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Tag: Euthanasia

  • Euthanasia (part 2): caring for the patient

    Euthanasia (part 2): caring for the patient

    Last month we discussed the importance of caring for clients during the process of euthanising their much-loved pet. This month, we focus on your patient.

    The goals of euthanasia are always to make it as painless, fearless and stress-free as possible for the patient.

    Pain relief

    Most patients presented for euthanasia are either suffering from chronic, terminal or traumatic disease.

    The first thing I like to do is ensure the patient’s pain is managed. This usually means providing opioid pain relief. Methadone is my opioid of choice. Butorphanol provides minimal pain relief, but is excellent for mild sedation.

    Next, if your patient is in shock, you need to try to alleviate some of it through IV fluid resuscitation. This is important as poor circulation will slow the process when you administer the euthanasia solution.

    Calm and stress-free

    One of the most important goals in the euthanasia process is to have the patient as calm and stress-free as possible.

    If the patient is stressed or anxious, some sedation may be required. Diazepam or acepromazine are good choices, depending on the condition of the patient, of course, and, together with the opioid you have administered already for pain relief, will help calm the patient. Try to avoid using medetomidine as a sedative in all but the most fractious of patients, as it causes peripheral vasoconstriction that will make IV catheter placement difficult.

    The aim of sedation is to relax your patient as much as possible without rendering them unresponsive to owners when it is time to say goodbye. This can be tricky as every patient responds differently to sedation, so you must make a point of warning owners the sedation may make their pets very sleepy.

    IV catheter

    Where possible, I avoid performing euthanasia without first placing an IV catheter. It makes the delivery of the euthanasia so much smoother. Including an extension to the administration line also allows you to stand a little away from the patient and their owners to give them a little privacy while you administer the euthanasia solution.

    Once your patient is sedated and an IV catheter placed, I set up comfortable bedding in the room where I will perform the euthanasia and bring the patient to the room. The amount of euthanasia solution I have with me always exceeds how much I think I will need; the last thing I want is to have to leave the owner and patient to get more euthanasia solution.

    Once I have administered the euthanasia solution, I check the heart and once that stops completely, I then tell the owners their pet’s heart has stopped, which they understand as their pet has passed.

    Performing euthanasias is the one of the hardest parts of our job, but also a privilege we hold as vets, so I hope my tips will help make the process easier for you, your client and, most importantly, your patient.

  • Euthanasia (part 1): caring for the client

    Euthanasia (part 1): caring for the client

    Euthanasia is a big part of our work as veterinarians. Working in an emergency setting, it is something I have to face on every shift.

    It doesn’t get any easier no matter how many times I have to do it, but I have fine-tuned my approach over the years so each euthanasia process runs as smoothly as possible, with minimal additional stress to both patient and client.

    This month, I will talk about taking care of your client.

    Communication is key

    dog and owner
    Euthanasia is a big part of our work as veterinarians.

    The most important aspect of taking care of your client in this difficult time is to make sure you really focus on communicating clearly, effectively and, most importantly, with sincere empathy.

    First, I listen to their concerns, and why they have made the difficult decision to euthanise their pet.

    Quality of life decisions can be a very grey area, and sometimes what you think may be manageable as a veterinarian can be a huge quality of life concern for a pet owner.

    A prime example is osteoarthritis in older dogs. You may assess them as being clinically well except for some difficulty walking, but the client sees their pet every day and notices the struggles they go through.

    Euthanasia is a difficult conclusion for them to come to and, in most instances, I will defer to the client when it comes to assessing the quality of life of their pet.

    Quality assessment

    One way I help clients assess their pet’s quality of life is by asking them about a few aspects of it, including:

    • Can your pet do the things that make them happy?
    • Do they spend more days sad, depressed and ill compared to the number of days they are bright, happy and eating?
    • Is your pet in pain? Is this pain manageable?

