key. We let her relax for about 30 minutes, then placed an IV catheter in her leg and began running fluids.

The first day was hopeful. Her owners came and visited multiple times, but whenever they did, Molly would get too excited and stressed. We knew it was tough for them to see her like that, but we asked them to view her from afar, without approaching and getting her excited. She seemed to be responding to all the treatment positively and she was able to sleep, something she hadn’t done for a few days due to her respiratory distress. We did her evening treatments and settled her in for the night. She would be monitored by the night assistants and doctor for any changes.

The next morning, I came in and she seemed ok, not as perky as the night before, but still doing ok.  She ate some of the canned renal-specific diet we gave her and took her morning medication. I had her out of the oxygen cage while I was taking her vitals, and she immediately became cyanotic. I quickly finished taking her temperature and placed her back in the cage. When the veterinarian came in for the morning, I let her know that Molly was still unable to be out of the oxygen. We both knew that didn’t bode well.

The morning progressed and got busy. I was taking care of other animals in our treatment area and we had a few surgeries to preform. Molly’s cage was positioned strategically in the middle of the treatment area so we could monitor her while doing other things.

Late morning, I noticed a change. She was laying sternally in the center of the cage, head down, panting. It was the first time she had been panting while being on oxygen without having been taken out of the cage first. However, that wasn’t the most concerning symptom; her eyes were glazed over. I stopped what I was doing and tapped on the outside of the cage. She didn’t move. I opened it and petted her back. She raised her head slightly, but immediately put it back down. I called for the vet. She rushed over and listened to her chest. We made eye contact and I knew, Molly was leaving us. The vet rushed to the phone and called Molly’s owners. They had called that morning and were to be coming in mid-day, but Molly wasn’t going to make it that long.

She told me they were only a few minutes away. I had wrapped Molly in her towel and hugged her to my chest. I gently bounced with her, as you would with a new born baby to quiet them, and hummed gently to her. I wanted her to know I was there and she wasn’t alone.

Death isn’t pretty. It isn’t like it is in the movies. Death is ugly and sometimes takes a few minutes to fully take hold of a being. For Molly, she started to stretch and began agonal breathing- a gasping, reflexive type of breathing. I gently laid her on the treatment table and listened to her chest with my stethoscope. Her heart had stopped. I began chest compressions on her tiny frail chest. From my vantage point, I could see into our parking lot and saw her owner’s car pull in. The doctor took over while I ran outside to get them.

I met them at their car and told them Molly was leaving us. They moved as fast as they could into the clinic and I lead them back into our treatment area where the doctor was listening to Molly’s chest. They were a minute too late. Molly was gone. We brought them into an exam room and wrapped Molly in her blanket so they could spend time with her.

They stayed with her for more than an hour, reminiscing and telling her they loved her. I came and went in between my obligations to other pets. Finally, they were ready. Molly was cold and her bladder and bowels had expressed when her muscles had relaxed after death. Luckily, the blanket had concealed most of it. They had decided to have her cremated and have her ashes returned to them in an urn. I had already filled out the paperwork for the crematorium and prepared the cadaver bag for her. We clipped a tuft of Molly’s hair to place in the sympathy card and I gently placed her in the cadaver bag. I gave her one final pet and told her goodbye, a habit I had gotten into with any pet who I helped over the rainbow bridge. She had been very loved, and I smiled knowing she was out of pain now.

Every pet I have been there with has taken a little piece of my heart. It’s a blessing and a curse to be able to euthanize, but it’s much harder to have them die in your arms, knowing you can’t do any more. To feel their hearts stop beating, their chest stops breathing, their body relaxes as life leaves them. Sometimes it’s tragic. A life taken too soon due to an accident or a sudden illness. Thankfully, most of the ones who I held until the end were in the end stages of life and death was a welcomed friend.

Remember to Floss!

I entered my next room. The chart had said the dog was vomiting, not eating, and feeling depressed. She was a sweet little mutt who came wagging over to me when I closed the door. I went through my usual spiel to gather information on what was going on. How long has it been happening- the past 12 hours. Any diarrhea-no. Has she wanted to eat- she sniffs it, but doesn’t eat it. How many times has she vomited- three times total. What does the vomit look like- yellow bile. Could she have eaten anything out of the ordinary for her- no, we don’t feed her table food. What about foreign objects or garbage- well….. she did chew up a floss container yesterday but I don’t think she ate any.

I stopped writing and looked up at her owner. Are you sure- yes, I was able to put the container back together. I am not concerned about the container as much as the floss. Do you think she ate any of the floss- no I don’t think so.

