Today we started our three-day refresher for the vet hospital attached to the course. We spent three weeks there over the course of last year, and we have a short three-day stay this year to refamiliarise ourselves with the routines, as we have to supervise first-year students later on in the year. Today was ridiculously busy - we had four scheduled surgeries, plus three emergency dropoffs, plus a full booking of consults in every available time, PLUS a few boarding patients, a euthanasia, and two stitch ups, only one of whom we could fir in. Luckily there are ten people in our groups, so there were enough students to get almost everything done, though we did stay from 8 until 6 and even went overtime by half an hour - and there were still two patients to finish up, plus the last of the cleaning to do.
Today I was acting as the Clinical nurse, who is the nurse that helps out in consults (holding the animal and such) reception, and general stuff around the clinic, like filling orders or restocking shelves. A friend of mine was acting as Receptionist, but we swapped back and forth a little since the rules for our refresher are reasonably loose. We'll be working together tomorrow as well, but as Hospital nurses - so we'll get to prep any surgery patients, and recover any patients undergoing anaesthesia. Then, on Wednesday, we'll be acting as Surgery nurses, and scrubbing in to any sterile surgeries, as well as helping clean instruments and assisting the anaesthetic nurses with their areas.
Some of the highlights of today were:
-the 12 week old Golden Retriever puppy that visited, who was absolutely adorable and well behaved.
-the red tipped Husky that had a dental, with really soft fur. She was a bit of a wimp (wanted to be back in her cage, wouldn't leave her owners, etc) but really unusual in colouring.
-the pair of 12 week old kittens that came in for vaccinations. Brother and sister pair, and purring like anything.
-the litter of kittens plus wild mother that one of the vet nurses had set up in the break room - didn't have much to do with them because the mum is quite feral, but had a peek from a distance, and the kittens are about palm-size, being around a week old.
-Holding a grumpy DSH for subcutaneous fluid therapy and NOT letting her bite anyone, not even when we had to rip off some of the tape holding in her catheter.
We also had a few not-so-fun cases today, like we usually do.
-The first one was one of our major surgeries, a leg and tail amputation. The cat in question had been found on its owner's doorsteps with a mostly severed back paw, and had had infection set in, which made amputation necessary. That was one of our major surgeries today, though apparently it was quite successful. They're a little worried about septicaemeia, but are hopeful that antibiotics will help counteract that.
-We also had a few remarkably unhelpful clients, who just didn't understand what we were trying to ask. One of the staff nurses was talking to them, and asking if their cat could walk - to hear that he wasn't right now. Asked if he HAD been walking - gingerly. Was he weight bearing on all legs? No, none. So he wasn't walking? Yes, he was. So he COULD put weight on all legs? Yes. Client also asked about rabies (not present in NZ) and asked if he HAD to bring his cat in (it hadn't been eating anything except gravy for three days). Another client was a backyard breeder who was deliberately trying to foist a puppy with a several thousand dollar urinary problem off for 'free' to people, knowing that the puppy had the issue. That's just plain irresponsible, especially since no one's really going to shell out several thousand dollars for a risky sugery that could lead to lifelong complications. The puppy should have been euthanised as soon as the issue was evident, and it's a little sad that the breeder didn't seem to get that. Nevertheless.
-Our last interesting case that I was involved in was a DSH whose owner rang up for a consult because his kitty wasn't breathing very well (huge respiratory effort), and had lost a lot of weight very recently. She'd been a small cat to start with, so the weight loss brought her down to a mere 2.3kg, and she was almost painfully thin to look at - you could feel her pelvis clearly just by stroking her back. The vet took her temperature and got a massive 41 degrees celsius, which is two degrees higher than normal, so we put the kitty on some ice packs covered by a towel to try and bring the temperature down while we got ready for some radiographs. She was a really sweet cat, but she did seem quite disoriented, and when I offered her some water, she took a few moments to orient herself, realize what I was offering, and remember what to do with it. Unfortunately, the radiographs showed that her lungs were filling with pus and fluid, which is a very expensive thing to fix, and has no guarantee that it would even work on a cat in her condition. The owner didn't have the money to install a chest drain, so unfortunately she had to be euthanised. I think it came as quite a shock to the owner, who sounded like he thought it was a case of "take these antibiotics and she'll be on her feet in no time", but instead it was more along the lines of "Sorry, there's nothing we can do". I was quite sad, because I'd been hoping she'd pull through, though I had a bit of a suspicion from how she looked that it wasn't going to be very positive news.
