We recently got the results back from the U of M regarding the necropsy (autopsy) of Sam, the dog who died from cardiac arrest. The results showed that he had a large tumor--most likely cancerous--on his spleen that ruptured following anesthesia. We never saw it coming! I mean, this dog's bloodwork was completely normal, he wasn't acting out of the ordinary, or anything. He seemed a perfectly normal healthy dog. But it kind of made all of us feel slightly better about the whole situation. Not that we're happy about what happened, but at least there was a reason for his passing; it wasn't anything that could have been prevented.
In other news, I met Sprite's evil twin today. Literally, these cats look almost identical. The only difference is that Sprite has a half white/half black nose, and a gray spot on her head, whereas her twin's face is all black. Oh, and her twin is seriously evil. I couldn't come within 10 feet of her without her hissing. Even 10 minutes after she woke up from her spay earlier today, she was growling and hissing and freaking out, trying to lick at her incision. For the most part, she was fine until you went near her. Otherwise she wouldn't make a sound.
Work is making me exhausted, guys. I'll be honest, I need like a week off right now. I've been working 50+ hours a week for the last 2 weeks, and I'll probably end up getting at least 60 this week. On the bright side, I'm still getting 2 days off. But the days I do work are super long and tiring. For instance, today I was on a surgery shift. I was scheduled to work 6:30-4:30. I ended up going on my lunch break at 4:45, and worked until 7:00. I went 11 hours without eating. It wasn't pretty. One positive note from today: we might have had to do a foreign body surgery today, but didn't do it because the owner couldn't afford it. If we did the surgery, I might have stayed til 9. So that's a plus. Although, in a way I wish we would have done it, for the sake of the dog. Poor guy.
One of the most adorable puppies came in yesterday. She was a corgi/border collie mix, but she looked like a full-grown long-haired dachshund. 12 weeks old, black, long silky hair, the cutest little puppy. And smart, too. Her owner said she was already potty trained and knows how to sit. She didn't bark or whine at all while she was at the clinic, and she liked to cuddle. Overall, I'd say she's a perfect puppy. I wish I had a picture of her so I could show you guys. Cuz she's adorable.
Tuesday, March 25, 2014
Saturday, March 15, 2014
Perspective
This is the story of how I got peed on by a dead dog. Before you start laughing, it's not as funny as it sounds. Sure, the end is funny, but the story leading up to it--not so much.
We had always been taught in tech school that you should have a fear of anesthesia. But not like a phobia or anything, a healthy fear, a respect, the type of fear instilled in you when driving a car or handling a gun. One of my instructors always said that the day she stops having that fear in her is the day she stops monitoring for anesthesia. Why? Simply put, when the respectful fear is gone, it becomes more of just a routine, you get too comfortable, and that's when mistakes happen.
I know what you're thinking, and no, we did not lose a patient under anesthesia. But what did happen was almost worse. Almost.
It started out as any other busy day at the clinic. Full appointments, numerous early morning drop-offs, seven surgeries, 3 techs and 2 doctors. This was my fourth day in a row out of five, and I was pretty exhausted from the three days before. Even so, I still had to do my job and help out everyone else where I could. The morning went pretty smoothly in spite of being crazy busy, but it was just one of those days where you could feel something was different. Something in the atmosphere wasn't quite right, and you knew something bad was about to happen. Around 3:00, I came out of a room and noticed a lady sitting on the bench with her dog. This dog had just had a dental cleaning and was being discharged to go home. He was a bigger dog, about 105 pounds (his name was Sam). He was still really sleepy from the anesthesia, and didn't look like he wanted to move. I offered to help the lady take him out to the car, and she thanked me for the gesture, but she thought it might be better if he just stayed at the clinic for another hour or two to give him more time to wake up. I thought it was a good idea, and she helped me take him in the back and put him back in his kennel.
He laid in the kennel for a while, and as we walked by we would check on him to see how he was doing. This has also become a routine for most of us, and we don't really think much about it, especially when we're so busy doing other things, and sometimes don't even notice the dogs in the kennels unless they're barking at us. It sounds horrible, but that's how things go. (It doesn't help that we've been short staffed lately, so everybody's kind of stressed and trying to focus on what needs to be done.)
