- 4 weeks ago
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00:01This program is brought to you by Open Paddock, a more open pet food company.
00:06Welcome to ReadyVetGo, the vet paramedics.
00:10Australia's veterinary paramedic service responding to critical pets at home,
00:15bringing pre-hospital care and emergency transport to pets and owners in crisis.
00:21Redefining the standard of care and bridging the gap between home and hospital,
00:25combining emergency vet medicine with the human ambulance,
00:30taking you where cameras have never been before,
00:33into the complexity and the fight for survival.
00:36This is ReadyVetGo, the vet paramedics.
00:43Last time on ReadyVetGo, the vet paramedics,
00:47the team responded to Kenya, a 15-year-old labradoodle,
00:50in critical condition after prolonged seizures.
00:54Receiving life-saving stabilisation in the home,
00:58Kenya's owner now faces a difficult decision
01:01on whether to pursue treatment in hospital or to say goodbye to Kenya.
01:06We come in and we say, you know, three options.
01:08One option is can we treat pets at home,
01:10make sure that they're stable and in a safe position,
01:14which she's not at this stage.
01:16The second option would be getting her into a hospital.
01:19You know, there is the third option of end-of-life care.
01:22With owner Ken currently away, he is now forced to make a very time-critical decision for Kenya.
01:30If Ken wants to pursue active treatment for Kenya,
01:33the best chance of survival is to get her into the nearest emergency vet hospital as soon as possible.
01:40With humans, we always know the goals of care, recovery or comfort.
01:44But with pets, we know that euthanasia and end-of-life care are also options.
01:49So it's all about helping pet owners weigh what's in the best interest of their animal.
01:53With the support of Nick and Paul, Ken decides to proceed with the treatment
01:58and requests for Kenya to be transferred into hospital.
02:01Now that we know that Ken is wanting to get Kenya into hospital,
02:05we need to get moving with the plan and prepare her for transport.
02:08We certainly aren't out of the woods yet.
02:10And this transport is risky.
02:12But this is our field of expertise and it's her only option.
02:15A challenging but key component of paramedicine is navigating the extrication of Kenya out of the bathroom
02:23and to the ambulance safely.
02:25It takes time and careful planning.
02:28You name it, we've been there.
02:30Extricating pets from all kinds of places.
02:33And there's no one way to do it.
02:35Every situation demands a different approach and Kenya is no different.
02:39Taking careful consideration of how Kenya is moved safely to the ambulance,
02:45the team move Kenya on a stretcher.
02:48We do not have time to waste if the goal is to actively treat Kenya.
02:52So we need to get moving immediately.
03:03Once in, they are able to get a closer look at Kenya's condition
03:07with a cardiac monitoring system.
03:09Adding to the complexity of the transport,
03:12the sedative effect of the anti-seizure medications put Kenya's airway at risk.
03:18It's a balance that the team have had to face many times before.
03:22Managing Kenya with just two people was difficult enough.
03:25Even though I am obviously still going to be with her at all times,
03:28we need one person to drive and I'll be back there by myself with her.
03:32I need to be prepared for anything that could occur while we're transporting her.
03:36Setting up equipment and medications prior to transport is a vital component
03:41of being able to intervene on the road.
03:43But thankfully, it's a much more controlled environment with Kenya stabilized.
03:47With Paul in arm's reach of Kenya at all times,
03:50he is able to monitor Kenya for the 30-minute drive.
03:54He focuses on maintaining a balance between keeping the seizures at bay
03:58without over-sedating her.
04:00The anti-seizure medications used in these scenarios work quickly,
04:04often stopping seizures almost immediately.
04:07However, they have a short half-life lasting only about 15 to 30 minutes.
04:11This can be both a benefit and a risk.
04:14If Kenya becomes too sedate, there is a risk that she could stop breathing on her own
04:18and we would have to manage that for her.
04:20But if the medication wears off, the seizures could start back up again.
04:24There are so many benefits to medical transports for a critically ill pet.
04:28Being able to intervene at the first sign of a seizure
04:31is one of the greatest benefits of all.
04:33Intervening at the start of that electrical misfiring means
04:36that Kenya is able to remain in a recovery state.
