Most of the cases we see out of hours turn out not to be
true emergencies, but in the case of "Ginny",
a 10 year old Yorkshire Terrier, there was no doubt when
I saw her at 3am on a Sunday morning that she was a genuine
emergency, and I certainly couldn't resent getting out of
bed to see such a case.
Ginny had collapsed, and when I saw her she was rigid and
unable to stand. Her heart rate was extremely slow, and
I soon realised that if I didn't act quickly, Ginny would
die. I called in the on-call nurse, and we ran some blood
tests and an ECG, and realised that Ginny was having an
Addisons disease is an uncommon condition where the adrenal
glands (small glands near to the kidneys) stops producing
certain vital hormones. The most serious consequence of
this is that the body cannot regulate the levels of sodium
and potassium in the blood. When the potassium levels rise,
the heart muscle cannot function normally, and eventually
the heart will stop altogether.
We had to take rapid action to reduce the levels of potassium
in Ginny's blood (which was twice normal levels). We did
this by putting her on a drip, to dilute the potassium down,
and also by giving her drugs which cause the potassium to
move out of the blood and into cells in the body, where
it is less harmful.
Ginny required intensive treatment over the next few hours,
but gradually started to respond to treatment. She remained
in hospital for a further five days before she was stable
enough to return home - her £800 bill all fortunately
paid for by her pet insurance. She will need lifelong "hormone
replacement therapy", but the outlook for her now she
is over the crisis is excellent.
With hindsight, I should probably qualify my statement
about out of hours work: it can be one of the worst points
of my job, but in life-or-death situations like this, it
can also be one of the most rewarding parts! I'm sure Ginny
and her owners would agree.
Young BVSc CertSAM MRCVS
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