Julian Norton: Lottie's nightcap is just the ticket

My night on call this week was Thursday. As evening surgery was drawing to a close, there was a phone call from a worried farmer. A calf had come down with pneumonia. I went immediately, with Laura and Rory, one of the camera crews, in tow. Pneumonia in cattle can be fatal so prompt action was essential. Fortunately the calf was not too sick, so having given it some treatment I headed for home, while Laura and Rory went in search of sustenance in the supermarket.

Julian Norton, pictured with his three year old Jack Russell, called Emmy.

However, they had to abandon their shopping basket, as another call came in. A cat had returned from her day’s adventures with a large laceration on her tummy. This was quickly followed by a Jack Russell who had been hit by a car. My pager kept bleeping. The last message was about Lottie the Staffie. She had drunk some antifreeze which is a serious problem and not one I would’ve expected in the summer.

“You’d better come straight down,” I told the worried owner.

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It was nearly 9pm but the waiting room was busier than it’d been 12 hours earlier. The cat needed to be stitched up, the Jack Russell needed X-rays and Lottie needed urgent attention to stop her from succumbing to the effects of ethylene glycol toxicity (the active ingredient of antifreeze). I quickly assessed all the cases. It was clear I needed to deal with Lottie first.

We see antifreeze poisoning every so often, usually in winter, and most frequently in cats, who like to lap the sweet liquid from screen wash that has dribbled out of car windscreen washers. It causes rapid and severe kidney damage. Lottie’s owner explained what had happened: “I’d been draining the radiator of my van and there was about half a washing up bowl of radiator fluid in the garage. I came back and found her drinking the stuff. I don’t know how long she’d been there, but she’d definitely drunk some. I can’t say exactly how much.”

The first thing to do was to make the Staffie sick - an easy but horrible job. Usually, vets are trying to stop cats and dogs from being sick! An injection of apomorphine works reliably. I talked Lottie’s owner through the process so he knew what to expect.

Right on cue, 90 seconds after the injection, Lottie’s facial expression changed. That unmistakable worried look appeared on her face and she wretched violently. Four piles of vomit appeared, just as I’d predicted. I hoped a good portion of the antifreeze would be some of what had come up.

Next up was to provide an antidote to the ethylene glycol to counteract its catastrophic effects on the kidneys. The antidote is pure alcohol. Ideally this should be administered via a drip, but Lottie was so anxious she’d barely stand still to be examined. It would be almost impossible to place an intravenous catheter, let alone keep her settled to allow the alcohol to run in slowly overnight. I also knew very well from experience that alcohol gets absorbed quickly and effectively when taken by mouth. I carefully worked out the dose. Plan B was to spoon measured aliquots of vodka into Lottie’s mouth, every hour for the next four hours.

Next stop for Lottie and her owner was the off license. I checked her the following day.

“How was the evening?” I asked. “A bit strange,” came the reply. “She fell off the sofa twice and I think she had a massive hangover this morning.”

But Lottie was completely mended. The blood tests confirmed this. So did her wagging tail.

Julian’s book, Horses Heifers & Hairy Pigs: The Life of a Yorkshire Vet, is on sale now.