Читать книгу Tales from a Young Vet: Mad cows, crazy kittens, and all creatures big and small - Jo Hardy, Jo Hardy - Страница 7

Sometimes the simplest things give you the biggest headaches. Like administering kennel cough vaccine – something vets have to do all the time.

It should be so easy. You prepare the vaccine and then squirt it up the dog’s nose. And that would be fine, if it wasn’t for the snorting, sneezing, head-shaking canines determined to get it all out again.

I looked at the young retriever sniffing round the surgery, tail wagging enthusiastically.

‘Let’s put Jiffy up on the table, shall we?’ I said to the owner, who was dressed in a smart navy suit.

Once on the examining table, as his owner stood next to me, I held Jiffy’s head up, positioned the plunger and squirted – just as Jiffy jerked out of my grip, shook his head and snorted the vaccine all over his owner’s face and the front of her jacket.

‘What was that?’ she asked, startled.

‘I’m so sorry, it’s some of the vaccine, but don’t worry, it’s not toxic and it shouldn’t stain. Let me get you a tissue.’ My cheeks were scarlet.

As she mopped the vaccine off her face and clothes I could only hope that some of it had actually got into the dog it was intended for. And I made a mental note – always position the owner behind the dog.

I was on a fortnight’s work experience in a small, friendly veterinary practice close to my family home in Kent. It was a great opportunity for me to get some hands-on experience, with the added bonus of being able to see a bit of my family in the evenings.

This placement was one I’d arranged myself, as part of the sixteen weeks of EMS – Extra-Mural Studies – that we were expected to fit in between the compulsory rotations allocated by the college.

Puddlefoot is a country practice based in a building that looks a bit like a mobile home, but bigger. The staff I was working with included four friendly vets, a couple of them part-time, and a very helpful and chatty nurse, Chloe. The patients we saw were ninety-five per cent small animals, plus a few horses. The vets were encouraging and helpful, and with their supervision they allowed me to do consultations, give injections, scrub in to help during surgery and administer vaccines – hence the embarrassing scene with Jiffy and his owner.

That wasn’t my only vaccine disaster, either. My next patient was a tiny eight-week-old Chihuahua, a fluffy little ball with the minutest nose I’d ever seen. I took one look at it and my heart sank. No way was I going to get the whole vial of kennel cough vaccine into that nose. I drew up the vaccine into the syringe, and the dog started shaking its head before I’d even approached. All I could do, as I placed the syringe in front of one minuscule nostril, was hope that a bit would go in and that the owner, a charming elderly woman whom I positioned carefully behind her dog, wouldn’t notice how much of it dripped down the dog’s face and was snorted onto both me and the table.

As a final-year student I was being taught about the latest developments in the industry, and the practice vets were keen to know what I could pass on. When a cheerful collie came in with urinary incontinence, it was a chance to show off my knowledge because we’d done it as a topic just a few weeks earlier. The vets liked quizzing me on subjects, not only to help me reinforce what I had been learning but also to remind themselves. One of the vets, Cheryl, started asking me about the modes of action of different drugs that work on the bladder, so I drew a bladder on the whiteboard, with all the drug receptors. ‘It’s been years since I’ve gone into this much detail,’ Cheryl laughed. ‘It’s great to have a refresher.’

Most of the time I was the novice learning from everyone else, so it felt good to be able to redress the balance a bit.

The funniest case that week was a beautiful, glossy saluki crossbreed called Matilda, who had torn her ear on a barbed-wire fence. Ears bleed and bleed, and when their ears feel funny, dogs shake their heads. Matilda soon had the surgery looking like something out of a horror film, as her ear flapped from side to side, spattering blood up the walls and all over everyone in the room.

We treated the wound with cauterising powder and bandaged the ear to her head like a helmet. Then off she went, with her very charming owners, a young mum called Tina and her five-year-old daughter, Daisy, who giggled non-stop as we bandaged Matilda’s head.

‘You know, Daisy,’ I said, ‘at university they teach us to bandage on cuddly toys, so I’ve fixed the ear of many squishy doggies with poorly ears.’ Daisy giggled even more.

A couple of days later they were back for a change of bandage, along with Daisy’s cuddly-toy puppy, who now had a heavily bandaged head, which I duly admired.

