We all wonder how things have changed for every profession and walk of life since lockdown and us all adapting to the ‘new normal’, so here is a day in my life to share what it is like to be a vet coping with the changes of how the pandemic has shaped a new way of being a small animal vet.
I work as a weekend GP vet (consulting only) at a really lovely practice in Nottingham. I have worked there since 2003 – on and off as we are an army family and have been sent to live abroad for many years. I did however keep working weekends even when posted to Northern Ireland as I used to catch ridiculously cheap Ryanair flights from Derry airport to East Midlands purely because I loved the practice!
My choice of only consulting comes from a love of people and animals. I am fascinated by the human animal bond and find my greatest satisfaction as a small animal vet comes from listening and then advising what is best for both the owner and their much loved pet as I empathise with them all being a pet owner and an animal lover too. The bond we have with our pets fascinates me.
The pandemic has changed everything about how we all work. I have been fortunate enough to work almost every weekend since lockdown was first declared and so feel that I have adapted to all the changes as they have happened, but none of it has been easy and some of the changes that we have to make are just heartbreaking.
The practice is situated in a pretty old Victorian house with lots of rooms and one entrance leading to the reception desk as it used to be a house almost 70 years ago until it became a veterinary practice. This means that the changes needed to abide by the regulations and protect both staff and the public from the threat of catching Covid-19 has meant that even 2 months after the lifting of lockdown, we can still not allow owners into the building as we cannot safely socially distance. We have adapted and amazingly the animals have adapted and they come running into the building without their owners, rushing to the familiar waiting room expecting a bustling room full of other dogs and cats to smell, but they are only faced with a darkened room with no life, just used as a pet food storage room.
Yesterday was a typical full day of consulting on a Saturday. I arrived at work and walked around the side of the building to the front door of the practice, picking up litter on my way that was left in the carpark and on the pavement, as very sadly, the carpark and pavement in front of the vet practice is our new ‘waiting room’ and I feel a good impression needs to be made for when owners arrive. The front door remains locked with signs all over saying how owners need to stay in their cars and phone when they arrive as we will phone them back for their ‘consultation’ before their pet is seen.
I feel for all the owners as there is nothing worse than having to leave your beloved pet at the door who is reluctant to go in or who is feeling weak and ill, and having to return to the car awaiting a call from us as to how to proceed or what we have found with their pet.
The most challenging is speaking to an owner about something as important as the possible end of life of their pet without them being in front of you. As a vet with 25+ years of experience, we pick up so much from standing in front of the owner and just listening and watching them and their pet and these clues lead us to what they eventually need for their pet.
The way they move, the way they talk and the interactions they show all give us clues as to how we proceed with a very ill or very elderly pet. Talking to someone on their phone while they sit in their car about something this important is the hardest change I feel as a vet we have had to deal with. There are no social visible clues and we all hate talking on the phone and cannot truly be ourselves and show true feeling or empathy.
When a client had to make the decision yesterday about her 6 year old cat who had undergone so many tests and visits with various vets and she was just not getting better, my thoughts were with the owner and how she was coping with a chronically ill pet with renal failure. When I explained to her as gently as I could that even with the best care she was providing, her cat was not going to get better and would with time get worse as renal failure is progressive; she just broke down on the phone.
The anxiety of coping with her ill cat was affecting her own health leading to anxiety attacks. Eventually, we together came to the decision on the phone that it would be kindest to end all the suffering and offer no further intrusive and often painful tests. When I met her at the front door to sign the consent form, she was heartbroken and we both stood there in our masks and the feeling of not being able to hug or even stand close I found so so hard.
Her appointment was swiftly followed by a darling Springer puppy who had a minor concern with lameness. She flew into the surgery leaving her owner behind and madly licked me all over – mainly licking my mask. How sad that there is a whole group of puppies (so many born before lockdown with a greater demand for pets) that accept that a human wears a mask and that is their ‘normal’. They will have been in isolation with their owners when they so badly need socialisation and there will be a whole group of puppies who will grow up with behavioural concerns thinking that people walking towards them on a walk outdoors, will always cross the road and socially distance so they will never appreciate true socialisation.
Lola was a young and very sweet Crossbreed who came in with a concern over some discolouration in her eyes. We had her on the consulting table with the nurse holding her as I checked her over to find out what was wrong with her (our nurses are the true heroes here quietly getting on with their job where they cannot socially isolate from us while holding the pet on the table for us in place of the owner). Lola licked our faces and calmly allowed us to put a fluorescein dye in her both eyes as I diagnosed an autoimmune condition known as pannus. The owner also mentioned that she had diarrhoea.
When I met the owner in the doorway to give him the eyedrops for her eyes, I asked about what he was feeding her as he felt the upset stomach wasn’t that bad. He told me that she was raw fed. We do put ourselves at great risk as vets and vet nurses with dogs that are raw fed. The bacteria that remains on their saliva from the raw necks and meat that they are fed are as bad as if you just licked a kitchen counter yourself after preparing raw meat. The dangers are very real and every lick we receive from these pets worries me hugely. So many vulnerable young nurses and vets are pregnant or suffer from immune stress-related conditions that puts them at high risk of severe infections or even worse, of miscarriage if they were to contract Listeriosis from the kisses of a raw feeder, just doing their job and loving the animals under their care.
When I stood in the doorway of the practice handing over Lola and her medication, I had only 3 or 4 minutes to try and warn him of the dangers of raw feeding, as elderly Mrs Barkeley was waiting 2 metres away holding her Shih-tzu for the other vet on duty to take her little dog in and my time was so limited.
