The relationship between dog and postman is well recognised. Almost every postman I know lives in fear of dogs and can spin lengthy yarns about the various canines they have to encounter on their daily rounds. If there is a postman training course, it should probably include a session on dog handling and behaviour as the most challenging part of the job! Although we have many postman clients who love their own dogs, even they are often clearly fearful coming into the waiting room of a full clinic – in fact they more commonly wait out in the car until we call them.
Of course from the dogs’ point of view the relationship is perfectly understandable. There they are, doing a perfectly ordinary day’s work, protecting house and home, either in sole charge of an empty house or, even more importantly, protecting their beloved owners, when an strangely uniformed, usually male, body invades the territory. This unusual unknown character is never greeted by the owners to come in for a cup of tea (apart from maybe in our house, where Molly’s tea-making fetish ensured that the offer was always extended). The suspect then further unnerves the diligent dog by thrusting sheaves of paper, bearing not only his unwelcome scent, but also the scents of many other unfamiliar hands, into the letterbox and then without any acknowledgement, skulks off again, usually at speed. What self-respecting dog warrior would not be perturbed by this suspicious behaviour, day after day, without any logical explanation? As the pattern is repeated at a similar time every day the trusty canine builds up an anticipation of the event, growing in anxiety with each passing visit.
It’s one of those situations where I can empathise with both parties. On one occasion, I was called to a house for the last visit to a little Jack Russell. Sophie, defying her gentle name, adored her owners, but was an absolute terror to Harry the local postman. I had heard reports from both the owners and from Harry as to her life-long mission to defeat his unwelcome invasions.
Harry himself was the owner of a great big slob of a Labrador and, as a genuine dog lover, was understanding of Sophie’s phobia and had even showed me multiple puncture wounds on his ankle from when she had beaten him to the gate one day. He had never even mentioned the episode to Margaret and George, Sophie’s elderly owners, as they were clearly besotted by their child-demon.
Harry simply took it in his stride and devised his own tricks and techniques to guide him safely to the letter box and back each morning, leaving Sophie, in Harry’s words as ‘at least a bit of protection on that lonely laneway’.
But in her later years, Sophie began to have seizures. Epilepsy is not uncommon in terriers, but it usually presents at a relatively young age and can be well managed. In Sophie’s case, although for the first few weeks she responded well to the treatment, before long the seizures returned and with increasing aggression. I explained to Margaret and George that it was most likely that some sort of a brain lesion was causing the seizures and even if an MRI scan was a financial option, that a diagnosis would be unlikely to offer any realistic treatment at Sophie’s age.
After one particularly bad night, the decision was made, so after the morning clinic, I made my way to their cottage to find them sitting outside in the sun with Sophie, clearly between seizures, on the front lawn. A half dose of sedation was enough to render Sophie oblivious to the sound of Harry’s familiar green van crunching down the gravelled driveway. With tears in her eyes, Margaret commented that it was the first time ever that Sophie had failed to ‘greet’ the postman and that even the previous morning she had ‘almost got a nip in’.
Harry was unaware of Sophie’s medical condition, not knowing that the excitement of his daily visit often triggered a seizure within minutes of his departure and that I had tailored her medication to be at its peak level for his arrival.
Pulling up alongside us, he rolled down the window and recognising me sitting with the couple, roared out, ‘I hope you’re putting that divil to sleep!’ I could see it in his eyes that before the words were out, understanding dawned and if he could have hauled them back again he would have. There was an awkward moment of silence before George graciously inclined that Sophie had indeed ‘had her moments’ over the past few years.
Harry muttered a brief ‘I’m sorry for your troubles,’ before moving on and slowly walked up the remaining laneway to carefully place the post in the letterbox. When he reversed back out the narrow lane, it was at a speed and delicacy that would have well befitted any funeral undertaker. With the untimely intrusion over, I proceeded to inject the intravenous anaesthetic that would result in Sophie breathing her last and was relieved to be pulling out of the drive myself after a sober cup of tea, at an equally reverential speed.
I think the unfortunate story went around postman circles for a long time, as even our own postman commented on it a week or so later.
My next postman versus dog encounter happened shortly afterwards and was, thankfully, a much more inspiring experience!
