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shawkins
10-01-2011, 05:37 PM
I recognize that this is a bit far-fetched, but if anyone would care to weigh in I'd be grateful.

Say you've got a normal strip-mall sort of veterinary practice and someone drives up in a minivan with an adult male lion in back. He's lost a lot of blood. There's a big bite wound in his rear leg. He's in shock or going into shock.

Can anyone outline the treatment that might plausibly be given in such circumstances? I'm too embarrassed to ask my regular vet.

areteus
10-01-2011, 06:11 PM
Based on what our vet does with our dog everytime he gets in to a fight (he's a terrier, he fights a lot and seems to not understand the concept of 'no win situations' like going toe to toe with a Rottweiler and an Alsation) they will usually do pretty much what they would do with a human - clean and dress wounds, stitch if necessary (and perform whatever surgery is needed to stitch up severed vessels or damaged organs if the wounds are deep enough). They may also treat with an antibiotic injection as a preventative against infection and give pain relief (both in injection on the day and for you to take away with you).

However, because it is a lion, they may refuse to treat unless you are already registered with them and your records indicate you have a lion and they have treated them before. This sort of thing is usually dealt with by specialists and big cat vets (like farm vets) usually come to you rather than you taking the animal to them.

shawkins
10-01-2011, 07:02 PM
Thanks! The stitching and cleaning makes sense. What I'm less clear on is what (if anything) could be done about the shock and blood loss. My understanding is that in people you'd give them blood and/or plasma to get blood pressure back up, but I'm not sure if the vet would have anything on hand that you could give to a lion. Nobody's going to keep lion blood on hand, but maybe there's some sort of plasma for housecats or something that would work?


However, because it is a lion, they may refuse to treat unless you are already registered with them and your records indicate you have a lion and they have treated them before. This sort of thing is usually dealt with by specialists and big cat vets (like farm vets) usually come to you rather than you taking the animal to them.

Very reasonable point. I forgot to mention that this was sort of a gun-to-the-head type of situation. The MC isn't going to hurt the vet, but the vet doesn't know that.

Fenika
10-01-2011, 08:08 PM
Out of curiosity, how did this lion get in the mini van? If it lost a fight or got shot, it might not willingly walk on a leash into the van (assuming it normally, however unwisely, did so for the handler/owner). Is this a normal animal or are you writing fantasy? If the lion is out cold, then were there men on hand to drag it into the van? If it was out cold from blood loss, it died on the way to the vets, unless it was only bleeding from one limb and got a tourniquet (don't apply too tight btw)

So we have a presumably normal lion, bleeding out in the back of a van, and he's going to have to be starting to go into shock soon after he arrives at the vet, otherwise he's going to be dead pretty quick. How is your van equipped to keep an injured lion secured in the back without killing the driver? Even if he's a nice lion, in his injured state he'll likely climb over by the driver to see about getting out via the windshield and cause major issues that are not productive in getting said critter to the vet.

Next, gunpoint or no, the vet, assuming he's had even a tiny bit of exotic med teachings, is going to absolutely insist on shooting the kitteh up with some injectable anesthetics. No one in their sane mind takes an injured lion and throws him on a gurney and hopes he doesn't jump up and kill everyone in the process (even if he arrived out cold). So pissed off, half in shock kitteh (who probably doesn't look very much in shock due to adrenaline) needs to go night night. Vet is probably going to grab his drug book, look something up, guess the lion's weight, and draw up the drug or drug cocktail. You don't need to specify, but it will be whatever they use for cats only A LOT more (hopefully he has enough on hand. If you want him stressing, have him be just short the correct amount. Also, as an aside, he's going to have to explain what happened to all that controlled substance. Taking the bottles and dropping them on the floor and making up something later works. But your characters don't care, that's the vet's prob).

Okay, we've got the drug, or nearly enough of the drug. Next we have to get it in the kitteh. Unless your vet lives near a city that has the type of subculture that keeps exotics (maybe he sees a few monkeys from time to time, maybe a small zoo uses his services), he won't have a dart gun or dart pole (whatever the second is actually called, I dunno.) If the cat isn't restrained, he's going to tell the lion guy to stab the kitteh with the nasty sharp needle in the muscle. Normally he'd give quick instructions on where best to inject it. At gun point I'd say 'stick him in the ass' and hope for the best, because if I got technical, person with gun would make me do it.

Next, wait a few minutes for the drugs to take effect. Guy with gun gets impatient. Vet might mention how impossible it is to fix a lion with an arm shredded or while bleeding out in the parking lot.