All I could say was that with the current pandemic we find ourselves in, we should all be so acutely aware of zoonoses (diseases transmitted to humans from animals) and we must ensure that our immunity is strong enough to cope. When I mentioned how dangerous it was to raw feed if anyone visiting his home and coming into contact with Lola was immunocompromised in any way (something we’ve also become more aware of); Lola’s owner mentioned that he had had his kidney removed, and he was a young man. I tried in the 2 minutes I had left to convince him to stop with raw feeding with the recent discovery of drug resistant bacteria, and E.Coli found in most samples of raw meat (mainly raw chicken), as the main cause of bacterial bladder infections or cystitis in humans; which in the case of this young owner, could be a death sentence if he was to develop an E.Coli kidney infection!
I had no time to advise, but I so badly wanted to convince him of the benefits of plant-based feeding, or at least to cook the food he was feeding, but our time consulting in the current situation is even more limited than it used to be and sadly owners are not being given honest, good advice in such a short space of time.
I had a second euthanasia later in the afternoon. Hattie was a 15 year old Jack Russell who was on so much medication for various ailments but she had stopped eating. She had been seen just 2 days ago and the vet she had seen had convinced Hattie’s elderly owner that some more tests and injections may work. Hattie stayed the same and I fully supported the owner’s decision that it was her time. I do not believe in one extra test or extra treatment if it is so obvious that a pet is not going to improve. You just end up feeling guilty as an owner that you have put your pet through more unnecessary pain just for you to hang on that bit longer and sometimes the kindest thing you can do is to find to the strength to say goodbye before this happens.
Hattie’s owner was wonderful. She was 85 (she told me) and she insisted on being with Hattie at the end. I respected her wishes and connected Hattie to a long intravenous line so that she could sit on her beloved owner’s lap and I could socially distance and perform the euthanasia. We all wore our masks which I find just so sad as you cannot truly support someone behind the barrier of a facial mask. Being with an owner when their pet is put to sleep is one of the most private and privileged moments you have as a vet as you are with someone at their most vulnerable time. Hattie’s lovely owner particularly touched me as she explained how she had had pets all her life and as she was now 85 and in a housing complex that did not allow pets, Hattie would be her last.
Mikado was a 13 year old Japanese Akita who had a weeping ‘cyst’ under her elbow as her owners described it. They did not think it was anything to worry about, but thought they should have it checked. My heart dropped when I read that she was 13 years old and had to undergo an emergency spay 3 years ago as she developed a womb infection or pyometra. This means that she had 10 years of having seasons every 6 months which very sadly hugely predisposes females to developing mammary tumours or breast cancer. Spaying at an early age protects against breast cancer. I have worked for a few years at the PDSA charity where many owners simply cannot afford to spay their animals. The number of loved dogs that I had to put to sleep due to breast cancers that were so advanced were proportionately higher compared to in private practice where most females are neutered when they are young (or at least after their first season). I always found these the hardest to deal with as I knew deep down that this cancer could have been avoided by something as simple as spaying when young.
My fears were justified when I felt Mikado’s side and she had a weeping tennis ball sized weeping lump on her chest with a hard marble-shaped lump further along on the same side. She would need a full mammary strip ie have all her mammary glands removed on the one side as a form of complete treatment. If the owners chose this, we also had to advise a chest x-ray as just as with humans; breast cancers spread very quickly to the lungs and if they had already spread, it wouldn’t be fair to progress with a very painful procedure when the prognosis was so poor.
Mikado’s pyometra operation (which also could have been avoided by early spaying) cost her young owners £1250 three years ago. I carefully worked out an estimate once I had told the devastated and shocked owners what we were dealing with. I explained that some procedures were not entirely necessary such as pre anaesthetic bloods (as she was an amazingly healthy old girl) and a histological exam to tell us what type of cancer it was, was also not necessary as it felt so obviously like a hard malignant tumour, but even with these removed; the estimate still came to over £1000. The young husband stared at me with such stress in his eyes as he explained how he had recently been made redundant from his job due to the recent job cuts in every sector and they just could not afford it. The only choice for dear Mikado was to keep her as comfortable as possible with pain relief and poulticing and cleaning of her weeping growth until the time came for her to be put to sleep.
I thought that my day could not get sadder but there was worse to come and I broke all social distancing rules.
The other day vets and I were doing last minute phone calls and getting ready to leave at the end of the day while the overnight vets arrived to take over. There was suddenly a very loud noise at the door and the doorbell was rung with someone holding their thumb to the buzzer allowing it to ring continuously. We also heard the crying and wailing of a desperate woman. The after hour vet and nurse rushed to open the door and were met by an owner holding her lifeless Border Terrier in her arms with blood coming from her dog’s mouth spilling out over the owner’s shirt. They took the Border Terrier from the owner and rushed her to the hospital at the back, but very sadly she had gone.
Everyone was around the back and I rushed to the front door where the extremely distraught owner had crumbled to the wet mat at the entrance of the practice crying and shaking uncontrollably. A nurse ran upstairs to bring her some sweet tea and I listened while she told me how they were out walking by the canal and Bonnie had run after a ball dangerously close to the road and a car had hit her and driven off. The car behind picked the owner up and rushed her straight to the practice but it was all too late and she was deeply in shock. I cried with her and broke all socially distancing rules as all I could do was imagine what it must be like to lose your pet under such terrible circumstances.
How we love our animals and the current pandemic has cemented this love even more and made our job as vets even more poignant and challenging.