The moment the bandage was removed, Matilda shook her head, opened up the wound again and redecorated the surgery with what seemed to be another litre or two of blood. We all sighed, cauterised the wound again and re-bandaged the ear, before wiping down the consulting room before the next client came in.

After the third time this happened, Tina was getting worried. ‘Is it ever going to heal?’ she said. ‘We seem to be going round in circles.’

We did, and although the ear wasn’t hurting Matilda too much, we needed it to stop bleeding. Once again, under Cheryl’s watchful eye, I bandaged it up, making Matilda look like a one-eared alien. ‘This time we’ll take our chances and leave it for an extra day or two,’ Cheryl said firmly. ‘The issue’s not that it isn’t healing. It’s healing pretty well, but every time we take off the bandage Matilda opens it up again. Next time she comes in, after the extra couple of days, it will hopefully have had time to heal a bit more and won’t reopen. But since there are risks to leaving a bandage on, if it starts to smell or you see anything soaking through, bring her back in straight away and we’ll have to come up with a plan B.’ We all gave a sigh of relief.

At the end of each day I drove back to my family home near Tunbridge Wells. We had lived in the same house since I was one, and I always loved going back to a proper meal and my own bed. Ross was away at university, so it was just me, my mum Clare, my dad Giles and the dogs, Paddy and Tosca. I’m close to my parents – we’ve always enjoyed each other’s company – so it was nice to catch up with them and fill them in on how the rotations were going. Each evening, Mum cooked my favourite beef stew or shepherd’s pie, and it was a rare treat to relax in front of the television with the dogs.

We’re all animal lovers and Mum was juggling her Open University degree in Humanities with Creative Writing with her other passion, working as a volunteer transporting rescue dogs to new homes. After we got Paddy, Mum realised that a dog being cared for by an animal charity is often miles away from the people willing to give it a home. A network of willing volunteers with transport is vital. Mum would get a call, often at short notice, asking her to collect a dog and deliver it to the new owners, or in cases where the dog needed to travel long distances, to be part of a team collecting the dog from the previous driver and taking it on to the next. The transport charity she helped out did much more than just delivering dogs from charities to new homes, though. It also picked up dogs from pounds when their time was up and they were about to be put to sleep, and took them to charities that would provide them with training, which would mean they could be put up for adoption. She was helping to save lives.

After my two weeks with the team at Puddlefoot, I packed my bags and headed back to the Queen Mother Hospital for dermatology, known by the students as ‘dermaholiday’ because it involved cushy hours, no emergencies and straightforward consultations, generally along the lines of ‘How long has your dog/cat been scratching?’

Dermatology is mostly about allergies, and a big part of the job is persuading the owners that they need to take the allergies seriously. A lot end up at the QMH with their dogs and cats because they’ve ignored the advice of their first-opinion vet and continued to feed Tibbles or Rover food that is making them itch and break out in rashes. Eventually either they demand a second opinion or their exasperated vet suggests they see a specialist.

The only real way to find out what’s causing the allergy, once you’ve ruled out parasites like fleas and mites, is by a process of elimination. The animal has to change to a hypo-allergenic food for six weeks to see if the problem clears up. If it does, after that you can gently re-introduce other foods, watching to see if there’s any reaction. If the food elimination doesn’t work, you can assume it’s an environmental allergy and start the process of trying to desensitise the animal, although in many cases it’s down to food and eliminating the allergen should be all that’s needed.

But for some owners it isn’t quite so straightforward. Take the very earnest lady, Mrs Hooper, who came in with her little pug dog, Muffin. A blood test had indicated that Muffin, who was scratching and rubbing his head on the floor, was definitely allergic but, as is often the case, the test hadn’t indicated what he was specifically allergic to. It only indicated he was allergic to a great number of things.

‘Start with his food,’ I explained to Mrs Hooper, under the watchful eye of the dermatology clinician, Annie. ‘Give him hypo-allergenic food and nothing else for six weeks, and see whether his condition improves.’

‘Oh, I’ve done that,’ Mrs H said. ‘It didn’t help.’

‘Are you certain that was all he had?’

‘Yes. Well, apart from his chews, but they’re chicken and chicken’s good for sick dogs, isn’t it?’

