Adventures of a Mixed Practice Vet (Student)

I’ve just completed my very last placement of final year! I still have rotations to do (they are organized by the university not myself) before I’m totally finished. I booked my placement at this mixed animal vet clinic to be 1 month long. I wanted more time to get to know the vets, the area, and follow up on patients—which are features that you do not get when your placements are shorter.

I started at 9am on Monday, by 9:30am the first patient was in the hydraulic squeeze in the bovine exam room and I was in charge of replacing his rectal prolapse. Luckily the prolapse was quite small and I really only needed to put in a couple stitches.  As for other cattle work —I tried to jump on all these calls because this was the hands on experience that I wanted.  I went to a lot of herd health appointments– usually the first appointments of the day.  This is usually an appointment that occurs every 2 weeks at a dairy farm to assess the health & pregnancy status of the herd.  I preferred to get my practice with rectal palpation and trying to diagnose cows as ‘pregnant’ or ‘open’.  Some cool things other than pregnancies that I felt included cystic ovaries and a mummified fetus from an aborted pregnancy. Sometimes I watched the ultrasound screen while the vet checked the cows. You can tell how far along the pregnancy is by looking at the size of the embryo on the screen.

One particularly memorable call was helping out a heifer who having difficulty calving. She had already been going several hours and the farmer said her calf was dead. By the time we got out to the farm the rain was bucketing down from the dark clouds. We pulled up to an uncovered head gate with the heifer waiting for us.  With thunder and lightening rolling in we got to work. Calving calls usually requires a lot of lube…. and I mean a lot. I dumped a 1L bucket of lube into a pail and used a stomach pump and a hose to pump all the lube into the birthing canal (sorry for that mental image all you non-vet people). We also slathered both our arms in lube and got to work.  The dead calf came out piece by piece. I felt like we really helped that heifer; and bonus: we didn’t get struck by lightening!

We did a left displaced abomasum (LDA) surgery in clinic. I explained what this was in one of my previous blog posts about a cattle placement. Working on our large animal calls in clinic is often much nicer than on farm because all of our equipment is right there, we are in a controlled (& heated!) environment and we can often be a lot cleaner/more sterile than in the field. The LDA surgery was performed similar to others I have seen except this time we were able to wear gowns, gloves, and perform a proper scrub in the sink before starting.

We saw quite a few cattle with joint infections. Often all this takes is a small cut or wound over the incision that allows bacteria to come in and colonize. Sometimes these patients can be treated and sometimes they cannot. Close to the end of my placement a calf with a very badly infected joint came in. The situation looked grim but the farmer was game to try and save the calf.  We sedated the calf until it was laying on the ground. I was in charge of clipping the hair and scrubbing the foot (imagine how long it takes to clean a cow’s leg that has never been bathed ever in its life!) before we tapped the joint (stuck a needle into the joint space). We ended up draining a lot of the STINKY infected joint fluid before we flushed out the joint space and injected some antibiotics directly into the space. I applied a big bandage to the cows leg and was chatting to the farmer—it was almost 10 minutes later I realized I had chunks of joint material & dirt hanging off my face. #classy.

We drove out one day to an extremely nice property to see 3 highlander calves ((the fluffy ones!) who are apparently famous on instagram?!) that were coughing.  We suspect that they had lungworm because they seemed healthy otherwise and started coughing whenever they had to run around. On our way back to the clinic one of the tires on the truck blew off… so that was quite the adventure!

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I went for a sunset swim in the river with friends after work

Seeing ‘bull with broken penis’ on the appointment scheduler is always interesting. I think we saw about 3 of these cases while I was at this practice. One of them just had a bad infection and the other bull had a massive abscess all surrounding his sheath. I drained out & cleaned the abscess. Both the bulls went on antibiotics and they will be out for the rest of the breeding season this year.

Someone brought in a much older cow and an unrelated calf who both had walking issues. On rectal exam of the older cow you could feel spondylosis (extra bone growth) between all her vertebrae.  This is an age related change and was probably the bone just trying to stabilize itself. We didn’t think she could be safely bred any longer.