    Confirmation

    Once a client has expressed they want to euthanise their pet, I always try to confirm three things:

    1. That they have actually decided to euthanise their pet. I frame the question like: “So, my understanding from our conversation is that you have made the decision to euthanise Fluffy today?” Sometimes, when you ask this question, the client reveals they have not actually come to that decision yet, which means you will need to backtrack a little and guide them through the decision process again.
    2. Whether they would like to be present for the euthanasia.
    3. How they would like us to handle the after care.

    I also always try to manage all documentation and finances before the euthanasia so the clients will be in a position to leave immediately after the procedure, meaning they can begin to grieve rather than have to do paperwork. The only exception to this is when the patient is in a critical condition, meaning euthanasia cannot wait.

    Explaining the process

    Try not to perform the euthanasia in your consult room or in the main treatment areas – if you have a private room for euthanasias, that is the most ideal. This is important especially if the client comes back in the future with another pet or a new pet. They often find it difficult to walk into your consult room and be reminded of the euthanasia of their beloved pet.

    I like to give clients some time to spend alone with their pet to say their goodbyes in private. When I come back into the room, I start by explaining the process of the euthanasia, covering the following things every single time:

    • Euthanasia is an overdose of an anaesthetic agent
    • dog collarThe process is quick – 10 to 20 seconds
    • It is completely painless
    • The pet doesn’t close their eyes afterwards
    • The pet can have a couple deep breaths and muscle tremors
    • The pet can release their bowels and bladder (especially important to warn of this if the clients want to hold their pet)
    • Lastly, if their pet came into the hospital in shock and obtunded, where I have fluid resuscitated them, meaning they are now more bright and alert, I warn the clients that despite their pet looking better, the underlying disease remains the same.

    Once the euthanasia is performed, I again ask if the client wants to spend a little more time in private with their pet. Finally, when the client leaves, they typically will say “thank you”.

    Whatever you do, do not say something like “my pleasure” or “you’re welcome” like you would for a vaccination consult – this is a natural response, but would be a terrible faux pas. I simply say “I’m very sorry for your loss. Take care for now and let us know if we can help in any way”.

    Next month, I will talk about taking care of your patient throughout the euthanasia process.

  • When emotions run high

    When emotions run high

    Vets have to handle a variety of difficult situations, from delivering bad news to addressing financial difficulties. But when it comes to tackling client grief, awkwardness or anger, it’s a bit like that old children’s book, We’re Going on a Bear Hunt – we can’t go over, under or around it – we’ve got to go through it!

    I recently had a three-hour communications practical, during which my fellow students and I were tossed into a randomly selected clinical scenario designed to help us deal with uncomfortable areas of future practice. These included such topics as:

    • discussing the needs for euthanasia
    • apologising for clinical mistakes
    • reasoning with angry farmers when their herds came back TB-positive

    Role play

    We’re Going on a Bear Hunt, written by Michael Rosen and illustrated by Helen Oxenbury, is available from Amazon.co.uk and other booksellers.

    All scenarios were conducted with real actors portraying the clients – and although we’d been given a list of topics to revise if we wanted – any revision turned out to be next to useless as the exercise was less about what you knew, and more about how you dealt with people.

    Personally, I find this type of practical as rewarding – if not more so – than our clinical skills work. We have countless opportunities to practise suturing, spaying and catheterising in the labs at school, and in final-year rotations, but dealing with the raw side of client communications is the one thing we never actually get to experience until we’re suddenly in the driver’s seat.

    It’s completely understandable – nobody wants a student present at their most vulnerable moments. If my own pet was being put down, I’d want the comfort of an experienced vet doing the job and walking me through it from start to finish.

    Learning experiences

    That’s why I think communication practicals are so incredibly useful, and it’s a real shame that I’ve only had three in my course so far. It can be difficult to learn from and build upon experiences spaced years apart from one another, and I feel incredibly sorry for the year before me (while I was intercalating) who had to do their scenarios over Zoom.

    One of the most valuable lessons that these practicals have taught me, is not to be afraid of emotion.

    It can be difficult – especially when a very valid defence mechanism for many medical professionals is to distance yourself from it at all costs – but there are moments when all is required of you is simply to be there, to listen and understand.

