Thursday, June 28, 2007

If at first you don't succeed......

Before I begin retelling some of my grand large animal stories, I wanted to let everyone know the strange thing that happened this past weekend. Those of you who know me are aware of my fascination with reptiles and my possession of two snakes. One of my snakes is an adult, male ball python which I adopted from a coworker of mine back at an animal hospital in Maryland. He was in high school and his parents were forcing him to get rid of it for reasons I cannot recall. For the past three years, he's been a consistent eater and has been perfectly healthy. However currently, he hasn't eaten since February. While I know there are pathologic causes for anorexia in all species, I know that snakes will sometimes decide to just not eat for months for no reason, and most often it has to do with poor husbandry practices. Therefore, I've done my best to ensure a perfect light cycle, cleaned his tank more frequently, ensured the proper heat, etc. None of this worked......of course. Much to my surprise this past Sunday, while at my computer, I look over to my left in his cage and saw how he laid 6 eggs. Yeah, that's right........woops. The guy who previously owned him claimed to have had it sexed and told me it was male. The gender of the snake played no role in my adopting it, so I just believed him. Now she is back to eating regularly and all is well. Never a dull moment....never.

Now, onto another story. I mentioned in my previous post how I've done some traveling to farms with the huge food animal practicioner. On the same day as the previous story, we got a call to a beef cattle farm where there was supposedly a lame cow (i.e. it was limping). We arrived at the farm to find out that the farmer was certainly correct in his assessment because she wasn't putting any weight on one of her hind limbs. Since the herd was (at that moment) at the edge of the pasture where it borders with a forest, the clinician wanted to attempt lassoing her without sedation and tying her to a tree long enough to place a halter on her. She would have nothing to do with this and promptly darted away whenever he made an attempt. Then came plan B.......the dart gun. The clinician spent a few minutes assembing the dart and loading the gun, only to approach the cow, fire the gun, and have the dart bounce off of her thigh/hip. There is a reason footballs and shoes are made from cows, folks :). After another failed attempt and a dart flying into the woods, the cow caught onto the act and started to run when we came within 30 feet. To compensate for only having two legs, the clinician decided to drive along side the cow, lean out the window, and dart her. Again.....::ping::!!! Having given up on the dart gun, we decided to repeat the plan from the previous farm and lasso the cow while I drive the truck over to the clinician. I was better at driving the truck this time, but the rest of the damn herd wouldn't get out of my way! I kept honking at them and they wouldn't budge. Thankfully, the cow came back towards the truck where we tied the lasso to the truck long enough for the clinician to halter her and tie her to a fencepost.

After perfoming a physical exam, which did include rectal palpation, we discovered that she had "cancer". She had an enormous kidney and a huge mass on the inside of her pelvis, which is most consistent with lymphosarcoma, the most common internal cancer of cattle. I was hoping that with all the effort we went through to catch her that we'd at least be able to help her. What's worse is that the owner cannot sell her for slaughter because cancer automatically causes the entire carcass to be condemned, so all he could do legally is have her slaughtered for his own consumption (if he wished).

Oh, and before I forget, you're probably wondering what's the deal with the picture in the post. The other morning, an equine clinician went out on an early morning call to a local horse ranch (before the students arrived at school). While there, she left one of the rear doors open on the truck and the chicken hopped up on the floor of the backseat. The clinician closed the door without looking inside, and the chicken didn't make a sound the whole ride back to the school where she was discovered with much surprise and laughter. "Henrietta" was later picked up by her owner who found the whole thing as hilarious as we did.

Tuesday, June 26, 2007

I'll tell you what.....

I apologize for the delay in posting, but I've been absorbed in reviewing everything I've learned over the past 3 years on cattle, horses, pigs, sheep etc because I am on my ambulatory large animal medicine block. That's right folks, I'm doin' the James Harriot thing for three weeks. I've already completed the first week and have been delightfully surprised. I initially came in with much anxiety and concern about the danger of working with the large animals and the smell that comes with them. However, my first week involved working with exclusively cattle (both beef and dairy) and I had a blast. The clinicians are fantastic, the clients are real characters and most importantly, you're outside and driving around everywhere! Speaking of which, the picture shown here is of my classmates and I returning to the truck after cutting the teat off of a lactating beef cow that had severe mastitis in one of the quarters of its udder. Note, there was a bridge we could use, but since we were wearing coveralls and big rubber boots, what fun would there be in doing that. :)

I do admit that I am very fortunate to be attending school in such a beautiful area of the country. While driving around, the views of the Appalachian mountains still never cease to amaze me. Initially, however, I was a bit concerned because some of the calls have been to farms out shall I say......Deliverance country. Every client that I've met has been great to work with and very friendly. I'm trying to diet at the moment, and these farmers are making difficult by offering us their delicious home-made country foods, and it's considered an insult to turn it down. As mentioned previously, the food animal clinicians are really nice, very willing to teach, and very down to Earth. There's one clinician in particular that I've worked with alot this past week, and I'm grateful to him for his patience with us small animal folks, and for the memories that will last with me forever. In addition, he goes to Hardee's every single day for lunch (no joke) and somehow remains in fantastic shape.