Regardless of the mixed bag we got today, I'm back in tomorrow in Hospital, so that should be interesting to see what we have happening - hopefully it will be slightly less busy than it was today.
Monday 28 March 2011
Belated Specialist Clinic Day 3.
My bad for getting this out late, but I've been super busy with lectures and work. Since I've got another post to write about the vet clinic that I was in today, this one'll be quite brief.
The deal today was that we swapped over at lunchtime to a new group of students starting their half-week in the specialist clinic, which meant that we didn't get to do very much at all because most of our patients arrived at around 11/12. But, we did get to see the amount of progress that our motor neuron schnauzer had made - which was fantastic. I was first in, so I went to see her before I started, and was a bit concerned because she looked exhausted and was barely responding to me, but it turned out that she'd just returned from a walk - yep, a walk - under mostly her own steam all the way out to the grass at the front of the building (maybe 35-40m, but a big deal for a sick dog) with just a sling (rectangle of fabric with handles) behind her front legs and another sling in front of her back legs, which just allowed the nurses to help support her if she tripped or needed a bit of extra help. She was doing really well, and was slated to go home later that day when we left. Took her out for another walk before we went, and she got all the way out and back with only minimal help, and managed to urinate by herself as well - extra bonus. My entire group was so proud of her for recovering so nicely, and it was really good to be able to see the progression of her recovery, not to mention the esteem boost of having a successful nursing case.
We also had some bad news though. The Newfoundland that was in on the second day came back in to the after hours clinic, and was unfortunately euthanised. I have to admit that I think it was the right time for her to go, but it would have been very sad for her owners, and it was a little bit of a shock to us, seeing as it hadn't really been discussed the day before. I do feel for her owners, but I think that in the end they made the decision that was best for HER, not for them...and i commend them on having the courage to make the hard choice.
The deal today was that we swapped over at lunchtime to a new group of students starting their half-week in the specialist clinic, which meant that we didn't get to do very much at all because most of our patients arrived at around 11/12. But, we did get to see the amount of progress that our motor neuron schnauzer had made - which was fantastic. I was first in, so I went to see her before I started, and was a bit concerned because she looked exhausted and was barely responding to me, but it turned out that she'd just returned from a walk - yep, a walk - under mostly her own steam all the way out to the grass at the front of the building (maybe 35-40m, but a big deal for a sick dog) with just a sling (rectangle of fabric with handles) behind her front legs and another sling in front of her back legs, which just allowed the nurses to help support her if she tripped or needed a bit of extra help. She was doing really well, and was slated to go home later that day when we left. Took her out for another walk before we went, and she got all the way out and back with only minimal help, and managed to urinate by herself as well - extra bonus. My entire group was so proud of her for recovering so nicely, and it was really good to be able to see the progression of her recovery, not to mention the esteem boost of having a successful nursing case.
We also had some bad news though. The Newfoundland that was in on the second day came back in to the after hours clinic, and was unfortunately euthanised. I have to admit that I think it was the right time for her to go, but it would have been very sad for her owners, and it was a little bit of a shock to us, seeing as it hadn't really been discussed the day before. I do feel for her owners, but I think that in the end they made the decision that was best for HER, not for them...and i commend them on having the courage to make the hard choice.
Tuesday 22 March 2011
Specialist Clinic Day Two
So today was my second day in the Medicine department of my specialist clinic, and it also went pretty well. We had both the mini schnauzer with possible Addison's (which was confirmed today) and the motor neuron schnauzer with us again today, but the Westie from yesterday had gone home after his cardiac tests were done. In addition to those, we had a few other patients - a 12 year old Newfoundland, a DSH cat, a husky, and a mutt, in for various tests.
