Visiting Vet: Sea change

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On Thursday evening, August 25, I got a call from Richard, my mother’s partner for 28 years. Both in their 90s, the two have been living independently in the house where I grew up in Connecticut. Richard still drives, and most days he and my mother would go to Calf Pasture Beach and walk along the shore. In recent years, my mother, who is 97, often opted to wait in the car enjoying the view while Rich walked, but occasionally she would venture out, take Richard’s arm, and promenade slowly with him to the pier and back. But that Thursday evening, everything changed. My mother fell down the stairs at home, and was taken by ambulance to the hospital.

On Saturday morning, Oct. 1, another big change happened here on the Vineyard. For more than 20 years, Island veterinarians have had a volunteer coalition taking turns providing emergency care after hours and weekends for both large and small animals. To clarify, in veterinary parlance, “large animal” refers to big farm animals. Horses, cows, sheep, goats, pigs, llamas, alpacas, maybe even emus and ostriches. “Small animal” means dogs and cats, and “pocket pets” like guinea pigs, hamsters, rabbits, and rats. It may also include birds of all sizes, from cockatoos to canaries, and even reptiles like iguanas and geckos. But nowadays birds and “exotic” pets are often the purview of vets who specialize in such critters. So what is changing here, and what does it have to do with my mother?

When I got the phone call at 9 pm, I was actually the vet on call. The last ferry, soon to depart, was fully booked, and I no longer drive on the highway after dark anyway. “Maybe she just has a bad bruise or sprain,” I said optimistically. But reality slowly set in. I began packing. Unable to sleep, I drove to Vineyard Haven before dawn, and managed to get the 5:30 am ferry standby. As I stood on the deck of the freight boat watching the sun creep over the horizon, I suddenly remembered I was still on call. Well, early morning emergencies are uncommon. I would field any calls by phone and, if necessary, wake up whichever doc was scheduled to take over next.

Twelve hours later, after much deliberation, including last-minute misgivings on the part of the surgeon about the risk-to-benefit ratio, my mother had a partial hip replacement. A hemi-arthroplasty, in ortho lingo. I won’t take you through the days that followed. Many of you have been there in one way or another, caring for a frail elderly parent, seriously injured child, or critically ill loved one. I quickly learned that hard as it was for me to accept, the needs of my mother eclipsed those of my patients and their people. I simply could not manage both at full capacity. I relied on telemedicine, my staff, and the kindness of other veterinarians to care for my patients as I negotiated a maze of decisions, emotions, and responsibilities for my mother. After three weeks, when I finally felt I could risk leaving her temporarily, I drove home to work for a few days.

The night after I returned, one of my favorite dogs, a 13-year-old epileptic springer spaniel I’ll call Whitecap, fell down the stairs. The poor guy was unable to stand up. His right front leg was swollen and painful, and his hindlegs also seemed affected. He had feeling and motion in all limbs, indicating an intact spinal cord, but just could not support his own weight. The parallels to my mother did not escape me. She could not stand up. Her right arm had inadvertently been pinned under her body during surgery, causing a problem with her IV catheter, leaving her entire right forearm massively swollen and purple. Even her memory loss and post-anesthesia dementia felt like a neurological equivalent of Whitecap’s seizures. 

Unlike my mother, Whitecap’s radiographs did not reveal any fractures. “Maybe he just wrenched his back and sprained his foreleg,” I said dubiously. Over the next two weeks, we tried splints, harnesses, and various pain medications. I drove back and forth to Connecticut, but stayed in touch. We tried doxycycline in case tick-borne disease was implicated. He still couldn’t stand up. I suggested consulting an orthopedic specialist. I tentatively mentioned euthanasia. Finally, I shared the old vet’s adage, “No animal should die without the benefit of steroids,” and prescribed the potent anti-inflammatory prednisone. Much to everyone’s delight, Whitecap responded well, and was soon able to get up and walk a bit on his own. My mother? I’m too superstitious to say much, but she also seems on the road to recovery. Her fall, however, precipitated a sea change that was about to happen anyway. 

There is a nationwide shortage of veterinarians. It is especially severe here. One of our group is taking a month’s leave. Another has stopped doing any emergency work at all. The hard reality is that although our “urgent care” coalition continues, there may not always be an Island veterinarian on call. So after hours, please start with a VetTriage telemedicine consult via urgentvetcaremv.com. Their doctors will give medical advice, and will know if an Island doc is available if needed. What about those rare occasions when no local veterinarian is available, but VetTriage advises immediate care? For small animals, take the ferry (or call the Patriot Boat and then an Uber), and go to Cape Cod Veterinary Specialists in Bourne. For large animals, call one of the mainland equine practices, and follow their advice until an Island large animal vet becomes available. We ask for your understanding. We’re getting older. Our numbers are dwindling. Maybe our parents are failing, or our children need us. Maybe we are hoping to retire, or our own health requires us to slow down. We’ll continue to do the best we can for you and your animals, but I have to go call my mother now.