On my first day of the block (first call actually), we were called out to this beef cattle farm about an hour south of the school to help pull a calf out of a cow who should've been out two days prior. Before I go further, I need to point out why I said "beef cattle". Dairy cattle spend their whole lives being handled and spending alot of time indoors, so they are much, much easier to work with; beef cattle however live out on pasture their whole lives and you have to herd them into a chute to work with them....and they aren't too fond of the idea either. The farmer claimed that the cow trusts him and won't run away if its just him, so we gave the farmer a syringe with sedative in it to give the cow (which he did with no problem), and we went to go check on it in a few minutes. We offroad through the pasture to where the cow was laying on its belly, thinking to ourselves that the sedative worked. The clinician hopped out of the truck and got a rope ready to lasso her head and try to tie her to a fencepost long enough to put a halter on her. Before doing so, the clinician told me to hop in the driver's seat of the truck and get ready to drive it, and I had no idea why. I quickly learned why as the cow lept up after getting lassoed and started to take off with the clinician holding on and running for dear life shouting at me, "Drive the truck to me so I can tie her to it!" While I do know how to drive stick, I've never driven a big pick-up truck before, nor have I driven off road on Appalachian mountain foothills at a 60 degree angle. The clinician is actually a really big guy, easily 6'5" and built like a house, but the cow couldn't have cared less. So here I was driving this truck around the pasture after this cow, and I guess fate pitied us because the cow ran indoors where the clinician could tie her to a wall.

Thankfully, we were able to save the cow because we could take the calf out without much difficulty or surgery, but the calf was long dead. This was the first time the cow had given birth, and sometimes they just produce calves that are too large for them to come out naturally. I still have plenty more stories, but I'm going to stop here for tonight because I can go on for while, but I will be doing my best to post each day this week to catch up on all my stories. Thanks for reading!

Friday, June 15, 2007

A Gallery of Craziness

Well, my external block is over and I had one helluva time. I will post a detailed description this weekend, however, I promised to post some pictures I took of my cases. Also, I failed to post a reply to comments on my previous posts because of my busy week, but I wanted to say thank you Elaine for reading my blog and for your comments. It reassures me to know there are others who feel the same way as I about birds :). Now, onto the pics! (Don't worry, I am refraining from showing the gross/graphic ones I took from either necropsies or surgeries)

This is an English Bulldog with a disease called "Seasonal Flank Alopecia": a disease where dogs will lose hair from their sides for reasons unknown (not allergies), and it does not itch. The hair usually grows back.

These are the remains of a corn cob that were taken out of a dog's stomach via exploratory gastrotomy. The owner's were not neglectful or anything, the dog rumaged through their trash while they were away. I (jokingly) wanted to say to the owners, "I hope you enjoyed the corn, because that was the most expensive corn cob you'll ever have."

Here is a leopard gecko that suffered some serious burns along its back. My initial thought was that the owner was using a heat lamp that was too strong, however the reptile expert at the hospital thinks it was potentially due to too much UV light.

For those of you who have never seen one of these, this is a Sphinx cat, a hairless breed. While their appearance may not appeal to everyone, they have fantastic personalities and (from what I've heard) good for people who are allergic to cats. However, they have a plethora of health problems, like difficulty developing a proper immune system. This one in particular had pneumonia.

This is a xanthoma (a common benign tumor of birds) on the wing of a parakeet. In this case, the tumor was so large that the bird not only couldn't fly, but it couldn't remain on perches because it would fall off from the weight. The bird went to surgery and the mass was removed, but because of extensive local invasion, it will likely recur.

Here is a young boxer dog that presented with a huge abscess (mentioned in my previous post) under his jaw. The abscess was not removed in its entirety because the post-operation care is rather intensive. We just lanced it open, drained it, and placed a drain in it to keep it as small as possible till the owners returned home to NC where the full procedure should take place. This dog was a really great patient and incredibly sweet.

