‘Watch me snip snip, watch me neuter’

I’m on my way back to Australia right now; sitting in LAX (my least favorite airport) and killing 9 hours.

Yesterday I finished off a 2 week placement at Tri-Municipal and Meridian vet clinics. They are a mixed animal practice–with the majority being small animal work.

Throughout the week I followed doctors into dog and cat consults. Often I would just listen but sometimes I was involved in the discussion of the case. I  also did my own physical exams and administered vaccines and dewormer to the patient.

Early in the first week I got a chance to try my hand at a cat neuter.  This is a relatively ‘easy’ surgery in small animal medicine—you still have to go to school for a lot of years to get to do it though!  There is a few different techniques and I wanted to try them all.

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I made sure to practice on this string with a knot in the end… I probably castrated it about 18 times. #poorstring

We diagnosed a textbook case of demodicosis.   This is a skin disease caused by a little mite that lives in the skin and can cause a dog to be itchy and lose patches of hair. You can find the mite by looking at a sample under the microscope. This was interesting for me because it is not an overly common disease. As well, quite often you can diagnose a patient with the disease without ever finding the little bug! This particular case presented an interesting opportunity for research to determine if this animal was safe to breed. There is a concern that this could be passed on to future puppies.

My favourite calls this week were the cattle calls. The first one turned out to be a bit of an emergency— we were called to a farm who had a cow with an episiotomy. Unfortunately the cow was bleeding out and the vet had to rush in and suture her up! I hear she is doing great!

We also went to a couple of small hobby farms to do some preg-checking. Yes, this is one of the times where vets stick their arm up cow butts to see what they can feel. It was nice to be on a small farm for these appointments because it allowed us to go a bit slower.  I palpated each cow after the vet and gave my own diagnosis of pregnant vs open (not pregnant).  You can diagnose this based on what the uterus feels like. I need more practice before I can really start being specific about weeks of gestation.

We went to a dairy and examined 4 sick cows. Two of them likely had pneumonia. This was interesting for me to see after my last placement where we did lots of post mortems on cows that had died of pneumonia. This week I got the chance to examine and observe clinical signs of pneumonia in live cows.

Abscess are pretty common in cows. And if you are one of those people that love ‘Dr. Pimple Popper’ then you will love cattle abscesses. So when we got a call about a ‘cow with a lump on it’ that is what we suspected. But, that was not quite the case….

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This is not an abscess, not an abscess at all.

Instead we were presented with a really weird tumor hanging off the cow. It had appeared to have burst open then sealed and re-grown. We determined that it would be best to sedate the heifer for the removal procedure. We attempted IV sedation via the tail vein. Either we under-dosed or the heifer was just not having it—she got a bit loopy and angry but never sleepy enough for us to cast her. She paced at the end of her rope on the non-ideal side of the squeeze.  A bit of a rodeo ensued but eventually she was safely inside the squeeze again, and we infused the stalk of the tumor with a local anesthetic before removing it. The sun was going down and it felt like a bit of a race against time. When we finally had the tumor off I cut it open to see what it looked like inside (classic vet student… because this thing was gross!!).

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It was swollen and dark red inside. When you pressed on it a black liquid came off in my hand

The inside was really weird looking and my best guess is a hemangioma? Any other vet field friends have guesses as to what it could be?

 

I had been crossing my fingers and saying little prayers that we would get a calving call on one of my placements. It is a bit too early for lots of calving in Canada right now.  But we got a call for a c-section! Surgery was preformed in a fantastic and heated (yay) barn! with warm water and facilities—like a table! Everything went great and we had a live (large) calf at the end of it! We did a 2 layer closure on the uterus and a 3 muscle layer closure, then sub-cutaneous tissue, then skin. I definitely got my practice in with cattle sutures!

We had a few other interesting cases this week. One of them was a dog who could not pee. He is an adult dog but we suspect that he was born with an abnormality that prevents him from urinating. We took x-rays and he had a huge bladder! I catheterized it and drained a lot of urine for him! You could tell that he started feeling better by the minute. We hadn’t got to the bottom of the problem by the time my placement was over.

