Rural Notes 18



I was invited to a Christmas party a couple of weeks ago, given by two of my oldest friends, one of whom who was also my best man, Robert and Amber. Robert and Amber are advocates, and as such, the party was filled with their colleagues from chambers. My hosts specialise in medical negligence litigation and as such, I like to keep them closely by my side as much as possible! Actually, Robert’s sphere of specialism includes medical negligence, but the overall area of his interest is Personal Injuries.

I am delighted to report that to date I have precious little direct experience of professional negligence, but I do have some of personal injury litigation, having acted for Robert and Amber’s chambers in the capacity of an Expert Witness, in cases where there has been an appropriate veterinary or animal aspect. Obviously, the details cannot be disclosed, but the procedures of the court and the judicial process on each occasion has been utterly absorbing. I am sure their very extensive training is key to their powers of deduction and argument, but in general terms, the faculty of advocates contains a lot of very intelligent and quick witted people, and generally they make for most amusing company.

I believe it widely accepted that 99% of lawyers give the other 1% a bad name (!), but there is a real artistry and theatre in the workings of the court which means these practitioners need to think on their feet, and remember the minutest details of each account given of any particular incident, and by picking away at the details of testimony offered, and by setting traps to catch the unwary, or the untruthful, they eventually develop a picture of the events such as they believe them to be.

In many ways, this is not dissimilar to what vets do, where we have to prod and test possible diagnostic theories from a patient/key witness who is unable/unwilling to tell us what they feel/saw. However, I am reasonably confident when I speak for anyone who has had the misfortune to find themselves seated beside a vet at a supper party, that the average advocate makes for more entertaining company.

I digress- (see what I mean). At the party, I was introduced to yet another barrister. On learning that I was a vet, my new acquaintance said something which at the time I thought a little odd. It was along the lines of; “You are very lucky. A lot of our medical court work arises from an elective procedure, where there is no real medical problem in the first place, and a treatment or an operation is performed to reverse nature. As a vet, you must always be working with nature, trying to help a patient recover from an illness or an injury.”

I thought this was an interesting opinion, and one I’d never heard expressed before, and I’ve been thinking about it over the past fortnight. I think that it is right in many ways. If a horse has a cut, it will form a scab to staunch the bleeding, and to provide a scaffold on the site of the injured tissue which will allow a stable (!) and effective repair of the injury. When the cut is more serious, involving a vein or an artery, and it won’t stop bleeding, we intervene and physically suture the vessel (acting as a surrogate clot) and the we stitch together the edges of the wound (acting as the scaffold), thus helping accelerate tissue regeneration.

In this way, and countless others, my new friend is correct. Antibiotics are prescribed to help the immune system defeat infections. Metal pins are implanted into broken bones to keep them stable and encourage new bone growth which will glue the fracture and make good the repair. Insulin is given to replace that which a damaged pancreas can no longer produce, and thus prevent the symptoms of Diabetes.

However, nature is rarely so straightforward, and I immediately thought of Ginger, the much loved and sweetest natured cat in the practice, who belonged to another good friend of mine and who gave the lie to our always working with nature to best effect. Ginger was (barely) of an age to be visited by kidney disease. This is the curse of the feline world. Renal failure is to cats what coronary heart disease is to Glaswegian men. It is a very common disease which strikes against an unfairly large percentage of the population without apparent or predictable rhyme nor reason blighting the later lives of many otherwise healthy felines.

Renal failure is bad enough in people, where the skills, resources, and ethical backdrops allow for dialysis and kidney transplants. In the veterinary sphere, these life giving options do not exist. (Most curiously, the governing body with a statutory responsibility for overseeing the activities of the members of the veterinary profession in the UK did make a formal legal allowance for kidney transplants in cats a few years ago. I say curiously, because they sanctioned the procedure without ever really dwelling on the subject of where the supply of donor kidneys might lie, and I am not aware of any such transplant having been undertaken in this country.)

At any rate, the plight of the cat with kidney disease is one where nature seems to enter a self-destruct mode, with a cycle of damaging events leading to a natural response which actually creates further damage with yet more unfortunate consequences. In renal disease, as in Cardiomyopathy, where the heart embarks on a devastating cycle of ever enlarging in size, but ever weakening in contractile strength, the role of the vet is to intervene and try to work against nature. Or at any rate, against the seemingly poorly engineered natural response the problem initiates. These viscious cycles of self destruction are always less successfully managed than the ‘simpler’ assaults on the flesh wrought by invading bacteria or trauma. It is no coincidence that in human technology, the development of transplant technology stemmed not from trauma repair but from those conditions which allowed no meaningful attempt to heal damaged organs following disease development.

Transplants in humans fill a huge void in the conventional medical weaponry. I hope it never happens in veterinary medicine for fear of the inevitable trade in an abhorrent donor trade. Lets hope that Stem Cell technology advances quickly and makes any argument moot. I am very sad to report that Ginger gave a most valiant fight against his condition but ultimately succumbed to overwhelming odds. He was a very nice cat indeed, the perfect patient to treat; a real gentlecat, and I hope that his memory, especially of the dignity with which he bore his illness, comforts his owner, who in turn is a real gentleman.

On the subject of Kidney Disease, I have been asked by Sue, our Head Nurse, to highlight the lethal danger posed by Antifreeze. Over the past month, we have had several cases of cats poisoned by having access to antifreeze, which they love to taste because it tastes sweet. It is very toxic indeed, even after dilution with water, and a mere mouthful can be enough to cause irreversible kidney failure. With so many new home being built and enjoying the luxury of a garage accessible via the house, and with the onset of winter, and so many cars having their radiatior levels and screen wash fluids topped up, there is a greatly heightened risk of open containers of antifreeze being left accessible to cats, and it is vital that all responsible drivers, acting ion the best interests of their engines, extend this concern to their own and their neighbours inquisitive moggies and make sure all containers are properly closed and place out of harm’s way, and that all fluids drained from cars are responsible disposed of.

This only leaves me to hope that all our readers can put their lawyers, and their antifreeze locked up and safely out of reach, and that they and their pets all enjoy a healthy and happy Christmas.


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Glen Watson
Partner at Links Vet Group