One more overnight

I'm down to my final overnight shift, which will start in ~2 hours.

The last couple nights have been manageable. We've not had any emergencies come in either evening, but there have been quite a few inpatients, some requiring a good deal of care.

Thursday night:

1. The young Presa Canario post-op Wobbler's surgery, still here since Tuesday (he's Tuesday's patient #1 here)
2. The middle-aged Dachshund post-op hemilaminectomy, still here since Tuesday (he's Tuesday's patient #3 here)
3. A youngish Yorkie, post-op tibia-fibula fracture repair after acting like a little nutcase when her owners took her out for a brief leash walk 3 weeks after bilateral patella repairs
4. A youngish Great Dane, post-op forelimb amputation after a presumed hit-by-car and severely damaged hock joint (tibiotarsal luxation with complete collateral ligament rupture)
5. An elderly Beagle, 1 month post-op from a partial maxillectomy for a fibrosarcoma, with waxing and waning lethargy/anorexia since his surgery, and an acute onset of hypotension, respiratory distress, and vomiting; suspected Addison's disease
6. An 8 week old kitten from the humane society, post-op from a PDA ligation (congenital heart defect requiring open-heart surgery); was so hyper and active after surgery that he removed his own chest tubes and IV line, and wanted nothing more than to make biscuits and suckle on your shirt all night; SO CUTE

Wednesday night's patients #2, 4, and 5 were discharged on Thursday. Unfortunately, Wednesday night's patient #6 (the very sick border collie mix) continued to decline and was euthanized during the day on Thursday.

I've not heard anything on how Boxer Puppy (suspected parvo) from Wednesday night is doing, but Golden Puppy from the same shift was hospitalized for about 12 hours on fluids, did very well, and was eventually diagnosed with a load of GI parasites (cryptosporidium, giardia, and roundworms) likely responsible for her GI upset.

Last night (Friday night), my 7 inpatients were:

1. Our friend the Presa Canario, post-op Wobbler's surgery on 8/23
2. Our friend the middle-aged Dachshund, post-op hemilaminectomy on 8/23
3. The elderly beagle with probable Addison's, patient #5 above (doing much better last night -- feeling well enough to be annoying)
4. An older German shepherd with acute hemoabdomen (belly full of blood) and a very low PCV of 18, who went for exploratory surgery where they removed his abnormal looking spleen, and biopsied lymph nodes, GI tract, and liver as well; he had several transfusions during surgery and did okay in recovery except for a common post-op splenectomy cardiac arrhythmia called VPCs/v-tach, which was managed fairly adequately with a lidocaine infusion
5. An 8 week old Pit mix puppy from the humane society, whose foster parents suspected he had eaten a sock or a piece of a soft toy when he started vomiting; he was taken to surgery last night and had an entire sock removed from his small intestine; did well post-op after getting out of surgery around midnight
6. An elderly Shiba Inu mix, post-op forelimb amputation for a soft tissue sarcoma; was doing pretty well with pain management and actually ambulated quite well for his first 12 hours post-op
7. A 1 year old mix dog who got loose from her owners, ran into a street, and was hit by a car, sustaining multiple pelvic fractures, the most severe of which were repaired surgically yesterday

The only patient who gave me any trouble was, unfortunately, patient #1, our dear darling Presa Canario. Though he entered CCU with a reputation for aggressive behavior and about a zillion caution signs on his cage and chart, he'd been nothing but a big sweetheart until my shift started last night. Yes, he was fearful and easily startled, and yes, we went slowly when approaching or handling him, but he had previously let me do all of his treatments (including unpleasant things like rectal temperatures and inspecting his urinary catheter) by myself.

Last night, though, he started growling at one of the CCU nurses (who has been caring for him all week) any time she would stand outside his cage and look at him. He was fine for his 11 pm and 1 am treatments (in fact, I did all of his 1 am treatments by myself) but started growling and curling his lips at me when I attempted to do his 7 am treatments.

Sigh.

With a smaller dog of a different breed, I'd push the issue a little more or not hesitate to muzzle the dog for whatever I needed to do. However, although this guy is still somewhat dopey on drugs, and is restricted in how quickly and in what direction he can move because of the surgery on his neck, he can sure whip his head around quickly if you're up within biting range, so I'm not going to push my luck. I did what I could do, and left the rest for the neuro department when they came in late morning to assess and walk him.

Hoping he'll have gone home today, but I'm guessing I'll see the bad guy again tonight!