A Day in the Life at the Hixson-Lied Small Animal Hospital

Daylight comes and goes. So do patients and clients. Veterinarians, vet techs and support staff spend as long as 12-hour shifts on duty.

Fourth-year veterinary students in some rotations will spend that long as well.

But the day never truly ends at the Hixson-Lied Small Animal Hospital. The lights never go off. The doors, while locked to the outside world, are opened whenever the need arrives.

And that need arrives at all hours of the day.

On this particular day the need did indeed pop up at all hours. After all, the Hixson-Lied Small Animal Hospital is open 24 hours a day, 365 days a year. Thursday, February 28, 2019, is no exception.

Opening Bell

Officially, the day’s first appointments start at 8 a.m. but things really get hopping an hour earlier when the hospital’s faculty, residents and interns filter in for rounds in the Intensive Care Unit (ICU). On any given day, dozens of animals are seen in the ICU with many of those hospitalized overnight.

The ICU is a hub of activity at 7 a.m. At least 30 faculty and students are checking on their patients and the rounds give a not only updates but provide the day an energetic start.

“Some of the patients have had surgery or they have come as emergencies overnight and have transitioned to this service,” said Liz Wunsch, ICU veterinary technician.

Today, the faculty, residents and interns are greeted with a variety of cases including a pair of dogs who accidentally ingested medical marijuana and methamphetamine the evening before.

By the time the first patients roll into the hospital, the specialty care services are fully staffed. The appointments today range from rechecks to issues such as an abnormal bladder, skin conditions, chemotherapy treatments and eye exams.

The Canine Rehabilitation Center is booked solid and the surgical suites are kept busy throughout the day.

Specialty Appointments

The Hixson-Lied Small Animal Hospital is one of the most advanced animal care facilities in the world. Opened a little more than five years ago, the hospital offers advanced veterinary specialty care with board-certified veterinarians leading each specialty area.

But first and foremost, Hixson-Lied is a teaching hospital. That is clearly evident when you drop in on an appointment. No matter if a resident is conducting an eye exam or a surgeon is in the middle of a procedure, they are asking questions of the attending fourth-year students and constantly teaching, teaching, teaching.

Speaking of surgery, two “rare” surgeries are performed this afternoon. A dog has a lung removed while another dog’s gall bladder is taken out.

The average time spent with a patient is likely higher at the Hixson-Lied Small Animal Hospital than your local veterinarian. The level of care though is just as high. As is the care and compassion these veterinarians show each and every animal under their care, regardless of how easy or difficult the animal is to treat.

“You guys do good work here. Thank you so much,” said Jake Winters of Hubbard, Iowa, after being reunited with his dog after her successful treatment.

Spend enough time in an appointment and you’ll surely hear these phrases uttered to a patient… “he’s so sweet” and “good girl.”

“I believe learning that phrase was part of one of our classes,” joked Megan Nickel, a fourth-year student who this day is on a radiation rotation, “and the higher the pitch (of your voice) the better.”

Heartbreak

The concern is evident on the clients’ faces as they rush into the hospital’s main doors. Their pet needs immediate attention and as soon as the call comes over the intercom for triage, the critical care team jumps to action. 

Today, two critically ill patients come in, in rapid succession mid-morning. A small dog has just suffered a head trauma while a cat is lethargic. Teams of veterinarians, technicians and students work diligently to stabilize the animals, all the while using the experience as a teaching moment for the students.

Sadly, the dog passes, but the cat is stabilized enough to be sent home with a diagnosis of diabetes. It’s an emotional time that takes its toll not only on the owners but faculty, staff and students.

That’s no more evident than at the reception desk where the patients are admitted. 

“You just have to be strong and compassionate,” said Brenda Wilkinson, receptionist. “Sometimes you cry along with them and other times you tough it out and cry afterwards.”

Tears were plentiful later in the day when Sheba, a six-year-old Labrador Retriever, was reunited with her owner. Sheba is a guide dog for a legally blind handler who was brought to the ER the day before for continued bleeding after a dental procedure at her local veterinary clinic.

Sheba seemed to be progressing well until she collapsed in the ICU after returning from a walk. The quick care of the veterinarians on duty soon had Sheba back on her feet, evoking an emotional (for both the owner and veterinarians) outpouring on the ICU floor.

A Long Night

The Hixson-Lied Small Animal Hospital “closes” at 5 p.m. with no more appointments scheduled for the evening.

As an emergency hospital, the facility remains open throughout the night. As the evening dawns, the ICU is now the heart and soul of the Hixson-Lied Small Animal Hospital. 

In the early evening hours, the ICU is heavily staffed. Multitudes of veterinarians, technicians and students are finalizing their patients’ care or checking their progress. 

Fourth-year veterinary students on ICU rotations work 12-hour shifts, either 8 a.m. to 8 p.m., the reverse times or 10 a.m. to 10 p.m. They pull two-week nightly shifts and  two-week daily shifts.

“I can’t say that it is fun, but it is a great opportunity,” said Erich Hodges, a fourth-year veterinary student. “It can be exciting at times and it’s certainly intense.

“But it’s not fun.”

Tonight’s emergency patients include a cat who suffered an apparent seizure, a dog who ingested an e-cigarette cartridge, and Mongo, a five-year-old Rottweiler who was experiencing acute vomiting.

However it was the patients that didn’t come to the ER that caught the interest of the staff and students. One owner called about his puppy who had its foot smashed in a door, while a referring veterinarian called to warn the Hixson-Lied staff that his clients were thinking of flying their Golden Doodle to Ames that evening from Omaha on a private plane.

Neither happened.

“An owner flying their pet in for treatment would have been a first for me,” said Dr. Sarifa Lakhdhir, a rotating intern who on this day had ICU responsibilities.

By midnight, staffing in the ICU is down to one intern, a vet tech and two fourth-year students. Despite the short staff, the mandatory “2 o’clock treatment hour” goes off without a hitch.

“All the dogs need to be walked, fed, given exams and be given their medications,” said Loni Ellsworth, a fourth-year student on ICU rotation.

And every hour on the hour, one of the four individuals on duty tours the other wards where dogs, cats and exotics are hospitalized for the evening. These are animals that don’t require around the clock observation, but instead are checked every 60 minutes.

Most of the team’s efforts each and every evening is providing care of the animals residing in the ICU. There always seems to be vitals to be checked, medications to be administered, alarms that need to be reset or charts to be updated.

It can be a long overnight, particularly, like this early Friday morning when no emergency patients come into the ER. The first emergency phone call came in just after 6 a.m. and it wasn’t that much later before fourth-year students started to arrive to check on their overnight patients.

That’s when the day “starts” all over again for the faculty, staff, students, clients and patients of the Hixson-Lied Small Animal Hospital.