On some days this job just sucks
15-yo FS Golden Retriever, recumbent on arrival, faint heart beat, barely perceptible femoral pulses, blood still oozing from rDVM catheter site. Discussed quality of life, likely coagulation disorder, age, etc. Owners elect euthanasia and want to be present. Shave arm with catheter site - ecchymoses up and down transitioning to petechiae. Other arm looks better. Dog has no BP - finding the hint of a vein requires a tourniquet plus the tried-and-true hunt and peck technique. 2 of 10 cc goes in before the vein blows. At least the dog is asleep now.
Lateral saphenous - completely invisible. Back to the arm, another cc goes in. Discard the remaining 7 cc as it's so mixed with blood I can't tell when I'm in a vein or not. Talk to owners, explain that dog is now asleep, that they were the last thing it saw, and that it's now resting comfortably. Ease them out to the waiting room. Get spinal needle and go intracardiac with remaining 7 cc. Finally the dog is dead. My lab coat has multiple blood stains on it.
"Dr Pomes, the other euthanasia is ready in Room 2."
Room 2 is an older feline, not obviously debilitated. "What's the story?"
"It's a diabetic and the owners can't manage it anymore."
Manage what, I ask myself, the cat, the disease, needles, expense, something else? I'd like to care but there are still three rooms to go. The techs assure me that the owners are good clients and wouldn't do this unless circumstances forced them to. 2 cc in the medial saphenous vein and kitty's troubles are over.
The next room is an older kitty that can't walk. Both hind legs are cool to the touch while the ears and forearms are normal. They've read about saddle thrombus and decline a workup. Maybe TPA would work, but no one wants to spend several hundred on an experiment. Another 2 cc in the medial saphenous vein and another closed file. I'm thinking of a name change to Dr Death.
The last two clients just want their rabies vaccinations and out of here. They've seen the other clients and know that today has sucked. Otherwise one would definitely be asking why he had to wait so long for just a rabies, come on now Doc!
I'm going to go back home to San Diego on cruise control, hug my wife, and lay down with her for a while.
Lateral saphenous - completely invisible. Back to the arm, another cc goes in. Discard the remaining 7 cc as it's so mixed with blood I can't tell when I'm in a vein or not. Talk to owners, explain that dog is now asleep, that they were the last thing it saw, and that it's now resting comfortably. Ease them out to the waiting room. Get spinal needle and go intracardiac with remaining 7 cc. Finally the dog is dead. My lab coat has multiple blood stains on it.
"Dr Pomes, the other euthanasia is ready in Room 2."
Room 2 is an older feline, not obviously debilitated. "What's the story?"
"It's a diabetic and the owners can't manage it anymore."
Manage what, I ask myself, the cat, the disease, needles, expense, something else? I'd like to care but there are still three rooms to go. The techs assure me that the owners are good clients and wouldn't do this unless circumstances forced them to. 2 cc in the medial saphenous vein and kitty's troubles are over.
The next room is an older kitty that can't walk. Both hind legs are cool to the touch while the ears and forearms are normal. They've read about saddle thrombus and decline a workup. Maybe TPA would work, but no one wants to spend several hundred on an experiment. Another 2 cc in the medial saphenous vein and another closed file. I'm thinking of a name change to Dr Death.
The last two clients just want their rabies vaccinations and out of here. They've seen the other clients and know that today has sucked. Otherwise one would definitely be asking why he had to wait so long for just a rabies, come on now Doc!
I'm going to go back home to San Diego on cruise control, hug my wife, and lay down with her for a while.