04:39Having maintained her stabilisation,
04:41the team arrive at the hospital with Kenya still in a critical condition.
04:46Carefully wheeling Kenya through reception and into the emergency room,
04:50the team hand over to the hospital staff,
04:53where it's time for them to take over.
04:55This is Kenya.
04:57While Kenya's outcome remains uncertain,
05:00her survival depends on how her body responds to this catastrophic event.
05:05The roads are quiet.
05:16We absolutely love it.
05:20It's New Year's Eve morning and the team get a call about Reggie,
05:25a 14-year-old staffy mix who is having difficulty breathing.
05:30Her owner is away and is extremely worried from afar.
05:34Reggie's owner, Natalie, describes Reggie
05:36has been gagging and coughing incessantly
05:39to the point that she's making herself vomit.
05:41Reggie is being looked after by Natalie's dad,
05:43who is also very worried about her.
05:45Arriving to assess Reggie, Natalie's father, Cole,
05:49greets the team and provides them with some information
05:52about Reggie's condition.
05:54Cole, when did this start?
05:56This morning.
05:57Just this morning?
05:58Early this morning.
05:59Yeah.
06:00And was she okay last night?
06:01Yeah.
06:02Yep.
06:03Has she had anything to eat that she might be potentially stuck?
06:07Any bones?
06:09Chicken neck.
06:10Chicken neck?
06:11And was that last night?
06:13Sorry, guys.
06:14I'm beat.
06:16Cole is a very charismatic man
06:19and is clearly very passionate about Reggie's wellbeing.
06:22But we need Cole to focus because every time we hear Reggie coughing, Cole gets worried.
06:29We just...
06:30We've just given her some medical...
06:31Can't quite...
06:32Having a feel...
06:33Get to...
06:34Finishing the sentence.
06:35Finally, the team are able to get enough information from Cole to proceed with the physical exam.
06:42Dr. Paul can hear the irritation in her trachea, which could be the cause of the persistent coughing and vomiting.
06:49Hearing the coughing and being able to feel around Reggie's airway, I'm not able to stimulate a cough.
06:54This information, along with this harsh, striderous cough, does point me in the direction that she might be dealing with what we call a tracheal collapse or a narrowing of her airway.
07:04This makes the trachea so irritated after periods of repeated coughing that even the slightest movement or stimulation could set off that additional cough response.
07:14I'm gonna give her a little medication just to get her relaxed and just to help her stop coughing, okay?
07:20It's a really distressing presentation either way.
07:23I'm not surprised that Cole and Natalie are so worried about this and I'm glad they've called for help.
07:27Particularly with it having gone on for hours, everyone is tired, especially Reggie.
07:33Yeah, it's really stressful.
07:37It's very, very distressing to hear this.
07:40Yeah.
07:41Look, hopefully the medication will help calm her down and help relax.
07:48With Cole's distress, the team makes sure that the plan has two sets of ears on it and decide to call Cole's son to go over the plan.
07:57So, right now she's stable.
07:58She's actually just walking around the yard, toileting, doing fine, not coughing as much.
08:03But my suspicion is, based on her exam, she probably has a collapsing trachea or an airway that gets narrowed.
08:11I would say right now she doesn't need to go into hospital.
08:14She's in a safe situation.
08:16But ideally, if this is continuing, we would want to get her back into her day vet, like on a scheduled basis.
08:23Or if she's having a bad crisis after hours, we'd want to get her into an emergency hospital for a chest x-ray and bloods and things of that sort.
08:31But we're not in that position right now.
08:33Though Reggie's presentation is distressing, Reggie's vital signs bring some reassurance to the team.
08:40What is probably happening is she's spent all morning coughing and being very uncomfortable.
08:47That's very tiring for her.
08:50And then on top of that, the medication to help her stop the coughing is going to help make her feel tired as well.
08:58So don't be too worried.
09:01We need to see how it goes.
09:04But for now, Paul's assessment, he feels comfortable enough to give the medication and to see how she goes.
09:11And we can call back later and see how she is.
09:14Considering that she is vitally stable, it's a fair call to keep Reggie at home with some medications.
09:20If this is persistent, she may need to get further testing done for definitive answers.
