Sunday, 21 September 2014

How do we do what we do?

People ask me this all the time: I do what I do simply because I. Love. Animals.... so very much - and also their animal loving families with hearts of gold - which is why my colleagues and I want to help them all have time to say goodbye at home. With loads of love & dignity - the gift of peace I call it!  Nothing less... Just love! 

Tuesday, 2 September 2014

Life in the fast lane...and having a very big fit!

The fast lane... hmmm... Well yes, I am always in it - but reality for an on-call mobile vet is it's never as fast in the 70 MPH lane as I would like - or more often - need. As a trained emergency, out-of-hours vet operating this far more urgent home service, alongside my main service of looking after geriatric and end-of-life home pets, a Batmobile - or just a small helicopter - is definitely on my Christmas list... every year!

Very much to my own - and many an anxious pet owner's - disappointment I do not have the flashing blue lights that I'd really like at times and especially frustrating is it to have to disappoint desperately upset pet owners, as I am not included in the government-funded ambulance service programme (aka NHS Paramedics) with a response time of less than 8 minutes!
I am a mere mortal driver in a small white Range Rover (as someone told me - probably a sales rep from Land Rover!? - that this is the car brand a "proper country vet" should be driving- so ok I aim to please!) and very sadly I have to follow normal traffic regulations like anyone else.
On the up side though - I do enjoy now also being an Out-Of-Hours mobile vet as juggling traffic is much more fun and far less challenging when the road is fairly empty - if it wasn't for those sneaky little annoying yellow boxes that do not care what time of day it is or just how devoid the road is of anything human, when it's 3am and I have a poor animal in need...

Alex, my practice manager, the car and I with Benji,10  (a lucky stay at home patient)

Now as a "novice blogger" I hope you bear with me as with this - my first blog - I want to share some of my most challenging, interesting = least menial, special, different and hopefully thought provoking experiences from "the road" - hopefully on a regular basis - as material and opportunity presents itself! I will try not to blog while I am driving - promise.
But it would be wonderful if you, my reader, if you enjoy reading my posts you would be so kind and give me your feedback so perhaps I can improve the writing as I mature with mastering this beast of a blog - throw me a grumpy, territorial Rottweiler (actually some Mastiffs are far worse) any day instead of this blog and I will feel far more at home... but I hope my blogging skills will develop at the same life-saving rate that my mastering of the grumpy Mastiffs did - I will show you my scars later...!

Anyhow - let's dive in....this week on Saturday 8.15 am, a lovely autumnal English morning, I receive a call from a local veterinary practice - they have a very upset client without a vehicle (being serviced at the garage) with a fitting dog on their other line but they are sadly unable to attend as their Saturday vet has a full diary-meaning soon a waiting room full of animals - so could I maybe pleeeaaase go see this poor dog asap! But of course I can... we are here to help practices out, so I get dressed, forget to check the mirror (as usual) and leave home almost on two screeching tyres to arrive less than 15 minutes later at this poor client's house - in the small pittoresque typical English village next to mine.

The house is a nice modern flint, semi-detached house of the typical English countryside type. The lady, Mrs.Jenkins, is standing in the front door, in her PJs and with a very upset and clearly tear-stained face having woken up to her only 3 year old rescued Border Collie mixed breed dog, lying on his side on the floor jerking away with all legs all over the place, passing urine (and worse) while making guttural, horrific noises - one of every pet owners worst nightmares and a very scary way indeed to be woken up on a sunny Saturday morning I should think. This is the first time the dog - and the owners - have ever experienced anything like this.

