Never Hear Wolf

Being a veterinarian here in Vermont is pretty awesome all of the time. There are two seasons that are especially awesome to be a vet here; Winter and Summer. Both seasons bring in tourists and both seasons are a little bit slower for our regular clientele so we can focus on catering to our out of state clients without feeling like we are ignoring our regular folk. It’s a really fun situation. Also, I like skiing and swimming. Not at the same time of course.

I am using three out of stater stories to illustrate the importance of taking to heart the complaint a client calls in with.

1. It was the first July I was in practice. It was hot and my wife and I had only recently found out we were expecting our first child (we didn’t know it was a girl until she was born.) My in-laws were visiting and we were living in East Dorset at the time. There was a great little pick your own berry farm just down the road from us. The afternoon plan was, we were going to pick some berries then head down to Emerald Lake State Park for a quick swim before grilling some dinner on the deck. It was going to be a pretty sweet New England summer afternoon and night.

But I was on call and of course my phone rang as we were headed into the berry farm. I took down the client’s information and called while I was finding a parking spot. It was legal to use a hand held device while driving at this point. I might be the reason it’s not anymore. The client was visiting from Connecticut and their Labrador Retriever puppy had been spayed the day before. There was a problem with the incision. I called and the woman owner – a pleasant but slightly frantic pet owner – answered. She informed me that her dogs spay incision was open and she was pretty sure that she could see intestines.

I was fresh out of school, young and at least as excited about veterinary medicine as I am today. I told her I would meet her at the hospital right away. I told my wife what was happening and she – infected by my enthusiasm – agreed to walk the mile back to our house. In the heat. Pregnant. I left in a hurry and made the drive from East Dorset to Rutland in 19 minutes. Google map that. This story will be here when you get back. I have a client who is on a police force in Southern Vermont and lives in one of the towns I drove through way too fast. I am sorry. I am glad no one got hurt.

I pulled into the driveway and was kind of excited that I beat the client there. I got out of the car, grabbed my keys and went to unlock the door. Then I caught a glimpse of myself in the reflection in the window. I had on board shorts, an athletic shirt and flip flops. (Relax OSHA I have Crocs in the clinic (relax fashion police I’m a veterinarian I’m supposed to look terrible)) I wondered how anyone was going to take me seriously. I threw on a pair of scrubs and my Crocs.

The client arrived and I led them into the exam room. I carefully asked the dog to lay down and had a look at her incision. I’m not sure what I was expecting but I did my best to hold in a laugh, told the woman that the incision edges were just a little swollen and there was a small strand of subcutaneous fat that was poking through the edge of the incision. To ameliorate her concerns, I applied a bandage and told her she could remove the bandage in 24 hours and could apply an antibiotic ointment twice daily until the incision was healed.

2. The second incision emergency was in a Labrador Retriever visiting the Ludlow area from New Jersey one Winter. The owner carried her in as I was finishing appointments one evening. I remember it being already dark so here in Vermont it might have been just a little past noon on a Winter day. The dog had been spayed a few days previously and her owner was adamant that the incision had opened up while they were out snowshoeing that morning. A brief six mile snowshoe adventure in some fairly deep and fresh snow. He also mentioned that he was taking the dog cross country skiing tomorrow and that the dog’s intestines were poking through. In the same sentence. Both of those statements can not be true.

I took a look and he was half way correct, the incision was open a small amount at the very top of the incision. The intestines? No that turned out to just be an extra long suture tag from the closure. I trimmed the suture back a bit and encouraged the owner to apply a small amount of antibiotic ointment to the open part of the incision until it healed. And to try to tone down the exercise for a week or so.

3. Ah the rule of three. Also known as the comic triple. The third call came in the Winter as well. A young couple from Massachusetts had brought their recently spayed Labrador Retriever – a recurring theme in incision issues all around – with them on a ski vacation. One of their friends had come along with them and was watching the dog while they were enjoying a sunny and warm ski day. We got the call on a very busy Saturday morning. Labrador. Visiting from out of state. Spay incision is open. Something was sticking out. I told the receptionist to have them come right in. I remember turning and looking right at the two technicians we had working that morning and making a joke about it needing a good application of antibiotic ointment. I remember having a brief conversation about telling them to wait until they got home to their vet in Massachusetts because we were so busy. We decided to play it safe and that it would be quick and easy. I would probably just step out in the lobby, look, tell them it would be fine and would send them on their way.

