Sibling rivalry

So, I had a case yesterday that really bothered me.

A husband and wife brought in their great pyrenees (7 years old) and their saint bernard (1.5 years old). They were concerned that the pyrenees may have bit the bernard on the head. The owners noticed some crusting on his head Friday. (Yesterday was Tuesday).

The pyrenees had a history of biting. She had bitten three people in the past and had been know to pick up the other 2 (smaller) dogs in the house and shake them. The owners were concerned that this dog did not have a high quality of life, and she was a danger to other people and animals. They were not interested in trying anxiety meds nor did they want to look at placing the dog in a rescue - to see if she would do better in another environment.

They were at the clinic to have the wound on the bernard assessed and to have the pyrenees euthanized.

The owners wanted the bernard to be worked on first. I noticed that at his last visit, he needed to be fully sedated to be examined. I never mind sedating a dog if it makes his experience at the clinic better, so I pulled up the proper dose for a 170lb dog and brought him to the back treatment area. The dog became totally sketchy and was trying to lunge at the face of my 110lb technician. I injected the meds IM and waited for them to kick in - all while treading very lightly around this dog. The dose was not adequate. He would lie down and one step toward him made him spring up, bark and lunge at us.

After an additional 2 injections, and eventually leading the dog back to the exam room at the end of a rabies pole, the owner stated that "She always envisioned him as being a good dog once he got older." That "he was in puppy class and seemed to do pretty well".

Once back in the exam room, (of course) the beast passed out. I was so over him at that moment, that I let the OWNERS start working on shaving the entire top of his puss-covered, crusty head. I then headed to the back to work on the pyrenees...

She was in the back, wagging her tail; I gave her a small sedative - just to take the edge off and we placed an IV catheter with no problem...

Meanwhile back in room 1, the owners were working away at the abscess, and taking pictures of the passed out dog with their phones. I pitched in to speed up the process, scrubbed the wound and discussed that we will be putting the dog on antibiotics to clear all of this up.

I reversed the sedative on the bernard and asked the owners if they were ready to have the pyrenees back in the room to say goodbye.

The human mom flippantly threw her hand in the air and said, "Don't worry about it; you can do it back there".

My receptionist had them sign the paperwork, and checked them out. After doing so, she came to the back back room to tell me that their phones were going off left and right. They told her that they had posted the story on Facebook and all their friends were saying they were sorry about the passing of the pyrenees.

I swallowed the lump of hatred for humanity in my throat, and returned to the back to help the pyrenees pass peacefully.

Stories like these demonstrate the shitty part of my profession. I agree that a dog who is prone to biting people and other dogs IS a HUGE risk. A dog who feels like they have to behave that way is not a happy dog. Sometimes it IS necessary to keep the bigger picture in mind, and help them cross peacefully.

What I found to be so bothersome, is this dog lived with an evil bernard TWICE her size - in a house with a couple of fricking IDIOTS - and SHE was the one who was getting euthanized.

I would have loved to see her placed in a different situation - just to see how she would have done.

So, it's been a looong while since I last posted. Since then, I have graduated, got murried and celebrated my 1-year anniversary as a working veterinarian. In the last year, I have seen so many interesting things. I have saved so many lives and I have encountered so many INSANE people. I'm going to try to start documenting some of the more ridiculous moments of my life... for those of you who care... Stay tuned....

Off Block > Anesthesia

Off block was a much needed break from things. Arthur and I had a total blast. I did spend 2 days with an neurologist in the city. I'll finish that externship in a couple of blocks. It is amazing to spend some time at a small animal clinic away from the Teaching Hospital. Things move SO fast because the clinicians are not having to spend the time teaching while they do things.
In the 2 days I was there I saw so many cool (some sad) things:
Golden with anxiety disorder was fly snapping and walking in wide circles
4 hemilaminectomies in a day
A cat with FIP in the brain
An 8 week old pug with scoliosis and hind limb paralysis
A boxer with a meningioma that we removed in surgery.
A cat with peripheral neuropathy.
Along with many other things. It was pretty sweet. Both days were 13 hours long, but the amount of cases we saw was incredible.

Anesthesia started this week. I was anxious going into anesthesia. So much depends on making sure you have all your ducks in a row. You need so many drugs and equipment handy, tons of calculations, etc. It is SO easy to really ef something up. Day 1 I got to follow another student who had already been on anesthesia. Days 2 & 3 were both dentals on healthy animals. I'm on call this evening, so we shall see what awaits me.

This year is flying by so far. I also started to study for boards this week. I guess it's about time. Boards are the end of Nov or beginning of Dec.

