An ethical poser

RE: An ethical poser

Mark Hedberg — Wed, 15 Aug 2018 20:00:42 GMT

[quote user="Thomas Johnson"]

[quote user="Mark Hedberg"]Probably because 99% of owners will mis-report to their friends that "The vet said it was agony breathing, it was horrible!!!" [/quote]

Or you warn them beforehand, "sometimes after they've gone there are some reflex breaths, they can sound a bit distressing, but they're not a sign of any pain or discomfort."

[/quote]

I always called them reflex breaths :)

RE: An ethical poser

Thomas Johnson — Wed, 15 Aug 2018 12:43:13 GMT

[quote user="Mark Hedberg"]Probably because 99% of owners will mis-report to their friends that "The vet said it was agony breathing, it was horrible!!!" [/quote]

Or you warn them beforehand, "sometimes after they've gone there are some reflex breaths, they can sound a bit distressing, but they're not a sign of any pain or discomfort."

RE: An ethical poser

Mark Hedberg — Wed, 15 Aug 2018 11:50:41 GMT

[quote user="Thomas Johnson"]

[quote user="Neil Wheadon"]I've been euthanising dogs and cats for the past year, trickling the euthatal in slowly rather than bolusing. I haven't seen the paddling/chain stoking and it's a lovely way to do this, I'd recommend this way to anyone. My impression as well is that I need less drug.[/quote]

Interesting, but as an aside why do vets generally refer to agonal respiration:

https://en.wikipedia.org/wiki/Agonal_respiration

as Cheyne-Stokes respiration?:

https://en.wikipedia.org/wiki/Cheyne%E2%80%93Stokes_respiration

[/quote]

Probably because 99% of owners will mis-report to their friends that "The vet said it was agony breathing, it was horrible!!!"

RE: An ethical poser

Luke Edwards — Mon, 13 Aug 2018 20:20:45 GMT

[quote user="vetbl.locum"]Surely once the cat had been scooped just transport it to nearest vet clinic? Why was attendance needed at roadside?[/quote]

Both the Member of the Public and the RSPCA said that the clinics that had been contacted either refused to see the cat or had directed the guy to an out of hours clinic 1 hour away. Since the guy had just come off a late shift and was exhausted, and since he had already spent considerable time trying to locate the cat's owner he didn't really want to drive an hour back in the direction he had come from. I don't really blame him - remember the guy was not the cat's owner and was just being a good Samaritan - willing to put bit more effort into this cat than the practices that were contacted.

RE: An ethical poser

Thomas Johnson — Mon, 13 Aug 2018 15:59:50 GMT

Interesting, but as an aside why do vets generally refer to agonal respiration:

https://en.wikipedia.org/wiki/Agonal_respiration

as Cheyne-Stokes respiration?:

https://en.wikipedia.org/wiki/Cheyne%E2%80%93Stokes_respiration

RE: An ethical poser

Evelyn Barbour-Hill — Mon, 13 Aug 2018 15:47:31 GMT

Agreed. I've been doing this for three or four years and recommend it. When the patient is unconscious, of course you can whizz the rest in as quickly as you like.

I wouldn't suggest this for horses though.

RE: An ethical poser

Iain Richards — Mon, 13 Aug 2018 14:53:19 GMT

[quote user="Anthony Dennison"]

[quote user="Anthony Todd"]I still think trying to get 60 ml in a 60ml syringe into a horse's jugular when it may be thrashing about will be difficult but at least it seems we have established that 60 ml quickly will drop any horse [or is slowly better?][/quote]

[/quote]

3 x 20ml is faster and a lot easier

RE: An ethical poser

Michael Woodhouse — Mon, 13 Aug 2018 14:51:36 GMT

[quote user="Anthony Dennison"]Because you don't go directly off the syringe, you use an extension line...[/quote]

I don't. Much easier to move with the horse if your hand resting on the neck

RE: An ethical poser

Anthony Todd — Mon, 13 Aug 2018 12:56:05 GMT

[quote user="Anthony Dennison"]Because you don't go directly off the syringe, you use an extension line...[/quote]

Sorry, must have missed that bit; makes sense!

RE: An ethical poser

Anthony Dennison — Mon, 13 Aug 2018 12:51:46 GMT

Because you don't go directly off the syringe, you use an extension line...

RE: An ethical poser

Anthony Todd — Mon, 13 Aug 2018 12:44:31 GMT

[quote user="Arlo Guthrie"]VetSurgeon.org produced some 'in-emergency-break-glass how-to guides' for rare scenarios which nevertheless happen often enough for it to be helpful.[/quote]

Exactly why I have persisted [and the variation in dogma has amazed me!].

