‘So you just need to give the right amount of poison?’ Kathy asked.
‘How do you know what the right amount is?’ Lachlan said.
‘Yes, it is poison and, well, I don’t know what the right amount is. That’s the difficulty. You’ll have to give it to her for a few days at home then test her again.’
‘And what is the alternative if we do nothing?’
‘If you don’t treat her, she’ll lose the ability to maintain muscle. So she may have heart problems. She’ll become pot-bellied, lose a lot of hair, and waste away despite a voracious appetite. She might become aggressive and start stealing food off tables, off people, off children. But eventually she’ll fade away and die.’
How do you convince someone to give their dog poison for an uncertain outcome at considerable cost?
But Lachlan and Kathy were great. They wanted to pursue this to the end. We treated Dolly with the mitotane for three days then got her back in for another test. The results came back the next day showing we hadn’t treated her for quite long enough so we dosed her for one more day before we pulled back. We got Dolly’s ‘Cushion’s’ disease well under control and she returned to a happy life. A few years later, a safer drug came around, but things were so well controlled by the mitotane that we decided not to risk a change.
It would have been three years later, when Dolly was about twelve years old, that she was brought back in, really sick and bedraggled. She’d lost a lot of teeth, she was smelly, her ears were bad, and her eyesight was failing. It didn’t take more than a cursory look for me to determine that this was the end of the line for Dolly Sabel.
Cushing’s is, ultimately, a cancer. Most dogs with Cushing’s don’t live long enough for the cancer to start causing other problems. Dolly was a tough dog but now it appeared her condition had caught up with her. When I tried to stand her up on the examination table, she collapsed, making a groaning noise.
So we had the big talk. Everyone was upset. I said that Dolly had had a great run, living with Cushing’s so long, but that it always got them in the end. It was time to think about Dolly’s best interests. Kathy was very distressed but, like a lot of women in that position, remained rational at the same time. She asked a few questions through the tears. Lachlan looked at me as if to say, I’m only holding it together because I don’t think there is room for the two of us to lose it.
Lachlan was getting quieter the longer we talked. I’ve noticed with a lot of men that they’ll come in with no emotion – ‘Everything’s under control here. Ignore my wife. She’s very attached to Fluffy. We’ll handle this man-to-man. We’ll go out the back, shoot it then go have a beer.’ They don’t actually say that, of course, but you get the drift. But when the blokes crack, they really go to pieces. And here’s the thing: they always crack.
Lachlan was saying nothing now, striving to maintain the strong outward persona, but his upper lip was quivering. Kathy was crying, but talking. She was the one who took charge. ‘Look, we know we’re going to have to put Dolly to sleep; we just want one more night with her. We know she’s in distress and discomfort but we need one more night to deal with this.’
So we put Dolly on a drip and sent her home with painkillers. Lachlan and Kathy hoped that Dolly would pass away quietly in her sleep but I knew that dogs don’t go quietly. I was fully expecting a call in the middle of the night.
Despite my reservations about letting Dolly go home, the Geoffs had drilled into me that there was no right or wrong way. If a client had very strong feelings in one direction, and there were no obvious welfare issues, it was best to go along with them. The Geoffs had over sixty years of veterinary experience between them and, despite my misgivings, they were my mentors and I accepted their views.
Still, I didn’t think that Dolly would see out the night, or that Kathy and Lachlan were well equipped to see her die at home.
First thing the next morning I called their home expecting to hear that Dolly was dead or that they wanted me to come straight out to put her down.
Kathy, however, was peculiarly bright and effusive. ‘I’m going to bring her in straight away,’ she said.
‘Okay, we’re free now.’
I went and got the Lethabarb, gathering my gear for the sad job at hand then, minutes later, Dolly trotted through the door, looked at me, barked, ate something, drank from a bowl and proceeded to sniff around the waiting-room chairs.
‘We sat up with her for most of the night,’ Kathy explained. ‘She was very quiet all night, we thought we’d lost her numerous times; however, she kept breathing and would open an eyelid when we called her name. We both fell asleep sometime around 4 a.m. and when we woke up we couldn’t believe our eyes. Dolly was trotting around the house like nothing was wrong. She had even chewed her drip line out as if to say, “I don’t need that any more.”’