Now, lion is out. Vet will check corneal reflexes really quick. Now you have to figure out how a guy with a gun, a vet, +/- a tech or two are going to get a massive cat into the hospital. Maybe they have a gurney on wheels that is low to the ground and designed for animals who can get up and down a little but can't walk well. Not likely for a guy who doesn't do orthopedic surgeries or major cases (he refers those), but maybe he happens to have one somewhere for some reason. Otherwise, up on a normal steel gurney the lion goes, and will barely fit. Either way, he's getting his arse strapped down 100 times over, and he still might kill someone if he wakes up fast. Fun, right?

And I've used up a lot of time walking through all those little details. Messing with lions is not a small matter though, and if you don't play it safe, you are screwed.

So while the lion is out, and hopefully he isn't reacting badly to the drugs due to the increasing shock, the vet and or techs are going to do a quick check for the critical stuff- level of shock (oops, worse than we thought), vitals, etc. Temp can wait until things get stitched up.

First thing to do is stop the loss (initially with a tourniquet or pressure if possible, to slow it. Then with clamps or a quick stitch. Maybe some ER docs, vets or not, could help you here.) +/- get on gas anesthesia. Gas anesthesia also helps deliver O2, which a critter in shock needs. As long as he's on O2 and the blood has stopped, things aren't totally critical, unless while doing this the critter went totally into shock. In which case we need fluids, which is what any extra hands are working on, or is what the vet is doing now that the initial stabilization is done.

They need to give proper fluids (same as a cat or dog would get for shock) to fill the blood vessels. It isn't critical that the lion get blood right away as long as it hasn't lost too much. It would help greatly if he got some very soon, because fluids aren't a perfect answer. After that, clean, stitch properly or finish stitching (depending on the wound- ie, you don't have to stitch the skin before you give fluids). The vet will give antibiotics, but might not have enough for full course of lion sized dose, but enough to get them started.

The vet may also have a specialized blood product he could get out after all the important steps are done to further assist the lion. There are 'washed' blood products that carry oxygen that are fairly universal and the only issue again is the amount the vet keeps in stock, particularly if there are other vets around and he doesn't normally see ER cases (if he normally sees none, he won't have any special products, and he won't likely have the experience or smarts to keep your cat alive)

Also, your lion can't get domestic cat blood, and your strip mall vet absolutely doesn't keep any on hand anyways. It goes bad too fast. Vets who regularly need cat blood keep blood donor cats around. So at least your vet won't be doing anything dumb by giving the lion domestic cat blood :D

Next, is the lion going elsewhere for further treatment, +/- blood, or what?

And now I've spent too much time at the computer. Hope that helps :)

Fenika
10-01-2011, 08:10 PM
Also, as an fyi, in the states you need a license to keep a lion. So the first question someone might blurt out, if they were a bit surprised, is 'do you have a license for that animal and did you bring the documentation?'

Especially if initial impressions, before the gun came out, made the vet think the animal was stolen.

shawkins
10-01-2011, 09:12 PM
Wow, this is INSANELY useful. I really appreciate you taking the time to type all this up. The book's a fantasy, and this is far from the most improbable scene. I just like to touch base with reality every so often. I think it adds flavor.


Out of curiosity, how did this lion get in the mini van?

Um...our hero carried him? What do they weigh, about 250ish-300 lbs? I'm fairly sure I could lift one in a fireman's carry. Or could have in my youth, at any rate. Am I way off base here?

Assuming the lion's full cooperation, of course.


If it lost a fight or got shot, it might not willingly walk on a leash into the van (assuming it normally, however unwisely, did so for the handler/owner). Is this a normal animal or are you writing fantasy? If the lion is out cold, then were there men on hand to drag it into the van? If it was out cold from blood loss, it died on the way to the vets, unless it was only bleeding from one limb and got a tourniquet (don't apply too tight btw)

I was thinking duct tape. They just busted out of a basement where the zombie dogs were holding them prisoner. Would duct tape work?


So we have a presumably normal lion, bleeding out in the back of a van, and he's going to have to be starting to go into shock soon after he arrives at the vet, otherwise he's going to be dead pretty quick.


How is your van equipped to keep an injured lion secured in the back without killing the driver?

The minivan has one of those little TVs built in to where the overhead lights used to go & they turn it to the Food Network. It so happens that this lion is really into Rachel Ray. No, I'm kidding. But the actual answer is only slightly less ridiculous. <shrug> It's a fantasy.