Second week FARMS

So this week has been great. Coming back from such an intense externship, I was feeling a little down when it comes to large animals. This week has totally helped get my attitude back on track. I currently have 2 in house patients but have worked on laproscopically inseminating 25 ewes, castrating 2 bulls, vaccinating some heifers, and assessing a lame leg on a suuuper cute 16 day old angus today.

My in house patients are a valuable sow who was a show pig and is now a breeding sow. Her job is to pump out expensive babies. She has been lame and has gone off feed. The last 2 days have been rocky, but today she finally ate. All it takes is a little baby talk, and Jos holding a 60 cc syringe full of creamed corn to get a girl going. She gobbled down 10-12 syringes of yogurt, heavy cream, and creamed corn... DELISHHH!!! She is still refusing to eat out of her bowl, so I will continue to baby this girl for another day or so. If she still refuses, we may see if her mouth is bothering her or something like that. My hereford heifer has osteomyelitis in one of her toes that we arthrodeised today. Hopefully by drilling a hole through her toe, we can get the joint to fuse and make her sound again. She is also an expensive creature and her owner would like her to be an embryo donor cow in the future. So we will see if she can get through this. She is a super sweet girl, so I have been enjoying working with her so far.

I also was told that I was doing a great job managing my patients today, which was great. A little compliment every now and then is all I need to keep going full speed. ;)

Nice day off

We decided to split the weekend, so I had a nice 1.5 days off.

I totally needed the break because I was starting to get super exhausted form the 12+ hours of work a day.

I took a trip into the twin cities. Stopped and picked up some stuff for the wedding and bought a little something for Arthur and my dad. They both have birthdays coming up. I found a lake and took a walk around it. It has an area with food and beer so I bought a fish taco and had a beer. It totally hit the spot.

I have 5 days to go on this rotation and I'll admit I am getting more and more comfortable working with cows. I'm not sure where I'll end up in the future, but I will say that by the end of this upcoming week, I will probably have seen it all...

Calves on a dairy

I'm not too sure where I stand when it comes to calf processing on a dairy.
I've only seen a few places (so far), but I can't say I agree with it 100%.

The future of a dairy is the calves, in my opinion. If you want more milking cows, then you have to replace your old ones with new ones - who are your calves. It seems, however, that the calves are last priority at many dairies. This may have something to do with survival of the fittest (like if they are weak, let 'em die).  I don't know what percentage of calves should live, but I feel like if you give them a little tlc and analyze your calf processing protocol, then you should be able to achieve a pretty high survival rate.

Also my deep thought for the day is if I were to die and come back a living thing, I would put male dairy cow at the absolute bottom of my list. You cannot GIVE them away which is a little troubling to me. I will leave it at that.

The dairy uses sexed semen which is giving this dairy a 65% heifer rate. So I supposed when you look at the shear volume of this dairy, it is WAY better to get 65% than 50 (or whatever it is naturally).

The birth of a dairy cow is so awesome to watch. After any semi-crappy day, you can always go watch a couple of births to lift your spirits. The ONE main thing, though is you CANNOT look at their junk. Just walk away and tell yourself , "It's a girl! It's a girl!! And BAM your day just got a little better!

Dairy Rotation: Day 1

This dairy is flipping HUGE!
Every time I looked out into the maternity pen, there was another cow birthing. It is incredible. A huge pen of new born calves. They get to dry off inside before going out to their calf hutches. It is the cutest thing when they get their bottles. Their little tails wag and they all stand up and come to the fence. So precious!

Today we got to do a bunch of physical exams on the fresh cows. I think this will be the daily routine. In that pen, we had a lot of udder edema, retained placentas. There were 2 cows with eye issues. I helped to do a subconjunctival injection on a cow with a melting ulcer. I also learned (and got to practice) using my nose to detect infection. ew!

Then we head to the sick cow pen and attend to those ladies. They are so sad, but in the grand scheme of things, there are way less cows in the sick pen than at smaller dairies. The whole scale thing skews your perspective.

In the sick pen, we had a prolapsed vagina and rectum on ONE cow that we got to put back in place. We also had several down cows. It is amazing how flipping a cow and giving her a hit of calcium can make a lady perk back up. There was one cow who I thought was going to be a euthanasia today. She must have must been down and out; after we flipped her and gave her Ca, she had her head up and was eating and drinking.
We also drenched a few gals (gave them cow gatorade). A cow who had her eye removed last week was back in the sick pen to have her socket cleaned out. That was very satisfying! And gross!!