    Just be there

    There’s no textbook in the world that can teach you that. When a client (or an actor pretending to be a client) is crying in front of you, you want to fix their grief because fixing things is, quite literally, your profession.

    Your instinct is to talk and fill the silence, but instead, you need to wait for them to process the moment and then be there to answer their questions.

    Some things you can’t fix and you can’t work around – you just have to go through them.

  • Good intentions

    Good intentions

    Less than a month into my master’s degree in wildlife health and rehabilitation, and it’s already become apparent that a vast array of misconceptions are held by the public concerning local wildlife.

    I’m already armed with far more wildlife facts than I ever thought my brain had room for. For example, did you know that a group of hedgehogs is called a prickle? Or that bees have five eyes?

    The vet course is a lengthy and arduous endurance, and even so a whole wealth of animal knowledge gets left out because, for the average vet, there’s little need to know that a kangaroo has three vaginas. Unless, of course, you’re a vet working in Australia – in which case, g’day!

    The unfortunate facts

    In my lectures, alongside these charming facts came the statistic that in the majority of wildlife rescue centres, more than 50% of “abandoned orphan” admissions are a mistake on the well-meaning public’s part and are, in fact, just young fledglings still getting used to their wings.

    That’s in excess of 50% of “avian orphan” admissions that have to be assessed, put through the system, housed and then released back into the wild – more than 50% of resources wasted.

    It’s also true that feeding hedgehogs milk and birds bread can make them ill, and that setting out food or bird feeders can provide a breeding ground for disease transmission and propagation.

    And it’s a truth that is kept somewhat from the public that, for a large proportion of wildlife casualties, there is little to be done but palliative care and euthanasia.

    Small acts of kindness

    This topic really gets me down, because with all of the ecological, environmental and diversity destruction ongoing around the world, small acts of kindness and sympathetic good deeds seem few and far between – and as someone passionate about wildlife and conservation, the last thing I want to do is discourage them.

    A lot of problems exist in this world, and humans cause 99% of them, so when someone goes out of his or her way to try to do the right thing and it ends up causing more harm than good – whether he or she knows it or not – it seems like such a waste of good intentions.

    swallow
    Image © raquel / Adobe Stock

    Can’t do right for doing right

    The real crux of the matter is the paradox of education. It’s understandable that the public make mistakes regarding wildlife when so much is still unknown to the professional community.

    That being said, if the wide range of new data at our fingertips could be available for the layman, such mistakes might be mitigated. However, there’s only so much unrequested education people can tolerate before they just give up.

    Similarly, if you let every member of the public who brings in an injured animal know the percentage of animals that have had to be euthanised that day, they might just take it on themselves not to bring it in at all, or (an even worse possibility) attempt to care for it themselves.

    Sad, but true

    Stories of people attempting to hand-rear everything from birds to large cats are, while superficially admirable, most often doomed to failure.

    Research is constantly being conducted into nutritional requirements, behavioural norms and habitat necessities on all the species we’re still not 100% on… and that’s pretty much all of them.

    If the leading minds in the field are still messing it up, there’s not much hope for the average Joe – even with all the good intentions in the world.

  • Grieving as a professional

    Grieving as a professional

    The pet of a close friend of mine has just passed away. Zilla the black Lab was the most beloved dog, who had a fondness both for rummaging through the bins and belly scratches.

    She’d had progressive problems with her health and, earlier this month, it became clear that, sadly, the time had come for her to leave.

    I’m sure that, just as parent’s try not to prioritise one child over the other, vets do their best not to pick their favourites, but in my mind it’s an inevitable outcome of having a human inside the white coat; some little lives are bound to touch us more than others, sometimes without us even knowing or in ways we didn’t realise until we properly reflect.

    Early consults

    Without me realising it, Zilla wove herself into my early veterinary evolution. When we were younger, my friend and I would often joke that I would be Zilla’s vet in the future.

    thumbnail_Zilla 2
    Eleanor Goad‘s first “patient”.

    Even in the era of early GCSEs, friends would consult me on topics ranging from “that strange rash came back” to “she’s eaten half the box of Celebrations – wrappers and all!”

