A typical Saturday here at the Hospital.
Normally on Saturdays we do straight appointments. No surgery, no diagnostic work-ups. We are open 8 a.m. to Noon.
Today is a typical Saturday. The appointment schedule is full with 3 double books. So here is a typical Saturday written as time allows.
7:45 a.m.: I arrive and check on the pets in the treatment area. The ferret who I did an adrenal tumor resection on yesterday is doing well. The surgery was complicated since the tumor was growing right next to the vena cava and it had a pretty good sized blood vessel over the tumor. There was more bleeding then expected. The ferret is fine this a.m. He's bright, alert and responsive (BAR), eating, drinking, urinating, defecating. The tech staff will give him his morning medications.
The rabbit spay looks fine. She's BAR also.
The dog spay looks fine. BAR.
I grab yesterday's receipts and put together the Bank deposit for one of the staff to take to the Bank this a.m.
Lisa, one of the techs is checking the answering machine. I kick on my e-mail and check messages on my voice mail (there are none) while Outlook is booting.
8:02: my e-mail is pretty quiet. My 8:00 appointment (appt) is not here yet. Back to e-mail. Dr. Lennox, President of the AEMV is responding to my e-mail about setting up a continuing education (CE) seminar for the American Board of Veterinary Practitioners (ABVP). I also have a few e-mails from the ABVP Executive Board.
My first appt arrives and is in the room. Stitch is a 3 year old Lab. Very happy. Exam = needs a diet. I talk to the owner about diet. Pet needs Frontline for tick control. Probably going to be a bad tick season since mild winter.
8:15: next appt is here. An Akita named Samurai that needs to be sedated for a nail trim. A lot of dogs hate their feet being touched. I administer a reversible sedative called domitor. While the staff is monitoring the dog, I check over today's appt schedule. Most are dog and cats. That's unusual for a Saturday for me. About 25% of my caseload is exotic pets. Samurai is out enough to trim nails. While the staff finishes the nail trim, I write up Stitch's record.
We have a electronic medical record (EMR) office, more commonly called 'paperless'. We went EMR about 6 years ago. Works great. Added about 10-15% more efficient to the record keeping. The vet software company did an upgrade last month, changed the inventory around a lot. Causing a lot of frustration in that area.
Nails are trimmed, the reversal agent is administered. One of the staff will watch the pet until he is up. I Put Samurai's invoice in and write up the medical record.
8:28: my 8:40 appt arrives. Angel is here for routine medical care. Her record is marked that she has had vaccine reactions before. She gets an injection of diphenhydramine (benadryl) 10 minutes before I'll give her the vaccines to minimize the risk. The other dog in the household is a feces eater. I discuss why dogs eat poop. We have a handout about things one can try. Can be frustrating disease.
8:48: My 9:00 appt arrives. A recheck of a chronic recurring mass on the foot of Brutus. We had biopsied the mass before and we can expect it will regrow. The mass cannot be removed totally unless we amputate the affected toes quite high. So we debulk the mass every few months.
8:51: My first double book arrives. Zeus is a mature Rottweiler who is acting stiff getting up. On exam, the right hip has a decreased range of motion. Most likely, given the age, breed, exam; the pet has degenerative joint disease. X-rays can help in diagnosis but medical treatment consists of weight reduction, activity that helps maintain muscle mass BUT does not fatigue the muscle, non steroidal anti-inflammatory drugs and chondroprotective agents such as cosequin.
9:03: My next double book arrives. This actually is a technician appt. A pet with chronic kidney disease is here for some subcutaneous fluids to try to preserve kidney function. Ideally the owner would be doing this two or three times daily at home. It's hard for this owner to do this so we having been seeing the pet once weekly.
Clients are starting to trickle in to pick up food orders and other medications. Having Saturday morning hours is a real benefit for clients whose work schedules make it hard during Monday to Friday.
Looks like I have about 10 minutes before next appt. I'll log onto Veterinary Information Network. Great resource for vets. A lot of discussion groups, online CE, summaries from articles, etc. Nothing of interest on VIN's homepage, I'll check the latest transcripts of CE lectures.
9:18: My next appt is here. Mojo is a healthy 4 year old German Shepherd. Exam - normal.
9:34: Next appt is here. Oscar is a 7 year old cat with no illness. He has a little tartar and gingivitis on his teeth.
9:44: Have about 15 minutes. Got an e-mail from a Board member of the local veterinary ER. Deals with treating exotics over at the ER. Composed a response and sent it off.
9:59: Next appt shows up. My 11:20 a.m. appt calls and cancels. Staff is calling my 11:40 appt to see if they can come earlier. If so, then the staff can start end of day a little earlier and try to get out of the doors right after closing at Noon.
Dog spay's owner shows up. Pet is licking at her incision a little so we dispense an Elizabethan collar. These are those plastic lampshades you occasionally see pets wearing. Keeps their mouth from the incision.
10:34: Just finished two dogs' exams owned by the same person. One neutered male dog marks his territory a lot. The female one is compulsive and licks everything, including the cat. The male one has an urinary tract inflammation. I think the female has compulsive behavior that can be a common finding in terrier breeds.
At the same time the last double book came in. Older dog with numerous mammary gland tumors. One of them has a hole in the side and pus is present. I discussed with the owner that we can remove these cancers but they have a tendency to recur. We should do a chest x-ray to see if there has been spread of the cancer at this point. In the end, the owner elects to euthanize the pet.
10:42: Next appt is here. Healthy 10 year Black Lab named Haley. Because she is over 8 years old, we recommend a check of internal organ function. For that we do a complete blood count (CBC) and a biochemical profile. Between these two tests we will check on most older dog diseases with the exception of cancer and heart disease. There are not any good blood screening tests for these two items. In our practice, we find about 21% of dogs will have abnormal lab results. Some require monitoring, other require more tests to diagnose the abnormality.
11:05: Just finished examining Trouble, a 7 year old ferret. She looks pretty good but starting to get skinny. In my experience I have found that when ferrets get below one pound, they are more susceptible to a variety of illnesses and have less reserves when they get common illnesses like colds.
11:33: Saw a guinea pig with a whitish ropey discharge of the right eye. Seems fine now. At this point, I think it's probably OK. For now, the owner elects to monitor. The guinea pig's owner used to be my supervisor when I worked summers during college at a local vet hospital. My current staff got a chuckle out of that.
11:45: The last appt of the day was supposed to be here 5 minutes ago. We're all just waiting for the client to show up. It's a in heat female dog to show up for artificial insemination (AI).
11:49: Last appt called. The semen did not show up so we will schedule for Monday on the AI.
And that's a typical Saturday here at the Hospital.