I got to hear some lungs on pneumonia cows, and we worked on a foot abscess. We also cut a right DA and I personally got to remove a 6+lb highly vascular mass on a cow's shoulder. I hated EVERY moment of it, but the only way I'm going to get better is to do it over and over. Even thought I wanted to cry the ENTIRE time, I'm all about doing another one.

Overall today was pretty cool. the dairy has a rotary milker that milks like 76 cows. At one point today we got to stand in the middle of the rotary and look up at all their faces. I probably could have stood there for hours staring at their ridiculous faces.

After our day we headed into town and got dinner and had a beer.

On the list of to-dos tomorrow: fix an umbilical hernia on a calf, and go through the same routine we did today. Hopefully I will be presented with another opportunity to cut and suture. I have to force myself to get better at that crap!

Dairy rotation

Since U of I does not offer a dairy specific rotation, I decided to take one in Minnesota. It is affiliated with the University of MN College of Vet Med. I just rolled into town. This dairy is HUGE!
The weather has been so hot here that the maintenance guy who greeted me said that they lost 80 calves last week due to the heat. That's right EIGHTY! Holy Crap!!

I imagine I will get to see everything dairy here. My personal checklist: palpate lots of cows. I need to get better at finding the repro tract and diagnosing pregnancies. I'd like to assist with some dystocias, and get to help fix a DA or 2. And I plan to avoid all vats of shit (unlike the other day).

We stay in a pretty nice set up. There is an upstairs above the offices that is only a couple of years old. Every room has 2 beds. Every 2 rooms shares a bathroom. There are a ton of kitchen appliances. This place is in the middle of nowhere, though. I imagine I am going to get pretty bored. No alcohol is allowed either, so we can't even have a beer in the evenings. Guess I'll get some reading in and catch up on a few tv shows online. Maybe there is a town close by where we can go hang out for at least a night.

I'm also hoping for 1 day off to squeeze in a visit with Stefanie in Minneapolis.

Ambulaory

I'm on day 2 of ambulatory.

Yesterday:
We pregnancy checked some mares. We used ultrasound to see the heartbeats.
We filled out health papers for some beautiful dairy show cows.
We made a farm call to check on a down beef cow. Mystery as to why she was down. The most gigantic bull was standing over her. They get big. REAL big! We took her (via sling lifted by tractor) to the barn so she could be in the shade.

Today:
We drew blood from a bunch of dairy cows on a 3000 head dairy. The U of I wants to buy some cows for the students to palpate, etc. So these are cull cows we were testing to see that they were disease free so we could buy them. I got to draw blood form 14 different cows. And then I managed to step in a drain and lose both my boots. Shit poured into them and I was stuck mid-calf deep in shit. Thank goodness Dr. Hermann sent me home to shower. I was probably offending everyone!
Then we ultrasounded a mare that had 2 embryos. They were still both there but are too close to terminate one safely. So we are just going to give it time
And finally a trip to Kickapoo to check out a lame fawn that we could not catch.

Small Animal Emergency

So I'm just wrapping up my 2 weeks of Small Animal ER tonight.
I've gotten to put in several catheters over the last couple of weeks. The one thing I never was able to do id hit the jugular of a small animal. I could get the jug of a big dog, but that is on my list of to-do's over the next several months.

Memorable cases:

An english coonhound with hind limb paralysis. It started as 1 leg, then moved to both. She was 11 years old. Blood work was all ok. Radiographs showed complete lysis of the spine of T10 (or so). So she had neoplasia.

A 7 month old bishon presented for convulsions that the reg DVM could not control. On presentation, she had severe meisois with no pupillary reflexes. We administered drugs to control the seizures including diazepam and propofol, gave manitol to reduce the swelling of the brain. All blood work checked out ok. The clients were out of town and the dog sitter said they kept a close eye on the puppy the entire time they were watching it. We assumed it was necrotizing meningitis. This is something that bishons and pugs get. It can happen anywhere from 6 months old to 7years old, has a grave prognosis and it some sort of auto immune thing that cannot really be managed. We were ready to euthanize. We all agreed that this puppy was in GRIM shape. From vacation, the owner insisted we give it just a little more time. So we gave her supportive care through the night. The next morning, the day shift came in to see the dog sitting up and perky. At some point through the night she snapped into being a normal dog again. She got to go outside to pee, was eating, etc. So it turned out to be (most likely) a toxin of some sort. Put away your pills people!

