Tag Archives: Tu Dyreklinikk

Holiday

Even after many years, I still greet Christmas and the New Year with a heightened sense of joy that I don’t have to work on either day. All round the world, many wonderful people in the emergency services give up those days to help others, and I send my good wishes to all my friends and colleagues who have been, and will be working over the holiday period this year. I expect when I return tomorrow, there may be a few Christmas related cases. It only takes a moment or two for a dog to eat something that he or she shouldn’t, and chocolate and raisins can be toxic for dogs, as well as the simple problem of too much turkey.

Last Tuesday, the day began as I walked through the prep-room on the way to change into my uniform.  Linus, (whose picture you can see at the top of the page) had been very ill and vomiting for a few days, and he was in a lot of pain and seemed utterly exhausted. His abdomen was so painful that Dagny had to sedate him to examine him properly, and when she did, she could feel something. Whatever it was, it wasn’t visible on the x-ray (some items show up clearly, but not all do) so the only way to help Linus was an exploratory operation. His owners were naturally very fearful. Linus is eleven years old and as the lump wasn’t visible on the x-rays, it could be anything from a peach-stone to a tumour.

As Dagny readied herself for surgery, I prepared Linus for the operation. The monitors attached, I was concerned to find that the oxygen levels in Linus’ blood were very low: not very surprising as I could see that his gums were pale, nothing like the fresh pink colour they are in a healthy dog. I turned the intravenous drip as fast as it would go, and kept the anaesthetic levels to a minimum as Dagny began to cut.

It didn’t take long for her to locate the lump, and it was immediately obvious that it was a foreign body and not a tumour. The gut was inflamed where whatever-it-was had already passed through. I opened up the set of special clamps and the  multiple packs of gauze I had ready and Dangy placed them around the gut to keep everything clean.

Pausing for a moment, she looked up and smiled. ‘What do you think?’ she asked. ‘I’m betting on a kongle!’ Kongle is Norwegian for pine cone. Her attention firmly back on her work , she cut carefully into the segment of intestine and drew out what proved indeed to be a section of pine cone. Poor Linus. No wonder it had been so painful.

From that point in the operation, it was obvious that things were improving. As Linus’ guts began to function again and the fluids from the drip got to work, his oxygen levels climbed from sixty-two right up into the high nineties, which is where they should be when everything is functioning well.

‘Would you mind just quickly going and telling his owners that it wasn’t a tumour?’ Dagny asked, as with the hole in the gut closed, she began to stitch the abdominal muscles. ‘They were so worried.’  As everything was stable, I was delighted to run through and tell them. What better Christmas present could there possibly be for me and them?

There are one or two things I find difficult about being an assistant. It’s not so easy for me to telephone owners and ask for an update, as I might do with one of my own patients. But I hope that the signs that I saw during that operation boded well for Linus and that he and his owners have had a wonderful Christmas together.

Merry Christmas everybody.

 

In Which I have to Speak Norwegian.

So it’s been an exciting week for me on two fronts. Firstly on Monday, I was lucky enough to spend a day out with Åsulf from the large animal practice, and second, I am now officially employed by Tu Dyreklinikk as a Veterinary Surgeon and not as an assistant. Of course, the terminology might be confusing to those who work in veterinary practice in the UK, because there my official title was always “Veterinary Assistant” because that is the normal term for vets who are not partners. Anyway, I feel very proud of my new role.

Mostly the transition has gone smoothly. I have handled consultations before at times when things have been especially busy, or clients have arrived unexpectedly, so it wasn’t wholly new. But like most people I find any kind of change comes with a degree of uncertainty. My mind was distracted doing my assistant work in the morning (I start consulting at twelve) as I contemplated the cases I was to see later. Indeed I had a particularly embarrassing moment when I started to shave a dog’s leg for a cruciate operation. Unfortunately, with my head wrapping itself around the potential complications of a male dog who had blood in his urine, I started to shave the dog’s hip instead of the knee. It suddenly came to me, about two clipper strokes in, when the damage to the coat was so great that there was no way to hide it. I contemplated just shaving a massive area off to try to cover the error, but it would have been obvious, and so I had to crawl red-faced to Dagny and tell her. Happily she just laughed, although she did toy with me evilly when she came through by suggesting that I had shaved up the wrong leg. I was very restrained though. Even after she carefully aimed a spurting artery at me in a later operation, I refrained from trying to drop sharp scissors into her toes.

One of the conditions of my change of employment is that I am strictly to speak Norwegian at work from now on. Although I had started out well, I had fallen into the easy habit of speaking English most of the time with my colleagues, although to clients I have always tried to stick with Norwegian unless they have indicated that they want me to do otherwise. Naturally though, Dagny’s is very concerned that the practice’s clients are satisfied with my performance, and therefore she did spend some time with a very serious look on her face urging me to always speak Norwegian to the clients.

On Tuesday then, my appointment list was full. Happily my first client was Kari-Anna, the nurse who is on maternity leave, and her dog was in for a blood test, so that was pretty much stress-free, as was my next case which was a cat with a cut on its neck whose owner had left it for examination, so there was no owner, no history to take, and until the owner returned, no discussion at all. It fell therefore, that my first genuine official client was the owner of a dog that had been in a fight and had a wound over its eye.

Gerd brought the owner and patient through, and as I led the them into the consulting room, the owner said to me

“It’s okay if you would rather speak English.’

With Dagny’s dire warnings about language still ringing in my head, I replied in Norwegian that it was quite alright, and if it was easier for her, that would be fine. She started to laugh,

*I’m actually from Scotland,’ she announced, and after that we got on like a house on fire. I really hope that she will ask to see me if she comes back in.

