Emergency Work

Emergency Work

/ Dr. Christine McFadden / Leave a comment

 

Dr Mc Blog

January 14, 2016
Emergency work is not as much fun as it’s cracked up to be. I imagine it’s easier when that’s ALL you do, and staying up all night takes on a kind of rhythm, you adjust to sleeping during part of the day. I am one of those unfortunates who do not do well after 24 hours of being on my feet and some adjustments have had to be made in my career because of it.

They should have recognized this back in vet school. One particularly hellish week I was assigned to the Small Animal Intensive Care rotation. I am certain they used this to weed out the weak : I was assigned evenings, over-nights, and mixed them back and forth. I had one day. In addition, we were all to present for Rounds at 11 AM, or else. By the end of the week I was so groggy from lack of proper sleep that I had to stand, then sit, then jump up again during rounds just to keep awake. My remaining memories from this time were of a dog that presented for near-fatal bleeding ulcers of the stomach, caused not by the 5 pound box of Valentine’s candy he ingested (chocolate can be very toxic to dogs) but by the helpful owner who heard you can give them hydrogen peroxide to make them throw up and instead of a tablespoon (which would have been the recommended amount for a 90 pound dog by her veterinarian) she managed to throw a good pint down his throat. The dog lived, but it was nip and tuck for a while. There was a parrot caught in a typewriter. (We ended up dismantling the typewriter. The bird suffered a small laceration on one toe, which healed beautifully). And there was a female client who was so impressed with her station in life that she addressed her husband as “Dr” and we all wondered if she wasn’t allowed to use his first name. I’ve met more of that type since and now understand that they just need to get over themselves. But these days in school only served to underscore what I already knew – some of us just can’t pull all-nighters.

And of course my first job (yes, here in Merced) involved rotation through emergency work. To be more precise, an emergency medical call can occur at any time of day – seizures, poisoning, hit-by-cars – and it can be inconvenient to drop everything, annoying your other clients, to attend to that pet. On the other hand, at least here in Merced, most clients recognize that that could be them with their pet and they graciously forgive you.

So during the daytime, I can pretty much handle whatever walks through that door. My definition of emergency work is confined to those cases that come in after normal day time business hours, during sleep, on days of presumed rest.

My very first week of being on call in Merced I had two hit-by-cars on different nights and removed two bleeding spleens around 2 AM. They both lived. The third spleen (yes, things come in three’s) came in with a little dog suffering from an immune disorder. He also survived and improved after his splenectomy. So in the first month that I worked as a veterinarian fresh out of school I removed three spleens! I found that odd, but this career has always provided many unusual and odd things to get through.

There was the night I was driving to an emergency call (yes, driving the speed limit) and a cop pulled me over. He knew me (I took care of the police dogs) and he said he thought I’d wobbled. I assured him I’d had nothing stronger than orange juice (it is extremely rare for me to drink alcohol. The effects are worse than emergency work). He replied that he believed my story about an emergency because he knew I never looked that way in the daytime………..

So it is to everyone’s benefit that I procure 8 hours of sleep every night. You might say it’s just what the doctor ordered!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

Heatstroke

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

 

May 24, 2016
Summer is coming. In Merced that can mean baking temperatures over 100 degrees. Even if the day doesn’t go over the 90’s, the black asphalt paths that line Bear Creek, Black Rascal Creek and many other favorite walking paths will heat up significantly, holding the heat well into the evening hours. People walking in rubber soled sneakers may not notice how hot the ground feels. I actually recommend that clients who take their pets out for an evening stroll bend down and place a flattened palm to the sidewalk or path – only then will they recognize what their dogs’ feet are feeling. Sometimes my hand has burned at 9 o’clock at night! If at all possible, consider early morning walks with your dog – they can be quite refreshing and you might take in an egret or hawk flying overhead.

Dogs are digitigrade (love words!), meaning they stand and bear their weight on their toes, not a sole or heel like a person. Each toe is covered by a protective pad of keratin, a horned callus that protects them from injury. Inside that is thick fatty tissue, a good shock absorber. This pad is soft in young puppies, thickening and hardening with the use they get from exercise and exposure to different terrain. A dog that has sat on the couch all summer will have tender feet if suddenly expected to go game hunting for miles in the fall. That bicycle ride you took, with your dog running gamely behind? Don’t be surprised if he or she comes up lame the next day, bare patches of pad rubbed away to expose bleeding sores. This goes way beyond blisters and will take weeks to heal, as the lost tissue can’t be sewn back on, but must slowly granulate in from the sides of the wound. Walking on soft grass is about all those dogs can bear to do for some time. Don’t take your dog’s feet or athleticism for granted – they need regular, planned exercise for peak performance and health. This is your chance to shine as a Personal Trainer! Don’t blow it!

