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]