Saturday 30 January 2010

Threat Alerts

If you are PC then do not read the following. If you still have a sense of humour knowing it is humour (well l think it is l mean it couldn't possibly be true), then the following is for you.

The English are feeling the pinch in relation to recent terrorist threats and have raised their security level from "Miffed" to "Peeved." Soon, though, security levels may be raised yet again to "Irritated" or even "A Bit Cross." The English have not been "A Bit Cross" since the blitz in 1940 when tea supplies all but ran out. Terrorists have been re-categorized from "Tiresome" to a "Bloody Nuisance." The last time the English issued a "Bloody Nuisance" warning level was during the Great Fire of London in 1666.

The Scottish Parliament raised their threat level from "Pissed Off" to "Let's get the Bastards." They don't have any other levels. This is the reason they have been used on the frontline in the British army for the last 300 years.

The French government announced yesterday that it has raised its terror alert level from "Run" to "Hide". The only two higher levels in France are "Collaborate" and "Surrender." The rise was precipitated by a recent fire that destroyed France's white flag factory, effectively paralysing the country's military capability.

It's not only the French who are on a heightened level of alert. Italy has increased the alert level from "Shout loudly and excitedly" to "Elaborate Military Posturing." Two more levels remain: "Ineffective Combat Operations" and "Change Sides."

The Germans also increased their alert state from "Disdainful Arrogance" to "Dress in Uniform and Sing Marching Songs." They also have two higher levels: "Invade a neighbour" and "Lose".

Belgians, on the other hand, are all on holiday as usual, and the only threat they are worried about is NATO pulling out of Brussels .

The Spanish are all excited to see their new submarines ready to deploy. These beautifully designed subs have glass bottoms so the new Spanish navy can get a really good look at the old Spanish navy.

Americans meanwhile are carrying out pre-emptive strikes, on all of their allies, just in case.

New Zealand has also raised its security levels - from "baaa" to "BAAAA!" Due to continuing defence cutbacks (the air force being a squadron of spotty teenagers flying paper aeroplanes and the navy some toy boats in the Prime Minister's bath), New Zealand only has one more level of escalation, which is "Shit, I hope Australia will come and rescue us".

Australia , meanwhile, has raised its security level from "No worries" to "She'll be alright, mate". Two more escalation levels remain, "Strewth!', I think we'll need to cancel the barbie this weekend" and "The barbie IS cancelled". So far no situation has ever warranted use of the final escalation level.

Monday 25 January 2010

Sweet, Loving, Abandoned.

Saturday night we had a lovely rottie cross brought in. He was a big dog about 45/50kg. His owners had moved out the house and left him. We got a call via the police to go and collect him. If l was going to get another dog he would have been it. I don’t think he knows what the word “nasty” is and is a big lolloping softie.

He knew commands and so despite being scatty and bouncing all over, when l went into the kennel and said settle now lad he would sit and grin his big happy smile, tongue out, front feet slightly twitching waiting to be told he could move.

He has gone onto kennels l just hope he gets the home he deserves and not some scroat who is looking for a tough guard dog and treats him like dirt.



Thursday 21 January 2010

Breedings Easy In'it

I don’t mind giving advice over the phone helping people and their animals, l do it all the time. In certain cases though l get angry that people, in easily remedied situations, have not taken the time to do their own basic homework.

I had 6 phone calls between 04:00 and 06:00am the other day. The woman was hysterical about her bitch giving birth. I told her at one point to “put her husband on who l could hear in the background and sounded less upset. Then go and make coffee, bake a cake, anything that got her OUT of the area the bitch was giving birth as she was winding the bitch up screaming and crying over her, hugging her and poking her and she [bitch] would probably kill the puppies”

“Oh dear, oh no oh my god l didn’t realise l was causing a problem” followed by more crying and howling down the phone. She handed the phone over for this call but did all the rest.

None of the calls were quick all needed Q and A and repeating of A as she wasn’t listening properly. There was no complications just people who had not taken the time to learn. The calls kept dragging me away from the inpatients, genuine cases that l was trying to deal with.

The vet took the 7th call as my arms were full of an injured cat it was to tell him the puppies were suckling and wasn’t it exciting, then she put the phone down. The vet looked at the phone like it had bitten him and, then looked at me and said “What was all that about”?

Was it wonderful, no actually it wasn’t, we were dealing with a genuine emergency who were more important than some woman who should have taken her time to do her basic breeders homework. Who couldn’t deal with the basics of a bitch giving birth normally and who stressed her [bitch] to almost reject the puppies, and interfered with the care of genuinely ill patients because of her lack of fore thought.