We also saw lots of sick cows which allowed me to practice my physical exams. We even had a few conversations about dart guns, treating wild cattle, and which drugs were the best to use because of amount, effectiveness, and depth of penetration of the dart (subcutaneous administration vs intramuscular). And yes, then I went and checked out a dart gun & some of the 10ml darts that are being used.

There was always something going on with the cats and dogs in the clinic. I placed drains in a couple of different patients with wounds. The drains go into ‘dead space’ beneath the skin of the animal and assist in draining out fluid that would delay or prevent healing. The first drain I placed was in a dog who had a lumpectomy surgery and his incision had dehisced. He came back in a week or so later for a suture check and then for his sutures to be removed; the wound had healed up great! On my last day of placement a large breed dog who had been attacked by another had a head & neck FULL of wounds. I placed 2 drains in his neck. A few days after I finished my placement one of the vets texted me pictures of his healing wounds!

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I had only been at the practice 4 days… and I already had clients leaving messages for me 🙂 

Speaking of wounds, because of the rural area there was a lot more appointments of pets that had been fighting, were attacked, etc. I looked at many wound patients, or hit-by-car patients, watched enucleation surgeries, and pulled porcupine quills out of dogs (one of my favorite appointment types)! I even saw my first cat with quills stuck in her face — cats usually run away so this was interesting.

During my first week there was a young puppy who refused to walk. The x-rays showed a broken leg. I got to see this puppy several times over the next 4 weeks as he came back in for bandage changes.

There was one dog who was diagnosed with bladder cancer, this is typically a fast moving and impossible to cure cancer. We were trying to manage this patient to be as comfortable as possible. She was having issues urinating so I helped to pass an indwelling urinary catheter that would sit in her bladder and allow her to pee. I also helped pass a urinary catheter in a male cat who was blocked (usually a stone stuck in his urethra preventing him from urinating).

One day a dog came in for ‘excessive slobbering’. This problem actually turned out to be a lot more interesting when we discovered the dog was unable to close his mouth and likely had a nerve paralysis!

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We had to do an emergency surgery on a dog who we thought swallowed a sock or a rope. It turned out that this dog was just obsessively eating grass until he packed his stomach solid with it. 

I was able to perform castration and spay surgeries by myself. As well, I taught the veterinarians & techs about a new surgical technique we learned (the Millers knot) that is really good for crushing tissue. The vets loved it and are going to use it themselves now! I scrubbed in and helped in a very large breed dog spay & a pregnant spay and even a c-section on a Frenchie! The vet let me deliver the last puppy myself— slipperier than expected!  I had a super interesting conversation with a vet one day because we had several puppy vasectomies and hysterectomies booked in. These are not common de-sexing procedures because they leave the testicles & ovaries behind in the patient which can continue to produce hormones. There are some breeders in the area that were requesting these surgeries. Speaking of puppies & breeders…. we did several first puppy exams. This means that I stood in a room of 5-10 puppies and got to cuddle them all!… I mean… examine… and then give them needles (vaccines). I’m talking white Labs, chocolate Labs, Beagle crosses, German shepherds….

We saw a young mastiff dog was was limping heavily, after some x-rays we discovered a severly diseased elbow with a condition called Ununited Anconeal Process (UAP) which requires a specialist surgery.

We did a couple of post mortems on rabbits! Not your typical case….

I started all of the small animal consults by myself, did my own exam, took samples, etc. before chatting to the vet about my suspected diagnosis. Then we went back in and finished the appointments together. I saw a puppy who was only a few weeks old that was dripping fluid from his nose & sneezing everywhere. We suspected pneumonia, although neither me or the vet had ever seen this condition in an animal so young.  We saw an old Caviler King Charles Spaniel with an extremely impressive display of decompensated heart disease with a murmur that likely could have been heard in the next room. We sedated a dog who’s owner thought he had porcupine quills stuck in his ears. Once I examined his ear canals I found a grass awn and managed to pull it out for him! Imagine just how irritating that would be?!

