Vet Tails Excerpt – Toby’s Tortuous Twenty Hours

Vet Tails Excerpt – Toby’s Tortuous Twenty Hours

This story began many years ago but for now let me tell you about my Friday evening…. it had been a long week and miraculously I was finished early at 6 p.m., having seen all the critters needing help for the day. With my other work up to date I thought that I would head home, have a relaxing evening, a nice long bath and an early night.

Of course, even the best laid plans can go awry especially being a vet on call 24/7 for emergencies! I had a call from Bev. Her gorgeous ragdoll cat Toby, who is always a character, just didn’t look right and he had a swelling that was suddenly visible under his tummy. She was concerned because even his Labrador friend Jet was licking him gently as if something was wrong.

She rushed Toby in and an examination showed that his claws were sheared and he had a large hernia (hole in his abdominal wall) through which some of his guts were protruding. Toby is a remarkably tough big boy, very determined and although he was in a lot of pain, he was still quite bright and responsive. I suspected that Toby had fallen off a height and landed badly a few hours earlier, shearing his claws as he came down and landing with great impact on his tummy to create the massive damage.

It was clear that Toby would need emergency surgery but before we started, Bev helped me to take an x-ray to get more of an idea of what his internal injuries were. I especially wanted to make sure that his lungs were OK and that there was no damage to his diaphragm (the big breathing muscle separating the chest from the abdomen) as this would mean more complicated surgery and higher risk. His x-ray confirmed the hernia, his diaphragm appeared intact and his lungs looked fine which was good news.

Our wonderful vet nurse Karen was called in to help and at 7 p.m. I sedated Toby, placed him onto intravenous fluids to support his blood pressure and we then gave him an injection to put him under anaesthetic. We also gave him intravenous vitamin C (remarkable at supporting tissue healing and helping to minimise further damage by free radicals, which are chemicals that are produced from severe trauma like this) and an injection of a herbal and homeopathic preparation (incredible at supporting healing, regulating inflammation and minimising bruising) into a special acupuncture point that would help to support Toby.  I always rack my brain to think outside of the square and consider “What else can I do that will help my patient” – this was inspired a long time ago by some special people, including my high school biology teacher back in South Africa when I was growing up.

Next step was to shave away the hair on his tummy so that we had a clean field to do surgery and repair the damage.  Karen did one of her beautiful haircuts – definitely not my forte – remembering back to my early days having a mobile vet practice when I did a home visit to groom some bad knots out of Bob the cat and left him with a mohawk. Bob’s owner Jenny gently advised that she thought that I should stick to my job of being a vet and not go into hairdressing! Underneath Toby’s fur was severe and extensive bruising; poor Toby was really black and blue and all of this bruising would make healing from surgery slow and possibly create complications like the skin dying, but we had no choice except to continue.

I donned my gloves and surgical gear, poised the scalpel blade and began what was going to be a pretty big job. First I needed to make the incision in the right place, then gently part the tissues to identify what was what, which can be tricky when everything is so traumatised. Layer by layer, I managed to identify the different parts but suddenly there was a big gush of air and my heart sank. This meant that there was damage to Toby’s diaphragm that wasn’t picked up on x-ray, and not long after I found that he also had two broken ribs and a grazed liver.

I spoke to Bev and explained that his injuries were a lot more severe than anticipated and we could be in for a rough road with his recovery and have a number of risks through surgery and after. She elected to proceed and encouraged me to do whatever I could. I remembered back in high school when the same biology teacher who coached a number of sports teams that I was part of, imparted a key message that has stayed with me always, “When the going gets tough, the tough get going”.

Slowly but surely I sutured everything back together while Karen monitored Toby’s anaesthetic, reporting that he was stable and doing well, which was a relief as with such severe injuries many animals “crash” and need further intensive care. Three hours after starting I placed the last stitch just in time for Bev and her daughter Caitlin to arrive with some yummy dinner they had prepared for us.

We bandaged Toby’s abdomen and chest to help protect his injury and he slowly came around after we injected him with pain meds and anti-biotics. Bev and Caitlin headed home and when Toby was stable enough I packed him into my car, with his drip, our drip stand and pump, etc. and took him home so I could monitor him for the night as we occasionally do with our patients when needed.

