Friday, April 5, 2013

24 HOURS IN THE LIFE OF A COUNTRY VET


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The sacred sanctity of the night is quickly disturbed with the harsh shrill of a pager resting by the nightstand. Harry unwillingly tries to focus with one eye on the illuminated clock. He fumbles for his reading glasses and turns on the stabbing light as he presses the offending device into a muted state. The old collie whines and howls in distress and is comforted by a reassuring pat. It is 1:13 a.m. and the answering service has summoned him from his peaceful sweet serenity.

He calls for his message and a brief report on the case at hand. He dials the client’s number from a scribbled unintelligible writing only he can decipher. The rings go unanswered, with the phone abandoned by the farmer now in the stable. The farmer assumes the veterinarian will arrive at his beckoning call within minutes. No need to waste time sitting the by the phone as the farmer rationalizes.

There is no such thing as a typical night call. Most often it is a cattle call for milk fever, a hard calving, horse foaling or colic. An injured saddle horse after a summer evening’s ride of misfortune or a fence encounter in a pasture is also commonplace.

Feeling the effects of sleep deprivation, he wanders to the bathroom. His jaw widens in protest with a stubborn prolonged yawn. He washes the sleep from his face and runs a comb through his equally tired locks of graying hair. He pulls on the freshly laundered coveralls; grabs the keys to his four- wheel Jeep and walks into the coolness of the night air.

With a feeble attempt a slight wandering hand clicks off the nightstand light. His slender wife recoils to a semi-fetal position, as she hugs the pillow. She wonders for a moment, how long this call will take or even if her husband will see the sheets of a warm comforting bed before dawn. She worries at times, for the emergency calls carry personal risk. It could be a night of freezing rain or a howling snowstorm with no plows on duty to clear the way. It may even be a driving rainstorm with lightning briefly showing the way with its angry flashes of light. A deer may appear over the hill in the haunting darkness of country road or a sudden curve on an unfamiliar route give cause for concern as the Jeep rolls and jives to the pitch of the road.  He grabs the shifter with his toughened hands that bear the deep cuts from dryness and weather, guarded only by tape. His hands resemble the roughness and imperfection of fresh hewn logs. Strong and determined hands, yet gentle, searching and caring. Above all else, these hands are his greatest tools in healing. Hands not pampered or absent from hard physical work or protected from the elements of nature. He slips the Jeep into gear with intention.

His practice covers 60 miles from one boundary to another and includes two clinic locations. The active clientele averages 5,000 large animals alone. The practice is split evenly with fifty percent cattle, sheep, pigs, goats; the remaining fifty percent being horses of all breeds, disciplines and purpose. He treats exotic pets, including llamas, emus and ostrich. Ailments can be seasonal. Eighty percent of the spring and summer months' emergency calls are dedicated to horses. In winter cattle demand more attention for urgent care.

There are two other veterinarians that share the large animal clients and three small animal veterinarians on site. The workload is burdening with only one weekend off in three and alternating weekend shifts, standbys, as well as two or three evenings during the weekdays that he must cover. It is not a nine-to-five job but a 24-hour service. Vacation time is rare in this profession and burnout can be a serious side effect.

He is also the official veterinarian at the local racetrack for the Sunday racing card. He inspects the horses as they do their token jog by on their way to the paddock for saddling. Groomers in hand nod their heads in recognition with greetings of “hello doc.”  “Trot that bay by again please” he asks. This time with a more even gait, Harry gives his approval for the groom to continue to the saddling area.

As the horses begin to warm up on the track for the post parade, Harry takes his place with the trainers and race crew. He bumps along unceremoniously in the back of a pick-up that rolls quickly and without caution over the untamed grassy strip that follows the rail and dirt track. As race veterinarian his duty is to bear witness at the starting gate for each race to ensure the wellbeing of the horses. It is here nervous energy can spill over into jeopardy as the taut muscles and eager minds wait for the starter’s bell to release them. This is the place where accidents are most likely to occur and not in the stretch run. Harry is also required for post-race inspection. When injuries do occur, many are catastrophic and ultimately fatal for the horses.   

As the Jeep groans and bumps along following the landscape of the gravel road, Harry ponders what might be required in the next hour. With a new supply of inventory of medicines packed securely in the Jeep, he wonders what working conditions he will find this night.

