So, today my only patient was a little yorkie named Stanley. His RDVM thought he might have a linear foreign body because he’d been vomiting for no apparent reason for a few days. So, RDVM opened the dog up. Only the linea and skin were cut. Upon palpating stomach and entire intestinal tract and finding nothing, RDVM closed the pup up and brought the animal himself to the Eclinic. 5.8 pounds of gorked dog with low temp placed in cage on iv fluids with warmers. temp every hour until normal…. all day long. This was at 2pm. pain meds, antibiotics, anti-emedics and the regular stuff, vomiting, diarrhea, urine output, mental status, pain score, TPR and repeat bloodwork to follow as directed. He didn’t look great. Part was meds. …. and for a while we thought it all was the meds from surgery. Until 9pm. I checked on that dog every half an hour at the most. closer to every 20 minutes because I was worried about him. He wouldn’t stay on the warmers or near them. But he wasn’t mentally alert either…… Panda sat on the counter in treatment all day……. literally. He knew something was wrong.
At 9pm, I went to the cage to do my regular hourly treatments and the dog was covered in blood…. I looked at his catheter thinking he’d pulled out or chewed the line… it was fine. The little guy was bleeding out of his incision and it was pouring out. “OH GOD OH GOD OH GOD>>> OH NO..”  as I pulled him out of the cage, putting a towel over the incision to staunch the bleeding. I was now covered fingers to elbows in blood. It was bad. Taking blood to do a rat poison test left him with a bruise. Each vein we tried blew or bruised badly.  Without time to call the owner for an update and permission, we pulled our blood donor out of the cage, took 120 cc of his blood and started a transfusion. The first 45 minutes, Stanley pinked up. Actually rallied some…. but was still very weak. Blood still seeped rapidly from his incision. I stood there, holding the little towel to his belly and watching the blood go slowly in to prevent antiphilaxis.  By 11:15PM tonight, the transfusion was done. Stanley was looking brighter, seemed coherent, but still felt like hell. It was as if he didn’t really know what was going on or where he was. I sat with him almost the entire time as I was able due to the patient load and the constraints on the doctors. I’m still worried about him as I write this…. I am wondering if Panda was telling me to keep a close eye, which I did, or if he was telling me there was nothing I could do.
I left Adrian with his care. She’s the only one on the overnight of the techs I trust tonight with a case that serious. She’ll call me if something happens. And There is always a standing order to call me in if there’s a patient of mine that needs something and they are busy. I will always come in. I hope he stops bleeding. Stanley’s platelets were almost zero. This means no clotting factors. I am hoping the transfusion reverses that, but there’s no way to know right now. We suspect Immune Mediated Thrombocytopenia…. never good in dogs….. most of the time if not always, deadly. GODS I hate this. I HATE that I kept saying he’s pale, he doesn’t look right and just not being able to pin it down, but there was no history of a bleeding disorder… nothing. There was no way for us to know until it all started blowing up. I still hate it. I feel like I should be better able to know these things. I didn’t want to leave him, but I have to get some sleep tonight…. I’ll be no good to anyone tomorrow if I don’t get some sleep.
Lady keep him safe, warm and without pain tonight. What ever happens, I can say I did everything I knew to do and then some.
Panda knows….. how he does this I am uncertain, but what *I* know is that gift is not one I could handle. I am glad Panda is with us. Sometimes just the knowing that things are inevitable helps when the unexpected and sadly fatal happens. I know that ultimately Death will win. Doesn’t mean I have to like it. Doesn’t mean I won’t feel horrible when it happens. But at least this time, I know I have done everything by the book, pulled out all the stops with the doctors and fought the good fight. Not all days end like this. Some are really happy. Some are terrible. Many days I don’t come home feeling like I have fought the good fight with any effectiveness at all. Today is different. Today I fought back. Today I am proud to do what I do and proud to work with the people I work with.
Now if I can just get Panda to tell me how he knows what he does……. Or not.
LH