Yesterday was a crap shoot. Literally. First it was Monday and Monday after military payday is always a barely controlled hot mess. We basically move from room to room, barely taking a breath, and examining all of the vaccination appointments as well as seeing every possible sick animal you could possibly think of. From Cushinoid animals to those that have urethral obstructions. Constipation to femoral head fractures.
And all of that craziness is always preceded by several surgeries that must be completed before 10:30 am. As of yesterday, we were lucky. We had one OHE (spay), an orthopedic surgery involving the stifle (CCL rupture), and an patient that was really less than ideal of a surgical candidate.
This gal was my patient.
She was a geriatric dog who had a mammary mass that had become necrotic and recently ruptured. She was also from a lineage of dogs that are notorious for cardiac disease. Unfortunately the owners had declined a full work-up on her which would have included chest radiographs and blood-work. This exact scenario is why veterinary medicine is often so difficult. We do not have consistent insurance offered for pets and so the work-ups that are recommended are often declined due to finances. I cannot stress how jealous I am of those professionals in the human medical field because of this. As a result we are often forced to take more risks with our patients. This fact is not right but is often the case in many situations.
As with all my patients, I always offer the best treatment plan first and if that is not financially feasible, I discuss the next best alternatives. I always stress the increased risk with opting out of certain diagnostics. As was the case with this surgery.
And so we did a very small presurgical panel which showed nothing noteworthy. We premedicated her and then moved to put her under anesthesia. In this practice we use IV propoful to induce and then we place an endotracheal tube in order to maintain them on O2 and isofluorane. It is one of the safest protocols in veterinary medicine.
Unfortunately once she was induced and the endotracheal tube was placed, her heart rate had ceased. Immediately we place those patients that arrest on O2 and begin manual ventilation. This is paired with chest compressions as well as IV epinephrine. In her case, we were unable to revive her.
My suspicions is that not only she had cardiac disease which was not apparent upon auscultation but also had metastatic disease due to the mammary mass. Unfortunately the owners declined a necropsy so I will never know. Making that call, letting them know their beloved pet had passed, is hands down one of the worst things we as doctors have to face.
Suffice it to say that I hated yesterday. Naturally I also had another case of a 1 yo, very healthy, very sweet small breed dog that had a traumatic fracture of her femoral head. In these case because of her size and age, we often recommend a femoral head osteotomy. Once completed the surrounding structures provide able support and stability to allow an almost complete return to function. Very simple procedure and very successful for small breed dogs.
These owners were unable to provide the financial backing and were going to opt humane euthanasia. Wonderful. Again why veterinary medicine can be so difficult. Thankfully a couple of the wonderful ladies I work with offered to re-home the pet so that we could do the surgery pro-bono. Thank the sweet heavens.
Beyond the crazy that was yesterday, today was my much needed day off in which I honestly slept in until noon. I just recently put on real clothes. And that was only because I didn’t want the Hubs to judge me. I am planning on taking the doggies for a run and going to the gym. And of course I can’t help but mention that we are around 5dpIUI. I seriously love those progesterone suppositories. But I am really feeling okee dokee, smokey. Hope all of you wonderful ladies are doing amazing today!!