One candidate seemed suitable, friendly, and confident. She was keen to do all three of our target species. Ottawa was home, so it would hopefully be a comfortable match. The contract was ironed out, uniforms and nametags purchased, newspaper ads placed to announce the new vet in the town, and the new relationship began.
Cheryl had had some experience with horses and was keen to get more. Although not from a horse background, she was smart enough to get the lingo fast. Besides, no equine person had applied. Her small-animal skills seemed sound enough, and I felt I could train her in the rest over time. She was bubbly and enthusiastic. As the first few weeks went by, I found I wasn’t as patient as I had thought and I often had difficulty steeling myself to repeat the same instructions over again. I went home at nights vowing to be more like Jim and shuddering at the fact that some times I reminded myself of Dr. Moore. I was anxious to get Cheryl up to speed quickly so that the pets and clients had minimal disruption.
Several weeks into her new job, Cheryl had to perform a horse euthanasia for a rather difficult client. The “old favourite,” Cherokee, had been ill for a long time with Cushing’s disease, and repeat episodes of laminitis had caused him to have chronic foot pain. It was time to end that pain, as winter was coming on and the frozen ground would make walking difficult. There was no way I could go out that day, though that was requested. Reluctantly, the owner agreed to have Cheryl go on the call, as that was the appointed day, the burial site had been prepared, and everyone had said their goodbyes. This could not wait. Cheryl had euthanized several other horses, and the procedure had gone smoothly.
After about an hour, Cheryl came back pale and obviously shaken.
“That did not go well,” she said. “I must have hit the carotid artery instead of the jugular, because he went down convulsing; it was like he was galloping on the spot.” She burst into tears.
“There was not enough help, and it took me several tries to get the vein again with his head moving. It was awful!” It was a situation I might not have gotten into, as assessing the need for sedation in advance or clipping the long hair over the vein are things one learns through hard experiences such as these. I felt sorry for her.
It was not half an hour later that I received an angry phone call from the horse’s owner. She ripped up one side of me then down the other for having sent Cheryl to do this critical job. Her complaints were many, but the most strident was the fact that her final image of her pet was of this stressful debacle. I apologized profusely, understanding her point, but also trying to point out these things could happen to any of us, especially with thin, dehydrated animals. Indeed, it had happened to me. I was left feeling frustrated that I could not shelter Cheryl from all the hard experiences I had had no matter how I tried to anticipate everything I needed to tell her.
The horse people were merciless. I understood it would take patience on their part to allow Cheryl to learn, but had no idea how little they had. Even discounted bills didn’t appease them. And then there was the talk within the horse community to combat. Cheryl started to feel nervous going out on calls, although many went well. She was definitely more comfortable staying in the clinic. I was left wondering how to make it all work out.
One cold night, she had a late call for a colic, the most serious equine emergency. Although a blanket name for any abdominal pain, the word colic strikes fear into every horse owner. In some cases, it will be caused by a simple problem like gas buildup or impaction; in others, a twist of the bowel will cause rapid worsening of the pain. Without surgery, some of these animals die. The skill is in deciding which animals need surgery in time to send them to the vet college before it is too late to save them.
“MacDonald,” the old gelding in question, had had several impaction colics due to poor teeth and indigestion. His owner, Mrs. Tailleur, was a scientist and an experienced horsewoman, having seen many vets perform. As the horse was inactive, he always tended towards too-dry manure. Cheryl went through the routine examination of vital signs and decided it didn’t look too serious. His gut sounds were diminished, and she did a rectal exam of the senior citizen, feeling the expected impaction. It was still small and should be easy to treat. A stomach tube would have to be inserted via one nostril, and mineral oil and warm water pumped into the animal in a large enough quantity to soften the mass.
After several fruitless attempts, the horse started to throw his head and struggle. He could not be convinced to swallow the tube. On the last try, the left nostril started to bleed profusely and Johnny snorted blood vigorously all over Cheryl, Mrs. Tailleur, and the stall wall. The amount was sensational, and soon large clots were hanging out of the horse’s nose.
“We’ll have to sedate him and try the other nostril; he must get this oil,” Cheryl said. “The bleeding will stop soon,” she tried to reassure the unconvinced owner.
After sedation and a nose switch, the anxious young veterinarian tried on the other side. Despite changing the head position and stroking the throat, the animal would not swallow the tube and started gagging. Now the oil would have to be administered by dosing syringe. The lack of co-operation continued, and Cheryl wore half of the gallon of oil on her coveralls. Frustrated, she cleaned up and left, telling the owner to continue with the oil and walking the horse throughout the night. Thankfully, Johnny did pass manure the next day, but it was the last straw for Cheryl.
The next day, she approached me at a quiet time and said she was throwing in the towel. I certainly had no trouble knowing how she felt, remembering my own cattle troubles.
“I think I’ll be better off in a city practice,” she said, “and I’d love the no ‘on-call.’” I realized it was probably for the best. It was unfair for her to be subjected to such pressure. I was alone again.
