Vet on the Loose

by Gillian Hick

  Soon I was back at Joyce’s house in an atmosphere of Christmas cheer and doing justice to the huge plate of dinner that had been kept warming in the oven for me, not caring if the gravy was the only thing keeping it moist.

  Joyce seemed bewildered by the whole situation.

  ‘I’d kill her if I was you,’ she kept repeating to Donal as her wine glass teetered dangerously close to the edge of the arm rest. Luckily, both he and Greg were engrossed in an old video of a hurling final, and were oblivious to all else.

  It was five o’clock before I managed to haul myself back out of the chair and return to the surgery, not daring to think what I would do if it had all been a waste of time. Donal came with me this time and I was glad to have some moral support as I braced myself for the worst.

  The little cat was sitting up looking decidedly perky although the right eye was slightly glazed. I waited as I ran my hand along her back and although she quivered as I touched over some areas of bruising, by the second stroke, I could detect her regular purr. She sat uncomplainingly as I examined the cast leg and listened to a heart which was now much stronger and more audible. Another quick examination revealed nothing further, other than a full bladder – which meant that at least the organ was probably still intact.

  Miraculously, by Stephen’s Day morning, she was up and walking around, daintily holding up the injured limb. She purred with an almost tiger-like growl as she wolfed down the leftover turkey I had brought her.

  I finished my locum stint that night and left a note for Bill outlining the details and leaving him a number for the lady.

  Despite my being sure that the cat had an owner, as yet none had turned up. I was beginning to get worried, but having a long drive home, I had no option but to leave her where she was. Her purrs as I said goodbye seemed extra throaty, as though she knew.

  I tried to put her out of my mind, which wasn’t too difficult as I joined a busy three-vet practice in Wicklow with Christmas lambs and calving heifers. An exceptionally good summer and mild autumn had left a lot of them in too good a condition, with oversized calves in fat cows, and it was here that I did my first two Caesareans.

  About three weeks later, a letter arrived that had been forwarded from Bill’s practice. As I slit it open, out fell a picture of a sleek-looking, glossy black cat, with a red velvet collar, being cuddled affectionately in the arms of a young girl.

  The attached note began: ‘Dear Christmas Day Vet’. It was from the owner. She had turned up the morning after I had left, overjoyed to find the little animal alive and well. Ebony, as the cat was called, had made a full recovery, she said, and was now purring even louder than ever before.

  If only they knew how that purring had probably saved her life.

  MIXED - ANIMAL PRACTICE IN WICKLOW

  CHAPTER TWELVE

  A DESPERATE CASE

  It was eight o’clock by the time I had finished the evening surgery and I still had one more call to do. A farmer had rung to say that he had a cow with a prolapsed uterus. I was only a week into my new job in the heart of Wicklow and this was my first evening on call by myself. Although Riverdale Veterinary Clinic was a mixed-animal practice, as it was now coming into spring it seemed to be largely taken over by the cattle and sheep work.

  ‘Give us a ring if you need a hand with anything,’ Seamus, the boss, had offered, on his way out that afternoon.

  A prolapse in a sheep is rectified easily enough but in a cow, when the whole uterus or calf bed is forced out, it’s not so easy. I had seen experienced vets struggle with such cases, and wondered how I myself would fare as it would be the first time I would attempt to replace one. I hesitated for a moment, wondering if I should ring Seamus, for the cow’s sake as much as for my own, but then decided against it. After all, I didn’t want to look like a total waster in my first week.

  Twenty minutes later, I was standing in a small, dark shed on the top of the hillside, observing my patient. The cow was stretched out, eyes rolling in her head, moaning softly to herself. As I became accustomed to the darkness, I shuddered to see the enormous, red, bulging mass protruding from her rear end. Somehow I didn’t remember the ones I had seen during my student years ever looking quite as big or as swollen as this one.

