‘You’ll get the chance to see everything. When we go to the surgery for consultations, you’ll come with us. I say “we” because I won’t be the only vet you’ll be with. My colleagues will be there too, and the nurses, and it’s important that you should see all the different ways of approaching our work and theirs. So you’ll be there when we operate in the operating theatre. You’ll come to the kennels, to the treatment rooms, to farms and to stables. All I ask of you is to be discreet. You should wear “ordinary” clothes like the ones you’re wearing today, we’ll lend you a lab coat. You’ll be able to touch the animals, but only when we say so: often the cats and dogs are very friendly, but here they’re often frightened too. So they might not react the way you expect them to. If we tell you it’s OK, go ahead: be careful but not fearful. Occasionally I’ll tell you that I’d rather go without you.
‘Some clients aren’t easy to deal with, and with you there it would be even harder. And for instance when we put a cat or dog down, because it’s in too much pain and we can’t treat it, it’s a very difficult time for the owners, and they often want me to be alone with them. But if I can, I’ll try all the same to give you the chance to be there when I put an animal down. You can choose not to, as you can with anything else: I said you had access to everything, but that doesn’t mean you have to do anything. If you don’t want to, that’s no problem.
‘If you’re lucky, you’ll be able to watch a calving, or a caesarean section. There will be births and there will be deaths. There will be sick animals, and there will be animals that come in for vaccinations. You’ll also see us doing a great deal of paperwork. We won’t make you watch us signing cheques or chasing up unpaid bills, but you’ll see that we spend quite a bit of time on these things. Every profession involves a lot of paperwork. We have mountains of it. Being a vet isn’t just about treating animals. I’ll try to make you aware of my role as business manager, and of the financial side of things. And don’t worry: there’ll be litters of puppies to vaccinate too.
‘Any questions?’
*
Usually there aren’t. Not before their work experience, not during it. So I prompt them. I try to do debriefs. Especially after putting an animal down. Yes, this is their first experience of the world of work. But it may also be their first experience of death, and of the pain that goes with it. No one emerges unscathed from witnessing the pain and tears of an adult who is losing their companion. Or from the absurd and brutal suddenness of death.
This is the reality of my job, of my practice. Other vets have different career paths, do different things. Some get up before dawn every day to inspect the carcasses of the animals that we’re going to eat. Some are attached to the military. Some study wild animals and treat them, oversee the health and hygiene arrangements of factory farms, or carry out research in universities or pharmaceutical laboratories.
We’re all vets.
L’Origine
When the man came in carrying his dog in his arms, semi-comatose, we pointed him straight away to the first treatment room.
The drip was already in place and we’d started resuscitation before we exchanged any words about the nature of the problem.
‘She’s my best hunting dog, doctor. There isn’t a dog in the region with a keener sense of smell or finer instincts.’
She was remarkable, his dog. Not just that, she was intelligent, gentle and sweet-natured. Irreplaceable. Sadly she was also ten years old. Which for a hunting dog was long in the tooth. She’d never had pups. Or rather, her pups had always been stillborn. This time the man had chosen the best sire for one last try: having a litter at the age of ten was really pushing it.
‘You have to save l’origine, you have to preserve the bloodline! I know her urea levels are high, I know her hunting days are over, but I can’t let her pedigree die out just like that!
Fine.
Calculating from the date when she was covered, she had to be pretty much at full term. A quick scan to check: the pup was alive. For the mother things weren’t so clear. Tests confirmed she was developing a serious metabolic complication, and that she needed to give birth very soon.
We scheduled the caesarean for the afternoon, which left us the morning to patch up the future mother.
By late morning she was in a coma, and we embarked on an emergency C-section. Without anaesthetic: she was no longer with us anyway.
Intensive care, help with breathing, the pup was born alive: it was a singleton, and it was enormous, which was why it had got stuck. A boy.
Our efforts had paid off and we could finish off the operation in the normal way: even the mother was saved, for the moment at least.
The man wept for joy.
The mother took almost 24 hours to come round completely, but her metabolic complications were less marked and she was lactating normally. The pup was in robust health.
