Wishing you all.....

.... a merry merry Christmas!


And if Santa Claus doesn't visit you this year, it's because he's chilling out in his flip-flops down south, in the Carribean! But I hope he does come and y'all have a fine time out there.

All I want for Christmas.... is a moderate amount of calls out as I shall be on call:)

An unusual case

Well, imagine my puzzle a few days ago when somebody brings in 2 rescue puppies.

That in itself is not something unusual of course, especially since we collaborate so closely with the local Humane Society. But there was something else about them...




No signs of trauma, normal temperature, wagging their tails... but on sternal recumbency and over all....no muscle tonus. The consistency of a kitchen rag. And mildly dehydrated.

But...both of them??? In the same time?
They were quiet and sweet. But what is wrong?

However, before I got to panic and put the worse in front and started a more complicated treatment, Dr. Brenda was around. A very experienced practitioner, she said...Oh, it looks like a case of botulism! Maybe they both ate a rotten chicken or something!

And turns out, she was right. That's because with nothing but supportive care, they gained more strenght every passing day, and now, about a week later, they actually stand up and even started walking. By the time I get back in tomorrow they might even be running around:)

As treatment, there is a specific serum out there but we didn't have it in the clinic (well...it's the first case I have seen ever and the first one there in almost a year of work. And they seem to do dandy fine even without it). So we just gave them oral antibiotics, corrected dehydration (with fluids SC even, as they resumed quickly eating and drinking provided it was...very available) and supportive care.

And before you know it, they'll be up for adoption!

What happened lately in the Caymans

Well, it's been a long time since my last post. I left the story to when hurricane Paloma was just about to hit us. It was quite an adventure. The hours before a hurricane aren't pretty...just windy and rainy, rainy, rainy. We all had our bit of fun trying to get all the animals from the clinic safe and sound, and then get ourselves safe.
I wasn't quite safe as we opted to spend it not far from the sea, in a lovely apartment without hurricane shutters ... but with a grand view. Luckily, about an hour before it would have been a direct hit, it turned and continued it's trip with rage, crushing straight into Cayman Brac, a mere 100 km away, as a hurricane cat 4. Lots of damage there, and many torned houses, luckily no human or animal victims that I know of. Can't put my hand in fire for the wildlife thou!

With this late comer, the 2008 hurricane season, and my first one ever, came to an end.

And then all others started flying by... Halloween, a big deal on the island. Many people dressed up, and even I went as a small Dracula. I had to, right:) ? Then Pirate's week, a weekend in fact of fun and everybody taking a turn of dressing up as a pirate or a wench, which is that tarty female you see in the company of pirates. All in good fun, thou! Then Thanksgiving, where there was plenty to eat other then the traditional turkey for the vegetarians amongst us;

And now the whole island is putting the lights on, preparing for the mega Christmans celebrations. Some are over doing it, but generally all in bright spirits. It's funny to see the palms lightened up like christmas trees, but one has to work with what's available, right?

Also, another warm December for me (and I don't complain there a bit!!). The weather and the sea have cooled down a bit, and it can be windy at times, but we are still enjoying a daily 27 C.
No question of a white Christmas thou, unless we count the perfect powder sugar sand!

Missing lots and lots my friends and family back home, and the lights from Bucharest, and all the fun free time I used to have around this time of the year....

Yours, from far,
Andreea

News flash

And just when we thought the weather has cooled off and the hurricane danger is off....
well not really....it doesn't officially stop till end of november!

And just to prove the rule right, we are again under hurricane watch. A new baby called Paloma will come to visit us within 24-36 h, hurricane potentially even category 3, will hit us full blast!

Keeping you posted. Already the 2nd hurricane of the season!

Paloma over and out,
Andreea

What tickled my brain lately...

Well, ... eyes. In fact lately I have had quite a few interesting opthalmologic cases which I could not refer so I had to deal with them on the spot. Thou I have consulted the diplomat specialist on one in particular.
I had 2 corneal ulcers. One was old and superficial and multiple attempts of conservative management failed. The eye kept staining with fluorescein, thru many frustrating weeks of believing it can be managed without surgery.
The other one was new and acute, a good case of desmetocel turned anterior chamber prolapse with some iris in the equation in an 8 month puppy.

I did in both a procedure, quite straightforward, which I've come to love...a 3rd eyelid flap. Technique is important, as tension applied had to be just right; owner compliance ever so important as after care as eye drops and E-collar is vital; and another new trick is the usage of own patient serum alternatively with antibiotics;

Both of them healed well after 3 weeks of the flap in place. Even the nasty iris one healed well, with a good new scar but still, healed!