It was one of those days that was already so busy that I couldn’t quite get my head around how I was going to get through it all when a neighbouring veterinary practice rang. A dog had been admitted to the surgery that morning by the local postman, Frank Rennix, who had found him having a full-blown seizure in the owners’ front garden. Clearly a dog lover, and unfazed by the sheer size of the thirty-five-kilo Boxer cross, Frank, abandoning all standard protocol and safety regulations, had scooped the fitting dog into the back of his van and rushed him to the nearest vet. Although he was able to supply the name and address of the house where the dog was found, as the owners were rarely at home, he had no further contact details.
The vet in question, focused initially on stabilising the patient who was discovered to have a sky-high temperature, whether it was as a result of the prolonged seizures or causing the seizures she was at that stage unsure. Over the course of the morning, intravenous fluids and anti-seizure medication brought the condition under control. The temperature dropped to normal levels, but with any reduction in the anaesthesia medication the characteristic spasmodic paddling of all four limbs promptly resumed, indicating the onset of full-blown seizure activity.
With the dog out of immediate danger, but still with a very grave prognosis, one of the nurses, filling in the hospital chart, scanned him for a microchip and was pleasantly surprised to find he was microchipped and registered to the name and address from which he had been brought by the postman. Until then, any attempts at getting a phone number had failed, so making contact with the owners was not possible. Although now with a phone number from the microchip register, the owners still could not be located as message after message was left unanswered. Decisions needed to be made as to the fate of the mysterious Brook, as he was identified by his microchip registration. Intensive and costly treatment would be required to simply keep him alive, without any guarantees as to his long-term outcome. In these cases, euthanasia is deemed to be the most realistic solution where no owner can be contacted. As the next line of enquiry, the persistent vet nurse decided to contact the veterinary practice where Brook had been microchipped and registered. When the phone rang in the office, I was elbow-deep in the abdomen of a dog who had swallowed a child’s small rubber ball two days previously and although grateful that the ever-ravenous Labrador had not choked on the sizeable object, was unfortunately seeing my warning to the owner on the phone that night come to reality, that there were no guarantees that the ball would pass through without surgical intervention.
The neighbouring practice nurse passed Brook’s details on to Amanda, who, after searching the client records, came into theatre to talk to me. I was surprised, as knowing I was deep in surgery, she would usually deal with such issues herself but when she told me the identity of the owner as per our client records I was stunned. The owner of the dying dog was my sister, Paula, or more correctly, my young niece.
The nurse was a little put out by the fact that the ‘owner’ had made no attempt to return the calls, but I didn’t have time to explain that my sister was a consultant paediatric surgeon, working hours unknown to us mere mortals and probably involved in equally life-saving surgeries on people’s children.
As soon as the rubber ball was retrieved and the Labrador left in Amanda’s capable hands, I sent my sister a quick text saying that Brook was in the vet’s, but I would collect him, and to ring me whenever she had a chance. I didn’t realise the seriousness of his condition until I arrived at the neighbouring practice. I had the three kids loaded in the back of the car as they were on a mid-term break, all quite enthusiastic about going on a mission to collect Brook. Now that the dog had an owner, the vets had pre-emptively booked for him to go to the emergency clinic overnight as his condition would require continuous monitoring. The receptionist, who I had never met before, looked slightly sceptical as I trailed three excited children through the waiting room and out to the back kennels.
I was slightly taken aback as I saw Brook, normally an exuberant body of pure energy and enthusiasm, lying lifeless in the bottom kennel, apart from the subtle sporadic twitching of his limbs, indicating that his body was still battling the unknown cause of his condition. The kids were equally taken aback and hung back in shock; they had obviously been expecting the Brook they knew and loved, who’d flattened them on numerous occasions with his joyful welcomes.
Fiona, always the sensitive one, began to cry, while Jack busied himself examining the nuts and bolts on the drip stand.
For any other client, I simply couldn’t, legally or any other way, transport an anaesthetised, seriously-ill animal in the boot of my car, on my own dog’s bed with three children in the back seat, without so much as informing the owner, never mind getting consent, but in the case of your sister, rules can be bent. Despite her slight anxiety, the nurse on duty allowed me to top up his anaesthetic with a slightly more long-acting intravenous medication, watching cautiously as I drew up a dose that would hopefully keep him stable for the relatively short journey home. I drew up an extra dose in case of unexpected delays on the way home.
Trying not to think of my many discussions with my sister of the team of anaesthetists that would monitor the patient while she operated and the post-operative intensive care monitoring, I bundled the sleeping Brook into the boot of the car while Molly, with the efficiency of the eldest sibling, busied herself buckling Jack and Fiona into their seats, sensing the urgency on hand.