He doesn’t always have the luxury of kneeling over an animal in the comfort of a deep bedded stall sheltered by stonewalls. Sometimes he points his Jeep to the roundup terrain of a dew-covered pasture. As he bends over a cow in the dampness of the night, the Jeep’s headlights provide the emergency lighting as he struggles to right a yet unborn calf. In wintertime, his only mode of transportation may be a Ski Doo that meets him at the farmer’s gate, waiting to take him to his place of need. In many instances you have to be inventive.

He may also arrive for a colic with a horse down and cast in a stall. Sometimes, only a flashlight provides meager assistance with his stethoscope firmly placed and a pocket light searching the distressed eye of the horse.

Wearing the telltale signs of sticky red stains from a late night emergency with a hard calving, he sighs. This night it was a cow suffering from the ill effects of milk fever and in hard labour with twins, complicated by a breach for one and a backward twisted leg on the other. He manages to save the cow, but the calves do not survive. He is pumped and alert as he wheels the Jeep around and heads home. One last bend in the road and the Jeep crunches the gravel of the driveway beneath its worn-treads. Soon the welcoming warmth of his home will be his again, as he prepares to retire to his bed. The curse of the pager announces yet another crisis. He heads out the door muttering his disapproval only to be lost to the silence and solitude of the night.

Finally his work is over as he longs to close his faltering eyelids and shut them for some much-needed rest. However, unlike other jobs, he cannot afford the luxury of sleeping in or calling in sick when illness takes hold. Six-thirty comes early this morning. There are chores to do before he makes his way to the clinic and begins another day. This will be a short night of sleep for him, an all too often occurrence.

Dressed, sitting pensive and weary in thought, he sips quietly on his refreshing orange juice. He spies the creamy yogurt before him and savors the taste for a few seconds of utter delight and relaxation. His health conscious breakfast now over, he moves his chair away from the table and prepares to feed his menagerie of animals.

With regularity, they eagerly anticipate his morning visits. Three cats who are a little too heavy even for a vet’s pet; two rather spoiled retired show jumping horses and a 150 or so fancy birds, racing pigeons and flying Tipplers, along with one lone peacock and two farm dogs. They greet him with coos, wagging tails, prancing paws and nickers from the stable. Oh to be so popular even if it is only cupboard love. Still he’s content knowing their needs have been met for at least this moment, as they munch away without concern or even acknowledgement of his presence now.

Back in the personal confines of his familiar Jeep he is slowly feeling the effects of his nightly rounds. The nagging ache of a recent injury to his shoulder inflicted by an ill- tempered cow reminds him not to be complacent in his duties today. He reaches uneasily for his seatbelt, turns the ignition; clutches and thrusts the stick into first gear.

As the clock in his jeep registered 8:00 o’clock, he rolls into the parking lot of his clinic. Henry, the lordly cat, strolls by indifferent to his visit. He turns the corner to his office and begins to review the papers laid neatly in a pile beside his appointment book open to the day.

He scans several laboratory reports for work done previously and returns his client’s calls advising them of post-mortem results he had found the previous day or the written verification of prognosis from the laboratory.

It is not a given to plan one’s day in an orderly fashion as emergencies are always a priority. The lines on his telephone flash with impatience as he answers one call after another. Soon his appointment book looks like a jumbled mess of notes with a sidebar of ticklers to remind him of important actions. This could be one of those days when he may have as many as 14 calls. After surmising from the various ailments of his patients as described by their owners he is scheduled to see today, he checks his supplies and restocks his portable medicine chest with the appropriate medium.

Harry’s first call of the day takes him to an elderly client whose two year old cow has been non-responsive to drug treatment for a period of time now. The old farmer keeps a few beef cattle on his treasured farm, long since the days when it was a bustling dairy operation. The tidy pens and barns stand in tribute to the pride of the farmer’s care. Harold, the farmer, dismounts from the rattle-rattle of his tractor and ushers Harry in to examine his sick cow once again.

