Vet On a Mission

by Gillian Hick

  She went on to assure me that both her mother and elderly cat were doing fine, so I wondered why she was ringing me late on a Friday night. But when she told me that her mother lived next door to Eve Wilson, I was immediately concerned.

  ‘I saw your business card on Eve’s fridge when I was in this morning and thought I should let you know that she passed away last night.’

  The instant she told me, I felt like I had always known this was going to happen. It turned out that Eve’s intense sense of privacy had ensured that nobody knew that her frailty was due to a serious underlying illness – one for which she had refused any but the most basic medical intervention, preferring instead to stay with her beloved dogs. Eve had passed quietly in her own home with her beloved companions.

  Although initially I felt overwhelmed with grief that the gentle lady had so little trust in the world that she could not have asked for help, I finally accepted that this was the way she had wanted it. All I could do now was to help organise things for her loyal companions; I and others did this over the following days and weeks. Ironically, Mrs Black, the only one of her dogs who had been terrified of me, ended up coming to live with us as, whether due to the stress of the change in her circumstance or not, her symptoms flared up again, so that I had to take her home with me.

  And on the very day of Eve’s passing, Slug, our beloved first child – as Molly had informed the local health nurse – decided that her time had come. Although I was the one who had depressed the plunger of the lethal injection as she took her last breath, she had decided herself that morning as she stared unknowingly at me, unable to lift her once-feisty head from the bed. In a funny way, when I heard that Eve had passed, I was glad that they went together, knowing that two such precious souls would surely find each other.

  If Slug had still been with us, I wouldn’t have dared to introduce Mrs Black into the house, but with that gaping empty space in the kitchen, it seemed the right thing to do. Although she had no experience of children that I knew of, she seemed particularly drawn to Molly and Fiona, and would happily spend hours lying under Jack’s cot as he slept. Mrs Black ended up living to an old age, exactly how long I’m not sure, as I never knew her age when she came to us, but certainly well into her late teens if not beyond. In a funny way, the little spaniel was remarkably similar in temperament to Eve – a very quiet presence in the house, but with her own ways of doing things. I felt that Eve would have approved of her choice of new home.

  Chapter 4

  A Miraculous Escape

  At times, veterinary is a strange career – even without running a business from a utility room with the help and assistance of three small children. Many people complain about the monotony of their job; the life of a vet can also be monotonous, but there are moments when I feel slightly envious of those who are reasonably confident in the morning that they know what they will be doing in the afternoon. In veterinary, a simple phone call can drastically alter the day’s best laid plans.

  On the day in question, the morning clinic had run smoothly, and I quickly tended to my two in-patients. Cheeky, a miniature Jack Russell, had heroically allowed me to bathe and trim back an infected ingrown toenail without complaint, while Rusty, an enormous oversized chocolate Labrador, had dissolved into a quivering mess as soon as I approached his inflamed ear. In the end, I had to sedate him before being able to thoroughly flush the ear canal which, judging by the amount of sticky black discharge, had been infected for some time. Taking a final examination with the otoscope to satisfy myself that the job was complete, I was just picking up his chart to write up his medications for discharge when the phone rang.

  With one hand on Rusty’s lead, I picked up the phone with the other and could hear several voices and shouting in the background. By the time Martin, the client, spoke, I knew my quiet lunch before collecting the kids was a thing of the past. Apparently Spud, an over-inquisitive yard collie, had been busy investigating a suspected rat among the bales of silage while her owner was out feeding their cattle. Just as Martin had directed the spike on the tractor into the pit to lift a bale, Spud had spotted the errant rat and dived in between the bales of silage. With the most astounding ill-timing, the spike of the tractor had completely impaled Spud, going right through from one side of her belly and appearing out the other. I can only imagine how the owner felt, looking at his much-loved yard collie lying totally motionless as Martin and his son struggled to pull her off the large metal spike.

  ‘She’s lying in the straw, but she looks like she doesn’t know we’re here,’ gasped Martin over the phone. ‘I think she’s done for.’

  ‘Just wrap her carefully in something warm and bring her straight in,’ I told him, anxious not to waste any more time with a dog that was clearly going into shock and would most likely be dead on arrival.

  In the twenty minutes it took them to arrive, I quickly set up the anaesthetic machine, heated fluids and prepared for abdominal surgery, but all the while I was thinking that my efforts were probably going to be wasted. It was more likely that Spud would be dead by the time she got here, from some form of massive internal haemorrhage or ruptured organs.

  I stood quietly checking that everything was ready to have the luckless Spud anaesthetised and out of pain as soon as possible whatever the outcome. Only when everything was in place did I allow myself to think back to a previous similar case – probably one of the most traumatic I ever dealt with back in my early days as a new graduate, which often came back to haunt me.

  I had been doing a locum job for a week in an inner-city branch practice when a call had come from the guards. Would I be able to carry out a post-mortem on a dead dog? I was surprised, as the guards usually did not take much interest in domestic pets.