A puncture would in the groin kept me at school until 6am this morning. Dog playing in the lake. We had  4 other cases last night (including a [most likely] osteosarc in a 7 year old golden [clients were in denial], a cat with FIP that we drained 1200 ml out of the abdomen, a [conscious] hit by car puppy with mild head trauma, a pug with a UTI, and a little dog that was licking the couch and eating grass [nausea]). Once we got to the puncture would we realized how bad it was- went through 2 layers of muscle. We had to do rads to be sure it did not puncture the body wall, then call the radiologist to read them, then call the ER doc to come assist with suturing the dog since it was a procedure that none of us ha done. So by 6am, the drain was placed and the pup was ready to go home on a crapload of antibiotics. Puncture wounds are things we will see ALL the time, so I was SO glad I stuck around to watch this procedure being done.

Overall this rotations has been great. I've learned a ton.

Deep thoughts from this rotation:
Cats like to turn blue because they can't breathe for many kinds of reasons (congestive heart failure and asthma are the 2 main reasons). Furosimide, albuterol and O2 are key.
A lot of stuff cannot be diagnosed.
It is sad, but relieving, when an owner chooses euthanasia for their extremely ill animal.
It is sad when an owner cannot afford treatment for a fairly easy fix.
There are stray dogs and cats everywhere but many have chips. SCAN THEM!
People love to "rescue" any kind of wildlife.
Always muzzle a dog - just do it.
Pain meds, pain meds, pain meds!
NOVA (stat blood machine) vs ultrasound? Hopefully I'll get both at MY clinic someday! I woudl never be able to choose.

Emergency is like feast or famine: sometimes all animals are ok in the world and sometimes all animals like to get acutely ill or injured. And it usually happens all at once!

I still love dogs and cats and people are crazy.
One more night shift on ER then off to 4 weeks of (hopefully) large animal bliss!!

I am exhausted!

So equine has officially kicked my ass. I am SO tired. I have one weekend of hell left and then OFF BLOCK!!! I'm second on call tomorrow then first on call Sunday. Then Sunday night I work 6pm to 6am Monday.

This past week, I was told I was wasting people's time during rounds. That sucked. There is also SO much to juggle. My ADD has been a big challenge. I have to work on that. Another highlight (or lowlight) was looking like a total idiot while suturing my patient's shoulder. Springy suture, having to do it quickly, everyone watching, me sucking and then saying "sonofabitch". OOPS!

Positives:

I performed a lameness exam this past week. It took 6 hours. It was a great case though. The owner just wanted to know if "Tucker" was still able to work. If he was not, then she would still keep him because he was such a nice boy. Turned out he COULD still work. So it was great news all around. Just a little osteoarthritis. I got to inject his joints too.

My current case is an osteomyelitis in the shoulder of a 2.5 month old foal. We have been battling a fever the last week. Yesterday we opened the area up to let it drain and the fever was down today!! So I'm hoping it worked and that we have the correct antibiotics. We shall see. It was a good case that made me think about bacteria and antibiotic choices.

And that's all I got. Going to relax a bit tonight and try to get some decent sleep.

Foal Sitting: Dummies

It is 5: 15 am and I have 45 mins left of my 12 hour night shift. We have been foal sitting a pathetic dummy since Friday at 1am - taking shifts to sit with him. I managed to get yesterday off (awesomeness) to surprise Arthur at Summer Camp. When I got here today, I finally saw that there has been progress with this dude. He needs to hurry up and turn into normal because he is reaching the max amount of $$ the owners agreed to spend. I'm keeping my fingers crossed that he hurries it up and starts nursing on his own soon. There is also a baby (dummy) cria in the large animal ward. It is ridiculous looking. I was able to get it to nurse tonight, so there is hope for that little creature. Dummy foals that are hypoxic during birth. They get cerebral edema and can't function normally. Their full recovery is based on how much the owners are able to give the nursing care as it is a full time 24 hours/day job. Usually they do make a full recovery if you can manage any seizure activity and make sure they get the proper nutrition. This dude is on IV fluids, O2 and a nasoesophageal feeding tube that we put mamma's milk in (after milking her first of course) Luckily the U of I has extra cheap labor (aka vet students). And back to counting down the minutes...

Equine: day 1

Long. Day. Started at 8am and ended at 7pm. Back tomorrow at 5:45. And this is how the next 4 weeks will go. I teamed up with Chelsea on a mamma, foal mini pony combo. He is ridiculous. Suspected pneumonia. We needed an x-ray of his chest, so how do you get a foal to the imaging ward? Put a lead on mamma! He followed right behind. Rads looked great! So the little dude and his mamma will probably be going home tomorrow.
Another cool patient is the HUGEST horse I have ever seen! Mare who's baby ended up hemorrhaging through her umbillicus and did not make it. Mamma then became pretty ill. We had the foal on necropsy a couple of weeks ago. Sad, but mamma seems to be doing well. She is going to be going home at some point soon. I think that if I extend my arm straight into the air, she would still be taller. pretty amazing creature.

