All posts by Sarah McGurk

I am a veterinary surgeon and author from the UK. I currently live and work in Norway.

Fifty Shades of Tabby

I found myself turning into Jan-Arne this morning. At least… I didn’t suddenly find myself with a shaven head, sporting a beard and infectious giggle, but I did drop my trousers on the floor. They shocked me by leaping out of the corner when I went back to check whether the washing machine had finished, half an hour into my shift.

I confess I was distracted on my arrival at work, firstly by a broken mirror in the car-park, then by the sight of a small muculent mess by the door. Such slimy treasures are not such an unusual finding outside a veterinary practice, but obviously it needed to be cleaned up. As I was juggling the twin thoughts that I needed a brush and shovel and a bucket of water, I was further disturbed by the realisation that I had taken the last large pair of trousers from the pile. I pulled them on with a slight feeling of guilt that I might be depriving others of their comfort, but still couldn’t bring myself to shoehorn my thighs into a medium pair. It was this action that prompted the return to the changing room where the washing machine lives. As usual, the ever efficient Jacqueline had been there before me and a new load of washing was chugging round as the first lot pelted around the drier.

Returning into the fray, I came upon Marita and Jacqueline lurking suspiciously in the lab. I was able to diagnose an escaped patient, and from their relative positions, I was also able to deduce the escapee was currently underneath the sink cupboard. Happily within a moment they had retrieved the animal, which turned out to be a small, very sweet-looking cat, the first of the day’s tabbies. Having joined in with the hunt, I was happy to help Marita as she went on to spay the cat, followed by the spay of its sister, which was another tabby. Marita is getting very efficient with her cat spays. In no time at all, she had finished both, in spite of the fact that the second was a slightly more complicated operation than usual. In fact, she was perhaps a little too efficient with the first one. As I was cleaning up the second, she went and injected the first little cat with the antidote to the sedative.

It was only then that we realised that we had to put a buster-collar on her. Despite the fact that she was obviously rather flighty (as demonstrated by her excursion under the cupboards), I hadn’t seen any suggestion that she was vicious, and so I decided to make a solo attempt. It soon became obvious this wasn’t going to work. Just getting her out of her cage was difficult. Calling for Marita’s help, I struggled to get her to keep still. She wasn’t nasty. She wasn’t showing signs of anger, or trying to bite. She was just really wriggly. And she really didn’t want a buster collar on. I was most impressed with the way Marita slipped the thing into place. It always amazes me how efficient vets become at some rather unusual tasks. I was dismayed to see a pool of blood appear on the floor however, and as soon as the buster-collar was in place, I lifted her up to inspect her wound.

‘Oh, it’s okay.’ There was relief in Marita’s voice. ‘It’s your blood.’

Indeed it was. Crazy as it sounds, I too felt relief. Far simpler to wash a couple of scratches than to re-sedate a patient, maybe have to open her back up to satisfy ourselves she wasn’t losing blood internally.

My day of tabbies continued with Tommy and Britney. Tommy was feeling a bit under the weather, whereas Britney was feeling much better, having seen Jan-Arne yesterday. The flood of tabbies was only interspersed with one small pug, who didn’t quite fit the pattern, but was nonetheless adorable. And my final tabby of the day was Lille Pus, who is pictured at the top of the page. How beautiful she is with those piercing yellow eyes. She was actually Jan Arne’s case, in for a spay, but Britney had been so much better than expected, that I had some time to spare and so I was able to give him a hand.

And then my work was over, and as I went out to my car (for once actually on time) I realised that I had never managed to find the brush and shovel to remove the broken mirror from the car- park. Luckily Irene, fount of all knowledge about where everything is kept, located it tucked away in the large animal section of the practice. Of course, never one to shy way away from some fun cleaning, she accompanied me out and I ended the day dancing around, picking up bits of glass on the Tarmac with Irene as the rain drummed down. There’s never a dull moment in veterinary practice.