  When the young guard, looking fresh out of college, arrived at the surgery, he filled me in on the background to the case. Two families had been involved in an ongoing feud, during which a man had been beaten and left tied up in a deserted woodland. He eventually managed to escape, but in retaliation, some of his family members had stolen the other family’s dog and impaled it on the metal spikes of a local graveyard. The dog had been found the next morning, frozen solid on the spike as the incident had occurred in the depths of winter. The fire brigade had been called and the firemen had cut the spikes from the railing; the dog was delivered to us in the surgery complete with two roughly cut metal bars piercing her mutilated body.

  Although I never knew the dog, and never saw her when she was alive, her case had a greater impact on me than many others that had come and gone, been treated and forgotten about. For the duration of the lengthy post-mortem examination, which I carried out the next day when the body had finally thawed, I felt numb, unable to even think how the poor animal must have felt or suffered before she died. The only consolation was that with the extent of her injuries I felt sure her death must have been quick.

  Equally, my mind dwelled on the perpetrators. What sort of people must they have been? How could any normal, sane person even begin to think up such an idea, never mind carry it out? How had they felt, or what were they thinking, as they hoisted the considerably sized dog up over the railing? Had they watched until the dog died? Had they laughed? Had they cried? Had they felt any sense of remorse? Any sense of uneasiness? Were they even aware that something had gone horribly wrong with their lives?

  The guards had only given me scant details as to the background as there were multiple court cases pending. I knew that there were appalling injustices on both sides, but nothing could justify the wanton and savage abuse of this innocent dog.

  Although I never met the people that carried out the act – and once my report had been submitted, I never heard any more details about the outcome of the case – I never forgot about them. Over the years, my initial anger towards the people subsided and – maybe with time or maturity or life experience – I have come to have sympathy for them. I still think about them. Who knows if they are still alive? They too could have becom
e victims of drug abuse or violence. They could be serving multiple prison sentences or they could have committed suicide. I can’t believe that, unless they were lucky enough to have had some sort of major intervention, they themselves could be in a happy place having carried out and witnessed such a terrible deed. Even if society had forgiven them, how could they ever forgive themselves?

  As I stood waiting, the familiar waves of nausea washed over me, as they always do while thinking back to that post-mortem. The skidding of car tyres interrupted my reverie and in an instant I pushed away all thoughts of Tilly, as I named her myself.

  Spud was lying on a duvet in the back of the jeep. Her entire body quivered as I gently laid my hands on her. Her eyes were constricted and focused on a faraway point in the manner of a dog that is in major shock. Quickly checking her gums, I was surprised to see that her colour, although pale, was not totally blanched. Martin, the owner was, if anything, in a worse state than his dog.

  ‘It might not be unreasonable to just put her to sleep. The chances of her pulling through this are very poor,’ I explained, justifying it as much to myself as to the owner.

  Although he was a big man, Martin’s reply came out in a whisper.

  ‘Just do anything you can if you can save her, but don’t let her suffer anymore.’ His whisper was barely audible over the intermittent moans emanating from Spud.

  I was happy to hear those words. This gave me permission to immediately anaesthetise Spud, despite the fact that it may not be safe to do so, considering her shock level. Once asleep, Spud would feel no more pain and then I could go in surgically to examine the extent of the damage. If the damage was irreparable, we could simply change the fluid in the giving set from the heated saline to an overdose of anaesthetic, which would allow her to drift off into oblivion.

  I did feel sorry sending Martin away so quickly in his state of shock, but I knew the best thing I could do for him was to take care of Spud.

  Within minutes, Spud’s ordeal was over and she lay peacefully on the operating table oblivious, to the drama that had been unfolding over the previous half hour. As she slept, I clipped and prepared the surgical site to allow access not only to the two puncture wounds, but to her entire abdomen, in case I needed to explore further. The penetration wound on the right-hand side was dangerously close to her rib cage. The exit wound on the far side was smaller, but at an angle indicating the spike had passed diagonally through her body, putting all her vital abdominal organs at risk. Ignoring the actual penetration wound, I made a large incision through her midline, allowing me access to her entire abdomen.

  As I extended the incision, I realised that I was holding my breath thinking back to the devastation I had found and painstakingly recorded in Tilly’s abdomen – how the large amount of clotted blood had floated freely in the abdomen, how the stomach had been ripped open, allowing the digestive contents to spill freely, mixing with the clotted blood. The guard that had come to observe the post mortem and take notes of my findings had excused himself long before I got to the point where I discovered that the vascular attachment of the spleen had been severed by the blunt force of the spike and the second spike had penetrated between the muscle of the two adjacent ribs, causing a large hole in the rib cage and a punctured lung. I could hear the guard heaving outside and he was ashen faced when he returned apologetically some time later.

  Gently, I allowed myself to take a few breaths, trying to focus on Spud, who still had some chance of being helped, observing how my hand was still slightly shaking as I continued the lengthy incision. To my relief, on this occasion, there was no obvious free blood in the abdomen, no stomach contents, nor anything else. In fact, if I had not known otherwise, the abdomen, on initial examination, looked remarkably normal. Usually, exploratory laparotomies are carried out when investigating animals with a foreign body blocking the gut, or investigating cancerous mass, or other equally sinister situations. So it was pleasant not to be greeted with the smell of infected peritoneal fluids or a purple and rank necrotic piece of intestine.