Shortly after Sam was put back in the kennel, the surgery doctor had just finished with a cat spay and was putting her in a kennel to recover. She noticed something wasn't quite right with Sam. He was breathing heavily and not responding to any noises. So she opened the kennel to look at him. His gums were a very pale shade of pink, and he had a slow blinking reflex. Immediately she got the other doctor to help put him on the stretcher to bring him over to the table and get him on oxygen. At this point, I had just walked into the back, so I didn't know what was going on. The first doctor shouted out that they needed help lifting him onto the table, so I grabbed the sides of the stretcher and lifted him up. I still didn't know what was happening, but both doctors and another tech were scrambling around, turning on oxygen and feeling for a pulse. That's when it hit me: Sam was crashing. We tried to intubate him but failed, so we just put a mask on him to give him oxygen. He had a steady but faint pulse, and low blood pressure. Doctor #2 grabbed a vial of glycopyrrolate and told me to hold off his vein so she could inject the drug. No luck finding the vein, so we attempted to place an IV catheter. His blood pressure was so low that we couldn't get a catheter in either of his front legs. Eventually we ended up successfully placing it in a rear leg, where we were able to give glycopyrrolate and epinephrine. After each time of injecting a drug, his pulse would get stronger and faster, but would grow fainter after about a minute. We decided to try to intubate him again, so that oxygen would be going straight to his lungs. I pulled out his tongue and it was cold and purple. We successfully intubated him that time, but he wasn't breathing on his own. That's when Doctor #1 made the decision to start chest compressions. Between the 2 doctors and 3 of us techs, we tag-teamed CPR for about 10 minutes, stopping after several compressions to check for a pulse. It was getting fainter every time. Our last hope was to inject epinephrine directly into the heart. For a few minutes after the injection, we continued with CPR. But Sam could not be revived.
We took x-rays afterwards and determined he had gone into cardiac arrest caused by anesthesia. It's a rare occurrence, but things like this happen. That's something that will stay with me for the rest of my life, and has really made me stop and think every time I monitor anesthesia now. This was the first time I was actually involved with something like this, and it's incredibly stressful. No amount of schooling can prepare you for these situations, and after that happened, guess what? I had to keep working. I didn't have time to relieve my stress. I had the worst headache for the rest of my shift, but for all the appointments I had to see, they didn't know what had just happened, so I had to act like nothing was wrong.
After we closed for the day, we had to transport Sam to the U of M to have him cremated. He was too big to fit in one bag, so we put a bag over his front half and one over his back half. As we were lifting his rear legs to put him in the bag, I was putting pressure on his abdomen and inadvertently squeezing his bladder. So of course that caused urine to go all over the table and my arm that was wrapped around him. And that's how I got peed on by a dead dog.
When I got home from work, I ate, I showered, I cried a little bit, and I slept it off. Unfortunately, I had to work another 12 hour shift the next day. That wasn't easy, but I got through it. I think that situation caused me to have a different perspective on the medical aspect of my job, not just for anesthesia, but for all of it. I also have a new-found respect for people who work in emergency medicine, both human and veterinary. It's not easy to go through those situations, and often we take for granted the routine of medical care without really thinking about the real-life risks of some of the things we do every day.
We had always been taught in tech school that you should have a fear of anesthesia. But not like a phobia or anything, a healthy fear, a respect, the type of fear instilled in you when driving a car or handling a gun. One of my instructors always said that the day she stops having that fear in her is the day she stops monitoring for anesthesia. Why? Simply put, when the respectful fear is gone, it becomes more of just a routine, you get too comfortable, and that's when mistakes happen.
I know what you're thinking, and no, we did not lose a patient under anesthesia. But what did happen was almost worse. Almost.
It started out as any other busy day at the clinic. Full appointments, numerous early morning drop-offs, seven surgeries, 3 techs and 2 doctors. This was my fourth day in a row out of five, and I was pretty exhausted from the three days before. Even so, I still had to do my job and help out everyone else where I could. The morning went pretty smoothly in spite of being crazy busy, but it was just one of those days where you could feel something was different. Something in the atmosphere wasn't quite right, and you knew something bad was about to happen. Around 3:00, I came out of a room and noticed a lady sitting on the bench with her dog. This dog had just had a dental cleaning and was being discharged to go home. He was a bigger dog, about 105 pounds (his name was Sam). He was still really sleepy from the anesthesia, and didn't look like he wanted to move. I offered to help the lady take him out to the car, and she thanked me for the gesture, but she thought it might be better if he just stayed at the clinic for another hour or two to give him more time to wake up. I thought it was a good idea, and she helped me take him in the back and put him back in his kennel.
He laid in the kennel for a while, and as we walked by we would check on him to see how he was doing. This has also become a routine for most of us, and we don't really think much about it, especially when we're so busy doing other things, and sometimes don't even notice the dogs in the kennels unless they're barking at us. It sounds horrible, but that's how things go. (It doesn't help that we've been short staffed lately, so everybody's kind of stressed and trying to focus on what needs to be done.)
