Tuesday, May 15, 2007

One week down, 51 to go

Well, so far so good. My first week (last week) went very well. So far I've done a necropsy on a foal (the one described previously), an adult horse with Ehrlichia and possibly Equine Protozoal Meningoencephalitis, a pig, and a goat (I don't remember what the latter two had wrong with them). I'm beginning to get used to the smell, but there are still some that are giving me problems. Without question the most interesting case thus far was another horse that needed a necropsy yesterday. Because of some work being done to the roof of the large animal facilities at the vet school, all of the patients had to be moved over to a research barn for a day or two. Go figure a patient is placed over there who later became suspect of having a disease caused Strangles: a highly contagious disease where a bacteria (Streptococcus equi) causes many problems inside the horses body, but most notably invades the lymph nodes right behind their jaw on each side, resulting in severe enlargement of those nodes. This often results in difficult breathing and eating, amongst other systemic signs. The students and clinicians isolated the horse and treated it appropriately for Strangles, and it appeared to begin improvement, but at 4:30 AM yesterday the technicians found it dead in it's stall with blood everywhere.

Because of the bizarre nature of this case, the horse was transferred to us on necropsy. We let the pathologist on duty do the honor of dissecting the head because it requires experience and precision when dealing with this disease. Upon opening the head and examining the throat area, the pathologist found a 5 cm long piece of metal wire that the horse had ingested that forced it's way back up into it's head, resulting in an infection with an abscess that resulted in the enlarged lymph nodes. To explain the bleedout, one must be aware of a lil anatomy. Horses (for whatever reason), have these two empty spaces inside their head just below their brain, but behind their throats called Guttural Pouches. These can be infected with many different infectious diseases as a separate entity, but the wire made it's way inside the right pouch. More importantly, right behind each pouch is the internal carotid artery, the primary blood supply to the brain. The carotids are under extreme pressure, so when lacerated by say...oh....a wire.....the horse (or any mammal for that matter) can die of blood loss and lack of oxygenation to the brain in a very short period of time. Overall cases like this are very rare in horses because they are selective, careful eaters. Usually cases of eating foreign bodies are reserved for cattle....or as I call them, the dogs of the large animal world :).

On a completely different note and per request from a previous post, I'd like to tell the story about how I got my cat, Kahlua. Last fall, when my classmates and I were first learning surgery, there were a total of three surgery labs over the course of the semester prior to that practical final I mentioned before. Two of these labs were spays on dogs, and one on cats (the surgeon that day gets to do both a spay and a neuter). The staff just assigned who was doing which surgery and they asssigned me to the cat procedures. All students are required to go to the school at 5:00 PM the night before the surgery to do a pre-surgery physical exam, do bloodwork and urinalysis to ensure the cats/dogs are satisfactory patients for anesthesia. Upon examining my patients, I found that the male was perfectly ok, but the female was another story. She was depressed with a heart rate of 240 beats per minute (200 is the most you can accept, and even then it's only if the cat is scared or excited), had difficulty breathing because of a mucous discharge coming out of her nose and eyes, had a heart murmur, and a temperature of 103.5 F (101-102 is normal). My partners and I kinda looked at each other with confusion and hesistation, so we decided to call over the surgeon on duty to take a look at the cat. His response was "Oh this cat's fine, just check the temperature in the morning just to be safe." Doing as we were told, we repeated the entire exam the next morning to find that nothing had improved, and the tempurature was up to 105.1 F. There was no surgeon to be found anywhere, so we just explained our concerns to a technician who said she'd leave a note for a surgeon once one came in for the day. After three hours of lectures in the morning, I came down to find out that the sickly cat had been taken away and replaced by a beautiful Birman cat named "Mese" because the rescue group thought she looked like a siamese but with long hair (and to be honest with you, I would've made the same mistake b/c I've never seen a Birman in person before). I was then forced to skip my 11:00 lecture to hurriedly fill out all the necessary paperwork and perform all the stuff done to the previous cat the night before. I say hurriedly because I still needed to eat lunch and all animals are expected to be anesthetized by 12:30. Thankfully, "Mese" was friendly and in perfect health. My groupmates joined up with me shortly afterwards and I performed my first surgery without complication.

Looking back, there's not a doubt in my mind that the previous cat would've died on the table without me even cutting it. From what I heard, it recovered and was spayed successfully at a later date. All of the dogs used in the surgery are owned by local clients, however the cats are all from a rescue organization and need homes. I saw that Mese needed a home, but found out that there were 14 other people interested as well. Being a vet student and the one who spayed her, I was bumped up on the list as far as possible, but they had already started the interviewing process for the first prospective adopter. I waited a couple days, then was contacted by a fellow student who said the interview didn't work out with the person because neither she, nor any of her references could be contacted after repeated attempts. So after much anxiety, I was selected to get her as my own, my very first every surgery patient. In fact, as I write this she is laying across my lap, making typing very difficult. She's a friendly, beautiful cat who thankfully doesn't hold it against me how I took away her womanhood ;). I don't have a good picture of her at the moment, but I'll take one and post it here this week.


Dave The Game said...

Wow, you can definitely talk the talk.

Next you can get your own sitcom: The Ghost Horse Whisperer.

Lis said...

wow i can't believe that horse ate a piece of wire. if i saw that horse with symptoms that looked like strangles, i would have thought the same thing (i know first years don't know anything, but we had strangles at our barn once...). but that's so great you got to see an interesting necropsy with a twist. too bad you can't remember the goat case (i love goats), but thanks for the update. it's great to hear how you're doing! :) also, if you DO get to go see those fainting goats, you must MUST take some footage/pictures with a digital camera to share.

=^..^= said...

Thank you for posting the story about how you got your cat. :) Awww... it's so heartwarming that you two ended up together under what could have been very sad circumstances.

And omg... can't believe the horse got the wire so far down and right back up again. *bleah*

~5-Cat Style

cynthia said...

I LOVE the quote ...great stories!