Another cool one, a case of Horner's syndrome in a 5 year old male neutered Dobermann; was a bit puzzled with that but after reviewing some neuro-ophtalmology and the nervous path way (long live Predoi..NOT:) all became more clearer.

And outside of the eyes, we had a magic case of a diaphragmatic hernia in a 3 month puppy...a very nasty one that made it succesfully.... more of that in a later episode.

And 3 cheers to my current favourite drug... long live Dopram. Respiratory stimulant that is a God sent:)

Pictures at last...and more to come

It took some time, and lots of trials and tribulations with an otherwise very friendly tool, Picasa and finally here is the link: http://picasaweb.google.com/turcoaz . I plan to make this my virtual space for posting my pics for the future, in a very careful selection that is.

Take two

More to come of our epic Caribbean journey soon.

1 in 4 Saturdays in my little island

Every 1 in 4 Saturdays, my turns comes for a working Saturday. We all have a big dislike for the day... not only you're working when most of the people are not, but the whole clinic is up to one vet to manage, which happens to be ... you, and apart from that the whole of George Town rushes in Saturday mornings to solve issues which they haven't had time to solve during the week.

It all starts at 6.15, out of bed, scrubs on, quick breakfast and the drive to work. Still have time to appreciate the scenery, the sea so peaceful in the mornings, as i drive right by, taking the slightly longer road to work. All to postpone the unavoidable...the following 9-11 hours of rush.

I drive by, look at the sea, the palm trees, the odd jogger (why don't they sleep???), and before i know it, I'm at work.

I don't have much time. I have an hour to finish the morning rounds, which is not a lot, and which means taking the files of every single animal in the hospital, making notes of each one's evolution from the previous day, giving the medication and deciding discharge, changes of treatment, etc. etc. I don't always get to finish in that small hour, despite the fact that I run around as fast as I can, but sometimes the sheer number of patients is too much. If I don't finish, I have to come in and out of appointments and finish the rounds.

Time runs, it's already 8 o'clock. The gates officially open. People sometimes queue up since 10-15 minutes ago, and before I know it, I already have 3 files lined up, waiting for me to call them in and do whatever everybody needs.

It doesn't stop for the next 6 hours. People line up, my stress levels used to go sky high when the files pile up and I had 5-6 waiting....now I am more cool about it, I just take each case at a turn and focus on that specific one. I have to see appointments, which tend normally to be yearly examinations, but also walk-ins, people that have an urgent problem and called in the day before to be seen, and on top of that if there is any big emergency coming in, like a road traffic accident, I have to drop everything off and solve that one and then come back to the waiting people. It feels like MASH for most of the time, except there is no Alan Alda around, but a receptionist that is just as hectic as I am, checking people in, answering the phone calls, trying to calm down the nervous people that have been waiting for an hour by now:)

At one the gates close officially, and that leaves me to finish off the rest of the waiting people. It's been 5 hours of non stop talking, so by the end I feel myself not being coherent. I fight that as much as I can:)

So typically around 2 the appointments finish. It's the time to go back in the main hospital area, and start doing all the animals that need further attention...x-rays, blood work, etc. They are either in-patients or patients that i have saved for later during the morning appointments.

In the same time, I am officially on-call after one, so I have to keep handy the on-call phone and make sure I answer it.

A good Saturday will not involve major surgery...but you never know.

Typically around 4 I finish everything...and I can start the afternoon rounds. Again the files, notes, the evening meds...

And so, around 5.30-6 pm a optimistic vet gets into the car to drive off at home into the sunset...which does not mean I will not have to come back within 3 minutes, (remember I am still on call? anything can happen. anything!), 2 hours, 5 hours, middle of the night....

or hopefully only the next morning when I have to turn the phone in....and I am off the hook!

By then, however, I am totally drained of energy, but I still can't help to enjoy my Sunday in the Caribbean. I love my diving on Sunday mornings, and the quiet underworld where there are no phones or emergencies:)

Vet Saturdays ...

I don't think many people out there have the 'privilege' to enjoy Saturday afternoons at work from time to time.. but there you go, for us, the vets, that's part of life... Not the nicest, though! So this is why I'm posting on the blog at 4.30pm on a sunnny Saturday, because I'm actually in the practice where I work, unlike the happy British people roaming around and feeling hot with these unbelievable 18 degrees that have come as a surprise after a 'summer' with mean temperatures of 15 degrees. And there you go, the phone rings... I'll leave you all until tomorrow, cause it will be Sunday, won't it? - and of course I'm working until 6pm... ghrrrr... :))

Sziget fest 2008

10-18 Aug, a week of fun!
If you're looking for a holiday to relax and rest, than surely Sziget festival is not the place to go! The festival takes place on an island on the Danube and this year reached it's maximum number of visitors, more than 385 000 peoples, most of them Hungarians and French.