I stayed a hair’s breadth below the speed limit all the way home, listening, over the kids’ excited squabbling as to how who would mind Brook, for his breathing, which was irregular and harsh. After a few minutes of dispute, Molly as the undisputed eldest child, proclaimed that I was the vet, but she would be the main minder as Paula was her godmother so, by that argument, Brook would be her godbrother. Fiona acquiesced, but not without offering a favourite unicorn to accompany him in the kennels.
By the time we made it back to the surgery, Brook’s breathing was becoming lighter and the limb twitching was getting stronger. I topped up his medication in the boot of the car, not wanting to move him while he was unstable. Before long, we had him settled in a kennel and stable once more and I couldn’t help wondering if at any level of his consciousness he was aware of the drama of the day unfolding? Misty the Labrador was doing well and sitting up, interested in the whole proceedings, as we drew bloods from Brook to see if they would give us any indications to the cause of his dramatic illness.
As Donal was now back home, I was able to focus on the evening clinic, without the aid of my junior assistants. While Amanda monitored Brook, I worked my way through the long waiting list, at one stage absently-mindedly noticing that it was quite some time since I had eaten. It was after eight when I had finished, and noticed a missed call on the phone from my brother-in-law. As an ex-agricultural scientist, he was ostensibly unperturbed by the whole event and promised to make contact with the postman, without whose intervention he would have returned with the kids after their hurling match to find a dead dog on the lawn.
The blood results had indicated that the most likely cause was poisoning although without more significant and costly analysis it would be difficult to prove. Both his liver and kidneys were struggling and I had to be realistic about his long-term prognosis.
‘Even if he does pull though, Jim, there might be too much damage to his organs. And there is only so long we can keep him safely anaesthetised.’
As a husband to a surgeon there was little I had to explain to him, apart from the difference in intensive care in a children’s referral hospital and a one-vet veterinary practice.
I did, of course, offer to send him to the emergency clinic but was unsurprised when he was adamant that Brook stay where he was.
By three o’clock that morning, I was beginning to regret his faith in me. Brook was still requiring deep anaesthesia to control the seizures and at that hour my brain was screaming resistance to trying to work out a fluid rate to maintain his kidney function while flushing out his toxic liver. Although I only had to hop a fence in my pyjamas to go from the house to the surgery, it seemed a long night. Jack decided to go out in sympathy with my disturbed night and woke frequently, syncing his times with the times when Brook was stable. At one stage I made myself a mug of hot chocolate and wearily munched on a handful of chocolate digestives, hoping they would give a bit of false energy to get me through the night. It was the early hours of the morning when I noticed a text from my sister who was clearly having a night like mine. Despite the hour, I texted her back, without being able to give any positive reassurance, knowing that she was as likely to be up at that hour as any other. The reply came almost instantly. She was even more realistic than me, knowing well the gravity of the situation.
By morning, Brook was neither better nor worse, still twitching slightly, but at least his temperature was stable and his urine output was copious – liberally soaking me every time I moved him! At least for the day time, I had Amanda and our new trainee nurse to take over some of the monitoring and I got to rest for a few hours in the afternoon, semi-slumbering on the couch in front of the TV with the kids.
By night time, Brook was frustratingly the same – perfectly comfortable, but showing absolutely no signs of improvement. I almost began to wish that something would change, either way. Despite Jim and Paula’s assurance that their kids were fine, I was sure they were struggling, not knowing whether their larger-than-life buddy was going to make it or not.
I had to make a decision. I knew from experience that I could do one night of up-all-night and still just about function the next day, but after the second night I simply wouldn’t be in a fit state to work or be responsible for three children. Ignoring all normal protocol, I packed a few boxes, and, with Donal’s help, hauled all the equipment that I would need to keep Brook stable for the night, over to the kitchen. The kids were delighted, preparing a thick bed of duvets and covering it with plastic and towels. I placed my drugs and syringes high up in a press, well out of reach of any inquisitive hands.
So that second night Brook stayed on the kitchen floor while I managing to top up his medications and monitoring without the journey over and back to the surgery. I had, on a few occasions, spent some or all of the night in the kennels with a patient requiring intensive monitoring, prior to the setting up of the Dublin emergency clinic, but at least with Brook in the kitchen I was still close to kids and could enjoy the comfort of my own bed even if for very short periods.
