Written by Sharon Marsh B.Vet.Med. MRCVS.
Partner, Cinque Ports Veterinary Associates based at Kingsnorth, Lydd
and Wye branches (also branches at Hawkhurst, Tenterden, Rye)
The day generally starts at 8.30am with a review of the in patients including those admitted overnight by the on-duty vet. One of the patients admitted overnight was brought in by the RSPCA inspector, he had been found injured by the roadside. X-rays last night revealed a fractured pelvis but he is comfortable this morning with his pain relief and is tucking into some breakfast. Sadly he wasn’t microchipped so we have to hope that an owner will come forward once he is noticed missing. Next I check on Jessie who was admitted yesterday as she had been vomiting and not eating. An x-ray revealed a stone, that she had eaten, lodged in her small intestine. She underwent surgery to remove the stone and is feeling better today. We try her with a little food this morning which she is keen to eat. Now we need to make sure that she is able to keep it down and, if so, she can go home to her very relieved owners.
We all discuss the other in-patients and the cases that have been admitted for surgery today. My colleagues start morning surgery and I start the operating.
We have 2 lovely 6 month old kittens in today for neutering. I give both a clinical exam to make sure they are in good health before their general anaesthetic and check their sex. We also check that the male has 2 testicles in the right place! After their surgery they recover under the watchful eye of our kennel nurse.
Next on the list is Snowy, a rabbit who is in to be spayed. Entire female rabbits can often become aggressive if they are not spayed and have a high incidence of developing cancers of the uterus and ovaries. Anaesthesia in rabbits can be more problematic so it’s important to have specialised equipment to monitor the anaesthetic.
During morning surgery my colleague admits a Shih Tzu that is passing urine frequently and the owner has also noticed some blood in the urine. My colleague is concerned that there may be a stone in the bladder and she is admitted for x-rays. We carry out the x rays under mild sedation and find that she has 4 large stones in her bladder and lots of much smaller ones. The stones are too large to dissolve with special diets so she needs surgery to have them removed. The stones have developed over a period of time within the bladder from crystals in the urine. Some dogs seem to be susceptible to developing these on regular diets
After a call to her worried owners she is taken to surgery. An incision is made into the abdomen and a second one into her bladder. The bladder wall is very thickened due to irritation from the stones. The bladder is packed full with hundreds of small stones as well as the 4 larger ones. It takes some time to flush these out. There would have been very little space in her bladder for urine and so the need for her to pass urine frequently. The incisions in the bladder and abdominal wall are then closed and she is allowed to recover. She will need lots of post op pain relief but in a few days she will be feeling much better. It’s important that we take measures to prevent the stones forming again. This depends on analysis of the stones so we can get her on the right specialised diet. She will need to be on the diet for the rest of her life.
I have lots of calls to make at lunch time so it’s a sandwich on the go.
Later, I’m off to do evening surgery at our new branch in Wye. Having just opened we have lots of new patients to get to know. Tonight one of the patients I’m getting to know is a 12 week old black and white kitten who’s in for his second vaccination. He’s much too busy looking out of the window to notice the injection. He’s weighed for his worming and to check he’s gaining weight and we discuss microchipping him when he comes in for castration at 6 months of age.
I’m on duty this evening and there’s no knowing what calls might come in. I manage to get some dinner and read bedtime stories to the children before my phone goes. It doesn’t sound good. A client is ringing about his German Shepherd who is trying to vomit and doesn’t seem to be able to bring anything up. The dog is very distressed so I arrange to see him immediately. During my clinical examination I find that Rufus has a distended abdomen. X-rays confirm my suspicion that he has Gastric dilatation and volvulus – effectively a twisted stomach. This is a rapidly fatal condition so he is taken straight to surgery. This is a problem that we see in large deep chested breeds that have taken in a lot of air with their food. This makes the stomach unstable and it can rotate very easily. When it does this the stomach can cut off its blood supply and the dog will die very rapidly.
Once we have him on Intravenous fluids he is anaesthetised. An incision is made into the abdomen and I am able to visualise his large gas filled stomach. This needs to be deflated before I can correct the rotation. The rotation is corrected and then the stomach is assessed for areas of damage. Because we acted quickly Rufus’ stomach should recover. We then place a tube into his stomach via his mouth and oesophagus to empty the stomach contents. This was not possible before the rotation was corrected. The spleen is also assessed as this can also become twisted with the stomach. For Rufus this is not a problem. To prevent this happening again for Rufus I perform a gastropexy which involves stitching his stomach wall to the inside of the abdomen.
The next few hours will be critical for Rufus and that means no sleep for the vet! (Subsequent to writing this article Rufus makes a full recovery).