Thursday was a little less busy than Tuesday. Today’s photo is of Trøffen, who came in to have a cyst removed from his head. Wivek was operating, and she called me through to the consulting room before she started to check with me whether I felt that she would be able to bring the skin together on his head if we removed the rather large lump. Trøffen is only eleven and a half though, and the cyst had already been emptied and had refilled, so there was a risk in leaving it as it might have become bigger. She decided to go ahead, and as you can see, she has done a beautiful neat job. Trøffen is a really lovely cat. Indeed I’m finding great pleasure in working with so many cats. Both Jan-Arne and Magne prefer dogs, and so I like to help out wherever possible. Magne was really impressed with me yesterday, when having easily taken a blood sample from a patient that has not always been wholly compliant, I also managed to give it a worming tablet. I guess I’ve always been fortunate, as most cats seem to like me as much as I like them.

The day out with Åsulf though was a revelation. It was utterly delightful from start to finish, even though the first visit was to a pig farm, and because of the way pigs smell and squeal, they have never been my favourite patients. I was very impressed though with Åsulf’s injection technique. He made it look easy, when experience has taught me that really it isn’t. As we went around, checking calves, examining cows (and yes, I did have my hand up a few cow’s bottoms) I felt completely at home. It just seemed so natural, and I really felt I could just slide right back into that way of life. It’s very different from small animal practice. And for the first time, I found I had very little difficulty with the language. For the first time, I felt that at some point in the future, it might not be impossible for me to work with production animals again. Anyway, for the moment I will continue with improving my Norwegian, and maybe I will ask Jan-Arne if I can go out with him again one Monday, as he now works there one day a week. Who knows. I might even be able to teach him something.

 

 

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.

Spray that Again

Holiday season has begun. This week Scary Boss Lady was off for her summer break. Just in case we were thinking of having a wild party with the Dechra rep who had made an appointment to come and tell us about their range of skin products, she left her daughters Ena and Sara in charge. Tornado Tawse was also presiding over the nursing duties and therefore the whole clinic was a hive of efficiency. Four pallets of pet food arrived at lunchtime on Thursday and within about ten seconds, the entire delivery had been redistributed onto the shelves. Before I knew it on Thursday, all the rooms had been cleaned. Luckily Gerd and Irene had booked me in some cases to see, otherwise I might actually have been at something of a loss for what to do.

One of the cases was desperately sad. A cat had been attacked by a dog and its injuries were serious enough that it had to be put to sleep. There was a little girl there. It is so difficult watching a child having to say goodbye to a loved pet. At the other end of the spectrum, Magne and I performed surgery on a lovely Cavalier King Charles spaniel for pyometra (infection in the uterus). Without our intervention, she would very likely have died. It was a pleasuritself to operate with Magne. This is the second time we have worked together on an uncomplicated pyometra and everything just clicked into place both times. It’s a delicate operation that requires nimble fingers and great care and the process itself was intensely satisfying, but the end result, when the dog comes round safely and greets its owner is the best feeling there is.

Due to the efficiency drive I mentioned above, I did have time to pop in and out of the dental room where Wivek and then Jan-Arne were working. Wivek was enormously helpful with the injured cat and so I was keen to do all I could to help her in return. Obviously she is much better than me at the actual work, but I was able to fetch things that she wanted. Jan-Arne was on good form as usual, telling me how simple Norwegian was. After all, he explained, there were very few words and some of them sounded exactly the same as each other. Prayers, beans and farmers are all pronounced in the same way, he said. At this point, he was about to set to with the ultrasonic descaler. His foot, he thought was not quite on the floor-pedal that operates it and so he reached out with his toe to pull it towards him. It was only when the instrument sent a jet of water right into my mouth that he realised that actually his foot had been on it the whole time. At least that was his excuse anyway. Personally I think it’s odd that that jet was pointed so accurately at my face. If I now come down with some awful cat-tooth disease, I know who is to blame.

The Dechra rep I mentioned at the beginning turned up late. He was meant to arrive at two thirty with lunch and so by two thirty five, everyone in the clinic was sitting in the staff room with bright expectant faces. For some reason, he had called into the clinic in the morning with boxes of sweets for everyone and as the clock ticked onwards, it seemed more and more likely that we were actually going to lunch on forty eight chocolate hearts and seven slightly-worse-for-wear grapes that someone had found lurking at the back of the fridge. However, at three pm, he finally arrived clutching a bag of seven enormous sandwiches to be split between the eight of us who were present. Looking around the table for someone to deal with this delicate situation, Gerd, officially recognising my superior surgical skills asked me if I could dissect each baguette into two. Sadly nobody had thought to tell the rep that Jacqueline was vegetarian and so she was left removing pieces of chicken to leave her with a lettuce and dressing salad. Hungry as ever, Jan-Arne demanded that she hand over the meat. Oddly though, when we later offered him the massed bits of cucumber, mayonnaise and chicken that had fallen from Ena’s sandwich and the slice of lemon that I had removed from mine, he seemed strangely to have lost his appetite.

The afternoon ended with Jaqueline delightedly swapping her Toffifee pack for a box of Sara’s chocolate hearts. Rarely have I seen such a pleased look on her face. Magne had to make do with the enormous pile of leaflets and pamphlets that the Dechra rep had left. For some reason, when I suggested he could take them home for a bit of light holiday reading, he seemed less enthusiastic. Anyone watching might easily have been fooled into thinking that really we clinic staff were actually more interested in the food than in the important information about what drugs the man was trying to sell. As if we were both hungry AND shallow people. Obviously though, as all of you kind people that read my blog know only too well, that could never be the case. Thanks for reading.

Today’s photo is Billy, who was in to see Wivek for some blood tests.