Tales from a Young Vet
Page 10
Rover was very quiet, and he looked at me with big, sad eyes. Although I wasn’t especially fond of ‘handbag’ breeds I felt very sorry for the poor little chap. He had been fishing with his owner and had snuffled up the bait. Unfortunately, the bait was on a fishhook, which he had also eaten. Now Rover needed surgery to remove the hook, which would otherwise almost certainly rupture his gastrointestinal tract and lead to septic shock, which would kill him.
I had a speedy read through his history and gave him a quick once-over to try to work out an anaesthetic plan. The Spanish anaesthetist in charge, Julio, was expecting me to tell him exactly what, when and how much anaesthetic we should be giving Rover. However, Rover had a real complication, in the form of the loudest heart murmur I had ever heard. Anaesthetic drugs have a profound effect on the heart, so Rover’s anaesthesia would have to be short and involve drugs I wasn’t used to using. The likelihood of his heart stopping was high.
I relayed my plan to Julio, and after a quick quizzing about how the drugs worked, during which I actually surprised myself with the answers that popped out of my mouth, he agreed with my choice.
I went to collect Rover from the Emergency Room, where he was waiting, to bring him to the induction room. I picked him up in my arms, giving him a gentle cuddle. Once he was on the table Julio and I first had to sedate him with an injection into the vein in his front leg, in which he already had a catheter. After that we slowly induced him into anaesthesia – at which point he stopped breathing. It was a rush to get the delicate intubation tube down his very tiny windpipe to connect him to the anaesthetic machine so we could give him some breaths. I had to twist and push while taking great care not to injure him. We were clearly in for a tough time if we were to keep him stable.
As soon as he was breathing for himself again, we wheeled him quickly down the corridor to the operating room. There’s an unwritten rule that if an animal is being wheeled down the corridor, everyone flattens against the wall to make way. As we whizzed along with Rover, people leaped out of our way. I was grateful for the rule – we didn’t have a minute to spare.
We only had one shot at removing the fishhook, and that would be by putting an endoscope (a fibre-optic camera) down his throat so that we could see exactly what was happening. The hook would then need to be gently removed.
The minimum amount of anaesthesia is used in a case like this, where there are potential heart complications, and the move had caused Rover to start waking up. A small top-up of anaesthetic was given to him intravenously, which sent him back to sleep but again caused him to cease breathing. He was proving difficult to manage; either the anaesthetic was too light and he was waking up, or it was far too deep and he was not breathing. After a short struggle to get him to a more stable anaesthesia depth, the two senior clinicians of the small animal medicine department, Hattie Syme and Chris Scudder, came to perform the endoscopy.
Chris slowly started inserting the endoscope down Rover’s throat and we all gazed at the screen as the camera showed us what was happening.
‘Ah,’ Chris said calmly. ‘The hook’s not in his oesophagus. It’s actually stuck through the oesophagus wall.’ There was an eerie silence in the room. Not a sound, apart from the bleeps from the anaesthetic machine. We all knew that the risk factor had just trebled. Getting a hook out of the delicate wall of the oesophagus would be incredibly hard; the risk of tearing the oesophagus was considerable, and that would be fatal.
After a long pause Hattie spoke up. ‘Well, if you don’t get that hook out, the only place this dog is going is to heaven.’ We all knew it was true, but her words still felt shocking.
Over the next ten minutes, the tension in the room could have been cut with a knife. Everyone was feeling it as we watched the screen intently. Chris had inserted a small pair of forceps and was very gently wiggling away at the hook, trying to cause as little extra damage as possible. Finally, to an audible sigh of relief, it slipped out of the oesophagus wall and we could see the whole thing on the screen. It was a big hook for such a small dog.
The next step was as tense as the first. The hook had to be brought up without scraping against the throat, or being dropped. Chris passed a soft tube down Rover’s throat and then gently and slowly manoeuvred the fishhook into it and pulled out the tube – and the hook. As it came out the room erupted into cheers. He had done it.
