Well That's One Way to Party on a Friday Night... in Ponderings of the Universe

  • Nov. 4, 2017, 8:21 p.m.
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  • Public

I have much tired.

Yesterday’s clusterfuckery continued on into the night. Hospitalized patient’s owners were given the option to transfer her to an emergency clinic overnight for continued monitoring as we do not have 24 hour staff so hospitalized patients are alone all night. If they are unstable we recommend a transfer. At first they wanted to, but then they learned that the nearby e-clinics don’t allow owners to stay with patients all night (overnight staff is usually smaller and visitors tend to get in the way of doing their job). They really wanted to stay with her all night but she definitely needed continued veterinary care. One of my techs ended up staying the night with them, which is not something we typically do. She was probably the best person to do so because she is a fantastic technician and very level-headed. My colleague, M, arranged it as she was not in appointment when patient started to do less well, though she was supposed to be transferred to me. It was good that she took charge. I was definitely having a deer in the headlights moment. There’s a reason I’m not in emergency medicine!

So, I went home, pretty spent, and ordered pizza. Shortly pizza was delivered, got a call from my technician, T, that our patient was not doing well and she needed help with a blood draw. Aaron and I headed over (I don’t drive. I’m neurotic, I know. Thank goodness work is 5 min away). Helped T get blood. Patient looked much worse than earlier and was continuing to get worse. Bloodwork didn’t change much. Discussed what was going on with M because, again, totally out of my comfort zone and I rely on her years of experience. Then, had a very frank conversation with the owners. M and I didn’t think she was going to improve. We were still unsure of the underlying cause of her sudden onset of symptoms and decline. She may benefit from meds and/or procedures available at an emergency clinic, but she might not be strong enough to survive. Could continue to monitor and do what we were doing. Euthanasia also on the table. Owners weren’t sure what to do. They weren’t ready to say goodbye yet, they hadn’t even really had time to process everything that was happening to their pet (symptoms had only started that morning). They opted to stay the course.

We went home, with T staying behind to continue monitoring and supervise owners. I went to bed. She called me about an hour later. Patient was doing worse, having signs indicative of a GI bleed. In my startled awake state I was not very helpful. I groggily made some suggestions. We hung up. I had a panic attack that I didn’t initially realize was a panic attack. At first I thought I might vomit, but then realized it was just my body freaking out. I don’t do well with middle of the night calls. Eventually got a grip, got my wits about me and texted T some actually semi-useful suggestions. About half an hour later, got another call that Patient was having another seizure and that owners were ready to euthanize.

Headed back to work. Talked them through the euthanasia process and things they could expect as the body shuts down as they had never been through euthanasia with a pet before. I like to warn people about the most common things that bodies do when they’re dying that look scary but are pretty normal. The euthanasia itself went very smoothly. They owners were, understandably, very emotional. I never know what to do with sobbing people. I tend to let them let it all out, trying to be as unobtrusive as possible, saying things that seem like they may be comforting and true in moments of quiet. Eventually, gave them time alone to say their final goodbyes. Once they left, we packaged her up for delivery to the crematorium. Still unsure what caused her illness, we cleaned like mad, especially since there were many bodily fluids and we weren’t sure if it was a contagious disease. Owners declined necropsy, so we won’t know. Told T that, next time she wants to hang out, maybe we should watch a movie and order pizza instead of this nightmare. She and I have similar dark senses of humor, definitely helps us cope in times like these.

Got home around 3. Went to bed. Got maybe 3-4 hours of sleep. Then got up for my shift for today! Whee! Luckily, today wasn’t bad as far as Saturdays go. Had a moment of panic when I thought I might have a patient with a possible GI obstruction. The idea of having to do foreign body removal surgery on so little sleep made me want to cry, especially as I’ve only done one other. Lucky, xrays showed the eaten item in the colon, so it should be pooped out without difficulty. SUCCESS!!!

Neglected my paperwork (the stack is mighty), came home and napped. I’ve been pretty useless for the rest of the day.

My job isn’t usually this stressful, thankfully. But cases like this really take their toll on me.

It’s really hard to write about cases while trying to keep details at a minimum. That’s why everything is so vague. I just don’t want to be too specific here on a public forum, you know?


Jigger November 05, 2017

I think you're striking a good balance here. And I think you handled that case as well as it possibly could have been. Sounds like there was only one way it was going to end.

I'm an Okking Fool Jigger ⋅ November 06, 2017

Cases like that are so hard because you're 99.9% sure it's going to end poorly for the patient but the owners aren't quite ready to face the reality of euthanasia/their pet dying. It's hard to be firm and realistic, yet gentle at the same time.

TellTaleHeart November 05, 2017

I love that you took the time to explain the euthanasia process beforehand. When we had to put one of our dogs down, there was no explanation. His body shuddered at one point and I asked if that was it, but the vet said he was already gone and that was a post-mortem spasm. Then I felt an extra layer of sadness because I felt like I missed the moment he slipped away.

I'm an Okking Fool TellTaleHeart ⋅ November 06, 2017

I try to prepare people the best I can. Death is not always as quiet and peaceful as we would hope it to be. I once had a cat yowl and jump off the table as it was dying. I think that was just it's body's way of shutting down and didn't indicate fear or pain.

I'm sorry you feel like you missed his last moment. It's hard to come to peace with a regret like that. I think, though, what matters most, is that you were able to be with him during that final moment and provide some level of comfort, even if you didn't know exactly when the moment was.

Emily November 05, 2017

What a difficult situation :( Possibly insensitive question here.. but do you get paid for going in at night?

I'm an Okking Fool Emily ⋅ November 06, 2017

It was pretty awful :(

Not insensitive at all. I do not get paid extra for going in at night, but I am salaried. Luckily it's a good kind of salaried and I'm not taken advantage and rarely work more than 40 hours per week. The technician, however, is hourly, and the majority of the 24-hour personalized care cost that was added to the bill will go directly to her. She did most of the hard work by staying with those owners and pet, giving emotional as well as medical support.

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