Week of Awesome Does Not Disappoint, Part 2

Warning: Standard warning about a post that describes more graphic procedures and/or dead animals. This one has some pictures. Though they are the tamer ones, read with discretion.

Dentistry: Day 2 was dentistry. That's right, everything in part 1 was just tuesday. Dentistry is actually less horrible than you'd expect, although the high-pitched whine of the ultrasonic scaler is still slightly distressing.

Basically, we took out teeth until we got tired of it. Depending on how many roots a tooth has, it's more or less complex, but they all involve sticking a "dental elevator" down into the tooth socket and pushing and rotating until the tooth jiggles out. Only one of the drills was working, so there was a rather awkward queue because everyone lifted up their table with the dead dog on it, and carried it over (because the drill is on a short power cord). So at any given point, there was a group using the drill, and a group next to them that had brought over their giant metal table.

Dogs don't really get cavities. We were actually using the drill for extractions. You use it to slice the tooth apart between the roots, and also to expose the roots from under the bone. The other thing we did was to practice local blocks. As most of the nerves come out of specific holes in the skull, the aim was to feel for those holes and see if we could stick the needle into them. The result was a dog mouth full of needles.

Orthopaedics: Half of day 3 was dedicated to the wonderful world of metal bone implants. Drills, pins, plates, screws, wire, interlocking nails, prosthetic nylon ligaments. There were too many things to practice so each group only picked a few things. Depending on what you picked, the surgeon would come over with the bone saw and make a fracture in your bone of choice.

The first thing my partner and I did was an ulnar fracture. This involved two pins down the shaft of the bone for stability, and a wire inserted in a figure eight to create tension.

Then I did a knee repair of a ruptured cranial cruciate ligament (in people referred to as an ACL). Since it wasn't actually ruptured, I had to go into the joint and cut the ligament, but that's normally part of the procedure since you have to inspect the joint anyway. Then you drill holes into the tibia that are used to hold the nylon prosthesis into a position that approximates the function of the ligament. The nylon loops around a bit of bone in the back, goes around the tibia via the holes, and voila. 

My classmates got up to some other exciting stuff, like external skeletal fixation, where the implants come out of the skin and get connected by bars. They look pretty impressive. 

Ophthalmology: The last thing we did was eye and eyelid surgery, with a boarded ophthalmologist. It's kind of weird and creepy, but it's a lot more comforting to do it on a dead dog, where you know it doesn't matter even if you somehow exploded the eyeball or lost it or something. The downside is that since we only had one eye each to work with, a whole bunch of lid surgeries on one lid tend  to make it look like franken-dog. The most exciting part was cutting or sewing onto the cornea, because it's amazing that you can even do that. It's layered like an onion, so if you have to remove a diseased piece, you cut a little square and it just peels off. Another cool thing you can do is actually use the conjunctiva like a bandage, where you cut a little pedicle flap out of the surrounding membranes, bring it across the eye, and sew it onto the cornea. I wanted to include the picture of this, but dead dog eye surgery is really creepy so I thought better of it.

Also, the lens is surprisingly soft and pliant. You think of it as a hard thing, but it isn't.

Unfortunately, as I was squishing it gently in amazement, I broke it and it burst apart into a pile of clear, gelatinous goo. Whoops. The eruption of laughter at another table a few minutes later indicated that other students encountered this unexpected turn of events as well.

Week of Awesome Does Not Disappoint, Part 1

Warning: This post discusses medical procedures on dead dogs. Neither aspect of that sentence is very pretty, so if you're squeamish, or sensitive about animals, proceed with caution.

As the title suggests, this week has been heaps of fun. Starting tuesday morning, we got our cadavres, and had three packed-full days to get as much out of them as possible. We cut, stabbed, tied, dissected, and tubed every single part of their little bodies.