The usual Sziget fest day starts with drinking your coffee as you stand in line for showers, which takes about 20 minutes of standing in the hot hot sun. The water should be hot but the boilers are no match for the huge filthy croud.
:))


Then u can visit Budapest, or go to the supermarket to buy food, or stay on the island where there are many things to experience, like drawing, making your own earings or clothing from recycled materials, body painting, bunjee jumping, climbing, visit the luminarium or different exhibitions, shopping and so on.



Starting 3:00 p.m. there are live performances to go to, on more than 10 different stages, so there's plenty to choose from and no way to see everything you'd like. Among others, we saw Alanis Morisette, Goran Bregovic and REM. After 00:30, the best party is at Roma tent, where everybody's dancing like crazy on Gipsy rhythms, performed mostly by East European Bands.

After that, you can either dance all night (you've got many discotheques to choose from) or go to sleep..


..home sweet home!
To conclude, I definitely recommend it to all party lovers out there ;)

Post hurricane

From the category "all is well when ends well" so was hurricane Gustav, at least as the Cayman Islands are concerned. Everybody was super prepared, and all activity has ceased during the storm. Winds of up to 70 km/h, some rain, water level rising quite a lot, but in the end, all finished without consequence and the sun is out again. And so are the usual invited visitors, like this huuuge male crab from the above picture.

Pre-Gustav...the preparations

The dreaded hurricane watch flags are out.....

Everybody is in the midst of preparations, especially making sure windows are protected....


Until all of the houses end up looking like that...

Some people have taken and left their cars to the very few higher ground places on the island...

Even small planes make no exception....


And now we are all waiting for the storm!

Meet Molly the beige female, a Humane Society dog that I am currently fostering and the unknown choc lab mix, a 3 legged from the neighborhood that is currently sleeping more often then not in front of my house. And we are all in for the hurricane:)

Gustav...the perfect storm?

It started on Tuesday. At work. One of the computers was opened with a satellite image of a storm over Haiti. "What is that, a hurricane, haha" I said, passing by. "Maybe", my boss said quite seriously. "well now... what's it called? Gustav?"

I didn't understand nor took it too seriously. Yes, the hurricane season was opened on 1st of June. Yes, 4 years ago there was Ivan. Al thou the island has been 100% rebuilt after the 2004 grade 5 hurricane, I have seen plenty of pictures, on books and private collections. What force is enough to bring a huge fridge from inside a normal, big villa and smack it in 2 in the middle of the yard, 100 m away? What takes a jeep and brings it in the middle of the pool?

Well... still these stories seemed far away. Not this year, it is one in 200 years of that magnitude. I still hope that. But, as Gustav kept bouncing back and forth from tropical storm to hurricane status, and slowly progressing towards us, the good inhabitants of Cayman Islands became prepared.

It is very unusual for an European that has not experienced anything like this before.
All the houses seem to have their eyes closed. With hurricane shutters, or for the cheaper versions, with pieces of wood hammered across. Everybody got dozens of cans and water and candles. Some cars, and even 2 small plains, have been safely parked across the few, rare, higher places of the island. Everything is shutting.

Even us...the hospital is empty. The 4 full time residents have been fostered. Not far away, the Humane Society shelter is also trying hard to evict the animals. I have one of them, a big dog called Molly. We're only doing very big emergencies for the days to come.

It's right now across Jamaica, moving slowly (which is bad) and has been quite unpredictable. One can only meditate thou on the modern technology available...100 years ago such hurricanes were deadly and unexpected.

I...am quiet. Took the dogs to the beach tonight, watched a fantastic sunset. The quiet before the storm. Nothing announced Gustav's closeness...

And yet, as I was safely tucked in tonight in front of the computer, all of a sudden, the more then normal winds have turned into very serious winds. More then I remember them in a terrible night on the ridge of Fagaras (that is my personal worse). And a rush of rain, beyond any torential rain I have experienced before.

And it is still in Jamaica, and these small storms are only the messengers....
Brrrr.... Keeping you posted provided the net doesn't break down, which it will eventually together with the water and electricity, which will be shut down even just for safety measures.

It is still 18 hours away...

One of my nights

We are a 4 vet practice, and we kept considering what would be the best routine to split the on call nights amongst us. Our practice does after hour emergency service, and there is a lovely phone that we have to keep close to us in those nights when we are on call and answer it regardless of time. Originally we had a week each one of us, and for the whole week we would have the phone, on turns. Coming out fully drained out of the week on call (and somehow before you knew it...it was your turn again:) we decided to switch the strategy and just keep the phone one night at a time. Thus, 1 night in 4, I am on call.

