Thursday 27 March 2014

Yes, We'll Give Him Your Magic Water

A rabbit came in to the local clinic I've been at for a castrate (a surprisingly common occurrence). He came with a bag of goodies that included his hay to eat during recovery, and a little bottle of stuff to give him. The stuff was called Arnica 30, and the label very informatively said something to the effect of "Apply as required. Use to help reduce symptoms."

I think it's supposed to help their recovery and maybe provide pain relief or reduce inflammation or something. But it doesn't. I can promise you that. Why? Because it's homeopathy, which means it's water. It does absolutely nothing because it literally is just water.

The vet was all "We said we'd give it, so whatever," with a bit of eye rolling. She grabbed the spray bottle, puzzled over how you even use it, and squirted two or three puffs into the rabbits mouth--who, by the way, was rather "WTF?" about the whole ordeal. The vet wasn't sure if you actually give it in the mouth, but it was one of those "Shrug, it doesn't really matter" moments. The nurses kept laughing about the whole situation, but that rabbit got his Arnica just like he was promised, even if the only thing it accomplished was startling him a little bit.

The Two-Legged One's As Bad As The Four-Legged Ones

The general rule about how to deal with children in the consult room is: don't. Ignore them. Let the parents manage them and stay out of it. As a vet student I'm pretty good at this because while shadowing the vets, all I do is stand in a corner and stay silent, anyway (and subtly get my hands all over the animals doing a quiet physical exam, usually).

Today there was a four-year-old in our consult for a pair of Italian Greyhounds. These dogs were tiny, skinny, nervous, rat-like things that took some time for me to warm up to--even the client didn't like them. She was taking care of them for someone else, and one of the first things she said was "I'd never own dogs like these!" and I couldn't blame her. I ignored her little boy as I'm wont to do, but still enjoyed the progression of his behaviours through the consult.

Stage 1: I didn't notice him at all. I was half-listening to the vet talk about routine vaccination stuff.

Stage 2: I guess he got bored, too, because he decided to be Spiderman (I learned this after the fact). This involved him crawling around in circles on the floor, on four legs, making growly noises, and all of a sudden I found myself trying not to step on him in the same way I was trying not to step on the nervous dog. I wasn't looking at all, and felt some playfulness at the bottom of my pants leg, like a dog pulling on it or batting at it. Turns out it was actually the kid, mock attacking my leg. I still don't understand how this relates to Spiderman, but it was pretty much indistinguishable from what it's like in a puppy consult.

Stage 3: Mom told him not to do that to the lady, and that he can't play Spiderman right now. He stopped, pressed himself against the wall, and became completely still, silent, and sullen. Mom mentioned that he's hiding so we can't see him. At the sound of his name, he complains repeatedly to be left alone.

Stage 4: The vet produced a shiny toy that was as effective in entertaining vet students as little kids. It was a bright, highlighter-yellow, reflective band, of the sort that you smack against your wrist and they curl up. Then you have the pleasure of unfolding them, snapping them into a straight band again, and repeat. Reluctantly, I handed it off to the little kid, and he got as much pleasure out of this as I did. This kept him occupied for a long time, especially since he couldn't figure out how to snap it back straight, so it kept flying out of his hands and curling up again.

Stage 5: He climbed into the empty dog carrier and closed the lid over himself.

Wednesday 12 March 2014

Brain Tally

On the whiteboard in the pathology museum:

A: 1/4 1
H: 1
L: 0
A: 0.2
G: 1/2 + 1
L: 1

You see, we're supposed to remove as many brains as possible over the week, and the prof is keeping score. For the record, my 1/4 was from a kitten brain, because the skull was so tiny it was basically snip-snip with the scissors, rather than a big ordeal with a saw.

Tuesday 11 March 2014

My Life is A Horror Movie

Warning: I'm on necropsy this week. It's a little hard to tell, because we get so desensitised that we can easily eat our lunch while reviewing pictures of bloody, disemboweled animal corpses, but I'm pretty sure that talk of necropsy is disturbing imagery for the average person. Proceed with caution. The point of the post is, basically, blood and gore.

