Road Trips and Lameness Exams on my Racetrack Veterinary Placement

My second week of my Easter break was another clinical placement. This week I worked with a racetrack vet.  Horse racing is something I have never been involved with so a lot of the cases we saw this week were new for me. Almost every horse we saw was to investigate a gait issue, do a lameness exam, inject joints with medications, change a bandage, etc. These are a few of the calls that stood out to me…

Each day started with trot up exams at the Flemington Racecourse (the same place they hold the Melbourne Cup!) We also did trot ups at other stables around the area. A trot up exam is where someone ‘trots’ with the horse up and back a path while the vet examines the horse’s gait and how they are moving. They are looking for abnormalities, swelling, pain– anything indicating lameness.

The first farm call we drove to was a horse who had chronic swelling over his fetlock. We had to do an x-ray to try and figure out what was causing the swelling. This was one of the first times I had assisted with a portable x-ray machine (as opposed to large ones that are permanent installments in hospitals).

We investigated another horse with an interesting skin issue and discussed different possibilities–infection, allergy, multiple conditions, atypical presentation of a sarcoid tumor.

During the week we also did a few nasal scope exams. Scoping is where a special camera is inserted into the nose of the horse to check for any abnormalities of the respiratory tract if trainers or owners or potential buyers would like to investigate the larynx and pharynx. Some of the horses we scoped were done before they were sent to the yearling sale and a few we scoped because there was some concern for disease.

Each evening I was reviewing lectures for an upcoming midterm. A lot of the lectures were on eye conditions. So it was particularly interesting for me when we drove out to see a horse that had a healing corneal ulcer. The horse had a lavage system sutured into its eye—to make it easy for his owner to give him his eye drugs

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This tube sits just inside the eyelid of this horse so that the owner can stand back and  put medications into the other end of the tube. The meds will then drain onto the eyeball.  

http://westernveterinaryhospitalpllc.com/wvh-stories/corneal-ulcer–glass-s-story.html

My favorite call during the week was to a lovely farm with a colt who was suspected of being a cryptorchid. The vet I was working with was unable to palpate both testicles while the horse was standing. Apparently it is sometimes easier to find the other testicle (that has not descended) when the horse is sedated and rolled onto his back. After sedating horses in class a few weeks ago I was excited to see this in practice again. We  safely ‘dropped the horse’ and rolled him over. The vet immediately found the missing testicle so then we quickly gathered his instruments and he performed the castration surgery. This was also great because it allowed a discussion of open vs closed castration (different surgical methods that we have been learning about in class lately).

On Friday I had planned to wake up early and go observe a dynamic scope. Unfortunately it was cancelled and instead I spent a day at the Oaklands Junction Sale Yards with an internal medicine specialist. We were at the sales in case any of the clients wanted pre-sale scopes, microchipping, or any other assistance.

I appreciated listening in on a lot of the client interactions and observing how to generate important relationships with clients. The vet would call and talk to another vet or a specialist if there was something he was unsure about. I enjoyed my week learning about racehorse medicine and driving around the Yarra Valley, Cranbourne, Pakenham, Mornington Peninsula and other places. I’m already thinking about future equine placements I could organize.

20170421_103847 Special thank you to Flemington Equine Clinic who had me tag along for the week!

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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…

 

Volunteering at the Equine Hospital

In the 3rd year of the DVM degree there is a volunteer program run at the equine hospital on campus for some students.  I wanted to volunteer to improve my clinical skills with horses and help solidify the concepts we learn in class. My housemate and I are partners and we’ve already had 3 shifts. The shifts usually start at 6pm after our classes end and most of the daytime staff at the hospital have gone home. During our shifts we work with the overnight nurse until about midnight.

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After our first shift! 

Our shift usually starts with physical exams on the horses staying in hospital. On our first shift we reviewed how to do it and then me and my housemate have been on our own. Same principles of examination apply for any animal–start at the nose and end at the tail. We assess the face for symmetry or any swelling, look for any discharge or other facial abnormalities. Moving on to mucus membrane color (looking at the color of a horse’s gums) and then taking out our stethoscopes for a listen. I really enjoy listening to horse hearts because I feel like I can understand and better hear the differences in sounds at different valves in the heart—> horses are easier than cats and dogs because their hearts are larger. Horses have a different gastrointestinal tract (GIT) than cats and dogs (and humans!) and it is usually quite noisy! We always listen to different areas of the gut to make sure normal sounds are heard. My favorite sound (yes, i have a favorite animal GIT sound….) is the ileo-cecal flush. Here is some horse gut sounds for those who are super interested. We also check for the presence of a pulse before eventually taking a rectal temperature. Counting respiratory rate in a horse is fairly easy–we just watch their flank (sides) move in and out with each breath.