Two days later, the mother’s condition appeared to deteriorate. Metritis – inflammation of the uterus – and mastitis. We changed her antibiotics, put her on a drip, force-fed her; two days later, despite all our efforts, she died.
Since the infection started she’d had no milk, in any case. We took turns to bottle-feed the pup, eight or ten times a day or even more – the nurse as she answered the telephone at the desk, any of the vets who happened to drop in on the ward between two appointments. The whiteboard filled up with little black crosses, each one of them signifying a feed.
My colleague ended up taking the pup home with him, so that his children could feed it when they came home from school. When he got it home he declared: ‘We have to save l’origine.’ And so, as they watched television, had their tea, in the evening, during the night, when the youngest had a nightmare, they saved the bloodline. Him, his wife and his two oldest children.
Thanks to all these exertions, the pup’s growth curve eventually became normal.
It was exactly a week after the mother was admitted that we made the phone call: ‘We’ve saved the pup, he can go home, but he’s going to need a lot of looking after.’
When my colleague handed the man the pup his face lit up. His expression was priceless, especially when my colleague said:
‘My children have looked after him a lot. They’ve found a name for him.’
The man looked at him questioningly.
‘He’s called L’Origine. And we’ve saved him.’
*
L’Origine has grown up into a magnificent hunting dog. All his mother’s and father’s qualities seem to have fallen by the wayside, on the other hand, but the old man isn’t bothered. Now and again he reflects that qualities can jump a generation, and that with a stud dog and all the pups he’ll be able to sire there’s bound to be one good pup at least.
A bitch, perhaps.
Carnage
Saturday, 12 noon
It’s very quiet when I go home for lunch. After lunch there are three appointments, really straightforward things, removing stitches and the like. For the past few weeks (months?), Saturday afternoons have been very quiet … As I leave, a woman runs into the surgery carrying a cat. My colleague Olivier is on call, he’ll take care of it.
Saturday, 14.05
I’m a little bit late. Olivier and Perrine, one of the nurses, are already there. As I pass the open door, Perrine calls out from the other side of the surgery:
‘There are two hunting dogs with gashes from wild boar in the courtyard, and another one’s on the way!’
Sigh.
Scarcely have I passed the doorway when a pick-up truck screeches to a halt behind me. It belongs to Benoît, a young local hunter. I can hear the unmistakable howls of wild boar hounds.
Tonight I’m invited for dinner with some friends. I haven’t seen them for ages.
I don’t even turn to look as Benoît gets his dog out of the truck. I head for the first two dogs in the courtyard. A quick glance reveals that one has its cheek slit open, revealing its jawbone, while the other has a very nasty bite on its upper
hind leg, the muscles are torn but it doesn’t look too deep. Both wag their tails when they see me at the kennel door. They can wait. I’ll go and see the one that’s just arrived.
Saturday, 14.10
Benoît is carrying the griffon and doesn’t look too panic-stricken. I know him well, we have a good working relationship. He’s a regular at the surgery, his dogs often get knocked about: they always tend to get in too close. When the boar stands its ground they should keep their distance. They’ve got attitude. That’s what makes them good, says Benoît. This one looks pretty elderly.
I pull on my white coat.
‘Was the hunt a long one?’
‘Barely an hour, but they did a lot of running.’
‘Quite old, this one?’
‘Six.’
OK, drip to the max, it must be dehydrated, we need to protect its kidneys. I insert a catheter while keeping an eye on what’s going on outside the door. Olivier quickly takes over the last appointment, and he’ll be able to take care of the stitches too. Three dogs we can cope with. The telephone rings. I hear Perrine say:
‘No problem, we’ll be expecting you.’
Oh dear.
‘More injured dogs, Benoît?’
‘I dunno, they’re all on their feet for the moment, I’ve just got these three.’
He holds the dog, which waits patiently and keeps still as I insert the catheter. It’s soon asleep, and I give it a quick shave around the wound. I open box no. 1, small suture, and we stay in the prep room. The ‘proper’ operating theatre might be needed for more serious surgery.