If you insist on breeding your dog or cat you should at least learn the very basics about what goes on. Instead the vast majority of people look at an average litter, add a couple of extra babies (optimism).
They then look at what new things they want, after all, why use the money to pay off debts.
They look for the cheapest pedigree stud of the breed needed available, preferably their own male but if not any close ones will do.
Unless you want a cross breed litter with a fancy name then any old mutt or moggie, will do.
Finally they take a calculator and work out how much to charge for each puppy/kitten.

It is no excuse to say that it was an unplanned litter and giggle about how exciting it is and how you wonder what is going to happen or be shocked at what does. If you know the bitch is pregnant deal with it, properly. If the bitch or queen is not neutered learn what can happen, you know that bird and bee stuff naughty sex. If your bitch gets a sudden weight gain and they have been in season a couple of months before what did you assume…they ate doughnuts DUH!
Yes, l had that said to me once that they thought the bitch had eaten some doughnuts lying around.

The checklist below is in no particular order; The majority of questions below are not all the questions, just some basic ones the “breeders” wouldn’t even think to look into and if they do, they ignore the question as it would cost money or time or effort or all 3. After all animals have babies all the time so what's the problem...in'it

Should you look into the various birthing stages and what happens?
Yes…ignore

Should the animals (male and female) have any tests for genetic problems?
Yes…ignore

Should you check the family history of the dam and sire to avoid inbreeding?
Yes…Ignore

Should the mother be wormed pre and during and post pregnancy and the pups?
Yes…ignore

Should there be no fleas about (these can suck usually kitten’s dry of blood)?
Yes…Ignore

Should the mother be vaccinated?
Yes...ignore

Should the homes be checked?
Yes…ignore

Should the mother and the pups be fed on good quality food?
Yes…ignore

Should you look at buying in milk substitute and feed bottles in case needed?
Yes…Ignore

Should you look up information on how to hand raise puppies/kittens?
Yes…Ignore

Should you look into the cost of a caesarean and other vets fees?
Yes…Ignore

Should you look into the post birth problems of mothers?
Yes…ignore

Should you know how old the mother should be bred from till?
Yes…Ignore

Should you make sure the dam and sire are fit and healthy?
Yes…Ignore

Should you only breed at responsible times? i.e. Not at Christmas
Yes…Ignore

Should they make up stupid names and charge a fortune for cross breeds?
Yes… Confirm

Should they make sure their pedigree is registered with the kennel club so they can give out paperwork to charge as much as possible?
Yes…Confirm

Should you advertise as cheaply as possible to make as much money as possible?
Yes…Confirm

See you checked the important things yes; breeding animals couldn’t be easier, now just sit back and wait for the money to roll in.

Wednesday 20 January 2010

Bella Mouse and Meetings

I had an update today from a friend about an illustrated book he (author) and his wife (illustrator) are bringing out for children ‘Bella Mouse at Mobberley Edge’. Everything is clicking into place with the publishers and the book should be out around March/April time. I will put up more details then on the storyline, where it will be available and price. I do know that they want it keep reasonable which is missing in a lot of book prices nowadays.

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After cancelling the night staff Christmas party and upsetting all the night staff one of the more polite vets drafted a letter of complaint which a lot of us signed. It was then sent to hr at head office, and we heard nothing about it, nor did we expect to.

At the night staff meeting the other day the regional director was a bit upset at the letter saying no-one had asked him. He gave his blessing for it to go ahead if someone would organise it and also arrange for everything to be prepaid. As l am just along the road from where we are going l said l would.
A bit later on he muttered a bit sheepishly, “I didn’t know about it but IF anyone did ask me l would probably have said no before l found out how cheap it was for the meal”. Then he changed the subject, taking time to glare at me for bursting out laughing and telling him that “honesty is the best policy”.

As usually the rest of the meeting was a waste of time but the one admittance to putting his foot in it and a go ahead for the party made up for it.
I also got an ok to put publicity info out in all the surgeries on ‘Bella Mouse at Mobberley Edge’ when the book comes out, no point on missing a chance to help friends if l can.

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I have been trying to get used to posting on Twitter using my mobile phone. The main problem is that it doesn't tell me on my phone how many characters l have used so it is a bit hit and miss at the moment. I won’t Twitter much when l am off duty, unless l happen to be doing anything interesting which is rare.
I like being able to do short notes on things that may not merit a full blog, or l may be able to build into a blog at some later date. The idea is as l get used to it more to give a flavour of life behind the scenes at a vets.