The most interesting things we did today were probably with the motor neuron schnauzer and the Newfoundland, as the others were mainly dealt with by the nurses, or by other departments. The schnauzer was looking much better than she had been yesterday, which had been an improvement on how she had been over the last half of last week - when we arrived this morning, she was in sternal recumbency (lying on her chest, fairly upright and centered) and was very bright and wagged her tail when she saw us. She also had a lot more energy, and seemed to be less withdrawn. She ate some food (shredded chicken and prescription dog food meatballs) and was able to urinate on her own, which was a big improvement from having to have her bladder expressed manually - it's not really pleasant for the animals, and dogs can get funny about urinating or defecating inside once they're toilet-trained. Since she was so much better, we started doing a bit of physiotherapy with her, so she doesn't lose too much muscle tone and to start getting her back on her feet, hopefully. (I'm not sure what was causing her problems, the last I heard of it was that it could have been a tumour, poisoning, or botulism, so it may or may not be something that can get better, per se)
Her therapy involved the use of a sling that fits into a rolling framework, with holes for all four legs. It can be set varying distances from the ground, but the sling supports most of the dog's weight while still allowing them to feel like they're walking by themselves. She seemed to really enjoy it, though she had a bit of trouble keeping her back legs under her and they kept slipping forwards in a sort of bunny-hop fashion. It was quite funny doing our circuit of the main area, since there were three students and two nurses all cheering and coaxing one staggery little dog around the corridor. She seemed to enjoy it though, likely because she'd been recumbent for nearly a week, and bed rest can't be all that interesting for a dog. We did another short journey with her in the afternoon, and found that if someone helped support the weight of her bum, she could use her back legs more easily. It's a pretty good step forward (so to speak) and she may be able to go home and be cared for in her home environment if it turns out that she can use a sling (around her lower belly, so that her owners can help support her weight) to get around.
Our other interesting client was the Newfoundland, though this was one of the...less appealing sides to nursing. She's 12, which is very old for a giant dog, and she has a variety of health problems, including very weak back legs, a heart block, spinal pain in the neck and hip regions, and more or less complete urinary incontinence. She can get up on her own, but has a sling that is generally used to help her up and down, so that she doesn't strain herself too much. The urinary incontinence was one of the worse problems when it comes to quality of life, since she basically just trickled urine about half the time. This meant that her bedding was damp all the time, the floors where she lay down would be wet when she got up even a few minutes later, and she was getting some very severe pus-filled nodules/skin tags/lumps around the urethral opening due to the urine scald - more or less nappy rash - caused by the incontinence and more or less constant dampness of that area. Added to this, she also smelled appalling.
For her, we ran some electrocardiograms (ECG) to find out what was happening with her heart, which led to us finding out about the heart block, and treating it with Atropine. which showed us that she also had a fair number of secondary problems with her heart, as a lot of the beats were quite abnormal even after treatment. She also had some radiographs taken, dealt with by Radiology, on her hips and neck, and had had some done of her heart and chest a few days prior. For the incontinence and urine scald, we clipped all the fur around the lower belly and perianal region, and bathed the area with some mild shampoo - we did this twice during the day, once when she was recovering from the sedation used for her radiographs, which allowed us to shave and clean the area much more thoroughly than when she was awake. There wasn't much we could do about the pus nodules except clean their surface, though she did smell remarkably better after the second wash.
One of the procedures that I got to do today involved the Newfoundland as well. She needed a catheter placed so that there was I/V access while she was sedated, and that's one of the tasks that we need to complete during the year. My teammates had been able to run the ECG's on some of our patients, so I was chosen to try and place the catheter, which I managed reasonably well for a first attempt. Since Newfoundlands are such large dogs she had big veins, which makes finding them quite easy - although they can also be quite tough-skinned, and the veins themselves can slip away from the needle tip quite a lot sometimes. Her cephalic vein also branched into the accessory veins quite far up her leg, with a lump on or near the vein about an inch above the branch point, which somewhat limited my choice of spots to catheterize. It's necessary to start as low as possible on the vein, so that if the catheter is not successful, you can try higher up the limb next time. I did find it harder than I expected to pierce the skin, but managed to get the vein on very nearly my initial penetrative angle - I had to correct slightly to the right, but got the vein immediately once I had done that. She did bleed through the stylette a little while I was advancing the catheter into the vein (we use over the needle catheters mostly, which have a needle with a hollow plastic tube over it, the whole thing is inserted into the vein and then the needle is withdrawn, leaving the tube in place, the end is blocked with a cap, which is then replaced with an injection cap, which has a rubber seal on the end that you can inject through without hurting the animal, damaging the cap, etc) but not very much considering her size. I also had some minor trouble taping the catheter in place, as she had very puffy fur and was by that point determined to lie on her side instead of upright, which made things slightly more difficult. Nevertheless, I was pretty pleased with my attempt, and I'm looking forward to gaining more practice.
