The Life of an Emergency & Critical Care Vet

Dr Tara Morris

Dr Tara Morris gives us a quirky and real insight into the day-to-day (or should we say day-to-night), life of an emergency and critical care veterinarian

5pm – Alarm goes off and I get up to broad daylight and hot summer temperatures.  I have to feed all my animals, have a shower and get ready for work.

6pm – Arrive at work.  Hospital patients are handed over from the previous shift.  During the day there is usually less patients in hospital than at night.  Tonight there is one patient still here.  She has haemolytic anaemia.  This is where the body attacks the red blood cells and can be life threatening.  But she has had treatment and we need to check her blood count every 4 hours to make sure it stabilises and hopefully she can go home in the morning.

6.15pm – the first patient arrives from a nearby veterinarian.  He was treated for a tick today at his regular vets.  Because he is a brachycephalic dog (that’s a dog breed that has a short, squished in face), he is at a high risk of developing a respiratory obstruction, so it’s important that he stays here for us to watch overnight.  He might need oxygen or if his airway blocks we might to place a tube into his throat or even do a tracheostomy (that’s when we cut down over his throat to place a tube directly into his windpipe!). 

6.53pm – a border collie arrives who has been attacked by his Rottweiler brother.  He has a small wound over his neck that needs sutures, but I’m worried that he may have further injuries, as often dog bite wounds are much more extensive than we first realise.  I give him some pain relief and admit him for a chest x-ray to make sure his lungs are ok and for surgery later in the night to investigate the wounds.  While I go see the next consult the nurses are placing an intravenous cannula and performing the x-rays.

7.36pm – next up is a cat is who having trouble urinating.  He has been sitting in his litter tray a lot and only passing drops of bloody urine.  When I feel his bladder it is very large and hard.  This little boy has a blockage and cannot urinate.  This is an emergency and needs to be admitted and unblocked immediately!  The nurses put him on fluids and take blood.  It is important that I check his kidney function and electrolytes before giving him an anaesthetic.  When cats cannot urinate they cannot regular their electrolytes and this can be extremely dangerous causing a low heart rate and even death.  Thankfully this boy is in good health and I anaesthetise him without incident.  I successfully manage to unblock him, but not before spraying urine all over my assisting nurse.  Sorry!  I place a urinary catheter and he’ll need to keep this in place for at least 24 hours.

9.56pm – the Mexican takeout has arrived.  I get two mouthfuls and a toilet break.  Then I check the x-rays of the border collie attacked by the Rottweiler.  His lungs look good! 

10.07pm – it’s starting to get busy.  The other vet has been busy with consults while I’ve been unblocking the cat.  I better get back into it (while eating Mexican in between consults).

12.23am – two more patients have been admitted, the rest have been treated and gone home.  A little doggy who has been vomiting all day.  She stole some fatty bacon offcuts yesterday and I’m suspicious she has pancreatitis.  Fatty foods can aggravate the pancreas causing it to become inflamed and painful.  Some blood tests will help me determine if this is the case.  Unfortunately not one test can determine pancreatitis, but the history from the owner, physical examination of the dog, some blood tests and even an ultrasound can help reach this diagnosis.  She’s going to need fluids and pain relief.  The other patient admitted is a puppy that was accidently dropped.  He has a seizure at home so he is staying here to make sure we can treat him quickly if he has another seizure and to have some medication to help reduce any swelling that may have occurred on his brain. 

1.04am – Now it’s a bit quieter I can start surgery on the border collie.  His bloodwork and x-rays look good so I put him under anaesthetic.  I have a nurse monitoring him.  She checks his vital signs and the depth of anaesthetic.  She lets me know when he’s stable and I start to investigate the wounds.  The small wound on the neck is actually the gateway to a very large pocket where the skin has come away from the underlying muscle.  This is often the case with dog bite wounds as the offending dog grabs and pulls at the skin.  This space can fill with fluid and develop infection, so I need to place a drain to help prevent this. 

While I’m doing the surgery, the nurses tell me that my tick patient admitted earlier is not oxygenating very well.  Normal oxygen levels are 98-99%.  Anything below 95% and we get worried.  This patient is oxygenating at 91% and it improves to 98% when an oxygen tube is placed in front of his nose.  I think it’s time to place a nasal oxygen tube.  The nurses do that straight away and now he is breathing better. 

2.42am – I’m getting tired and put bandaging material on my hands and pretend I’m a gladiator.   It’s the crazy hour!

4.19am – I’m doing all my medical records and checking my patients again.  The dog with haemolytic anaemic has had a stable blood count for the last 2 checks.  If it’s stable again at 6am I think she can go home!  The tick doggy is doing well on oxygen, but if he still needs oxygen by the time his regular vet opens, he will need to stay here.  The border collie is asleep after his anaesthetic.  The cat who was blocked is not liking the party hat that I’m making him wear so he doesn’t pull out his urinary catheter.  He is glaring at me when I go and say hello to him.  Bloodwork and an ultrasound confirmed pancreatitis in the doggy who stole the bacon.  She has stopped vomiting now after giving her something to help with that and is sleeping comfortably after some pain relief.  The puppy who was dropped hasn’t had any seizures and he is barking his little head off.  I think he’ll be ok.  I need him to be quiet though while I type my records, so I put him in my pocket and he goes to sleep. 

5.04am – A stray cat is brought in hit by a car.  She is not breathing very well and can’t seem to feel her back legs.  She is scanned for a microchip and she has one.  The nurses are talking to her owner now.  I place an intravenous catheter and give her some oxygen and pain relief.  The owner is on his way down. 

5.22am – the stray cat’s owner is here and has confirmed that he wants us to find out why she is not breathing very well and cannot feel her back legs, so we do some x-rays.  Unfortunately it’s bad news.  She has a broken pelvis and a diaphragmatic hernia.  That’s where the muscle separating the chest and abdomen is torn and some organs from the belly move into the chest!  She will need lots of supportive care and surgery once she is more stable.  Her owner makes the very difficult decision to euthanise her due to the extent of her injuries.  This is a very sad end to the shift.

6.00am – my replacement is here!  I have lots of in-patients to hand over and some will be staying for the day, some go to their regular vet for continued care and some will get to go home.

7.02am – I’m walking out that door and get to go home!  My dogs are very excited to see me and sniff my shoes, but now I have to go to bed.