Friday 15 January 2010

Twitter & Care Homes

Well l have tried to go all posh. I have had mobile internet put on my phone and trying to get used to using it, as it is very slow by comparison to a landline this is taking time.
The l got even posher and decided to set Twitter up with the thoughts that l could do fill ins while l was on duty and stole 5 minutes loo time,usually the quiet area where l can catch a quick break and not be called.It really is "time in loo".
I am back on duty this evening so will see how l get on with twittering or tweeting.
We are due phone upgrades in February and march and l am dithering over the iphone 3gs and the blackberry bold 9700. If anyone has those 2 please let me know what you think of them. The phones are a let down on both and l can not decide which to get. Bold has better write up but smaller screen. iphone mixed reviews but bigger screen.

My Dad is in the care home, they are great. As l said before not the most up to date building but they care. My dad is in the lounge/dinning room all day, they are big on tea and it is just about on tap there. Even we get offered in the second breath after hi. Apparently the food is very good, it is all cooked fresh on the premises
There has been a few muddles with his clothes as they were not marked up but the carers labelled them up for us yesterday.
The cost is a lot less as well as my parents only have to part fund it as opposed to full fund. Again a big relief.

The same praise cannot be said of the hospital and his arrival. Last Monday amid all the blizzards in the north west the care home had said their drive up a slope was undrivable and the roads not good. I notified the hospital and left things up to them. On the monday evening when we visited my dad we dropped a bag of warm clothes off for when he moved.

I confirmed with the care home similar situation on Tuesday and again told the hospital, being as how my dad was due to go to the CH on Tuesday.
At about 17:30 l got a call from the ward sister saying they had a land-rover ambulance and were going to take my dad over. I was worried about this but assured all would be well and they would ring the CH.
We went in on Wednesday and were told of the "arrival". The ward sister rang the care home and said we insisted my dad was moved now. The CH were not happy but said well if it is safe, and again assured of the land rover.

At about 19:00 the carers heard a vehicle and went out. There was a transit people mover unloading my dad and his wheelchair in a blizzard, the driver refused to help the 2 girls get my dad inside and they only had indoor shoes on. They had to haul the wheelchair up the slope of a long drive. To make things worse my dad had a thin hospital blanket over his legs and the half open scrub suit he used as pyjamas. They left the warm clothes in a bag. He had been hauled out of bed, put in a wheelchair and pushed straight to the van.
This is a 92year old with severe disability, suffers chest infections, has just been on drips and treatment, body weight about 45kgs no fat, has no proper temperature regulation and struggles to stay warm.

Thankfully he is fine. I have been dithering about complaining as doubt sod all will be done.

Monday 11 January 2010

Humour and Relaxation

If anyone is looking for a property in the Manchester area this may be ideal. I do not think it is to expensive and is ready to move into. one bedroom house

And this is l am told the Ukraine’s version of “You’ve got talent” and boy does she have talent. I struggle to draw one side of a stick man and get the other to line up.

Saturday 9 January 2010

Close Call

I took my mum to wynsors shoes a couple of days ago. There was a woman in a bulky Arab dress with headscarf on sort of like a semi burqa just sitting on the isle end on one of the stools if you want to change footwear.
She looked odd from the start and l got bad vibes off her, there was no kids around with headscarves or anyone else who appeared to be with her, she had no shoes around her as if she had been trying them on and was not gazing around the shop looking at the shoe isles. She was perched and just didn't fit in.

My mum got some shoes and sat about 7 foot away and slightly offset opposite the woman to try them on, then walked round to test them. As l was watching her test the shoes something made me spin round, burqa woman stopped dead a couple of feet from the handbag and looked in her bag, snapped it shut and started to walk round the store. She made my hair rise and hackles it was just to false.

I went straight to the bag and hunted in it checking purse, card holder and anything else, all there. My mum looked up and asked what l was doing. I didn't want to worry her so said oh just being a nosey cow, she went back to her shoes.

My skin was crawling at burqa woman walking around the isles, she was not browsing just vaguely acting like she was. I went to an assistant and asked about her and was told..."she asked about extra wide shoes.. come to think of it it was a long time ago".
I told the assistant what had happened she got worried but not sure if she told anyone. I hope so no way was that woman genuine. I am not sure if she had the "dress" as a handy bulky place to hide her stolen items inside or to yell racist if caught, possibly both.

Handy place shoe stores, woman leave their bags and walk about look down a lot so if you go shoe shopping and do try shoes ... carry your handbag. My mum was just bloody lucky.

