abigail414's diaryland diary ----------------------------------------------------------------------------------------- A 'Real' Veterinarian I stopped writing for a number of reasons, one of which is that most of my writing about work seemed to be about death. In truth, most of my work is about life, just not as dramatic - new life with puppies and kittens, maintaining quality of life with preventative medicine, and run-of-the-mill diseases like sneezing cats and ear infections in dogs and lumps and bumps and things that itch in the night. Occasionally you get an interesting case that requires deeper thought. I first saw Nala, a 10 year old boxer, inbetween my other appointments. She was lying on her side � panting, stiff, and drooling. She had been in the office seeing another doctor earlier that morning, diagnosed with a possible back disease, and treated accordingly. The owners took her home and then she had a seizure � eyes bulging, tongue lolling, urinating type of seizure. I was seeing the post-seizure Nala. She was the classic, �oh god what do I do� kind of case. She looked on death�s door, like a lot of old dogs who can�t walk into the clinic. After the exam, I just stared at her. And decided to give her valium up the butt. Yes, you read that right. Dogs having seizures are hard to hit a vein, or doctors seeing 2 appointments at once have a hard time hitting a vein, and putting liquid valium rectally works really well. I gave her about 70 mg (the entire bottle, which is well over 10x a human dose) and let her wait for 10 minutes while I saw my other appointment. It was the magic bullet. I walked back into the room and there she was, aware, sitting up, no panting or drooling, and wanting to walk. She was still weak, and the owners agreed to take her to the emergency clinic for the night to monitor for future seizures and get her supportive care. She came back the next morning walking well, looking totally normal, and was sent home with anti-seizure medication. Another interesting case was Shady, an 11 year old shepherd mix who had trouble walking, vomited a couple times, and didn�t feel like eating the past week. She also had some pre-existing conditions (Cushings disease, low thyroid). Her face and attitude was a lot like my beloved Lola. The owner agreed to bloodwork, which showed that she had both pancreatitis (inflammation of the pancreas) and diabetes (our insulin is made in the pancreas). Most owners would quit at this point � after all, she is 11 years old, with two diseases already, and pancreatitis is hard enough to treat without the complication of diabetes. The owner was crying in the exam room, but decided to have her treated. Shady was hospitalized, an ultrasound done to rule out pancreatic tumors (bad prognosis, and she didn�t have one), and started on high doses of intravenous (IV) fluids, an IV drip of insulin, plus IV antibiotics, stomach protectants, and anti-nausea medication. After 2 days, she had some interest in food, and on day 4 she went home for good, almost pulling her owners out the door. I joked with the owners that she was their Christmas present this year, and they said that their son was coming home from college, and they really wanted her to be part of their family Christmas. It is at times like this that I feel good about being a veterinarian. Other times I am exhausted, stressed by clients, or bored (like every time I have to explain what heartworm disease is). Plus, I don�t do surgery, (I don�t like it, and they don�t need another surgeon at my clinic), so I don�t have many chances to see an immediate cure. I�m starting to feel experience kicking in. My Lola had seizures and responded to rectal valium, so she helped with Nala. Shady was my fourth pancreatitis/diabetes case, so I�m starting to have a little more confidence in this scary combination of diseases. Of course, I did get sprayed by anal glands today and my last appointment was a feisty kitten who scratched up her owner, but the above two cases made my week all the better. 8:22 a.m. - 2007-12-15 ----------------------------------------------------------------------------------------- |
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