09:25For Reggie and for Cole, we get the medication to help suppress the cough on board so her airway can settle down.
09:31And we also get some medication to support her gut health and to trial her at home with some ongoing cough suppression.
09:37Despite today's events, Cole still has the ability to gift a little gratitude to Nick and Paul,
09:44showing that the little things matter, even in stressful situations.
09:49How do you say thank you, Macedonian?
09:51Fala.
09:52Fala.
09:53Fala.
09:54Even with everything going on and with Cole feeling so worried, he comes out with this gift.
09:59We are just happy to be able to walk away knowing that everyone is reassured and there's a plan in place to keep Reggie comfortable for today
10:06and hopefully get her back on track to her normal self.
10:09Getting to meet people like Cole who love their pets this much is genuinely a great privilege.
10:15This is all pets wish for, is to just be loved as much as this.
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10:37I'm just wanting to touch base with Archie.
10:50We're probably still about 30 minutes away just with traffic.
10:53A critical ambulance transport has been requested for seven-year-old dash hound Archie,
10:58brought in by his owner Deanna to Wandon Vet Clinic after finding Archie unresponsive at home.
11:05Having no idea what had happened, all signs point to a deadly Australian predator, the brown snake.
11:12Coming in, we already knew that Archie was extremely sick, but looking at him now, this is worse than what we thought.
11:19He's working really hard just to maintain a pretty ordinary outcome.
11:23When a dog presents like this, floppy, non-responsive and with severe respiratory distress,
11:29we have to consider snake envenomation as a potential cause.
11:32Brown snake venom is a neurotoxin.
11:34It works by breaking down the muscle, paralyzing the muscles that control breathing,
11:39affecting the nervous system and can cause paralysis,
11:43leading to respiratory failure and potentially death.
11:46Looking at him, we aren't convinced that he'll be able to maintain this for another 45 minutes,
11:51which is the time that it's going to take just to drive to the emergency hospital.
11:56Needing to be transported 45 minutes from Wandon Vet Clinic
12:00to Melbourne Animal Specialist Hospital in Ringwood,
12:03the ReadyVetGo team are concerned about Archie's increase in rapid breathing
12:07and the pressure this is adding to his tiny body.
12:10The way that Archie is breathing is not sustainable.
12:13Eventually, his need to get more oxygen is going to make his lungs and heart work
12:17to a point that he might go into cardiac arrest.
12:20It's imperative that we take control of what we can before heading out for a transport like Archie's.
12:25If there is a greater risk of Archie deteriorating in the context of being transported,
12:30then we need to intervene before that happens.
12:32The goal is just that we have full control over the situation,
12:35that we're not allowing any risk that he would deteriorate on the way there.
12:40So we want to make sure we're supporting him in the best way,
12:42doing the safest thing that would be supported in the ambulance with ventilation.
12:46So Nick and I are going to proceed to doing that next.
12:49After assessing Archie, the team decide that the best course of action
12:53is to anesthetize Archie and insert a breathing tube.
12:57By intubating him and anesthetizing him, we can get better oxygenation
13:01and also give his little body a rest.
13:03While Paul monitors Archie in the clinic,
13:06Nick discusses with Archie's family the complication of his condition.
13:10Yeah, no worries. Okay. Well, yeah, thank you.
13:13We will keep you posted as we are.
13:15Luckily, Archie's owner is a human paramedic.
13:18She knows all too well the value of the transport
13:21and understands what's happening when we talk about Archie's respiratory distress.
13:25She, thankfully, is all on board.
13:28Otherwise, this would be a transport
13:30where we are crossing our fingers the whole time
13:32and hoping for the best.
13:34And if there's any changes, we'll just let you...
13:37Yeah, we'll obviously let you know.
13:39With consent given, Nick and Paul work swiftly.
13:43They prepare to intubate Archie in the clinic
13:45and prepare him for transport.
13:47But what should be a swift procedure suddenly turns critical.
13:52As that tube goes in, I can see it fill up with pink frothy fluid,
13:55which is not a good thing at all for Archie.
13:58And now, we've just lost the airway.
14:01Immediately, we work to suction the tube
14:03and see if we can clear out that fluid.
14:05We don't want to have to remove the tube if we can avoid it.