I still think trying to get 60 ml in a 60ml syringe into a horse's jugular when it may be thrashing about will be difficult but at least it seems we have established that 60 ml quickly will drop any horse [or is slowly better?]

I am sure that loads more vets now have a protocol for something they may never have to do but if they do are relieved.

RE: An ethical poser

Anthony Dennison — Mon, 13 Aug 2018 12:42:04 GMT

[quote user="Michael Woodhouse"]I have it on good authority 400ml of Hibiscrub will kill a cow when stored in an old calcium bottle and given IV (not me thankfully).[/quote]

I've seen this. When I was a student, I spent 4 weeks in Jaipur. We put a rabid camel to sleep using chlorhexidine, about that amount.

As a side note, a camel's jugular is massive. about the size of my forearm.

RE: An ethical poser

Iain Richards — Mon, 13 Aug 2018 10:19:14 GMT

[quote user="Beats"]

PS - I would NOT recommend the scalpel up the rectum trying to cut aorta! I have it on good authority from a first time practitioner of the technique that this is neither as simple nor as effective as fabled...

[/quote]

It isn't. Mine was actually cutting the aorta after a slash type caesar. I asked if the farmer had a gun, he said no, then, after the cow eventually died, said, "I do have a shotgun"

RE: An ethical poser

Clare Tapsfield-Wright — Mon, 13 Aug 2018 10:18:47 GMT

I see where you are coming from Arlo though I always have concerns about written protocols in one off situations which could lay down a right way or a wrong way in tablets of stone.When in dire straits sometimes you just have to make a decision using your brain and awareness of your capabilities, and what you have to hand , even if there could have been a better way using the retrospectroscope later. Some loose guidelines could be helpful though, you are right.

RE: An ethical poser

Arlo Guthrie — Mon, 13 Aug 2018 09:55:28 GMT

This thread makes me wonder if it would be useful if VetSurgeon.org produced some 'in-emergency-break-glass how-to guides' for rare scenarios which nevertheless happen often enough for it to be helpful.

This might be a starting point. Instructions for SA practitioners: How to deal with a large animal RTA, inc how to euthanise a horse/cow/sheep etc.

I'd obviously get them written by LA / Equine practitioners (ie not just me googling the answer!).

Probably also cover SA emergencies for LA practitioners.

I suspect there would be quite a lot of stuff we could prepare about exotics and small mammals too.

RE: An ethical poser

Neil Wheadon — Mon, 13 Aug 2018 09:54:49 GMT

[quote user="Beats"]100ml of euthatal will kill most animals in my experience as long as pumped into vein fast enough[/quote]

I've been euthanising dogs and cats for the past year, trickling the euthatal in slowly rather than bolusing. I haven't seen the paddling/chain stoking and it's a lovely way to do this, I'd recommend this way to anyone. My impression as well is that I need less drug.

Neil

RE: An ethical poser

Wren — Mon, 13 Aug 2018 08:59:42 GMT

[quote user="Beats"]Out of curiosity, how far does a bottle of medetomidine / ketamine go in a horse?[/quote]

Never used medetomidine in a horse, but to GA a horse in the field I use 3ml/100kg of ketamine, following strong sedation with romifidine/detomidine and butorphanol.

RE: An ethical poser

Beats — Mon, 13 Aug 2018 08:10:29 GMT

RE: An ethical poser

Beats — Mon, 13 Aug 2018 08:09:05 GMT

100ml of euthatal will kill most animals in my experience as long as pumped into vein fast enough. I'd be very nervous having only 100ml of euthatal in stock though - not a drug I like to be rationing.

Certainly enough that could be finished off with something else found in a smalley (KCl) into the vein humanely I would have thought?

Out of curiosity, how far does a bottle of medetomidine / ketamine go in a horse?

Having a large enough bore needle / catheter would be my biggest concern, but I would imagine I would attend. (I have attended horses in RTA's before armed with not very much - my logic being I'm probably more use than the other folks already at the scene - on one occasion I came flying down the dual carriageway expecting carnage with a loose horse on the road to find a dead horse with a blue flashing light on top of it - I poked it in the eye, confirmed it was dead and I offered to help pull it off the road (declined) before returning to the clinic.)

It's hard to justify insisting on large animal component to course for vets wanting to do small only if euthanasing a horse involved in an RTA is not considered a core skill...