Currently, due to holiday/ hurricane season, most people are away from the island and there is a certain feeling of relaxation, especially when it comes to the dreaded on call nights.

I was almost certain it was going to be one of those quiet Friday nights, when all else that remained on the island are out having a good time, and every animal soul will be safe and sound in their homes.

How wrong I was:) It started at 7 pm. Wife has got a parrot, husband gets bitten in the face by the parrot. Husband throws the parrot on the floor, parrot stunned, not moving, panic, why did you throw the parrot?!, aaargh, and that's when they called me.
We arranged a clinic meeting, half an hour later. By then the parrot had recovered uneventfully with all limbs intact, a pain killer for his contusions and off they went. Wife was happy, husband will probably not touch the parrot ever again.

At home, in bed, midnight. Dozing off happily, when the phone rings. Cat, attacked by dogs, just barely was found in the yard, unable to move hind legs. Panting, shocky, the whole picture. Again meeting at the clinic, thankfully i never fell asleep driving over. Exam, IV, fluids, steroids, antibiotics, XRays, temporary closure with surgical staples of the few superficial wounds.

2 hours and a half later, back in bed. This time, I think to myself contently, the night is nearly over, what can go wrong now, time to doze off.

Wrong;) 4 am, a seizuring dog and his worried owner were calling. Luckily, I may say, this is a dog known to have seizures for years, and all the meds don't seem to do much for him, they last a couple of minutes every time and he recovers uneventfully (so far, at least). Knowing the whole history, we postponed till the next morning, bright and early.

This time, I really adored the 1 in 4 nights on call. Another consecutive night like that....

What I saw lately...

Almost a month ran by, and no posts;) I hope y'all are holiday-ing somewhere keeping you away from computers. I don't have this excuse even... anyway, for your viewing pleasure, 2 interesting things I came across lately....

...this is a fun-to-watch 10 min short movie put together by a vet student from over here, it is an intro to mast cell tumors, http://www.youtube.com/watch?v=ZJuJQ3VCXlE . I liked it. Came in on good terrain, as I just referred a grade II mast cell tumor case post-surgical removal.

...second thing, far longer, about an hour and a half, http://www.youtube.com/watch?v=ji5_MqicxSo , takes you onto the last lecture of a reputed american professor, that knowing he is about to die, puts together a very inspiring and optimist last lecture, going back to life's essentials. Inspired me as well to go back to a childhood dream, so I have decided to start again serious riding lessons. There are venues on the island for it now, and for once I can afford it;) The question will be now... will I find time?

...and third of all...to all of you that know me...this is what my climbing gear is doing lately...actually apart from one climbing trip, this is the sole task of my quickdraws nowadays. No comment. They are solid thou:)

And that last picture... is my unreliable dock buddy. I keep a fair distance, but he's harmless. There is a snake around thou...brrrr....

Goodbye and Hello!

Uhmm.. I didn't say, did I... why vet? As with all important great things in my life... it just happened! Of course, I always loved animals and wanted to have a little dog or kitty (or horse, lizard, panther, giraffe and many others), but becoming a vet never crossed my mind until 12th grade. And there I was, 12th grade, April or so - when all my colleagues had been preparing for a long time already for admission exams to university - refusing to take a decision that would affect the rest of my life. Then, because my mother insisted repeatedly, I bought the brochure with all Universities and I started cutting one by one all I thought I'd hate. I was left with architecture and vets, and architecture required good maths marks during high school (my average was around 5!)... so here I am!

I remember as if it were yesterday how it felt, the first day at the University, when right after the opening festivity I had to rush to get to the Histology lab; I didn't want to be late (as I was almost every day back in college years ;)) and as I was trying to find my way to the building situated in the opposite corner of the yard, I was thinking it seemed enormous and labyrinthic...

I also remember clearly how was the first lab exam (colocviu?) - anatomy - the bones! with Georgescu; a whole week of studying like crazy, determined not to miss a single exam and to be a model student... off course I failed! Almost all of us did.. that was the first from a long stream of deceptions.

Then better days followed, I started getting used to it, understand how it goes and what needs to be done to be all right.. but still I remember I couldn't wait for it to be over and done with, finish the faculty and escape from that sickening environment.

And then, in the very last day, right after the presentation of my work license, i was overwhelmed with a bunch of contradictory, surprising feelings: some sorrow that I didn't study more, that I didn't take advantage of all opportunities, that in my rush to finish faculty I didn't stop to enjoy it more, like I should have.. but also gratitude to my parents who supported me and kept me going so many years (..another 7!), and a huge gratitude for the Pathological Anatomy team of teachers, who helped and supported their students in a way I think no other teacher did (and a special big THANK YOU for Teo Soare who was absolutely great all the way!).




