Vet on the Loose (10 page)

Had I not been too far away I might have taken up Paddy, from my first attempt at euthanising a dog, on his offer. Being so laid back, they might not have minded a Christmas callout.

In desperation, I removed the red collar yet again. This time I clipped some hair from the neck, hoping to find a jugular vein. So engrossed was I in the procedure, that I jumped guiltily when the phone rang, as though someone had caught me in the act of doing such a feeble job. Joyce’s voice brought me back to reality with a start. I glanced at my watch and realised it was after two o’clock.

‘Gillian, where are you? We’re here waiting for you. Donal’s been here for ages. What on earth are you doing?’

Apologising as humbly as I could, I filled her in and asked her to go ahead without me. Judging by the merry sounds in the background, I wouldn’t be missed too much anyway.

‘I just hope the owners appreciate what you are doing for them,’ Joyce finished, clearly indignant about the whole business. I didn’t bother to fill her in on the details of the cat’s present unclaimed status.

By now, the bag of fluids heating in the sink was
practically
boiling, so I emptied the sink and filled it with cold water, feeling slightly as though I were setting out on a merry-go-round. After a last failed stab at the elusive
jugular
, I decided on a new approach. Trying to recall our fluid therapy lectures in college, I could picture the page of options in the typed notes: subcutaneous (too slow),
intravenous
(if only), intraperitoneal – too slow as well but, at this stage, probably better than nothing.

While not an ideal option for a cat suffering from shock, I had no alternative now, so I clipped a small amount of hair from the abdomen and, having swabbed it with
disinfectant
, gently inserted a needle through the body wall. I hoped I had hit the right spot as I injected first one, and then a second syringe full of the now suitably cooled fluids.

The cat was still motionless. Now, no matter how hard I tried, I couldn’t elicit the purr. I was beginning to wonder had I imagined it all.

Feeling disheartened, I rechecked the tiny body but, other than the eye and the broken leg, I could find no other obvious injuries – well, not obvious to me anyway. I didn’t know if there was any internal bleeding or not but decided to bandage the abdomen anyway – it could do no harm.

I filled another syringe full of fluids, gently flushed out the prolapsed eye and with a fresh piece of saline-soaked gauze, I managed to clean off the pieces of dirt that had adhered to the drying organ. I placed a suture in both
eyelids
, wishing it was not Christmas Day and that I could call on an extra pair of hands to help. Although under normal circumstances, this procedure would be carried out under general anaesthetic, with the cat unconscious, there was no need. Using one hand to pull the eyelids apart, I used my other hand to try to ease the lubricated eye back into the empty socket with the moistened gauze swab. It took far more pressure than I had anticipated as it stubbornly slithered out first one side and then the other, obstinately refusing to go in the direction I required. I was beginning to reconsider that syringe of lethal injection when
suddenly
, as if by magic, the eye slotted back into the socket and, for the first time, I felt that maybe there was hope. The eye looked relatively okay but I decided to suture the lids together anyway, having applied a generous squirt of antibiotic eye ointment.

Next, I examined the leg which dangled helplessly off the blanket. After a quick examination, I thanked God that at least it was a pretty clean break and that no sharp edges had gone through the skin. However, trying to straighten the leg required a bit of effort. Slowly and carefully, I pulled the fractured end from the body, while trying with my other hand to realign the sharp edges. As I did so, a sudden deep yowl came from the cat and she pulled her leg against me. Despite her obvious pain, I was delighted to get some reaction. Initially, I had been afraid to give her any further medication but now I injected more
painkillers
, frustrated that I didn’t have access to a vein to allow them to work more rapidly. Another rummage through the presses revealed an assortment of bandages and some plaster of Paris that would do to cast the leg. Having soaked the casting material in some warm water, I applied it as best I could, hoping that the realigned ends of the fractured radius would stay in place until it set. After a few minutes, the cast was nice and hard and I started the
laborious
task of cleaning up the mess.

The cat was now quiet again, and her breathing seemed easier than before. Her pale membranes still scared me though.

By this stage, I decided that I was so late anyway I might as well have a last try for the elusive vein.

