Monday, January 12, 2009

Juggling Puppies

[Author's note: this is a story about something that happened a few years ago - as you will no doubt surmise from the May Day reference - but I thought it was too good not to re-tell.]

So, I don't know what it is lately with me on call, but the last 3 times I've had the pager I've had to go in at 3 A.M. every time. This time it was for a very sweet hit-by-4-wheeler pit bull mix (whose owners probably won't have the funds for repair of her two fractured femurs, unfortunately). The owners were out camping on Jim Creek when she was injured - running loose, naturally - and the poor thing dragged herself and her two broken back legs back to the camp site. The man (an extremely handsome Native guy) seems to be the thinker of the pair; his girlfriend was not only reeking of alcohol but was sloppily tearful and faintly belligerent by turns, not to mention that she also appeared to have spent HER camping trip rubbing dirt on her face and clothing. (Okay, in fairness, due to genetics, the guy's skin color - a gorgeous smooth coppery brown - might've disguised some dirt, if he'd had any, while the girl was almost white-blond and pale, a perfect canvas for besmirchment - but he sort of looked like he'd just stepped out of his apartment, neatly dressed, pressed and clean. Maybe it helped that HE wasn't the one who was three sheets to the wind.)

At any rate, I did my best for them, but the upshot was that I was pretty tired come Saturday morning (between that and other emergencies I got maybe two hours of sleep that night - second time this week, so it had unexpected impact). I went in early to take thorns out of the eye of a darling little King Charles mix, which turned quickly into not just doing that, but also taking porcupine quills out of a large and gentle-tempered Akita mix, euthanizing a 19-year old cat and doing a vaccine appointment all before 9 a.m. (when I officially begin work on a Saturday). It sort of took off from there - an exceptionally busy day, with no time to regroup and several dicey medicine cases to frazzle my badly-frayed reasoning skills. By the time 1:00 rolled around I was in a weird sort of daze - slightly removed from my body, nauseated from fatigue and hunger (no time for breakfast OR lunch), and inclined to slow, rolling dizzy spells. It was a little like being tipsy; but that afternoon I kept sort of coming back to myself to find that I was talking to clients with no awareness of what I had said for the last 10 minutes. I could remember doing my physical exam and I'd "come to" hearing myself give correct advice on home care, but I could not remember anything in between. Very disconcerting; makes you hope sincerely that you've confined your comments strictly to the medical.

At any rate, all this combined to make me VERY glad that the owners of the 93# American bulldog didn't have the money for the C-section she so clearly needed. I felt bad for the dog, of course, especially as she had waited over an hour for me to see her (as did every other walk-in we had that day); but I would have been deeply questionable as a surgeon by that time. In addition I had an obstructed tomcat to catheterise, and 3 clients to call back about blood work. So, when we finally closed the doors I was relieved (for her sake and mine) that the beluga-esque form of the bulldog bitch had evidently travelled on to another vet, perhaps the one the owner's mother patronised, who might cut them some slack on billing or holding checks for the sake of the mother's patronage. We had never seen any of them before that very day, and the clinic's policy forbids expensive procedures for non-clients without a deposit of some kind.

I no sooner finished my call-backs when the answering service called to chirpily inform me that the bulldog's owners had borrowed the money for the C-section. Fortunately Dr. J had the pager for the rest of the weekend, so I suggested they call him. I called him a few minutes later to round him about my in-hospitals, and (to my mute astonishment) I hear my voice going: "Would you like me to stay to help you with that C-section?" Dr. J hesitates, but says, "Well, it would be nice if you could, but you don't have to." Well, I'm hardly going to turn down THAT invitation. Not only is he my boss (which means this is a chance to please the guy who signs my paychecks) but that's his way of telling me he'd prefer my skills to those of the on-call tech (flattery will get you everywhere).

Which is how I found myself prepping the bulging dome of this bulldog's abdomen 20 minutes later. The owners were banished to the front but told to stick around in case we needed hands. I prepared baskets with heating pads in the bottoms and a pile of towels, as well as syringes of dopram (to stimulate breathing) and dextrose (since the two commonest causes of neonatal death are hypoglycemia ans hypothermia), while Dr. J made a long incision in the abdomen and exteriorised the biggest uterus either of us has ever seen (well, on a dog, that is.) I am standing by with my towel-draped hands held out like an acolyte about the receive manna from the high priest, while Dr. J opens the uterus.

"Here's two," he says. "No, three." He deposits three slippery bloody water balloons into my outstretched towel, each containing a very large puppy - all of which are moving, I see, as I rush them to the heating pads and start tearing the tough slippery double membranes off them. Amniotic fluid is gushing everywhere, and Dr. J keeps coming in with another pup, and another, piling them into the overflowing baskets and onto the towels. I'm thinking I should have gotten out more towels. I'm ripping gestational sacs as fast as I can (not as easy as it sounds), and trying to keep everyone's mouth above the placentas and the rising tide of fluids. Only when he pauses to exteriorise the other limb of the uterus do I have time to go up front to tell the owners we need hands. They traipse back uncertainly and hesitantly begin to mimic my frantic resuscitory activities (which, due to the mounting puppy count, are sort of like that guy in the circus who keeps all the plates spinning at the same time - except that in my case there's considerably more blood and other assorted body fluids). It is the husband I have to tell three times that he is being too gentle and he needs to STIMULATE these pups; they haven't had the arduous passage through the birth canal to wake them up, and in addition they have had some of their mother's anesthetic across their placentas. His wife and mother-in-law (both of whom have had children) seem to pick up more quickly how much force to use. I thought it was rather dear that he was afraid he would hurt them, and how ginger his handling of them was; but at the same time I was afraid his resuscitatees would die if he wasn't a little firmer with them. But he gradually got the hang.