So I guess I bored you enough with this sentimental stuff, but I just felt I gotta let it all out so I can say GOOD BYE COLLEGE YEARS! and HELLO to what I hope will be an exciting great VET LIFE!
I'll get back to you soon with a brief from Great Little Britain,
Miss you all out there very much!
Irina

Memories

Ioana's loss brought back memories. And they were not great memories.

Memories from University. The famous Uni from Bucharest, where our horse vet chief surgeon, still preached about the benefits of firing horse tendons, when the rest of Europe had already banished it by law and classified it as animal cruelty.

The time when we were sneaking in as students trying to give a very dehydrated horse, lodged in the large animal hospital, more then the prescribed 1 L of IV fluids. One whole litre!!!

I could dig back dozens of such memories. I could also dig back the endless amount of unnecessary information, from the 60's if not sooner, that we had to memorize as students.

I could remember the times when I watched in amazement how, in the small animal clinic surgery, the reputed ortho surgeon repairs a fracture without gloves. "I can't feel the structures just the same with gloves" was the running excuse. Hello??? This is not like wearing a condom, optional! Performing surgical acts with sterile gloves on is mandatory nowadays!

Or speaking on his mobile during surgery, closes the phone and then goes back into surgery. For the next surgery, the same instruments were sprayed with alchool a few times, and reused again without blinking. And all these in the main teaching institution, that should set a good example to everybody else.

I used to feel guilty for not spending time in the university's clinics and see "practice". Another "rebel" vet colleague, who is probably abroad as well now, told me once "I don't want to hang around, just in case I get some bad habits". Too right!

Still, while a student, I never really comprehend the full extend of the lack of professionalism and diagnostic errors that occur in veterinary practice in Romania. I had a vague idea, thinking that even for the most reputed clinician, lacking lab tests, X-rays, cages to keep animals hospitalized, etc., life would be pretty impossible.

And then I finally graduated, and found an opportunity to work abroad in a vet practice abroad. It was in Cyprus, the influence was very British in the practice...and that's when everything started for me personally; it wasn't anything by any stretch of imagination extraordinary, just a regular small animal practice at European standards. I learned in the first year there more about small animal practice then in the whole years spent in the university. It wasn't easy, but before every new surgery I would see the next day, I got books at home and red in advance. And by books, I mean updated, large, reputed small animal textbooks,....not the leaflet i received in university as my small animal surgery book.

After a year and a half spent abroad, I decided to return and practice in Romania. That's when it hit me, the huge gap between what could be and what really is happening.

I watched my colleagues doing surgeries on half awake animals (full deep anesthesia is very dangerous). I watched everybody taking surgical instruments off the shelf, rinsing them in alcohol, if that much, and getting to surgery. I watched very simple and basic ideas of surgery being slayed, just as plain skin closure techniques, that in view of most Romanian vets, need to be done with the thickest suture available and as tight as possible "to hold well".

I also saw the other side, of being employed in a small animal practice and getting a salary of 400$ monthly...and sometimes not getting that at all.

I saw, in 2007!, 2 great value products being used on animals...tarantula venom that is meant to help in localising the abscesses, and moth ball powder sticked onto fresh wounds to keep parasites away. I saw many medieval concepts. I also saw it's a battle to change the old ways, and certainly, should I ever feel like changing the ways and opening a practice in Romania, it would have to be either on my own, or together with some other open minded other vets with some years of experience of practising abroad.

Because a sad reality is...Ioana speaks about referring the cases. Well, my sad Romanian conclusion is ...apart from 2 places I could think of where I would refer my animal in Romania, (and both of them away from Bucharest), all else is silence. One is a vet that moved out from Israel, and has a practice in Arad. The other one is our very own Ricky, that despite just having started the practice 6 months ago, is growing it into a nicely equipped practice, and compensates with his solid theory knowledge all else. They both lack something essential thou...a serious Romanian lab for accurate hormone dosing, biopsies, cultures. I mean, seriously. Where would you sent a thyroid panel in Romania?? And mostly, how many Romanian vets would see the necessity of the exam?

Anyway, sad but true, the romanian reality in vet medicine is very sad. I think there are some very big hearted people out there. But the lack of proper training, the "books are written from books" concept and the complete lack of basic equipment leads to some serious errors.... and I hardly see things changing anytime soon.

From the other end of Europe, which happens to be an island :)

It wasn't my graduation ceremony, but to me it was as important as mine... This moment seemed so far away 4 years ago when I met Irina while cleaning the stables of our rescued gipsy horses from the Uni. This moment seemed even further away 5 years ago, when I asked Ovidiu to help me clean up the poo of new-born mutts in a dog shelter. And here they are... They are no longer 'the kids'... They are finallyyyy, laaadiiies and gentlemeeeen, VETS!!!!


