This week, I spent 3 1/2 hours in with consulting vets and it was far from quite to say the least. After a couple of cats in need of booster vaccinations, a German Shepherd was brought in. It was shy and desperate to escape the hands of the vet; we could tell this was going to be a difficult case. This dog suffered with regularly occurring cysts which would not be a problem until he began to scratch at them and vigorously lick the fur surrounding them. This had happening to a cyst on its side. The vet tried to shave the fur around the cyst to make it more visible but this soon became an arduous task as the dog whimpered, struggled and barked. The vet quickly made the decision to put a muzzle on him. Afterwards she told me that if there was any ever doubt, she would use a muzzle as she liked her fingers. Better safe than sorry. The struggle continued as the area was cleaned before the cyst was punctured and flushed out. It had become infected so antibiotics were prescribed and a buster collar was fitted. that dog was very glad to turn his back on us.
Immediately after this, an owner brought in a new Golden Labrador. Its owners had died tragically and so this family had given it a new home. They had only had him for about 5 days and he appeared very excitable. They had all his history but he still needed a check up and this is when the problems arose. During the process of placing the stethoscope near him, the dog went crazy, rolling on his back and snapping at the vet. There was no way to tell if this was playful or serious so a muzzle was put on him. After more struggles, the vet fetched a nurse to help hold him but still with no success, we took him out back to the kennels. I helped here in grabbing the legs of the struggling dog and eventually we managed to manoeuvre the dog in a position where he finally lay still. With the vet, nurse and me pinning him to the floor the vet peered into his ears using an otoscope. The ears were filthy and infected so she took a swab to be sent to the lab and advised the owners to stop giving the medication that had come with the dog and wait until the problem could be diagnosed and the best method of treatment could be decided. It was also suggested that sedation and a full flush would be necessary for the best long term results. In the meantime, she highly recommended that they underwent training with their new, enthusiastic though slightly boisterous dog.
A cat came in for a check up after a very bizarre episode the previous week. It had been rushed into the vets appearing ‘drunk’. Its limbs and back had seemed out of control and the vet described how it had managed to back flip off the examining table. The vet suggested a number of possibilities as to the cause ranging from accidental poisoning if the cat had drunk any chemicals it should not have to a virus or an accident which damaged the nervous system in some way. However, the vet had no real idea of the true cause but as the cat was steadily improving back to her normal self, it was admitted that they may never know the cause unless it happens again, in which case more investigations would have to be made.
We saw a Boxer with an ulcer in his eye which had been there for at least two weeks. After this long it had become bloodshot and as a result the dog had been brought to the vets. However, with all eye problems, it is recommended that immediate action is taken to optimise full recovery. The vet used fluorescein to highlight the ulcer which could be clearly seen when the lights were turned out. She then applied a local anaesthetic to the eye and swabbed around the eye for a foreign body such as a grass seed which may have cause the irritation. Unfortunately nothing was found on which the blame could be cast so eye drops were prescribed in addition to the ear drops the dog was already taking and the owners were told to bring the dog in again on Monday in order to monitor progress carefully and take action where necessary.
The surgery was now running very late and as I moved consulting rooms to a different vet, I encountered a very different consult. An old spaniel was brought in which was covered in lumps. There was one particular, very large lump on its side which had been tested and confirmed to be cancerous. The owners were now battling with the difficult decisions which accompany cancer. The dog was on steroids which were significantly reducing the size of the lump but did not have the ability to get rid of it completely. As the lump was very large and very near the leg of the dog, it would have been impossible to operate and remove the lump to ensure that the appropriate margins were met and that the skin could come together and heal cleanly. So, by using the steroids this introduced the possibility of surgery, giving the owners a choice as to what could be done. The ultimate decision was whether to take the risk of an operation, possibly extending the dog’s life, or just going for the option of palliative care and continuing to provide the best quality of life and considering euthanasia when the time was right. However, underlying this was the question of steroids and the time in which all this could be done. Hindsight is a wonderful thing but without it, it is necessary to make life changing decisions and be confident that you are happy with what you have chosen and not question your judgement.
In the kennels today had been a diabetic west highland terrier who had been undergoing monitoring to assess the doses of insulin it needed. The reason this dog had become diabetic was as it was very overweight. Because of this, the owners had to strictly monitor the food in the hope of reducing the weight and working to optimise the insulin injections. Most of its life, the dog had been used to having large portions of food at least three times a day, therefore, I found it interesting to hear that they fed it carrots when it was hungry with the idea that they had a very low calorie content but filled the dog’s stomach. The decision had been taken to give the dog two lower insulin injections a day rather than one large injection it had previously been used to. Although this would be more work for the owners, they were prepared to put in the extra effort to help maintain a steadier blood glucose concentration. In addition to this, the owners asked whether, if they ever forgot to give an injection, they should give it as soon as they remembered or leave it. To this the vet explained that if it was a long time since the dog had eaten they should not inject insulin, for it is more dangerous to have low blood glucose levels than high.
The last patient today gave me another opportunity to see the use of fluorescein, however, this time the result was negative. A border terrier seemed to be in significant pain, whimpering and with its eye half shut and streaming. The vet put in local anaesthetic which eased the pain and then used the fluorescein. Nothing showed up and the vet began to worry. With eyes it is so hard to tell what is wrong when it is not simply a foreign body. She gave it some eye drops to dilate the pupils and told the owner to bring the dog in again tomorrow, after which they would monitor progress and possibly consider sending the patient to an ophthalmologist.