  Initially, I carried out a general examination and then, as there was nothing abnormal obviously visible, I began to carry out a more carefully systematic examination of each organ. Thankfully, the first point of penetration was just in front of the diaphragm, the large muscle that separates the heart and lungs in the thorax from the other organs like the liver and kidneys and stomach and intestines in the abdomen.

  The liver showed absolutely no signs of damage as the large blunt spike had obviously bounced off the edge and passed uneventfully by the stomach. Carefully I checked both right and left kidneys. The spleen was exactly where it should have been – the large vessels pulsing away happily unaware of how close the point of the spike must have passed by. The intestines looked perfectly normal, as their loose attachments had clearly allowed the spike to pass through as they spilled around the edges. The bladder was intact. Throughout, I could feel Spud’s rhythmic, relaxed breathing as she inhaled a mixture of oxygen and anaesthetic gas.

  ‘This is really weird,’ I finally spoke out loud. ‘Everything looks absolutely normal.’

  Another thorough examination confirmed that everything was exactly where it should be. Apart from the two lacerations where the spike had penetrated both sides of the abdominal wall, Spud had escaped miraculously unharmed. Mindful of the many millions, if not billions of trillions, of bacteria that might have gained entry on the spike as it passed through her abdomen, I set about lavaging the entire cavity by flushing some four litres of sterile saline through to reduce the risk of Spud developing peritonitis. After the third litre, one small wisp of silage did emerge from between two pieces of intestine. I was almost grateful for the evidence as the whole surgery was beginning to feel a little surreal.

  The second laceration was relatively easy to repair, but the first took a bit more attention and effort, as the spike had penetrated high up on the body wall, making it difficult to get decent access to close the various muscle layers. By the time I had placed the final suture in the large abdominal incision over an hour had passed.

  Spud recovered uneventfully in the kennels, wrapped in a heated blanket and with a heat lamp. As I monitored her over the remainder of the day and the next morning she seemed comfortable without needing the heavy-dose pain relief that I had prepared just in case. Her temperature remained stable the next day, indicating that the thorough lavage of her abdomen had done its job.

  When Martin came to collect her the following morning she trotted out the door and jumped into the back of the jeep as though nothing had happened. I suspect that it took Martin a lot longer to recover!

  Chapter 5

  School Talks

  It was with a sense of trepidation that I awoke that morning. Before I was fully conscious, my mind started to scan through the possible reasons for this feeling of unease. Had I a particularly complex surgical case pending? Perhaps a difficult owner due in with a tricky case? Was the clinic double-booked from 8.30 this morning? Had one of the kids a potentially serious medical appointment pending?

  No. Suddenly it came to me in a rush. Today was the day of the dreaded school talk.

  A very noble and worthwhile initiative had been set up by Veterinary Ireland some years previously, whereby vets were invited to make themselves available to local primary schools and other community-based organisations for the purpose of giving talks. The thought of having the opportunity to enlighten the next generation to the joys and responsibilities of pet ownership seemed too good to miss, so I enthusiastically put my name forward. In my early days I had been through a harrowing experience of giving a talk to over two hundred inner-city Dublin secondary school kids, but I figured that the small class numbers in rural schools and the general innocence of pre-teens would be well within my capabilities.

  For the first year, I had carefully planned my talk and even gone so far as write out notes, which I then converted to prompt sheets before each session. I had carefully thought out how
to deal with various issues, such as neutering and spaying, for the younger and older groups, having been exposed to some valuable in-house training by Molly on this very issue.

  Although I usually tried to keep her out of theatre, she arrived over one morning as I was neutering a particularly large Rottweiler. She chatted away for a few minutes, seemingly oblivious to the whole procedure. Then after a few moments of silence (normally an ominous sign), she blurted out, ‘Why are you cutting out the doggy’s humps?’

  I racked my brains for a suitable answer.

  ‘Well, Roly was being a bit bold,’ I finally replied, ‘so this just helps him to have better manners.’

  At the time, Molly was having an issue with one of the older boys in the local playground, who seemed to delight in terrorising anyone younger or more vulnerable than him. After a few moments of thoughtful silence, during which I thought the matter had been dropped, she continued, ‘If you cut Nathan’s humps out would that make him have better manners?’

  Silently, I thought it sounded like a great idea; I had recently discovered an inner aggression I never knew I possessed, when exposed to any sort of violence – no matter how innocent – towards my children, but reluctantly I told Molly it really only worked for dogs.

  With this experience in mind, for the younger-audience school talks, I generally avoided any discussion of humps or any other anatomical details and focused instead on the whole unwanted-puppies issue.

  Despite my best intentions, however, I soon discovered that this was totally wasted on the under-tens in general.

  ‘But I would want to keep the puppies,’ the first child would start.

  Carefully, I would begin the explanation of how one puppy would lead to five more, and then five more again.