And straight after graduation Irina found the time to come and see me in old Britain before she starts the hard vetting life. Here we are :)



Nine days have flown by and now we have a few more things to remember when we'll be pensioneers :p Like...some long walks on the canal in the green county of Surrey, consulting on Saturday morning in a small brit veterinary surgery and clubbing in London on Saturday night near Picadilly Circus. And of course, the one morning that we spent together at the surgery where I regularly work, that was meant to be just the beginning of a whole week of work experience for Irina. This was brutally interrupted by a manager much too worried about 'insurance issues' and very determined to keep Irina away from any British animal or owner. After one afternoon of typical Romanian anger I reminded myself Dr Jeff Young's favourite saying, 'All British people are pussies!' and I reached the conclusion it was their loss anyway. Therefore, I went on by myself with our endless consults for bunnies and other little creatures and I encouraged Irina to explore London by herself. Which she did and which she'll tell you about very soon...

FOR ALL THE VET WANNABES OUT THERE!!

OK, so I have 2 things to write about, and I have no idea why the hell I am writing now, a bit more than 24 hours away from my private pilot exam, with about 1000 pg left to review. BUT I am in the same time excited and pissed off.

The single good thing that happened to me lately is that today I was accepted to the EAZWV Summer School. Ovidiu too. Of course the rest of the students accepted are either German, Swiss, or anyway German speaking. The courses will be in Germany. So more German…joy… not that is bad…I just wanted to hear some English for a change. Or French…French would be nice too.

Now for the pissed off part. I don’t know if I should write this in English or in Romanian, so that all the “language impaired” Romanian vets could read this.

My dog died last Sunday (Dona, for the ones who knew her), and it was mostly because of poor (or totally inexistent) medical training or professionalism. Partly because the owners (me included) reacted waaaaay to slow to the symptoms.

To make a long story short: at one moment or another (I was in Vienna and my parents couldn’t tell me exactly when) Dona started to show a mild apathy (my parents thought is was because of the heat). It continued to develop into moderate apathy and inapetence (?!nu stiu daca exista cuvantu in engleza), up to a point, after about 2 weeks or so, when the situation aggravated. I urged my parents to take her to a vet (suggesting to go to the faculty).

Well, they finally took her to a so called vet, recommended to them by an aunt. I have no idea what kind of clinical exam that vet performed, but the diagnosis was warm infestation and treatment was of course antihelmintics (don’t know which one…). Apparently, after that Dona eliminated some parasites (again, don’t know which kind or how many).

However, after a few more days, Dona’s state was getting worse. She stopped eating. No defecation, no drinking, no nothing. My mom tried to force feed her, but Dona vomited on the spot all that was given to her.

So they tried their luck to a second vet. This one had a more elaborate diagnosis: chronic bronchopneumonia. Injected her with some fluids and drugs (couldn't find out what they were)., and sent my folks home with the following treatment (please sit down while you read): PROPOLIS TINCTURE!!!! That was all...

Guess what... a few days passed and the dog got worse and worse. My folks went to the countryside, took Dona with them, and found a third vet in Ramnicu Valcea. The vet they found was a very well intentioned nice man, but his knowledge was a big zero. He is a 3^rd age formerly cattle vet, recently reoriented on small animals. He spent 4 hours examining her, searching and trying to understand what is wrong with her. But how?! Using med books dating back from the 60’s?! Reading on the medicine packages?! With only a stethoscope and a thermometer?! He dismissed from the start the possibility of doing some blood work, stating that he doesn’t trust blood analysis in animals (!!!!) He refused to place an IV line, allegedly because Dona had a heart problem and he was afraid that he would stress the heart even more, and the veins were too small anyway!! What he actually heard was the stress tachycardia she always had at the vet. But she was too weakened to react; she couldn’t even raise her head. So he injected her according to my father 8 times, out of which 2x20ml IM!! The treatment was purely symptomatic, and that is I think what kept her alive a few more hours till I arrived.

When I found out about this odyssey I literally rushed the 1100 km back to Romania (thank you, Adrian!), 2 days before schedule, and found her in a heart breaking state. I took her to Bucharest, and because it was Sunday, and there was nobody at the vet school (at it was 6 a.m. anyway), I took her home, made a quick exam (she was subfebrile, bradicardic, weak arrhythmic pulse, pale-slight cyanotic mucosa, severely dehydrated and some neurological symptoms: late pain reaction in her extremities, no support reflex in either feet). She still had some strength in her left and she wagged her tail. I placed 2 catheters (call me paranoid, but I learned that when shock is suspected or anticipated both fore feet should be catheterized). I had only some 5% glucose left in the house, until I went to the pharmacy to buy a whole list of drugs.