‘Well, it can be. Chicken is plain so it can be good for a dog with stomach problems. But in some cases it can actually be the problem. Plenty of dogs are allergic to chicken.’

‘No, it isn’t that because he was still scratching when he was eating beef chunks.’

‘I’m afraid that nearly all processed dog food, even beef chunks, has chicken in it. The company only has to have a certain percentage of beef in the food to be able to call it beef chunks, and the remainder is made up of other meat. So you really do need to give him the hypo-allergenic food on its own and nothing else. At all. No biscuits, chews or treats of any kind.’

Mrs H looked put out. ‘Well, that seems a bit hard on him. He really does love his treats.’

I tried to sound patient. ‘I know it’s hard, I really do appreciate that. And I’m sure he loves his treats. What dog doesn’t? But put yourself in Muffin’s shoes. Would you want to be itchy and uncomfortable all the time? You can always give him the hypo-allergenic food as treats, too. If the allergy isn’t cleared up it may lead to ear infections, bald patches and sore spots on his skin. So it’s really worth giving it a good go.’

Silence.

‘Oh. Well. All right then. If you insist.’

This conversation, or a version of it, happened a couple of times a day and was no doubt a re-run of the conversation the pet owner’s own vet had already had with them. Often it was only because a specialist repeated the advice that the owner eventually acted on it.

Of course, not all pet allergies are due to food; pets can also be allergic to dust-mites, fleas and pollen, which can make life for their owners pretty difficult. But food is always the place to start, and with the majority of pets this is where the answer lies.

One afternoon while I was in the dermatology unit a deafening alarm went off. ‘Crash,’ shouted Annie as she sprinted out of the room.

I went to the door, to see an impressively athletic clinician race past me, hurdle a trolley that someone had left across the corridor and disappear in the direction of the Intensive Care Unit.

‘What on earth is going on? Where has Annie gone?’ I asked.

‘It’s the crash alarm. My housemates told me about this,’ Lucy replied, joining me in the doorway as we watched more clinicians sprinting down the corridor. Lucy had spent the previous year living with three girls in the year above us, so she was invaluable when it came to hints and tips about rotations. ‘The alarm goes when an animal suddenly needs resuscitating or serious emergency care. Usually the case is either in the ICU or in surgery, and all members of staff who are available to drop what they’re doing have to run to help.’

‘I wish we could help,’ I said.

At that moment, an intern turned the corner into our corridor coming back from the direction in which clinicians had been sprinting minutes earlier.

‘What’s going on?’ Lucy called to him, eager to be filled in on the story.

‘We had a cocker spaniel in ICU, whose heart stopped. The clinicians who got there before me had the defibrillators and adrenaline out and they’d intubated it. They were doing all they could. Luckily lots of people were available, and so the ICU was pretty crowded. I was just in the way, so I left. Unfortunately it doesn’t look good, though.’

Half an hour later Annie was back. ‘We lost it,’ she said. ‘Lovely little dog, but it had septic peritonitis. That’s such a serious condition, and it threw its heart into a fatal arrhythmia. Its heart just couldn’t cope.’

I felt terribly sad. Someone had just lost a beloved pet, and it reminded me how close my family had come to losing our dog, Tosca, when she had the same condition just over a year earlier.

It had all started when Tosca began acting very strangely. Instead of being her normal annoying self and constantly demanding attention, she started hiding in strange places around the house and we’d end up hunting for her.

This went on for a few weeks until, one Saturday evening when I was at home for the weekend, I found her lying on her side groaning, with the biggest belly I had ever seen. She had managed to get into her dry food sack and eat an enormous amount before drinking a whole bowl of water. This was strange behaviour. She’d always loved her food and been a bit of a scavenger, but she’d never stolen from her food sack before.

Tosca had eaten so much that I felt alarmed. I rushed her to our local out-of-hours vet, Louise, who decided that there was too much food in her stomach for it to pass, because it had swollen with the water. Tosca would need to go into surgery that night so that her stomach could be opened and the food removed. Louise promised to call us when it was all over.

I spent the night in a restless doze, waiting for the call to say she was out of surgery and had come round from the anaesthetic. But it never came.

By two in the morning, four hours after I’d left her, I decided to call and see what was taking so long. Louise explained the surgery had gone well, but Tosca wasn’t waking up from the anaesthetic smoothly. She had been waiting for Tosca to wake fully before phoning.