    Young, utterly underqualified and fully aware of the fact, I would always advise the friend to consult a real professional – but that didn’t mean I wouldn’t take a little pride each time in being asked, or that I didn’t take a deep interest in the outcome or feel the emotional impacts of that outcome.

    Grief counsellor

    I’ve been a shoulder to cry on during the bereavement of several small furry friends, and so, without ever seeing a euthanasia in person, I am not naïve to the aftermath.

    Grief is an unavoidable part of the veterinary field, as it is a part of human medicine, and even as professionals on the other side of the examination table, it is bound to rock us from time to time.

    I worry that a part of the mental health decline in the veterinary population is a lack of addressing the small chinks in the armour that are bound to build up over the years.

    Toughen up

    Zilla’s passing hit me harder than I’d expected; she was the most beautiful dog and lit up every room she entered – and yet a part of me was telling myself I couldn’t be upset because I was going into a profession where death was part of the nine-to-five and I had to “toughen myself up” to it.

    I think it’s important for both vets and owners alike to acknowledge that they are allowed to grieve, and that the loss of an animal can hit just as hard as the loss of a person.

    Find a balance

    As a vet I am undoubtedly going to bond with many of my patients as I follow them through their lives, and their ups and downs, while striving to right all their wrongs.

    We are entitled to our emotions. It’s just about finding a balance between our responsibility as professionals to support our clients when things go downhill and the responsibility to ourselves when our mental health takes a downward spin – and to allow ourselves to grieve if we need to.

  • What about vets on the front line?

    What about vets on the front line?

    Our profession is generally pretty good at pulling together in the face of adversity.

    I’ve always loved the community feel of being able to go to CPD events, and usually know someone, or have connections with someone, who is there.

    I love being able to send a message to my uni friends at any time of day or night – be that for clinical advice, moral support or reassurance on something entirely non-vet related – and get a reply. Failing that, you can often seek an answer or support from one of the vet Facebook groups on numerous topics.

    In light of COVID-19, the veterinary world has rallied together… to a point.

    One for all, and all for…

    Those who have been furloughed are finding a wealth of free online CPD available to fill their time and keep connected clinically. Not only are there webinars, but there’s a plethora of online workouts or discussion groups to actively engage in.

    That all sounds lovely, but what about those of us who are still working? What support is there for the minimal staff left in clinics who (despite all these figures on turnover being down) are battling ridiculous increases in workload?

    Less is… less

    There’s less staff in most clinics, to varying degrees, but I have heard horror stories about severely restricted numbers and even certain groups furloughing everyone but vets.

    Whatever business decision may lie behind that, these clinics must be in chaos. Vets, who are already stretched trying to do their “normal” jobs (it is currently far from normal), are also running their own bloods, cleaning, answering phones, chasing and taking payments, sorting insurance claims and ordering stock, among other things.

    These tasks may be alien to some of us, and trying to navigate previously undiscovered depths of the practice management system at the end of an exhausting shift adds unnecessary stress.

    We love our nurses and receptionists as it is, but those who are currently deprived of them will be unearthing a a gargantuan respect for them in the future.

    Crisis consulting

    Consulting in this environment makes you realise how much multitasking we would ordinarily do. Currently, my consults look like this:

    • Owner arrives and calls reception.
    • I try to work out which car he or she is in, then take a brief history from 2m away.
    • Take the animal into the practice.
    • Find a nurse to assist with the handling.
    • Examine the animal.
    • Telephone the owner from the practice or go back outside to discuss with him or her from a safe distance, before returning to the animal to give treatment.
    • Give the animal back to the owner.
    • Dispense medication, then ask the owner to call reception again to pay…

    This takes a lot longer than normal consults, so working to offer the same number of appointment slots is both relentless and draining.

    Lies and abuse

    Everyone is used to certain number of disgruntled clients, but the barrage of abuse those on reception are receiving from clients is unprecedented.

    It would seem many members of the public are not getting the “stay at home” message and are furious when we explain a nail clip is not an emergency. As a result, we are now seeing clients exaggerating, or just plain lying, in order to be seen.