Pulling out yet another cannula from its sterile sheath, I stretched out the cat’s neck and placed my finger deep into the groove where the vein should have been. But to no avail – try as I might, I couldn’t feel anything. Hopelessly, I poked the point of the cannula into the general area of the vein, redirecting it again and again. Just as I was about to give up again, a little bubble of blood appeared in the hub and I held my breath, afraid to move in case the sharp tip of the stylet would pierce through the fragile, collapsing vein. Ever so slowly, I advanced the plastic cannula, gradually withdrawing the metal stylet, and, still holding my breath, watched as the drop of blood on the hub slowly enlarged and finally dropped on to the cat’s neck. I felt like dancing for joy but contained myself in case it all fell out. Then I realised that the giving set – the plastic tubing that connects the bag of fluids to the intravenous cannula – which I had left ready to hand, had by now made its way over to the far side of the table. This meant that I had to balance precariously on one leg still holding the line in place, while stretching over with the other hand, to retrieve the errant giving set with the tip of my finger. Having finally attached it to the bag of fluids, I released the valve and then cursed as nothing happened – until I saw the kink in the tubing. Once readjusted, the fluids ran in freely.

Happy at last, I sutured the cannula in place,
determined
that it wouldn’t come out again. Drawing from the depths of my memory of six months previously in college, I tried to recall the formula for the shock rate of fluids for a cat. Having hooked the fluid bag off a conveniently located press handle, I again began to stroke the black fur. And there it was – the deep-throated purr. Time blurred as I stood there, stroking the cat’s body in time with the purr, almost hypnotising myself, whatever about the cat.

Eventually, I dragged myself away. There was nothing more I could do. Although I doubted it, the colour of the cat’s gums did seem to be improving and, as I checked the reflexes in her unsutured eye, she started to paddle her paws.

Having done what I could, I suddenly remembered my neglected stomach and the smell of roast turkey that had been wafting out from Joyce’s porch. With the cat tucked up in a small cage, I fished in my pocket for the torn piece of paper and dialled the number of the lady who had rung me in the first place.

Soon I was back at Joyce’s house in an atmosphere of Christmas cheer and doing justice to the huge plate of dinner that had been kept warming in the oven for me, not caring if the gravy was the only thing keeping it moist.

Joyce seemed bewildered by the whole situation.

‘I’d kill her if I was you,’ she kept repeating to Donal as her wine glass teetered dangerously close to the edge of the arm rest. Luckily, both he and Greg were engrossed in an old video of a hurling final, and were oblivious to all else.

It was five o’clock before I managed to haul myself back out of the chair and return to the surgery, not daring to think what I would do if it had all been a waste of time. Donal came with me this time and I was glad to have some moral support as I braced myself for the worst.

The little cat was sitting up looking decidedly perky although the right eye was slightly glazed. I waited as I ran my hand along her back and although she quivered as I touched over some areas of bruising, by the second stroke, I could detect her regular purr. She sat uncomplainingly as I examined the cast leg and listened to a heart which was now much stronger and more audible. Another quick examination revealed nothing further, other than a full bladder – which meant that at least the organ was
probably
still intact.

Miraculously, by Stephen’s Day morning, she was up and walking around, daintily holding up the injured limb. She purred with an almost tiger-like growl as she wolfed down the leftover turkey I had brought her.

I finished my locum stint that night and left a note for Bill outlining the details and leaving him a number for the lady.

Despite my being sure that the cat had an owner, as yet none had turned up. I was beginning to get worried, but having a long drive home, I had no option but to leave her where she was. Her purrs as I said goodbye seemed extra throaty, as though she knew.

I tried to put her out of my mind, which wasn’t too
difficult
as I joined a busy three-vet practice in Wicklow with Christmas lambs and calving heifers. An exceptionally good summer and mild autumn had left a lot of them in too good a condition, with oversized calves in fat cows, and it was here that I did my first two Caesareans.

About three weeks later, a letter arrived that had been forwarded from Bill’s practice. As I slit it open, out fell a picture of a sleek-looking, glossy black cat, with a red velvet collar, being cuddled affectionately in the arms of a young girl.

