Emergency Situations

For my one and only off-campus rotation of the year, I got an externship at an animal hospital in the southwestern Chicago suburbs. It is a shelter based rotation, but the rescue itself operates out of an animal hospital. I've gotten quite a bit of spay/neuter experience (about 23 surgeries so far with two days left to go - my goal is to hit 30 total) as well as experience dealing with shelter illnesses - upper respiratory infections and intestinal parasites mainly.

What I want to share is what went on yesterday. First of all, I got the opportunity to assist with a TECABO (total ear canal ablation with bulla osteotomy) surgery. I chatted with the head practice partner about swimming, school, practice ownership, etc. It was a two and a half hour long procedure with about an hour of prep time, so we had ample opportunity to talk! Afterwards, I grabbed a quick lunch (it was 3:30 pm by the time we were done) and got my first surgery premedded. In the meantime, a hefty english bulldog had been brought into the hospital in respiratory distress. Apparently the owner had seen the dog breathing heavily early that morning. She went to work and returned to find her dog having a lot of trouble breathing, so she brought him into the nearest clinic (not her regular vet). He was immediately put on flow-by oxygen which helped his color tremendously. His temp was 103 when he was brought in and he was placed in the oxygen cage to relax. Unfortunately, his temp skyrocketed to 106 in a short amount of time and he was returned to the dental table for a cold bath, where his temp came down to 101. He started improving and began wanting to jump off the table. He was placed in a cage to see how he would do on room air, and at this point, I had just premedded my patient.

Three minutes later, he collapsed and stopped breathing. An ET tube was placed, he was re-started on oxygen. He had a heartbeat, so we moved him onto the surgery table close to ventilater and iso in case it was needed. A pink foam began dripping from the ET tube so we tilted the table and eventually picked him up and allowed it to drain from his lungs. At the same time, he was trying to vomit and up came about 2 cups of semi-digested kibble. Eventually he was put on iso and ventilator since he kept fighting the tube. There was no way he could breathe on his own with just flow by oxygen so this was temporary to keep him breathing to call the owners and decide on a next step. At this point, referral was the obvious choice - send him to an intensive care unit with a staff that could monitor him at all times.

As soon as Dr. E called the owner and explained what had happened, she began SCREAMING into the phone, and I quote, "YOU KILLED MY DOG, YOU KILLED MY DOG". When he told her he couldn't speak to her if she was screaming at him, she hung up the phone. She must have been waiting outisde, because she came immediately into the building screaming "YOU KILLED MY DOG" to the waiting room. After being put into an exam room, Dr. E went to speak with her and she began screaming AGAIN. No exaggerating, top of her lungs screaming... AND. POUNDING. THE. WALL. WITH. HER. FISTS.

(... are you kidding me? I don't care how distraught you are, that is no way to behave.)

Dr. E came right back out and Dr. S walked in (he is a partner of the practice) to reason with her. She then opens the exam room door that faces the waiting room and screams to them "THEY F***ING KILLED MY DOG". IN. FRONT. OF. CHILDREN.

When asked to stop or she'd have to leave because there were children present, she demanded that the children leave.

This continued for another 10 minutes, at which point the decision was made to take the dog to the specialty hospital. I drove and a tech and doctor sat in the backseat with propofol and an ambu bag with the dog. Fluids were hanging from my hanger hook and my cupholders held all the emergency drugs.

Of course, as soon as we were on our way, I realized I had NO gas. About 10 minutes from the hospital, I had to stop, run out of the car, pump 10 dollars as fast as I could and jump back in the car to get on our way. We only had a limited supply of propofol and we needed to get there. Plus, it was a 70 pound dog, so he needs a lot of propofol than a tiny dog!

About three miles from the hospital, we hit a standstill in traffic. An accident was about 10 blocks away and traffic had merged into a single lane directed by police officers. Dr. E said - "this better not take long or we are going to run out of propofol."

SHIT!

As I sat in the driver's seat shaking and praying for traffic to move its happy ass along, we finally began moving. We did make it and the dog was alive and pink when we dropped him off. After getting him settled, the owner tried to apologize, justifying her actions by saying this: "You just don't understand how much he means to me. You know I would marry him if I could."

You can't make this stuff up.

Today, the dog is still alive and on a ventilator still, so his prognosis isn't good... but we'll see what happens. It is out of our hands and hospital, so they can deal with the crazy if the dog doesn't make it.

Just a typical day in vet med.