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Yesterday was a wild ride for me so I thought I'd share a glimpse into the day of a mixed practitioner on call. Thread!!
Our clinic offers regular hours from 8-12 on Saturdays to accommodate sick cases and breeding's without ER fees, since animals don't understand the concept of weekends. So I arrived at 7:45am to review a few bills from the week and check on an inpatient, then hit the road.
1. Organic dairy cow 6 DIM and "struggling." I did a standard fresh cow workup: vitals WNL, no pings, blood BHB 0.6, uterus full of mucus with tan chunks. She was slow to rise and had some muscle fasciculations over the shoulder.
1a. DDx: subclinical hypocalcemia, mild endometritis. Tx: YMCP drench. Owner will monitor temperature to see if antibiotics become warranted and continue oral calcium supplements.
2. Mini horse dystocia, foal in true breech (tail coming first with both hips flexed). My colleague Mr. Big Arms called me to help get the foal out. It was unfortunately dead but the whole placenta came with it. We then lavaged the uterus since she tried to prolapse. Yay mares.
3. After the that, they asked us to check another pony with a lump on its jaw that periodically breaks open with pus. Took 2 seconds to realize it's a tooth problem. Unfortunately due to the pony's age, cushingoid look, and severe bony remodeling, they'll choose euthanasia soon.
4. Second breeding of a Percheron mare. Another colleague had been tracking this heat cycle and administered GnRH after the previous day's AI. That meant all I had to do was put semen into one very tall mare. Simple enough!
5. Angus cow seen staggering in the field. This was the Gator lasso guy. Temp was a raging 105.6, she was breathing hard, and had some yellow nasal discharge. More striking was the bilateral corneal edema, likely causing her to "stagger" due to vision deficits.
5a. DDx: infectious bovine rhinotracheitis (IBR). This herd was unvaccinated--the farmer bragged some of his cows were 14 years old without any vaccines! So it's only a matter of time before something like this happened... Gave Resflor and prayers since she's 8 mos pregnant.
It was just about noon when I finished with the beefer, which meant they switched the phones to our answering service and it was solo on call time. I've been at this long enough to get more confident while covering ER but it never fails to get my stress levels up.
6. Dogfight ~5 days ago, wound over back leg not properly tended since the dog licked it and now bone was visible. Options were hospitalization for bandage changes, amptuation, or euthanasia.
6a. Owner wanted to try to save the leg so we sedated for wound debridement. The wound was worse than we realized and tissue was necrosed almost circumferentially. There were numerous other smaller wounds found after clip&scrub. Owner elected euthanasia when we called to update.
7. Heavily pregnant dog with suspect pregnancy toxemia. Yup, blood glucose only 70 and calcium low. She ate canned food readily and was able to walk after initial calcium administration. She's a kennel dog so owner elected outpatient treatment rather than continued IV therapy.
After this dog went home (~4pm), I caught a short break. I made the smart decision to grab an early dinner and feed the animals since another call came in about 20 minutes after I sat down with my Chinese leftovers. Pro tip - always get takeout the day BEFORE you are on call.
8. Colic. Walking the horse for the 30min it took me to get there helped greatly. On rectal, the manure was super wet so likely the horse couldn't handle the lush pasture. Gave banamine and buscopan and had a little chat about managing grazing going forward.
9. Older dog with acute uncontrollable trembling. No neurologic deficits on exam and it didn't fit seizure activity. The hips were super arthritic and the dog reacted to palpation of the left lumbar region so top DDx was pain. Sent home with NSAIDs, gabapentin, and trazodone.
10. Tiny 4-week-old puppy with head trauma. Apparently a tire fell on it while playing with the kids? I immediately anesthetized it on presentation it but couldn't offer a promising outcome if we kept it hospitalized on pain meds and steroids. Euthanasia was a good choice.
11. At last, the classic Frenchie in labor. My first C-section of the day was called in at 7:30pm (colleague had already cut one during regular hours that morning, though, so it was actually number 2 for the day). All pups out alive and the surgery went uneventfully.
12. Amish draft stallion collapsed in the field, owners believed it to have overheated. YUP - its temp was 105.8 (!!!) when I arrived and they'd been cold hosing already... I sedated and started a fluid bolus. The horse drank about 8 gallons after my treatment, too.
12a. I was super nervous about this guy. I gave E-Se to protect the muscles as well as Equioxx (needed address that temp without frying the whole system) and urged a recheck in the morning. They brought over a gas generator so they could plug in fans for the horse overnight...
13. Mini poodle C-section. This one was infuriating because the owner noticed a water bubble around noon. Treated with 3 doses of calcium (no oxytocin??) and I guess around 4 confirmed he could feel a pup in the canal but waited until 9:30pm to call in...
13a. That call came in while I was headed to the horse so surgery didn't start until after 11pm. Poor little poodle was lucky to have only 1 dead pup in there, and only 1 of the 4 live pups was weak! Gave the owner a firm reminder about normal whelping progress times.
My head fiiiiiiiiiinally hit the pillow at like 12:45am. I was too tired to take a shower and wasn't excessively gross (sheets currently in the wash, though) so just washed my face and brushed my teeth. But then my frickin phone rang at 1:30 so that didn't last long.
14. Mare foaled a little before 1 and didn't want to rise, owner thought she had prolapsed her uterus behind her. Without lifting my head from the pillow I asked if he was sure it wasn't just placenta. He said he wasn't (ugh, lol) but wanted the mare looked either way.
14a. Thankfully it *was* just the placenta and the mare stood right up when I asked her to. I pulled the placenta out (<2 hrs after foaling so ideal time frame) and lavaged her. Gave banamine to mom, an enema to the foal, and headed home. At 3am, it was definitely bedtime.
I was grateful to sleep straight through until 7:15am when my alarm rang. We transfer on call duties at 7:30am, so I wanted to be able to brief my colleague on cases that would need to be rechecked by him. I still remain the "backup" for today's on call shift.
I should also mention that not ever call that comes in during ER time actually gets seen. I had 3 calls that I was able to resolve over the phone.
1. Suspect mastitis in a dog with 5-day-old pups. I had the owner check the dog's temperature and express milk from the gland. Those both looked normal and the dog was still eating/drinking/acting okay, so I gave instructions for warm compresses to stave off any progression.
2. Another dog with suspect pregnancy toxemia. The dog sounded stable over the phone and the kennel was equipped with both oral and injectable calcium so we reviewed a treatment plan and set parameters for what would necessitate hospitalization if his treatment failed.
3. An Amish man whose dog had a progesterone test earlier that day called back at 6:30pm... to ask if we would do a surgical AI that evening. The answer is always NO to elective procedures on ER.
3a. She likely would have been ready to breed today (Sunday) so we offer breeders the option to hospitalize their dogs overnight for Sunday breeding sans ER fees. He declined this because, being Amish, his intended stud didn't collect on Sundays. 
3b. I gave him the options of doing just regular AI himself that evening and again Monday morning, or to have a recheck progesterone and cytology on Tuesday to see if we might be able to squeak in a TCI. Sounds like he'll probably just try the regular AI after all.
So there you have it! A glimpse into my chaotic, wonderful life on call.
