This week started off with a bang. On Monday, I had 1 case, but the bureaucracy of a teaching hospital made me run around like a crazy person to work the case up. The dog had disc disease in the cervical spine, but needed an MRI to see if surgery was a viable option. The owners had a hard time deciding if they should do the MRI and put their 15 year old dog, who is otherwise in good health, through an MRI and possibly surgery. They decided to get answers. Two days later en route to the imaging center, however, they turned around and decided his time was done and euthanized him. While I know how much they cared for the dog and the cost was steep, they wrote him off because of age. Old age is not a disease and he very well had 1-2 good years left. It was disappointing and the news came after an even more disappointing Tuesday.
On Tuesday, we admitted a lab for a clinical treatment trial for a brain tumor. The procedure went very well and his recovery from anesthesia went well at first. Two hours after waking up, he had a seizure which we caught early. The second seizure did not respond to valium and we put him on a CRI of propoflo. After 6 hours we took him off the propoflo and he did fine, but 30 minutes later he went into cardiac arrest and died. He died of aspiration pneumonia caused by delayed gastric emptying. It was such a shame to see a dog with a brain tumor die of aspiration pneumonia. The reality of how common this occurs as a complication to anesthetic procedures hit me hard. I really held out hope that he would make a great recovery and live out some time with a shrunken brain tumor. Before the necropsy, I also wasn't sure if it was our fault for not intubating him while he was on the CRI of propoflo. Around 7 pm his heart rate picked up, blood pressure spiked, and his oxygen saturation was low. I knew something was wrong, but the doctors elected that he was okay. I now know it couldn't have been prevented or alleviated. He had a full stomach, but hadn't eaten in 12 hours before surgery, so something else was going on. He was an amazing dog with a dedicated owner and the story was tragic for me.
Besides being exhausted from 13 hour days, I was questioning how I would get through this year on lack of sleep and so much mental stimulation. For the millionth time in vet school, I was wondering "can I do this?"
Of course the latter half of this week our neurology service caseload has slowed down, perhaps someone looking out for me or just pure luck. I appreciate that I had time to process my feelings and get rest. I am terrfiied of surgery next block though, when a day off will cease to exist.
My mid-block evaluation went well. I need to "own" my cases more, and be more independent of the clinician, which has come a long way since last Monday, but has a long way to go. I have no clue how I will be ready to be a DVM in just 9 months. Time to take things just 1 day at a time again.