WATCH YOUR PURSES/BAGS WHEN SHOPPING

Wednesday 6 January 2010

Celia the Cuban

I wrote about the smaller crocs being moved to their new enclosure at Tenerife Sur Zoo but thought l would tell the story of Celia the Cuban crocodile and her move to the same enclosure…. Once the fence was made higher and croc proof.
Paco had built the new enclosure as he felt the smaller Niles were now at a size they were less likely to get eaten by Celia. Both sets of crocs enclosures had only been temporary ones, true for a few years but only “short term”

Celia had been at the zoo for a number of years. She is a very rare croc being a Cuban and her arrival was different to the normal sort of arrival.
A container ship had docked at Santa Cruz in Tenerife to off and reload cargo. The sailors had been in Cuba and South America on one leg of their trip and had acquired quite a few creatures, mainly parrots. They decided that they would sell the creatures in Tenerife to earn some extra cash.
They had sold most of the animals except Celia, sensibly the citizens of Santa Cruz decided that they would not buy her but stuck to the parrots and few smaller creatures.

At the end of the day when the ship was refreshed and due to sail the crew went back to the ship leaving poor Celia to walk around the streets looking for food and security. The zoo was called and they rescued her. She had been there growing since, and was now around about 7ft and happy in her home.

The trouble with moving her was she spent a lot of time in her pond. It was muddy and impossible to see into, and though only narrow it was deep and Paco insisted she had to be caught not trapped.
This “simple” job was accomplished by pushing a broom handle down into the muddy water and pinning her to the floor. As she reared up in anger a noose was to be dropped over her jaws and pulled shut, then she was hauled out, hogtied and carried to her new home.

No matter how Marco or l said it was a crazy scheme, your hands ended up in the water as the pond was deep, It stressed her out, it stressed us out, we risked injuring her, we risked her injuring us, we got no place he was adamant.
After 2 hours Paco had got bored of supervising, you notice “supervising” he was not putting his hands in there and wandered off but my hub had arrived by now and joined in.
We continued to push the handle down while one of us waited with the noose, every so often we would swop to give a broom pushers a break. You could feel her wizz under the handle as it brushed her. At times she would surface, grab a look and breath and go down again it was crazy. A couple of times we got her to rear up but never managed to get her noosed as she was always at the opposite end to where l was or to far away.

It took about 4 hours before they succeeded in getting her back end pinned, and on cue she reared up by me and l managed to get the noose over her jaws and pull tight.
She slammed around but l held on the other 2 leaping over to help. We got her part way out and more ropes onto her then pulled her out and tied to a plank and immobilised her tail and body.

We carried her over to the new enclosure with the smaller Niles. We were all barefoot, normal for me but not for hub or Marco. Hub cried out as he stood on something but kept going. When we checked his foot later there was just a small hole.

Celia settled quickly into her new home seeming to enjoy it but hubs foot didn’t get better. Finally after about 5 months of limping he allowed me to have a proper look. A dig with a needle and a hard squeeze and out popped a chunk of plastic, it must have gone in deep and the hole closed over it, once out the foot healed.
Celia had her revenge on at least one of us for the indignities of being caught as she was.

Sunday 3 January 2010

Uncharted Waters

I was reading Trauma Queen blog and his comment about fitting in a patient (although it was more complex than that and fitting was only a part of it) reminded me of some of the cases l have been involved with.

One of the ones that sticks in my mind was the 2 Labradors (not the real breed) that came in both fitting. You do not get that unless they have access to toxins but the owners swore blind they did not.
We pinned the dogs and got iv catheters in and a hopeful bolus of diazemuls/weight to stop the fitting.
They bolus did nothing so a second then a third followed. This stopped them for about one minute and they started again, going by that the dogs were in deep trouble and would need stronger drugs.

The first test on a simple glucometer with the blood from the catheter stylet drew paydirt part one, they had almost no blood sugar in them. We drew up a “hit” of glucose and put it into them.

The fitting continued and we tried another cocktail of anticonvulsants this slowed them for a couple of minutes but they still twitched. A quick ear prick to check glucose and it was 1. That was crazy it should have been climbing upwards. I called the results over to vet who was gazing at the drugs wondering which he should do and his cussing matched mine.

The vet got me to double the glucose bolus and went to speak to the owners. Coming back with the info the owner was a diabetic on insulin tablet control but swore blind he had all his tablets. The most likely case was he had miscounted in a panic at the dogs fitting, there was no blame as there shouldn’t be in accidental cases, they are that accidents. Ultimately reasons didn’t matter. The 2 dogs were in deep trouble and uncharted waters.