 

Tøffen demonstrating his buster collar for IcelandPenny
Tøffen demonstrating his buster collar for IcelandPenny

(Obsessive) Optimist

I have become obsessed this week with a song. It happens now and then, especially when I am trying to write (and this week, for the first time in ages I have found time to work on Ready, Vet, Go!). I’m currently writing a very downbeat section, but the song is quite the opposite (for those who would like to listen, it’s Laid by James). I have been listening when driving to and from work (which I have done a lot this week). I don’t know about anyone else, but when I listen to frenetic music, crazily loud in the car, I find it very difficult to drive slowly. Of course, in Norway that’s a disastrous concept. The speed limit on normal roads is 80km/hr (50mph) and you definitely don’t want to be stopped by the police. I failed to come to a complete halt once at a stop sign, and it cost me more than 5,000kr (£500 / 650USD). So instead of speeding, I have to beat the steering wheel in time to the music. Just as well no-one is watching.

Wivek too seems to have been singing a lot this week. On Monday, when she had to give a cat a barium meal (to show up the stomach and intestines on an x-ray) she mixed it in with some tasty food and left the cat in one of the kennels for a few minutes. When I commented that maybe, just maybe it would eat, she started humming a Norwegian song – Optimist by Jahn Teigen. I had never heard this song before, so she wrote it down and I Googled it to listen on YouTube. I confess I am less obsessively interested in that one. Deeply apathetic might be a better description, but maybe I’m just not giving it a fair hearing.

Of course the cat didn’t eat enough of the food for Wivek to be satisfied, so we had to try a little ‘encouragement’. This involved a towel, a wrapped up cat and a good bit of claw dodging, but we managed it in the end. Even after all that, we didn’t find anything significant, but a lot of veterinary practice is like that. A lot of people have commented to me over the years, that it must be hard being a vet because the animals can’t tell you what is wrong. I usually counter this by pointing out that although they can’t tell you what is wrong, they also never tell you any untruths. Still, I don’t suppose my GP very often gets bitten or scratched by his patients. Later on I remember Wivek singing Manic Monday… so that must have still been on Monday. It’s been a much longer week for me than usual because Irene and Gerd are both off, and so I’ve worked four days instead of my usual two.

In addition to all that driving back and forth, there was also a meeting in Bryne on Tuesday night. Dagny told me about it in theatre in the morning. I had been feeling vaguely uneasy because I had heard people talking about some meal out, and I had been wondering whether it was something exclusive that I wasn’t involved in, or whether it was something I had missed. I was invited though. Dagny told me I was already booked in. She berated me (humorously) for the fact that I had missed the information, which she told me had been given out on more than one occasion at the Thursday staff meeting.

‘Too busy eating and everything just going past you,’ she said. I fear there may be something in that. I asked Wivek if she was going, and she told me she was. When I said I hadn’t known about it, she said it had gone over her head too, though it was in her diary, so it must have been mentioned at some point. With Jan-Arne though, I hit the jackpot. When I asked if he was going to the meeting tonight, he said,

‘What meeting?’ I could have hugged him. (Actually, I often hug him, so it’s surprising I didn’t just take the opportunity to do it again).

My favourite Wivek song of the week however, was the Propofol song. Propofol is the intravenous anaesthetic we use most often. It’s very safe and quick acting and so as well as using it to produce deep enough anaesthesia to intubate animals before using gas, now and then we also use it when the sedative we have used just hasn’t worked well enough to allow us to treat the animal without pain. It’s so short acting that the dog or cat can still go home with its owner almost immediately. I used it today, for example, on a dog with a really painful anal-gland abscess. It was a tiny dog, and those are notoriously difficult to sedate. The normal dosages often don’t really work, and higher doses… well I don’t like to use those too much in case they are not safe. And so in order to treat the little animal without causing any unnecessary pain, I topped up my sedative with some propofol intravenously. Happily Wivek was there to help me. The whole practice has been working well together as a team lately, and as I got everything ready, Wivek started singing.

‘Propofol, propofol,, propofol,’ she sang, to the tune of ‘Here we go, here we go, here we go…’ Just as well sometimes that we ask the owners to go away when we do jobs which are going to be messy. Of course, there are times when veterinary work can be very sad. There are many more times when it is very rewarding. But I like best the fact that sometimes, we just have a lot of fun.