  It looked as if it might have happened some time ago. John, the farmer, had been away on holidays and had left a neighbour checking the stock, so it was hard to be sure exactly what had happened.

  As I tried to mentally rearrange the cow into a more suitable position, my mind flitted back to my final-year oral exam when I had confidently explained how to sedate the cow, administer an epidural and then roll her over to pull the two hind legs out behind her in a froglike position. I discussed in great detail how I would then cradle the neat little prolapsed organ on a sheet of spotlessly clean plastic. I had further explained the importance of pushing it back in, gently yet firmly, with the palm of the hands, taking great care not to use the fingers least they rupture the delicate organ.

  I was very proud of my honours degree in reproduction but now I felt that a bit more practical experience would have been a lot more help than the neatly framed piece of paper.

  I immediately decided to forget about the sedation bit. It looked as though even the tiniest bit would be enough to push the cow over the edge, and, I didn’t think that the collapsed form in the straw was going to put up much of a fight anyway. Instead, I decided to go for a hefty dose of intravenous steroid and some calcium borogluconate, hoping that they might improve her chances of survival. While I set about scrubbing and clipping the site for the epidural, I sent John to arrange a bit more light.

  Normally, a floppy tail indicates that the epidural has hit the spot, but this one was floppy before I had even injected her. I would have to wait until I started to work on the prolapse to see if she would strain against me. Although the cow was totally unresisting, it took three of us to heave her dead weight around to get her in a position that would allow me a bit of space to work under the flash lamps that John had organised.

  It took longer than I expected to gently wash and remove all the bits of dirt and straw and the semi-rotted pieces of the placenta that still adhered to the uterus, but the time passed quickly enough as I chatted to John and his neighbour, subconsciously trying to put off the inevitable moment when I would have to start the real work. They were both young farmers and I was glad to have pleasant company and a bit of extra muscle power for the job. I could have done with some sugar to pour on the calf bed because by now, having been out for some time, the prolapsed organ had become grossly oedematous, which was going to add to my troubles getting it back in. Sugar has an amazing ability to draw out a lot of the fluid by simple osmosis, but when I realised that the house was a good half mile from the yard, I decided to make do without it.

  Finally, I could put off the inevitable moment no longer and I started to push, remembering to use only the palm of my hands as indicated in our college lectures. I knelt behind the cow, cradling the engorged uterus on a piece of grubby, well-used silage plastic, supported on either side by John and his neighbour. Placing the palms of my hands around the edges of the mass, I pushed … and pushed … and pushed even harder until I could feel myself going red in the face.

  Nothing happened.

  I smiled confidently at the two men, rearranged my position and pushed again … and again … and again.

  Still nothing happened.

  I don’t know how long this went on for until I had to take a break. I sat back to look at it and said, as much to myself as to the farmers: ‘I think it’s getting smaller.’

  ‘Definitely!’ said one.

  ‘Absolutely!’ the other.

  Once I had caught my breath, I started again, this time concentrating on the underneath part. I thought I had progressed by a few centimetres until I noticed that it had all come back out at the top end. Both farmers jumped suddenly in response to the string of curses that broke out of me. I think until that point they had tho
ught I was refined and ladylike, despite the job.

  ‘Sorry,’ I mumbled, as they both stared at me.

  ‘Not at all, curse all you like if it helps,’ John replied politely.

  Another ten minutes of unsuccessful pushing went by, during which they were exposed to the full range of my expletives as I forced and strained against the fragile uterus, trying not to put my hand through it. My college oral seemed a million miles away and by now, I was desperately pushing with palms, fingers, elbows, knees and anything else that I could call into play.

  My arms ached and my legs were paining with the effort of supporting the uncooperative mass of tissue. No matter how hard I tried to convince myself that I was making progress, it still looked no smaller. I sat back and stripped off my jacket and sweatshirt and envied the male vets who, when in need, could discard all of their upper garments.