By this stage, all efforts at keeping monitoring records – often the most tedious part of a time-intensive case – had been dispensed with (thankfully a sister cannot really be regarded as a client and it was unlikely she would sue me if things went wrong). And really there was no change to record. Brook stayed stable but with as little sign of improvement as of deterioration. Each time I tried to reduce the dose of anaesthetic, the seizure activity immediately began to increase.
The phone calls to Jim or my sister, whichever was available, became increasingly futile as I relayed the same message each time. It was Paula who brought up the possibility of putting him to sleep. Apparently, the anaesthetists in the children’s hospital were intrigued by the daily drama and fascinated with how a dog in a humble vet’s kitchen could still be going, two days later.
By the third morning, as I tried to organise breakfast for the kids while Brook lay slumbering, attached to all the medical paraphernalia, it was Fiona who sat chatting to the patient. As I served up the hurried breakfast, I was intrigued by her continuous giggling as she sat talking to him.
‘He’s wagging his tail at me,’ she announced.
I didn’t bother to explain that his wagging tail was nothing more than twitching. Who was I to burst the bubble of a five-year-old? Amanda helped to carry Brook and all his equipment back to the surgery the next morning. Before moving him, I again increased the medication slightly, fearing that the movement could trigger a major seizure, which at this stage would make the efforts of the past forty-eight hours futile.
Before the evening clinic started, we repeated the blood tests, and although there was slight improvement in his kidney function, his liver was still struggling.
Wednesday was our half day at work, dating back to the days when I would close early to go my Blue Cross clinic in Ballyfermot on a Wednesday evening. At lunch-time, we had to reverse the journey of carrying Brook back to the kitchen to his designated hospital bed in front of the stove.
Fiona sat, arranging the increasing supply of teddy bears around his bed, thankfully not noticing the ones that went missing in the night after he had piddled on them.
I washed the dishes in slow-motion, wondering how long I could put off ringing my sister; we had agreed that three days would be as far as we would let it go without any signs of improvement before having to make the decision to push the anaesthetic past the dose of no return. I knew that the amount and duration of the medication in his system was dangerously close to, if not beyond, toxic levels. In the absence of the required level of intensive care monitoring equipment, it was reaching the stage where I was potentially doing more harm than good.
My internal struggle was broken by the sound of Fiona’s not unfamiliar giggling.
‘Stop tickling me,’ she squealed. I turned absent mindedly to prevent the squabbling only to see that she was lying alongside Brook and he was tickling her – his tail lazily wagging up and down across her head as it rested on his broad back. Quickly I glanced to the kitchen clock to see that yes, he had been due his next top up some fifteen minutes previously. Each time, I would wait for his depth of anaesthesia to drop and not until the tell-tale paddling limbs resumed would I add more anaesthetic via a port to his intravenous line.
But this time, although the heart rate had increased slightly, there was no limb paddling, only an intermittent wagging of the tail every time Fiona giggled. As I had long giving up on the charts, I could not fill in the response to external stimuli section with ‘wagged tail in response to child giggling’! Which was just as well as it would be never be approved if the case ever did get to being published in some fancy scientific journal. But yes, there it was again, the definite tail wag with each episode of giggling.
Fiona, delighted with herself for ‘fixing Brook’, was slightly put out when I had to relieve her of her duties, as allowing Brook to gradually come out of his enforced sleep could be slightly dangerous as his behaviour could be somewhat unpredictable and he could even be aggressive.
The next positive reflex I got was about two hours later, when the more continuous tail-wagging episodes progressed to a quick lick of my nose as I peered in the back of his eyes with the ophthalmoscope trying to ascertain his eye reflexes.
I tried to ring Paula a couple of times that evening and when she didn’t answer, I assumed she was avoiding the bad news. When I finally got hold of her, I was able to report that there was some progress, but although things were looking more positive, I still couldn’t guarantee that Brook would return to normal function.
But return to normal function he did! Although he stayed with us for almost a week, reluctantly giving up his stove-side private room to be downgraded to a general public hospital ward, by the following week he was fit to go home although he had lost a massive amount of weight and his blood results were still of concern. Six months later he finally got the all clear, when the last blood result returned to normal after a special liver diet that allowed his liver to rest and, as is often the case in a young and otherwise healthy dog, rebuild its own normal function.
We never did find out for sure the cause of Brook’s poisoning and I never did get to write up a scientific case report for the Vet Journal due to the absence of intensive care records.
And Frank, the postman in question, became a bit of a local hero – at least in the eyes of the kids who got their larger-than-life buddy back in one piece.