I am not sure how veterinarians survive in “1-doctor” practices. First of all, just for social purposes, it is always nice to have a colleague at your “level” in any organization—to bounce ideas off, discuss difficult cases, get a second opinion or agreement on symptoms that have you questioning your diagnosis, complain about difficult clients or staff, laugh about things that only another veterinarian finds humor in. Especially for a recent graduate of veterinary school, a second opinion from a “seasoned” veterinarian is invaluable.
Luckily, my first job in Brookline, MA was in a 6-doctor practice; even better, the practice was in a converted older home, and all 4 exam room “back doors” opened directly into the treatment area. Whenever a patient’s symptoms had me flummoxed, all I needed do was step into the treatment room and wait for another (experienced) veterinarian to show up. On this occasion, it was a middle-aged cat (“Sammi”), presenting for progressive lethargy and lack of appetite over the past week or so. Physical exam was normal, except that the cat had “cervical ventroflexion”–meaning her neck was visibly “flexed” with her chin tucked down against her chest.
I decided this needed further investigating, so I placed my hand on top of her head with my fingers under her “cheekbones” and gently pulled up. As the head returned to a more “normal” position, Sammi let loose with a feline “shriek”, pulled her head back down, performed a convulsive front “flip”, and then had a 5-10 second seizure on the table . . . oh boy!! I don’t remember being taught anything like this during my 4 years in veterinary school. I mumbled something to the owner about “consulting” with Dr. Poling, and high-tailed it out of the exam room.
Dr. Rod (Poling, practice owner) was handily right there—I said, “Rod, watch this” and performed the same maneuver on Sammi that I had just completed in front of the owner. Same manipulation, same result; except this time Sammi managed to inadvertently latch one of her canine teeth into my finger before starting her 360 degree somersault. As she lay on the table during her short seizure and I clutched my bleeding finger, Rod said, “I wonder if she has rabies”? He was (mostly) joking.
As it turns out, rabies had nothing to do with it. One of the other veterinarians in the practice spent some time getting a more complete history from the owner. The owners had been feeding Sammi a 100% tuna fish diet—not a good idea. 100% fish diets can cause a thiamine (Vitamin B1) deficiency in cats; resulting in a variety of signs . . . including neurologic abnormalities and seizures. We hospitalized Sammi for observation, switched her to a balanced diet, and she recovered fully. Also, I didn’t develop any symptoms of rabies!