One of my bitch spays bled on Monday. I had operated on her in the morning and was consulting when she was checked with ultrasound and taken back into theatre. Obviously these things are terrifying for the owner, but they are awful for the vet too. Which part of what I did went wrong? Will they find work so bad that they won’t feel safe with me working here? Will the poor animal die? It’s all my fault…

The realization that she was bleeding internally was also so late in the day, that I had to go home without knowing the outcome. Thankfully, the lovely vet who did the second surgery let me know just before 9pm that the bitch had been transferred to the overnight vets, so she had obviously survived the operation and was fit to be transferred, but I still didn’t sleep well.

I guess this is a particular peril of returning to something I haven’t done for a long time, but I have received incredible support from all the PDSA staff, as well as a vet friend. It was a very large dog and a breed which, so my vet friend tells me, are very prone to bleeding. To understand more, when vets do a spay operation, it’s necessary to tie off the fairly large blood vessels that supply the ovaries at one end of the uterus as well as the ones that supply the cervix and the uterus itself, at the other end.

Tying off the ovaries can be difficult because they are tied to the body wall by ligaments that attach high up near the spine and kidneys. These ligaments mean that you cannot easily get the ovary up to where you’ve made the incision, near the navel. They can be stretched a bit, but that carries its own risks. Anyway you can probably imagine, it’s easy to tie a knot round something when it’s clear of all obstacles. It’s much harder when bits of fat and other abdominal contents are all trying to get in on the act. You can’t afford for any of them to be caught in your knot. Your knot also has to be far enough away from where you eventually sever the artery, and tied tightly enough, that it can’t slide off.

But from what I understand, the main bleeding was from the other end of the uterus, down at the cervix. My ligature was still in place. I had stitched it in. She just bled past it or round it somehow. She was also bleeding a lot from other places, such as the layer under the skin. Some times, that’s just how it is.

Fortunately (to my huge relief) she lived. I am very grateful to the vet and nurse team that recognized there was a problem and fixed it, but it has shaken my confidence. I did two spays yesterday. The first went perfectly, I tied everything off without problems and the abdomen was dry with not a trace of blood. The second, which I had expected to be easier, was actually more difficult and the operation took a lot longer. I have modified my ligature technique and have learned to tie a self-tightening Miller’s knot. Even with that, I still stitched up that second spay with trepidation, but she went home fine, at the end of the day.

With time, it will all fade, but I can still remember, with horrible clarity, back in 1992 when a bitch I was spaying because she had pyometra (infection in the womb) bled out on the table. That one was my fault. I didn’t have enough experience back then and should have made sure someone was assisting me. I did learn a lot that day and my record from then till now has been good, partly because I’ve been careful and partly down to luck. This time round, it was a combination of things, but mostly just unfortunate. I will learn and move on, but this is one of the things that makes being a vet hard.

I haven’t done much this week, outside of work. Looking back through my photos, I see I took one of Triar last weekend. It’s not one of my usual shots of his shaggy, smiling face. It’s a shot of the back of his head and neck after he decided to explore a bush in my garden. I didn’t know there was Galium aparine under there, but I do now!

I guess if you’re reading this in a distant part of the world, you won’t have experienced the eclipse on Thursday. Not that it was worth noting in Paisley! It matched my memories of the one in (I think) 1999, which was another partial eclipse where I was. I’m sure seeing the real thing, where the sun is completely obscured, would be amazing, but on both occasions I’ve experienced, all that happened was that the light went a weird, dull grey colour for a while and that was that. Polar night is much more interesting, though I can see, as with the aurora, why our ancestors might have marveled or been afraid.

I’m thinking of visiting Crookston Castle today, after breakfast out, probably at Harry’s Fuel Bar. Hopefully next week at work will go smoothly, though as I said before, the staff could not have been more supportive and I am incredibly grateful for that. I will leave you with a few more photos from Paisley, taken as I wandered at different times of day. The picture at the top of the page is a lion from the 2016 exhibition, “Pride of Paisley”. I see it every time we walk to the grass in the morning.

Thank you for reading. I hope you have a good week.