I was on-call last night. My first call was a beagle who had been in labor for 2 days. I told the owners the costs of the emergency visit and c-section and the owners told me that we usually let them charge it because they always pay. I was still at the clinic so we looked up their account and there was this big notice saying, "No Sx and no charging until bill is paid in full." I told the owners what I had discovered and told them I would have to have payment in full for the c-section and emergency fee prior to surgery. They got irate and asked if there were any other clinics with emergency services, I gave them the number of or rival clinic, knowing they would not help them without payment. I tried to give them a number for an emergency clinic in WV but they hung up on me. They called  back after getting a no from the other clinic. I told them I cannot help them. They are yelling at me, telling me that I am killing their dog and that Dr. Wilcox would let them charge (even though he is responsible for the  no charging decree). They hung up on me again.

I made it almost home when I got a call for a different c-section...my first c-section. I called Dr. Wilcox to get the dosing for Ket/Val and he offered to come help me. I told him no and called a co-worker who is excellent at assisting with c-sections. I am in the middle of the spay (the puppies were out and Elissa was trying to revive 5 puppies by herself) when Dennis walked in. My heart started racing and hands started shaking...he makes me so nervous. He helped Elissa with the puppies and then started to watch me as I ligated with uterine body. The puppies were a lively bunch so soon both Dennis and Elissa were watching me. I told them they were making me shake so Dennis went to sit up front and wait on me. He eventually came back and watched me close the abdomen. Try closing the abdomen when your hands are shaking, you have needle holders that don't hold the needle well, and an extremely dull needle...it is not so easy.

I finished that c-section and the emergency service called me again with a man that had a beagle who had been in labor for "some time." I figured it was the same people. I called and the girl asked if we could put the dog in her boyfriends name and allow them to charge the surgery and emergency fee. I once again told them no and gave them the number to the emergency clinic in WV. I once again got yelled at and told that "no Carver's" would ever take their animals to us again. I told Dennis all of this and he was so sweet b/c he said that he would dupport me 100%. He also complemented my c-section awesomeness!

I have had some interesting cases. One was a dog fight victim with about 3 inches of SQ emphysema and a pneumothorax. We wrapped the dog and hoped the wound in the neck would heal. The dog did great and we sent it home but it is now back for us to disect around and see if we can find the wound in the trachea ( we hope it is in the trachea).

I currently have a seizing Dachsund in the hospital. We are not the regular veterinarian but we were the clinic on call. The dog had been seizing constantly for 2 hours prior to presentation. I wanted to put in an IV catheter, start fluids and run some bloodwork (after a healthy dose of Valium, of course). The owners didn't want to leave the dog and asked if I could just give it some Valium and send it home. IT HAD BEEN IN A CONSTANT SEIZURE FOR 2 HOURS!!!!!! I told them no and the valium worked wonders.

My other emergency for the night is a cat that was fine earlier today  but the owner found it flat out, moaning in the rain. I really dreaded the call b/c the owner is really annoying. She is antique and talks in this baby voice, kind-of like she is constantly crying. The cat has a head tilt to the left and horizontal nystagmus with the fast phase to the right and is ataxic. No known trauma, no known toxin ingestion.....KATHY if you are reading this, help? I put it on IV fluids, ran a profile (normal), FeLV/FIV test (negative), gave baytril and dexamethasone (per Dennis's suggestion) and it was the same when I left the clinic.

Now I am waiting for a phone call...I know an emergency is going to call when I am in the shower or when I finally get into bed.

I went to work Saturday, kind-of having a bad feeling about the day. I went into an exam room in which the chief complaint was difficulty breathing. The owner tells me the dog (a coonhound) has been vomiting for 4 days and then started having difficulty breathing that morning. The dog is open-mouth breathing with an amazing abdominal component. It was dehydrated and had diffuse crackles...like, really bad. I did a heartworm test and gave it a lasix injection while we waited. The heartworm test was negative and I told the owner that the dog should be hospitalized so that we could take a chest radiograph and get the breathing under control. The owner declined, insisting that the dog only had pneumonia. He asked me to give it a penicillin injection and start antibiotics. I did what he asked and made noted of his refusal of further diagnostics on the chart. He calls Dennis today to complain b/c the dog died on the way home. He told Dennis he thought more tests should have been performed and he wanted to return the antibiotics. Dennis was very nice about it when I apologized and he recognized that this is what I will deal with because I am a new doctor but I was still incredibky embarrassed. I hate people. I guess maybe I didn't express the fact that his dog was really sick well enough. Dr. Karr told me I should have used the words, " Your dog will die."

I guess I still have a lot to learn in the client communication department.