I also observed tail docking of some rottweiler puppies. This is quite the ethical/moral debate in the veterinary world.

Another interesting house call was to do puppy exams on German Shepherds (one of my favourite breeds!) at a breeder’s facility. This was a particularily cute….and wiggly exam day.

One morning we arrived to a severely sick scouring calf. We monitored vitals (heart rate, breathing rate, and temperature) and ran in warm IV fluids for a short while before heading off on a farm call. There was an older bull calf castration on the schedule that I wanted to watch.  The bull calf was a bilateral cryptorchid (inguinal crypts).  This means that his testicles were not fully descended and castrating him was not going to be as easy as we wanted it to be.  After putting in an epidural we got the job done on not 1, but 2 bull calves.

By the end of the second week I was lucky enough to have done a few feline spays, a couple of canine castrations, and a bunch of cat neuters on my own. I feel much more confident doing these surgeries by myself. I have yet to determine my own specific favorite method though—hopefully that will come during my de-sexing rotation in a few weeks time.

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So much focus and brain energy used. I also need to focus on not tensing up my shoulders during surgery.

 

 

After the last day of placement I said goodbye, and drove home in a beautiful snowfall to finish off my packing. Some of my friends stopped in to say goodbye which was lovely as well.

Thanks again to all the staff at Tri-Municipal and Meridian Vet Clinics! I had a great time!

 

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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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…

 

Chinese New Year in Singapore

When I started vet school I made a lot of new friends. Out of all the international students in my class the majority are from Canada and then Singapore. So naturally a lot of my new friends are from Singapore. This year I managed to find cheap flights (while I was procrastinating studying during final exams) and decided to go visit some of my friends in their home country. It was a quick vacation but jam packed of activities and celebrating Chinese New Year!

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Some of the MANY Chinese New Year treats we tried 

Something I have wanted to do for years was visit the Singapore Aquarium. Its on a little island called Sentosa which is full of tourist attractions. Our first day in the country included touring the aquarium and navigating the crowds around the rest of Sentosa.

Our friends have been raving about the food in Singapore since I first met them so this trip was definitely intended to be a bit of a foodie adventure. That being said…. We ate way too much! But there was so little time! A few of my favourites included the world’s cheapest Michelin star restaurant, fruit stalls in Geylang (jackfruit, mangosteen, jambun, and rata, and experiencing hawker food centers. Sanitation and food safety in Singapore is very important so the government inhibits street food vendors like you might see in other Asian countries. Instead, all the food vendors have been moved inside into ‘hawker centers’ where there is tables and chairs, sinks, inspections, and regular cleaning of facilities.

…I told you there was a lot of food….

We toured through both Chinatown and Little India. I really loved the murals and statues in Little India. We also walked along/through several shopping streets and districts. There is multiple shops of very high end brands everywhere! Tourism/shopping is one of Singapore’s main industries! I did not buy anything….

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Year of the rooster! Happy New Year! 

One day involved a big walk from Marina Barrage (with views across the water to Indonesia) all the way to Gardens by the Bay. At GBTB we visited the Flower Dome to see the displays. It was extremely busy inside, but very beautiful. Once the sun went down we stayed for a very impressive light show in the Supertree Grove. The tree structures are completely self sufficient as they have solar panels on them that collect sunlight energy during the day to power the night-time lights!

Another cool thing we did was a quick stop in at the Central Perk café (from Friends). It was very expensive so we didn’t order much but we hung out on the couch and watched a few episodes and took a lot of cool pictures.

I wanted to go to the zoo but we just didn’t have time. We walked all along the Singapore river and saw spectacular views of the Singa skyline and impressive buildings.

One of my favorite things we did was actually just before we left was called lou hei. It is a tradition you usually do on the first day of Chinese New Year. Everyone tosses the food into the air with chopsticks and shouts sayings of good luck for the new year. Whoever tosses the food the highest will be the best off.

Anyways, thats a few of the highlights (it barely covers everything we saw/did/ate in our week)! Thank you so much to my friends who took me into their houses, introduced me to their families, and included me in their busy CNY celebrations. I appreciate it so much and loved the experience. Thank you 🙂