    A choice example last week was a dog booked for a potential euthanasia, but turned out to be a weight clinic. We then had to stifle our disbelief and anger at these time wasters before moving on to the next client, who has desperately tried to hold off from having to make the difficult decision to say goodbye to their dearest pet under these circumstances – and yet we can only offer words of comfort from a distance and inject from the end of a drip line, which really doesn’t seem enough.

    Unfortunately, the COVID clearout seems to be worse than the annual Christmas clearout, and these scenarios are not isolated, but heartbreakingly frequent.

    Lost in translation

    And what support do we get? We get the RCVS and BVA back-pedalling on their original statement, to then shirk responsibility and leave it “up to individual practices” to interpret the “guidance” how they wish.

    After the clarity of the original stance on vaccinations, this ambiguous follow up was very disappointing. The truth is many vets feel that corporates and business owners will take this as a green light to return to business as usual, while firmly claiming that it is most definitely not business as usual.

    I can agree with that – the way we are working is certainly not the usual, but if we are now to do vaccines and neutering again, what exactly are we missing? Stable med checks, done via telephone rather than in person?

    Taking the high or low road?

    We get colleagues taking the moral high ground, questioning our commitment to the oath we took on graduation to put animal heath and welfare above all else. Just because I don’t think vaccinations are currently a priority, it doesn’t mean I don’t care about my patients anymore – human health has to come first.

    We get corporates issuing yet more paperwork to encourage us to document risk assessments – while seemingly offsetting the responsibility to us – so that if their business gets sued for denying to provide care or (God forbid) agreeing to see an animal that results in transmission of COVID-19 between owner/vet, it was the vet or receptionist who took the phone call’s fault for making that decision.

    Aside from this, the phones are ringing off the hook and vets are running around like blue-arsed flies, so practically, where are we going to find the time to fill in these bloody forms?

    Horseplay

    Before any of that, the request to risk assess mild ailments is fundamentally flawed when we are being told to go out and do horse boosters.

    While equine vaccinations and other routine work that is now being pushed again, because equine turnover is the most severely affected of all veterinary sectors, we are told to maintain safe social distancing at all times.

    With equine vets reported to be one of the most dangerous occupations, is it sensible to expect us to administer vaccines with no one holding the horse? In some, if not most, cases, that will probably be okay. But with owners consistently lying to us to be given an “emergency” appointment, how long before an owner lies about his or her severely needle/vet-shy horse and one of us pays the price?

    Heading for burnout

    I don’t pretend to understand the intricacies of business management, but you cannot flog a dead horse. Many vets who have barely had time to inhale lunch are working different and longer shifts just to cope with the “emergencies” – and yet you’re asking us to do more?

    It’s incredulous that the veterinary sector seems to think itself superior to all the other thousands of businesses up and down the country that are struggling or facing collapse. By continuing to pile the pressure on to staff with increasing risk of burnout, you might preserve some income, but you’ll be lucky to have any vets left by the end of this.

    Is anybody listening?

    We are angry that the higher-ups in the profession are treating us this way. We feel guilty for being jealous of, or feeling antipathy towards, our furloughed colleagues. We are emotionally drained. We feel guilty because this can only be a fraction of how front-line NHS staff must be feeling – and above all, we are exhausted.

    In a profession with an already poor record for mental health and suicide, we are now even more stretched, under even more pressure from all angles – and no one seems to be listening.

  • EMS: life, death and lost holidays

    EMS: life, death and lost holidays

    EMS is something I haven’t touched on too deeply, which is odd considering how much of a vet student’s life it takes up.

    For those not familiar with the term, EMS stands for extra-mural studies: work experience conducted outside of university term time.

    Each vet school organises its EMS slightly differently, but at Bristol we’re required to complete a total of 12 weeks preclinical work experience over the first two years of our course (“preclinical” essentially meaning anything from shadowing a vet nurse in practice to shovelling manure in a stable). It’s basically to get everybody up to speed where animal handling skills are concerned, regardless of individual animal backgrounds. Levelling the playing field as it were.