Back in the induction room Julio and I waited patiently for Rover to wake up. The anaesthetist’s role wasn’t finished until the patient was fully awake and back to normal. The cameras were still following us, and Rob asked us how we felt. Still a little emotional, I said, ‘We saved a life today.’ Julio roared with laughter and I turned pink. I hadn’t meant to sound quite so corny, but it was true – Rover had come perilously close to dying, and he was still with us, minus the hook. It was an overwhelming feeling, knowing that the team’s skill had saved him.
When it came to writing his formal feedback on my performance in anaesthesia, Julio put, ‘She’s a TV superstar.’ He thought the whole thing was hilarious.
I was keen to get away early on our last Friday because I was flying to South Africa the next day, but we weren’t going to escape without another ‘lucky dip’ interrogation, this time from Julio. He was a little softer on us than Haidar had been and we brought in cakes, which smoothed the way, so there was a bit more banter and a bit less grilling.
I had all my luggage in my car, so after saying goodbye to everyone in anaesthesia and to Lucy and the girls in my group, whom I wouldn’t be seeing for the next six weeks, I headed for Kent, hoping to spend the evening catching up with everyone at home. That plan went out of the window when a bomb scare on the Dartford crossing out of London stopped the traffic. I spent the evening in my car, with no supper, and didn’t get back until midnight.
On Saturday morning I rushed into town to get my international driving licence. I was flying to Johannesburg that night and meeting two other vet students, one from Poland and one from Germany, at the airport on Sunday morning. I’d arranged a hire car and we were going to drive up to Kruger together, to begin our placement early on Monday.
With the licence sorted I went over to the stables to give both the horses a ride out. I was so pleased to see them but, unbelievably, they’d got fatter! I spent a couple of hours with them, gave them a goodbye nuzzle and went home to pack. And that’s when the text arrived from British Airways to say that my flight had been postponed until the following day.
I was totally thrown. If I didn’t get there on Sunday morning the other two vet students, Natalia and Tina, would be stuck at the airport for twenty-four hours waiting for me, because the hire car was in my name. Dad got on the line to BA, but two hours and several calls later he’d had no luck.
‘Right, let’s drive up to Heathrow and we’ll find you a flight there,’ he announced. Mum said she’d come, too, so we piled my bags into the car, I said goodbye to Ross and we headed for the airport, where Dad managed to get me transferred to a Virgin flight leaving only an hour later. I was so relieved I burst into tears at the desk and then felt horribly embarrassed.
After a quick dinner and a change of terminal I said a tearful goodbye to my parents and was on my way to the departure gate when I bumped into Grace, on her way to New Zealand to spend a couple of weeks working with farm vets.
‘Sheep?’ I asked.
‘Mostly cows, actually.’
My flight was being called. ‘I have to go. Enjoy the cows. See you in a few weeks.’
As I hurtled off she waved and called after me. ‘Don’t sweat it with the lions. And have fun.’
CHAPTER NINE
Into the Wild
As I made my way through the terminal, with its brightly decorated walls and the morning sun streaming in through the windows, I felt the buzz of being in Africa again.
I spotted the two vet students straight away and went over to say hello. Natalia was Polish, tall with long, dark hair and rather shy and quiet, while Tina, from G
ermany, was short, blonde, a non-stop talker and a bit of a rocker, her eyes circled in dark liner.
I sorted the paperwork for the car and we set off. Natalia didn’t drive, so Tina and I had agreed to share the five- or six-hour journey between us. I drove first and I was grateful for Tina, chatting away beside me and keeping me awake. At the halfway point we switched and I climbed into the back to try to get some sleep.
The three of us were there courtesy of the veterinary services for a northern game reserve. We’d been lucky to get the placements because the veterinary services only took on international students once they had placed all their own South African students.
Our destination was a small village based inside the reserve where the vets were based, along with a cluster of tourist huts and a village for all the reserve staff, complete with church, school and swimming pool.
It was nice to view a few animals on the drive through the park to the village, especially since I had taken over driving again.
When we arrived, hot and dusty but thankfully in one piece, we were shown to the guest accommodation, which was tucked in between the clinic and the staff village. We had a bedroom each, opening onto a patch of grass that we had to cross to get to the showers. The kitchen was an open tent, with a table at one end. We would therefore be enjoying a lot of alfresco living, but with the warm, dry South African days and nights, that was fine with us – although, unlike the tourist villages, the staff village and our accommodation had no fencing around it to keep the wildlife out.
