The Emergency Vet…

chris-learns-emergency-and-critical-care

Accidents can and will happen, most often when you are not expecting them, and medicine is not cheap. This is especially so when it happens when your normal vet is not open, as then you are often sent to a specialist emergency vet, which is almost like an A&E department for pets. The vets here are trained to save your pets life; in addition to specialist training they have access to the important equipment and drugs necessary to do this.

Over the next 4 days I have been invited to join Vets Now one of the UK’s leading providers of Emergency Centres for Pets that have been in accidents or are seriously ill. I’m excited to learn a lot of things to help with emergencies, yet I am apprehensive about how intense it will be and how little I know.

I’ve been invited into two different centres in two different cities so I can see a range of different patients and learn from several different vets.

The first centre I am at just for the weekend, expecting to be there from 12 lunchtime until 7pm Saturday evening. Then again all day on Sunday from 8:30am until evening again with night staff taking over to continue to provide the care needed.

The second centre I am on overnights on Monday and Tuesday from around 6pm until the next morning as the normal overnight shift is 15 hours long. This centre also takes patients from the PDSA charity so is expected to be a lot busier.

During this time I’ve been allowed to tweet – so keep an eye on my twitter feed @vetschooldiary for live updates from behind the scenes as it happens.

And off course I will be blogging my experience as well (potentially once I’ve managed to catch up on sleep!).

Over the rainbow bridge…

Euthanasia - Crossing the rainbow bridge

As the vet reaches for the cats leg to give the final injection the cat lies alone on the table. She has had trauma and is not in good way, and her parents cannot stand to see her in this way. I reach out to do nothing more than stroke her as she starts her onward journey over the rainbow bridge.

As the injection goes in I see her laboured breathing stop, she looks calm and relaxed as I stroke her and wish her a safe onward journey. The injection is in and the vet removes the needle before reaching out and stroking her as well briefly before they listen for a heartbeat. I’m sure she’s gone but it is important to check, sometimes it can be difficult to tell with all the noises that occur after death so sometimes can feel like you are listening a long time.

I’m sad this cat I knew only for a short while at what is probably the worst point in her life couldn’t be saved, yet I take comfort in the fact she now gets to run free. We gently remove her IV cannula to go to the clinical waste, clean her, and then wrap her in her blanket to go home with her parents for burial.

She is not the first, and will not be the last; however she did not go alone. Even for those few minutes she took a piece of my heart with her, and she went on her final journey across the rainbow bridge loved and cared for. This is something her parents never saw and something maybe one day they will wonder about, however they should not worry. They have the memories of her running around the house not struggling to breathe unable to lift her head.

I will never judge a parent that cannot be there at the end, it’s one of those choices that is so difficult to make. There is rarely a right answer, and sometimes there is not even any time to even think about it properly. Yet these parents may say their goodbyes when it is time to bury her, I will never know. It is a choice that can only be made by you. Sometimes after trauma we will explain to parents what to expect to see as sometimes injuries look much worse after being shaved and cleaned so that the parent can make a choice.

Personally I believe saying goodbye is important, some vet practices even have rooms just for this so we can give as much time as parents need. Sometimes in a busy practice we do not have enough of these rooms so we make do with what we have. We will explain what will happen to you, and tell you what we are doing. We’ll never try to rush you, we’ll try to keep noise outside to the minimum, and we will all feel your pain.

EDIT
If you have lost a pet and are struggling with the loss then please do call the Blue Cross Pet Bereavement Helpline – 0800 096 6606 (UK Only) – or visit their website for more information at  https://www.bluecross.org.uk/pet-loss. It is a traumatic experience, and there are people that have experienced it themselves who want to listen to you.

Ticks and Fleas spread diseases…

Ticks like this carry disease

I spent years learning about diseases, medicine and surgery to become a vet so I could help make animals better. Yet sadly there have been many times where I’ve either seen a dog die or be euthanised because of diseases that are preventable. For me it is heart-breaking to see a dog die like this, yet even worse are the owners crying because they did not know any better. I hope by writing this I can help prevent suffering to another dog and their owners.

Most people with a dog will probably have seen a tick or flea at some time or other. Whilst it is common to believe they may just be an annoyance to your pet, in some cases they can carry diseases which may be spread to your pet or in some cases even you.

Actually calling fleas an annoyance may not even be accurate as the itchiness that they cause can be extremely painful and lead to a dog destroying its own skin trying to get it to stop. However today I want to rather focus on ticks. In April this year I saw 23 dead dogs due to a disease carried by ticks. It is one that is relatively new to the UK; however it is very common where I studied as a vet in Slovakia.

This disease is caused by another parasite called Babesia which exists inside blood cells and is transmitted by ticks when they feed. When it enters a new animal the parasite spreads in the blood entering the red blood cells and then replicating inside it causes the cell to rupture and die. This process repeats until there are very few red blood cells left, it is treated, or the dog dies.

The symptoms vary, when the dogs I have seen suffering from this have arrived they have often been lethargic, the worse ones have been yellow with icterus and collapsed. The common symptoms are blood in the urine, lack of appetite, weight loss, pale gums and tongue, lack of energy and collapse. In fact the symptoms can be so non-specific that one of my teachers here actually once told me that if I cannot explain the symptoms by any other means then I should check for Babesia.

Checking for Babesia is generally easy with a blood test where a smear is examined under the microscope – if it is positive for Babesia then they will be seen within the red blood cells as in the dog below…

Babesia parasite inside a red blood cell
The dark puple “butterfly” in the middle circle is typically what Babesia looks like under a microscope © Chris Allen 2017

So we have the diagnosis, now for the treatment. Unfortunately this is where it gets complicated as although there is medication to kill the Babesia parasite, it can often be a battle to keep the dog alive long enough for the medication to work. Without enough red blood cells to deliver oxygen throughout the body the organs cannot work, the heart starts working faster to try and move the few good cells it has around faster, and the waste is filtered into the urine. The regeneration of red blood cells takes a few days to really start, so one potential lifesaving treatment is a blood transfusion – however this often just buys more time as these red blood cells may then also be infected and destroyed by the Babesia parasite.

The next problem then comes with the cost of treatment as well; often these dogs need hospitalisation and intensive therapy which for some is unaffordable. It really can be a gamble as to whether or not they survive at all, even if treatment is attempted, potentially leaving a big bill and a dead dog vs the happy pet parent taking their dog home.

The main question though is why it is even necessary.  Although tick products are generally not licensed against tick borne diseases, to help prevent Babesia you should help protect your dog against ticks with a vet recommended treatment, remove any ticks you find as soon as possible, and especially make sure you do this if you travel into mainland Europe.

I fully support the Pet Parasite Action campaign – such a little thing as regular prevention could help save your dog’s life even though you may not know it. You don’t go out and leave your front door unlocked to avoid theft, why would you leave your pet unprotected against diseases such as this?

Click Below to Check You Are Protecting Your Pet…

Pet Parasite Action Protect your pet