The most interesting things we did today were probably with the motor neuron schnauzer and the Newfoundland, as the others were mainly dealt with by the nurses, or by other departments. The schnauzer was looking much better than she had been yesterday, which had been an improvement on how she had been over the last half of last week - when we arrived this morning, she was in sternal recumbency (lying on her chest, fairly upright and centered) and was very bright and wagged her tail when she saw us. She also had a lot more energy, and seemed to be less withdrawn. She ate some food (shredded chicken and prescription dog food meatballs) and was able to urinate on her own, which was a big improvement from having to have her bladder expressed manually - it's not really pleasant for the animals, and dogs can get funny about urinating or defecating inside once they're toilet-trained. Since she was so much better, we started doing a bit of physiotherapy with her, so she doesn't lose too much muscle tone and to start getting her back on her feet, hopefully. (I'm not sure what was causing her problems, the last I heard of it was that it could have been a tumour, poisoning, or botulism, so it may or may not be something that can get better, per se)
Her therapy involved the use of a sling that fits into a rolling framework, with holes for all four legs. It can be set varying distances from the ground, but the sling supports most of the dog's weight while still allowing them to feel like they're walking by themselves. She seemed to really enjoy it, though she had a bit of trouble keeping her back legs under her and they kept slipping forwards in a sort of bunny-hop fashion. It was quite funny doing our circuit of the main area, since there were three students and two nurses all cheering and coaxing one staggery little dog around the corridor. She seemed to enjoy it though, likely because she'd been recumbent for nearly a week, and bed rest can't be all that interesting for a dog. We did another short journey with her in the afternoon, and found that if someone helped support the weight of her bum, she could use her back legs more easily. It's a pretty good step forward (so to speak) and she may be able to go home and be cared for in her home environment if it turns out that she can use a sling (around her lower belly, so that her owners can help support her weight) to get around.
Our other interesting client was the Newfoundland, though this was one of the...less appealing sides to nursing. She's 12, which is very old for a giant dog, and she has a variety of health problems, including very weak back legs, a heart block, spinal pain in the neck and hip regions, and more or less complete urinary incontinence. She can get up on her own, but has a sling that is generally used to help her up and down, so that she doesn't strain herself too much. The urinary incontinence was one of the worse problems when it comes to quality of life, since she basically just trickled urine about half the time. This meant that her bedding was damp all the time, the floors where she lay down would be wet when she got up even a few minutes later, and she was getting some very severe pus-filled nodules/skin tags/lumps around the urethral opening due to the urine scald - more or less nappy rash - caused by the incontinence and more or less constant dampness of that area. Added to this, she also smelled appalling.
For her, we ran some electrocardiograms (ECG) to find out what was happening with her heart, which led to us finding out about the heart block, and treating it with Atropine. which showed us that she also had a fair number of secondary problems with her heart, as a lot of the beats were quite abnormal even after treatment. She also had some radiographs taken, dealt with by Radiology, on her hips and neck, and had had some done of her heart and chest a few days prior. For the incontinence and urine scald, we clipped all the fur around the lower belly and perianal region, and bathed the area with some mild shampoo - we did this twice during the day, once when she was recovering from the sedation used for her radiographs, which allowed us to shave and clean the area much more thoroughly than when she was awake. There wasn't much we could do about the pus nodules except clean their surface, though she did smell remarkably better after the second wash.
