Thursday, January 16, 2014

The Emergency Calls, The Screams In My Head, and Why Do People Still Use Rat Poison?

I had another booked Monday and my routine few ‘emergencies’ piled on top, (yes, again). Seems there are few ‘routine Mondays’ anymore. It is the nature of the veterinary beast, and in all honesty, the fun in the day. (I can’t stop the emergencies so I might as well embrace them, right?).

I had a conversation with a client the other day. He had called us two Mondays ago asking if we could do “an emergency C-section on his dog who was at the emergency clinic.” I had to ask, “Why his dog wasn’t having her C-section at the emergency clinic?” I wasn’t surprised to hear that it was because of the estimate they had provided him for the service. I then asked him if he had a “regular veterinarian?” “Yes, I do, but I called and they can’t see me today.”

Huh? I don’t get it? I don’t understand why vets turn away their clients when they are in dire need? Now I understand that there are always two sides to every story and I only heard one of them, but if you call me and your dog is in ‘DIRE’ need I am not going to have the receptionist tell you that I am too busy.

My heart went out to this owner and I couldn’t bear to hear that there was a dog sitting in an emergency clinic that needed any emergency surgery and wasn’t going to be helped. Another deep breath, a little bit of further Q and A and I was going to have a longer day than I had originally planned, but my conscious was clear. That day I performed a caesarian section on one of the sweetest Golden Retrievers I have met. She was full of infection and two dead puppies. But I know that if she hadn’t had that surgery she would have died a terrible death within a day.

Since that surgery I have decided that every emergency that I can do something about I am going to see. I am going to help my clients take care of their pets and I am going to move a mountain if that’s what it takes to get the care a pet needs.

This conversation reminded me of the conversation I had during today’s emergency.

I often stand there listening, taking notes in the medical record, wanting to ask a litany of questions, some for the sake of helping me identify the pets needs and some for just plain old curiosity, and some to address the inner voice in my head screaming,  “What the hell were you thinking!!!?”

The call this morning was about a puppy that needed to come in because the owner had found him eating on a rat bait package. I told the front staff to tell them “to come in as soon as possible!”

I began to re-arrange my schedule. The cat spay on the docket could afford to wait for her surgery tomorrow but that puppy needed to be seen today.

Thirty minutes later, a 3 month old puppy bounced his way into the clinic.

Little Zeus has a serious face with ears that stand straight up, bright intense eyes, a long mane of fur and all of the qualities of the German Shepherd breed  designed to impose fear onto any visitor his family will entertain. But, for now he is an adorable beautiful curious and clumsy boy of wags, and mouthy ‘hellos’.

As I met with Zeus’s mom we discussed how he had landed himself a trip into the exam room this morning.

It seems that Zeus had ‘found’ the container of D-Con under the couch. “He is at the age where everything goes in his mouth and he gets into everything” she told me.

I try very hard to just listen when I am in the exam room. It is very important to get a good detailed history and not interrupt the parents account of the patients tale. She went on to tell me that “the container had been under the couch for over a year and the blocks had started to come apart and were more of a cake-like consistency.” She went on to say that she was “also pretty sure that he hadn't eaten any of it, he was just playing with it.”

One of the ways that you can tell a seasoned veterinarian is that we learn to trust what we see, and what our gut tells us, versus what the parents tell you. We use some pretty excuse like, “It all has to fit together and make sense, or else we are missing something,” when our gut and brain are dueling with the diagnostics, history, and patients clinical signs.

It also is a true art to not let your mouth speak when your brain does. My brain is screaming, “What kind of person keeps rat poison under the couch?” 

Based on my presentation of a happy healthy puppy and a parent in denial we decided to run some blood work and start vitamin K as a precaution to the rodenticide exposure.

Along with the little pills I sent home, I did feel obligated to review basic home safety for pets.
Thankfully,  Zeus never skipped a beat. He never showed one clinical sign of having ever using the green blocks as a chew toy.

It is January. The weather remains chilly. The thermometer continues to hug the tipping point between the positive and the negative digits, and the snow bird rodents to migrate into your home. As the mice march in the house, the humans march to the “pest management” aisle at the hardware store seeking eradication mechanisms.

Now I know that no one wants vermin in their home. But when it comes to deciding what to do about them I have a few words of experience to impart. The poison you put in your home is designed to be “attractive” to all beasts. Your pets will find it (oh, gosh, please never put it under the couch), and they will eat it. Worse yet, they will eat it and you won’t know it until days to weeks later when they are bleeding out. Please never use these baits if you have pets! Glue traps, well, I think that they are just awful. Who wants to die because you are stuck in quicksand, and have to die by reason of starvation? The old quick and painless way is what I choose. You have to look your intruder in the eye, and you have to remove the carcass, but it won’t hurt your pets, well, not seriously.

I have seen countless cases of rodenticide toxicity over the years. Dogs with nosebleeds, blood just pouring out of their penis, or any orifice the blood can find to slowly drip out of. These bleeding guys are surreal, like some sort of zombie extra who lost their movie set.

Treatment for them has traditionally been to monitor red blood cell counts (or PCV’s), provide vitamin K, and maintain blood pressure by avoiding hypovolemia. But there is a new generation of poison (bromethalin is the active ingredient) that have no antidote for treating our pets against it. Unless these toxins are identified almost immediately allowing us time to induce vomiting and remove it, these pets will die if diagnosed after clinical signs of toxin exposure manifest.

For all of those dozens of dogs that have been successfully treated when they show up at the clinic dripping blood like a leaky faucet, the new generation of rat poison will kill your pet and I won’t be able to help.

As we move into the new generation of rat bait poison I fear I will see more patients who I can only wait and watch. Maybe I can buy them a little bit of time? But they will still die. 

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1 comment:

  1. I work at a home improvement store and I noticed that the rodent baits had changed. I researched and found exactly what you said, that there's no cure if it isn't caught immediately. I never have used these baits, and I never will, but it's terrible that they did this. What was the reason for the change in the bait I wonder? At least the older version had the chance of a cure.