My attention turns to the little white poodle in another kennel, hooked up to an ECG which is reading a dangerously fast heart rate of 280. The poodle’s muzzle is blackened with activated charcoal, a telltale sign of treatment for toxin ingestion. Sure enough, this little monkey came in last night because he chowed down on a K-cup pod he stole from the garbage and had enough caffeine in his system to power a tower full of groggy office-workers. I reviewed his case quickly and ordered an increase in propranolol, the medication used to counteract the caffeine until he can get rid of it from his body. He was newly adopted by this first-time dog owner, and she had just received a hard lesson on how a dog can get into trouble faster than a toddler on steroids.

There is a cat who can’t breathe and has nasal oxygen – he hates it and keeps ripping it out. I adjust the rate, so it is more comfortable for him, order some sedatives and make a mental note to review his case quickly. The dog who ate a barbeque skewer that punctured through his stomach, then worked its way up to his chest is finally well enough to go home after an extensive hospital stay. The seizuring patient had a good night with no more seizures, and his IV medication is being weaned off successfully. Fingers crossed he would hold for the day on his oral medications.

The oncoming ICU nurses get busy with their charges. The animal care attendants start taking patients out for walks, providing food and water and cleaning up the sometimes perpetually soiled kennels. I am amazed how they just laugh and exclaim “Really??!!” When a patient soils the fresh clean bed, they just lovingly made for them. I thank my stars that every one of the staff here really does love the animals and does the dirty work because they care that our patients stay clean, dry, warm and comfy. My hard-earned medical expertise is worth nothing to my patients if they are cold, hungry or sitting on wet, dirty laundry.

I settle down to my routine of reading the overnight notes, doing physical exams, adjusting medications and treatments, ordering labwork, reviewing new results and calling owners, who I know are waiting anxiously at home for some word about their loved pet.

I chat with the surgeon about what cases may need to come into the ICU that day ¬¬– get the lowdown from the overnight ER docs about any difficult cases they admitted that might need my help or advice, and manage the stream of bids for my attention; referring vets looking for updates on the patients they sent over, some advice to a vet who is trying to manage a tough case in Northern Ontario, far away from a referral hospital like ours, owners wanting updates. It’s 2:00 somehow, and I realize lunchtime came and went. I slip outside in the sunshine for a quick bite and quiet moment, away from overhead pages and beeping alarms, letting the nurses know I am just around the corner if a crisis arises.

The afternoon passes in a blur. The caffeinated dog is taking a while to recover and I need to reassure the owner all will be well but in the fullness of time; the Golden’s owners need lots of attention to help them through some difficult decisions with what tests to pursue and various possible outcomes; the cat with breathing trouble needs radiographs read, and I need to beg the cardiologist to try to squeeze him in his already overstuffed schedule. A patient comes in from surgery for some close monitoring after a rocky anesthesia and we must shuffle some patients around to make space.

The best part of my afternoon is sending home the dog who ate the barbeque skewer. We took him on a victory tour of the hospital so the numerous people involved in his care could say goodbye. He is a poster child for why I love being on the team in a good referral hospital. He needed everything we had, from a competent overnight ER service, ready to take him in at all hours, a high-tech CT scan to find the skewer that was not visible on plain radiographs or ultrasound, an anesthesia service that could deftly managed his precarious sick physiology, a great surgeon who could handle whatever surgical surprise awaited in his chest and belly and fantastic post-operative care with attention to all the essential details provided by the ICU team I head. We all need a paycheque, but seeing that dog’s exuberant joy on catching sight of his owners, and witnessing their tearful happy grins on finding their furry friend restored to health is, as they say in the MasterCard commercials, priceless.