Sometimes, certain horses need medications or treatments done. I have been lucky enough to be able to practice giving intravenous (IV) (into the vein) and intramuscular (IM) (into the muscle) injections. I have also practiced re bandaging legs and assessing surgery sites.

Later on in the night we complete ‘walk-bys’ which include walking infront of each horse’s stall and recording notes on what they are doing, how they look, if bandages have fallen off, etc. We also provide food and water.

On one of our shifts there was an extremely sick horse in the hospital. She was on fluids, but still very dehydrated. We took a blood sample to run and analyse.  It was quite exciting to listen to the vet and the nurse talk about what could be going on with this horse and her future treatment plan. We learned a lot about fluids in class this year so seeing it in practice was interesting.

We were also lucky enough to experience a euthanasia during our first shift. There was a couple of 4th year DVM students there who mentioned that they hadn’t seen an equine euthanasias during any of their shifts at the hospital or placements. We discussed how to appropriately check for signs of death in a horse and logistics of equine euthanasia compared to small animal or other livestock.

Another time I entered an isolation stall with the nurse to help treat a horse with a suspected case of Strangles. This was a great learning experience for me as we have talked about Strangles a lot in the last 2 years. As well, it was a great opportunity for me to practice appropriate use/application of personal protective gear (PPE) (safe clothing like gloves, gown, boot covers, etc) and attempting to minimize contamination.

On another shift my friend in 4th year was working on training one of the troublesome teaching horses. I do not have any experience training horses so I had a lot of fun chatting to him and watching his techniques.

I’m really starting to love equine medicine more and more. I can’t wait to see new cases and get a lot more practice on further shifts!

My Placement at a Riding Facility and Petting Zoo

This placement was super close to my parents house so it was very nice to be in town every day after working on the farm. This farm owned quite a few horses that were leased out or used for riding lessons. They also have tons of different animals that are part of a petting zoo….ferrets, chinchillas, guinea pigs, parrots, cows, pigs, chickens, peacocks, goats, emus, alpacas, llamas, hedgehogs, cats, dogs! I was also lucky enough to do this placement with my best friend/roommate (its about time we did a placement together!).

Each morning started with chores. Animals inside were taken care of first and stalls or pens mucked out. Then we grabbed the water truck and headed outside to all the outdoor animals. One of the problems with keeping animals outside in the winter is that you either have to have heated water containers (so no ice can form) or you have to go around and break all the ice out of the containers before filling them up! We brought a hammer to break up ice.

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At this point, I became pretty good friends with one of the parrots who rode around in my hood to stay warm.

All the animals outside received extra bedding or grain to help them keep warm when it snowed. Many of the horses wore thick blankets as well. Some animals require more specialized feed. For example, the guinea pigs received extra vitamin C and D in their water because they are prone to deficiencies.

There were 3 older horses who had a hard time eating hay and getting enough energy so we brought them inside every day and gave them a mixture of grain and beet pulp.

 

Horses were ‘worked’ or ‘broken’ later in the afternoon. Often they spent a long time running around in a circle on the end of a lunge line. During one session the vet came out from a nearby equine clinic to look at an older horse that had tripped hard earlier in the week. I took a couple of minutes to chat to the vet about Metacam and how it is metabolized differently in the horse than other animals.

My friend and I spent some time working with a pony. He will eventually be pulling carts and working with young kids so he needs to be quite comfortable with unknown sights and sounds. We ran him around in circles and over jumps. We also rolled barrels and a large exercise ball close to and over him. The pony was very uncomfortable with us touching his back and hind end. With some more work this pony will be well on his way to cart pulling!

Another day we assisted with breaking a horse to a wagon. Last time this horse was hooked up to the wagon she freaked out and sat on the bar (a very dangerous situation)! We made sure to move slowly and calmly. First we pulled the cart around the horse so she could get use to how it looked and moved. Then we walked the horse around the cart. Lastly, we slowly hooked the horse to the cart and then walked beside her in the arena. The session went very well.

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We spent a lot of time grooming horses, sweeping the barn, organizing the tack room, watering down the arena (to keep the dust down), blanketing and moving horses, and oiling tack. Tack is oiled to ensure the leather stays supple, smooth, and in good condition so that it can be used for many years.

 

On our last day of placement we worked on some worksheets about horse health, anatomy, and care. However, the highlight of this day was learning to ride English.  Previously, all my riding experience has been in Western saddles so this was quite fun for me. A couple of staff members were working with a young horse–getting him used to being ridden and the commands he needs to follow. My friend and I were riding older horses in the arena so the young horse would feel less nervous.

I had a lot of fun being around (and learning about) the huge assortment of animals at this farm. Thank you for the opportunity!