After her exam, the doctor highly recommended we take x-rays and run some bloodwork. The owner declined, but did allow us to give an injection to stop the vomiting and medications to settle her stomach and stimulate her appetite. The owner worked nights, so she wouldn’t be able to watch her overnight, but would give us an update in the morning.

We called the next morning and left a message to check on the dog. It wasn’t until 5pm that the owner called back. The dog was worse. When the owner brought her in, we got consent to run bloodwork and take x-rays. It was obvious that there was a foreign body in her intestinal tract on the x-rays. We needed to preform a laparotomy immediately. I got consent from the client and started prepping our surgery room. It was after our closing time when we started the surgery.

I was intubating the dog when I saw the floss, embedded under her tongue. It had actually cut into the tissue under the tongue, which would explain why we didn’t see it when she was awake and tense. Now that she was sedated and relaxed, we could see it after lifting her tongue. Once intubated, I started her on the gas anesthesia and we positioned her for surgery.  We clipped and scrubbed her abdomen, then I helped the doctor get into her gown and tied it behind her.

The doctor began the surgery and it was immediately obvious there was a problem. The intestines were all pulled to the top of the abdomen and appeared accordioned. When the doctor tried to move them, they were pretty firmly in that position. We started by cutting the floss under the tongue. From there, she opened the stomach and removed the small clump of floss that was stuck there. After closing the stomach, she started  following the intestines down until she reached something that was protruding almost through the wall. She made the next incision there and pulled out a piece of the plastic floss container, as well as a length of floss. She had to be careful about pulling because the floss could easily cut through the intestine if she pulled too hard.

I headed out to give the owner an update in our waiting room. She was slightly horrified when I told her it was the floss. I went back to continue assisting the doctor and monitoring anesthesia. In all, the surgery took 3 hours and we removed a good amount of floss that had wound its way through a few feet of small intestine. In all, she had made 4 incisions into the intestine,  plus the incision into the stomach. She hadn’t wanted to close until she was sure all the floss had been removed.

I sat with the dog while she woke up, just to make sure she didn’t move around too much. The doctor went out and spoke with the owner about what she had found and the after care that was to be required. We were just glad we had been able to remove it before it was too late and the floss or the plastic had perforated the intestines. After another half an hour, the dog was awake enough to send home. I gently lifted her and carried her out to the owners’ waiting car. She was very grateful and gave me a hug.

It was 10:30pm and none of us that had stayed had eaten since lunch. We decided to head to a restaurant next door. We talked and laughed about the floss and other foreign bodies we had seen. It was another day that I was proud of what we did. I was insistent that we needed to preform diagnostics and the owner finally agreed.Because of that, we saved that dogs life. When your vet or tech is telling you that we need to preform diagnostics, we are doing it for a reason. We have seen the worst case scenario and want to make sure that your pet isn’t suffering with something similar. Believe me, we wish we could just talk to our patients and have them tell us what they did!

Heat Stroke

It was a Friday evening and the clinic was winding down. Then the phone rang. Clients were on their way with their mastiff. They were pretty sure he had bloat. We dropped everything we were doing and started prepping for this surgery. Bloat is the common term for Gastric Dilation Volvulus, which means the stomach has stretched and twisted. It is an emergency and can be quickly fatal if left untreated. Even with surgery, mortality rates can be very high.

The dog entered the building panting and drooling excessively. He was obviously in distress. We rushed him back to our treatment area and the other tech stayed with the clients and to get the history. They had been playing in the back yard on that summer day for a few hours. He had seemed fine, then he had started drooling a lot. He wouldn’t drink any water. The owners knew that bloat was a common problem for his breed, so they called us immediately.

We started doing our prep for surgery while the doctor did his exam. I was taking his temperature and the doctor was looking at his gums. They were bright red. When the thermometer beeped, I looked at it. 105.5!!! I showed the doctor the thermometer and he told me to immediately bring the dog out to our outside runs and start cooling him off with the hose. Heat Stroke. He was not bloating, hopefully. We needed to get his temperature back down to normal before we would consider surgery.

After about 10 minutes of spraying him, he started trying to drink the spray from the hose. I brought him back inside and we toweled him off. I took his temperature again and he was down to 102. Now, we could assess if he had bloat. Taking x-rays shows us if the stomach is in the proper position and if it looks normal. We had already set up our x-ray machine, but he was much larger than we had anticipated and we weren’t sure our machine was strong enough to take an x-ray through him. He was a 150lb dog with a very deep chest. It took all three of us to get him on the table and in position.

