Wednesday, September 26, 2007

Low Calcium = Bad News

I have been on call a dozen times, and it wasn't until this past weekend that I got an early morning call that I actually had to go into the clinic for. I certainly can't complain with a history such as that. My phone has stayed mercifully silent in the wee morning hours. So, when my phone did start ringing at 3 am Monday morning, I figured my good fortune had changed even before I answered it.

The lady at the answering service cheerily informed me that there was a client, Mr. Earlyriser, who had woken up to get ready to go the work and had found his Yorkie, Mama, unable to stand, twitching, and panting. And, by the way, Mama had four 3-week old pups. As preeclampsia immediately jumped to the top of my differential list, it didn't take me long to convince Mr. Earlyriser that I should take a look at Mama pronto and not wait until 7 am when the office would open, and he could avoid the emergency fee.

I met owner and pup at the clinic, and one look at the dog confirmed my suspicions. Mama's legs were rigid, her muscles tense. She was panting and clearly in distress. Her temp was 103.1 and her heart was racing. I let Mr. Earlyriser know that Mama most likely had a calcium deficiency secondary to her quickly growing puppies. We would need to give her IV calcium and hope that would be enough to help her. Otherwise, we would need to hospitalize her and put her on IV fluids and a CRI (continuous rate infusion) of calcium.

There are a lot of the tricks-of-the-trade I am still learning. Hitting veins to collect blood or inject something is still something I'm working on. Due to the plethora of helpful students at school, we learn who to do so with the benefit of people who know how to hold an animal and know how to hold off a vein. Now in the real world, all I have is a well-meaning but ignorant owner, a nervous not-very-well restrained toy breed dog and a tourniquet.

Fortunately, all went well. The calcium got in (nice and slowly, avoiding dangerously low heart rates if it goes too fast) and, within 10 minutes, Mama was up and walking, albeit somewhat stiffly. After warnings that this is likely to happen again if it happens once, and it is a deadly, life-threatening condition that demands immediate attention, Mr. Earlyriser and Mama went home.

I didn't really get much in the way of productive sleep after that. After I wrote up the record, checked on the other critters in the clinic, locked up and arrived home, it was only an hour or so before I normally get up. But that is fine. Mama did well, and is feeling much better. Preeclampsia is one of the very few conditions in which one injection can produce a miraculous cure within minutes. That's a situation that makes everyone feel good. If only there were more conditions like that.....

1 comment:

Lily said...

Good job!! That happened to poor Bibi too :(