Benoît looks worried. As soon as the patient is asleep, he dashes off after the rest of his dogs, which are still out hunting with his party. We clean up, disinfect, and I suture.
It’s quite a nasty wound to the front left leg, a half-severed muscle, but it won’t take too long to mend. Continuous suture to the muscle, insert drain, cutaneous suturing …
Perrine pops in to see if I need anything, so I take the opportunity to ask her what’s going on.
‘What was the phone call about?’
‘Another hunting party arriving with five dogs.’
Saturday, 14.45
Olivier puts his head round the prep room door, then goes off to finish the appointments.
I hear Perrine in reception:
‘Could you weigh him please?’
Cyril, who hunts with another team, is standing in the doorway, a dog in his arms. I’m busy finishing my suturing, and my patient is starting to get restless.
‘What’s the problem?’
‘A small puncture under his stomach, with some fat coming out of it. And one of his pads is damaged, it’s bleeding quite heavily.’
Indeed. The floor is red already, and the smell of disinfectant is being overwhelmed by the reek of blood. The small puncture wound is probably a rupture. The little bit of fat protruding will be part of the mesentery. Just as well – this is strong membranous tissue that’s great for plugging this kind of wound. I’ve finished my initial suturing on the griffon, so I carry it to one of the cages.
‘Put him straight on the operating table, I’m just coming.’
The bleeding from the paw doesn’t seem too heavy, we’ll look at it afterwards, it can’t be too serious, I focus on the puncture wound to the abdomen. Catheter, drip, anaesthetic, the dog slumps, I put him on his back, the hunter waits for the diagnosis. I quickly shave a circle of about twenty centimetres around the little bit of fat that’s dangling. I spend a few minutes cleaning it up and disinfecting it, then clamp it and widen the skin wound. A fine three-centimetre perforation right on the white line, I slip a finger into the abdomen, palpate the adjacent organs: liver, stomach, diaphragm, all perfectly smooth, no irregularities: an internal lesion is highly unlikely. I clean the bit of mesentery again and push it back into the abdomen. I’ll insert a subcutaneous drain before I stitch it all up again.
Saturday, 15.00
I hear Olivier talking to one of Cyril’s hunting party. Apparently one of the dogs has been badly injured. It’s not putting its paw to the ground at all – a bad sign in these dogs that have an extraordinarily high pain threshold. If the dog can’t put its weight on the paw it must be broken. Or worse.
A mobile rings: the hunters are sharing the latest bulletins. Olivier gives a rapid examination to another dog and announces a collapsed lung. On paper it’s probably more urgent than the paw, but it’s better if he does the paw as he’s better at osteoarticular surgery, working on bones and joints, than I am. The collapsed lung can wait a bit in any case, and I’ve almost finished sewing my dog up again. I just need to have a look at his bleeding paw.
Saturday, 15.30
Olivier has put his dog under anaesthetic, and as he discovers the full extent of the damage to the humerus I hear him muttering ‘bugger bugger bugger’.
I’m in the middle of examining the bleeding pad, while thinking ahead to the suturing of the collapsed lung that’s coming next. The paw is more serious than I thought, the thorax and his collapsed lung will have to wait a bit: the wild boar has bitten between two pads and split them. And on top of that the wound is full of earth and sand. Cleaning, stitches …
*
I hear the phone ring. Perrine answers:
‘No problem. We’ll expect you.’
Now I’m starting to hallucinate. I call her in, I need her to help me clean this injured paw in any case.
‘What was that?’
‘The Volp party, seven dogs at least, here in half an hour.’
Fifteen dogs between the two of us is madness. I ask her to call my wife, who’s a vet but not working today, or not supposed to be at least. Otherwise there’s no way we’ll be able to cope. And I ask her to put off all appointments for the afternoon and to send any other hunting dogs to other practices. Fifteen dogs. It makes my head spin. I finish cleaning the dog’s paw, extracting gravel, thorns and grass from deep under the pads. I’ll stitch the top of the paw but leave an opening underneath. The hunter will have to clean it daily; it’s pointless to seal it up hermetically as the wound is too septic.
I sigh:
‘If any more hunters call in, tell them to go and see someone else.’