He knows the prognosis is not good. Still the kind-hearted farmer doesn’t want to give in to what will most likely be the inevitable. The heifer is not just any cow to him. She has become the pet, ambassador of better, healthier days for both of them.  He knows that the cow's fibrous lungs, damaged from the prolonged illness of pneumonia will only respond briefly to the concoction of drugs administered to her this morning. Harry examines the cow and prepares his intravenous cocktail. He finds the jugular vein inserting the needle and holding the bottle of fluids with a raised arm. With wonderment in their eyes a horde of kittens appear intent on exploring the case of bottles, tubes and an assortment of syringes in his open medicine bag. Harold chats with Harry who is anxious to make his round of calls before noon. Even so he doesn’t rush, and spends a few moments reminiscing with the worried farmer to help ease his anguish. Knee-high black rubbers washed and sanitized are stashed away in the back of the Jeep. He heads down the road for his next call.

As he feels the road with the steering wheel and navigates a sharp bend he comes upon a rollover. The blind curves of these rural roads make for hazardous driving to the foreigner. He takes note of the damage and cluster of people working to clear the wreckage as he drives by. A couple of horses are on his list this morning to re-check.

The first patient is a 20 something Thoroughbred that is recovering from a slight bow. The owner has been keeping it wrapped for support and quiet from the freedom of a large open field and fellow hoodlums in the herd. It looks good, and no further treatment other than time is recommended.

His next visit brings him back to the little Appaloosa gelding that re-injured his left hind cannon bone. The dramatic presentation of proud flesh is examined once the bandages are carefully removed. The owner has been diligent in her care giving. Her efforts are rewarded with the cleanliness of the wound now healing for the second time. Still she agonizes over the possibility of the leg scarring on her future show prospect. Harry brings her back to reality in what is best for the horse. A bump on the leg from scar tissue is minor in the overall scheme of things. Somewhat guilt ridden over the vanity suggested towards the show arena, she is satisfied to have a functional horse in the end. The bandage is reapplied and Harry departs the stable for his next call.

He picks up the handset of his two-way radio and announces into the speaker “2102 to 2100”. A voice responds on the other end. As he clicks the button down, he asks “any change?” the reply is “negative.” He shifts the Jeep into third gear and continues on his way.

 He arrives at a busy riding stable to examine a few more horses before returning to the clinic. He steps out into the choking road dust that now clings to the Jeep like a dirty brown blanket. He lifts the heavy case of medicine from the back of his vehicle that shows no mercy to his aching shoulder. Harry no sooner enters the stable than an anxious owner asks him to examine her mare if he has time.  Not a scheduled appointment, he bows to her wishes. But first he must see the pony with the injured eye.

The gray pony is summoned and walks cautiously down the aisle. Suspicious of the man in coveralls, Harry takes his time to reassure the little horse that he is here to help. The eye is ulcerated and the owner is advised to administer a prescribed eye ointment and to keep the pony indoors away from the stinging rays of the bright sunlight.

He moves on to vaccinate a finicky show horse that is rather reluctant to the needle. With good aim and swiftness directed at his target, the needle penetrates without too much reaction. One more shot and it’s all over for another year.

Finally he walks to the stall where the paint mare has evidence of heavily soiled quarters. The owner is concerned that something is amiss in the mare’s delicate condition. She worries that the mare has slipped her foal. He reaches for a long sleeved glove and prepares to do a rectal examination on the mare. Much to the owner’s relief, she is confirmed to be still carrying her foal and dismisses the dark yellow stained quarters as nothing more than some loose manure. Returning to the solitude of his Jeep he points the vehicle towards the clinic.

Harry re-stocks his case with the used drugs he administered and checks his desk for more appointments. He returns phone calls before heading off to make one last call before lunch. He grabs his favourite drink (Coke) from the refrigerator and turns the ignition key in the Jeep. He makes his way to a dairy farm to look in on a three-quarter mastitis case, a veterinary term meaning three of four teats infected..

It is a stifling hot day as he relishes the relief from the heat in his climate controlled Jeep. Record breaking temperatures have been playing out for the past three weeks now, with drought conditions day after day. Nature is cruel to the sick animals under his care. In some cases, the heat stresses these animals to the point of no return. Exhaust fans are working overtime in the barns these days, as farmers and stable managers try to provide some comfort to their sweltering livestock.

He comes prepared to infuse two other cows and treat the ominous case of escherichia coli in the one cow. The farm has a large herd of Holstein cattle and the sick cow with the urgent case of mastitis is his first patient.

