One more Day

One more day of shift...then it's off for 3 days...can't wait. Has been a little hectic this week...had some doozy cases. One was a very serious dog that was referred over from rDVM because of anemia and weakness, hadn't eaten in about 3 days, not drinking, very weak and lethargic. I did full bloodwork, thoracic radiographs, abdominal ultrasound, and prepped them for possible blood transfusion. Thoracic radiographs didn't show that much, small heart likely due to hypovolemia (shock condition); abdominal ultrasound showed weird changes in liver, spleen, pancreas that none of the docs could explain; bloodwork--disaster: anemia, severe metabolic acidosis (almost inconsistent with life), and liver enzymes so high they were unreadable. So when the dog first came in, because it was a cocker spaniel I assumed likely immune-mediated hemolytic anemia (IMHA) because the breed is poster child for it. However, the severe metabolic acidosis and liver enzymes just didn't fit. So, talked with owner again about any possible chance of liver toxins and they say no chance at all. Other abnormalities was the dog was severely hypoglycemic (this can happen with liver failure, sepsis)...so then is dog septic (meaning does he have infection through bloodstream, are we missing a huge nidus of infection somewhere?)??? In meantime, dog blew 2 catheters so had to place a central line in the jugular vein, started the blood transfusion, high fluids, glucose at constant rate infusion, antibiotics in case of infection, steroids for immune mediated disease...repeated bloodwork and values had improved...however dog still looking horrible...continued supportive care but owners decided to euthanize the next afternoon because dog not improving clinically and money had to have been through the roof with all we were doing. Unblocked an orange male kitty last night that had a urethral obstruction...then he was wigging out on his opiods so I had to reverse him from those.,...he was rolling around the cage and likely seeing pink elephants...but reversal worked well and kitty doing well. Had dog with ear infection last night, dog that ate burrs and was hacking (offered to scope the dog, but owner wanted to try medical support at first so placed on pain meds and some sucralfate to coat esophagus...burr could still be stuck, but if it gets into stomach dog should be fine); saw a rabbit (severely dehydrated, not eating, not defecating, hypothermic...admitted, gave pain meds and some sedation, went to take radiographs and rabbit began agonal breathing and died on the table....she was very sick and luckily I had warned owner that this may happen as bunny's like to circle the drain when they are in the hospital). So, we will see what cases I come up with tonight. I am all stressed out because I have this journal club to do next week...the articles my senior clinician came up with are way over my head so I have to study in order to study the articles!!!! Crazy...and then there is my paper...that needs to be written yet too...so I have a lot of work to get done this weekend. I am excited about the weekend though because Kevin is going to come up and visit...it's nice to see him as we hardly ever get to see each other much anymore. And he is going to stay all weekend I believe he is taking off work on Friday to visit...he has a lot of work to do with his class as well...for those who don't know he is in a Master of Biotechnology program--he absolutely loves it...but lots of work on top of his work at Covance...so we are going to hang out at some of the little cafe's around Milwaukee and do some studying this weekend... I am so lonely here that I am really looking forward to having a buddy... I really miss having someone to hang with, although I am becoming more independent which is a good thing. Kitties are doing well, they are zonked in the sunlight right now... they are waiting for me to have days off as well... it is so hard sleeping at night because they just fight over who gets to sleep with me... and now that it's getting chilly at night they want to snuggle down in the covers...becuase you know I don't turn my heat on...learned that from Dad!!...especially since I have to pay for it. Fall is coming, football season--yay!! Although it will come and go without me really noticing it--sorta like summer, I can't believe it is already almost over. And it is getting near that time when I have to start looking at where I want to do residency...right now...Minnesota, East Coast, California are in my mind....we will see though, life sometimes has a way of deciding for you...try to plan and you just end up disappointed...go with the flow, take the hits, get right back up, dust yourself off, and keep trekin' and you will find that it really isn't that bad and you will start to find smiles around you....the worst thing in life is not living it...the others are just bumps in the road meant to wake you up and alert you to things that need to be changed in your life....breath in life around you, open your eyes, watch the birds, catch a sunset or sunrise, listen to nature, dance in the rain.....and always always always go to bed smiling over what you have experienced in that day....THAT is what makes all the difference...