The vet went for the big guns. He set up 2 Propofol infusions using a high dose glucose drip (extra glucose added to a glucose saline drip). Propofol is a drug that looks like milk and used in humans and animals to induce anaesthesia. If you have had a general anaesthetic and the Dr looked like he was about to inject milk, he was probably using Propofol.

Being mixed into a drip and going into the patient at a set rate sends patients into a deep anaesthetic and stops the fitting. The time the patient is under varies on the condition the main criteria being “the shortest possible time” for the problem to resolve.
The patient is allowed to wake up slowly over a period and is observed to see that the fitting has stopped. If it hasn’t or starts again and is not controllable with other drugs they are once again seen into a deep sleep.

The 2 dogs continued to fit so we pumped more and more glucose into them. The magic barrier was 2.5 on the glucose scale. Not for any reason other than it was higher than we seemed able to get and hold them. They would get to 2 and within minutes they would slide back again towards 0.7.

With each glucose bolus “hit” the fitting would slow down to a twitch then within 5 minutes would start to fit. Without the Propofol control they were totally out of control. The longer (and harder) they fitted the more chance their brains would overheat burn out and their organs would be permanently damaged. Not counting what was being done to them with the lack of glucose.
I cooled them as best as l could with wet towels, fan’s and ice packs. The night was luckily quiet on patients and callers so it allowed us to concentrate on these two.

By about 4am we were becoming desperate for glucose. We woke the practice manager and made his night by getting him to go and raid the other surgeries for all their glucose products. We were throwing everything at these dogs, glucose syrup on the gums, Glucagon, injectable iv glucose and glucose No18 drips. The highest we got their glucose was 2 for a short time mostly it was around 0.7 to 1.5.

Around 4:45am we were loosing the patients. The dogs had come in at about 24:00 and had been uncontrollable since then. If we could control the fitting the glucose may have a chance to work, depending on what else had gone wrong that was not showing yet.

We used to have a drug called Sagital which is basically Pentobarb, the drug used to put animals down with but at a much lower concentration. This was discontinued in around 2004 and much lamented, it was ideal for fitting animals. It was then we switched to Propoflo drips.
I remember when the word came out about it going to be withdrawn and the vet l was on with checked out the % difference between Sagital and Pentobarb (for putting animals down).. just in case. I also wrote the dilution down as l worked with different vets.

Taking a breath l asked the duty vet what about diluting down Pentobarb to the Sagital dose and using that as a last ditch. He is very experienced and was a certificate holder in anaesthesia, even he baulked at the idea but we had run out of ideas. He rang the owners for permission as there was a good chance even diluted we would kill them in their state, permission was given.

He diluted the drug down and took a deep breath. Slowly he trickled it into the first dog and the fitting slowed and stopped. Then number 2 dog and the same result. We stood and stared at them and the clock.
2minutes... no fit…
3minutes... no fit…
5minutes... no fit…An ear prick at 5mins showed the last glucose bolus had taken the glucose from 0.6 to around 1.7 things had to be looking up the dogs were due a lucky break.

By 10 minutes there was no fitting but the glucose was dipping to 1 so more glucose bolus.

20 minutes and they still hadn’t fitted; they had more glucose boluses as their blood glucose fluctuated like a fluttering butterfly wing.

25minutes and they hit the magic 2.5 were we to early to think the prayed for miracle was coming that the 2 dogs may just make it against all odds.

30 minutes and 2.8 on the glucometer..

Suddenly then the dreaded twitches on dog two followed almost at the same time by dog one, more of the dilute pentobarb and it stopped again, but the glucose continued to fall back to 0.7 we managed to stop it there.

The glucose wouldn’t climb any more but the fitting had stopped, ok one out of two we could work on those odds just so long as we had glucose we hoped to hold the tide until it turned back in our favour.

By 6am the first dog had started to deteriorate and show other signs to the fitting. The vet rang the owners for permission to put the dog out of his misery they agreed, and were warned that dog two would probably end up the same as the first dog within a short time, probably minutes as they had mirrored each other step for step. In fact as the vet spoke on the phone dog two was showing similar signs.
The owner requested euthanasia for both dogs. As brothers in life they were inseparable, in death they would still be together.
I confirmed the request with him for the vet as it was over the phone and not in writing, a job l hate as you have to get the owner to repeat the request, not nod or just sign a piece of paper.

Wherever the insulin had come from, and it could only be that, it had done its job and pulled the glucose from the bloodstream.

By 06:10 both dogs were dead, the war was lost.