I thought vets had to have an agreement to "farm" out emergency/large-animal work to another clinic if not doing themselves?

I'm not being critical of vet in question, I think the only person capable of making a sensible decision at a given time is the vet being asked.

RE: An ethical poser

Michael Woodhouse — Sun, 12 Aug 2018 23:28:51 GMT

Mag sulphate works, I've used it. German vet I saw practice with gave cows 50ml Pentobarb and 400ml MgSO4 and it was nice.

I have it on good authority 400ml of Hibiscrub will kill a cow when stored in an old calcium bottle and given IV (not me thankfully).

RE: An ethical poser

Virginia Campbell — Sun, 12 Aug 2018 23:08:25 GMT

[quote user="Wren"]or working where Michael does where people are tight[/quote]

I think this may have been the reason for the method used where I started as a new grad.

There was a bottle of Somulose in the dangerous drugs cabinet, but I think it was being kept for Sunday best as I never saw it used. I don' t know how much it cost.

Homemade mag sulph is cheaper than pentobarb, so I think the method I was shown was a pentobarb sparing technique. I only recounted it here thinking what I would do now if I only had small animal stuff available and not enough pentobarb to be sure of killing it, and nobody with a gun handy.

RE: An ethical poser

Clare Tapsfield-Wright — Sun, 12 Aug 2018 22:55:36 GMT

The nub of this issue is that if an animal of whatever species is injured then do what you reasonably can to help it, and the situation, whether by phoning for someone more qualified, or stopping an arterial bleed, or stopping some wellmeaning person getting kicked in the head. It would be highly unlikely that there are many occasions where a vet would have to do something heroic and no one is expected to risk their own safety but it should not be the case that a vet casts about for excuses to avoid attending or to walk on by while an animal suffers.

I would expect a doctor or a dentist to do the same if a human collapsed in front of them , even if it’s just calling 999 or using a public defibrillator. Would they really leave that to someone who had never seen one before and carry on doing their shopping? If so then that’s not the way I would like to see our profession go.

most vets I’ve known over the years have scooped injured cats up off the road when off duty at great inconvenience and taken them to the surgery. A vet nurse did so for my cat one night after an RTA which broke his spine and I will always be eternally grateful to her for doing so, as she saved him from a long slow death in the road.

RE: An ethical poser

Wren — Sun, 12 Aug 2018 22:27:09 GMT

[quote user="Stephen Courtney"]Reading Virginia's instructions on how to perform IV equine euthanasia, I'm horrified at the thought of being expected to do that.[/quote]

I'll be honest, I'm an equine vet, been in practice nearly 20 years, euthanased more horses than I can possibly remember, and I'm slightly horrified. That's ridiculously complicated. I use Somulose - 50mins IV, given slowly, with or without a drop of sedative first. Job done. However for the purposes of this post, if I were a SA vet (or working where Michael does where people are tight...) i'd follow Michael's protocol above for pentobarb. I give the Somulose either off the (16 or 18g) needle, or using the 16g catheter supplied with the Somulose. However I neither use local in the skin nor suture it in.

RE: An ethical poser

Stephen Courtney — Sun, 12 Aug 2018 22:14:37 GMT

Reading Virginia's instructions on how to perform IV equine euthanasia, I'm horrified at the thought of being expected to do that.

I've shot a couple, but never performed an IV euthanasia on a horse, and haven't touched one for 25 years - I'm exquisitely sensitive to horse dander mixed with hay dust - so even finding an IV would be a concern let alone all the advice on how to avoid being crushed under an unconscious animal much bigger than me.

My last use of firearms coincided with Dunblane - now have no license ( gratefully) and no weapon but I would happily show the police marksman where to put a bullet.

RE: An ethical poser

Stephen Courtney — Sun, 12 Aug 2018 22:09:58 GMT

[quote user="vetbl.locum"]

[quote user="Luke Edwards"]

The most notable case was when the RSPCA rang at 3am to ask if I could attend a RTA cat at the side of the road. I said I was willing but perhaps other practices would be better qualified than me to deal with it The RSPCA said that other practices had been contacted but either a) did not do out of hours or b) were not willing to attend. This was corroborated by the member of the public who had scooped the cat off the road and was genuinely surprised and upset by the lack of enthusiasm shown by the practices he had contacted. Thankfully the cat had only minor injuries, but I was not impressed that an equine vet seemed to be the only one willing to help.

[/quote]

Surely once the cat had been scooped just transport it to nearest vet clinic? Why was attendance needed at roadside?

Rgds

[/quote]

Clearly no one had a suitable blanket...