The dogs come from a nearby shelter, usually a variable amount less than ten, and the roster is kept small so that there can be two students to a dog. In first year, it was five students to a dog, and in fourth year it was groups of three for surgery lab, so this is a huge opportunity. Somewhat distressingly, the shelter purportedly never has an issue with supplying enough dogs, and the animals are not withheld at the shelter for more than a day. Most of the animals are pit-bull crosses, so I think there's an unfortunate excess of unwanted, potentially dangerous young animals in the area. Anyway, we had 8 dogs for 15 students, and when they first arrived we had to be speedy to take advantage of certain things before rigor mortis set in.

First thing we had to do was put a little bottle in their mouths to keep their jaws open. Believe it or not, it's very difficult to later do stomach tubing if their jaw is locked closed. The next step was to jump to the procedures that involved fluids: blood, joint fluid, CSF, and bone marrow. For every procedure, the vets gave a demonstration, and we went off and performed it on our own dogs. Here are some of the highlights.

CSF tap: To obtain cerebrospimal fluid, you stick a needle in between the vertebrae into the space around the spinal cord. You can do this right behind the skull, or in the lower back. After you feel your bony landmarks, you basically just go for it, and pop the needle in. Unless you are awesome(*), it likely will hit one of the bones on either side and needs to be redirected--and let me tell you, the feel of a needle crunching against bone is horrible. When you get it into the joint space, it goes all the way in, nice and smooth. When you don't, it smacks into bone early and won't move, so you have to poke, redirect, poke, and redirect until you get it, with an awful scraping sensation against the not-quite-solid surface.

*I got the lumbosacral cistern on the first try. That one has a slower flow in general, and also our dogs are dead, so I wasn't sure at first. But I didn't want to give up on it, so I waited, and 30 seconds later came the satisfying clear goop oozing out of the hub of my needle.

Bone marrow aspirate: Take what I was saying about bone before, now imagine a giant metal stick with a handle that you shove forcibly down a shoulder into the humerus. Surprisingly good for getting out stress, as you crank that handle back and forth like you're grinding your fist into your worst enemy's face. If you get a little too into it, your marrow aspirate turns into a core biopsy, because you punch through the cortex and get a full piece of bone, rather than sucking up the viscous marrow. There is actually a difference in what they tell you diagnostically.

Chest tube: This one is both terrifying and hilarious, as your big, thick chest tube goes onto a similarly big, thick metal stylette with a pointy end. You grab the bottom about a centimeter up from the pointy end, to avoid skewering the patient, and with your other arm you bang it through the chest wall with one swift smack. Pop! Pointy end into the patient, and your fist stops you from stabbing the heart or something.

Another fun aspect is that you need to make a tunnel under the skin so you don't accidentally let a bunch of air into the chest. This means an assistant grabs fistfulls of dog fur and holds them to the side, so that once the chest tube is in, when they let go the loose skin will fall back into place and make it so the entry point in the skin was several rib spaces farther down than the point through the body wall. When you're all done, you can really see the tube there, right under the skin, a smooth squishy cylinder. You secure the tube in place by what is known as the Chinese finger trap suture, not even kidding.

Oesophagostomy: Since we had the foresight to prop open our dog's mouth, we were able to attempt stomach tubes. There are a few methods, like through the nose or through the oesophagus. The latter is useful because it can be a semi-permanent way to bypass the mouth or provide/force nutrition easily. The way it works is you make a cut on their neck, into the oesophagus, and stick the tube in from the outside. You have to fiddle around, grabbing the tube from the inside and fussing with it until it's in the direction you need, and apparently this is next to impossible in a dead dog. But because, as we've already established, I am awesome, I totally got ours into place.

Exploratory laparotomy and experimental surgery: Towards the end of the first day, we had to gut the dogs so they wouldn't become too smelly and horrid over the week. But there's no sense in just gutting them, so we explored their abdomens first. We checked out all the organs, took biopsies of everything (which involve a number of bizarre stabby instruments), did pretend surgery on the intestines, and generally poked, prodded, and sliced anything we could get our hands on. The pretend intestine surgery is fun, because you cut out a piece, tie it back together, then turn it into a water balloon to see if your seal was water-tight--that is, hold it off and inject it with water. We even castrated our dead dog, and put in a urinary catheter such that we could see when it got to the bladder.