By morning Tosca had finally woken up, but she was in a critical condition and clearly very ill. It was a Sunday, and I had to travel back to university. My parents promised to let me know how Tosca was, and I drove back feeling very afraid that something more than just a food-gorging incident might be going on.

On Monday afternoon Mum phoned. Tosca was deteriorating and she had been referred as an emergency to the Queen Mother Hospital. Mum was driving her up immediately, collecting Dad from his train on the way.

I waited outside the hospital as my parents drove into the car park, then ran over to open the boot of the car. Tosca was such a sorry sight. I was used to a bouncy, full-of-life dog, who would normally be leaping up to lick my face in greeting. But now she remained limp and unresponsive. Attached to an intravenous drip, she couldn’t even stand up.

Gently I lifted her in my arms and took her into the hospital, where the receptionist phoned the emergency team. Seconds later several vets and nurses rushed out with a trolley to whisk her away.

After giving an account of Tosca’s history to an impressively thorough final-year student, a tense hour passed before we were called into a consulting room with the senior clinician, Giacomo. Little was I to know that he would be the clinician in charge when I would be doing my ECC rotation a year later. He explained that Tosca’s abdomen had become septic after her operation and as a consequence her heart had started beating in an irregular rhythm that could be fatal. Even with further surgery to flush out the infected fluid, together with medication for her heart, she would only have a fifty-fifty chance.

I could feel the sob rising in my throat. Tosca was an invincible dog. And she was only ten, not old for a spaniel. How could this be happening? The clinician gave us a moment and then asked gently that if Tosca were to crash, should she be resuscitated? We said yes, of course, but desperately hoped it wouldn’t come to that.

He took us through to give Tosca a cuddle. I stroked her head and those floppy, silky ears, praying that it wouldn’t be the last time I saw her. Tosca was taken to surgery, my parents drove home and I went back to Welham Green to wait.

Once again there was no phone call. Hours passed as I tried to tell myself that no news was good news. Four in the morning came and went and I was still wide awake, so eventually I gave in and phoned. Tosca had made it through surgery, but was still in a critical condition. She hadn’t come round from the anaesthetic as expected, which could be indicative of a brain tumour – and this would also explain her recent change in behaviour. In addition, they had found another small cancerous tumour on her adrenal gland, but it was so close to a blood vessel that it couldn’t be safely removed.

The news that she had cancer as well as septic peritonitis was pretty devastating, but there was still hope. The cancer was in its early stages and might be a slow-growing type, so there was a good chance that she would have another couple of years if she made it through this ordeal. I said a little prayer. ‘Come on, Tosca,’ I whispered. ‘Don’t give up now.’

First thing the next morning I went in to visit her. She was in the Intensive Care Unit and I had to battle through a jungle of wires and tubes just to get to her. She had two fluid lines going into her, a urinary catheter, a drain out of her abdomen and four ECG wires. The ICU unit, surprisingly, was a very calm room, full of composed, friendly and helpful clinicians and nurses.

A week later Tosca was still in the ICU. Her heart had regained its normal rhythm, but she wasn’t recovering as fast as she should. She was very depressed and not eating, which was so unlike her. The staff decided that maybe a change of scenery would help, so she was moved to the much brighter soft-tissue ward. Another day passed, and she was much the same, so they took a further sample of fluid from her abdomen. The culture showed that she had a very resistant strain of bacteria that wasn’t responding to the antibiotics she was on. It was a testament to her strength that she’d made it this far.

Tosca was put on one of the strongest antibiotic drugs available, and over the next few days she gradually began to improve. As a vet student I was allowed to visit often, and I spent hours every day sitting in her kennel giving her cuddles, catching up on my studies and talking to final-year vet students about their experience of being on rotations. Tosca was still refusing food, and she had lost an alarming amount of weight. The ICU nurses tried to entice her to eat, and I tried, too, but she refused everything until, after eight days, when the clinicians were starting to seriously consider placing a feeding tube in her under anaesthetic, she finally let me give her a small piece of sausage. I joked that she must have heard that if she didn’t eat she would need to have another procedure.