I changed my tactics. I felt it was critical to get someone in place who was comfortable with horses, preferably before the next spring’s busy season, with its demands. Perhaps if this person could do horses well, he or she could do all the artificial insemination, and I could slowly train him or her to do small animals. I advertised the position differently.
Again, no experienced candidates applied but the fellow I did hire had good recommendations and credible horse experience. Richard started out with a splash and had a shiny suv leased and fully stocked for the road within two weeks. He really looked the part. However, we got into a totally different set of problems when it came time for him to wear his small-animal hat. It got so that I was afraid to be away from the clinic.
One day, I came back to a very distraught Erin after having spent a morning in surgery with this fellow.
“I had to re-tube all the animals,” she said. “He didn’t get one tube in the trachea.” She ended her long list of complaints by saying, “Please don’t leave me alone with him again.”
I kept an eye on what was booked and made sure it was easy enough, but I still felt nervous when I was on the road. On another occasion, I came back to find several staff members upset. Voices shaking, they surrounded me in the staff room.
“You must not keep this fellow,” Jill said. “I wouldn’t let him touch one of my animals, so how can we recommend him to the clients?” She had a point. I wrung my hands. What had happened?
“Dr. Carrera gave vaccines to a small dog whose file was clearly marked allergic/no vaccines,” Jill said. “Only because Erin was here and the puppy got oxygen and antihistamine did it pull through. It could have been a disaster.”
I threw my reading glasses on the floor in exasperation. I knew I couldn’t ask our clients to entrust their precious animals to a vet we wouldn’t trust with our own. Voices in my head questioned my ability to choose and interview a vet correctly. How had Jim been so tolerant with me all those years ago? I was finding it hard to be a good and patient mentor and found I had difficulty getting through the mistakes. I just knew that everyone at the clinic, including myself, was suffering th
e strain of being constantly on edge.
With a sinking feeling I knew I had to follow their wishes and let the vet go. We were well within the three-month trial period, and despite Richard’s good promise in the stables, there had been little interest or aptitude in treating our smaller pets. The job was clearly not meant to be “equine only,” and the fellow had to go before damage was done. It was one of the hardest meetings I have ever had to do.
“But I have just leased a vehicle and an apartment,” he protested. “You must give me longer.”
“I will pay first and last on the apartment,” I said. “That’s the least I can do. I’m sorry, but you’ll have to clear out your car.” As a last effort at goodwill, I muttered, “I am sure you can get a job doing horses only.”
After that, I gave up on trying to find a perfect match. I guess I felt that when someone was meant to fit in, he or she would come along. A lady veterinarian who did a great job on small animals agreed to work two days a week for us with no on-call. Although I was still on call seven days a week, I could now go out on farm calls those two days without worrying. It was a good solution for a time, and the practice continued to grow.
Not a summer goes by that we don’t have a case of maggot infestation in a dog or cat’s skin. The heat of summer causes skin rashes to become painful, developing discharging sores called hot spots, and if the dog has a long or thick coat, the results can be disturbing and repulsive. When Rip was pulled across the waiting room floor by his collar, unable to stand, we had no idea that what was about to confront us was the worst case of maggot infestation any of us had ever seen.
It was readily apparent to me that the old dog was in trouble. His mucous membranes were purple and the high fever confirmed toxemia. He was close to being in shock. I examined his coat, wondering where the awful smell was coming from. On parting the hair, I could see many moving fly larvae burrowing under his matted fur. When I rolled Rip over, his scrotum and anal area were alive. Shockingly, there were holes in the skin and maggots were actually travelling in and out of them before my eyes.
“This dog’s in danger,” I said. “He is close to toxic shock.” I tried to explain to the owner what had happened.
“He has been outside, he lives tied to a doghouse,” they replied, visibly upset. “We had no idea this could happen.”
“We see it in the summer, with the heat and long coat — they get hot spots, and the smell attracts the flies.”
“Please try to save him,” the traumatized owners pleaded.
None of us could cope emotionally with the reality of what the dog was suffering. I walked out of the exam room door, shaken. There was also the difficulty of coping with the smell.
“Cancel all the appointments,” I said to Jill. “This is top priority. I don’t know if I can even save him.”
I called a staff member at home. “Please come help us and bring your clippers. We need all the help we can get right now. This is a real emergency.”
We had set up an iv and started fluid and antibiotic therapy within moments. The animal was in extreme pain, and yet sedation was risky and possibly life-threatening. As we started to clip, we realized there was no way he could withstand the pain. I would have to sedate him. The drugs flattened Rip, but the fact he was oblivious was, in reality, a relief.
As the hair was clipped back starting from the shoulders, the coat started to peel back in a layer of mats that were all connected. With each new handful of hair, repulsive white wormlike creatures were revealed. They were in the mats and in the purple-coloured holes in the damaged skin. They were dropping on the counters and floor. Erin started to gag despite her facemask.
“I have never seen anything like this!” she muttered. “Is this neglect?” I paused, not knowing what to say.
