is still fairly young for a small dog. He was a rescue dog, they explained. They’d found him at a dog pound when he was just a puppy and they’d been devoted to him ever since.
As I went through a basic examination, which Mickey tolerated patiently, I rattled through a mental index of possible causes for a dog vomiting blood. The trouble was, it could mean so many things. Had he swallowed a foreign body? Did he have a tumour? Did he have gastritis? Did he have stomach ulcers? Did he have worms? Or might it be an infection?
This was my very first case as a fully qualified vet, and it had to be a complicated one. I had been hoping for something simple; a dose of worms, perhaps, or a vaccination and a bit of flea advice. Instead, here was Mickey, with his mystery condition.
It was early August 2014 and I had been a vet for all of three weeks. After graduating from the Royal Veterinary College (RVC) I’d signed on with an agency as a locum and here I was, on my first day at Braxton’s, a small practice in East London, filling in for two weeks while the regular vets were on holiday.
After five long years of study and training, I could still hardly believe that I’d actually made it. We’d been pushed to the limit – and never more so than in our final year, when we’d worked on rotation in every kind of practice, from small animal to stable, to farm and even the zoo. It was non-stop; sometimes terrifying and constantly demanding. But no matter how tough the challenges, there had always been a qualified vet supervising everything I did. Now I suddenly felt as if I’d had the safety net whisked out from under me. For the first time, I was on my own.
I took a deep breath. ‘I think we need to give Mickey an X-ray to see what’s going on in his stomach. There are a number of things that could be wrong and hopefully that will give us a much better idea of what it is and whether he might need surgery.’
Mickey’s owners looked at me, white-faced. ‘Will it cost much?’ said Mrs Thomas. ‘Because we don’t have pet insurance and we haven’t got a lot of money.’
My heart sank. The sum they mentioned wouldn’t cover the X-ray, let alone surgery, which could potentially run into hundreds of pounds. At college they’d taught us to diagnose and treat, but they’d given us very little advice about what to do in financially restricted situations.
In an ideal world, you would want to get a specific diagnosis and treat it directly, but I was becoming increasingly aware that the situation with Mickey was far from ideal. At this stage, Mickey didn’t seem like he was critically ill, and it also didn’t seem like he had an obstruction, since he was passing stools, so I felt confident that we could trial some treatments and come back to talk about further diagnostics if he didn’t improve, maybe with some financial help from a charity. So for now all I could do was give Mickey the medication that his owners could afford and hope it would be enough. I stroked him gently while I attempted a confident smile. ‘Don’t worry, there are a few things we can do that will hopefully help Mickey.’
I gave him a shot of steroids to bring down the inflammation in his stomach, plus a wormer and a rehydration electrolyte solution to drink and told them not to feed him for 24 hours to allow his stomach to settle, and then to give him a bland diet of boiled rice and chicken.
‘Keep a close eye on him,’ I said. ‘And if he isn’t improving in two days, bring him back in.’
‘Thank you so much. We will. Come on, Mickey,’ they murmured, tucking him into Mrs Thomas’s jacket. They left looking a little happier and I crossed my fingers and hoped they wouldn’t need to return.
‘Fancy a cup of tea?’ Karina, the practice nurse, asked.
‘Yes, please,’ I said gratefully. ‘And any chance of a biscuit?’
That morning, at the small hotel where I was staying, I’d been too nervous to eat breakfast. I normally love breakfast, but the prospect of starting my first real job had my stomach doing flips.
I had arrived at the practice bright and early and Karina had greeted me warmly.
‘Are any of the regular vets here?’ I had asked.
‘No.’ She smiled. ‘All three of them have gone away at the same time. It’s just you and another locum.’
I had tried not to look as alarmed as I felt. I had been hoping for a bit of hand-holding as I eased my way in, but there was clearly no chance of that. The other locum, Wanda, came in a couple of minutes later. She was from New Zealand and after we’d said hello she told me she had qualified 18 months earlier. At least she had a bit more experience than I did, but there was no getting round the fact that the place had been left to two vets who were unfamiliar with the practice.
Luckily we had Karina to help us. She was bubbly and smiley and knew her way around, which was a relief, because when we peered around the waiting-room door on that Monday morning we saw that it was already packed with animals and their owners. Karina offered to come into the consulting room with me to help me find my feet and I accepted gratefully. Just having her there, chattering away, made me feel much happier.
‘You only get 10 minutes per consultation here,’ she had announced cheerfully. I looked at her, feeling daunted. As vet students at the Royal Veterinary College’s state-of-the-art Queen Mother Hospital (known as the QMH) we’d had a whole 40 minutes in which to take the animal’s history in minute detail and perform the initial examination, before referring our suggested course of treatment to a senior clinician. Most practices allow 15 minutes, but some busy ones across the country have shorter consults, so 10 was going to be high pressure.
At least I had only agreed to do consultations. I didn’t feel ready to perform surgery on my own yet, without a more senior vet around. Wanda had agreed to do any surgery that cropped up, and thankfully she seemed fine about it.
After Mickey had disappeared with his owners, he remained on my mind. He was such a sweet little dog, I just hoped that whatever was wrong with him wouldn’t turn out to be serious and that the treatments I’d given him would sort out the problem.
The rest of the morning flew by and over a sandwich lunch Wanda and I compared notes. I told her about Mickey and she said she’d been bitten by an angry cat and had to put a very sick hamster to sleep.
Wanda was one of those people with a totally upbeat nature. She spoke with an accent so heavy that I had to concentrate to follow what she was saying. So I wondered if I’d heard her right when she announced that she was off to get a tattoo that night.
‘Really?’ I said. ‘A tattoo? I’d never be able to decide what to have. Plus they really hurt, right?’
‘Ah, won’t bother me,’ Wanda said. ‘I’ll just put a stick between my teeth and bite hard.’ She laughed as she got to her feet. ‘Better go, I’ve got a cat to spay and a pregnant guinea pig to look at.’
After a long afternoon, most of which seemed to be filled with overweight dogs, I began to feel as though the day would never end. When the final patient had left, I said goodnight to Karina and Wanda and gratefully went back to my hotel. Too tired to eat a proper meal, I bought some Pot Noodles on the way and ate them in my room where, thankfully, there was a kettle.
Locum work is tough for a vet straight out of college, but I’d chosen to do it rather than take a full-time job in a practice because I was planning to spend much of the next year travelling. I wanted to see some of the wilder parts of the world and to work in areas where people had no access to a vet.
My first stop would be South Africa in a few months’