Rushing in with a pack of compresses, Perrine nods.
Saturday, 15.45
A hunter arrives at a run. Our third hunting party.
‘He’s got a neck wound, it’s bleeding really badly!’
I do my last three stitches in a minute, then I tell Perrine to put the dog in a corner of the operating room so that we can keep an eye on it as it comes round. I tell the owner of the griffon with the wound to its thorax that he’ll probably have to wait a while. The dog looks at me, wagging its tail, as I run out to the car park.
I return with the hunter, who carries his prostrated dog inside and lays it on the operating table. Perrine barely has time to give it a quick wipe. We’re well past that stage.
While this is going on, I hear Olivier sighing as he assesses the damage to the shattered paw. Shredded muscles, scattered fragments of bone: he decides to do an X-ray. Listening to him, I wonder whether it’s worth bothering. Hunters aren’t that keen on three-legged dogs.
Working very quickly, I insert a venous catheter with a bag of colloids, to help restore blood volume; the dog is almost drained of blood but it’s got a regular pulse and is breathing and conscious. Not for long, as the anaesthetic drugs – barely a quarter of the dose it should have in theory – send it to sleep. I put the dog on its back and stretch its head back. Its owner leans over it beside me, his anxiety palpable. I know him well, a Limousin breeder who I often see for his cattle. A friend, almost. I make no attempt to reassure him:
‘The wound is in a really bad place, I’m afraid one of the branches of the arteries going up to the brain may be torn. Here it’s blocked by a big clot, which is stopping the bleeding. But there’s a danger it will begin again as soon as I start to explore the wound. It might finish the dog off, b
ut we don’t have a choice.’
I hesitate. If I leave the clot where it is and simply close up the wound it might work in the short term, but in a few days there’s a danger that the clot that has stopped the haemorrhage might disappear before the artery has healed up, which would mean another haemorrhage and probably the death of the dog. Also, I don’t really know the extent of the damage that lies beneath, and the larynx is only a few millimetres away. I decide on the interventionist approach: if the dog dies, at least I’ll have tried everything. Working very slowly, I start to dissect the torn muscles, gradually going in deeper towards the hyoid apparatus, and the carotid arteries. I’m not too confident. It could all blow up in my face at any moment, spraying blood everywhere.
Saturday, 16.20
One by one, I separate the multitude of muscles that criss-cross this small area of the throat. Where does this one go? Up or down? I advance methodically, gradually removing the fragments of blood clot, expecting a haemorrhage at any moment. It’s getting deeper and deeper, and I’m beginning to wonder just how far the wild boar has penetrated. I begin to worry about the windpipe. The dog hasn’t spat any blood, so it shouldn’t be damaged? But the hunter might have missed it in his panic. He’s just told me that he found another of his dogs beside this one with its throat slit, dead. He’s white as a sheet.
Unsure, I put my instruments aside and insert my fingers at the base of the dog’s throat, palpating and examining. The haematoma is visible through the pharynx wall, but I can’t feel any tear. Hesitating, I intubate the dog, which will help me to locate anatomical structures as I dissect.
As I continue my tentative exploration, I discover a new disaster: the hyoid apparatus is broken clean through. The function of these tiny bones is to support the larynx, pharynx and tongue: without this, I’m not sure whether the dog will be able to swallow or breathe normally. It’s impossible to repair the bone, it’s just too delicate. The wound doesn’t appear to go much deeper. Underneath it, I find a torn ‘small’ artery. It might have bled a lot, but it’s much less serious than a carotid, it’s OK. I close it all up, attempt to stitch the muscles around the hyoid apparatus, then close everything up, one layer at a time. I explain my doubts and fears to the dog’s owner. He’ll have to keep it on a liquid diet for several days and make sure it avoids any strain on its respiratory system. It may not be able to swallow. The hunter takes it well: he trusts me, and that hurts; I feel so small in the face of all this damage. I finish the stitches. The collapsed lung is waiting in the corridor. I’d almost forgotten about it, and about the eight or ten other dogs all waiting to be patched up. I hope my wife will get here soon.
Monsieur le Vet Page 5