Problems, problems

Thanks everyone for your name suggestions for the guest blogger.  I’ll add a poll for the naming over the weekend after everyone has had a chance to nominate.  As I hope you can see, he is doing incredibly well!

On the mend!

Despite his insistence that he’s just fine, let’s talk about problems – we’ll use him as an example since he has so conveniently interrupted.

As veterinarians, we learn to make lists of problems as a way of organizing our thoughts and finding solutions.  Often the problem list shifts, growing or shrinking depending on how the animal is recovering or responding to treatment.  Sometimes new problems are found with close observation Problems can be related to health, behavior, being an orphan, or just not being old enough for adoption.

It’s a great idea for foster caregivers to use a problem list too.  Have you ever seen The Checklist Manifesto? It’s definitely worth a read.

We love it when shelters give their foster parents a problem list when they pick up new fosters.  It’s best if the list has accompanying instructions for what to watch, questions they are hoping to have answered, and what kind of treatment is needed for each problem.  Sometimes that list will be complete and sometimes things will need to be added as more observations are made.  Having a list helps you run through each thing you might need to think about when you are caring for your foster friend.

A form for listing problems can be as simple as this:

Problem Date noted Shelter notified (Y/N) Date resolved

Here’s a sample form for you to download:  Sample Problem List

Monitoring actions and treatments would be listed on a more detailed form.

Here’s a sample of that type of form:  Sample Medical Treatment Log

You can find a treatment sheet example on our UC Davis KSMP website too.

Be sure you understand and can handle all the problems on the list before you leave the shelter.

As I said, our little guy isn’t a good starter case but he did have a good list of problems.  This little guy had a traumatic injury and it took some time to figure out exactly what problems resulted.  Some were obvious; some a little more subtle, needing time for observation and more diagnostics.

Here’s his hefty but abbreviated first list along with some questions, expectations, and and some sample of what might be on a monitoring/treatment sheet.  We’ll come back to those later.

1.History of head injury and rolling to the left –Does he seem to be able to control this?

2.Several puncture and linear wounds –Is infection developing? Give antibiotics.

3.Blood in his eyes (hyphema) – Should resolve with no treatment. Should not interfere with vision.

After some observation time we were able to refine it to add:

4.Well aligned fracture in his left knee – Needs to rest

5.Fractured bone in his front paw – More rest

6.Tongue laceration – Monitor eating.  May need assistance or tube feeding. Infection developing?

7.Possible URI –  signs of infection or congestion caused by head trauma?

His fractures (broken bones) were hard to see because they were still mostly aligned.  At first, it was hard to tell if he kept dropping and flipping over because he had no neurologic control, or if he was just so painful and couldn’t use either of his legs on the left side.

In our foster home, we could watch his behavior and condition over time.  Pain medication calmed him down tremendously.  After one night his neurologic problems were going away.  The swelling over his knee and his unwillingness to use his front paw sent us back for more radiographs (x-rays), and the fractures were found.

By today, a little less than one week in foster care, he has his list down to just his two fractures, still a big deal but not life threatening.  Everything else has resolved well enough to need mostly a generally watchful eye.

Now his only problem is that sometimes people want to stand up … and the lap disappears 😉

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2 comments on “Problems, problems

  1. Love the idea of sending home a list of issues with the recommended action for each animal. As a foster coordinator, I think having the list made before finding a foster could help fit the right foster home to the kitten. Thanks for the idea!

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