Tag Archives: anaesthesia

Big cats, Big surprises

lion, leopard, tigerThe standout feature of this week’s Safari Vet School – other than ITV’s incredible ability to massively over-dramatise everything –  was the lion dart, transport and release experience. As in previous posts most of the fun adventures that the students get up to manage to trigger some memory I have that I am able to draw parallels from with the safari experience. After all, in spite of being born in South Africa there are not too many Lions roaming the streets of Hampshire for me to get my clinical teeth into. Plenty of unpredictable, oft grumpy and sharp moggies though.

The students had to administer sedation to the two lions in question, in order to safely transport them across the reserve, and had to remain vigilant during the process due to the risk of the lions waking up. It highlighted the inherent unpredictability of sedation in general and how not all of our patients take note of the dose charts. We had a feline patient in yesterday who it was suspected may have had a foreign body impaction (ie may have had something stuck in his guts) as he had not been to the toilet and had been seen for vomiting previously. In order to fully assess him, including taking an xray of his abdomen, we opted to admit him for sedation and to start him on a drip in order to rehydrate him. In the end we needed to sedate him before we were able to place an i/v line as he was a bit of a flighty chap. The sedation worked a treat and within a few minutes our bouncy feline customer was a pliable bundle of fluff. This proved two points for me: 1. it is often preferable, both in terms of reducing stress on the patient and for making sure you, as the vet, are able to do the best job possible in the least amount of time, to sedate animals that are making life a little tricky when it comes to examining them; and 2. the response to sedation is such an inherently unpredictable game – another cat of the same weight may not have been touched by the dose we gave whilst the cat yesterday responded perfectly. Having top-up drugs, reversal agents, and additional medications and supportive treatments, such as oxygen, on hand is therefore essential, so that you are able to respond in real time to what is actually happening with your patient, rather than relying on what is ‘supposed’ to happen, as it rarely goes the way it should. The other thing to remember is that even though our patient wasn’t a 300kg lion, it could still have caused a decent amount of damage to either myself or one of my colleagues, especially during the recovery phase when animals are often very disorientated and confused. Anyone who has been on the sharp ends of a cat will certainly know what I mean. In terms of what was wrong with the cat, it turned out he was massively constipated and so a decent period of rehydration and an enema later and he was right as rain, including being significantly lighter than before! Ah, the glamour.

As a footnote, I just wanted to commend Fitz on her rather spectacular feat of acrobatics in diving out of the way of the zebra’s flailing hoof, which would have made quite a dent in her head if it had hit. Vets do seem to have to develop the reactions of a wired cat as, again, the unpredictability of our patients means that danger can literally fly at you from any direction at any time. Another feature of vets, and indeed nurses, seems to be our ability to contort ourselves into the oddest of positions and maintain said postures for lengthy periods of time in the course of administering to our patients. It sometimes feels like being a vet instantly puts you in contention for the title of World Twister Champion. Maybe compulsory yoga classes should form a part of the vetty curriculum?!

 

Death Is Coming

Red Hartebeest
Red Hartebeest

Elephant Adventures

The latest episode of Safari Vet School saw a new group of vet students arrive at the reserve, with most being more experienced than their predecessors yet just as keen to get stuck in to the fun. This week’s episode seemed to have much more of an edge to it, with the word ‘danger’ very much being the one that kept cropping up. Whether it was the ‘danger’ posed by getting too close to a protective female elephant and her calves, or the ‘danger’ posed to the Hartebeest that was very close to succumbing to the effects of hyperthermia, the new students had a lot to really keep their adrenaline levels at maximum.

The elephant experience reminded me of a story my late grandfather used to tell us, in which he came face to face with a rogue bull elephant whilst living in Kenya right out in the bush. The elephant in question had apparently been terrorising local people and it was suspected that it had something very wrong with it. My grandad was charged by it and had the terrifying and upsetting decision to make of having to kill it, in order to safeguard his own life and those of his family. As a result, we had it drilled into us from a very early age of the unpredictabilty and ‘danger’ posed by animals, even those we consider to be cute and generally harmless.