Finally, this week’s picture is of Cita who is seven years old. She is the kind of patient that makes all things worthwhile. Despite the fact that she had to have her eye removed after a cat scratched it, and has had both her hips operated on, still she comes in and is really kind and gentle towards us. I couldn’t resist taking her photo before Marita took her in to clean her teeth. I guess that if you’ve read this, you couldn’t resist her either. Have a great weekend.

 

The Cat Charmer and the Messy Chef

There’s a game I remember from childhood parties at my grandmother’s house. A tempting bar of chocolate was set on an table in the middle of a ring of children. Each child had to throw a pair of dice and if you got two sixes, you had a chance to go to the table and eat the chocolate. Before you could do so, however, you first had to put on a large pair of mittens followed by a woolly hat and scarf. Then, and only then, could you go and attack the chocolate, which you had to eat with a knife and fork, but woe betide you if another child threw two sixes before the process was complete. I was reminded of that game this week in the dental room. Whenever we are using the ultrasonic descaler, we put on protective gloves and a face mask and normally this takes seconds.

However, for some reason, the latest batch of masks are different from normal. Rather than elastic which slides easily behind your ears, these have individual ties, one set at the top and one at the bottom. Twice this week, one of my colleagues has come to me and asked, ‘Could you just begin this dental for me?’ and both times I have found myself putting on the latex gloves first (as I have always done in the past) and then went to put on the mask and found myself fiddling around for ages, trying to tie the bows at top and bottom. It sounds easy, but what with trying to get both tight enough so that the thing doesn’t slide off, and with my hair getting woven in, all hindered somewhat by the tight gloves which seemed specially designed for hair tanglage, I was inexorably reminded of the chocolate game as I wondered frustratedly whether the colleague in question would return before I had even managed to don the protective clothing.

I seem to have spent a lot of time in the dental room this week (not all of it getting myself tied in knots). Dagny called me in yesterday as she had decided the dog she was working on needed to go on a drip. Irene came to help me to put in the i/v catheter and both of them watched with some sympathy as I doused the leg in alcohol and then started doing the traditional ‘my fingers are nipping’ dance where you jig around the room shaking your hand where the alcohol has entered a wound.

‘Is it sore?’ Dagny asked (in Norwegian you understand).

‘Yes,’ I gazed down at both thumbs which were stinging horribly. ‘I must have a hole.’ It took me a minute or two to register that both Irene and Dagny were laughing at me, and a moment longer to realise what I had said. Of course we have been in this position before, only in English and with the roles reversed. Existing in a language that isn’t your mother tongue really does lead to a lot of faux pas.

With their laughter still ringing in my ears, I set up the drip and hung it up on a hook on the wall and Dagny said something to me. Thinking it was something about getting the drip into place, I failed to turn round to look at her… only to hear a few seconds later,

‘Ahem. Sarah.’ It was that tone. The one that lets me know I have missed something. I turned round… and realised that as I had hung up the drip bag, I had inadvertently turned the spotlight out. Dagny was trying to work in the dark. Fortunately she just laughed at my expression and carried on. At least she was using the light as it was meant to be used. Later in the day, in a moment of confusion, Wivek pulled the light fitting into position against a cats jaw. This would have all been very well if she was needing more light, but as she was trying to take an x-ray at the time, it was somewhat ineffective.

The cat in question was a beautiful cat called Laila. Earlier I had gone into Wivek’s consulting room to help with her sedation. It can be difficult to get cats out of their baskets when you want to examine them, but I was amused to see that Wivek, in a continuation of last week’s singing, decided that the way to charm Laila from her cage was by chanting her name very tunefully over and over. It was at least partially successful. Laila’s head appeared as she looked outside to see who it was who was singing so beautifully. Poor Laila. It must have felt a bit like the Siren’s song: irresistibly sweet, but concluding with an injection that sent her to sleep. Though whether those who were seduced by the real Sirens woke up with beautifully clean teeth, no-one will ever know.