This here is a tumor with a bird attached to it. We made a valiant effort to take this bird into surgery and have it taken out, but sadly, the bird did not make it through surgery. I will be taking a biopsy of the mass back to the vet school to find out what type of tumor it is.

I apologize for the quality of this picture, but here is a parakeet that was brought in from a Petsmart because its right leg was just a dead husk, and thus completely useless. We have no idea what the inciting incident was to injure the leg, but it had to go, so the leg was amputated.

This one is for Dave, who requested more cute pictures. I will leave it to The Foodist to insert appropriate and hilarious captions :). I hope you enjoyed the pics!

Monday, June 11, 2007

On a More Positive Note....

See? I told you my next post would be mostly a positive one. It's hard to get more positive than a bulldog puppy, or as I like to refer to them, cuteness in its purest physical form. The pup was only visiting the hospital to get its next round of vaccines, but I still demanded to take the time to see/play with it. I mean, come on.....wouldn't you?

Onto things that I've worked with over the past week. A young boxer came in with a huge abscess under and behind it's jaw (it was about the size of a grapefruit). The kicker though for this scenario is that the owners were a young couple from NC just visiting for a relatives high school graduation. Just over the course of this weekend, that abscess grew to the size that we observed. The vet recommended that the walls of the abscess be taken out down in NC, but still offered to open it up and place a drain in it to help prevent it from growing. We did as such and as soon as the dog was awake from anesthesia, we could tell it was feeling a lot better. It was amusing watching the vet teach the clients how to replace a bandage over the dogs neck that involved using a baby diaper.

One of the more amusing appointments I saw involved a morbidly obese Golden Retriever. The owner was a great, older gentlement (my guess was late 70's) who was a real card, and a pleasure to work with. While I was checking in the appointment before the doctor visited, he asked me why she was panting so heavily all the time. I tried to be professional and politically correct by responding with, "Well, we'll see what the doctor thinks, but it may have something to do with her size." Later, partway through the doctor's exam of the dog, the client said, "Yeah, I asked your student here why she's breathin' so heavy and he said it's cuz she's FAT!" Thankfully, the doctor just assumed I didn't say it like that because I wasn't about to correct the client, especially since he was saying it in a jovial manner.

This past week I was able to work with a number of different birds: a couple parakeets, a couple African grey parrots, some cockatiels, and a conure. I love working with the African greys because they like to talk to you while you handle them (even though they aren't readily handled). While I found it fascinating learning how to work with birds, my experiences at this clinic just further reinforce how I will most likely avoid them entirely post graduation. For those of you who have never owned a bird, they are by far and away the most frail creatures on this planet. Not only can you easily break their bones while removing the metal rings around their legs (or just from handling), they can literally die just from the stress of handling. The latter happened last week. A bird was brought in because the owner noticed it got its leg caught in something in its cage and just wanted to drop it off at the hospital for x-rays and to make sure everything was ok. The bird was left overnight, and the next morning a technician took the bird out to measure its weight. I observed the technician and he was not overly forceful with the bird by any means, but after taking the weight and placing it back in it's cage, it literally just tipped over and died. While the vets do explain to every bird owner how this can happen, the phone call still has to be made to the client. To be quite honest, it's not one I'd like to make.

Thanks for reading, and stay tuned as I post a bunch of pictures from my time at this clinic!

Sunday, June 10, 2007

A Wonderful time

Well, I'm two-thirds of the way through my second block and I'm absolutely loving it. This hospital has me working between 10 and 12 hours a day, and for once....I don't mind. In fact, I hardly notice the time go by at all. Thankfully, I think the owner of the place is really hyperactive which leads to the place being especially busy all the time. The one thing I hate the most at a job, above unsatisfactory coworkers and employers, is being bored. For the time being, the only part of my day where I'm bored is while I'm eating lunch, which is only for 20 minutes anyway.

Probably the highlight of my past week was getting to travel with the other doctors at the practice to this local meeting of a group called the DC Academy of Veterinary Medicine. The first Thursday of every month, doctors from all around DC gather for this monthly conference where speakers from all over will present the latest developments in the profession. This month, the speaker was a professor from NC State who presented the latest information about tick-borne diseases in dogs and cats, such as: Babesiosis, Ehrlichiosis, Lyme's Disease, and Rocky Mountain Spotted Fever. Not only was the speaker great, I especially enjoyed his talks because I knew I wasn't going to be tested on the information ;). There must've been a few hundred veterinarians there who all really reinforce what a great community this profession provides. Oh, and best of breakfast and catered lunch ;P.