I arrived home around eleven thirty, looking forward to settling inside and finally getting a chance to relax. I placed my key into the door to find that our front door lock was jammed and no matter what I tried, it just would not open! It had been a long week, a long night and I needed to get Toby inside to help him recover for the night, I had Bev’s tantalising food waiting and I was pretty hungry! I went all the way around the house to the back glass sliding door and managed to get my hand though the window and undo the bottom latch but the top latch was still holding the door shut. What would I do now!?!?

Like anyone with good South African genes, I had to make a plan to break into our house. Hoping that no neighbours were spying on me, suspecting that I was a burglar and making plans to come and tackle me down, I took the most likely object to get the job done, our drip stand! I fed it through the window and used it to manoeuvre the top door latch. It was tricky in the dark but I used our after-hours cell phone to shine some light and soon enough I was in the house! I sped through to the front door but no matter what I did it still would not open.

I had no choice but to unload Toby and all the gear I would need for the night and take it around the house, in through the back door and into the spare room where Toby would spend the night. He was still nice and sleepy and comfortable so I sat down to eat some dinner at 12:30 a.m. and put my feet up momentarily for my “relaxing evening” glimpse!

Soon after, Toby stirred. I checked on him and he started meowing and becoming restless although he seemed comfortable. I gave him an injection to help him sleep and soon he was snoozing peacefully and finally at 1:30 a.m. so was I. My alarm went off at 3 a.m. as Toby was due for more pain meds. He was awake again, meowing at me and a bit restless but seemed comfortable. I gave him another injection and we both settled for a few hours until his meow woke me again at 7 a.m.

I gave him a thorough check over, his wound and bandage were fine, he was bright eyed, amazingly alert and his pain was minimal but his meowing continued and he shook his leg at me almost as if free spirited Toby was protesting “It’s bad enough that I’m confined in this cage but I really don’t like this drip and bandage on my arm…”

My plan was to get Toby into work, give him another round of intravenous vitamin C to help him heal as unfortunately with the damage to his chest we wouldn’t be able to safely treat him in our hyperbaric oxygen chamber which accelerates healing at a staggering rate. I reloaded the car with Toby and all the gear, again having to go all the way around the house through the back door and we drove into work where Karen gave me a hand to get Toby’s drip going again. Toby was not impressed with this, he wiggled and protested and eventually we found that he had bitten a hole through his drip line at some stage. We had no choice but to remove his drip and holding him still enough to place another while we wrestled with his 7 kg of might (he’s a big cat as most cats are 4–5 kg!) was not going to be easy.

Sometimes, patients help us to make decisions and what medical protocol dictates, isn’t always in their best interests. In Toby’s case, he was obviously happier with his drip off and although I would have preferred him to have it on, it wasn’t critical at this stage so we decided to leave him be. Karen made him a smorgasbord of food and put it into his hospital cage. Whether an animal eats or not is often a very accurate indication of their well-being and this was a test that Toby passed with flying colours.

Toby devoured everything in sight and it finally dawned on me that in the early hours of the morning his meowing probably meant: “I’m starving here vet, I know that I’ve just had a huge accident and major surgery where any human would be feeling rough for weeks but I want some food!” He didn’t seem at all concerned about his pain and trauma, just about his next meal to support his seven kilogram frame. It had been a tortuous few hours for him without his grub!

Toby was making an extraordinary recovery but we weren’t “out of the woods” yet as potential complications could still arise. Because Bev is an attentive owner and has been a paramedic, it was clear that the best thing for Toby would be to go back to his home environment where he could be doted on.

Toby went home later on the Saturday morning. I checked in with Bev on Sunday and she reported he was doing well, still a little wobbly on his feet but bright and eating, although he hadn’t yet pooped. I assured her that “what goes in must come out” and thought about that same biology teacher who taught me that so many years ago.

Toby didn’t look back! We removed his bandage a few days later to find his wound and severe bruising were healing steadily. His progress was been phenomenal and he probably owes thanks to my high school biology teacher’s wise teachings instilled in me at an early age.

P.S. My high school biology teacher was Bev!