I would like to believe everyone knows not to leave a dog in a car in a parking lot during our summers. Forget cracking the windows. A CRACKED WINDOW WILL NOT PREVENT HEAT BUILD UP IN THE CAR. It has been estimated that even on a day when the outdoors temperature is in the mid-70’s, that the interior of a car can rise to over 100 degrees or higher in less than 30 minutes. Seventy degrees? Can you imagine how quickly that temperature spikes in our area on a real summer day? One estimate I read stated that on a 90 degree day the inside of a car could reach 110 degrees in less than 10 minutes! The American Veterinary Medical Association (AVMA) posts some interesting and horrible facts from several studies on Pets in Vehicles.  The car acts like a greenhouse, with the air unable to circulate or get back out through the windows. The pet cannot breathe in the overheated air and dies from heatstroke. The dogs core (inside) body temperature may go over 104 degrees. The highest temperature I ever recorded in the stomach of a dog that had died from heatstroke was 110 degrees – our thermometer didn’t register any higher. It was too hot to keep my gloved hand inside to perform the necropsy. (The word “autopsy” is reserved for post-mortem examinations of humans or “self”. An autopsy is an examination done to determine the cause of death. In animals we most commonly use the word necropsy.). These are very sad moments, indeed. California does have laws restricting leaving pets confined inside a car under conditions that endanger the pet’s life. Please, leave your pet at home while you run errands. Here in the Valley make sure your outdoor kennels are not all concrete, baking in the sun. Shade cloth is not enough protection, either. Mature trees, watered and shaded grass, even outdoor misters should all be considered for your dog’s health and comfort during the summer days when they are outdoors. As we see each summer, it is a matter of life or death.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

Snap the Cat and the Broken Jaw

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

October 22, 2014
His name was Snap. He had some Siamese in there somewhere because he had huge blue eyes and a white body with orange fur on his ears, tail and feet, a color we call “flame point”. A stunning kitten, he was all male : big, rangy body with long legs, on the prowl to explore my exam room as soon as he was set free from his carrier. Outgoing, slightly aggressive, he was not a cat to take well to indoor confinement. Fortunately Snap’s owners had a large yard and felt their kitten could grow up there safely. No animal is bred to live a life totally indoors, never seeing the sunshine.

Snap grew quickly, losing his first kitten baby tooth as he approached 4 months of age. Most kittens gain about one pound a month as they grow, but Snap gained more – he was going to be BIG! His owners reported that Snap, who got his name when he ran to them every time someone  snapped their fingers, had added fetching to his repertoire. Green beans were a favorite for some odd reason. Snap never ate the beans himself, but his family hated to be wasteful and found themselves researching new green bean recipes as they tried to keep up with his passion. Thanksgiving was the only time of year they could look forward to without guilt (add canned mushroom soup and French fried onions for a traditional casserole).

When Snap was neutered at about 6 months of age he was just losing his baby fang (canine) teeth and looked quite adorable. Neutering helped to suppress his urge to wander and would markedly decrease the likelihood of fights with other cats, which in turn could expose him to diseases like feline leukemia, feline AIDS (FIV, the Feline immunodeficiency virus, NOT infectious to people) or problems like abscesses. “Tomcats”, an old fashioned expression for unaltered or intact male cats can also develop “stud tail” – you don’t want this folks, however manly the name may sound. It’s a greasy patch that dirties the hair of the upper tail. Yech! And the urine of an intact male cat has a unique smell that can only be called a “stench”. It’s hard to draw breath in the same room. The good news is that one surgery and the smell, the greasy tail, and all just go away and you are left to enjoy your cat.

If the average cat weighs 10 pounds, Snap was out to prove that he was anything but average. By 2 years he was 14 pounds of lean muscle, extremely athletic and he enjoyed accompanying his owners on their nightly neighborhood walks. He was a powerful hunter of toy mice. He could jump from a standstill straight up ten feet. He talked frequently, expressing his disapproval if they were a little slow serving him breakfast. Snap had scheduled petting times, also, and showed his displeasure if one was missed by turning his back to the family when they finally came home.

But one night it was Snap who didn’t come home.

The following day we received a phone call that he had been found and was being rushed down to the hospital. And oh, the look of him made our collective stomachs drop. The beautiful fur was wet from mud and blood. His jaw hung crookedly and his nostrils were plugged with clots of blood. He was able to stand and even walk, though there were long scratches abrading one side of his body. It was obvious that Snap had been hit by a car, thrown through the air, and slid hard coming down. The broken face had been the site of impact.

Animals suffer from concussion the same as people. Snap’s pupils were pinpoint (meiotic) but he was responsive and even in a daze he was able to follow visual cues to show us he could still see. We started him on IV fluids and shock therapy and under gentle sedation assessed and cleaned his wounds and took x-rays of his skull. It was pretty bad. He had fractured the center of his lower jaw, so the right side of the mandible was split from the left. Worse, his upper jaw or maxilla had broken and the pieces shifted so that part of the roof of his mouth, the hard palate, was shoved upwards on the right, crunching into his nasal passage and sinus. Oddly, the soft tissue of the hard palate, though bruised, was intact. We were able to wire the lower jaw together on the spot. There wasn’t much we could do about the roof of his mouth but wait and see. All the teeth still overlapped correctly, so he could close his mouth properly. We inserted a feeding tube down his esophagus to the stomach and threaded it out the side of his neck to facilitate eating during recovery. And what a recovery. By day 3 his pupils were normal and his attitude improving. By day 5 he was eating soft food on his own, so IV fluids and feeding tubes were removed. Snap went home, returning to have the wire in his lower jaw removed 6 weeks later. Snap lived to be 15 years old. He never liked to have his mouth examined after all that and his face was a little crooked, but we knew he’d made it when he left a green bean on his owner’s pillow one night.

Christine McFadden, DVM

Valley Animal Hospital