All of our smiles and laughter disappeared when a trembling, nervous black lab was led into our treatment area. I could tell from where I was standing that something was wrong. Yes, I’m pretty good at recognizing problems but also she had something that should have been in her abdomen trailing behind her on the floor. So it wasn’t too hard. I could not tell if the dangling bit of innards contained intestines but it was large and starting to smell a little putrid so at that point, anything was possible. I was pretty worried about this little puppy. On top of that she was justifiably upset and nervous. We couldn’t get her to hold still for much more than a physical exam and even then getting a temperature was an exercise in futility. I desperately wanted to sedate this dog and determine how bad the issue was and what needed to be done as soon as possible. But the owners were still skiing and not answering their phones. Megan, one of our technicians sat with the puppy and tried to keep her calm until we got in touch with the owners. I carried on with appointments, putting the distressed little puppy out of my mind as much as I could while I examined other pets and addressed other concerns. Finally about an hour after the initial phone call, the owners called and gave me permission to sedate their dog. They were coming right down from Killington which is about a half hour drive from our practice on River Street in Rutland.

We sedated the dog and examined the incision and the abdominal contents coming out of the incision. A small amount of the omentum which is a lacy blanket of fat that covers and protects the abdominal organs was hanging from a very small hole in the abdominal incision. Fortunately, there were no intestines and just a few blood vessels associated with the omentum protruding from a two inch long section of open incision. By the time the owners showed up, I had the problem figured out and a solution worked up. We went over the plan, the costs and the expected recovery. We agreed on everything and we took the dog into surgery immediately.

The technician working with me in surgery, Alex, would feel like I was leaving a little bit out if I didn’t inform you that the surgery was not straightforward. During the removal of all of the omentum that had been outside the body a large artery was inadvertently transected with the needle attached to our suture material. The resulting bleeding was fairly remarkable and it took some time to get the bleeding stopped, clean away all the blood and be certain that the bleeding was not going to come back. We had allotted an hour for surgery and all in the procedure took us a little over two hours.

We had a few appointments we had to reschedule due to taking the surgery into overtime. So on top of a stressful and exhausting surgery, I had to make a bunch of apologetic phone calls while waiting for the lab to recover from anesthesia. The puppy recovered and we ended up sending her home later that evening. The puppy went on to make a full recovery.

I’m glad I had the puppy come right in. I’m glad I didn’t give in to the pressure of a busy day and the past experience of false alarms. Asking them to wait until Monday would have been a disaster. Hopefully they wouldn’t have followed that recommendation but more importantly, I’m glad I didn’t make it.

I hope that life will continue to throw enough of these experiences at me so I don’t get complacent or comfortable enough to start taking my clients concerns less seriously than they do. At least not until I confirm that the exposed intestines are actually just suture material.

Thanks for reading.

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A Walk in the Woods

“I took a walk in the woods and came out taller than the trees.” Thoreau.

The above quote by Henry David Thoreau only fits this story if the reader is enamored to irony.

This was hands down one of the best experiences of my career. I learned a ton, messed up huge, looked like an idiot and still somehow came out of it all with an awesome new client who owns two awesome dogs. Names have been changed to protect the innocent.

It was an odd phone call on a Thursday afternoon. One of the clients I have been fortunate to get to know personally called with a problem. Actually, the problem belonged to a woman she had just met. I got the rundown from my client and decided to call this woman I had never met about a problem I sort of understood. Right now anyone in just about any service profession knows that this situation can only lead to hilarity.

The woman – let’s call her Becky – had adopted a dog – let’s call her Sandy – from a rescue group. To say this dog had a rough life before being placed with the rescue group would be a touch of an under statement. The poor dog did not know how to live with people and would not come inside. So they were keeping her in an outdoor pen. The problem was; she escaped the pen and had been living in the woods by their home for a few weeks. She would eat food they left out for her and she stayed near their home but she was living in the woods. Winter was coming. As was hunting season. We wanted to have her inside before the flurries and the shooting started.

I thought long and hard about how to trap a dog that was living outside and didn’t want to be trapped. I called and emailed all of the people I could think of. I looked it up online, synthesized what I found online with responses I received from a few experts in the field of wildlife medicine and finally arrived at a plan I thought had a decent chance of success. I called Becky back and we set up a day for me to come out to the house and try to sedate her and capture her.

The day was mild but overcast. A technician and I – let’s call the technician Jess – drove out on the gravel road into a thick hardwood forest with expansive pastures and the beautiful homes that can only belong to craftsmen. The type of homes that someone has to build over a lifetime rather than have thrown up in a few months as a second home near their favorite ski mountain. We pulled into the drive of Becky’s house and met her husband – let’s call him Dave – we chatted a few moments while I laced some canned dog food with the tranquilizers we were going to hopefully capture Sandy with. I made friends with their older Labrador retriever – we’ll call her Lacey – and we discussed the plan. Then we loaded ourselves into the back of an ATV and rode down a carriage path into the forest. We stopped a few hundred yards short of where she was typically fed and we found a comfortable point on the forest floor to wait. It was an old growth forest with tall and sturdy Sugar Maples making up majority of the population. The gravel road was a few hundred yards to our left and just about twenty yards to our right was a steep hill that led to a marsh pond.

