end of the road - already?!

I wasn't going to post this today, but now I've written it I will - bit of a downer for just post number 2!  I had to write about this at some stage. It's an inevitable part of the job, but I really didn't realise it happened so frequently and that I would be confronting it so soon into seeing practice.   One of the reasons it's so important to do a lot of work experience before applying to vet school.  Press the Back button if you don't want to read some sad stuff - and it's all a bit dramatic/sentimental, and "me me me!" too, how I dealt with/felt about stuff.  I've had the opportunity to get a better idea if I could go into a profession where I would have to regularly put animals to sleep.


Day 1, second consult (i.e. 10 mins after the doors open!), a mum and her daughters bring in their aged and much-loved cat to confirm their suspicions that she's reached the end of the road after going losing the use of her back legs over the weekend.  They said their tearful goodbyes and left her to be euthanised by the vet team.  I didn't expect to witness this sort of thing so soon. 


I was present during the procedure and it was the first time I had actually seen an animal being put to sleep.  I had been curious to know how I was going to react, which is a bit morbid, I suppose.  I thought I would cope prety well with it, because although I'm an animal lover and have compassion for them, I'm a realist and not, I think, overly sentimental.  I was fairly right, this time. 


I had in the past found Dinky, one of our pomeranians, dead of heart failure in his basket one evening when I was a teenager.  He was only four.  I was devastated, in howls of tears every day for a long time.  My dad tried to help by suggesting we get him stuffed so he could be with us always.  I was never quite sure if he was serious or not.  My pom Mitzy lived to a ripe old age (and boy was she ripe by then!) and was taken to be put to sleep by my mum when she got too doddery to have a decent quality of life.  I think I would have made sure to be there if I had been in the city, but was living away at the time - and I think I was secretly a bit relieved to not have seen her go.  I should have been grown up enough by then to face death, I feel.  Years before I had chickened out of being there while one of my ten hamsters (good old Crunchy Nutter!) was put to sleep.  Even though he had chewed himself an extra hole so had a prolapsed intestine and was obviously in pain I was too cowardly to stay in the room while he was put out of his suffering - my boyfriend stayed while I paced the car park.  Thinking about Crunchy now doesn't upset me, but I still to this day get a bit teary when I think about old Mitz.  I have also been known to tear up at some of the overly dramatic parts of Emergency Vets and other programs of that ilk. I blame the music (and worry that maybe I don't have the emotional strength it takes to be a vet).


On to more recent times - back to day 1:  a few more consults go by, vaccinations, post-op checks, all good stuff, then a visibly upset couple came in with a very poorly looking cat.  She was very old, very dehydrated, off food and not drinking.  The owners didn't have much hope for her but had blood tests done to try to find out what the problem was, and the results came back showing creatinine levels up in the 600s, when the upper range is somewhere in the mid-high 200s.  Creatinine is a metabolic waste product from normal muscle breakdown and from the diet.  Usually it gets excreted in urine, being removed from the blood by the kidneys.  Abnormally high levels in the blood are a sign of kidney disease, and at such high levels as shown by this test, at quite a progressed stage - renal failure.  Once the kidneys cease to function they can't be repaired.  So another case where the kindest option was to put her to sleep.  Tact warrants not having work experience people hanging about during such a sensitive time for the owners so I made myself scarce, but the sight of one of the owners in the waiting room coming to terms with her loss had me feeling incredibly inadequate, realising how little I know about coping with such a situation.  Going to hide in the kennels was the easiest option (shame).


That wasn't the end of the sad stuff for the day, unfortunately.  Later on a 'stray' cat was dumped at the practice, and after some skillful sleuthing by a vet nurse the perpetrator was tracked down and admitted he had been feeding the stray but was now moving, and didn't want to take it with him. 
This is a whole other big area which I'm going to go into in another post - who is to take responsibility for the welfare of strays or unwanted animals.  Anyway this cat was in a terrible state, badly matted, very old, advanced teeth decay right up through the gums, lethargic and sshowing signs of cat flu. There was no hope of her ever being rehomed, the local cat charities were full, and the RSPCA won't take cases like this.  The 'owner' gave consent for her to be euthanised.  This one I was actively involved with, being shown how to restrain a cat for treatment, how to raise a vein, and then held her while the overdose of anaesthetic was administered and she went to sleep.  It happens very quickly, within a couple of seconds.  The drug shuts down the cerebral cortex causing rapid loss of consiousness, and then the overdose depresses the deeper area of the brain, the medulla, which controls respiratory and cardiac systems.  So they go off to sleep, and then the body shuts down.  Afterwards the vet has to confirm that death has occurred by verifying that there is no longer a heart beat.  Even a more or less ownerless stray, with no-one to pay the bill, was treated to a respectful death in the end, which was very nice to see.  Well, not nice, but you know what I mean.  She was in such a sorry state it was... not easy, but less difficult to deal with than the gorgeous British Blue cat from the morning.  Still not a pleasant end to the day though.  Sigh...


