The patient waits in the Intensive Care Unit alone – quarantined – and curled in a downy ball. The cocker spaniel puppy has a highly contagious virus with symptoms of lethargy, vomiting and bloody diarrhea – an affliction the couple who just welcomed her into their family was unaware of when they adopted her 16 hours ago.

The cocker spaniel’s X-rays, printed minutes ago from a photographic disc, lay on the table in the ER. Brandy Redernick, the clinic’s head technician, fires off medical terminology civilians would need a crash course in medicine to decode as she assembles a bag of IV fluids with potassium and electrolytes. Nearby, an assistant technician prepares a syringe to take a blood sample. The probability of the puppy’s survival is 50 percent.

The technicians move quickly. Their efficiency is vital, not just for the puppy, whose chances of survival increase as they swiftly apply treatment, but because they must attend to multiple patients simultaneously.

Another assistant technician, Sarah Smith, adjusts the speed of a fan blowing on another dog’s face. The pup’s jowls flap as if she was hanging her head outside of a moving car, but this is no joy ride – she’s sitting in a kennel with 104-degree fever, a swollen abdomen, milk ducts enlarged after giving birth to a litter some weeks ago and, most painfully, an abscessed uterus. According to Redernick, without an emergency spay she has no chance of living.

Meanwhile four 2-week-old chihuahua mixed pups the size of small guinea pigs shiver in a nearby incubator. Some suckle on each other futilely – their mother prematurely stopped nursing them due to her own calcium deficiency. Every two hours the technicians unpack them from the compact balls they have formed for bottle feeding. Some, however, are too weak to suckle and are fed by syringe.

It’s another Saturday at the Monterey Peninsula Veterinary Emergency and Specialty Center in Monterey’s Ryan Ranch. Because it’s open when other veterinary offices are closed – 5pm to 7am nightly and all holidays and weekends – bouts of fast-moving action are common here.

“It’s life or death, and we don’t make appointments,” Redernick says. “I enjoy the fast pace.”

It was the demanding environment that drew her from normal daytime clinics.

“It’s fun to give puppies and kitties vaccinations, but I’ve learned more about animal care here,” she says.

Not all days are as eventful as this Saturday. Two nights ago, talk didn’t center around abscessed uteruses and calcium deficiencies but the color of the waiting room walls, which are a bright and friendly yellow.

As she sips her coffee, Redernick ticks off recurring culprits she sees: foxtails in ears, dogs overfed on table scraps, snail bait and anti-freeze poisoning. “If snails will eat it, why wouldn’t your pets? It’s candy to them,” she says.

Quiet nights like this present some of the intriguing realities that exist here: They depend on emergencies to survive.

“It’s unpredictable,” she says. “If we have a slow night it means we’re not making money.”

Smith presents another challenge: not becoming overly attached to patients.

“We have to distance ourselves,” Redernick says. “It’s difficult and I’ve had cases I became really invested in.” She says she has four dogs and four cats, some of which she is fostering after the clinic took them in as wounded strays.

She’s not alone in her compassion. Vet Medical Director Dr. Katja Herrmann notes that contracts with local cities and the county to care for rescued strays don’t cover all of their costs, but she and her staff often pony up the extra money to nurse those animals to full health and find shelters for them. Hermann constantly reminds pet owners how vital proper pet identification is.

“We can’t overemphasize the importance of a collar and a microchip,” she says.

The toughest challenge they and their clients face, though, is deciding when an animal’s survival is worth the cost of an expensive treatment – Hermann has seen pet owners struggle with the hard choice while the pet fights for life.

“A lot of people don’t understand that we have to be paid,” she says. “Our priority is to stabilize a patient while [owners] make a decision. We don’t want any animal to suffer.”

Yet another challenge: Helping clients deal with the grief of losing a treasured friend. To that end the clinic offers grief counseling and cremation services.

It’s unlikely that these tasks rank among the staff’s favorite parts of the job, but their disciplined and compassionate approach reflects an understanding that dealing with death is part of being able to save a life.

Monterey Peninsula Veterinary Emergency and Specialty Center is open 5:30pm-8am during the week and 24 hours a day on weekends and holidays. 373-7374.