Next, gunpoint or no, the vet, assuming he's had even a tiny bit of exotic med teachings, is going to absolutely insist on shooting the kitteh up with some injectable anesthetics. No one in their sane mind takes an injured lion and throws him on a gurney and hopes he doesn't jump up and kill everyone in the process (even if he arrived out cold). So pissed off, half in shock kitteh (who probably doesn't look very much in shock due to adrenaline) needs to go night night. Vet is probably going to grab his drug book, look something up, guess the lion's weight, and draw up the drug or drug cocktail. You don't need to specify, but it will be whatever they use for cats only A LOT more (hopefully he has enough on hand. If you want him stressing, have him be just short the correct amount.

Wow, this is great stuff. I really can't thank you enough.


Also, as an aside, he's going to have to explain what happened to all that controlled substance. Taking the bottles and dropping them on the floor and making up something later works. But your characters don't care, that's the vet's prob).

The vet's in the clear. Commandos show up a few minutes later and arrest the MC. You wouldn't happen to be a Navy SEAL or Green Beret or something, would you? I have questions about that as well. :)


Okay, we've got the drug, or nearly enough of the drug. Next we have to get it in the kitteh. Unless your vet lives near a city that has the type of subculture that keeps exotics (maybe he sees a few monkeys from time to time, maybe a small zoo uses his services), he won't have a dart gun or dart pole (whatever the second is actually called, I dunno.) If the cat isn't restrained, he's going to tell the lion guy to stab the kitteh with the nasty sharp needle in the muscle. Normally he'd give quick instructions on where best to inject it. At gun point I'd say 'stick him in the ass' and hope for the best, because if I got technical, person with gun would make me do it.

Next, wait a few minutes for the drugs to take effect. Guy with gun gets impatient. Vet might mention how impossible it is to fix a lion with an arm shredded or while bleeding out in the parking lot.

LOLZ. You understand the spirit of the scene perfectly.


Now, lion is out. Vet will check corneal reflexes really quick. Now you have to figure out how a guy with a gun, a vet, +/- a tech or two are going to get a massive cat into the hospital.

Maybe they have a gurney on wheels that is low to the ground and designed for animals who can get up and down a little but can't walk well. Not likely for a guy who doesn't do orthopedic surgeries or major cases (he refers those), but maybe he happens to have one somewhere for some reason. Otherwise, up on a normal steel gurney the lion goes, and will barely fit. Either way, he's getting his arse strapped down 100 times over, and he still might kill someone if he wakes up fast. Fun, right?

And I've used up a lot of time walking through all those little details. Messing with lions is not a small matter though, and if you don't play it safe, you are screwed.

So while the lion is out, and hopefully he isn't reacting badly to the drugs due to the increasing shock, the vet and or techs are going to do a quick check for the critical stuff- level of shock (oops, worse than we thought), vitals, etc. Temp can wait until things get stitched up.

Anybody know how to tell what the level of shock was? My medical training is pretty much limited to what I see on House.


First thing to do is stop the loss (initially with a tourniquet or pressure if possible, to slow it. Then with clamps or a quick stitch. Maybe some ER docs, vets or not, could help you here.) +/- get on gas anesthesia. Gas anesthesia also helps deliver O2, which a critter in shock needs. As long as he's on O2 and the blood has stopped, things aren't totally critical, unless while doing this the critter went totally into shock. In which case we need fluids, which is what any extra hands are working on, or is what the vet is doing now that the initial stabilization is done.

How would you give a cat that big gas? I'm having trouble visualizing the equipment. Is there something I can google?


They need to give proper fluids (same as a cat or dog would get for shock) to fill the blood vessels. It isn't critical that the lion get blood right away as long as it hasn't lost too much. It would help greatly if he got some very soon, because fluids aren't a perfect answer. After that, clean, stitch properly or finish stitching (depending on the wound- ie, you don't have to stitch the skin before you give fluids). The vet will give antibiotics, but might not have enough for full course of lion sized dose, but enough to get them started.

What would a dog or cat get for shock? Is there like a brand name or something?


The vet may also have a specialized blood product he could get out after all the important steps are done to further assist the lion. There are 'washed' blood products that carry oxygen that are fairly universal and the only issue again is the amount the vet keeps in stock, particularly if there are other vets around and he doesn't normally see ER cases (if he normally sees none, he won't have any special products, and he won't likely have the experience or smarts to keep your cat alive)


Also, your lion can't get domestic cat blood, and your strip mall vet absolutely doesn't keep any on hand anyways. It goes bad too fast. Vets who regularly need cat blood keep blood donor cats around. So at least your vet won't be doing anything dumb by giving the lion domestic cat blood :D

Mildly off-topic, I once read about a guy who injected himself with rabbit blood. (Thought he was a vampire or something, I forget.) He lived, but apparently it was incredibly painful.


