My Thoughts on "Lethal Ingestion"
November 16, 2015
Fandango, the alpaca, was an emergency case I had during my cardiology rotation. I got another chance to learn how to interpret echocardiograms and apply the knowledge from previous years to a clinical case. Upon examination, we were able to identify pericardial effusion, or an accumulation of fluid within the pericardial cavity. Although the amount of fluid was small, it was still enough to cause a significant decrease in cardiac function, leading to congestive heart failure. Unfortunately, the prognosis was very poor, since the cause of the bleeding could not be identified and the procedure to remove the fluid was both difficult and dangerous.
As veterinarians, we are one of the few (if not the only) professions that has the legal capacity to end a life. This can weigh heavily on an individual, especially if you consider the number of times a vet has to perform this procedure over a period of 5, 10, 15+ years. Fandango’s euthanasia did affect me that day. Yet during cases like this, I am learning how to cope with death, since I know it is an unavoidable component of my job. On the plus side, I like the ability to bring an individual peace (and I’m referring to both the patient and client). I don’t think I will ever become stoic or numb to the process, and honestly I do not wish to.
My Thoughts on "The Big Rotation"
November 16, 2015
I was very excited to take the Equine Specialty rotation. It was the only opportunity I had while in vet school to learn how to float horse teeth and other horse-specific diagnostics. Floating is the process of leveling off the points that form on the teeth in a horse’s mouth in order to prevent future lacerations and ulcers on the cheeks and tongue. I had some experience floating teeth prior to the rotation as a veterinary assistant, but I wanted to have more detailed training to understand what I see in general practice.
It was great to learn how to perform a complete dental exam. This includes learning how to make notes on a dental chart, take x-rays, and put all this information together to develop a treatment plan. I became familiar with the different rasps, or instruments used in order to float the teeth. Most important, I began to develop a preference for the different rasps. Now, when I float teeth, I know the type of instruments I’ll need in order to get the job done. For example, I will want to use a power float for one purpose and manual rasps with a particular angle in order to reach certain teeth.
One of my interests within veterinary medicine is ophthalmology. I enjoyed the ophtho lab during the rotation because we learned how to perform a complete eye exam on a horse. One of the skills that we were able to learn is a particular nerve block that is great when you are trying to exam horse eyes. Knowing the different landmarks and techniques to perform the nerve blocks is different when learning in a lecture versus actually trying to do it in real life. Practicing that skill was so invaluable and far from uneventful (I ended up splashing myself in the face with an anesthetic, leaving half of it numb for a while). Overall, my expectations for this rotation were satisfied and goals were met. It was a great two weeks.
My Thoughts on "In Need of a Miracle"
October 07, 2015
Leslie was one of my first patients during my Large Animal Internal Medicine rotation. Donkeys are in the same family as horses, but they are not the same species. Sounds simple, but people commonly make the mistake in thinking otherwise. I was at fault for assuming the medical parameters between the two would be the same. Once I did my research, I learned the differences in temperature, pulse, respiratory rate commonly referred to as TPR. I also learned how to determine the body condition score in donkeys (they distribute fat VERY differently than horses). If you refer back to the episode, you can see in the shaved areas of Leslie’s back lumpy areas. These lumps and humps are actually fat stores.
Next, I learned the proper technique of looking into the mouth of a small equid (pony, horse, or donkey). Someone who does this often in horses might say, “Oh that’s easy, just go in and grab the tongue.” Yes, that is what you do in full size horses; however, there isn’t nearly as much room in a mini to reach in and grab the tongue without getting bit (on the show, Leslie happily shows the hazards of doing the technique incorrectly). Side note: thanks to Rose for showing me how to keep all of my fingers.
Finally, I learned about their temperament. There is a reason donkeys are referred to as stubborn creatures in literature for centuries. When they put their mind to it, they cannot be budged. This is emphasized at the end of the episode when I attempt to load Leslie into her trailer for her trip home. Everything is going well until she locks her knees and begins to lean backward, making it very hard for me to lead her into the trailer. With an extra set of hands, I was able to successfully load Leslie, but I almost fell in the process (once again, captured on camera for your viewing pleasure).
Overall, working with Leslie was an absolute treat. I can still remember her loud signature honks reverberating down the halls of the large animal hospital. I didn’t know what to expect from Leslie when I signed up for this case, but she proved to be a great introduction into the world of donkeys. I don’t know if I’ll ever work with donkeys again in the future, but I’ll definitely be prepared.
My Thoughts on “Day One”
September 29, 2015
My goals while on the Cardiology rotation were to get better at interpreting EKGs, understanding which drugs (and in which combinations) were used for the different heart diseases, and most importantly as a general practitioner, when I should refer a case.
It was great to be able to take cardiology because there were many concepts of the heart that I memorized for the test, but didn’t fully understand. With my first patient, Millie, a lot of that changed. I got more comfortable understanding the pressure differences within the cardiovascular system and how changes in those pressures cause the development of structural changes within the heart and even murmurs.
When studying medicine, you learn which diseases have a high or low probability of having a positive outcome. Most of the time, the cases in the hospital follow these statistics. Yet, it is great to have a patient that doesn’t follow the norm. It serves as a reminder that every case is unique and sometimes stats are just stats. It reminds you that you should treat the animal, not the disease.
I had cardiology pretty early in my clinical year. Millie was also my first case where the patient had a fatal disease and euthanasia was a plan B. Thankfully, Millie fought through the procedure and beat the odds.