10 September 2009

Belabored

*Gore alert: Bloody pics below!*

After spending the midweek getting through what may or may not have been the piggy flu (still haven't heard test results), I thought I was ready to head back to work on Saturday. I was still a little on the weak side, but I had slept, I was rested...

...I was so very wrong.

In general, our two busiest weekends of the year are Memorial Day weekend and Labor Day weekend - the two bookends of tourist season here in Vacationland. I also worked Memorial Day weekend, and it was pretty manageable. The rains were starting, people were nervous about spending money, and while we were reasonably busy, we were spared too much hell. Not so for Labor Day weekend, though.

The weekend came after a week or so of gorgeous weather with the beginnings of dry, autumnal air, so the hordes descended like we hadn't seen for at least a couple of years. And at the clinic it really, really showed. In the course of my nominal 15 hour shift, I saw 24 cases, which exceeds the Upper Limit of Manageability (ULM) by quite a few. In fact, the overage could have made for a moderate night in itself.

The end result was that my so-called 15 hour shift lasted for 21 hours. And by the time I collapsed in the overnight room and managed enough of a sleep that I could drive home without being a menace to others, I had been at the clinic for about 28 hours. I got home about 30 hours after I'd left, then got up the next day to do it again.

Thankfully, Labor Day itself squeaked in right about at the ULM. Truly, the most beautiful sight of the day for me was driving up the Turnpike to work and seeing tens of thousands of vehicles heading south. Traffic was literally at a crawl or a standstill all the way up to the 20 mile marker, and they were all leaving for the season. Had I not been driving, I'd have danced a little happy dance to celebrate.

Of course, not all my cases were happy ones. One of the first ones I admitted Monday night was an old brittany spaniel who turned out to have a bleeding mass on her spleen. About 80% of these masses are malignant hemangiosarcomas, which I understand are fairly rare in humans but are very common in dogs. Survival times for these are incrementally better with surgery and chemotherapy, but the bottom line is that about 95% of cases are dead within a year, even with aggressive chemo. In a nutshell, double plus ungood.

Still, the owner wasn't quite ready to say goodbye and opted to proceed with a transfusion and surgery. I was able to pick up the bleeding mass readily on ultrasound, but I was reluctant to put the dog into potentially stressful positions because of the hemorrhage and shock and had missed a couple of other masses in the spleen. Note the fist-sized clot I took out of her abdomen.

090809Hemangiosarcoma 001

I had also not been able to get good views of her liver and had not seen one large mass taking up most of the quadrate lobe, which is essentially a time bomb waiting to blow. I called the owners during surgery just to make sure it wasn't going to change their decision, and it didn't. I also could feel at least two other nodules in the liver that weren't readily visible at the surface. And this is the blood I suctioned out of her abdomen.

090809Hemangiosarcoma 002

That's like a pint and a quarter. If it were Ben & Jerry's, you'd gain about a pound eating it, though I'm not sure it's a flavor that'd sell. It's also more blood than I transfused into her, but it's clear that without the transfusion first she would not likely have survived surgery. As it was, she did relatively well and went home the following afternoon, albeit on borrowed time.

In Cheerier News...

I finally got the chicken coop up on pressure-treated stilts today. And for extra butch points, I did it all by myself. Well, Tuck supervised, but I provided all the muscle. Despite my efforts at engineering the coop to be relatively light, it's quite a heavy and bulky beast. But by cleverly using braces and leverage I was able to get the stilts on one side firmly screwed in place, then jack the other side up with my shoulder and a brace board to get the stilts on the other side. I didn't even strain my back doing it, either.

I also got a double layer of predator-deterring chicken wire laid across the top with a layer of mylar-coated bubble wrap insulation sandwiched in between, plus a layer of chicken wire on the underside for more predator deterrance. Tomorrow will hopefully be spent on getting the corrugated metal roofing on and getting a ramp/hatch in place so they can enter and exit from underneath.

The plan is to enclose the area underneath to they've got a protected area where they can hang out in inclement weather. Aside from that, there are also little details to attend to - latches, window and windowsill, wheels, some sort of system to hold window and doors open, etc., but it looks as though I may actually have it ready for them before really cold weather sets in.

5 comments:

Yarndude said...

Wow, what a sad story. Brittanys are one of my favorite dogs.

That's exciting about the chickens though!

Emily (owner of cats) said...

Holy Moley. Wow. That was some operation. I'm glad the dog survived & went home. Wow.

Kenny said...

I LOVE BLOOD AND GORE!!!! I see you changed your template. I really like it.

TheBunny said...

Poor Brittany! She must have felt crappy with all that going on!

Did you write down the patterns for the cute sweaters you knit for Tuck? A friend at work just got a little French Bulldog who simply MUST have a cutie-sweater from me.

tornwordo said...

I love the blood and gore too. Pics of the coop please. Glad you're feeling better.