Marita too was thinking of a change in direction this week as she stood in theatre, removing some tumours from a dog. She had discovered the pleasure of removing lipomas (fatty lumps) from under the skin by ‘dissecting’ bluntly using her fingers. It’s amazing how efficiently a lipoma can be removed as they are usually well defined and ‘shell-out’ quite easily.

‘I feel like a messy chef,’ she commented idly as she ran her fingers around the mass. She didn’t seem particularly amused when I suggested that after she was finished, she could use the lumps to make meatballs.

This week’s picture is of Dagny suturing a puppy’s eye. The unlucky pup had been scratched by an angry cat and as you can see in the picture, Dagny used the microscope to carry out the repair to the cornea using tiny suture material that was about the same thickness as a human hair. After stitching up the breach, Dagny clipped a section of the conjunctiva and sutured a flap over the damaged area both to protect it, and to carry blood to the area, which has no natural blood supply. The flap will be left in place for at least six weeks. Dagny’s final act was to inject some fluid into the front of the eye to make up for that which had leaked out. The whole process was utterly fascinating. Best of all though, without such care, the pup would have definitely lost one of her eyes. Hopefully this operation will give her a chance to grow up with both.

Specialist eye instruments (tiny scissors and forceps)
Specialist eye instruments (tiny scissors and forceps)

 

Happy Birthday

Tomorrow is Jan-Arne’s birthday and at nine o’clock this morning, I received a message from Wivek to say that she and Marita were planning a special lunch for him at the clinic. I immediately wondered how I could contribute, and after some careful questioning, I managed to ascertain that whilst the savoury food was all planned, they were lacking a coherent cake strategy. Armed with only butter, eggs, flour sugar and cocoa powder, I began to throw something together. Luckily I also found some decorations hiding in my cupboard and so with only moments to spare, I made it in on time to join in. The other food was delicious. Marita had baked the most fantastic focaccia and aioli, and Wivek had provided a wonderful chicken salad. Somehow or other, I failed to take a decent photo of either, which is not like me at all. Like many food worshippers, usually I can’t resist taking photos of beautiful meals. Still Jan-Arne certainly looks happy.

IMG_4787

Last weekend, Tu Klinikk held its first CPD weekend on the subject of anaesthesia. CPD is vetspeak for Continuing Professional Development and in the UK, all vets are required under their agreement with the Royal College of Veterinary Surgeons to do an average of thirty five hours each year. The requirement in Norway is not quite so stringent I understand. More a recommendation rather than a requirement, as it was in the UK until only a few years ago.

Anyway, the subject of the weekend was anaesthesia. I confess I was delighted by this as I have spent a good part of the year working as anaesthetist for Dagny and Magne. It is unusual outside of the universities for vet practices to have a dedicated anaesthetist who is a fully qualified vet. Generally the vet who is carrying out the surgery also technically oversees the anaesthetic as well, and the patient is monitored by a nurse (or more rarely, an assistant). I find it very rewarding to have a ‘specialisation’. The lectures were in Norwegian (the lecturer came from Oslo). In the morning this was fine. I found I could follow quite easily, though my one-cylinder brain stopped translating as soon as I tried to write anything down so I had to make do with listening very carefully and plucking at Wivek’s sleeve at the end of each section for the bits that I knew I should have noted down, but didn’t manage.

I also managed to answer some questions that the lecturer posed about anaesthetic circuits, though slightly to my chagrin, I had to answer in English. I still don’t actually know how to say “one-way valve” in Norwegian, though as Wivek already laughed at me for my translation of “gas-flow rate” on my poster in theatre, I should have remembered that I really didn’t have to translate that one, other than adding an extra “s” onto the word gas. Just to make it more Norwegian you understand.

On my return to the practice on Tuesday morning, I discovered that Dagny and Magne had invested in some lovely new kit in the form of a drip driver, an infusion pump and a new oxygenation unit, so we will be able to make some positive changes to our anaesthetic regime. Whilst I fumbled through the set-up on my first run-through, it was obvious that Tornado Tawse already had everything running as smoothly as a weir in high summer. I only wish I could make everything look so effortless.

