Second Years Move In Slow Motion

This week I'm at one of the local practices in town. I think it's Easter break for people who have normal semesters (I had the option to have time off, but needed to schedule a week here). Apparently, as part of the new curriculum, the fledgling vet students start doing some clinic practical work in second year, where the school makes arrangements for them to spend two weeks with a private practice somewhere.

Instead of spending time with the vets, they actually shadow the vet nurses, learning things like IV catheters, bandages, monitoring and recovery from anaesthesia, and just what clinics are like and where things are. I think it's a fantastic idea. However, I'm totally not envious of them, because while I get to stand in on consults and surgery, they have to putter around the back, cleaning.

Interestingly, the second years are super slow. I know students are always slow, but it's fascinating to watch their brains go. For instance, they get asked to draw up a drug. It's one of the first times in their lives they've ever done that. What would take me somewhere between 10-30 seconds, and would take a vet nurse like 2-5 seconds, for them takes 2-3 minutes. I'll see one with a bottle, syringe, and needle one minute, turn away, and when I turn back the needle's made it onto the syringe and she's putting it in the bottle. Go do something else again, and when I look back, the drug is about 1/3 drawn up. Then 2/3. Then finally finished! Now... where does the bottle go?

Since they have so little clinical experience, they don't have the hang of where to look for things, or even what sort of cupboards and drawers there usually are. For me, I need to waste time poking around for the needles & syringe drawer on the Monday at a new clinic, but then I know where to go. For them, it's a mission to find anything, every single time.

They also stand around doe-eyed and lost-looking occasionally. The most fun part is that they'll look to me with questions, which makes me feel all knowledgeable and stuff. Unfortunately, since I've never been at this clinic before, I have no idea how things are done, either.

Specialists Are Very Important and Serious

Our local ophthalmologist is a friendly old guy that literally everyone knows, because he's pretty much the only ophthalmologist around (it's a small country). He's been at it so long he didn't actually have to do a residency, he just learned it all himself and sat the board exams just like that. So, that's cool.

Considering he drives a very expensive looking car and travels around the area doing all sorts of fancy I-didn't-know-you-could-even-do-that surgeries, you'd think he'd be a serious kinda guy, but he isn't. He wears a T-shirt during surgery, flirts with all the ladies, and makes bad jokes constantly, in between sewing up his suture pattern that's so tiny he's using a microscope to see his incision. I was holding something for him at one point as he cut away some excess tissue in a non-sterile procedure. He quite casually kept wiping bits off of his forceps onto my bare hand.

I don't know how he doesn't go cross-eyed doing those tiny surgeries every day, but he makes several thousand dollars for like fifteen minutes of work, soooo... some days, ophthalmology is pretty temping!

I Got to Go Out With the Coast Guard

Wildbase had a giant petrel in hospital for a few days, and with those giant seabirds it's quite important to get them back into the wild asap. More than a few days in hospital can end up causing a downhill turn. In this case the patient had been found on a beach, which means it must have been pretty sick, but as tends to happen in these cases, a particular cause wasn't identified. It was nursed and given lots to eat, and a big factor is restoring the waterproofing of their feathers.

After a few days, it was time for him to go home, which meant a trip out to the coast!

A forty minute drive to the coast later, with the petrel in a dog cage in the back, covered by a towel, we met the two guys at the little dock with their little boat. We climbed on in, and it was suggested to me that I not sit in the back, because I might "get a little wet." Instead, we stood in the cabin area, where there were back supports instead of seats. These made sense once we got going: after clearing the small bay, we took off.

It was super windy that day, and along with it came massive waves. And I mean several meters high. We'd go up one, fly off the crest into the air, freefall, and slam back down onto the water. Then up the next one, into the air, and down again. Fssssh-woooosh-POW. That's my impression of it.

Though somewhat terrifying, that part was pretty fun and not particularly nauseating. The difficult part was when we got far enough out (several kilometers, I forget the exact number), and came to a stop. The wildbase person I was with brought the bird out of his cage and put him over the side. Freedom! We waited to see what he did--would he paddle and drink and flap his wings like a normal bird? The answer was yes, he looked very happy and healthy! He quickly drifted away from us, exhibiting all the normal behaviours, and we watched him for a long time.

 

This turned out to be less fun than expected, because those waves were still massively high, and instead of rocketing over them, we were just sitting there, waving steeply back and forth. The wildbase lady described it later as, "I was telling myself, 'just focus on the bird, focus on the bird,' trying not to puke." Getting back to solid ground was quite a relief.

The Things You Go Through For Assignments

We have to write a few case reports this year, and one of the things that we're supposed to include is all the costs to the client. I had a case last week that was in hospital and got euthanised and necropsied on friday. It's been exactly one week since the farm visit, so I figured I could get my hands on the costings today. I never realised it would be such an ordeal.

Just like the other case report I did for a large animal, I went up to farm services and asked nicely for the costings. Last time, they looked up the case and printed it off. This time, they scratched their heads for a while trying to find the case, then scratched their heads for a while trying to find costings. One person asked another who asked another, and eventually they told me it hadn't been done yet.

So I went over to the vet, relayed what I'd been told, and asked for costings. She said the reception should have them. Reception said she should have them. We went out to reception to find them. Turns out they were on 2 different sheets on 2 different desks (one for the farm visit, one for the hospital stay). A nurse kindly offered to type them in right then and print them out for me. Phew! Finally. Thanks for doing that, sorry to bother you.