Overheating & Death as an unhappy fact of the job

The incident with the Hartebeest was a close one and it was clear that the group very nearly lost the animal to over-heating. This really drove home the fact that in spite of our best efforts, animals are ultimately complex biological systems with all of the inherent unpredictability that you’d perhaps expect but which can serve up real curve-balls on occasion. This is an important lesson to learn early on in a veterinary career as there are guaranteed to be a number of such situations throughout any vet’s working life. I had one such case on the weekend. We had a middle-aged Rottweiler transferred to us from it’s vet for ongoing fluid therapy and treatment for vomiting, weight loss and bloody diarrhoea (not the nicest of combinations). The dog was also very yellow and clearly had significant liver issues. Owners have a great way of really piling on the pressure and the owner’s parting words were that her dog “could not die.” As I say, no pressure. Further blood tests and an ultrasound scan later made it clear that the dog had serious liver problems and as such the prognosis was guarded to poor. She did, however, start to look better and more responsive after a few hours of fluid therapy, and as such we felt that we may have made a difference. Now this is where as a vet you have to be very careful as animals like this have a particularly nasty habit of perking up just before a major crisis, and that’s exactly what happened. The dog suddenly went downhill, turned pale and basically started dying in front of our eyes. Unfortunately, in spite of our very best efforts, the damage was too great and she was put to sleep. This really drove home the fact that cases can take an unexpected turn, sometimes for the better, sometimes for the worse, and that as vets one of our most important tasks is to sensibly manage owner expectations. It would have been easy at admit to reassure the owner by telling her that her dog was “going to be OK,” but that would have been misleading and caused even greater anguish to her compared to being realistic and cautious by advising a guarded prognosis. Although the dog’s owner was understandably very upset, she had been given a chance to come to terms with the fact that her pet was very ill and may well die rather than languising under false, or misguided, thoughts that everything was going to be OK. So, the thing I would say to the Safari Vet School students is that in spite of their best efforts, that particular Hartebeest on that particular day had obviously ‘decided’ that it was going to test the boundaries between life and death. Sometimes stuff just happens and you have to be prepared to accept the fallout, learn any lessons and then move on.

Two of the most motivating words ever: “Can’t” & “Never”

LionManaged to catch up on Safari Vet School thanks to the good old ITV iPlayer (did I mention how much I love my iPad?!). This week’s episode saw the team of vet students and safari vets take on darting and surgically implanting a tracking device into a lioness, which was pretty nerve-wracking stuff, and then finish up with a mass capture of Zebra, who apparently can kill with a single kick, something that anyone who has worked with horses will appreciate. Of course I’m not saying that rounding up a herd of Zebra is anything like working with your standard hack but the power and innate unpredictability of large animals – well, in fact ANY animal – is something that’s important to always have in the back of your mind as a vet.

One of the stand-out parts of the show for me was the point at which Charlotte was recalling the advice she received whilst at school, regarding her ambitions to become a vet. She was advised to “have a plan B” and to “give up,” something which I hear a lot of from prospective vet students. Yes, it’s a tough course to apply to and yes, it’s not a bad idea to consider, even for a fleeting moment, what you might do if, all things going awry, you don’t succeed with applying, but to be told to give up just seems ridiculous. One of the main issues I have identified through advising prospective vet school applicants and through my book is that many careers advisers (I use the term in the very broad sense to include teachers who are not necessarily careers ‘specialists’) don’t fully understand the unique nuances of preparing for and applying to vet school and as such, rather than seek to fill the gaps in their knowledge so that they can better inform and guide their students, it is often easier to revert to the assumed misconceptions about veterinary being “impossibly hard” to get into and to thus encourage other career options to be pursued. I wonder how many really fantastic vets we may be missing out on simply as a result of a student being told at that critical point in their young lives to “give up.” It’s something to ponder. Good on Charlotte though for sticking to her guns and focusing on her ultimate aim of getting to vet school – if she hadn’t been so determined then darting lions in Africa would have been but a hazy daydream!

Safari Good Fun

I have just watched the new ITV vet show ‘Safari Vet School’ and it instantly brought back several memories of being a student myself – not necessarily memories of being out in South Africa, although my training did involve dealing with a few ‘exotic’ species – but more of finding oneself very much out of a comfort zone. The rotation that this was most noticeable on was anaesthesia, which is what seemed to cause the students in the show the biggest challenge.

Stepping out of your comfort zone, putting the books aside and placing yourself in a position where things don’t always go according to the textbook is a feature of life every day for vets, with the very nature of anaesthetics, and indeed biological systems, being unpredictable and thus intrinsically risky. I actually thought they did well on the show, considering that it was their very first day, they had no real idea of how much the wild animals they were dealing with weighed, and, lets be honest, none of them ended up getting injured – quite an achievement I would say!

I for one am looking forward to the next episode and learning more about each of the intrepid veterinary travellers as we go along.