The attached note began: ‘Dear Christmas Day Vet’. It was from the owner. She had turned up the morning after I had left, overjoyed to find the little animal alive and well. Ebony, as the cat was called, had made a full recovery, she said, and was now purring even louder than ever before.

If only they knew how that purring had probably saved her life.

I
t was eight o’clock by the time I had finished the
evening
surgery and I still had one more call to do. A farmer had rung to say that he had a cow with a
prolapsed
uterus. I was only a week into my new job in the heart of Wicklow and this was my first evening on call by myself. Although Riverdale Veterinary Clinic was a mixed-animal practice, as it was now coming into spring it seemed to be largely taken over by the cattle and sheep work.

‘Give us a ring if you need a hand with anything,’ Seamus, the boss, had offered, on his way out that afternoon.

A prolapse in a sheep is rectified easily enough but in a cow, when the whole uterus or calf bed is forced out, it’s not so easy. I had seen experienced vets struggle with such cases, and wondered how I myself would fare as it would be the first time I would attempt to replace one. I hesitated for a moment, wondering if I should ring Seamus, for the cow’s sake as much as for my own, but then decided against it. After all, I didn’t want to look like a total waster in my first week.

Twenty minutes later, I was standing in a small, dark shed on the top of the hillside, observing my patient. The cow was stretched out, eyes rolling in her head, moaning softly to herself. As I became accustomed to the darkness, I shuddered to see the enormous, red, bulging mass
protruding
from her rear end. Somehow I didn’t remember the ones I had seen during my student years ever looking quite as big or as swollen as this one.

It looked as if it might have happened some time ago. John, the farmer, had been away on holidays and had left a neighbour checking the stock, so it was hard to be sure exactly what had happened.

As I tried to mentally rearrange the cow into a more suitable position, my mind flitted back to my final-year oral exam when I had confidently explained how to sedate the cow, administer an epidural and then roll her over to pull the two hind legs out behind her in a froglike position. I discussed in great detail how I would then cradle the neat little prolapsed organ on a sheet of
spotlessly
clean plastic. I had further explained the
importance
of pushing it back in, gently yet firmly, with the palm of the hands, taking great care not to use the fingers least they rupture the delicate organ.

I was very proud of my honours degree in
reproduction
but now I felt that a bit more practical experience would have been a lot more help than the neatly framed piece of paper.

I immediately decided to forget about the sedation bit. It looked as though even the tiniest bit would be enough to push the cow over the edge, and, I didn’t think that the collapsed form in the straw was going to put up much of a fight anyway. Instead, I decided to go for a hefty dose of intravenous steroid and some calcium borogluconate, hoping that they might improve her chances of survival. While I set about scrubbing and clipping the site for the epidural, I sent John to arrange a bit more light.

Normally, a floppy tail indicates that the epidural has hit the spot, but this one was floppy before I had even injected her. I would have to wait until I started to work on the prolapse to see if she would strain against me. Although the cow was totally unresisting, it took three of us to heave her dead weight around to get her in a position that would allow me a bit of space to work under the flash lamps that John had organised.

It took longer than I expected to gently wash and remove all the bits of dirt and straw and the semi-rotted pieces of the placenta that still adhered to the uterus, but the time passed quickly enough as I chatted to John and his
neighbour
, subconsciously trying to put off the inevitable moment when I would have to start the real work. They were both young farmers and I was glad to have pleasant company and a bit of extra muscle power for the job. I could have done with some sugar to pour on the calf bed because by now, having been out for some time, the
prolapsed
organ had become grossly oedematous, which was going to add to my troubles getting it back in. Sugar has an amazing ability to draw out a lot of the fluid by simple osmosis, but when I realised that the house was a good half mile from the yard, I decided to make do without it.

Finally, I could put off the inevitable moment no longer and I started to push, remembering to use only the palm of my hands as indicated in our college lectures. I knelt behind the cow, cradling the engorged uterus on a piece of grubby, well-used silage plastic, supported on either side by John and his neighbour. Placing the palms of my hands around the edges of the mass, I pushed … and pushed … and pushed even harder until I could feel myself going red in the face.

Nothing happened.