One of the procedures that I got to do today involved the Newfoundland as well. She needed a catheter placed so that there was I/V access while she was sedated, and that's one of the tasks that we need to complete during the year. My teammates had been able to run the ECG's on some of our patients, so I was chosen to try and place the catheter, which I managed reasonably well for a first attempt. Since Newfoundlands are such large dogs she had big veins, which makes finding them quite easy - although they can also be quite tough-skinned, and the veins themselves can slip away from the needle tip quite a lot sometimes. Her cephalic vein also branched into the accessory veins quite far up her leg, with a lump on or near the vein about an inch above the branch point, which somewhat limited my choice of spots to catheterize. It's necessary to start as low as possible on the vein, so that if the catheter is not successful, you can try higher up the limb next time. I did find it harder than I expected to pierce the skin, but managed to get the vein on very nearly my initial penetrative angle - I had to correct slightly to the right, but got the vein immediately once I had done that. She did bleed through the stylette a little while I was advancing the catheter into the vein (we use over the needle catheters mostly, which have a needle with a hollow plastic tube over it, the whole thing is inserted into the vein and then the needle is withdrawn, leaving the tube in place, the end is blocked with a cap, which is then replaced with an injection cap, which has a rubber seal on the end that you can inject through without hurting the animal, damaging the cap, etc) but not very much considering her size. I also had some minor trouble taping the catheter in place, as she had very puffy fur and was by that point determined to lie on her side instead of upright, which made things slightly more difficult. Nevertheless, I was pretty pleased with my attempt, and I'm looking forward to gaining more practice.
Monday 21 March 2011
Specialist Clinic, Rotation One.
Today was my first day in the Specialist clinic, which is a three-part business - there's a separate company for Medicine, Radiology, and Surgery, and each department is completely separate, down to the level of supplies, wages, and personnel. There's also an after-hours vet that uses the premises, and looks after overnight patients as necessary, but students aren't required to spend time there. I was working in the Medicine department today, and I'll be back there tomorrow and the next day, to complete my first rotation.
They're a referral clinic, so they only see really sick patients, or animals that are in need of fairly major surgery - the Surgical department does a lot of TPLO's - Tibial Plateau Leveling Osteotomy - which is a surgery to stabilize dog knee joints in the case of damage to the cruciate ligament. Radiology also does echocardiograms and ultrasounds, and Medicine looks after animals that require intensive nursing, or who are suffering from conditions that can't be easily diagnosed or treated elsewhere, such as radioactive iodine treatments for hyperthyroid cats, and chemotherapy for some types of cancer.
Today was pretty quiet as things go, so it was a nice easy start into the practical work for this year. I have two other people in my group, and we were working with three other nurses and one vet, for the main part. Today, we had a schnauzer with a degenerative motor neuron disease, megaoesophagus, and aspiration pneumonia, who was recumbent and unable to urinate or defecate unaided, who we gave nursing care to throughout the day (that involved turning her every four hours to help her breathe and prevent pressure sores, IV fluids all day, lubricating her eyes since she had difficulty blinking, and making sure she was comfortable and clean at all times), a miniature schnauzer who was undiagnosed by the time we left (we'd sent bloods to the lab, but no word back as yet), and a West Highland Terrier in with cardiac arrhythmias and other heart problems. We also had a brief visit from a pitbull, who needed chemotherapy, one of the receptionist's cats, who needed to have a geriatric check, and we had a stray that one of the vets brought in, who was hopefully being rehomed despite being FIV+ - he was a really beautiful cat (silver tabby with white markings, and a white splotch on his back), and super friendly, so fingers crossed that he finds somewhere really nice that can look after him.
One of the procedures that I got to do today were a jugular blood collection on the pitbull. It's the first time I've taken blood from an animal, so I was ecstatic to get a large, well-behaved dog with nice short fur. One of the nurses held for me, and another guided me through the process, so I managed to get the vein and take the sample after one failed try. I also helped with an electrocardiogram for the Westie, which was really interesting to see the printout and compare the normal beats with the abnormal beats, though the dog himself was fairly unimpressed with the whole procedure. Other than that, we also checked catheters, measured temperature, pulse, and respirations of all the animals (this is a TPR check) and generally assisted with a variety of small things done by the vets, or helped the nurses with any tasks they set.
I had heaps of fun today, and I feel like I learned quite a lot during the time there. All of the nurses that work there were spectacularly helpful, and answered all of our questions with well-thought-out, precise answers and a wealth of detail. Since it was quiet we also got to have a bit of a demonstration on making, staining, and reading blood smears, which can be an important part of ensuring chemotherapy patients are well enough to have their next treatment. Even though it was a long day with lots of new things, I think I performed at the level I would expect myself to be at right now, in regards to practical competency, and general knowledge. I'm back again tomorrow, so we'll see if that's equally successful.