    As a second year student, this is the world I’m living in and, since I completed roughly 12 weeks of work experience to get into university in the first place, as you can imagine, EMS has become a big part of my life, and roughly a third of this year‘s summer holidays.

    Pros and cons

    There are highs and lows to every aspect of uni, but it can be difficult not to let the sheer volume of extra work that needs to be done get to you. Vet students, after all, have some of the highest numbers of contact hours among their cohorts, up there with medicine and dental students, who are also required to carry out extra non-curricular work when the majority of the student body are taking three or four months off.

    But it’s important to remember there’s a reason for it, and although you’re not yet aiding diagnoses or learning neutering techniques, preclinical EMS teaches you a lot of skills you’ll need to have by the time you first step into practice, such as patience with and confidence around animals.

    It can also help prepare you for the harder aspects of the job, and that’s really what I want to address here.

    muck heap
    “Preclinical EMS essentially means anything from shadowing a vet nurse in practice to shovelling manure in a stable,” explains second-year vet student Eleanor Goad. Image © Nigel Baker / Adobe Stock

    There at the end

    Working on a farm for any decent period of time will allow you to become familiar with two things: life and death.

    Death is a part of the veterinary career that’s easy enough to understand as a concept, but far more difficult to teach in practice; vets face the death of patients regularly enough that their mental health as a profession rivals that of human medicine for being so staggeringly low. In my mind, it’s definitely an area of our education that could be improved upon, but the trouble is it’s so difficult to do.

    For example, I have been volunteering at my local practice for almost seven years and yet I have never seen an animal euthanised. This isn’t for lack of opportunity but, rather, a case of respecting the owner. I’ve had to leave many a consult once the bad news is broken, regardless of the level of training because, quite understandably, having your animal euthanised is a very personal and emotional experience that you wouldn’t want a stranger observing – especially one with an open notebook and poised pen.

    The (other) problem with death

    The trouble is, giving patients the space they want and deserve might not be in their best interest in the long run – especially if it goes on to produce a generation of veterinarians who’ve never seen euthanasia until a whole three or four years into their training.

    Nobody wants some trainee hovering over such a private and, often, devastating moment – I know I certainly wouldn’t – but if the procedure is to be done with the same level of maturity, professionalism and understanding as it demands, this takes observation and learning, like anything else.

    This is one of the reasons why I think EMS plays such a vital role in shaping young vets outside of the lecture theatres and in the real world.

    Perfectly placed

    My latest placement is on a pig farm, and despite being one of the most enriching and enjoyable weeks I’ve completed so far, it has hit me, emotionally and personally, in way I had not anticipated.

    I’ve spoken before about how working with livestock intended for human consumption is different from working with cherished pets (and it definitely is), but an animal is still an animal and, especially when you’re starting out, it can be difficult to acclimatise to the professional separation the job often entails.

    That said, I’m incredibly glad for my experiences over the past week and in every placement I’ve been lucky enough to visit. Farmers and veterinary professionals alike offer up so much of their time and experience to help you improve your own skill set in ways you never even knew it needed. You grow in ways you didn’t expect and your opinions change a little bit each day in light of everything new you learn.

    On paper, EMS might sound like a lot of lost holiday time and long days of manual labour but, in reality, you only get out what you put in. And what you get out is often invaluable.

  • Musings on a month in Morocco

    Musings on a month in Morocco

    Obviously I’m biased, but I think the University of Glasgow offers the best selective rotation options of the vet schools in the UK. Numerous opportunities exist to go abroad, with a variety of options based on species or type of practice.

    Jordan in Morocco
    Jordan spent a month working with American Fondouk.

    The traveller in me was never going to pass up an opportunity to take to the skies, so halfway through my final year (eek) I found myself with five classmates on a plane to Morocco.

    Language barrier

    American Fondouk is a charity clinic for the working equids of Fes. Every morning the gates open at 8am and a stream of mules, donkeys and horses wander in with various ailments.