Day 2 was a different kettle of fish (or dogs and cats? No-one's turned up with a goldfish yet).  I'll write about it later though, because I want to keep this post more or less about one topic.  Everything stayed alive, yay!!!  


Day three, a half day at the practice, was a rather hectic morning.  Lots of large dogs to be put on diets and owners chagrined for making them into fatties with premature hip problems, and several cat wormers expertly administered through snapping, pointy-teethed jaws by the vet.  A few cysts, wound re-visits, annual check-ups and then for the last consult of the day in trots, albeit slowly and unevenly, a little terrier.  She's very advanced in years, and in a bad way.  A close relative of her owner has brought her in to be put to sleep. Oh no, another one already!  A thought hit me - "uhoh, this one's a dog. I wonder if this will be harder to deal with."  The vet took her away to prep her by inserting a catheter in a foreleg to make the procedure more straight forward, reducing potential distress for both dog and carer. As he brought her back in I headed for the door to leave them alone, but was told I could stay, so I ended up observing from the back of the room.  This did turn out to be much harder than the cats on day one. 


I was glad to be in the background with no need to speak because the lump in my throat would have got in the way.   I got busy telling myself the dog was going to be better off, having been labouring for breath, difficulty walking, advanced dental decay, large growths, and probably more less-obvious ailments.   That helped suppress a few sobs, but only until I was on my own after wrapping her up and taking her remains out to the freezer where she would stay until collected to go to the crematorium or home with her owners. A few sniffles escaped then for sure, and there were definite signs of leakage from the eye area...


Strange that the cats on the first day didn't effect me so badly. I remember thinking how very sad it was that they were so ill and not having any decent quality of life any more, and I was quite able to hold it together then, with maybe a small lump in the throat.  Maybe it was first day culture shock in a new enviroment that meant I was affected less than I was by this little terrier.  The cats had all looked miserable and disinterested in life, whereas the dog was still looking about, looking me in the eye from the examination table.  I had to avert my eyes and studied the drugs cabinets on the other side of the room.  I was wondering afterwards if it's because I'm definitely a dog person, and not a cat person that this was hard to stay composed for?!  But most likely it was having a distraught carer there during the procedure that made it so excruciatingly difficult to stay dry-eyed and calm-faced, but I think as a vet that's going to be a necessary skill, for the clients' sake - and my own too at the end of the day.  I think it's easier to remain more detached in the presence of the vet and nurses and their professional manner.  I'll have to find out how the vets and nurses cope with it - what they think during the procedure, how to stay composed while telling the clients, and whether it gets much easier to be around... 


That's a situation I'll have to develop a coping strategy so I can maintain (at least a facade of) composure during.  Learning to manage the whole process from breaking bad news right through to seeing them out the door in a bereaved state afterwards is going to be one of the toughest things to master.  I hope I never get to a stage where I'm desensitized to seeing an animal die, or lose empathy for the owners.  I think that would mean becoming an unpleasantly cold-hearted creature.  I want to go into large animal practice when I qualify, which will mean dealing more with farmers than pet-owners, so I anticipate much more matter-of-fact discussions about culling, and more commercial viability-driven decisions.  That should be easier on the old emotions - although if I'm lucky enough to end up doing equine then we're back to heartbreak territory again! 


Telling management their multi-million pound project going to make the ship date pales into insignificance. 


Yes, today I did sit down and have another think about whether I could handle a life of regularly putting animals to sleep, and am still sure I can.  The good stuff is enough to make it worthwhile.  Next post will be all about the good stuff, I promise!!!