A vets gift of euthanasia and great sadness…

Today’s Diary Entry is sponsored by Pet Webinars

As vets we are given a great gift to be used with great responsibility. We are given the right to euthanise animals in order to alleviate pain and suffering. Translated to English the word euthanasia means good death, and when used by a vet it generally is. It is painless, and for the animal just like going to sleep. For some animals that are sick and suffering it cannot be done fast enough – and though the vet may wish there was more that they could do to make the animal better it can be justified.

Now what I have noticed is that the techniques and methods for euthanasia are not covered in most of my textbooks. Instead my textbooks even with chapters on euthanasia tend to focus this towards dealing with the owner and how to prepare them for this instead of how to make this good death happen. Generally though for euthanasia an animal is sedated or given an anaesthetic drug to make them sleep, and then a different drug is injected into the animal to stop the heartbeat.

So there were two dog euthanasia’s today but they couldn’t be more different in how they made me feel.

I arrived this morning to a road traffic accident with a large dog, once we got this patient stabilised and completed the initial exam we rushed them into xray to get a better assessment. Waiting for the images to come up on screen I was slightly excited about the surgery to repair the damage, however when the images came up a deathly silence feel among us. It was not good. It was very very bad. Now you see with a large dog there is a lot of weight that needs to be supported, this is a lot of force on the legs, and so even one leg compromised can be disastrous. However this dog had 3 legs that had been damaged. We anaesthetised at this point so that a full physical exam of the injuries could be performed, after assessment and after discussion with the owner elected that it was kinder not to allow this dog to wake up. This dog was in great pain and suffering, and so the ability to deliver the gift of a painless death was a privilege.

Throughout the day there was an 8 week old puppy in for assessment of a congenital deformity to one of the front legs. Being a puppy this was a very cute dog, bouncing around wagging its tail and being very happy whilst receiving a lot of attention from everyone passing. Now after xrays and exam at the end of the day a discussion with the owner took place. The owner left without the puppy, and it was here that I realised something was up. The puppy was to be euthanized. Not because it was in pain or suffering. But because of a choice. There were surgical options available. The puppy could be fixed. However for whatever reason the owner elected not to. So it was us with this great responsibility that cuddled the puppy as it fell asleep. It was me that listened to the chest to make sure the heart had stopped. This puppy that had tried to soak me with water from its water bowl just hours before was gone. The tail wasn’t wagging.

Now you can probably guess the one that kept me awake that night… Not that I didn’t wish that there were surgical options for the big dog and was frustrated with our lack of ability to do anything… The one that kept me awake was the puppy that was happy and had good surgical options for a good life. Sure we shouldn’t get attached to patients, but there is just something about animals that makes you love them.

Sometimes euthanasia is necessary, however I believe it is a gift to be used to relieve pain or suffering. I realise that the world is largely based around consumerism now, and I hate the thought that by setting out on my quest to help animals that I may become a way to “return” a dog or other animal… As vets we are there to save as many as we can, I hate that sometimes money gets in the way, but until we have a better system I will advocate for every single pet out there being insured to remove this money factor from what is often the hardest decision pet owners have to make. Euthanasia is and should be about the animal.

Some thoughts on removing limbs and body parts…

There are times when I find myself wondering just what we actually do and found myself there again today. I’ve always had the image of surgery being a beautiful act of fixing things, making animals better. Yet today I kept a dog sleeping comfortably under anaesthesia whilst I watched a surgeon remove its leg. The other week I watched a surgeon remove part of a bone, the sound of the saw making it definite.

For some reason when I imagined surgery this isn’t what came to my mind. Surgeons putting things back together, suturing vessels, intestines or constructing metal frames around limbs. This happens a lot of the time, however there are times like today when I just start to wonder.

When I actually think about it, we often remove parts of an animal’s body during surgery, whether that is the uterus and ovaries or even a tumour. All of these are routine and I have never considered it fully before. I guess here I think it is that the animal will not miss these parts though, with good pain management the animal may not realise even that there had been surgery.

Now when it becomes a leg I guess it just takes a different perspective as I am pretty sure an animal may miss it… And worse that the animal has come walking in with 4 legs, yet will be waking up with a leg missing. Sure there won’t be pain, I gave the morphine that ensures that, but when the dog tries to stand it stumbles and falls. Unlike ovaries or a tumour, it actually notices that a leg is missing… That is before you consider things in humans such as phantom limb syndrome and then wonder if animals can also suffer from this… If they do then they can’t say…

This is where for me a beautiful art really does become a little less beautiful…

Starting 2015 by assisting in emergency surgery…

Today’s Diary entry is sponsored by Spikes Wildlife Foods

It has been 2015 for just over 9 hours, one of which was filled with fireworks, 6 of which were filled with sleep, and 2 which were preparation for another day in clinic. Sometimes I feel old, last night instead of joining the thousands out partying I read a book by my favourite author Lee ChildPersonal the latest in the Jack Reacher series which I had been saving since the summer. I actually finished it in one sitting as it was such an awesome book…

Anyways back to 2015, it’s now a little closer to 9:45am, and we have a patient transferred from the internal medicine service onto surgery that had shown abnormalities on ultrasound. It was believed to be a intussusception caused by a linear foreign body as there were changes in the intestines, so we took the patient to xray to have a look at what we could see. There were some changes on xray to part of the intestine and the rest of the intestine was filled with gas (this is not normal and is a sign of foreign body) however it was non-specific. We then did a second palpation exam of the abdomen and found what felt like a ping pong ball hard round lump.

Finding this the only course was surgery to perform a laparotomy (opening of the abdomen) to examine the intestines, and remove this lump whatever it was. Because of the holiday there were only two of us in the building, so I started prepping the patient whilst the doctor started prepping surgery. I am able to say that it really isn’t as easy doing it alone as with help, even when it’s just holding a leg out of the way it really does make a difference. After I finished prep and got the patient onto the table I sorted out the anaesthesia and got everything connected whilst the doctor scrubbed and then once I was happy the patient’s anaesthesia was stable I went to scrub myself.

After scrubbing and gowning up I moved to assist in surgery whilst keeping an eye on the anaesthesia, this was my first time assisting in an abdominal surgery on a dog so I was really excited. The doctor had found the foreign body, so we removed the loop of intestine from the abdomen before we then opened it to remove the foreign body. It was actually a intact nut that the dog must have eaten a few days, caught up in a bunch of other “stuff” that I could not identify. There were several sites in the intestines where you could see it had got stuck before moving on however here it really had not moved on. It was a case of getting it just in time as the intestines had started to have pathological changes from the blockage here with some change in colour and bruising.

We then had to close the incision we had made into the intestines, and then check the rest of the intestines for any further blockages before flushing them with sterile saline and replacing them back into the abdomen. Now the first time I saw peristalsis (muscular movement to move contents of intestines along) in equine intestines was amazing, and though peristalsis in this dog was decreased I could see all the blood vessels and the pulsing of them which really was amazing.

We closed up the abdomen and I set about recovering the patient, because it is so cold here and the rooms so large maintaining temperature is very difficult. In this case we also did not have anyone to manage it during the surgery so the body temperature had dropped down to around 34 degrees so I set about warming the patient as well. Once I had the patient up to a good temperature, and awake I relaxed a little and actually realised that I had just made a milestone in my education to become a vet.

Barely 11 hours into 2015. I put all my knowledge learnt so far to use to give a dog a chance at sharing another year with its owners. Some people like to party, and I may be old, but there is nothing like the buzz of surgery especially when your patient looks up at you afterwards and tries to wag its tail.