14:08Seeing a breathing tube fill up with blood
14:10is every vet's worst nightmare.
14:12And that fluid leaking from his lung tissue into those small airways
14:16is inhibiting his oxygen supply
14:18and making him at a great risk of sudden death.
14:21Thankfully, the team begin to see a positive change
14:25in Archie's vital signs.
14:27We're getting a good rise and fall with ventilation.
14:30We hear air going in and out
14:32and we actually see things improving.
14:34Once this tube is clear,
14:35we hope that the pressure provided by the ventilation
14:38can push some of that fluid back into the circulatory system
14:41and clear some space for oxygen
14:43to reach those tiny air sacs in the lungs.
14:45I can say this much.
14:47I've never been happier
14:48that we made a decision to do this here.
14:50Even though it wasn't what we wanted to see,
14:52I'm glad that we saw it here
14:53and that we were able to free up that space
14:55that was occupying the lungs.
14:57As soon as Archie is in the ambulance,
14:59we'll have to work fast to get him situated
15:01and ready for us to head to the emergency hospital
15:03as soon as possible.
15:05We're looking at a 45-minute transport time.
15:07It becomes an art of juggling him remaining asleep,
15:10monitoring his oxygen levels,
15:12breathing for him,
15:13watching his vitals,
15:15keeping him warm,
15:16all whilst dealing with a moving vehicle.
15:24Archie's preparation for transport
15:26to the Melbourne Animal Specialist Hospital in Ringwood
15:29has taken a turn for the worse
15:31when the breathing tube to relieve his respiratory distress
15:35fills up with blood-tinged fluid.
15:37The presence of the fluid gives more insight
15:40as to how unwell Archie is in his current condition.
15:43That fluid leaking from his lung tissue
15:46into those small airways
15:47is inhibiting his oxygen supply
15:49and making him at a great risk of sudden death.
15:52Having overcome this hurdle
15:54and getting Archie stable,
15:56they can finally make their way to the ambulance.
15:59He's ready to hook back up.
16:01He's becoming a little bit light,
16:03so I'm just going to get some propofol on board for him.
16:06Thanks, Nick.
16:13Give a whopping dose there.
16:16As the team move Archie out,
16:18his anaesthesia begins to wear off.
16:20It's important that while his breathing tube is in,
16:23Archie remains asleep to prevent any chance of him chewing on the tube
16:28or removing the airway.
16:30Just inducing him under anaesthesia,
16:32getting him into a nice plane where he's very sleepy.
16:36He cannot be awake while we're on the road breathing for him.
16:41Although wanting to move as quickly as possible,
16:44it's imperative that the team ensure
16:46that all monitoring equipment is in place
16:49so that they can monitor Archie's oxygen levels,
16:53breathing patterns, blood pressure and heart rhythm.
16:56This way, if any of Archie's vital signs deteriorate,
17:00they will know immediately
17:02and will be able to intervene at the first sign of concern.
17:06Concerned that the motion of the van
17:08may have moved some fluid on Archie's lungs,
17:11the team makes sure that Archie's vital signs are in safe parameters.
17:15It is.
17:16Vitals are great.
17:1796 pulse ox.
17:19Sometimes the biggest risk with these transports
17:23is to move from inside into the van.
17:27That's where we can get these fluid shifts
17:29if we've got any fluids in the lungs.
17:31And we just want to make sure that we have him settled
17:34before moving onto the road,
17:37which is in peak hour traffic and an airway.
17:43Ensuring that everything is at his fingertips,
17:46Paul gives the all clear for transport to begin.
17:49The stress in these moments is intense.
17:51We both are generally pretty quiet in transports.
17:54Paul's watching everything to keep Archie stable
17:57and I'm watching everything on the road.
17:59I have to be hyper aware of the potential for traffic lights to change,
18:02who's weaving in and out of lanes,
18:04how much room is in between me and the next car.
18:06We have a three-ton vehicle and with the fluid on Archie's lungs,
18:09any major braking is going to potentially occlude that airway again.
18:13But even with stopping safely,
18:14each traffic light delays our arrival by minutes each time.
18:18He could already be where he needs to be
18:20and it's just frustrating and each one feels like a lifetime.