The team included three wildlife vets, another vet training to be a wildlife specialist and a number of ground staff, including an anaesthetist and several technicians, plus extra staff to help haul the larger animals in and out of trucks and crates. And, of course, we three eager but uninitiated trainee vets.
After an outdoor supper of boerwors, a South African beef sausage that’s absolutely delicious, and a chat with Natalia and Tina, I was in bed by 8pm, absolutely wiped out after my twenty hours of travelling.
The following morning the three of us turned up at the clinic at 7.30am ready to get stuck in, only to be told by Gale, the head vet technician, that it was going to be a quiet day. He showed us around the clinic, a large building full of offices, labs and storage rooms, and the pens and bomas that held the inpatients inside. Once we’d looked around, Gale told us that that there was nothing for us to do until the hyena capture that night, so we went off for a game drive.
No matter how many times I see wildlife in their natural habitat, I still feel absolute awe. On our three-hour drive we spotted buffalo, giraffe, zebra, impala, warthog, elephant, rhino and cheetah. All of them living free, in the wide open spaces and natural beauty of the park.
When we got back we had a swim before reporting back to the clinic at 4pm to help pack the pickup trucks, known as bakkies. We were going out to try to capture a few hyenas, hopefully five or six of them, for research purposes. The vets wanted to find out whether hyenas carry tuberculosis. Hyenas have never produced clinical cases of TB but as scavengers they feed on the remains of carcasses – including the lungs – of animals that have TB, so the suspicion was that they might well be carriers.
We met two of the vets: Dr Pretorius, the senior vet in charge, and Dr Jenny, a qualified vet training to be a wildlife specialist. Dr Pretorius was tall and deeply tanned, with a full head of white hair. He was friendly, but at the same time you had a feeling that it would be better not to cross him. Dr Jenny was tall with curly brown hair and she was extremely easy to talk to. Vets in South Africa are all treated with great respect and addressed as Doctor, so once qualified I would be Dr Hardy, or Dr Jo. I quite fancied that idea.
When everything was on board the pickups we were told to climb into the open back of one of them. Hyenas are more active at night, and in any case it wouldn’t be possible to dart them with curious tourists around. So as the sun was setting, and after the 6pm curfew for tourists, we set out for a spot where a group of hyenas had been seen. Strictly speaking the collective name for a group of hyenas is a cackle, which makes you want to, well, cackle. And for rhinos it’s a crash, while for giraffes it’s a tower, for buffalo it’s a gang and for hippos it’s a bloat. Who knew? The only one I was familiar with was a pride of lions.
Anyway, several trucks set out in convoy for a known hyena den, but we found nothing there, so we moved to a more open spot where, through speakers on top of one of the trucks, we played the distress sounds of warthog and buffalo, hoping to trick the hyenas into thinking that something in this area would be easy prey. It was pitch dark and we sat in silence with the lights off, our eyes straining for any signs of hyena. I really didn’t like the noises, which did actually sound very distressed.
Twenty minutes passed, then thirty, with no sign of any hyenas. Off we went again, to another clearing a few miles away where hyena had been spotted earlier. Out went the lights and the distress sounds were played again. After five minutes we picked up the distant whooping of hyenas. But they didn’t come any closer. Sound alone wasn’t enough; they were waiting for the scent of prey.
A couple of brave helpers offered to get out and tie some meat to the tailgate. While they were doing that, it was everyone else’s responsibility to keep a lookout. When they were done the men dived back into the truck and the driver did a few laps of the clearing to spread the scent. They then got out again and tied the meat to a pole sticking out in front of the truck. All the lights were turned off again, the distress noises were played and the whooping came closer. They had to be within a few hundred metres of the trucks, but none of the torches were on so we couldn’t tell for sure, until, suddenly, two large shadows swooped so close to the truck I was in that I jumped. The hyenas had arrived.
We gave it a couple of minutes to make sure they had taken the bait and then the headlights were switched on to reveal four startled hyenas, standing right in front of us. Dr Pretorius fired two darts and they scattered into the bush. He was confident that he had hit two of them and we were told to get out and help the assistants find them.