Here's how necropsy rotation works:

We show up in the morning (9am start! how unusual!) and have a little tutorial with the pathologist teaching the roster. We go over all the cases that have been submitted for the day and talk about our differential diagnoses and what we might expect to find on post-mortem. We divvy up the cases between the students, then head off to the PM room floor.

The PM room is designed with an elevated viewing area in front of the entrance, which includes things like the tutorial room and locker room doors, and a lower floor area that takes up most of the room. You have to go down some steps and wade through disinfectant to get there, and the floor is usually pretty wet. It's filled with drains, metal tables, and all the equipment you might want: tubs to carry organs around in, clamps to put heads in while you saw them open, tables of knives, a band saw in one corner, stuff like that.

Something slightly distressing to some is that the animals don't always arrive dead. The upshot is that means a very fresh PM, rather than something that's been in a freezer for a month, but the downside is we have to euthanise them ourselves. In the small animal world, it's a simple injection. But euthanising large animals is, I find, particularly unpleasant and not for the faint of heart--the larger the animal, the worse it is. They're rendered insensible (and probably dead) by a captive bolt into their skull, then to make extra super sure that they're dead, you slash open their throat so they exsanguinate (translation: ocean of blood on the floor).

Once they're not only merely dead, but really most sincerely dead, the students are unleashed. Basically, you go through everything, outside and inside, in a systematic way. While it's all very scientific and medical, to an outside observer, it's skinning, tearing out the heart and lungs, cutting through vessels and spilling blood everywhere, stuff like that. It's quite hack-and-slash feeling. When it's time to look at the abdomen, you've just got organs all over the place. And to check out the brain, you break out the saws and cut open the skull. The things you didn't realise you signed up for, eh?

One of the most disconcerting things is that the muscles keep twitching due to the nerves firing. I always find it startling, even when I know it's coming, that when you cut through a big nerve (like the sciatic), the leg jerks.

Something a little morbidly interesting is that the method of euthanasia dramatically impacts what the PM is like. I had a calf with a suspected central nervous system disease, so we didn't want to use a captive bolt and destroy the brain. I used the injection instead, which means the calf didn't exsanguinate like the others. Out of the three calves that were PM'd at the same time, guess whose table was drowned in blood?

At the end of the day, we have to write up everything we found and submit it for the pathologist to edit and finalise. We have these green sheets to take notes on, and by the end of the morning, both sheet and pen are saturated with essence of dead animal. Yet we just fold them up, take them home, and type it up on our computers like there's nothing unusual. I guess, to be honest, there isn't.

Monday 10 March 2014

Necropsy, From the Tiny to the Giant

Warning: Descriptions of dead animals.

Pathology rounds are every friday afternoon, and for as long as we've been in vet school, we've been encouraged to attend. It requires nothing on your part, simply show up, stand around the post-mortem room, and watch. At first, it's practically incomprehensible, but as you progress through the years you start understanding more and more of what's being said and what you're looking at. Pathology rounds are a regular fixture in (some of) our lives, a weekly occurrence that's gone on as long as vet school has.

And finally, it becomes our turn to take the floor, our turn to stand on the other side of the room and hold up the cold entrails of dead animals for all to see.

You see, this week I'm on necropsy. On friday, we are the ones to present the cases that come in during the week. Some come in dead already, some arrive alive and get euthanised on the premises. We hack apart their bodies completely and utterly, send samples off to the lab, and save whatever is interesting for path rounds.

Today we had three animals: a kitten, an alpaca, and a cow. I got the kitten. Nine days old, it had been found dead underneath its mom, suspected crushed/smothered. Everything was so tiny, it was hard to do the PM steps like normal. Her teeny tiny mouth and tongue, and teeny tiny GIT and kidneys and spleen and everything, and super teeny tiny uterus--actually it was pretty cute. Or at least I thought so, and one other person, but the production trackers thought that was weird, and were all, "Psh, smallies people." But at any rate, I kept accidentally crushing and tearing things, and fur got all up in everything, and it was very difficult to cut organs open and get a good look at everything. I practically needed a microscope.