After three weeks she was finally well enough to go home. It was a Friday, which was great, as it meant I could travel back with her. My parents met me at the hospital and Tosca was brought out, still weak and wobbly, but with a wag in her tail. Mum and Dad had tears in their eyes; we all adored Tosca and we had come so close to losing her.

We put her on her bed in the boot of the car for the two-hour journey home. Soon after pulling out of the car park, Tosca started howling and yapping. It was a habit that she had when she was excited or wanted to go for a walk. Normally it annoyed us, but now the sound of her yaps was like sweet music. We all laughed. We had our Tosca back.

Over the following months Tosca recovered well, but then she gradually lost her sight and her head began to tilt to the left, confirming that a slow-growing brain tumour was probably the root cause of her problems. But even blind she coped remarkably well. She knew the layout of the house and she still insisted on charging around as she always had. Since trying to slow her down was an impossible task, we put bubble wrap around the trees in the garden and horse boots on the legs of the dining room chairs. She had no problem finding us and then, as she always had, sitting at our feet and pawing at our laps until we gave her our undivided attention. And her radar still guided her unerringly towards the dishwasher after dinner, where she licked the plates as it was being loaded.

We were lucky with Tosca. It could so easily have gone the other way for her, but she’d survived and, a year on, she was still doing well.

Before I left dermatology for my next placement we were told that our student year group had been approached by ITN Productions, who were casting for a series about trainee vets that would be broadcast on the BBC. We were all invited to a question and answer session in which they explained that any student could apply, and that they would then pick up to ten for a reality series, following us through our final year of training.

Around a hundred students went along to the casting sessions. I decided to apply because, well, what was there to lose? And I was curious – what would it be like to be filmed? I once dreamed of being an actress, and as a child I even went to weekend stage school. Now this was the nearest I was likely to get, so I decided to have a go. At the session the producers chatted to us for a bit, and then each of us had to spend a minute talking to camera about ourselves. I thought a minute was going to seem like forever, but it went too quickly, and afterwards I left feeling that I hadn’t said most of what I’d planned to say.

I didn’t have time to think about it for long because the following day I packed my bags again and headed off to Wales for a fortnight of farm work. This time the five of us in my rotation group were working with another group, so there were ten of us staying together in a rented cottage. We were there to do what’s known as population work – studying herds of cows on local farms and writing reports on how to improve the standard of health in each herd. We had to score every cow on nutrition, locomotion and general health, so it was pretty repetitive work.

The days when James Herriot dashed out to save the life of an ailing cow have given way to economically tougher times, as farmers, who often struggle to make a profit, can’t afford to be sentimental or have one sick cow affect the health of a herd. The emphasis has to be on keeping the whole herd as healthy as possible.

With ten of us under one roof, tensions began to run high in the student house. Some of us wanted to write our reports as we went along, others wanted to leave it to the last minute, so there were a few clashes.

To escape the strains within the house – and the endless cows – Lucy and I went out to explore the area with Chloe, a friend from the other group. We drove to the Brecon Beacons, and decided to stop and walk up a hill that we were passing.

‘Won’t take long,’ Lucy said cheerfully. ‘It’s only a little hill. The fresh air will do us good.’

An hour later we were working up a fair sweat as we climbed. Somehow the ‘little hill’ had become more of a mountain, but having decided to climb it none of us was going to be the first to turn back. By the time we got to the top we were hot, thirsty and exhausted. We sat on the grass, admiring the wild ponies and stunning views.

‘See? It was worth it,’ Lucy said, taking a swig of water and passing me the bottle. ‘And going down will be a doddle.’

I was examining the large blister on my heel. ‘Lucy,’ I said, smiling sweetly, ‘next time you see a “small hill” and decide to climb it, count me out.’

Soon after we got back to college at the end of the fortnight we heard that ITN had picked the first five or six students for the series. We were all agog to know who had been chosen, and were delighted to hear that one of them was Grace. She was stunned. It was going to mean working with a film crew trailing behind her at some of her trickiest moments, so she wasn’t sure whether to be pleased or horrified.

I heard that I’d been put on a list of students they were undecided about. I was pretty sure that meant it would probably never happen, and that was fine with me. I had plenty to occupy me over the coming weeks and felt relieved that I wouldn’t have a camera crew there to add to my embarrassment by recording the inevitable trail of blunders I’d be leaving in my wake.