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…

 

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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!

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!

Last Day of DVM1

WOW! I love vet school so much! Today was simply amazing, not because it was my last day of lectures—but because of all the fun and interesting things that happened:

I came in before my class to help my roommate with a bake sale she planned to raise funds for the Australian Rhino Project. We baked 300 cupcakes and decorated them all and then sold them in front of the student’s union building. All of the proceeds are going to the Aus Rhino Project who is working to bring a breeding herd of rhinos to Aus as a conservation measure. There will be 80 rhinos brought over in the next 3 years. The bake sale was an idea inspired after listening to a completely engaging and terrifying lecture on the future of rhinos in Africa (and how close they drift towards extinction).

Save the rhinos! Buy a cupcake!

Save the rhinos! Buy a cupcake!

I left the bake sale to go to a case study. This year we have 2 to 3 case studies a week (one for each class) that works to bring a lot of the learned concepts together. This case study was HUGE! It was complicated. And I understood…most of it…. (I might have to go home and review my notes again). The class worked through a dog that was brought into the clinic after being hit by a car. After looking at physical exam results, radiographs, ultrasounds, and blood gas analysis we determined that the dog had a pneumothorax and a uroabdomen.

Next was a practical class where we watched our professor artificially inflate a pair of sheep lungs to demonstrate ventilation/perfusion matching, pneumothorax, atelectasis, etc. It was very cool to see this instead of just reading about it.

Then I caught a quick tram ride to Melbourne Zoo where Zoos Victoria was hosting a Zoo Conservation Ethics/Welfare Q&A lecture with Jenny Gray and Peter Sandoe. The discussion was HUGELY stimulating, intellectually diverse, and even heated at times. We raised many complicated questions of best methods for zoos to work in conservation, culling, public education, and how to categorize zoo animals (are they wild animals? domesticated? tamed? companions?). By the end of 2 hours my brain was exhausted— but I couldn’t have asked for a better way to end my first year of DVM!! I can’t wait to see what my last day of DVM2 looks like 🙂

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Now excuse me while I go hermit away and study for finals!