I left home just after six tonight for an evening shift at the emergency clinic. I arrived to a single van in the parking lot. The treatment area was quiet. My coworkers were all reading, some worthwhile materials like a veterinary anesthesia text, others more mindless materials, like US Weekly. Walking in the lounge area was Porter, Dr. W.'s dog, who got reprieve from the chilly weather on his "mat" (a blanket) inside. Porter usually does come to work with Dr. W to work, but this is the first time I've seen him inside. Seeing as it was quiet, I slid down the wall, sat cross-legged on the floor, and opened the paperback that I shoved in my hoodie pocket before I got out of the Jeep. I'm still making my way through The Secret History by Donna Tartt.
For the first three hours or so of my shift, it continued to be quiet. Every once in a while, Dr. W would start up a conversation, but they all seemed to quickly end. Politics, vet school, the drunk guy that was found in the ditch outside the hospital earlier in the week, bad toasters, and my previous weekend were all topics of conversation for a few minutes at a time. When my left leg fell asleep, I decided it was time to stretch, and see if my energy drink from last week was still in the refrigerator, or if it had found its way into someone else's hands.
Around 10:30, I jumped up at the chance to do a "work-up." It was better than reading about J. Lo's plans to have a baby soon or Britney's desire to be called by her new married name. Begrudgingly, I slipped off my hoodie, so that I looked a bit more professional, and grabbed my stethoscope off the counter. I was instantly cold! Dr. W seems to operate at a lower set point than most humans. "Dutchess," a 92 pound black lab, had trouble walking in to the exam room. She seemed weak, and as if taking another step was going to be just too painful to bear. Except for her respiration rate, all of her vitals were within normal limits. Apparently, she was quiet in the morning, but in the afternoon, she could hardly move to even go outside. She hadn't been eating, and in general, was not the "happy lab" of usual.
After Dr. B went in to examine the dog, she came out with orders for radiographs of a very tender abdomen. Another tech and I went in the radiology area, and snapped the pictures. What they revealed was a very fluid-filled abdomen. With the dog lying quietly on the table in radiology, Dr. B decided that the first thing we needed to know was what the fluid was inside of her abdomen. With a needle and syringe, she pulled out some blood from the abdomen. Not good! After a few seconds of thought, she decided to try again, with a new needle and syringe. In the off chance that she had hit a random blood vessel in the abdomen, she wanted to confirm her findings. With the second stick, there was more blood and confirmation that the cloudiness on the radiographs was a blood-filled abdomen. Now, the next question is, where was the blood coming from?
The doctor ordered blood work, which revealed the expected low hematocrit. The liver values were also off the chart. While there could be several things going on, perhaps a primary liver tumor with other secondary problems, it was apparent that whatever was wrong with this dog was not going to be something that we could "treat and street," i.e. fix.
In this case, the best option for "Dutchess" might have been humane euthanasia, especially if this was a primary tumor. However, the problem lies in the fact that the owner was in Las Vegas. The pet-sitter and the owner's adult son were trying to piece together the history a little more for us. Somehow it was brought to our attention that the dog had recently spent ten days in the hospital for another problem (unknown) and might or might not have already had surgery for something. That's about as clear as mud!
Repeated phone calls to the owner were fruitless. So while the owner was in Vegas having a good time, betting away at the blackjack tables or whatnot, their dog was dying in the emergency clinic. The pet-sitter nor the adult son felt able to make the decision as to whether or not to euthanize the patient. Instead, we ended up moving the dog to the back kennel area to wait for some kind of contact from the owner. As carefully as we could, we lifted her down from the gurney. She yelped in pain, and turned her head to bite, but was tightly muzzled to prevent just that. Instead of just one blanket, we gave her three, for both warmth and comfort. Even though she was in pain, she really was a very nice dog. It was sad to think that her owner would likely not get to say goodbye. As quickly as she was hemorrhaging into her abdomen, I doubt that if she's not euthanized that she will make it through the night.
What's the lesson to take away from this? It's actually quite simple. If you're traveling out of town, and have decided to use a pet-sitter, be confident with that person's ability to make decisions in your abscence, and authorize them to do so. Do not just say "sure, take my pet to the vet." Write it down. Make sure the pet-sitter knows what vet(s) you prefer, if your vet isn't available should the sitter take the pet to an emergency clinic, how much money should the sitter spend, and if possible, leave a credit card number for that purpose on file with the local veterinarian. If you want the pet-sitter to be able to make a decision for euthanasia, make sure you write that down too!! Provide your pet-sitter with a detailed history of the pet's recent medical issues, if there are any. Make sure that you are clear about giving the pet any medications. You'll sleep much better in Vegas, Sydney, NYC, or wherever you may be on your vacation if you know for sure that your pet is in good hands. Unfortunately, in this situation, it's obvious the owner was not betting on his or her dog to become so ill; and what's even worse is that perhaps while he/she is enjoying the casino scene in Vegas, "Dutchess" is hanging on to life on the floor of the emergency clinic.
Otherwise, the night was relatively uneventful. There were two hit-by-car patients, both which ended up going out of the clinic in black bags. I left an hour early, and drove home with the O.C. Supertones blasting through my speakers to stay awake. Surpisingly, once I got home, though, I was quite awake. Funny how that works...
J. Lo is having a baby soon? Who woulda thunk!
Posted by: Pauly D | October 19, 2004 at 12:09 PM