Only later did it dawn on me exactly what he had been asking of us; to go out into the pitch black into the African bush, with hyenas, lions and leopards all around, not to mention deadly snakes, to find two hyenas that might or might not actually be asleep.
Still, all in a day’s work, and we did find them both about twenty-five metres into the thick bush. Between several of us we hauled them onto stretchers then carried them out of the undergrowth and loaded them onto the back of a waiting truck. Tina, Natalia and I were told to get in beside them and to watch them to make sure they kept breathing and didn’t wake up.
Two was a good start, but Dr Pretorius wanted more, so again we were plunged into pitch darkness for a re-run of the bait and distress sounds scenario. Except that this time the three of us were in the open back of a pickup with two sleeping hyenas. Looking back on it, I don’t know why I wasn’t nervous. But at the time we were completely absorbed in the tension and excitement of what was happening.
Shadows flitted past, as the hyenas that had dispersed returned. Suddenly, the lights flashed on and Dr Pretorius darted a third hyena. The assistants went and found it and put it on the back of the truck beside the two that were already sleeping.
By that time it was eleven at night and it was decided that, as the first two had now been under for around an hour and the anaesthetic would soon begin to wear off, we should get them back to base to take some samples. So we set off, Dr Jenny with us and Dr Pretorius in the truck behind us. Because hyenas are big creatures and we were sitting in an area not much bigger than a dining table, we were practically on top of them and, as the bakkie rattled along the dirt road at 50 mph, we clung to the sides and tried not to fall on the hyenas. We continued to check that all three were well under but still breathing; every few minutes we listened to see if their hearts were steady and then we turned on our torches to see if they were alright – not easy when jolting along a dirt road.
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Twenty minutes later we pulled up at the gate of the clinic. We had to wait for Dr Pretorius, as he had the keys to the complex, but his truck was nowhere to be seen or even heard. Dr Jenny told us not to worry and said that he had probably just got caught up somewhere, possibly with something like an elephant crossing the road. We’d just wait until he returned.
Suddenly Tina yelped. ‘Jo, look, the one beside you is moving its tongue.’
I peered down at it, and then tried its blink reflex by tapping the corner of an eye. It blinked. This hyena was waking up! And we had no top-up drugs with us to put it back under; all we had were our stethoscopes and torches.
I told Dr Jenny, who phoned Dr Pretorius. He had stopped to dart another hyena, and was going to be a further five minutes. As she came off the phone, the hyena was starting to move its head. Dr Jenny told me to lie on it and pin its head down. So I did. I had my hands on its neck, pinning down its head with my arms while trying to keep my head out of the way.
Bearing in mind that hyenas are the strongest of all mammals, with 2,000 pounds of pressure per square inch to their bite, I wouldn’t have stood a chance if it had woken fully and decided it didn’t appreciate someone lying on top of it. I should have been leaping out of the truck and running in the opposite direction, but as the hyena began to move its head a little more and its legs twitched, Dr Pretorius finally arrived and dived out of his truck and into the back of ours, syringe in hand. Seconds later, to my immense relief, the hyena was out cold again.
Dr Pretorius had the fourth hyena sprawled across the back seat of his truck. Once the gate was unlocked, we drove them into the clinic and unloaded them off the bakkies. Given that they weighed upwards of 110 pounds each, it took several of us to lift each one, but eventually all four were inside. We took blood, did skin TB tests and performed BALs (broncho-aveolar lavages – aka lung washes) on each of them. A lung wash shows the types of cells within the lung and this can give clues as to whether the animal has healthy lungs and if not, what kind of disease the lungs were reacting to. The blood test, called a Bovigam test, indicates if the animal has had any previous or current immune reaction to TB, and a skin TB test shows whether the body has been exposed to TB previously. Antigen is injected and if the skin swells up over the next few days on the injection site, it’s a positive reaction, which indicates that the body recognises the antigen because it has TB, or has had it in the past. When we finished we put them into cages and woke them up. The plan was to keep them for a couple of days to see the results of the skin TB tests, after which they would be released into the wild again, back at the place where we had found them.