I asked myself what may have caused this all? I reached absolutely no conclusion. Heart was of course weakened, but still ok, lungs were indeed mittelgradig verschärft vesiculär (raluri umede moderate?!-> edema?), but all the symptoms were consistent with her not having eaten for 3 weeks. And the neuro symptoms? She had 5 kg instead of 7-8kg. What the hell caused that in the first place?! Poisoning? A chronic condition? Both??! She was actually developing signs of shock. So I came up with a treatment plan for the next day until I could get her to a real doctor. This involved all sorts of IV fluids (from ringer and glucose to dextran and HES. Ovidiu helped me with the doses and combinations. I even started considering finding a blood donor dog) + electrolytes and vitamins; ranitidine; minimum dose of furosemid or spironolactone and even a urinal catheter, because she had no urine output in days & renal function must have been a mess; I also wanted to use a human urinal catheter as a naso-gastric tube, for artificial feeding. This was the “support” part of the treatment. On VIN I found that in the case of septic patients is safest to use a combination Ampicillin+2^nd/3^rd generation cephalosporine (they’re plenty for human use). I found cefoxitine. As for an antiinflamatory I couldn’t find anything injectable at the pharmacies around me. I started making a quick check up with a chart with vital parameters every hour. I tried my best to make out of my bedroom an improvised ICU. I know, basic treatment. Nothing fancy. I didn't want to risk making any more damage. But is guess it should have been enough for one day, until we had access to some blood/urine tests, ultrasound or eventually Rx, to find out more and set a diagnostic…

After 1.5h on the glucose she seemed to be a bit more energetic (but it can be of course my sick mind after 30h of not sleeping trying to convince itself that Dona was going to live). After I returned from the pharmacy ready to start with the aforementioned treatment, she became more and more agitated. She developed abdominal spasms and eliminated a dark reddish-brown, viscous paste (fecals, blood, intestinal mucosa?...), with a putrid smell, and in great quantities for such a small dog. She relaxed immediately. For one more hour she just stood still, probably tired from the spasms. But she started having them again, this time not eliminating anything, and she died in my arms, without being able to do anything.

So, for all the Romanian vet wannabes out there: YOU ARE NOT DOING MEDICINE!! YOU JUST ARE PLAYING DOCTOR! BADLY!!

The lack of knowledge is unacceptable, and nobody should blame that on the lack of money, the fucked up university, the lack of equipment, or the stars in the sky. Good books actually DO exist, information IS really there, if you can spare some time to find it and learn it. Lives can actually be saved, and you don’t need some fancy equipment to make an assessment. And when you’re over your head, don’t send the owner home with some pills and pray that everything will be all right. REFER! There are other doctors who know what they are doing!! And YES! Modern medical technologies REALLY DO EXIST FOR ANIMALS TOO!! Nobody will ask a neighborhood vet to perform a phacoemulsification or a TPLO, but taking a shitty blood sample won’t kill you! Might kill the patient if you don’t!

I am so sorry there is no malpraxis law in Romania…

PS I know, I made a long story even longer.

[in work]

Costa Rica report

It’s a small country with treacherous, narrow roads, and with lovely people that don’t care much for road signs, but that will guide you gladly, in Spanish, to wherever you want to go. About 20% of the country surface is a national park, and rightfully so, as they host many microclimates, and rare species of plants and animals. Everything is hilly and abundantly green. There isn’t a single tree that is a separate entity, but rather a tree supporting a vast number of other epiphytes that cover a lot of it’s trunk. There are orchids, butterflies, monkeys and lots of birds. (I was expecting to see macaws flying like sparrows. I was wrong there….there are lots of them in the wild but not as abundant.)





It’s a very tourist friendly country, with lots of nice and reasonably priced accommodations.
Stranded between 2 oceans, there are lots of beaches. We weren’t very bothered with them. There are lots of beaches in the Caymans. Instead, I was keen to see the whole rest. The volcanoes for instance…they host Arenal volcano, that at about 1600 m high is the 3rd most active volcano in the world. The smoke that you notice around the peak it’s actually smoke coming from the crater.

Another feature of the volcano are the Tabacon thermal springs, which is a luxurious resort that combines the green of the jungle and the hot thermal water into a natural spa. Walking at night in the discreet lightened jungle park mix with lots of waterfalls and natural Jacuzzis while a misty rain was falling was an experience of a lifetime.