A few hiccups typing them in meant it took rather a while. The patient sheet was a huge mess because like half a dozen students had tried to write things on it, and of course no one put their notes in any of the correct places. Also someone had given a drug but not told me what exactly they'd drawn up, so I knew it was a vitamin B injection, but not which product it was. Nurse sighed about this, but took it in stride, without much more than a "They never help us" comment.

Then, just as she's about to finish, smack from the printer next to me. Or rather, from the cow vet standing at the printer next to me. He was trying to swipe his town library card instead of his university ID card, so it wouldn't read it or let him print. He got frustrated enough to punch the touch screen, which cracked it. Like, cracks radiating from the centre, covering the entire screen. And guess what--it's a touch screen. Even though the display didn't break, it wouldn't register the touches anymore, so the nurse wasn't able to actually select "print" for her document.

After a bit of a kerfuffel among the receptionists and some eye-rolling behind cow vet's back, the nurse and I headed for the vet tower. The vet tower is under a lot of construction, which means whenever you want to get through the hospital you have to re-route through some strange convoluted path. Eventually, we made it to a printer there, only to find someone in front of us trying to print. On a broken printer.

Fortunately, it turns out that printer only needed paper. Unfortunately, there wasn't any. The nurse went on a brief hunt, found a box, then no scissors with which to open the box. New hunt for scissors.

Finally, the printer was set to go. The other person printed her big pile of stuff. With bated breath, we waited while the printer charged up ours. And then at long last, I got my one little sheet with the list of costs for my calf.

Turtles and Geckos and Kiwis, Oh My

Day 1 on wildbase was a busy swarm of awesome. The wildlife ward is this tiny room tucked in between the treatment room and the dog kennels in the small animal hospital, which you walk by multiple times a day without ever really noticing. It turns out that just inside, there's a little mini clinic. There's one main room that includes a central surgery area (the whole place isn't much bigger than a dorm room), and then a doorway into the mini wards. There's a large room for a big animal, and another room packed with various sized cages. Five weeks in the smallies hospital, and I never realised there were a bazillion bird patients hanging out right there. Today, there were close to 20 inpatients.

The day started with a bang and never slowed down. On account of being a monday, after a brief tour, I got thrown into the whirlwind of getting food and meds to all 20-odd patients, with only the most basic experience to go on. After cutting up fruits, veggies, and almonds, my first animal-related task was to hold a kiwi while the vet tech force fed it. That's right, a kiwi.

One of the patients is a Kaka.

Mondays are apparently particularly hectic because they have rounds on mondays and thursdays. Treatments had to be finished by nine, and then all the wildlife staff (less than ten people) gathered around the tiny clinic to go over the history, diagnostic findings, and treatments for all the patients. There are a number of birds with wing or leg fractures that got surgery, with pins and external fixators and the whole kit and kaboodle. There are a few skinny birds that have been losing weight, a few odds and sods like strange skin lesions or neuro. One bird is in for diagnostics to confirm diabetes insipidus. At the other location, near the large animal teaching unit, there are purportedly three penguins and a few other big birds, but I didn't get out there today. One of the patients is an endangered New Zealand bird, and there are only around 400 left in the world.

After rounds, we had radiology booked for the morning, as we had three birds to radiograph. A harrier, a kingfisher, and some sort of pigeon. Wildbase is great because they have students every week and plunge you right into it. Almost right away, I was positioning the animals, holding, taking blood, making blood smears (badly), running PCV/TP, palpating lesions, all sorts of stuff.

 

A harrier.

After lunch, there were two consults. One was a sulfur crested cockatoo who we admitted for a whole slew of diagnostics, including bloodwork and skin scrapes. The other, however, made my day. It was a pet turtle with conjunctivitis, secondary to vitamin A deficiency (quite a common deficiency in exotic pets). So we did an ophthalmic exam on this turtle. I got to hold it while we examined and treated this turtle, and turtles are exactly as cute and awesome as you'd expect them to be (as long as you don't get bitten). Its little legs waggled around as I sandwiched it between my palms.

Ours was larger, but looked basically the same.

After the consults, it was time for the gecko surgery. Yeah, gecko surgery. It had a mass on its neck that was removed. Anaesthetists joined us to manage the anaesthesia, and the whole process of induction and intubation was quite an undertaking. The gecko was on a mask, and when it was asleep enough to lose its "righting reflex" when flipped over, they tried to get the endotracheal tube in. However, the gas anaesthetic diffuses out of the lungs pretty quickly, so there was a limited amount of time for each attempt. Because of the unusual anatomy, it took many attempts.

Despite all that, overall, the procedure wasn't much different than it would be for any other animal. The concerns about respiration and blood pressure are basically the same, it's just a tiny-sized animal. Surgical technique is the same. Suturing is the same, it's just scaly reptilian skin instead. Though, there are a lot of quirks to bear in mind as well. For instance, turtles' lungs are attached to the dorsal carapace, so if you need to ventilate them, you can flap their legs back and forth, and it actually works the lungs!

I also learned that the bottoms of geckos' feet are really, really cool. Not only do they look neat, they feel pretty neat, too.

 

More surgeries and radiographs and anaesthetics on the schedule for tomorrow, with all sorts of native New Zealand birds. Should be pretty exciting!