18:24It's 24 minutes.
18:29Finally, the Ready Vet Go team arrive at Mash Hospital.
18:33Carefully transporting Archie inside,
18:35a handover is provided to the vet care team.
18:39This was a really tough transport.
18:41It was successful and the beauty of this service
18:43is that we give the best chance of survival to every patient.
18:46I have some serious doubts that Archie would have been able to make it
18:50without that ongoing support that we provided in the ambulance.
18:53It's been a bit cold as well.
18:54Yes.
18:55We've got his temperature up quite a bit,
18:56but I'd be happy to throw a bear hugger on him.
18:58You want me to just steal one of these?
19:00Yeah.
19:01Providing handover to the Mash veterinary team,
19:03Archie is left in their care.
19:05And I think still preemptively a snake bite diagnosis.
19:08I think they're waiting on coags to come back.
19:10Yeah.
19:11They had gotten a CK measurement that was high
19:12but not dramatically elevated.
19:14They did send along some wee if there was any need.
19:17I think someone had requested this for snake venom detection kit,
19:20potentially.
19:21Oh, okay, yep.
19:22So I'll leave that with you guys.
19:23Yeah, perfect.
19:24Were you able to get any improvement in blood pressures
19:27with the boluses?
19:29No.
19:30When we serially checked it,
19:31it looks like we've got a good one now.
19:33137 over 64.
19:35And the next few hours will determine
19:38whether Archie's condition improves
19:40or if the damage from the venom is too severe to recover from.
19:43We genuinely don't know how this will go.
19:46He's such a little guy
19:47and the team are going to have to take this hour by hour.
19:50We see these situations go either way.
19:53Some where they're home in a few days,
19:55but the nature of this is that we don't always win.
19:58But we know we don't leave any stone unturned
20:00and that's the most important thing.
20:02Thanks, guys.
20:03Yeah, no worries.
20:04Thanks.
20:05Cheers.
20:14Despite the efforts of the amazing intervention
20:17from Wand and Vet Clinic, MASH and the Ready Vet Go team.
20:22Archie succumbed to the illness of the snake venom that night
20:25and was euthanised in the hospital.
20:27Glived in the hospital.
20:31All pulver ax Robin
20:33gal
20:34in the hospital.
20:36Huh?
21:06We're out here in Baronia to catch up with Kenya.
21:26The last time that we saw her, we had taken her to Advance Vet Care.
21:30So we've reached out to her owner, Ken, to see how she's going and what the end result
21:35for that was.
21:36My name is Margaret, I'm Kenya's mum and I'm so grateful that she was being able to
21:45be looked after by the vets coming to my daughter's house and then taking her in an ambulance to
21:52the hospital, the animal hospital.
21:54We're very, very happy and relieved that she's with us.
21:59It was such a great feeling to see Kenya stand up and bark at me.
22:05This is honestly just the best result and I'm ecstatic to see her doing so well.
22:11This is exactly why we have this service.
22:13This is exactly why we need this service.
22:15And we're just so happy that we could be there for her.
22:18If it's only one dog that we've ever saved, this whole thing was worth it.
22:23We're just so happy to know that she's okay.
22:24We're here at Mel's house.
22:26Mel is one of the All for Paws dog rescue foster carers and she's just had a new dog that's
22:31come into her home as a foster.
22:32We know that when you get a new foster come through that things can be quite hectic.
22:37So we're here to help out.
22:38We've got some products from Nature's Miracle to eliminate any odours or remove any stains.
22:44And also, of course, open paddock food for all the nutrition that they need.
22:52Next time on ReadyVetGo.
22:55After being gone for a few days, Boots is found in her garden with an aggressive infection in
23:01her foot.
23:02Meanwhile, Rosie requires critical transport to a neurologist after a sudden onset of
23:08paralysis.
23:09The ReadyVetGo team are called to transport Finn to the Animal Emergency Centre in Moorabbin
23:15for ongoing monitoring.
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23:51or baby if you need zaczyna leave?
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23:53Here we go.
23:54See you soon.
23:55Dope now.
23:56See you soon.
23:57Bye.
23:58Bye.
23:59Bye.
24:00Bye.
24:01Bye.
24:02Bye.
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