"If you get bored": As if we didn't have enough to do, they had tons of extra equipment to make extra sure we didn't run into any down time. There were otoscopes, slides for looking at our samples, nail clippers, syringe and needles for lymph node aspirates, you name it. Unfortunately, because our dogs arrived an hour later than they were supposed to, we ended up quite tight for time.

Fuzzy Scalpels Continued

So I have been pondering the name of this blog lately, which mostly came about through picking two cool sounding vet-related words and putting them together. Both "fuzzy" and "scalpel" have their own aesthetic appeal to me.

I mentioned before that the image that came to mind was from using scalpels in anatomy lab. While humorous, dissecting cadavres in anatomy lab is so first year.

Since I would like to continue this blog into my clinical years, I thought of a few other [not strictly-first-year-vet-school] instances where you could get fuzzy scalpels (i.e. no surgical prep):

• Necropsy <-- this is the big one I thought of
• Skin scrapes and biopsies
• Emergency tracheotomy

Er, I guess I can't think of as many as I'd hoped. There must be more! I'll keep you posted.

Commence Week of Awesome

So after suffering through what was pretty much the most horrible stretch of vet school to date, I seem to have been given my reward.

You see, the past two weeks, we had a "block course." Straight lectures all day long, with a few workshops in the afternoon. Normally I don't mind lectures too much, because, you know, we learn vet stuff. However last week was a mind numbing escapade through public health and the legislation of animal welfare, that left me alternately terrified to eat anything, and so bored my brain was melting out of my ears. Who knew there was so much to say about meat processing.

I'm going to leave it at that, more because I don't want to relive it, than the fact that it would make a stupidly boring story.

This week, however, things are going to be different! We started off today with a simple orientation from 9-10am, explaining the week and the two assignments. That was it for the day! Well, sort of. Then I went home and studied for hours.

Normally this wouldn't happen, especially on a Monday, and especially on a week where most days start at 9 or 10. But guess what this week is! No, don't, you'll never get it.

The roster I'm on right now is called "small animal clinical procedures" and is compulsory for small animal trackers like myself. We spend the week getting hands-on practise with clinical techniques like CSF taps, joint taps, eye surgery, bone marrow aspirates, dentistry, chest tubes, orthopaedic surgery, and a dozen other things. We get special tutoring with veterinary surgeons, ophthalmologists, and dentists during this time. It's hands-on, laid back, and we even get a catered lunch on friday.

Even the assignments are kind of awesome. We did one today that involved going out to a store (different groups went to either a pet store, supermarket, or pharmacy) and assessing the available pet products. It's actually a great idea--what can clients go and get over the counter? What potential dangers are there with the products there, or the way the products are displayed/presented? How much information is available on the nutrition of the pet foods? And, after all that, we bought a bunch of truffles before going home.

So bring it on. For a change, the stuff I spent three hours studying today is all stuff I'm going to do tomorrow. Like actually, properly, do myself. Vet school is finally paying off.

My Dog Got Dog Shamed

My mom is taking care of my two dogs (shelties) while I'm in vet school. They also own a little fluffy white dog, named Bella. Yesterday, my mom emailed me a series of photos...

Just Another Day in Class

This week, we have a block of lectures. It's a full day of back-to-back lectures and very tiring.

A person in the front row today pulled out a chopping board, a knife, a tomato, and a wheel of cheese. She quite casually got to slicing and making up crackers. In the middle of lecture.

Another interesting thing that happened was a catered lunch. Goodness it was delicious. Coincidentally, we received our "fifth year packs" today, which mainly include paperwork, but we also got our stamps. Yes, our stamps!

Your Name
BVSc

People were pretty enthused about this. As in, stamped blank pages, stamped each other, stamped the free food. Everyone had stamps on their hands and arms. I'm not kidding about stamping the food: I found an apple slice with someone's name stamped on it.