    My French is minimal and Arabic non-existent, so history taking usually involved the owner pointing at the affected body part and translation with the help of a multilingual staff member. Even so, the histories were usually little more than “he fell over” or “it’s been like this for a week”.

    Clinical exams were also not without challenges. For a start, it’s important to note donkey “normals” are different to those of horses (at first, we thought everything was hypothermic), and mules kick – in every direction.

    Normal’s not normal

    horse-delivery
    “It’s been like this for a week…”

    Treatment of outpatients could vary from ivermectin and a dental to admission and intensive care for critical cases. It was just a case of dealing with whatever walked through that door.

    Certain normal parameters for horses are different in Morocco than in the UK and for a while I couldn’t understand why so much fuss existed about PCVs of 40% – it turns out the Moroccan normal range for PCV is much lower than I was used to.

    A full hospital with multiple high-maintenance inpatients certainly kept us on our toes for the month. However, after a couple of weeks, we’d gotten used to a lack of sleep, the protocols for treating certain conditions and the general craziness our daily lives had become.

    I felt competent with a number of practical skills I’d never tried before I came to the clinic and could diagnose a tetanus case before it was even off the box. Wound care and bandaging were daily requirements – it was astonishing to see how well some seemingly horrific wounds would heal and the animals recover.

    Ethical dilemmas

    equids-morocco
    Acting in the interests of the animal without its owner’s permission is not allowed in Morocco.

    The hardest thing I found about working at the clinic were the ethics surrounding euthanasia.

    To the owners, these animals are often their only source of income – their livelihood – and the economics of replacing a mule are heartbreaking. Emotions run high when a seriously sick mule with a heart rate through the roof, suspected of a surgical colic, desperately in need of the pink juice would leave the owner with nothing.

    The other logistical obstacle is the legal status of these animals. In Morocco, these animals are considered property of the owner and as such, permission must be gained before euthanising an animal.

    Acting in the interests of the animal without permission is not allowed, so if an owner is not contactable, some unavoidable suffering may occur. This is limited as much as possible through pain relief, despite knowing what ultimately needs to happen in the interests of the animal.

    Outside the box

    On the whole, we were able to do our best for our patients and provide the optimum care.

    I had a great, albeit exhausting, month. Working in a busy environment with somewhat limited resources pushes you to think outside the box and embrace different approaches to problems.

    I learned a lot, gained confidence and even managed to discharge a patient in stilted Arabic by the end.

  • Dealing with children and other animals

     

    Image ©iStock.com/Photo_Concepts

    Not everyone loves children and, certainly, a proportion of people who choose to become vets would rather avoid them and stick to dealing with animals.

    However, it’s important to realise early on that, depending on the type of vet you become, you’re likely to see a large number of worried pet-owning children walk through your consulting room door.

    Practice types

    In general practice, farm vets are most likely to have adult clients to deal with, although some children will be very involved in the family business from an early age and may attend appointments.

    Equine vets will treat a lot of children’s ponies and, as such, may be expected to discuss the pony’s health and prognosis with the child as much as the parents.

    However, it is the small animal practice vet who is most likely to meet children as the owners of small, caged pets, as well as part of family units worried about their dog or cat.

    Appropriate communication

    Not everyone is comfortable with children, but you must be able and willing to hold a conversation with them to ensure you fully explain the care and treatment of their beloved pet and the importance of their role in that.

    If the thought of this causes panic, consider becoming a farm vet rather than a small animal vet, where you are likely to encounter young owners most often.

    If a child is obviously interested and asking lots of questions about pet care, try not to get frustrated and do your best to answer in a way the whole family can understand. Remember, you are providing a service to all the family, not just the bill payers.

    Saying goodbye

    Unfortunately, many young owners attend with older, ailing small pets, including rodents and rabbits. Treatment options in these cases can be limited and humane euthanasia may be required.

    Parents may have anticipated this. However, life and death is a difficult concept for children, and the family may prefer to outline the situation their own way.

    If possible, before proceeding, allow parents a few minutes alone with their children, so they can explain the fate of the pet in a way they are comfortable with.