Infusion pump and syringe driver.
Infusion pump and syringe driver.

Wivek, true to form, was the first to use the new anaesthetic kit, putting her first heart-murmur dog on a propofol infusion. Like Jacqueline, she too seemed perfectly calm and utterly self-contained. I must say I was relieved when she confessed to me later that she thought that her own heart was hammering away far more rapidly than the happily anaesthetised patient.

Feeling that I had to make some contribution to this wonderful new era, I managed to create two pages of flow rates for ordinary surgical patients and shock patients, but the final task I set myself on Thursday afternoon was the rather complicated calculation required to work out the flow rate for post-operative patients where we won’t be using the drip driver. To give a brief oversight, you first have to work out how much fluid the patient will need in an hour. From that, you have to calculate how many millilitres will have to pass through in a minute. Then you have to work out how many drops that will be… and finally you have to split the minute into that number of drops so you can give a “time between drops” specification. Given that there are also two types of giving sets: one that gives 20 drops per millilitre, and one that gives 60, it is perhaps unsurprising that my brain came unstuck somewhere in this process and exploded messily all over the computer screen. Fortunately Jacqueline was there to clean up the vetty mess before anyone noticed. Just as well she’s as patient as she is efficient.

Happy birthday Jan-Arne.

Cake worship.
All hail the chocolate cake..

 

 

Jan-Arne and the Well Preserved Eye

Intravenous catheters can be frustrating things. When I was working in the emergency clinic, almost every patient we admitted had to be put on a drip, so back then I got quite good at inserting them. Nowadays it seems a bit more hit and miss. There’s a definite pattern though. If I’m on my own, generally I can get them in without too much problem. Under the benevolent gaze of Magnificent Magne or Jan-Arne, it’s usually not too difficult. But both Dagny and Wivek make the thing look so simple that I seem to go to pieces whenever they are watching. Dagny doesn’t even have to be watching. She only has to be in the room for the difficulties to take effect.

Early on Tuesday morning, Dagny had all her kit laid out for an operation and (tactfully) wasn’t watching me in my attempts, but stood chatting to one of the other staff. The dog was a dachshund, and its legs were so short, that even after I had shaved quite an extensive area of its foreleg, its body hair was so long that it obscured almost everything. With shoulders that were becoming decidedly tense already, I selected the smallest possible catheter and took aim. Slipping the stylet through the skin, I was encouraged by seeing a tiny droplet of blood moving up into the breach. Quickly, I slid the needle a nanometer further in… and the bleeding stopped. I had gone right through. Trying to keep my breathing steady, I withdrew a little, but it wasn’t to be.

I decided at that point upon a tactical withdrawal. Often it is better to start again with a fresh catheter, which can’t be blocked and hasn’t been blunted by its first traverse through the skin. Selecting a slightly bigger catheter (sometimes this works better as they are less flexible) I set the tourniquet back in place to raise the vein and once again tried heroically to keep the hair out of the way with the final two fingers of my left hand whilst still stabilising the vein between my finger and thumb. This time, the catheter went into the vein, but when I tried to slide the sheath down off the stylet, it just bent. Through all of this, Dagny had been carefully not watching, but I could tell she wanted to get on. I confess I was relieved as she finally elbowed me out of the way and did it herself. A few moments later, with the catheter triumphantly in place, she looked around for the laryngoscope so that she could put the tube into the trachea for the gaseous anaesthetic but it wasn’t there. Ever efficient with her cleaning, Irene had already tidied it away.

A little later, and another dog, this time a little pug dog (or mops, as they are called here). This one was having its corneas treated with the cryoscope. Marita came into the room and began to ask Dagny about the freezing effect, and how strong it was. Ever the scientist, Dagny thought it would be a good idea to try it on herself. She held it against the back of her hand for a moment.

‘It’s not sore,’ she announced airily, and moved the tip to a different place with a smile.

‘Ouch!’ A moment later, she was staring at a white mark on her skin- ‘Okay,’ she admitted ruefully, ‘Maybe it does hurt.’

