As I grow older, I often realize that my father was right. He said that I should be a pharmacist instead of a vet. Then I balked at the thought of spending my life between 4 walls, never getting my hands dirty. Rural veterinary practice was all I was interested in. I was going to rush about the countryside, saving lives and being eternally appreciated, not to mention well paid.
I worked the past weekend. Saturday morning at least was civilised and the rest of the afternoon was busy, but manageable. We even managed to anaesthetise and examine a raucous sulphur crested cockatoo without anyone being hurt - including the bird. But then the sun set, the moon came out and the madness began. The first caller had a dog with bloat. Now this is a life-threatening condition in dogs where minutes can make a difference. I rushed about to make sure I had everything ready for emergency treatment and surgery, and ensured that the after-hours nurse’s phone number was next to the phone. Then the wait began. The estimated time of arrival was exceeded by nearly 40 minutes.
When the dog finally arrived, it was soon apparent, that although he was seriously ill, this was not an acute stomach torsion. After some careful questioning, the owner’s claim, that his dog was fine until 24 hours ago, when it refused to eat, was replaced by the admission that his wife had noticed that the dog was unwell a month ago. Some emergency! However, the dog was quite sick and with the owner’s help, I managed to carry him to a table and set up a drip. Just when the dog was finally stable and settled and the owner appeased that the dog would not benefit from immediate emergency surgery, the phone rang again. “Doctor, my cat’s stomach just burst open”. It is late. I am not thinking clearly. My tired mind conjures up images of the fireworks at the Strand. I see a cat fired up into the sky, clawing frantically at the night sky. It explodes in a star-burst of red entrails, silhouetting a flying fox against the smoke. I collect myself, suppress a giggle, and ask with measured voice “What exactly happened? Did the skin break open?” “Yes, she was bitten by a dog a month ago, and there was a big lump. Now it has burst and there are guts poking out.” OK, this one does sound like a real emergency. “Bring her in right away!” I set up for surgery again. When the cat arrives, I find that she is called Smoky. There is a fair sized lesion on her belly where necrotic skin has sloughed off and an abscess has opened, but thank goodness, it is only through the skin. Some necrotic tissue and subcutaneous fat protrude from the lesion, but Smoky should survive the night. Her name is placed on Sunday’s lengthening surgery list. Meanwhile she goes onto a drip, pain relief and antibiotic. I clear away the surgical equipment.
The phone rings again. “We bathed our dog today and now her bottom is itchy. I think it is her anal glands”.”OK, you can bring her in, but there is an extra charge after hours”. Silence on the other end of the line, then “Umm, but do you think it is an emergency?” “Well no, it does not sound like one, she may be uncomfortable, but she should live, but you obviously think it is an emergency. Would you like me to see her tonight?” “Oh, no, we’ll see how she goes and call you tomorrow”. Sigh...
Then I went to watch World Cup rugby with the Annandale Afrikaners. The Springbucks played their hearts out and lost. I know the feeling, believe me. I get to bed just after midnight. At 6 am I am roused from a deep sleep by the insistent ringing of the phone. “My little dog is a patient of yours and you vaccinated him 6 weeks ago. Now he is paralysed.” It takes a few seconds before I even register what language is spoken at that time of morning. The innuendo is lost on me. Slowly my brain starts to function.
Is he breathing normally? Yes, but he groans a little.Is he mentally alert? Yes, but he seems a little distressed.
Did he sleep inside last night? Yes, he slept on my bed.
Can he move his legs? Yes, but just a little.
Is he in pain? I don’t know.
I can see him now. Bring him to the surgery, I’ll meet you there.
Oh no, we don’t want to pay extra. We just wanted to know what time you open today.
I am awake now anyway, so get up and make coffee. Later, at the surgery, the dog comes running into the waiting room on all 4 his paralyzed little legs. When I try to take his temperature, he spins around and nearly amputates my fingers. No neurological deficits there. He is obviously not an early riser either.
The day is busy. It takes careful planning to ensure I’ll have enough time to lance Lucky’s abscess, fix the burst cat, X ray the bloated dog and clean Minx’s sore ears with consults coming in as well. By 2 pm everything is on track. Then Susan bursts in though the door. Joan, can you come and help, please? A client who is a wildlife carer has a big trunk on the back of her truck. Inside this Pandora’s box is a hissing goanna. He thrashes his hard, rough, incredibly strong tail from side to side. I stare at him, mesmerised. Lana, the wildlife carer clambers onto the back of the truck in her miniskirt. The next moment she loses control of the situation and the goanna. He half leaps/clambers over me and rushes down the street with his ungainly side to side gait, but he is injured, and not as fast as he might be. Lana, myself and Susan, the vet nurse from Arizona, are in hot pursuit. He makes a stand, raising himself up on his hind feet. As a warning he blows up his throat and pokes out his very long eerily blue incredibly creepy tongue. Compared to this monster, a leguan is a thing of beauty and a joy forever.