The poor dog, named Skye, had been fitting (Grand Mal seizuring to be more medically precise) for almost an hour non-stop which is a very dangerous condition due to the risk of suffocating and suffering other vital organ repercussions and he would need immediate help and medical treatment to stop the fitting.
While I am talking to the owners, asking questions, I prepare and draw up the necessary emergency treatment - intravenous valium - but attempting to shave the dog's leg to remove the fur to be able to see the vein is proving quite the task as the legs are all over the place, moving jerkily in the air.
With the help of Mr Jenkins, I manage to hold one leg still just long enough to slowly give the first dose of valium I/V and strap the syringe to the leg with plaster - and immediately the effect is evident - PHEW - in a matter of seconds a long awaited peace finds and fills the poor dog - and not least his "parents" are sighing with relief as it is obvious Skye is now relaxing and breathing more normal without the accompanying horrific sounds. 
Within a few minutes he is contactable, aware of his surroundings and his owners cannot believe their luck. Again their eyes seem a bit moist - but this time only from profound relief. I quickly check Skye's "vital signs" such as his gum colour, heart rate and other such indicators - but I leave the syringe with the next valium dose strapped in...

So next we need to talk - Mr & Mrs Jenkins and I - about Skye's situation and options - this while waiting to see if he will start seizuring again which is fairly likely. Most dogs, if not all dogs, would normally be adviced to go to hospital to control this serious state we call "Status Epilepticus" - a state of fitting without stopping when left without medical intervention.
But this dog was a rescued, very nervous large dog who the elderly owners could not possibly carry out of the house in a state of severe fitting, even if they did have a car available - a mobile at home vet was definitely needed and their only option - at first.
Before, when I was working in normal brick and mortar small animal practice and never left my practice and with the benefit of having nursing staff, I was like everyone else there of the opinion - even most of my seasoned vet colleagues - to tell clients to "just pop" their pet into the car and come to the clinic - how hard can it be!! Really...really really hard actually... After nine years on the road away from the safety and comfort of a clinic with staff at hand and seeing the sticky situations in "real life" outside of practice and not least the effect after on animals that get to stay at home under illness and duress (please note only for eligible cases and not possible for every emergency) - I really know now the reality for pet owners is far more complex than these vets in practice think - I used to be one of them!
I will come back to this in my blog time and time again I am sure, if the past 9 years are anything to go by...

Back to the fitting dog - well actually still not fitting now -  the relieved owners are very much up for trying to treat his problem, if it can be managed with medication to stop him having fits in future, they defintely want to give this young dog the chance. We discuss the potential reasons and the options and not least the plan for Skye over the next hours and over the weekend until he can return to his own vets for a full check up and to perhaps start a permanent control program of medication, which he may have to stay on for a very long time and maybe even for life, depending on how his situation and his health develops in the very near future. 
This long-term outlook, is however not my main worry as an out-of-hours (evening/weekend) emergency mobile vet - my biggest challenge right now is to get him through the next 24-48 hours without any more seizures and getting his medication spot on - to not drug him up so he is completely off his head - and legs - but enough to stop him having fits so he can stay away from the 24-HOUR hospital as the owners so badly want to avoid given his nervous temperament. I then give him a quick intramuscular injection to keep him on track until he can start having medication with his food in a few hours.

I leave after 1 1/2 hour having left the now very relieved owners with a lovely although slightly weary and groggy boy who despite his ordeal, is almost back to himself and wagging his fluffy tail just a little bit again. I leave them with a stash of medication to last till the morning appointment at their regular vets on Monday - even if it means the poor elderly couple have to take turns getting up in the night to give Skye his tablets.

I slowly drive back looking forward to some well-earned breakfast (or lunch by now) with the family....and perhaps I should check the mirror for the first time today!

Mrs Jenkins calls me the next day - Sunday morning - and I can hear a big smile on her lips when she happily relays to me that Skye has not had a fit since yesterday morning when I came out and is eating and taking his meds fine - well in cheese, the ancient trick of the trade - so far so good....

Monday morning and Skye is now well back under the care of his usual vets who after some tests, will design a control program to keep him seizure free - hopefully giving him a long lovely life with his loving "adoptive pet parents".

A very happy end indeed - and one last time - I remind myself once again that no matter the urgency of a call to never leave the house without checking the mirror...

Happy again!