I have no idea what caused her illness and no idea how she got better. But she did. It was a resurrection. Dolly Sabel lived for another two full years. Just fine.
I learnt an important lesson that day. If I had based my decision purely on my medical training, Dolly would have been euthanased. But because I listened to the client, nature took its course and surprised me. You don’t learn everything at university. Sometimes you have to listen to the people around you.
A POSH PADDLEPOP
James
The Wisbech clinic had a loyal employee, Ricky Watling, who’d been there for twenty years. Now, while Ricky had a mild intellectual disability, he worked diligently at cleaning the cages, helping to hold animals and doing all the little jobs that needed doing around the place. He must have been in his late thirties and he’d spent all those years accumulating an encyclopaedic knowledge of the Liverpool Football Club. Because I was male, he pretty much assumed that I’d be equally fascinated by Liverpool FC and all things related to English soccer. He’d talk about it all day every day, which was fine by me, but everyone else was like, ‘Please, Ricky, shut up.’
Ricky was also a keen observer of patterns. He knew, for instance, that if Ronnie was in town, we’d go to the pub for lunch, and he also knew our favourite places for dinner. Lo and behold, he would always turn up. As we tucked into our meals, we’d see his dumpy frame heading towards us with his very short dark hair and see-through pale skin. We’d have to laugh. It was all part of the fun. He was a real character.
But Ricky had a bit of a target on his back. He had the ability to sometimes upset people by being not as socially aware as others. One night we were at the pub and he must have said something because one of the chavs wanted to fight him.
We drank up and grabbed our jackets: ‘Come on, Ricky. We’ll walk you home.’
As we strolled back to his place we chatted about his life. ‘You live with your parents?’
‘Yeah, yeah. My grandparents, my parents, my brother and my sister. We all live in the house together.’
‘What do your grandparents do?’
‘Nothing, they’ve never had a job.’
‘And your parents?’
‘No, never had a job neither.’
‘And your brother?’
‘No, he don’t work. Who’d give him a job?’
So Ricky, with his intellectual disability, was the only one in three generations who’d had a job. It didn’t seem to me that Ricky thought of his employed state as being anything out of the ordinary. He wanted to turn up each day in order to help animals and to talk about Liverpool FC. The fact no one else in his family worked was totally normal; he’d just decided to go a different way.
Wisbech certainly was different. No more so than the day Mary Goodacre burst into the clinic with a border collie cross in her arms. I’d seen a bit of her and the dog, Posh, in recent weeks, and my predecessors had looked after her before that. Mary, a slightly stumpy woman, came through the door like her greasy black hair was on fire. ‘Quick, quick. You’ve got to see Posh. Where’s the vet? She’s dying.’
For Mary, everything was an emergency.
So we weren’t as hurried as we otherwise might have been.
Posh had horrendous diabetes, which Mary had been unable to treat. I gathered that Mary suffered a mild intellectual disability and, no matter how much she loved Posh, she just hadn’t been able to keep up with the rigorous treatment. She hadn’t fed the dog regularly enough, nor had she kept to the tight schedule of insulin injections. Treating diabetes sporadically is dangerous.
Posh couldn’t walk now. She looked up to me from Mary’s arms with sad, slow eyes sunken in their sockets. She was impossibly skinny. I examined her and it appeared that Mary was right. I diagnosed diabetic ketoacidosis, which I explained to Mary was the end stage of diabetes when the animal is crashing and basically attempting to die. Because Posh couldn’t metabolise glucose, her body had started to feed off the protein in her muscles, which left them wasted and thin. Typically, dogs can survive like this for a while, but eventually an infection comes along and everything falls to pieces. That’s where Posh was at now: dehydrated, weak, very skinny and moribund.
As gently as possible, I said, ‘Posh has reached this point despite your very best efforts and so I think it might be time to put her to sleep.’
Much discussion ensued with Mary speaking in her short, urgent sentences, and me doing my best not to sound like I was blaming her.