Once we took the x-rays, we had to wait for them to develop. It was back in the days where we still used physical films and chemicals to develop the images. The other tech went to develop them while I sat with the dog on the table. We didn’t want to have to move him back and forth if we didn’t need to. It took a few minutes, but one they were developed and dry, the other tech brought them into the room. They were light, but we were able to see the stomach. It was in the appropriate location and appeared normal. On top of that, the dog had stopped panting and was acting normal. He was tired and was just fine to be left laying on the x-ray table, but his gum color was back to normal and the rest of his vitals had stabilized.

We placed a catheter in his leg and began running fluids. His body needed to recover and he needed to be monitored. We called the local emergency clinic and let them know he was on the way for 24 hour observation. We plugged the catheter, and sent the clients to the emergency clinic with the bag of fluids we had been using. He recovered well, thankfully and went home the next day.

What I took away from that experience was how important physical exams are. If we had skipped taking his temperature, we may have put him under anesthesia unnecessarily and risked his life with his temperature being so high. Sometimes, physical symptoms can be the same for very different problems. It never pays to skip steps, even when you are sure of a problem. Between the physical exam and diagnostics, we were able to accurately determine what was really going on. Heat stroke can be just as serious and fatal as bloat if left unchecked and unresolved. Around 106.0, permanent damage can be done to vital organs. The owners were correct in realizing there was something wrong with their dog and bringing him in immediately saved his life.

Girl or Boy?

We were having a typical day of appointments when our receptionist came back and asked if we could take a walk-in. We weren’t overly busy and said it would be fine. Once the new client had filled out all the paperwork, the receptionist walked it back to me. I read through the client’s comments and answers on the form and headed into the room.

There was an adorable tan puppy with black ears waiting to great me. She was an older pup, maybe around 5 months old, but she was a sweetie. The client was new to the area, and had just moved into her house a few months ago. She had been outside gardening when this little sweetie had come running up to her, no collar on. The client had gone door to door around her neighborhood, but no one knew the dog. She had decided to name her Aphrodite.

The first thing I did was scan for a microchip, but she did not have one. I launched into my usual spiel about vaccines and puppy care. The client had mentioned she hadn’t had a puppy in a long time, so I made sure to go into detail about the schedule she would need to be on and preventive care. I told her one of the next steps was to spay her. The client agreed to the treatment plan for that day and I fetched the veterinarian.

I took notes while our doctor did her exam and talked with the client. While palpating her abdomen, our doctor noticed two small lumps near the mid-line. Our vet determined that they may be hernias and should be repaired while we did her spay surgery. Otherwise, she was a perfectly healthy puppy with a mild case of roundworms. We got her some dewormer, gave her the first round of vaccines, and set her up with heartworm prevention. The client also went ahead and scheduled her surgery for a few more weeks.

The next time we saw her, she had grown significantly. Apparently, regular care and a loving home was all she needed to thrive. Her owner showed us that she now knew how to sit and shake hands. She was a very well behaved girl and was starting to look like she was possibly a guardian breed of dog. We got her all checked in for her spay and her mom gave her a kiss on the nose.

We prepped her for her surgery and once she was on the table, anesthetized, and scrubbed, the doctor came in already gloved and gowned to begin. Upside-down on the table, the two hernias looked much larger than when she was standing. Our doctor began her incision along the mid-line and used the spay hook to locate one of the horns of the uterus. One of the other assistants was monitoring anesthesia while I was cleaning instruments from a previous surgery in our prep area. I could hear the doctor and assistant talking, their voices becoming more and more excited. I got curious and peaked around the corner.

It turns out those weren’t hernias at all, but testicles. Aphrodite had female external genitalia, but internally, she was all male. No uterus or ovaries. They were definitely testicles and vas deferens. I stood in the doorway, completely enthralled. Our doctor told us she had never seen a hermaphrodite quite like this one before. The ones she had seen had been half female, half male; one testicle and one ovary. We used the doctors camera to take some photos for her records.

The pup recovered well from her surgery and we called her owner to come get her a few hours later. When the client arrived, we brought her in one of the exam rooms and went over aftercare. Then, our vet went in to talk with her about what she had found. The client was floored! She was more excited than anything and thought she had aptly named her little girl.

The puppy grew into a beautiful adult dog and she stayed as sweet as she had started. Nature does odd things sometimes, but in the end, Aphrodite was very lucky to have found the wonderful home she had happened upon.

Be Careful While Mowing!

It was noon on a Saturday and we were done with appointments for the day. Due to the rotating schedule, it was my turn to answer the phone and take care of any clients who came in to buy products or medicines during the afternoon. The other two techs were putting on their coats when we got the call. A good client of ours was calling us frantic. She had been mowing her field with a tractor and her boarder collie ran in front of her. She said she had put a bandage on the wound, but was on her way.