We are now up to 14 puppies - all alive, and thank God that's the last of them. Dr. J is closing, which means I have to trot back and forth bringing him suture and managing anesthesia, as well as keeping my 4 puppies going. Fortunately the owner didn't wait too long before getting the dog sectioned, so the pups are not severely distressed, and by the time the last one is out, the first one has essayed her first tentative warbling cries. Pretty soon most of them are in good voice, and it sounds like we have Alvin the Chipmunk and 13 of his closest friends all drunk and singing away. The bitch (now about 20# lighter) is covered in blood, and it looks like we slaughtered several chickens in the O.R., but everyone is alive, even the very last pup, who is having a slow start and requires extra help from me.

Dr. J and I carry the somnolent mother out into the treatment area and lay her on a prep table where we can wash the assorted blood and fluids off her. I trade off with Dr. J, who has the instruments and is severing umbilical cords. I wash the blood out of the bitch's white coat. For some reason I have trouble rolling her over. The surge of alertness I had borrowed from my adrenal glands is fading and I am puzzled. After two or three attempts I realize one of her nipples is caught between the bars of the treatment table rack. (Yikes!) Fortunately she is still asleep for the most part. I free her (noting that now there is milk mixed with the blood and fluid in the sink under the rack.) Well, hey, at least she's got good milk production. I proved it. But I am a bit glad no one saw me do it.

Several of the pups are making lusty attempts to crawl over the edge of their baskets and plummet to their deaths (or at least a good splat on the floor), so I rummage around in the back and find a Rubbermaid bucket that a client left us, which might fit all 14 pups and two hot water bottles. After I set it up I have one of those moments of dawning consciousness that have dappled my afternoon and I see just how big a mess we have made. Not only is the O.R. streaked and spattered with blood and smears of green and black from the placentas, but there are trails of gore traipsing back and forth from the O.R. to Treatment, where we did our resuscitations. Both treatment tables are liberally painted in red and green and black, and stripes of blood trail down the sides of both. Heaps of sodden towels are wadded everywhere, slimy with blood and fluids, and gelatinous black and green placentas are scattered amongst them like some malign species of jellyfish. The newly-recovered bitch is now laying sternal on the floor, a pool of dark blood gathered under her tail (and no wonder, poor thing, what with the number of placentation sites she has to involute). I don't even want to think about the state of Jack's shoes, which I have noticed are making squishing noises as he walks. A strange little smile breaks over my face. For some reason I think all this is hilarious. I go get the mop and start in, giggling quietly to myself. (Fortunately everyone else is engrossed in the puppies, trying to decide which ones look most like the father.)

About the time I notice I am starting to bump into things, I decide I might just have enough juice to get home if I leave NOW. I make sure Jack has things under control and weave on out to my truck (don't remember much of the drive home, but there are no new dents on the truck, so it must've gone okay). On my return home I have an invitation to a May Day party at Wildwood Farm on my answering machine, but I am now so tired I want to burst into tears, so I decline and pitch headlong into my bed. I slept like the dead and today I feel somewhat restored, but in the back of my head I have the niggling question: just what DID I say to some of my clients yesterday? (Sigh). Unless it's embarrassing, we'll probably never know.


MaskedMan said...

Holy cow.

That's a LOT o' puppies! The owners are about to discover that breeding is *really* expensive, as immunizations and vet visits for 14 puppies and their dam are about to eat their income. OTOH, fourteen sets of puppy breath, and fourteen sets of puppy kisses, can make up for a lot of angst. ;-) Nicely done, even if dead tired and exhausted.

I've been to that exhaustion place before - Many times, in fact. Every Operational Reactor Safeguards Exam (ORSE) took the entire engineering department of my boats to that place, and it's amazing how well you can functin whilst there, IF you've already internalized the skills.

Holly said...

Dear God, 14 puppies and a C-section! The most I had with my oldest corgi was 7 (and I got to help with the puppies) and for the vet tech that was like a lazy susan! I'm so glad all 14 made it, though the thought of 14 puppies and one bitch is exhausting, I lost 3 of mine. We ended up with 4 nice puppies, which was a good number for a first (and last) time mother to care for and nurse.

When you started to giggle I thought you were going to say that all of the others started too and it turned into a howlfest.

Claire said...

Oh my, it was exhausting just to read about that. I feel like I need a good nap. Thanks for the great story! Makes my office job seem so boring and mundane by comparison. I guess sometimes that's a good thing! But we are expecting a baby goat here on the farm. Hopefully no C-sections necessary.

Jenn said...

14 little miracles! Poor mama dog probably had her paws full of puppy-mischief for a long, long time!

I've been to that stage of exhaustion and it's definitely surreal. Especially when you don't really remember how you got from point A to point B.

Dragon43 said...

I walked into a tree once, in front of a Lt. Colonel. I was an E-4. He took me and put me to bed with a guard who was to make sure I got 14 hours......

My unit thought I went AWOL ...

Your experience was better.....

Anonymous said...

I just got really tired reading this story at work!!!

Do you keep a journal? Or are you really good at remembering what you have done in the past?

AKDD said...

It WAS a lot of puppies. Poor mama.

I'm SO glad it isn't just me that's gone to that "so tired [or concussed] that you enter a fugue state" thing. I feel bad about that sometimes - like I should be able to stave it off, if I only could detect it before it hit. Those are the days when I think "Now, WHY did I decide to do this for a living, again....?" :p

Beth, it's a little of each. Some of these stories are ones I wrote to my sister or BF at one time or another, which I have just copied over here; others are ones that just happened, or ones that I recall but have not yet written about.