Posh was getting on too. I presumed she had been a pup when the Spice Girls had had their first hits, so she was probably about eleven or twelve. Even if Mary could have given her the best care, Posh wasn’t going to live much longer. It took a long time to explain this to Mary and to have her understand what we needed to do.
‘Yes. We must help Posh,’ she said, eventually. ‘You’ve got to stop her pain.’ And so it was with much sadness all round that we put Posh to sleep for the very last time and Mary waddled out with tears in her eyes.
Two days later, however, I heard a commotion out in the waiting room and heard Mary asking for me. I came out into the reception area with some trepidation as she rushed over to see me, not quite leaving me the usual buffer zone of personal space.
‘I really want to see Posh,’ she said. ‘I really need to see her.’
‘Okay. Why do you want to see Posh?’
‘I need to know that she’s really dead.’
‘Okay. I can get Posh out for you. But you realise that she’s been in cold storage for several days? She might not be looking that nice.’
‘Yes, yes. I just need to see her. It’s for me own mental well-being.’
‘Okay, I’ll go and arrange that. You just wait here.’ So I went to the freezer out the back. Unfortunately, after Posh died she had urinated profusely post-mortem within the bag in which she was stored. The bag was put into the freezer on a slight angle and all the urine had run to the end where her head was, before it froze. So Posh’s head was now encased in an enormous golden iceblock in an awful contorted position. What do I do now?
There was nothing for it but to grab some surgical instruments and start chipping away in much the same way one might use a hammer and chisel. Immediately the edges started to thaw, the awful smell of deep-yellow urine from dehydrated dog filled my nostrils. I was screwing up my nose while banging at the weird icy dog-pop. My colleagues looked at me like I was demented.
‘You don’t want to know,’ was the best I could offer them.
‘Nah, what are you doing?’ Ricky persisted.
I told him. He scratched his chin from a safe distance. ‘Nah, I wouldn’t do it like that. You need a chisel.’
‘Thanks, Ricky. Can you get one and give me a hand?’
‘Nah, we ain’t got a chisel. But that’s what you need. Or a hairdryer. Maybe a heat gun?’
It took about twenty minutes of hard work. I was sweating. But I’d got the ice off and managed to make Posh look a little less horrific, positioning her nicely and wrapping her in fresh towels. Still it wasn’t pretty. I figured, however, there was nothing more I could do short of a complete mortician’s makeover.
‘If you could come this way, Mary,’ I said in a gentle voice like I imagine undertakers might use. I led her in, full of apprehension. ‘Now, she has been in cold storage and she doesn’t look her best,’ I said.
Mary looked at the dog for perhaps two seconds. ‘Yep, that’s definitely Posh. She’s definitely dead. Thanks, James.’
She turned around and walked away, nonchalant.
I suppose she needed to lock that one away in her own mind. It wasn’t about grieving. I’m sure I could have left Posh’s head in the ice and Mary wouldn’t have cared. I don’t know, maybe she thought we were stealing her dog. One thing I did know was that people deal with death in many different ways. Whenever we put a dog to sleep we explain that we can do it however the owner wants. You can be with the dog. You can leave the dog with us. You can pick it up afterwards to bury yourself. You can have us send it to a pet crematorium. However, we never, ever offer to have their heads encased in a golden iceblock.
MANNING THE FORT
Anthony
There was an interesting dynamic between the two Geoffs. Geoff Scarlett was a really big man. Thick-set and outgoing, he had a big personality and was a social kind of guy. Geoff Manning could also be like that sometimes, but it was underneath a few layers of complexity. He was, essentially, reserved and quiet – characteristics that could be perceived by those who didn’t know him as gruffness.
Geoff Scarlett was five or six years Geoff Manning’s junior. I always assumed that when Geoff Manning retired I’d buy him out and go into partnership with Geoff Scarlett, which was part of the reason I’d chosen to come to Berry in the first place. But one day I overheard a snippet of conversation between them suggesting that Geoff Scarlett might be leaving. It left me in a bit of a limbo, not knowing what was going on, but eventually Geoff Scarlett came and told me.
