Tag Archives: Misdiagnosis

Miss Direction

It seems that last week in the clinic, I missed out on the exciting moment when one of our feline patients did the wall of death around consulting room A. Most of the cats here seem very reasonable, but apparently this one was half wild. It’s amazing how  much damage can be done by one cat on a dedicated shelf bombing mission. Fortunately Dagny’s arm was long enough to reach in to its hiding place behind the fridge and inject it with enough anaesthetic to calm it down.

Hair raising anaesthesia was also the order of the day earlier this week when one of the patients I was monitoring stopped breathing near the beginning of its operation. Of course with gas anaesthesia, it is straightforward enough to carry out assisted breathing, indeed on our anaesthesia course, the lecturer quite casually mentioned that it didn’t really matter whether the animal breathed itself or not as it was easy to respirate. I guess it happens often enough that it must eventually become almost routine. It has happened a few times and every single time it has been fine, but I still find myself checking and rechecking the equipment and assessing the animal in every way possible, whilst trying to look perfectly calm. Having been the surgeon in that situation, I know how disconcerting it is trying to operate and wondering all the time whether the animal is okay, and whether you should be doing something  to help. Trust is very important in those circumstances. Jacqueline has been incredibly calm before in that situation. Indeed when I asked her if everything was okay, she looked at me as if there was nothing untoward going on at all. My nerves are not as steely as hers though and I was profoundly happy when the dog woke up perfectly normally at the end of the operation.

On Wednesday I went in for my own hospital appointment. It seems that with tonsillectomy, there is a risk of post-operative bleeding and as I am attending a wedding in Scotland on the 24th May, I won’t be able to have my operation next week. They have rebooked it for Wednesday 27th May, just two days after I return. As I live an hour away from the hospital, they will be keeping me in overnight. Just as well as Charlie will be in Spain at the time. I’m glad now that I don’t have to wait any longer.

I was reminded the other night by a conversation with Wivek just how difficult it can be to get an accurate picture over the telephone and how confusing it can be when the owner has already made a diagnosis. It was Marita who was on call and Wivek was helping when they had a call from a client who told them that her bitch had a prolapsed uterus. In twenty or so years of veterinary practice, I have never seen such a thing in a dog. Plenty of cows, a couple of sheep and a very occasional pig, but never in a dog. Of course, such a conversation usually causes that lightning strike in your brain. How on earth will I deal with that? In that frozen state, it can be difficult to rationalise. So busy working out what you are going to have to do that alternative thought is banished. The reality is often that the owner hasn’t got things quite right, (in this case it turned out that the bitch had a polyp in her vagina) but I am sure I have a few extra grey hairs from this phenomenon.

Very occasionally the owner turns out to be correct. The one day old puppy I once saw with its liver hanging out really was just that. A proud moment for me when that dog reached six months of age. But more often, with hindsight, it is possible to look back and laugh, though obviously not in front of the client. Great tact was called for on the day when the owner rushed her dog into the clinic on an autumn day in Glasgow with a wound on the back leg which the lady thought had become infected.

‘It’s the wound on her leg. It’s gone all yellow.’ Dramatic hand to forehead. ‘Oh I can’t bear to look.’ Bending over the dog to inspect its leg, I was initially surprised by just how yellow it was until I realised that actually the dog must have sat down on a fallen leaf which had stuck to the slightly sticky wound. Another occasion, another panicky phone call.

‘My dog’s broken its leg. There’s a piece of bone hanging out,’ and then once again those portentous words, ‘Oh I can’t bear to look.’ On that occasion it was part of a stick of rock that was stuck to the leg. Quite how the owner had missed the fact that her dog was using its broken limb without even limping still passes me by.

My favourite story however is the apocryphal tale of the PDSA client who came into the clinic very angry. They had bought an expensive Rottweiler puppy and it wasn’t growing. It was left to the rather bemused vet to explain that the reason that the puppy was not making much progress was because it was actually a guinea pig. Somehow I have never been able to convince myself that story was true, even though I have been assured that it did really happen. Still it’s a great story, and there is just enough possibility in there to make it wonderfully tantalising. You really do need a great deal of tact to be a vet.

Today’s picture is Tiger who is in for a vaccination and is looking very fine at the great age of 16 years and 9 months.