On a sadder note, I assisted with the first few euthanasia's at the hospital since I've been there. One was done on an old Golden Retriever who had malignant melanoma and prostate cancer to boot. The vet asked me to join him in the room and warned me about what a tear-jerker is was going to be. In the room was not only the dog, but the entire family consisting of a husband, wife, and two teenage daughters, both of which were audibly bawling. By the end of it, the vet started losing it as well since these clients have been coming to him for over two decades. I managed to keep my composure, but only because of my own awkwardness. To be completely honest, I never have any idea of what to say in these situations so everytime I've assisted with a euthanasia, I've kept my mouth shut. While I did my best to take the doctor's consoling words away with me, it wasn't exactly the type of scenario where it would be appropriate to take notes. The other euthanasia I had difficulty with involved an owner who couldn't bear to watch the act, so they left the dog at the hospital. I don't personally understand how someone could view it that way, I still certainly respect it. This dog was a lab who had a really distended abdomen, was having some difficulty getting up, and was defecating all over the owner's house. What bothered me though was how the dog still seemed happy and had a positive attitude. Fortunately, the owner opted for a necropsy for some closure, which I performed and found the dog had hemangiosarcoma of the spleen: a really nasty malignant tumor which can (and did in this dog) spread to the heart, and can burst at any point causing the dog to bleed to death internally. Therefore, while this dog did seem happy, he could've dropped dead in a terrible way any day.

This post is getting a little winded, so I'll post other cool cases (mostly positive ones) I saw last week in a post tomorrow. Thanks for reading!

Sunday, June 3, 2007

Onto the Living

Well, one block down, 16 to go. I completed my lab services/necropsy block two fridays ago, and have spent this past week doing an externship at a hospital in Maryland. As the title of this post points out, this is my first block working with live animals, and it is much more refreshing (in regards to both enjoyment and smell). The hospital that I'm working for is absolutely astonishing. Every other one I've either visited or worked at had a number of personnel that were absolutely miserable, whether they be receptionists, technicians, or even the vets. While I haven't met all of the employees of this establishment yet, every single person I have met has a great time and has a wonderful outlook on their job. You won't find many places where every single employee is actually having fun. In addition, all of the doctors and technicians are understanding of how this is only my second block and the fact that I have minimal clinical experience prior to entering vet school. All of them are superbly patient with me and love mentoring me.

In just one week, I have learned a plethora of new information that it's fruitless for vet schools to attempt to teach. The bonus in this case is how this clinic sees alot of exotic animals, which I have gained an interest in during the course of school. Thus far this week, I have seen and worked with an iguana, a burmese python, a bearded dragon, a cockatiel, 4 guinea pigs, 2 ferrets, a hamster and a rabbit. There are so many little things about each species that can really only be taught through a mentor, such as handling techniques, how to perform physicals, etc. Thankfully, I purchased a PDA during my last block so I've been taking down as many bits of wisdom that I can. Here are some examples:

-When force-feeding reptiles, make sure you look into their mouth to ensure that they don't aspirate any food into their lungs since reptiles don't have a cough reflex. If they do aspirate, they'll simply just die in a day.

-When handling a rabbit, always support their rear end, otherwise they will flail their hind limbs and can potentially break their back in the process. That I actually knew, but I didn't know that you should always put them back into their carrier backwards for the same reason. If you put them in facing the inside of the carrier, they'll push too hard trying to get inside.

-I knew that ferrets are more prone than other species to get severe reactions to vaccines, so never ever give them more than vaccine at once.

-If a female guinea pig presents with hair loss without being itchy, it is most likely due to an ovarian cyst.

-If a dog/cat has had immune-mediated hemolytic anemia/thrombocytopenia (where your own immune system starts to destroy your own blood cells or platelets) in the past but recovered, you shouldn't vaccinate them anymore for fear of re-stimulating the immune system to go nuts again. This will require writing a letter to the "man" saying this animal can't be rabies vaccinated.

-"Red-eye" is a common initial sign for glaucoma

There were plenty of other things for me to experience and observe. I watched a dog undergo exploratory surgery and have its stomach opened because it raided the owner's trash can and ate an entire corn cob. Later in the week, I watched an orthopedic procedure to fix a dog's knee (to be specific, the dog had patellar luxation). Above all, I'm really enjoying enhancing my technique with taking and interpreting radiographs (aka X-rays). While we are taught radiology very well in lecture, the best way to learn how to read a radiograph is through practice. So all in all, this hospital is giving me more practice and knowledge than I would've ever imagined, and in just one week. I hope to post more stuff as I see it, so long as there is time to post :).