Cats and Dogs at My First Clinical Placement!

First week of clinical placement done and dusted! The small animal clinic was a bit smaller and slower than the places I’ve worked in; but you can always learn no matter where you are. This pace of appointments was perfect for asking lots of questions. I took the time to try and have some interesting discussions with the vets including their rationale behind drug protocols, unusual points they’ve learned from specialists or conferences, and how to deal with colorful clients as a new grad.

The clinic had 2 senior vets and 1 new grad vet. I loved this because the new grad vet chatted to me about lots of practical advice on how to navigate (instead of struggle) through my first year in practice. Speaking to the senior vets was fantastic for further expertise on cases and discussion of more complicated surgeries and techniques. This was helpful because after discussing multiple techniques on how to repair ruptured cranial cruciate ligaments we saw a couple of patients with the disease —one dog with a suspected tear, and another dog for a post-op assessment.

One of my favorite parts of this placement was the opportunity to see a flank spay. We’ve been taught that they are generally an older surgery and it is more typical to do abdominal spays now. However, this particular patient was contraindicated for an abdominal incision. I also enjoyed one morning when I spent some time monitoring a critically ill patient who had been brought into the clinic with an acute onset of heart disease and pulmonary edema (fluid in her lungs).

We also performed an enema and an ear clean under general anesthetic and admitted a patient with a fractured pelvis. I enjoyed listening in on consults regarding a seizing patient and a patient with behavioral issues.

Once the vets learned that I knew how to put in intravenous catheters I was allowed to put them in on all the patients that needed one. Practicing my hands on skills was the best part of this week.

A huge thank you goes out to the vets and staff at Greenvale Animal Hospital who are now part of my journey to becoming a veterinarian!

 

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Beginning Clinical Skills Practice

Lets get back to the real reason I started this website… I won’t be doing any more traveling for a while as I have just started my 3rd year of vet school! The first 2 weeks were an intensive block on the ‘Principles of Professional Practice.’ The mornings consist of lectures and then most afternoons we have very interesting practical classes:

In our fluids practical class we worked through some case studies. We had to decide if a patient needed intravenous (IV) fluids, how dehydrated they were, and what kind of fluids to give them. Then we had to calculate how fast we were going to give fluids to the animal. Another part of the class was practicing how to put IV catheters into canine forelimbs. The university provides us with fake ‘skin’ and realistic dog arms with ‘blood filled’ veins to practice on!

I really liked our first surgery class! Initially we looked at all the different types of surgical instruments you could use, and talked about how to properly hold them, clean them, and what kinds of surgery you might use them for. Then we had some time to practice a few different suturing patterns and knots on fake skin! The other half of the class we learned how to properly do a ‘surgical prep’ —> shaving the hair and washing the skin of a dog prior to abdominal surgery. We learned the basics of maintaining a sterile surgical field and how to properly drape a patient. Then I was volun-told to scrub in for surgery, put on a surgical gown, and close glove (this means I need to safely wash my hands/arms, put on my surgical clothing/gear without contaminating myself by touching anything).

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All of the things we got to take home to practice our clinical skills with–masks, surgical gown, cap, gloves, hand brush, catheters, suture, and surgical instruments.

Radiology (x-rays) practical class could have been very boring, but thanks to great professors it was engaging. The first half of the class we talked about different radiology equipment and machines that we might use in practice. We discussed how they worked and why we might want a certain set up. Then we went into the teaching hospital and exposed some x-rays of single bones. We also got to explore and play with the university’s rad viewing software.

The communications practical class was something I was both very excited to do and very nervous about. In this class we had to go into the teaching hospital and read the history on a case. Then we went into the waiting room and called our client and patient into our consult room. Our job was to establish a good first impression, understand the client, and get a sufficient history. We were to conduct the consult up until the point where we began a physical exam of the animal–we will practice that part later in the year. The case I got was about a dog with itchy ears and eyes. Once I called my client into the room I became a lot less nervous and my questions and conversation flowed more naturally.

Equine Clinical Examination: this class was a bit of a review from DVM1 I think. We had to work in groups and do a clinical exam on a horse–this includes looking at the horse from head to tail and assessing all the body systems for abnormalities. We also used our stethoscopes to listen to the different heart, lung, and gut sounds. Then we practiced intra-muscular (IM) and IV injections (into the jugular/neck vein) using saline.

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Listening to the heart of a horse after it finished competing. This picture was taken in my first year of vet school. I was assisting with vet checks at an eventing day. 

So even though we have well over 30 lectures to study within the first 14 days of class –I love vet school. Third year is going to be a good time, I can feel it!

Blood smears and bone marrow

Every week we have several practical classes. These are the classes where we have hands on contact with animals, or are looking at microscope slides, or handling and assessing preserved tissues, etc. This year we have mostly had pathology practical classes. We spend a few hours in a cold room wearing our labcoats and gloves and handling tissues. Some of the tissues/organs we have been looking at are: digestive tracts (rumens, stomachs, esophagus), livers, kidneys, hearts, lungs (they have all been preserved). We look for signs of diseases, different presentations, abscesses, parasites, cancer, infection, inflammation, abnormalities…the list goes on! Usually the classes are long and overwhelming with information!

This week we did something a bit different than handling cold preserved organs. In the first half of prac we did some hematology work. Did you know that red blood cells are also called erythrocytes? We practiced blood smears; this is a common diagnostic test done in clinics. A blood smear lets you examine which cells are present, if they look normal, if there is too many cells or too few. This can give a veterinarian a lot of valuable information on a case!

My blood smears; practice makes perfect!

My blood smears; practice makes perfect!

We also checked packed cell volume (PCVs) of different animal bloods. PCV tells you the percentage of red blood cells in a sample (the other 2 parts of blood are plasma and a buffy coat (white blood cells and platelets). If there is not enough blood cells seen on a PCV, the animal might be anemic. We also spent some time looking at cells under the microscope to see if we could identify all the different types.

In the second half of prac class we got to practice bone marrow sampling. Did you know that red blood cells are made in the bone marrow and then move out of the bones into the blood? The bone marrow is sampled to check for signs of infection, disease, or other problems. We learned the correct way to use a bone marrow needle and the specific locations on the body that the needle need to be placed. The needle needs to be inserted through the skin and into the center of a bone in order to suck up bone marrow. After a few tries (on deceased animals) I was starting to get the hang of it!

This was a really fun and practical afternoon of practicing some clinical skills. I wanted to share with everyone so you could have a bit more of an understanding of what I do in uni!

From: http://www.kimal.co.uk/products/bone-marrow-aspiration-needle/

A bone marrow aspiration needle. Image from: http://www.kimal.co.uk/products/bone-marrow-aspiration-needle/