  I was starting to feel a lot sorrier for myself than for the unfortunate cow and I was amazed to hear the farmers muttering sympathetic things like: ‘You must be exhausted by now. Come on up for a cup of tea. Sure there was nothing you could have done anyway.’

  The prospect of having to give up on the animal and admit failure gave me a renewed surge of energy and determination. I set to work again, with a just a slight edge of frantic desperation.

  I had gone past the point of pain by the time I looked down and, to my immense relief, saw that this time the thing really was getting smaller. Both farmers had gone silent but you could almost feel the renewed hope in the air. Ten minutes later and it was by now about the size of a normal prolapse, even though over half of it had gone back in. I worked unrelentingly at the last portion and, with a feeling of disbelief, I watched as the last section was sucked back into the vagina. In a daze, I followed it in until my arm was in past the shoulder and I pushed the two horns of the uterus back into their rightful positions.

  If I was expecting a round of applause from the cow I was wasting my time: she lay, head sunk to the ground, apparently uncaring of her fate. John, however, was very appreciative of my efforts and thanked me profusely – a nice change from the tirades of abuse to which vets may sometimes be subjected if the job has taken too long.

  It was only when he said to me: ‘We were lucky to get you tonight. I reckon your boss would just have shot her,’ that a niggling doubt started to creep into my mind. Seamus was, after all, a lot more experienced than I was and, in all my student years, I had never seen such a bad case as this one. I quickly dismissed the thoughts from my mind. Right now I felt as though I myself was going to die, and I certainly couldn’t cope if the cow did too, after all my efforts.

  Working in slow motion, I placed a big Buehner’s suture around the vulva, wondering if it would be a waste of time if she decided to force again but at least it made me feel better. All that was left to do was to give her a shot of antibiotics – the rest was up to her.

  When I got home, I relayed my story to Donal and we sat up for a while, unwinding over a few cans. When I finally made it to bed that night, the dull throbbing in my muscles, unaccustomed to the day’s exertions, prevented me from sleeping. I tossed and turned and couldn’t help wondering how my patient was faring.

  I knew it was a sign of inexperience but at nine o’clock the next morning, I just had to ring John to find out how she was getting on. I sincerely hoped that she was feeling better than I was. My heart thumped as I waited for the phone to be answered.

  John’s voice was muted. ‘I really appreciate what you did for her last night.’

  ‘That’s no problem at all, but how is she now?’ I interrupted.

  ‘She died an hour ago.’

  Suddenly the pains in my arms and legs doubled. I realised that my lack of experience had put not only myself but also the cow through an unnecessary ordeal. I should have shot her.

  It seemed that fate was mocking me as in the weeks that followed I was inundated with calls to attend prolapsed cows. I have never seen one as bad as John’s cow since but, as my muscles toughened up and became accustomed to the hard labour, at least I knew that if I had managed to get that one back in, I would never fail again.

  CHAPTER THIRTEEN

  SIDNEY GOES HOME

  As always when confronted with a problem in my first year as a vet, my mind flashed back to my student experiences and what I had learned in the lab. It seemed like only the other day that we had stood over the dissection tables in our white coats, gulping slightly as the faint odour of not-so-fresh flesh assailed our nostrils. Not that the smell was in any way unusual to us at this stage of our training but, combined with the after-effects of the previous night’s drinking session, it was all just a bit too much. Our task for this practical was to first remove a section of intestine and then to surgically re-appose the cut ends, in preparation for the day when a real live patient might present with an obstruction in such an advanced state that the gut itself might have become necrotic and need to be removed. Sitting in the surgical lab, such a real-life scenario seemed a long, long way away.