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Feelin’ good! 

THEN, there was all the horse calls! We did a couple of pregnancy checks on mares which was good to do in a different environment because I did a lot of this at my last placement. One of the vets at this practice had also done another course on chiropractic & acupuncture treatment for animals so she had several appointments (horses & dogs) come in for this.

I got to try my hand at floating teeth with a power float… harder than it looks… and I still haven’t mastered the ability to see all the teeth at the back of the horse’s mouth without climbing inside…

On another day we were on our way to see a horse that was acting neurological, by the time we arrived the horse had died. We spoke with some people on the farm and then took a blood sample for testing; we suspected West Nile Virus. When the results came back a week or so later that was not the case but a different disease that could have been prevented by vaccination was found instead!

We went to another farm to euthanize a very old horse. And another farm to check on a couple of horses with wounds. One horse had a wound high up in his armpit, another had a wound on the back of his leg with his tendons exposed! Back at the clinic we saw some miniature horses that had been attacked by dogs and had significant wounds. It was an after-hours call that took us almost 2 hours to clean up & stitch back together. I heard that they are doing well.

The smoke had been so bad in the area (from forest fires in the next province) for almost 2 weeks that I wasn’t surprised when we went and did an exam on 2 horses with respiratory issues from the terrible air quality.

There was a horse with a really bad case of mastitis. Usually this is a problem that we see more commonly in cattle & if you see it in a horse it is easily treated. That was not the case for this horse. When we saw her her udder was very swollen, firm, and quite painful. We checked on her almost daily & prescribed her a whole slew of medications.  I also put in a couple of intra-mammary antibiotic treatments & an IV jugular catheter. Treating her with intra-mammaries reminded me that a horse udder has a different anatomy than a cow’s udder. One day we got a call that now her udder was looking better but she was 3-legged lame & couldn’t walk! Confused, we drove out to the farm again. The horse was hungry but didn’t want to move to the grass. Her legs and tendon sheaths were all swollen. We suspected she may have had a drug reaction & pulled her off all her medication. The next day she seemed to be on the up & up!

So that’s a lot of fun stories! And I didn’t even mention all the fun I got to have in the evenings & weekends being home with my friends/fam…. coffee dates, farm visits & parties, dinner with my grandmas, learning to ride a motorbike & pull a trailer, markets & fairs, swimming, campfires, drinks….

I really enjoyed myself at this practice. The vets treated me like a doctor, like a colleague, and I felt my opinion was valued and appreciated. Thanks a million to BarrNorth Veterinary Services and I wish you a fantastic fall and winter season ahead!

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The clinic had a taco-in-a-bag customer appreciation day so my mom and a family friend came for a tour of the practice! 

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Freezing Fingers & ‘Cutting Deads’

Its a balmy -10C outside today as I write this and think fondly back on my last week. I drove out to Calgary to work at Veterinary Agri-Health Services (VAHS), a practice that does a lot of feedlot work. They also service cow/calf operations. It was below -20C almost every day–what a way to kick off the year!

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It is not the best time for cattle work in Canada–a little too early for calving season which is usually in the early spring and can be quite busy. So my mornings at the practice were spent in the offices either helping with drug orders or studying. I sat in on a webinar about a new vaccine in Canada, attended a pathology presentation for feedlot workers, and listened to a presentation on Johnes disease in beef cattle from a previous summer student. I really enjoyed the discussion about that topic.

This practice is completely ‘ambulatory’ which means that farmers/producers will call the practice and the vet drives out to their farm (or feedlot) with all the equipment they need. All the exams, treatment, and surgery the vets do happen on the farm. So each afternoon I hopped in the truck with a vet and we headed out.