The posse has now followed him into an empty lot between the road and a deep dirty ditch. If he goes down there, I’ll be blowed if I’ll follow him into the mud. Time for lateral thinking. When we were little kids, there were many leguans in Cradock. The local; people believed that they sucked your brains out with their forked tongues while you slept. They used to catch them and sell them to witchdoctors for muti (medicine). They would prop open hessian bags and herd them to the opening. The leguans went willingly, probably believing that they have found a safe hiding place. I send Susan to the surgery to look for a suitable bag. She returns with a black plastic body bag. It rattles in the wind and lifts off the ground and bears absolutely no resemblance to a cave whatsoever. The goanna makes a last stand, hissing furiously, showing his creepy blue tongue, snapping at us, and slamming his rasp like muscular tail from side to side with deadly intent. Then Lana goes in for the kill. With the aid of a net, she half grabs him. I have no choice but to help. We subdue him and carry him down the street and into the surgery. Pop him in a cage, says I, we’ll deal with him later. No way, says Lana. I am not letting him go. However, I have a commitment to finish my booked surgeries first. I will give him a tranquiliser in the meantime. If that does not work, Lana will have to hold on. She agrees, looking very dishevelled and determined.
What in the whatsisname do you use to tranquilise a goanna? There are hundreds of books in the office, but I find nothing on anaesthetising goannas. . Finally I find a reference to ketamine. The dose range given is 10 to 100mg per kg. What a range! I do not want to kill him, stressed out as he must be, and opt for 20mg per kg. This has no effect. I add 40 mg per kg. He settles down slightly. I tell Susan to give him isofluorane by mask. In the meantime I have anaesthetised Minx- a beloved 8 year old Border Collie. She is breathing too slowly and her colour is too pale. I ask vet nurse Lachlea to speed up the fluid infusion and turn down the gas. Susan panics. The goanna has stopped breathing. He is lying on his back, looking pretty dead. I roll him onto his belly. His tail flicks dangerously. We change the gas concentration and tell Lana to hold on, but keep him on his belly.
Petra gets some paper towel. She screams. A giant spider just scuttled out of the towel holder. He hides behind the endotracheal tubes, with only his long legs sticking out. The radio on the shelf belts out pop music. It suddenly penetrates my consciousness. Kill it, I scream. They all leap on the spider. No, leave him alone! Kill the radio, before it drives me insane.
I continue cleaning Minx’s ears. She has managed to stay asleep through all the pandemonium.
Finally I can get back to the goanna, who is still wriggling furiously. Iso up to maximum settles him. Lachlea is tasked to make sure that he keeps on breathing. We suture the gashes on his body and inject antibiotic. What do you call a reptile specialist, someone asks. It’s easy, I say - a madman. We put him back in the hot trunk on the hot truck before he is fully awake, urging Lana to get him to a cool , comfortable cage before he cooks.
I still have paperwork to do, and X rays to do and the first of the afternoon consults are already waiting. I phone the bloated dog’s owner about tomorrow’s plans. He has not paid anything yet. I tell him the treatment plan and estimated costs. He explodes. “I always pay your practice. I have 67 dogs, I have been a client for years, why are you talking to me about money? Just fix my dog.” I try to explain that money or not, said dog may not be fixable. I arrange a meeting and second opinion with the boss, whom he claims to know very well, for Monday, to discuss the case before we proceed with surgery. It is called pass the buck. Next I treat a sick cat. The owner waits until I am done, then informs me that she left her wallet at home. I cannot help but wonder if anyone ever does that to a pharmacist.
The last client of the day brings in his dog that swung from a fence by her hind leg and shattered the bone. He has been to another vet and the leg is splinted quite effectively in my opinion. Why is he here? Because the other vet expected payment and he is not happy. I pass the buck again. I only work here. To pay my salary, my boss likes to be paid by people like you, mate. At least we have a credit agreement arrangement to help genuine cases. When, oh when will pet’s health insurance finally take off?
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