  Gingerly, my colleague and I, both looking equally ashen-faced and hungover, incised the smooth lining of the section of intestine lying on the table in front of us. We watched as the muscle layers below bulged out to meet us, neither of us either remembering or caring for their official titles, as the dog to whom they had once belonged had long since departed on his journey to the great doggy heaven in the sky. Trying hard to summon up some enthusiasm for the task, I methodically placed a pair of stay sutures at either side of the diameter of the gut, hands shaking slightly as I fiddled with the tiny round-bodied needle that the professor had reliably informed us would be less traumatic. Slowly, I began to reunite the gut with a series of minute sutures, no more than two millimetres apart. The aim was to apply the correct degree of tension to ensure an adequate seal without occluding what, in a live dog, would be the healing supply of blood vessels. Normally I enjoyed these practical surgery sessions but today, as waves of nausea swept over me and my head pounded, I wearily handed over the needle to my colleague who had long since lost interest.

  ‘Here, you have a go.’

  Reluctantly, she pulled herself up from where she lay slumped over the table beside me. Gradually, as she stitched, the sutures became further and further apart as her enthusiasm waned.

  ‘Do you think that would do?’ she enquired as she held out the completed section of intestine before me.

  ‘Emmm, well, I suppose it might – as long as he hadn’t chewed his food too well,’ I giggled as I poked a forceps between the sutures that were supposedly rejoining the gut.

  But today was no laughing matter.

  Today, I was a fully-qualified veterinary surgeon and the section of necrotic gut belonged to a very affable and very much alive Springer Spaniel with an unfortunate liking for rubbish bins. Today my shaking hands and the waves of nausea were a million miles from a hangover: they were purely stress-induced.

  * * *

  It had all started late the night before as I lay in bed assuring myself that it was going to be a quiet night. I had developed a habit of staying awake until midnight when I was on call as this was the time when most calls seemed to come in. It somehow never seemed quite as bad to have to get up, even if you had gone to bed, once you were still awake. Normally, once you hit midnight, most of your clients were in bed too, although it didn’t always work out like that. Even so, your chances of getting a decent night’s sleep were better.

  Just as I began to doze off, the phone rang. Twelve-twenty flashed the clock by the bedside.

  Half an hour later, I was down in the surgery where a very dejected-looking Springer Spaniel, called Sidney, lay prostrate on the table in front of me.

  ‘Are you sure he was okay when you went out?’ I questioned Jacqui, his owner, whose hastily thrown-on raincoat couldn’t disguise the glamour beneath – much more suited to the night out on the town that she had come from.

  ‘Well, now that you mention it, he has been a bit quiet for t
he last few days, but I thought maybe he was just starting to get a bit of sense.’

  I didn’t air my doubts, remembering the last time Sidney had visited the surgery when he had tried to jump out a four-foot high window, taking with him two cat baskets – complete with spitting felines – which, by some trick of nature understood only by a Springer Spaniel, had managed to become entangled in his lead.

  ‘Yes, I’m just thinking now … He hasn’t really eaten much for the past few days either.’

  ‘Any vomiting?’

  ‘Oh, of course,’ she groaned, ‘how could I have forgotten? You see, we’d just bought this new carpet for the living room and the very next day when I came home, well, I couldn’t even think about it now …’ she continued, hands clutched over her mouth as though she were going to repeat the actions of her luckless dog.

  At this hour of the night my sympathy was at its lowest ebb and I tried to hurry her up a bit.

  ‘Right so,’ I carried on briskly, running my hands over Sidney’s swollen abdomen. ‘What colour was it?’

  ‘What colour? Of course. Yes, well it’s a lovely delicate shade of peach, with just the slightest tint of silver running through it.’

  I stared at her incredulously for a few moments, until it struck me. ‘I meant the vomit, Jacqui, not the carpet,’ I replied wearily.

  Having ascertained that it was ‘a nasty-looking colour’, a detail that I didn’t bother to write down in my clinical notes, and that she had no idea if he had vomited again since she had kept him outside to make amends for his misdemeanour, I carried on.

  ‘Is he passing his droppings normally?’

  ‘Oh,’ she gasped, as though I had asked her about some of the more intimate details of her own private life, ‘I’ve no idea. Derek deals with all that sort of thing.’