This week we spey and neuter live, non-sheep animals, by ourselves, for the first time. At the beginning of the week we allocated patients to every student in an effort to have one spey and one castrate per person. The surgeries are on wednesday and friday, so the patients get admitted the day before.
My patient is a mixed-breed retriever/labrador-y thing with a ridiculous three-word name. She was scheduled to get dropped off at 10am, so from 8 to 10 I sat around with pretty much nothing to do. Now, there is a mandatory practical session for us to review suture techniques before we are allowed to do surgery tomorrow. My understanding is that the person running the prac suggested we all head on over to the wetlab if we weren't busy. At 10am. My roster-mates happily agreed and jaunted off to the prac without me, just as my patient arrived. This stressed me out as, so far, I've consistently missed all our scheduled tutorials because of other obligations. Roster-mates are unconcerned as they say "Oh well, we'll just tell her you'll be late."
So I cross my fingers that this will be a quick, routine admittance that shouldn't take more than 10 minutes. After all, my classmate admitted her castrate a half hour earlier without a hitch. Alas, I was out of luck.
The owner was not concerned at all, but this dog has pretty much every problem there is. It's standard procedure to ask after coughing, itching, or vomiting and diarrhoea. Normally the answer is "Oh no, no no, perfectly fine." This time, the answer to every one was "Oh yeah, every day." This dog coughs regularly, is itchier than their other dog, and has diarrhoea on a daily basis. Regarding that last one, I learned that she is fed fruit all the time--like, an apple or banana every day--so that made me roll my eyes, but less worried about the dog. And as for the coughing, at least the lungs were perfectly clear sounding. But then the owner mentions that the dog seems to have a UTI, has had one before and was on meds for it, and seems to be having another episode. Alarm bells go off that this could be a problem, and I need to talk to a clinician before I admit this patient.
To add insult to injury, I tried to finish my physical exam with the temperature, and this dog just would not have it. She whined and screamed and writhed. I asked the owner to hold her, and I still couldn't get the thermometer to stay in. What's worse, the owner's three young children were all there watching, and started complaining that it was hurting her. So I explained that it doesn't hurt, she's just a wuss, and we'd try to get a temperature later. Then I bolted for the exit and tried to find a clinician.
Naturally, there was only one clinician around, and because of it, he was completely swamped. The medicine students were pulling him left and right for the medicine consults and day patients, and I had to camp outside a consult room to try and catch him. He was too busy to really think about it, and just gave some hurried instructions as he walked around the hospital.
I ended up admitting the patient as if we would go ahead with the desexing, but prepared for the eventuality that we may need to change the plan if we find a problem. The owner was okay with this so I bring the dog into the hospital, at which point a nurse asks me to do the urine tests, and I am just like "I need to be at a tutorial 45 minutes ago, bye."
I did make it to the suture prac, where my roster-mates were sewing up disembodied dog legs, and had to get all the instructions repeated to me. I ended up rather rushed, but I'm a lot more comfortable with suturing than my classmates seem to be, so it didn't put me off too much. I got some good advice on subtleties about pulling the knots and what to do with your hands, but I'm already comfortable with the suture patterns, fortunately.
In the evening, my friend on after-hours treatments texted me to tell me my patient's spey is cancelled. She has too many other problems; apparently the word "vaginitis" was thrown around. So after all that, I don't even get to do my surgery.
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