“These people really care about their dog,” I replied. “They obviously have been too busy to groom it, though, or they would have known before now about the mats and this situation.”
“Lots of outdoor dogs never get groomed,” another staff member said. It was hard for all of us to believe this dog was loved.
We worked on him for three hours. Two people clipped the thick coat and then the legs. Two others washed the painful skin and flushed insects out of holes with water and disinfectant. We laid cool cloths on the burning skin. We sprayed the wandering maggots that seemed to be everywhere with insecticide. Still more emerged from the skin. It was a nightmare that seemed to go on and on. The old dog hung in there and fought for his life despite the odds being stacked against him. The rotten smell permeating the clinic got into our clothes and hair and noses despite our masks. We all wondered whether it would have been kinder to euthanize the dog.
We had collected a garbage can full of hair and writhing maggots.
“He seems to have a will to live. Let’s hope for a miracle,” I said, trying to buoy up the team.
At ten, we wrapped up the sleeping patient in a blanket and loaded him into my car. I was reluctant to leave him alone for the night. The next twenty-four hours would tell the tale. His temperature was down to 103 degrees from a life-threatening 105 by the time I had him home. I called the owners to say he had made it this far.
“His colour is a bit better, and the antibiotics are kicking in,” I said. “Tomorrow morning will tell us what to do next; there are still risks such as kidney failure in a dog his age.”
The next morning, I awoke from a restless sleep to see Rip looking at me from his crate. He fully intended to have breakfast, it seemed. He looked like a different dog. The miracle I had hoped for really had taken place. He was still a bit shaky walking with his iv line in, but the dark-red skin lesions were already a less inflamed pink, and the holes in the skin looked like they were going to heal quickly. I called the owners.
“The best place for him will be at home,” I said. “Pick him up at five after I take the iv out.” When the owners arrived, there were tears and hugs all round.
“We feel terrible,” they said. “Please tell other people to clip their dogs in the heat. Please don’t let this happen to anybody else.”
I decided to spare them a lecture. They had learned a very hard lesson and almost lost their dog.
“There will be a lot of after-care,” I instructed them. “You will have to bathe the skin faithfully and keep him in the cool garage. Apply this ointment twice a day to all the wounds.”
“He’ll be an inside dog, now,” they said as they headed out the front door with their pet.
My experiences with Cheryl and Richard underscored the difficulty I would have many times over in hiring a veterinarian. It is difficult to wear two hats; the small-animal clients must be completely comfortable with their vet, as the horse owners must be confident in theirs.
I realized I was a dying breed. Now commonly called dinosaurs in our profession, we were raised to believe we could, or had to, do it all. Like the old rural doctor, we were expected to handle everything presented to us. The new era of specialization had led to a very different type of graduate coming out of veterinary school, often suited to cattle or horses or reptiles or pets exclusively. It would take time to find a fit for our practice, but we were settled for now and I was proud of the team I was building and of the clinic.
The “Katrina Dogs” — survivors of Hurricane Katrina — arrived at three in the morning. We had waited since six the evening before … myself, reporters, and volunteers willing to take the traumatized animals home and foster them. They would have both emotional and physical wounds. There were coffee cups and cigarette butts on the front steps, and people were getting impatient, restless, running out of things to talk about. A rescue group from the city had travelled in convoy to New Orleans, with vans, RVs, and cars, and responded to the urgent need to get the unclaimed dogs and cats out of the city after the hurricane. Months had passed, and many remained unclaimed; charity was running o
ut. The local rescue group I most often dealt with had agreed to take sixty animals and perhaps more later. I had agreed in turn to do my part and receive them at my clinic for a screen before they went to the foster homes. I could detect ill health and dehydration, as well as parasites the new owners would need to know about. Perhaps I could prevent or detect a serious problem or disease outbreak.
The convoy of tired drivers pulled around to the back in the chill November air. We had the back of the clinic opened up for the screening, and several local high school students were there to help me. We took temperatures and looked for mange and malnutrition. We carefully handled and lifted the exhausted and shy and sometimes defensive animals, so short on trust, and fed their more exhausted human drivers. Emotions ran high, stories were told, and some fosters blatantly tried to claim the cutest dogs. One very shy dog got away into the night and was lost for several hours after surviving a 3,000-mile journey. The total situation was intensely dramatic for all involved.
There was one kind, middle-aged woman who arrived with the convoy that was actually far from home. She had driven an rv from Michigan to New Orleans pulling a second small house trailer and filled it with crates and animals. She had linked with the rescue group, who came back to me, and had driven well past her home to deliver her charges. They had gone many days with little sleep, driving and stopping only to feed, water, and walk the dogs. She was almost over the edge. On her lap when she pulled up, almost unable to stand herself, was a small kitten. At first I didn’t see it. The lady walked stiffly towards me in the night and started to cry. She thrust the strange-looking creature into my hands. It had burnt ears and a burnt tail. I’ll never forget the urgent voice I heard next.
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