Leslie the cow registered 103 F degrees on the thermometer. Her respiration has increased as he prepares medication. Harry administers Oxymycin, Dextrose and Vitamaster, a litre of hypertonic saline, 15 cc of Anafen and four litres of electrolytes. The treatment would later prove to be in vain.

With the other two cows infused with a bridine solution for a suspicious uterine infection, his stomach growls in protest as he breaks for lunch. Harry takes a juicy ripe plum from his pack of snacks and checks his wristwatch. It is now 1:10 p.m.

Back in the comfort of his home he prepares a simple meal. Famished, he feeds his hunger with slices of fresh tomatoes, seasoned and placed between two slices of bread and drinks a large glass of milk to toast the rest of the day. Just 30 minutes of reprieve from his duties his pager rings. Before he pulls away in his chariot of wheel and steel, he looks skyward searching the air for his Tipplers he released earlier. He counts their numbers hoping a prey-seeking hawk has not made a meal out of one of the babies.

This time it is an old mare writhing in pain from a previous day’s colic. His partner had seen the horse initially and forewarned him that he might expect another call.    

He comes prepared for the worst. As he accelerates into fourth gear, he questions in his mind the wisdom of owners who want to be present for that fatal injection. It is those owners who can’t be consoled and yet stay for the euthanasia he can’t understand. They sometimes endanger themselves when attempting to comfort their dying horse. The horse will fall heavily to the ground without warning or direction as the deadly effects of the injection grips the last remaining life from the horse. He prefers that the owner isn’t there at the end but carries the memory of the horse standing in better times. It is that final scene that he feels will haunt the owners for years to come, rather than give them closure and comfort. He knows all too well from personal experiences.

He arrives on the scene only to realize his worst fears for this horse. He begins his somber examination with care and compassion.The little girl sobs uncontrollably desperately wanting to help her dying horse. She is unable to accept the fate of her equine friend. Her mother flounders for the right words and correct diagnosis of the situation that such young ears and mind can comprehend. The small black mare fights on courageously staying on her feet, heaving in vain with groans of pain and excursion trying to relieve the horrendous cramp and bloat of a suspected twisted bowel.   

Her vitals tell the sad tale. Her heart rate is over 100 BPM, respiration 60 BMP and climbing. Her body temperature is falling below a normal 99.0 F; her clammy wet skin, dull tortured eyes and bluish gray gums spell circulatory failure. The hollow pinging sound of an air filled abdomen when the sides are tapped and the audio record from a stethoscope, gives rise to the fact that a deadly twist is probable. It’s all there in the clinical signs. Although a merciful death by injection is the most humane thing to do, an owner’s wish to save their horse is hard to relinquish. Saying goodbye is perhaps one of the toughest tests of our humanity and so it should be.  

Finally, the agreement to end this horse’s misery is reached. Still the young girl wraps her arms around the neck of her beloved friend who is mercifully quiet now thanks to the veterinarian’s assistance. Harry picks up the spent syringes and walks away in silence, leaving the owners to their sobs and tears in private.

 As he prepares to take his next scheduled call, he broods about past experiences such as this. It is these painful images that make his job difficult for those animals that take a turn for the worst, regardless of the cocktails of drugs and treatment given. It is so disappointing and yes, sad. Sometimes it simply is not enough. Perhaps it could have been preventable with a little more knowledge on the part of the client and loosening of the purse strings of the more frugal owner. “Penny wise and pound foolish” is the phrase that comes to mind as help has been delayed and the consequences become a sad lesson.

On occasion client’s grief and nagging conscience is targeted at the veterinarian who couldn’t save their animal. It is often easier for the owner to lay blame, than to accept the mortality of an animal under their own personal care. The owner may struggle through the emotional strain of a tragedy that they could not salvage, even with professional medical intervention. Veterinarians are human too. Harry subconsciously strokes his beard and wonders to himself if it is really worth it, being in the profession he has chosen. Then he remembers the near miraculous recoveries of those that have defied the odds, despite the ignorance of some owners or the challenge of the disease itself. He smiles. Yes, that is why I became a vet, he acknowledges.

He still has a battery of calls ahead of him before dinner. The Jeep will need to be fueled; the clinic called for an update, and an emergency just around the corner. At least tonight he can stay home as his partner takes over the night shift.

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