Cryptosporidiosis

I'm finally over the crypto curse. I'm at about 99% normal again. Poor Arthur ended up catching it too. The incubation period was for about 6 or 7 days. Super strange. I was never diagnosed with it - it's a tricky bug to see, but every symptom I had was by the book. It probably came from the calves at the Round Barn. They seem to have everything right now, and it turned out that my first few necropsy animals were calves from over there. I don't think I have ever had anything like it in my life, and I probably ended up a few pounds lighter as a result. I was moderately dehydrated, so I drank 60 oz of Gatorade and 60 oz of H2O in one evening. That seemed to set me back on track. Lots of fluid! ugh!

Anyway, I'm pretty sure it is officially over. :D
Hopefully this is the last of the zoonotic diseases I'll catch this year..... HOPEFULLY!

Cytology

I started my last week of Diagnostics today. For the last week, I am on cytology - reading all kinds of slides with cells. It is way slow, but I will admit that I was getting tired of the necropsy floor. It is hard work and I was covered in blood every day. It will be nice to NOT be covered with bodily fluids this week.

I'm having a little anxiety of starting equine next week, but I'm trying to focus on and make the most out of this week. My life and free time will be totally gone 1 week from now...

At least I'm not crapping my brains out anymore (like all of last week). I must have caught something on the floor. Then I passed it to Arthur. He stayed home sick today. McKinley found nothing when I submitted a sample. I will tell you that I definitely did not have "nothing". Who knows...

Today I saw some various neoplasias and inflammation - will be great for practice someday.

On call tonight. Just got word that some calf parts are being dropped off in about a half hour. Guess who gets to take them and put them in the cooler..... ***THIS GIRL***

...and then I'm going to make dinner! YUM!

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Reflecting on the past 2 weeks

So the last 2 weeks have been really amazing. I have 2 more weeks to go in this rotation. Just when I think I've seen it all, another case comes in that drops my jaw to the floor. I would never publish all the gross details, but I have officially worked on most animals. We even had 2 frogs come in on Friday from one of the local zoos.

Highlights from the week (there are really no such things as highlights on the necropsy floor):
We discovered a perforation in the stomach of a super spoiled dog from Chicagoland. Pretty sad story, but it feels good to know that they will at least know what happened.
A cat with FIP. FIP is a sick sick disease.
Racehorse with neuro signs.
Cow with mastitis.

As part of this rotation, I worked form midnight-6am this past Saturday in the large animal ICU. There were a bunch of horses including 4 sets of mares and foals. In the farms ward, there were 2 ridiculous goats and a male sheep. The time went quick because we have to go around every hour to check on everyone. The foals are incredibly cute, and goats are pretty sassy in general. I was totally fine until around 4:30 and I started to feel a little wiped out. It was a good intro, though to the next rotation. I'll be on equine and (one of my 4weeks) will have to spend a week doing exactly what I had to the other night. I think if I can get into a night routine, it should not be all that bad.

Arthur was down here this weekend (since I had to go into the clinic on Sat). He is going to be my rock this year.

First week down.

First week of clinics (A1 Block: Diagnostics).
Overall this week was awesome. Diagnostics is a good way to ease into clinics. We start every day at 8am and are usually done by 3pm (depending on how many bodies we have to work on of course).

It was also the last week for the old 4th year students (class of 2011). They are over it and pretty apathetic. Though pretty helpful, you could tell they are ready to be done with clinics. I think there will be a little more excitement this week with them gone, since we are all pretty optimistic at this point in the game.

Cool cases this past week:
a few calves with scours (probably E. coli)
pig with whipworms
a cat with eosinophilic infiltration in almost all of its organs
a few other cats
foal
foal with half birthed mare probably the coolest just due to size. Courtney and Julia did a beautiful job on them.
goat
ewe with picture perfect ileal torsion (just like in our textbooks)

Diagnostics is pretty gross, but it is a great review of diseases and it is fun to have a "mystery" that we have to try and find an answer to.

Overall: great week. Cake schedule. Great residents and pathologists.

I had the weekend off of clinics: Taylor's shower. Arthur's grandpa's 90th b-day. NFL draft.