I worked with a couple of female vets this week. I really appreciated this experience as it allowed some conversation about how to survive as a female in the world of large animal vetting and agriculture. We discussed confidence, work/life balance, how to protect your body from breaking down, and how to pee when you haven’t seen a washroom in 100+km…

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I honestly have missed seeing that big Alberta sky, but that doesn’t leave a lot of spots for privacy…

Feedlot vets do a lot of post mortems (autopsies); while this might sound a bit morbid to some of you I actually quite enjoy them.  The colloquial term a lot of vets use is ‘cutting deads’. It is very exciting to be able to open up an animal and look at 1 or 2 organs and diagnose why the animal died. We did post mortems everyday– they aren’t easy work but it will keep you warm outside!  Its not the safest work either—when you can’t feel your hands and your standing on ice—it just takes a few tries to learn some of the tricks! At the beginning of the week I struggled with finding where to put my knife and remembering all my respiratory pathology from first year–by the end of the week I felt a lot more confident about what I was doing and what I was seeing. But I’m sure I’ll be getting a lot more practice with this.

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Twice this week we looked at some cattle for export. This means that they are being transported across the border from Canada to the United States before they are slaughtered. This involves walking the pens and looking at the animals– and holding back any animals that look sick or have sore feet/legs and who would not transport well.

We got asked to check out a cow on a feedlot that had been acting a bit weird–when we got there the cow had neurological signs. There is a lot of things that can cause a cow to have neurological problems. We often don’t investigate these problems in cattle the same way we would in small animals — with x-rays, CT scans, and diagnostics. Sometimes you can figure out what is going on in cattle but it is quite hard.

On the Thursday the vet and I went out to a large feedlot where they had two bloat surgeries for us to do. Depending on what cows are eating sometimes their stomachs can fill up with gas or bubbles and become really bloated! This can actually be lethal for a cow if the problem isn’t discovered and treated and prevented. If you are interested, this is a really good article from Alberta Agriculture about bloat. The vet did the first bloat surgery and then I did the second one. We were in a shed and there was a heat lamp but it was still so cold! Loosing feeling in your fingers, freezing suture, and frozen blood on the suture is a whole new level of difficulty. Very simply speaking, a bloat surgery puts a hole from the stomach of the cow to the outside world so they can safely release gas!

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This was a great placement! Despite it being cold and a little slow I felt that I gained a lot of knowledge (or topics to study up on) about the Canadian cattle industry and common diseases in feedlots. I appreciated a chat I had about being a practice owner and what that could look like–this is something I have always aspired to! Lastly, and not related to cattle…. I now know which little town to stop in and find the best peanut butter pie on the prairies!

Thanks again to all the wonderful vets and techs at VAHS!!

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Eyeballs, ovaries, and anesthesia!

Its finally the start of our Easter break and its given me a chance to write another post. This has been a full on semester…the material is a lot more clinically relevant and interesting. I love that we get more hands on experience. This is the fun stuff, the stuff that counts, its what I’ve been looking forward to for years.

Recently I had a really good week of practical classes:

The first one was our Ophthalmology Practical class.  I’ve helped out with tons of eye examinations at work over the years, but only got to use the equipment myself a few times. I have never been overly interested in eye cases but this class was a lot of fun for me. We had our ophthalmology lectures a few days earlier which were full of different pictures and explanations of what to look for. Our lovely teaching greyhounds were present and we got to practice Schirmer Tear Tests (STT (measures tear production)), fluorescein eye stains (highlights wounds or ulcers in the eye), and examination of the eyeball with a focal light and an optivisor. I’m starting a clinical placement at a small animal clinic this week and I am really hoping to get a chance to practice my examination skills.

We had our second Bovine Reproduction Practical class where we practiced rectal palpation on female cattle. Our main objective was to attempt to find and palpate the cervix, bifurcation of the uterus, and both ovaries. I was able to find all the structures; one of our cows even had a cystic ovary. That ovary was a lot larger and easier to find than the normal healthy ovaries. The week before we had an Equine Reproductive Practical class where we felt for the same structures in horses. It was good practice to go between species and think about the differences in anatomy. Horse ovaries are bigger and you feel for them higher up than cow ovaries.