‘Look, I’m retiring,’ he said, explaining that his right wrist was giving him hell and he couldn’t continue to work. Among other things, he’d aggravated it lifting cows’ tails during the tuberculosis eradication program in the 1980s. They’d had to go around to all the farms and give every single cow a small dose of intradermal tuberculosis in the fold under the tail. Two days later, they’d gone back and lifted each cow’s tail to see if a bleb had formed. If it had, the cow had tuberculosis and she’d have to be culled. The incidence of tuberculosis was minimal in this area but it was a national program so no cow could be missed. He tested 30,000 cows. Now he was the final casualty of bovine tuberculosis. ‘I’m a cull,’ he said. ‘You’ll have to talk to Geoff about what’s happening with the practice.’
After a brief discussion, Geoff Manning explained that he was buying Geoff Scarlett out but that I’d be looked after. A year later, in 2008, Geoff Manning sold me half the practice at a very reasonable price. Geoff and I went on to have a fantastic partnership. He was like a father figure to me. I had a great relationship with his family, who all treated me like I was one of them. I was the same age as Geoff’s children too. In fact, his daughter, Georgia, was born the day after me. Geoff was caring and always supportive, and increasingly over the years I got him on side with my ambitions for the practice.
I wanted to open a branch clinic in Kangaroo Valley, but I knew Geoff would be reluctant because he’d had thirty years to do it himself and hadn’t. The two Geoffs had once run a branch practice at Shoalhaven Heads out of someone’s garage, but once council got wind of it they let it lapse and just reverted to the regular Tuesday run out there. Then that Carol-stealing competitor opened a practice at the Heads, cutting our grass. We considered the Heads to be our turf, just like we considered Kangaroo Valley to be ours.
I thought we couldn’t let that happen again. I was determined to open a practice in Kangaroo Valley. It was a prime spot for some young vet to come along and hang his shingle . . . and that young vet was going to be me.
We had dropped from a three-vet practice to two, but I wasn’t keen to put anyone else on for a while. Like anyone who buy
s a business, I was driven by fear. Geoff and I were working much harder, but turnover and profitability were up. I wanted to keep it going with the Kangaroo Valley expansion. Eventually I talked him around with the idea that we’d start on a very small, low-cost scale. We opened for business in one of our nurse’s garages for just one day a week.
I’d go over there at 7 a.m. and there was so much to do I wouldn’t get back to Berry till 3 p.m. or 4 p.m. We realised we were on to a pretty good thing. So we just built it up slowly. I had to prove that each step of the way wasn’t a waste of money and that it made business sense. As we went along, Geoff became easier to convince because the ideas were working.
We toiled five days one week and five and a half days the next, and we each did every second night on-call during the week. Whoever had the weekend would do Friday night to Monday night. So when the weekday rotation gave you Tuesday as well, you ended up doing five nights straight on-call. You have to have done on-call work to know what that’s like. It’s not about being busy, it’s the fact you are waiting for the phone to ring; not being able to switch off and go for a run or a surf or even to Kiama because you have to be within a certain distance of the practice. Work dictates your life and is partly why it is difficult to get young vets to the country. Most of the city practices switch their phones to 24-hour emergency centres. You can’t do that in a country practice because the distances are often too great.
After a while, I figured that the practice needed a facelift. It was a major undertaking to convince Geoff to spruce up the place, since it was working just fine as it was. I talked him around but didn’t tell him something else I had in mind.
One day when Geoff was out I saw all the nurses, Trish, Marie and Rebecca, standing at the front desk. ‘What would you think about having a fish tank here?’ I asked, gesticulating like a game-show hostess. Their chorus of assent indicated I was on a winner. ‘I’ve always wanted a fish tank in the practice,’ I said. ‘It’s a nice finishing touch, a soothing noise and it’s pretty. But Geoff’s going to go through the roof. He’s going to hate it. So I need you guys to be a part of this. When I put the idea to him, you’ve got to chip in and say what a fantastic idea it is. Okay?’
Village Vets Page 22