Jan-Arne managed to injure himself this week as well.  On Wednesday, he had taken a biopsy and opened up the small container filled with formaldehyde that would preserve the sample while it was sent to the laboratory. With an aim that he presumably couldn’t recreate, even if he tried, he managed to drop the sample into the pot in such a way that some of the formalin splashed up into his eye. After much salt water washing, he was packed off to the doctor’s to get it checked over. Fortunately there was no permanent damage.

He has though, been evilly trying to tempt me with birthday cake all this week. He brought in the leftovers on Tuesday. Heroically I managed to resist. I’m not really sure how many birthday cakes one person needs, but he seems to have been very well supplied. Then again, he’s so generous to everyone that he deserves good things in return.

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The remnants of the cake were still there on Thursday, but I confess I found it much easier to abstain. Also, someone had brought in a pack of freshly baked boller. Boller are widely available in Norway. They are a kind of sweet bread roll or bun, often with raisins or chocolate chips inside. These ones had bits of Smash: chocolate with caramel and salt. After taking one and eating it, Irene announced that she had discovered a new taste sensation. Jan-Arne and I, both foodies, were looking at her very intently.

‘I had a piece of the boller with a bit of cucumber,’ she said, with wonder in her voice. ‘It was lovely.’

There was wonder in my head. Specifically I was wondering whether such a combination could possibly be delicious or whether Irene had finally lost the plot. I hadn’t come this far with my resistance to eating extraneous sweet things lightly however, and somehow I managed to curb my enthusiasm towards this idea.

‘You could design a new boller,’ Gerd offered. ‘An Agurk Boller.’ (Agurk being Norwegian for cucumber).

‘A Cucumboll?’ suggested Marita.

‘What’s English for boller?’ Irene asked.

‘Bun,’ came the reply.

And so the CucumBun was born. At least it will be, when someone takes the time to make it.

 

Todays picture is Chika who was in for her first vaccination.

Go Gentle

I have been wondering whether I should talk about euthanasia for a little while now. As you can probably tell, working in the clinic is mostly a joyous experience, but there are times when veterinary work can be very sad. It seems to me, after twenty years working as a vet, that death is as much a part of life as birth, but outside the clinic it is more hidden, less talked about. When it is discussed, it is done in a hushed reverential way.

From what I understand from talking to people, I believe that I have something of an unusual view. To me, death seems a peaceful thing, rather than something to be afraid of. Except in exceptional circumstances, most of the animals we put to sleep are old or very ill. There are occasions when, from seeming terribly distressed, breathless, weary or in pain, you can see your patient relax. The strain disappears and it is obvious that they have found peace.

For the owner of course, it’s a sad time: sometimes devastating. Many people feel their pets are members of their family, and so the loss is intense. For me it has always seemed somehow very intimate and it is important not to intrude, but even after all this time, with each ending, I continue to share the sorrow . I have read other vets saying that they try to keep things brisk and professional, but I have never been able to do that. Usually there are tears in my eyes.

For the animal, I try to make sure that the experience is as peaceful as I can make it. Most animals don’t enjoy going to the vets. It’s important  to take my time, to talk to both the owner and their pet. With dogs, I usually try to inject them without lifting them up onto the table. I always feel they are more comfortable on the floor: more secure, though of course smaller dogs can sit on their owner’s knee.

The process is different here in Norway and actually I prefer it. In Britain, it was the norm to give an overdose of anaesthetic directly into the vein. Personal experience has taught me that when being anaesthetised, it is like a light going out. It’s very rapid and I usually explained that before beginning, but sometimes I could see it was a shock to the owner that the whole thing was over so fast. There were difficulties sometimes in finding the vein and in making sure the injection went in correctly, as otherwise the whole experience could cause unnecessary pain.

At Tu, it is the norm to sedate the animal: deep sedation, so that he or she becomes unaware of the surroundings and is profoundly calm. Often we leave the room so the pet can go to sleep in peace alone with the people they know best. Once the animal is sleeping, we return. Generally we encourage the owner to leave the room, though they are welcome to return afterwards if they wish. The final injection is usually given into the heart, which isn’t the most pleasant thing to watch, but I am comforted by the fact that the pet is wholly unaware.