So here I am, with my animal that can fit in the palm of my hand, holding up its tiny heart and lungs between two fingers and poking at it with a pair of forceps, and at the table next to me is the team working on the cow: heart the size of my head, a mountain of rumen contents all over the floor, sawing and hacking with giant knives, cutting the ribs with massive bolt cutters, an ocean of blood leaking out of their animal. The liver alone was an entire armful. It amazes me how these two very different creatures are so similar in their composition. My kitten's little heart the size of a fingernail had all the same components as the massive cow heart, just miniature.

The alpaca was interesting, too, just by way of being an alpaca.

Snooze You Loose

Student: *Half falling asleep on desk* *Big yawn*

Prof: Warm afternoon on a sunny day, eh?

Student: Sorry! Post-prandial coma.

Prof: I fell asleep during my own tutorial once. A student was answering a question, and it must have been the soporific effect of her voice or something, put me right to sleep.

Monday 3 March 2014

The Low Points of the Career

Some days being a vet isn't very glamorous. It's even worse for vet students, because you're at the bottom of the heirarchy. For instance...

Vet is pregnancy scanning cattle. Cows get lined up in the milking shed, vet goes down the line with the ultrasound. Vet students get remote screen so we can see the ultrasound as well, but it has a short range, so we have to delve into the pit to follow the vet.

Streams of urine and faeces pour out intermittently and unpredictably from both sides. You try to stand in the middle, but can't very well because all the milking cups are hanging there, in the way. Dodge forward, out of a splatter, into a spray. Dodge backward, out of a spray, into a splatter. Random cow gets a fright and kicks poo onto your arms/chest/face. Scurry forward to the end of the pit. After the vet is finished, time for the cows to go, and the next group to come in. Scurry back to the other side of the pit, get more poo kicked on you as cows hurry out of the shed.

Repeat.

A gradual, slow accumulation of cow poo. Slowly run out of clean spots on limb to scratch face, which is a bad combination with hundreds of flies in the shed. Poo lands on you. Flies land on poo. Poo lands on ultrasound screen, wipe it off... start running out of places to wipe it onto.

Long shower afterwards.

Saturday 1 March 2014

What Horse Vets Do

After a week of straight horseyness, here's my glimpse into the equine medicine world:
  • Dentistry - mostly grinding off sharp points, and a few extractions.
  • Scanning mares - rectal ultrasound for detecting heat, pregnancy, twins, etc. Pretty cool but very difficult to see the screen when it's so sunny.
  • Castrations - everything involved in horse surgery is size massive. The endotracheal tube is as long as my arm and probably thicker around. The rebreathing bag is the size of my torso. Don't even get me started on the vaporiser and breathing circuit.
  • Feet - horses are all legs. Lots of lameness exams. Abscesses, bruised feet, fractures, and more.
  • Skin - poor itchy horse with a tick allergy. Ticks are horrid things.
  • Eyes - saw a horse with uveitis (made the eye look all cloudy). My classmate got to see a squamous cell carcinoma (looked like white spots on the side of the eye).
  • Pre-purchase exams - vets need special insurance to do these. Very thorough, including a general exam, lameness exam, scoping, and many radiographs. Possible to induce much trouble and lawsuits if done poorly.
  • Laryngeal endoscopy - for various reasons including horses making noise when exercising. Very cool gadget and neat to be able to visualise the larynx of a live horse as it breathes.
  • First aid sort of things - lacerations from kicks and whatnot.

Still not going to be a horse vet. But I wouldn't mind some riding lessons one day. There's something about the power and grace of horses--so big and beautiful and strong. As long as they don't try to kill me, that is. I'm sticking to my original opinion of "I appreciate horses at a distance."

As an aside, it's interesting and alien to see the horse world. Everyone seems to be born into it. The horsey people and horsey vets have all been riding and owning horses since they were children. The racing industry is unlike anything else, with all sorts of quirks and peculiar rules. It's a completely foreign world to me, so spending a week involved in it was something of an adventure.