I ran back and asked the other two techs if they could stay until she arrived to see if we would need more help. They knew this client and her pets well and both agreed to stay. Then, I called the vet, who was in her office on the second floor, and informed her that we had an emergency coming in. She said she would be right down.

The owner had told me the dog had a laceration, so I went back to our surgery room and started to get out a laceration pack and suture. I made up chlorhexidine solution to flush and clean the wound with. Then I made sure we had enough gauze and towels. Little did I know, I was woefully unprepared.

About 10 minutes after she called, the owner rushed in with the dog. We ran them both back to our treatment area. The owner was a nurse, so she had wrapped a bandage around the dogs front left paw. It had been white, but the bandage was soaked through with blood and was now a dark shade of red. Both the dog and owner were covered in dirt and hay clippings. Blood had matted the once white hair around the dogs chest. We could tell the dog was in severe shock and clipped the hair on the other front leg to place a catheter.

The other technician spoke to the owner, calmly asking her what had happened and trying to calm her down. The dogs gums were pale and his eyes were dilated. He was panting heavily and, although he was sitting up, he was unresponsive to our poking and prodding. His temperature was low and we were concerned with the amount of blood he may have lost already. Although we couldn’t see what was under the bandage, we knew is wasn’t going to be pretty.

Once the catheter was placed, we began running fluids at full tilt. We also gave an injectable induction medication and intubated the dog. We hooked him up to our anesthesia machine and began shaving his leg above the bandage. Our vet had come out of her office and was talking to his owner while we were prepping the dog. The doctor walked her to our waiting area until we were finished.

The vet returned to the surgery room and placed a tourniquet around the bandaged leg, positioned it in the bend of the elbow, and pulled it tight. She grabbed the bandage scissors out of our cold-sterile pack and started cutting the bandage. What we hadn’t realized, is the bandage was pretty much holding the dogs foot onto his leg. The vet carefully pealed the bandage off from around the foot. There was a 3 inch piece of skin, a few tendons, and a thin layer of muscle holding the outside of the paw onto his leg. The four of us stood for a few minutes, staring at the extent of the wound. Bits of dirt, rock, and grass were everywhere and the doctor told us to get to work cleaning as much out as we could. She went to scrub for surgery. One technician monitored the dog under anesthesia, while myself and the third tech began delicately picking grass and dirt from the tissue. We used the chlorhex solution I had prepared and a large syringe to flush the area over and over to wash out as much as we could. Even with the tourniquet on, he was bleeding at a decent rate. The vet had to get in there and close this wound.

She called for one of us and I ran out of the room to tie her sterile gown while she gloved up. She immediately got to work and we stood at the ready to get anything she needed. Hours into the surgery, she finally was making progress. We could see that the muscle was coming together and she had been able to reattach some of the larger blood vessels. There was a chance that she had saved the paw. I went out of the room and updated the owner. She looked exhausted and I offered her some water, which she accepted thankfully.

Four hours after we began, the doctor placed her last stitch and pulled off her gloves. We turned off the anesthesia and began to recover the dog. We placed the warmer blanket over him to keep him from becoming hypothermic in the recovery cage. The three of us started cleaning the surgery room and instruments while the doctor spoke to the owner. She lead her back to the recovery cage and the owner sat with the dog while he woke up. We had given him injections for pain, swelling, and an antibiotic while he had been under. One of technicians filled the medication prescriptions the dog would need for recovery.

Within 30 minutes of finishing the surgery, the dog was awake and the owner was carrying him out to her car. We trusted her to be able to care for him and our vet handed the owner a card with her personal cellphone number on it in case she needed anything. It was the beginning of a long road for the dog, but with a diligent owner who took him for physical therapy, he regained almost full function of the paw. It had been a miracle that we had been able to reattach his paw.

Everyone left after the owner had, but I still had an hour of work left. I finished cleaning up the surgery room and prepped the surgery packs we had used for sterilization. It was then that I looked down at myself. I had blood up to my elbows and down the front of my scrub top. The blood on my arms had dried and I ended having to scrub them with a bristle brush to get it off. We hadn’t had time to glove up when we were cleaning the wound and we had been so busy that I hadn’t realized how bloody I had gotten. I made the horrifying realization that I had walked out to update the owner looking like this. At least she distracted by the good news I had given her.

In one case, I had learned how amazing veterinarians could be. Our doctor  reattached the dogs paw, then just went on like a normal day. I also learned to assess my appearance before going to speak to a client and to always know where my pets are when they are outside with me.