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We both found ovaries! Well on our way to diagnosing pregnancy…. 

Our Small Animal Reproductive Practical class finished off our clinical skills in our reproduction block. Unfortunately there was no dogs or cats present in our class so we mostly used microscopes to examine slides of swab samples. Cytology (the examination of cells) is one of the best ways to determine which stage of a cycle the bitch (female dog) is in. It is very important to know what stage she is in so that she can be bred on the right day and get pregnant with puppies. Looking through microscopes is definitely not my favorite part of vet med but after this class I understand a lot more what to look for in these cases.

My favorite practical class that week was our Equine Anesthesia class. We were split into 2 groups of students. Half of us were given a drug protocol and had to calculate drug doses and draw up our medications. The other half of the class had to complete a physical exam on our patient. My roommate and I were in the same group and we felt quite confident about how to start and complete a physical exam on a horse because of our time volunteering in the horse hospital. After we completed our exam we had to clean, prep, and insert a jugular catheter so we could administer the premedication drugs. Our group had a ‘Triple Drip’ drug protocol which is very common in horses. Then we proceeded to anesthetize our horse with our maintenance drugs. When the patient was asleep we were responsible for monitoring his vital signs and recording everything on the anesthetic record. We also practiced intubation. I’ve done intubations in cats and dogs before, horses are different because it is a ‘blind intubation’. That means that you cannot see exactly where you are placing the tube and instead have to rely fully on feel and knowledge of anatomy.

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I am holding the maintenance drugs we used for our TIVA (total intravenous anesthesia) Triple Drip protocol and equine intubation tubes. 

So vet school? Loving it!

After a full 9 weeks of class I’m ready for a 2 week break to catch up on lectures and complete some clinical placements…

 

Semester 2

I think its about time I sent out a quick little update! After finishing my first semester of DVM the winter break in July was much anticipated! Now I’m back into the thick of it, and have just finished my first midterm of semester 2. The classes I am in this term are:

Cardiovascular System

Foundations of Animal Health 2

Animal Health in Production Systems

Cardio takes up a lot of my time, but I find it quite interesting! This is the first class I’ve taken where I’m actually required to build on knowledge I’ve learned in previous classes (last semester) to understand whole concepts. Previously I’ve just gathered knowledge, but now I’m starting to integrate it. We have had some cool practical classes in cardio so far, listening to equine hearts and trying to hear murmurs, testing out our stethoscope skills on dogs, trialing drug reactions on organ tissue, and practicing blood pressure readings.

Foundations of Animal Health 2 is a continuation of FAH1 that I took last semester, currently we have been learning about controversial animal welfare issues. A lot of these issues I learned about, researched, or wrote on in my undergrad (beak trimming, tail-docking, de-horning, housing systems/confinement, sentience/ability to feel pain, etc), however, it is now very different to learn about the issue from an Australian perspective. I’ve also been able to discuss some more Australian-specific issues such as: jump racing, kangaroo culling, and mulesing. So far I;m liking this course a lot better than I did last semester!

Animal Health in Production Systems has so far covered the different types of animal industries that I might be working or involved in. We have focused on swine, (pet) exotic birds, dairy, beef, camelids, sheep, and horses. This course included the information and handling practice I completed during my very first week of vet school! The lectures we have had on birds have been really interesting to me! While working in vet clinics I have seen many sick birds come in; now I have the background knowledge and husbandry tips to better understand this cases. The dairy industry has probably been my favorite for a few years now; I love working with the sweet girls and learning about the reproductive management on dairy farms. The Australian dairy industry is vastly different from the North America one so that has been difficult to wrap my mind around!

That’s it for now, I’m out for some fun this weekend after a long couple of weeks of studying/cramming!

A group of us hanging out and learning how ECGs work and how to read the traces to tell us information on heart disease.

A group of us hanging out and learning how ECGs work and how to read the traces to tell us information on heart disease.