I am good at what I do. I have a keen intellect. I know when to trust my intuition and when to listen to what a client says or what they don’t say. I also have a good head for numbers and probabilities. That means that I usually know the chances of things going well or not. Because I am not all knowing or any other form of god-like, I never promise that things will turn out okay or say that they won’t. My word is what I have to give, and that includes never lying. I will give my honest opinion about a case. Sometimes it is great to be wrong.
My week started in the wee hours when I heard Tango vomiting. With all the things that the three labs eat, it is not an uncommon sound at our house. However, there is nothing like an animal vomiting to raise you out of deep sleep. We have an agreement at our house. They vomit in the bathroom, and I continue sleeping.
This time was different. Tango had vomited at least five times during the night. When the alarm went off, I knew he would be getting treatment. What I didn’t know is how bad it was. In the bathroom, there were several large puddles of increasingly bloody vomit and a pile of bloody mucus that looked like jelly. I assumed the jelly was diarrhea but wasn’t positive. Either way, a twenty-inch circle that is an inch deep of bloody stuff is not good. Not fun to clean up, either.
Just like a client’s dog, he got blood work and radiographs, although he had to wait for a break in the appointments. Surprisingly, there was nothing exciting that he had eaten in the stomach on the rads. He would not need surgery today. Blood work revealed significant dehydration. I assumed that he would not leave his IV catheter in place, but he was pretty sick and left it alone for the three days of IV fluids and antibiotics. Just like a client, I assumed that it was really bad and he was going to die.
Beanie and Maddie both had hemorrhagic-gastroenteritis this week. Both were on IV fluids, and both have done well. Neither has done as well as fast as I wanted, but I am not known for my patience. As the old staff told the new staff, I want things done correctly the first time. Period. In this week of major medical, life-threatening cases, both Beanie and Maddie were somewhat routine.
As routine, as they were, Savage was not. He arrived in a heap on the lobby floor. Becky and I both thought that he might die before we got him to treatment. Not time for the gurney, we picked up a portion and between us picked up the 90-pound dog to get him to a treatment sink. For a temperature this high, water should only be put on the brain to cool them down. The feet and groin regions are for heat stress, not a stroke. In people, sometimes they do a cardiac bypass to get the core temp down. The thermometer read 107.6F. This is actually as high as the thermometer will read. Since it took several minutes to get to 105.4F, I suspect it was higher than 107.6. Immediately, I started an IV to assist with the cooling but left my staff to get a second IV in while I spoke with the owners. The prognosis was guarded with a heat stroke.
Although we were able to get his temp quickly under control without overcooling, Savage did not respond. He did not act like he knew anything about any of what was going on. When he did respond, he started seizure-like activity. Pulled out of an exam room, I gave him Valium and watched as he relaxed. Becky and I stayed with him for three hours after closing, but all we saw before we left was a blink. As much as we expected the possibility of him dying immediately, we knew that he would be dead by morning now.
Thumper was as bad off as Savage in a different way. A rescue baby rabbit that came in too sick to even set up. Severe dehydration and electrolyte imbalance almost never lives. The owners wanted to treat him and paid for the wild rabbit that they had gotten attached to. Subcutaneous fluids, medicine, injections and a warm incubator kept him alive until nightly checks, and I was surprised to see an ear twitch when I came back to check on him, but I never dreamed that Thumper would be sitting up looking at me in the morning and eating by himself in the afternoon. It seems Austin was similarly impressed. As dazed and sick as Savage was, Austin was not surprised by that miracle. The rabbit did surprise him. Actually, in a week with several critical cases, everyone except a baby mockingbird did well this week.
When I arrived on Friday morning a few seconds after we opened, I was ready to ‘teach’ and ‘re-teach’ my staff about the importance of letting me know when patients die, even if we expect them to die. But I was wrong. All my expected-to-die patients were doing well! I was extremely happy to be wrong about Tango, Savage, and Thumper. Sometimes it is great to be wrong.