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:)