Next, is the lion going elsewhere for further treatment, +/- blood, or what?

The magic librarian shows up & fixes him in the next chapter.


And now I've spent too much time at the computer. Hope that helps :)

Seriously, thank you SO much. I know it must have taken forever to type up, but it's been hugely helpful.

rugcat
10-01-2011, 09:29 PM
Um...our hero carried him? What do they weigh, about 250ish-300 lbs? I'm fairly sure I could lift one in a fireman's carry. Or could have in my youth, at any rate. Am I way off base here? They weigh a bit more than that, apparently.

http://wiki.answers.com/Q/What_is_the_average_weight_of_a_male_African_lion

Also, I doubt the average vet would know how much anesthesia to give a lion, or what type. A guess could easily not work or even kill it.

However, the vet could call the local zoo for information -- or perhaps he or she would know which vets in town treat exotic animals, and call them. There can't be that many; not unreasonable to suppose that most vets would know who they are.

shaldna
10-01-2011, 09:35 PM
In our practice we would have sedated him, not knocked him out though. examined him, cleaned the wound, dressed it, xrayed it, antibiotitcs, and probably a tetanus just to be one the safe side.

jclarkdawe
10-01-2011, 10:06 PM
One thing to be aware of is that wild animals are notoriously hard to use anesthesia on. Results are incredibly unpredictable.

I have a mustang, i.e., a formerly feral (or wild) horse. His DNA is identical to a domestic horse, since his relatives were domestic horses. He's be under anesthesia twice. Once by my vet, the second time at Tufts Vet School.

The first time, my vet, having worked on a mustang before, and about to separate him from his family jewels, gave him a dose on the high end of the recommended scale. Didn't impress him at all. A second dose was required, which left him a bit wobbly, but no where near what the vet wanted. It was just enough so she could perform the separation without getting killed.

The second time was so that his throat could be scoped. Again, you want the horse standing and conscious, but not to the point of being able to do anything. The vet (who wanted to impress the students) was warned by me and his experience with exotic animals and explained how he was going to start with a double dose, and watch carefully. By this point I'd owned the horse for a couple of years, he looked and acted mostly like a domestic horse. Again, another dose was required.

On the other hand, I've heard stories of wild animals dropping dead with minimal amounts of drugs.

In other words, the vet is going to do a lot of experimenting here. Especially with a lion. I'm not sure how much the gun is going to impress the vet. He's seen what animals can do. The gun, probably not.

I'd talk to your regular vet. Here you want not only the practical considerations, but the, "Oh, crap! What am I going to do!" that can't be captured on paper.

Best of luck,

Jim Clark-Dawe

Friendly Frog
10-02-2011, 02:13 AM
Over here no big cats can be kept as pets, so the only vets knowledgable to operate on one, will probably be bound to a zoo. My guess would be to get a zoo-vet on the phone as quickly as possible, if the gunman allows it naturally. If not, I can imagine a vet saying: "Look, either let me make the call, or expect your lion to die, because no gun in my face is going to make me capable of handling an injured lion."


Next, gunpoint or no, the vet, assuming he's had even a tiny bit of exotic med teachings, is going to absolutely insist on shooting the kitteh up with some injectable anesthetics.
Isn't it very dangerous to try and anaesthetise an animal in shock? It further lowers blood pressure, does it not? My gut instinct would be against that. Though I suppose something that relaxes the muscles or something, rather than putting the animal under completely, may be useful.

Both the guy with the gun and the vet will be needed to get a full grown male lion on the vet's table, and they better be strong men themselves. Usually it takes a few more people to life an adult lion, if all those wildlife programmes I've seen can be believed.

ULTRAGOTHA
10-02-2011, 07:32 PM
Oh, ask your vet! Go on.

My wife is a nurse and she asked one of the doctors at the hospital about a story we wrote and how much and which drugs not to give so the wounded guy wouldn't crash. His reply?

"Let him crash." With a gleeful look. "You can revive him later."

So you never know. Your vet might have even more interesting ideas. Experts are often flattered to be asked.