I smiled confidently at the two men, rearranged my position and pushed again … and again … and again.

Still nothing happened.

I don’t know how long this went on for until I had to take a break. I sat back to look at it and said, as much to myself as to the farmers: ‘I think it’s getting smaller.’

‘Definitely!’ said one.

‘Absolutely!’ the other.

Once I had caught my breath, I started again, this time concentrating on the underneath part. I thought I had
progressed
by a few centimetres until I noticed that it had all come back out at the top end. Both farmers jumped
suddenly
in response to the string of curses that broke out of me. I think until that point they had thought I was refined and ladylike, despite the job.

‘Sorry,’ I mumbled, as they both stared at me.

‘Not at all, curse all you like if it helps,’ John replied politely.

Another ten minutes of unsuccessful pushing went by, during which they were exposed to the full range of my expletives as I forced and strained against the fragile uterus, trying not to put my hand through it. My college oral seemed a million miles away and by now, I was
desperately
pushing with palms, fingers, elbows, knees and anything else that I could call into play.

My arms ached and my legs were paining with the effort of supporting the uncooperative mass of tissue. No matter how hard I tried to convince myself that I was making progress, it still looked no smaller. I sat back and stripped off my jacket and sweatshirt and envied the male vets who, when in need, could discard all of their upper garments.

I was starting to feel a lot sorrier for myself than for the unfortunate cow and I was amazed to hear the farmers muttering sympathetic things like: ‘You must be exhausted by now. Come on up for a cup of tea. Sure there was
nothing
you could have done anyway.’

The prospect of having to give up on the animal and admit failure gave me a renewed surge of energy and determination. I set to work again, with a just a slight edge of frantic desperation.

I had gone past the point of pain by the time I looked down and, to my immense relief, saw that this time the thing really was getting smaller. Both farmers had gone silent but you could almost feel the renewed hope in the air. Ten minutes later and it was by now about the size of a normal prolapse, even though over half of it had gone back in. I worked unrelentingly at the last portion and, with a feeling of disbelief, I watched as the last section was sucked back into the vagina. In a daze, I followed it in until my arm was in past the shoulder and I pushed the two horns of the uterus back into their rightful positions.

If I was expecting a round of applause from the cow I was wasting my time: she lay, head sunk to the ground, apparently uncaring of her fate. John, however, was very appreciative of my efforts and thanked me profusely – a nice change from the tirades of abuse to which vets may sometimes be subjected if the job has taken too long.

It was only when he said to me: ‘We were lucky to get you tonight. I reckon your boss would just have shot her,’ that a niggling doubt started to creep into my mind. Seamus was, after all, a lot more experienced than I was and, in all my student years, I had never seen such a bad case as this one. I quickly dismissed the thoughts from my mind. Right now I felt as though I myself was going to die, and I certainly couldn’t cope if the cow did too, after all my efforts.

Working in slow motion, I placed a big Buehner’s suture around the vulva, wondering if it would be a waste of time if she decided to force again but at least it made me feel better. All that was left to do was to give her a shot of
antibiotics
– the rest was up to her.

When I got home, I relayed my story to Donal and we sat up for a while, unwinding over a few cans. When I finally made it to bed that night, the dull throbbing in my muscles, unaccustomed to the day’s exertions, prevented me from sleeping. I tossed and turned and couldn’t help wondering how my patient was faring.

I knew it was a sign of inexperience but at nine o’clock the next morning, I just had to ring John to find out how she was getting on. I sincerely hoped that she was feeling better than I was. My heart thumped as I waited for the phone to be answered.

John’s voice was muted. ‘I really appreciate what you did for her last night.’

‘That’s no problem at all, but how is she now?’ I interrupted.

‘She died an hour ago.’

Suddenly the pains in my arms and legs doubled. I
realised
that my lack of experience had put not only myself but also the cow through an unnecessary ordeal. I should have shot her.

It seemed that fate was mocking me as in the weeks that followed I was inundated with calls to attend prolapsed cows. I have never seen one as bad as John’s cow since but, as my muscles toughened up and became accustomed to the hard labour, at least I knew that if I had managed to get that one back in, I would never fail again.