My first assistantship was with a Royal College registered Veterinary Hospital. The Hospital scheme was still in its infancy, for most veterinary surgeons at this time were in mixed practice, dealing with mainly farm animals, along with horses and pets. So a vet dealing with 100% companion animal practice was the exception rather the rule, and veterinary hospitals were even fewer. For example, the Scarsdale Veterinary Hospital was a long time in the future.
The day started with an open surgery – appointments were unheard of. This was followed by either the rest of the morning in the operation theatre, or doing home visits – in these early days, far more clients wanted the vet to call rather than attend surgeries. Another open surgery followed at 2pm, followed by more visits. Then evening surgery started at 5pm an frequently went on until 8pm. If that wasn’t enough, the duty vet remained on call until the following morning, and could be called out quite frequently. Each practice was responsible for providing a 24hour emergency service. Out of hours emergency clinics and practices sharing OOH rotas were completely alien.
Although radiography was available, other diagnostic aid such as blood test and ultrasound were not available in those days, so the vet had to rely upon a combination of clinical skills, common sense, experience, and a silver tongue. The older generation of vets I encountered had developed this art to a considerable degree.
A veterinary consultation cost 10s. 6d., or 53p in present day currency, a home visit was 1.05, and a full canine vaccination course 4.20. On the other hand, a newly qualified vet could expect to earn 1,500 per annum, plus car and accommodation provided by the practice.
Animals seen were mainly cats and dogs. There were more budgerigars and tortoises in the early days, but fewer rabbits which was just as well, for comprehensive veterinary knowledge about rabbits were will into the future.
Canine distemper and feline infectious enteritis were frequently seen, whereas nowadays they are very rare, because more owners have their pets vaccinated. Many of the illnesses we wee nowadays were yet to be recognized. Examples include canine atopic dermatitis, canine cardiomyopathy, feline cardiomyopathy, feline leukemia, feline immunosuppressive virus, and feline hyperthyroidism.
Prescription diets were limited to the old Pedigree canine obesity and canine nephritis diets, and there was more limited number of vaccines available, for protection against kennel cough, feline leukemia, and Chlamydia was still in the future.
In the next article, I will say ore about my early years in practice, with special reference to what went on behind the scenes and, if space permits, about the early PDSA clinics. Subsequent articles will concentrate on modern times.
My second article will describe what went on behind the scenes in my early days of companion animal practice, when my time was divided between three Royal College of Veterinary Surgeons registered veterinary hospitals which had to fulfil certain basic standards and be inspected regularly, so at the time in question, which was 1968-1979, these hospitals were in the Premier League of companion animal practice.
There were none of today’s RCVS guidelines for Continuing Professional Development, so it was very easy for old-fashioned methods to survive in new hospitals. Furthermore, there was no attempt to organise specialist education at general practice level, so animals requiring such attention could only be referred to veterinary colleges or to the Animal Health Trust. Instead, many of the practices would attempt to do work such as orthopaedic and ophthalmic surgery themselves. Compare this with the situation where your own family doctor removes an appendix, or does a hysterectomy as well as routine medical treatment. Anybody can play a piano but few become successful concert pianists!
When I first qualified, I joined a hospital practice, which was using ether as its sole form of gaseous anaesthesia. Early PDSA clinics were using chloroform to castrate male cats.
The usage of both anaesthetic drugs in now illegal because ether is explosive and chloroform damages the liver.
The next hospital practice I joined was owned by a man who was a highly skilled and dexterous surgeon who was able to work very quickly. It was just as well for intravenous thiopentone, a short-acting barbiturate was his sole form of anaesthesia, and he had neither fluid therapy nor oxygen in case things went wrong! Thiopentone used to be used to induce anaesthesia prior to intubation for maintenance with a gaseous anaesthetic, but because of the risks, its use has been superseded by propofol. Halothane was the most popular ‘gas’ at the time, but it has been replaced by a newer, even safer, ‘gas’.
Great advances have been made in veterinary diagnostics since my early days, when there were no tests for many of the serious feline viral infections we encounter nowadays. Radiotherapy was the only form of imaging available, and protection measures were not always undertaken, for example, one of the practices checked police dogs for hip dysplasia. Four police handlers would simply hold the dog down on the X-ray table without the wearing of protective, lead-lined clothing and monitoring badges! The only means of monitoring heart disease was the stethoscope, for practices didn’t have electrocardiography and echocardiography, i.e. cardiological ultra-sound, was still in the future. In house laboratory testing wasn’t routinely available in most practices, commercial laboratories were rare, and only universities were reasonably equipped. Furthermore, there was only a limited range of tests available. For example thyroid function tests weren’t performed routinely, instead, many fat, lazy dogs were guessed as having thyroid deficiency and put on thyroid tablets.
A word or two about the structural design of these early hospital practices. Six veterinary surgeons worked at my first practice; therefore, it was very busy. The waiting room was too small, there was excessive kennel accommodation, but only one operating theatre. On one particularly busy day, there were three veterinary surgeons at work in this single theatre! The second practice was a converted stable block. The owner had worked on building sites during his student days, so he did most of the design and construction work himself. The building was long and narrow, so clients had to pass through one consulting room to gain access to the other, even when it was occupied! The third practice achieved registration while I was there. The old practice was housed in a wooden-panelled terrapin building, which was dismantled and reconstructed on a new site. A brand new building was constructed on a fresh site to house the hospital, then the terrapin was joined on to it and housed the nurses’ accommodation, practice offices, reception and consulting rooms. After a few burglaries, a notice used to be left informing the intruders where the cash was stored so that they wouldn’t do excessive damage! At the time, the RCVS regulations did not specify how a building was constructed.
Finally, and on a much more positive note, I will mention, in my next article, some of the better ideas to emerge from these early practices, some of which were well ahead of their time, and if space permits, talk about the PDSA.
13th February 2005