Really, you're suprised?

So I'm working at one of our smaller vet clinics today - myself and one other Doc. This morning, I noticed that she had a patient with an ear hematoma - basically, the pet's ear infection was bad, the dog was shaking her head constantly & broke blood vessels in the ear flap so the space between the skin and the cartilage filled with blood. Its a common thing in dogs, and looks rather funny - as if someone blew the dog's ear up like a balloon! So, if the hematoma is small, we can drain it, give meds for the ear, and it will likely resolve. But, if the blood fills the whole ear flap, it often needs a surgical repair... So Molly's owner had dealt with this once in the past - years ago. The issue was small then, and draining the ear worked - today, however, the entire ear was involved. Despite my colleague's advice (and warning that there was a 95-100% chance the hematoma would not resolve, given its size), Molly's owner decided to take her chances... so, the hematoma was drained, the ear was wrapped securely to the head with a bandage, and an Ecollar ("lampshade") was applied to keep Molly from tearing the bandage off.

Fastforward a few hours... the woman calls back, saying the ear is all filled up with blood again. By this time the other doctor had gone home for the day... so it became my problem. I'm thinking to myself 'HOW did that dog get the Ecollar AND the bandage off?!?' Should've known. Stupidity at work again... Molly's owner says "Well, she couldn't stick her head past the end of that thing, and she hated it - so I trimmed it off to make it quite a bit shorter. That way she could see and it didn't bother her. She still had it on when she got the bandage off. I just don't think those things work well at ALL. Is there something else we can do?"

Really?!? I don't know if I'm surprised more by her comment / action, or by the fact that it surprises me. I really shouldn't be surprised anymore. Common sense is CERTAINLY not common...

So, we scheduled a recheck appointment for tomorrow, to replace the bandage and get a new Ecollar - and told her now we'll need to do surgery next week. Ok she says... "But do I have to pay for the new Ecollar? And can we just take all the money I spent today and deduct it from the cost of the surgery?" Uuummmmm..... NO. We recommended surgery in the first place. YOU decided not to take our advice. YOU cut up the first Ecollar. *sigh* I'm glad the day is almost over.

Veterinarian or Psychologist?

I think they should offer psych classes in veterinary school. Or maybe they should require them! Many, many times I feel that I'm treating the person rather than the animal... The elderly gentleman who comes in 3-4 times a month to pick up meds for his animal when he could get them all in one trip - instead, he says "Well, I don't have anything else to do, so I'll get them one at a time and I can visit with you as well." The woman who thinks she has bugs crawling on her skin, but her MD says she's fine - still she brings all her pets to us to check for the elusive "bugs." And today, the elderly woman who lives a very sad, paranoid life. Her dog is totally normal, but she feels he's being poisoned by relatives & the "meth-heads" down the street. Poor woman is convinced she has been threatened, poisoned, followed, and even had people steal the 'evidence of the poisonings' from her lockbox at the bank. I do my best to visit when I have time, to convince them their pets are bug free, and to appease them that we're looking into the allegations of abuse / poisoning... And yes, its all part of the job that I had been warned about, that I knew to expect... yet I often feel underqualified.
Today, we called the division of aging services... I hope the elderly woman finds the help she needs.

show & tell

Today I thought I'd break out some photos from a case I saw while working in the animal ER...

My patient was a middle aged cat that presented for vomiting of several days duration... he was dehydrated & painful when I pushed around on his abdomen. I suspected I was palpating a foreign object, though it was hard to tell for sure since he resisted my exam. His owner ok'd xrays, and this is what we saw...

Can you spot the foreign object?

Now, a little help for those not familiar with xray anatomy...

And, for the "fun" part... we always like to play Guess-The-Foreign-Body - basically, we see who can come closest to predicting what the foreign object will be... THIS particular xray had us all stumped...

Have you guessed yet?!? Well, here it is...

What is it, you ask? Well, I still don't know! It appeared to be a hoof from a small hooved creature (baby sheep or goat). But none of us could figure out how or why this cat could have gotten hold of such an object... turns out, neither could his owners! Even when we showed the "hoof" to them, they couldn't ID it... never seen it before. If only animals could talk! I'd love to know what this was and where our kitty friend found it! The good news is that our patient recovered well with no post-op complications. :)

Eeeeww.

We get a lot of strange phone calls in the veterinary profession. A couple of examples:

- Can I come by your office and get that allergy injection for my dog? You know, the shot you give him so that I'm not allergic to him anymore? (gee, I wish I had that - I'd be a MILLIONAIRE!!!)

- My dog has been vomiting for 5 days, has been having diarrhea for 4 days, hasn't eaten anything or been able to keep water down for 4 days, and is acting really listless... can I give him something at home so I don't have to bring him in? (oh, and PS - when I finally do come in to see you [10 minutes before the office closes, demanding to be seen because its NOw become an emergency], I will tell you I only have $20 to spend on my beloved pet that is like my child - I have a $200 purse, drive a $40K car, and have obviously had plastic surgery, but your $40 exam fee is simply outrageous and I refuse to pay it - but do everything you can for my sweet dog, I will bring you the money in 7 weeks - I'm good for it, I swear)

Today, however, I heard a new one... and I literally just shook my head, and then didn't know if I should laugh or shudder... so I did both.

- I've been breastfeeding my baby, but I have extra milk. Can I bring my breastmilk in and donate it for the cats and dogs? (ok, so this is strange, and would in no way help the animals [we need species specific milk replacer], but it was a very nice thought - an animal lover with good intentions, no doubt. on the other hand, as our staff began talking, we discovered that sometimes, even good intentions can be taken WAY too far - someone once knew a woman who literally BREASTFED puppies [or was it kittens?] - didn't pump the milk and bottle feed it to them, she literally breastfed them - now that?!? THAT is a little disturbing)

Gross. But part of the job.

I see a lot of disgusting things in my job. Maggots in a pus filled wound. Bloody diarrhea. Anal gland secretions. But today, I was reminded of one of the worst possible sights and smells that comes with my job - a crazy hyper puppy.... so crazy that he vomited the entire contents of his stomach - partially digested food, dewormer, and oh-yeah... partially digested poop. Yep, the puppy at his own poop, and then vomited it up - and then tried to eat it again! The most disturbing / funniest part of the whole thing? Those of us in the room were simply laughing at the whole situation. I love my job! :)