The sun burned off the cloud cover while we waited patiently for the dog to eat the laced meal. The plan was simple, after she ate the food and was properly sedated, we would sneak up on her and contain her with a slip lead on a pole. This is sometimes endearingly referred to as the “rabies pole.” Once she was on the rabies pole we were going to place a muzzle on her and lift her into a large crate. There she would peacefully sleep off the tranquilizers and we would get back to the office so I could see afternoon appointments. It was a foolproof plan.

Unfortunately, I’m not a fool. I’m an idiot. And the plan was not idiot proof.

Becky sneaked quietly up to where Sandy ate and placed the laced dog food. We waited patiently and quietly out of sight while Sandy made her way over and ate the meal. It took about forty five minutes for her to become drowsy and eventually she bedded down in some tall grass and didn’t move for over ten minutes. It was time to make our move.

We quietly made our way out to the gravel road and traveled down until we were lined up with where she was laid out on a small knoll. We crept through the brush until I caught sight of her and then with the rabies pole in my hands like a spear held by a gladiator, I began my approach. She saw me coming – likely from the road – but waited until I actually thought I was going to get her on the first attempt before she decided to make a drunken run for it. I was horrified she was going to stumble down the hill and end up passing out in the pond, so I gave chase.

Sandy stumbled her way through the brush because she had been drugged. I stumbled my way through the brush because I am just under six feet tall and uncoordinated. There were a few times where I came close to her but she eventually gave me the slip all together and I made my way back to the house. A little discouraged but not defeated. I still had another dose of tranquilizer. If she wanted to make like she was the Keith Richards of dogs, I was going to indulge her. When we made it back to the house I had Jess return to the office in my car. This was taking a little longer than I expected but I was determined to have Sandy in custody before I left that day.

I mixed up another batch of drug laced canned dog food and we locked Lacey in the house. We were waiting for Dave to get back with the ATV and decided to grab a few glasses of water while we waited. I set the plate of drug laced dog food down on the porch and stepped inside for a moment to place my empty glass by the sink. I opened the door to return outside and Lacey brushed past me on her way back into the house. I went to pick up the plate and noticed something wasn’t quite right about it. In fact everything was wrong. The plate was completely clean. Licked clean. By Lacey. The old, not scared very docile dog had just received a rock star worthy dose of tranquilizers. You know that pit of your stomach feeling when something goes terribly wrong? You know that skin too tight feeling when a well thought out plan has gone completely sideways and there’s no hope for success? I had both of those feelings at the exact same time. I could have burst into tears. Thankfully, before I did that I caught sight of the bumper sticker on Becky’s car that read, “Proud Mother of a United States Marine.” I couldn’t break down and cry over a little set back like sedating the wrong dog and not being able to capture a loose dog on the first attempt in front of a woman who had raised a Marine. She probably wouldn’t have known what to do and might have had to put me down out of pity. So I swallowed hard and tried to shrink the lump in my throat before explaining to Becky what had just happened. She took it surprisingly well and I did my best to explain that Lacey was going to be just fine and would sleep off the dose she had taken while simultaneously trying to keep her from seeing my fingers crossed in hope behind my back.

We went back out in search of Sandy and while we had a few more attempts at snaring her with the rabies pole, we ultimately concluded that it would be best to return another day. We went back to the house where we found a passed out Lacey  blocking the kitchen door. I moved her to a dog bed in the living room, apologized for the outcome of the day and walked to the end of the driveway to sulk, call work and wait for a ride back to home base. I dialed my wife to hopefully get some words of encouragement and my phone beeped at me twice to remind me it needed to be fed some electricity and then powered itself off. I sat back and tried to enjoy what had become a sunny and warm Autumn day.

Jess picked me up about fifteen minutes after I called. I took over the driver seat and we drove mostly in silence the whole way back to the office. Once at the office I immediately set out to purchase a blow gun with injection darts and prepared to make a more aggressive attempt at capturing Sandy.

I received a text message a few days later that Becky had finally captured her. I am happy to report that both Sandy and Lacey are doing fine and neither dog has lost any of their faith in me. Fortunately, neither has Becky.

I still haven’t used the blow darts to restrain an animal but I practice all the time and am pretty good with it. So if you ever have a need….

Thanks for reading.

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