Talking about weather, the country is very close to the Ecuador, in july they are in full rainy season and there were a few hours of warm rain every day. It was dark at 6 pm every day, which made the starting hours very bright and early….also because there were so many things to see and time was, alas, far too limited.

The rain forest is an experience in itself, tall and dark, abundant, green and noisy. They came up with 2 eco friendly experiences for a better observation of the forest, and they are called canopy tours. One kind are a sort of suspended, fixed series of bridges, hanging at about 40-50 m at the forest level, which gives one the chance to see the tree tops, and the upper levels of the forest. The other sort is a zip line, and with a harness and a trolley, one makes his way around the forest from one platform to the other, in a Tarzan style. The zip lines can be stunningly long; I went across one of about 500 m, crossing an entire valley. It was the closest I ever got to flying, and it was pretty magical.
Normal hikes are also a must in the forests, but likely they have pretty organized trails in the forest,…that also makes eventual snake spotting very easy. I never saw one but in a snake garden, but it was good for my paranoia.

The cherry on the cake was the last hotel, for the last night, only a few km away from the aiport (we figured, rightly so, that it’s best to be as close as possible to the airport in a country where the Panamerican highway, road number 1, is a strip of asphalt with two lanes and no markings and the incidental pothole…not that I complain, knowing our own national Romanian roads, but..). So, the last hotel was reproducing a 17th century multi columns hacienda, with an inner patio and overlooking a coffee plantation.





All a bit too rushed, a bit condensed, but what memories, looking back! Back to work, back to the sick animal kingdom, and dreaming of future holidays. Nevertheless, Costa Rica does come highly recommended and I can only hope future roads will take me there again, as there are still many things to explore….

Life's surprises

It was a very busy practice with 4 vets on duty. Then one of us takes a 3 week holiday break. Just days after, another vet, which also happends to be a very nice boss, is taken to intensive care due to a lung clot. So now we are 2, and the days (and evenings on call) have suddently became longer, and 3 weekends in a row spent at work will become history.
I'll make it thou...but it won't be easy:)
On a positive note thou, a brief of latest events:
1) i did my first bladder-urethral-tomy in a female dog. there were lots of small stones and grit in the the bladder of a 15 year old dog. After the cystotomy i still couldn't pass the catheter and so i decided to cut up the urethra as well, about 3 cm away from the origin. good decision, the urethral walls were impregnated with loads of grit. ah, the feeling when i finally passed the catheter and left an indwelling patent urinary catheter.... the dog is ancient, but holding on strong really well. it's been 2 days already. she even ate today. still waiting for the report on the stone analysis. she has had them 2 years ago, had been on a urinary diet...interesting.
2) i have a week to go till my third overall but first large canine FHO. i don't look forward.... but we have to get it done.
3) finally acquired my first SLR camera YES!, a brand spanking new EOS 450D. still saving up for a lens, so for the time being the body-only stays quiet in one corner of my room.
4) and finally, as one dear friend would say, "we can live from holiday to holiday". I have a small one coming my way, in about 3 weeks, a few days spent in Costa Rica. It's quite close to this corner of the world, and my new camera will have volcanoes, rain forests and loads of other great stuff to shoot.
Thou I must confess I am already freaking out at the prospect of the many snakes any decent rain forest shelters:)))
I am off to sleep now... zzzzz

Talking about wild life...

One sits quietly at home, and... does mundane things, such as for instance, writing emails... all of a sudden, quite an ordinary thing for Cayman standards happens. Not for the Romanian in me!!

A massive iguana crawls quietly in the sunshine, onto the front deck, about 30 meters from where i sit quietly onto the couch, writing my stuff. They are pretty much everywhere, and I am sure by now one as let's say Ovidu, would have 3 pet iguanas around...well, not me:) I respect them, and I am happy to see them in their environment, but i do like to keep my distance. We do get them in the clinic at times thou, with road injuries, or attacked by dogs, but mainly they thrive well, and actually have completely managed to push aside the indigenous species, the blue iguana, that is currently on the brim of extinction.

There is a breeding programme for the blue iguanas, but sadly an ugly incident has shaken the caymanian community recently, as somebody broke in and killed a few of the main breeders one night. They did not yet identified the guilty party, but at least it has raised the awareness onto the blue iguanas ... and here it is, the famous one, only to be found here...























Living on a small island, there is so much one can do inland...but there is plenty o life in the waters around. This is a view from the famous Stingray City, a place where loads of stingrays of all sizes gather up, in very shallow waters, and currently wait for tourists to bring them some delicious squid.
Traditionally it started as a place where fisherman came to clean out their fish, and stingrays quickly learned they can have the rests.

Nowadays, one can come and move about surrounded by 30 some friendly stingrays,....keep those thumbs down thou if squid is to be offered:)