Shortly after Sam was put back in the kennel, the surgery doctor had just finished with a cat spay and was putting her in a kennel to recover. She noticed something wasn't quite right with Sam. He was breathing heavily and not responding to any noises. So she opened the kennel to look at him. His gums were a very pale shade of pink, and he had a slow blinking reflex. Immediately she got the other doctor to help put him on the stretcher to bring him over to the table and get him on oxygen. At this point, I had just walked into the back, so I didn't know what was going on. The first doctor shouted out that they needed help lifting him onto the table, so I grabbed the sides of the stretcher and lifted him up. I still didn't know what was happening, but both doctors and another tech were scrambling around, turning on oxygen and feeling for a pulse. That's when it hit me: Sam was crashing. We tried to intubate him but failed, so we just put a mask on him to give him oxygen. He had a steady but faint pulse, and low blood pressure. Doctor #2 grabbed a vial of glycopyrrolate and told me to hold off his vein so she could inject the drug. No luck finding the vein, so we attempted to place an IV catheter. His blood pressure was so low that we couldn't get a catheter in either of his front legs. Eventually we ended up successfully placing it in a rear leg, where we were able to give glycopyrrolate and epinephrine. After each time of injecting a drug, his pulse would get stronger and faster, but would grow fainter after about a minute. We decided to try to intubate him again, so that oxygen would be going straight to his lungs. I pulled out his tongue and it was cold and purple. We successfully intubated him that time, but he wasn't breathing on his own. That's when Doctor #1 made the decision to start chest compressions. Between the 2 doctors and 3 of us techs, we tag-teamed CPR for about 10 minutes, stopping after several compressions to check for a pulse. It was getting fainter every time. Our last hope was to inject epinephrine directly into the heart. For a few minutes after the injection, we continued with CPR. But Sam could not be revived.
We took x-rays afterwards and determined he had gone into cardiac arrest caused by anesthesia. It's a rare occurrence, but things like this happen. That's something that will stay with me for the rest of my life, and has really made me stop and think every time I monitor anesthesia now. This was the first time I was actually involved with something like this, and it's incredibly stressful. No amount of schooling can prepare you for these situations, and after that happened, guess what? I had to keep working. I didn't have time to relieve my stress. I had the worst headache for the rest of my shift, but for all the appointments I had to see, they didn't know what had just happened, so I had to act like nothing was wrong.
After we closed for the day, we had to transport Sam to the U of M to have him cremated. He was too big to fit in one bag, so we put a bag over his front half and one over his back half. As we were lifting his rear legs to put him in the bag, I was putting pressure on his abdomen and inadvertently squeezing his bladder. So of course that caused urine to go all over the table and my arm that was wrapped around him. And that's how I got peed on by a dead dog.
When I got home from work, I ate, I showered, I cried a little bit, and I slept it off. Unfortunately, I had to work another 12 hour shift the next day. That wasn't easy, but I got through it. I think that situation caused me to have a different perspective on the medical aspect of my job, not just for anesthesia, but for all of it. I also have a new-found respect for people who work in emergency medicine, both human and veterinary. It's not easy to go through those situations, and often we take for granted the routine of medical care without really thinking about the real-life risks of some of the things we do every day.
Friday, March 7, 2014
Finding humor in unexpected places.
For some reason, a lot of my interesting stories this week involve euthanasias. I'd really like to share them, because they're actually kind of funny...in a weird kinda way (but hey, if you work in vet medicine long enough, you find humor in literally everything). So if you don't want to read about death, you should probably just leave this page right now.
Somewhat funny euthanasia story #1:
An old black lab came in to get an exam on her eye that was red and swollen and looked kind of gross. She also had a sore on the back of her leg that looked like a ruptured mass. Turns out, she had severe glaucoma in that eye, and the mass that ruptured was on one of her several swollen lymph nodes. Long story short, the owner couldn't afford the diagnostics and treatment that we recommended, and decided not to make the dog suffer anymore. But the owner didn't want to be present for the euthanasia. That actually turned out to be a good thing, because the dog was really anxious and flinchy, and didn't want to lay down. As the doctor was injecting the pentobarbital (euthanasia solution) into the IV catheter, the dog jerked, the syringe came out, and pentobarbital squirted everywhere. This happened twice before the dog passed. I now know what pentobarbital tastes like. It's quite disgusting.