Whichever way it is carried out, I try to make sure that the owner is not too distressed by the procedure itself. Euthanasia is the last and kindest gift that an owner can give to their pet if they are in pain. The last thing I want is for their memory to be of my incompetence or of something frightening happening they did not expect. I try to ensure that I explain everything thoroughly and work as efficiently as possible. Experience has taught me that when things go wrong, it feels desperately traumatic, and if it is that way for me, then it must be even more so for the loving owner.

This week I carried out my first fully solo euthanasia in Norwegian. I was concerned that language might be a barrier. All the things that came so easily in English would be no longer second nature. I was worried I would be unable to properly offer comfort, but in the event it was obvious that body language counted for so much that it was not important that the words were not perfect or sufficiently profound. It was still a sad experience, and yet I find it somehow uplifting. It is such a generous act on the part of the owner. I am glad if I can help them carry that burden, even if only a little.

Guts

It’s been a week for exploratory laparotomies. For those who don’t know, a laparotomy is a surgical cut into the abdomen, so an exploratory laparotomy is where that surgical cut is carried out to investigate what is going on. Despite the fact that we have many ways to explore inside animals without surgery such as x-rays, ultrasound, or even simple palpation (still a valuable tool) sometimes there is no way to be certain whether there is a serious problem without opening up the abdomen and having a look.

My photograph is of Anette, a seven year old Cavalier King Charles who was thought to have eaten part of a towel. Happily for Anette, the towel had already passed quite a long way through and Magne was able to manoeuvre what remained down towards her rectum. I was the happy person who went in to retrieve it.

It is much more complicated however when it is necessary to cut into the intestine to remove the foreign body. There is a risk of contamination of the abdomen (any leakage from the incision either during or after surgery leads to peritonitis). Hardest for me is when there has been damage to the intestine. It can be a difficult decision whether to open and remove the object or to remove the entire section of gut which has been damaged.

Removing a section is technically more difficult and there is more risk of contamination afterwards, but if the damage to the intestine is severe, it may never recover. For me, those kinds of decisions can be the hardest part of veterinary practice. There is always a tense period after such an operation before you can be sure that the animal is going to recover. I don’t know whether other vets spend so much time agonising over such decisions post-surgically. I suppose though, it is that which drives me to want to be as good as I possibly can.

Jan-Arne assisted me with two of the operations. The final one was on Wednesday and he had asked me on Tuesday whether I could come in specially for an hour or two to help him. I was delighted to do so. He is always so keen to learn new things. I was also happy because for the first time since I have been working at Tu, Charlie had taken a day off work and was able to come and see round the practice and join me in theatre.

He watched with interest and also chatted quite a lot to Jan-Arne during the process. Jan-Arne, as I have said before, works as a large animal vet sometimes, generally covering out-of-hours work such as nights and weekends. Charlie was impressed, as am I, by his unending enthusiasm. Having spent a number of years in large animal practice ourselves, it is hard to imagine relishing taking on additional out-of-hours work on top of working more full time already, but Jan-Arne genuinely loves these opportunities to work with farm animals.

I haven’t talked too much about his history, but I am genuinely in awe of the way he lives his life, making the most of everything that comes his way. He told me that in school, he always wanted to be a vet, but the careers advisor threw cold water over the idea, and his young self lacked the confidence to tackle the heavy requirements that are necessary for entry into the veterinary world.

He spent, therefore many years working in hotels, administration and marketing of telephones. In his thirties however, he was struck down by horrendous pain from a neck injury following a car-crash he had in his mid-twenties. Faced with life-threatening surgery, he made the decision that if he came through, he wanted to follow his childhood dream to become a healer of animals.

He became the first Norwegian man to qualify as a veterinary surgeon from the University of Veterinary and Pharmaceutical Studies in Brno in the Czech Republic. Continually inspired by his dedication and love for animals, I am very proud to work alongside him and the other vets, nurses and assistants who make such a wonderful team.