‘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!

 

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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.  

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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!

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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My Placement at an Alpaca Farm

Over the course of my 3 month summer vacation I worked on an alpaca farm. I went to the alpaca farm on my days off from my job and other placements. There was just over 100 alpacas and crias—they are extremely friendly and curious creatures! Previously I had not completed a lot of work with this species so I found my time there quite informative.

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Some of the older boys patiently waiting for me to finish cleaning their pen.

We spent a lot of time trimming nails. This is done a couple of times a year. Alpacas are not necessarily prone to foot problems but depending on the type of ground they are living/walking on their nails can get quite long. After catching an alpaca (By hugging it around the neck) we would halter it and tie it to a fence. Once tied, one person would continue to hug the alpaca around the neck while the other person used shears to trim off the excess and uneven areas of the foot.

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Some of the older boys patiently waiting for me to finish cleaning their pen.

All of the alpacas received intramuscular vitamin D injections. There is not a lot of research backing up the use of this vitamin in alpacas. But due to the shortage of sunlight in Alberta throughout the winter the farmer was hoping that the injection would allow the alpacas to gain better condition and higher quality fleece.

Diatomaceous earth was used on this farm (and many other placement farms) as a means of parasite control.

We also gave many of the alpacas microchips. These were inserted into a pocketed area just below the ear. The microchips are required in any alpaca that the farmer wants to register. Register alpacas are also required to have a DNA test completed. We collected blood from the ear by sticking a needle into a vein until it spotted blood. The blood was then collected onto a card. Both breeding males and females are produced on this farm and they need to be registered for sale and competition/show.

We would trim hair out of their eyes so they could see better—it doesn’t matter how much fleece/hair you trim around their eyes as this is part of ‘seconds’ (lesser quality sections of fleece) during shearing.

I also learned a lot about grading of fleece. You grade alpaca fleece on a scale of carpet-1-2-3-4 based on fineness. Ideally you would like a ‘blanket’ (fleece from the neck and torso of the animal) to be dense and fine. Unfortunately these phenotypic traits are not directly correlated. Hence, breeding plans are extremely important in the alpaca world. Black is a recessive color in alpacas and is hard to obtain. Even if you breed 2 of the same colored alpaca together you might not get the same colored baby—quite the guessing game!

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This is one of the livestock dogs teaching me about grading fleece. Assessing and cleaning all of the fleece is done by hand. It looks like a ton of work! 

The farmer would either knit/spin her own fleece products and sell them at local markets or have the mill that does the processing create products for her. I now own my own pair of alpaca socks and mittens; they are very warm and soft!

I believe that this is the last placement I needed to complete for my pre-clinical requirements. I received previous credit for time I spent working at a zoo and a wildlife rehabilitation facility (possibly some throwback blog posts are in order?) before my acceptance to vet school.

One last thank you to all the amazing people I have met during this experience, and the people I was able to reconnect with. It really is a small world out there!

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I loved working outside on this farm and gained a ton of knowledge about alpaca husbandry and production.