If I was a vet asked to treat a lion, I'd duct tape it's mouth shut (around a breathing tube if necessary) and maybe tie it's paws up, too.

veinglory
10-03-2011, 12:08 AM
In a state where lion ownership is legal (I think they are endangered?) they will direct the owner to vet who can safety sedate and treat. In state where it is not legal the would probably call in a USDA or zoo vet. Barring proper permits (which require an on call appropriate vet) the lion would probably be seized. Even sedating the animal would require specialized knowledge and equipment

Using a paralytic without anesthetic would probably be illegal on animal welfare grounds. Everyone would be safer if the cat was out cold

But it is legal to keep some big cats in some states, cross bred tigers in Texas for example

shaldna
10-03-2011, 01:55 PM
Isn't it very dangerous to try and anaesthetise an animal in shock? It further lowers blood pressure, does it not? .

Yes, very dangerous.

In addition, some animals can come around from anethestic very suddenly. I have a horse who nearly killed the vet when he came round, he literally just snapped out of it and was on his feet before they could move. It happens.

There's no real way to know how an individual animal is going to react to any sort of medication. We use Settlin a lot here, it's a mild sedative, comes in a paste and is great. It generally wears off in a couple of hours with no side effects.

Once I gave a small, standard dose to a stallion and he lay down and didn't get up for three full days. I thought I'd killed him. That same dose wouldn't touch my mare, it just doesn't seem to do anything to her at all.

GeorgeK
10-04-2011, 05:11 PM
I think your strip mall vet would bandage the wound, place an IV, hang some antibiotics and point you in the direction of the closest zoo. The vet would have the books to calculate drugs and likely have on hand the fluids and tubing. However how you stock a "pet" veterinarian shop vs a large animal veterinarian shop is very different. What they would likely lack is lifting help, appropriate sized equipment and any way to appropriately restrain the lion once it recovers.

"The good news is we saved your lion. The bad news is all the stitches popped out when he woke up because we don't stock anything that strong and then he got angry and ate two of my assistants."

GeorgeK
10-04-2011, 05:14 PM
... she asked one of the doctors ... His reply?

"Let him crash." With a gleeful look. "You can revive him later."
..

Remember that doctor's name and never see him as a patient.

shaldna
10-04-2011, 06:24 PM
However how you stock a "pet" veterinarian shop vs a large animal veterinarian shop is very different.

In my experience there is no medial problem that can't be solved with vaseline, duct tape and some purple spray.

veinglory
10-04-2011, 07:27 PM
It is entirely possible that the vet would refuse to treat the lion in the US. There are liability issues up the wazoo

areteus
10-04-2011, 08:43 PM
It is entirely possible that the vet would refuse to treat the lion in the US. There are liability issues up the wazoo

I think there is a pressing stimulus of a gun pointed to his head which may force the issue in this case... liability or no it's die or risk being sued :)

Fenika
10-04-2011, 08:56 PM
Briefly, some anesthetics are worse than others re blood pressure. Also, I've seen a lion gassed down with iso. The lion was on deaths door and was on gas anesthetic for some time. It can be done at a small animal clinic. That et tube for the biggest dog imaginable wont be ideal for a lion but hope and a prayer and monitoring works.

And yep, there are exotic animal drug books that cover ferrets, rabbits, lions tigers bears oh my. Snakes, parrots, and others.

shawkins
10-04-2011, 10:13 PM
You guys are friggin awesome. I really appreciate this.

shaldna
10-05-2011, 12:07 AM
One thing to consider is this - if the city has a zoo then it has an exotic vet. find out who that is and you can get your animal treated.

Likewise, many circuses and shows have thier own vets.

Fenika
10-06-2011, 02:07 AM
So you gonna tell us more about the scene, Shaw? Are there techs handy? How abnormal/fantastical is your lion?

Fenika
10-06-2011, 02:12 AM
Two things:

You can't pick up a sack o lion or a conscious lion. A weight lifter who lifts near his limit strains with balance and has to keep the weights close. A lion is MASSIVE. Try picking up a 50 lb feed bag when it's wrapped in a foot of towels then imagine a grown lion.

Gas anesthetic, often delivered after IV or IM anesthetic (IM in most animals), is delivered through a machine. There are usually tubes that go up to the ceiling (if your vet only has canisters at the base of the machine, he's gonna run out. He needs to be a fairly large strip mall practice with at least 3 vets normally)

You open the sedated lion's mouth, get the biggest et tube you have into the trachea, put a little air in the cuff if it's that kinda tube, and make sure the critter is getting his O2. Then turn on the iso (or other gas) and get to work. This is why you need a tech to speed things up.

The details aren't important ofc, but you'll have some folks scurrying and tubes and machines and monitors around.