Somewhat funny euthanasia story #2:
We had to euthanize a snake. I volunteered to help, because I was the only tech at the time that would handle a snake. It's basically the same as euthanizing a dog or cat, except you inject the solution into its heart. And you have to sedate it first. It just makes things a whole lot easier. As the doctor and I were watching the snake slowly lose consciousness from the anesthetic gas, we noticed how cute his little face was. And we both actually started getting sad. Then we disconnected him from the gas, felt for his heart, and stuck him with the needle. We both shed a tear or two while watching the snake take his last few breaths. It was sad, guys. Fast forward 2 days....we walk into the treatment room in the morning, and the smell of death is in the air. We have no idea where it's coming from, until one of the techs discovers something in the back kennel. It's the dead snake. On a heating pad. And it had been there for 2 days. Yeah. It smelled pretty bad. Don't ask me how we forgot to get rid of a dead snake, but somehow it happened.
Somewhat funny euthanasia story #3:
It was another old dog. He had several cancerous masses all over his body, arthritis in all his joints, and had a really hard time getting around. He was also a very sweet old dog. Oh yeah, and he weighed 130 pounds. This dog wasn't terribly huge, but he was definitely solid. So we went through the procedure, and afterwards we had to transport him. (We store them in a big freezer in the back until they get sent out to be cremated). We have this stretcher that's supposed to help lighten the load a little bit with such big dogs. After we managed to get a black bag around him, we rolled him over onto the stretcher, and proceeded to lift him off the floor to carry him into the back. We made it probably 10 feet, and I hear this big crack simultaneously with 130 pounds of dead weight being pulled down to the ground. Our one and only stretcher broke. Apparently it wasn't meant to hold that much weight. So we got a third person to help us drag the stretcher back to the freezer. Two people were pulling, I was pushing. If you can picture it, I was pushing this huge dog with my rear end sticking up in the air, slipping on the hard tile floor and trying not to run into walls. One of the techs working just looked at us and said, "Never a dull moment."
Hope you can find at least one of these stories as funny as I did. Otherwise, I'll just feel like a horrible person for laughing about dead things.
Somewhat funny euthanasia story #1:
An old black lab came in to get an exam on her eye that was red and swollen and looked kind of gross. She also had a sore on the back of her leg that looked like a ruptured mass. Turns out, she had severe glaucoma in that eye, and the mass that ruptured was on one of her several swollen lymph nodes. Long story short, the owner couldn't afford the diagnostics and treatment that we recommended, and decided not to make the dog suffer anymore. But the owner didn't want to be present for the euthanasia. That actually turned out to be a good thing, because the dog was really anxious and flinchy, and didn't want to lay down. As the doctor was injecting the pentobarbital (euthanasia solution) into the IV catheter, the dog jerked, the syringe came out, and pentobarbital squirted everywhere. This happened twice before the dog passed. I now know what pentobarbital tastes like. It's quite disgusting.
Somewhat funny euthanasia story #2:
We had to euthanize a snake. I volunteered to help, because I was the only tech at the time that would handle a snake. It's basically the same as euthanizing a dog or cat, except you inject the solution into its heart. And you have to sedate it first. It just makes things a whole lot easier. As the doctor and I were watching the snake slowly lose consciousness from the anesthetic gas, we noticed how cute his little face was. And we both actually started getting sad. Then we disconnected him from the gas, felt for his heart, and stuck him with the needle. We both shed a tear or two while watching the snake take his last few breaths. It was sad, guys. Fast forward 2 days....we walk into the treatment room in the morning, and the smell of death is in the air. We have no idea where it's coming from, until one of the techs discovers something in the back kennel. It's the dead snake. On a heating pad. And it had been there for 2 days. Yeah. It smelled pretty bad. Don't ask me how we forgot to get rid of a dead snake, but somehow it happened.
Somewhat funny euthanasia story #3:
It was another old dog. He had several cancerous masses all over his body, arthritis in all his joints, and had a really hard time getting around. He was also a very sweet old dog. Oh yeah, and he weighed 130 pounds. This dog wasn't terribly huge, but he was definitely solid. So we went through the procedure, and afterwards we had to transport him. (We store them in a big freezer in the back until they get sent out to be cremated). We have this stretcher that's supposed to help lighten the load a little bit with such big dogs. After we managed to get a black bag around him, we rolled him over onto the stretcher, and proceeded to lift him off the floor to carry him into the back. We made it probably 10 feet, and I hear this big crack simultaneously with 130 pounds of dead weight being pulled down to the ground. Our one and only stretcher broke. Apparently it wasn't meant to hold that much weight. So we got a third person to help us drag the stretcher back to the freezer. Two people were pulling, I was pushing. If you can picture it, I was pushing this huge dog with my rear end sticking up in the air, slipping on the hard tile floor and trying not to run into walls. One of the techs working just looked at us and said, "Never a dull moment."
Hope you can find at least one of these stories as funny as I did. Otherwise, I'll just feel like a horrible person for laughing about dead things.
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