They're a referral clinic, so they only see really sick patients, or animals that are in need of fairly major surgery - the Surgical department does a lot of TPLO's - Tibial Plateau Leveling Osteotomy - which is a surgery to stabilize dog knee joints in the case of damage to the cruciate ligament. Radiology also does echocardiograms and ultrasounds, and Medicine looks after animals that require intensive nursing, or who are suffering from conditions that can't be easily diagnosed or treated elsewhere, such as radioactive iodine treatments for hyperthyroid cats, and chemotherapy for some types of cancer.
Today was pretty quiet as things go, so it was a nice easy start into the practical work for this year. I have two other people in my group, and we were working with three other nurses and one vet, for the main part. Today, we had a schnauzer with a degenerative motor neuron disease, megaoesophagus, and aspiration pneumonia, who was recumbent and unable to urinate or defecate unaided, who we gave nursing care to throughout the day (that involved turning her every four hours to help her breathe and prevent pressure sores, IV fluids all day, lubricating her eyes since she had difficulty blinking, and making sure she was comfortable and clean at all times), a miniature schnauzer who was undiagnosed by the time we left (we'd sent bloods to the lab, but no word back as yet), and a West Highland Terrier in with cardiac arrhythmias and other heart problems. We also had a brief visit from a pitbull, who needed chemotherapy, one of the receptionist's cats, who needed to have a geriatric check, and we had a stray that one of the vets brought in, who was hopefully being rehomed despite being FIV+ - he was a really beautiful cat (silver tabby with white markings, and a white splotch on his back), and super friendly, so fingers crossed that he finds somewhere really nice that can look after him.
One of the procedures that I got to do today were a jugular blood collection on the pitbull. It's the first time I've taken blood from an animal, so I was ecstatic to get a large, well-behaved dog with nice short fur. One of the nurses held for me, and another guided me through the process, so I managed to get the vein and take the sample after one failed try. I also helped with an electrocardiogram for the Westie, which was really interesting to see the printout and compare the normal beats with the abnormal beats, though the dog himself was fairly unimpressed with the whole procedure. Other than that, we also checked catheters, measured temperature, pulse, and respirations of all the animals (this is a TPR check) and generally assisted with a variety of small things done by the vets, or helped the nurses with any tasks they set.
I had heaps of fun today, and I feel like I learned quite a lot during the time there. All of the nurses that work there were spectacularly helpful, and answered all of our questions with well-thought-out, precise answers and a wealth of detail. Since it was quiet we also got to have a bit of a demonstration on making, staining, and reading blood smears, which can be an important part of ensuring chemotherapy patients are well enough to have their next treatment. Even though it was a long day with lots of new things, I think I performed at the level I would expect myself to be at right now, in regards to practical competency, and general knowledge. I'm back again tomorrow, so we'll see if that's equally successful.
Thursday 17 March 2011
Fun With Cats
Yesterday I attended another day at my external clinic. There was another student there - a pre-vet student, doing his ten day's worth of work experience prior to being accepted into his course. It was good having another student there, because it gave me a chance to explain some of the things to him while he was watching, which hopefully helped him get a better idea of how the clinic is run as a whole, as well as learning about the vet's role in the clinic.
We had a bitch spey on a Cavalier cross puppy, who was pretty cute, though she did tend to scratch at the cage door if you left her alone. Her surgery went okay, but we had a few problems with the endotracheal (ET) tube's cuff not being inflated to the correct size, meaning that there wasn't a good seal in her trachea, and she wasn't getting as much isoflurane as she should have been - as a result, she definitely felt the first incision, though we remedied that pretty fast. She also had a bout of hypotension, but a small increase in fluid administration rate helped clear that up, and the doppler signal was clear and strong, for her heart rate.
We also had four cats come in for boarding, who all came from the same home, were all strays, feral, or otherwise homeless at some stage, and were all in need of vaccination, worming, and flea treatment. The first of these was not a very friendly cat, and she resented being held quite a lot, and by the time it came to worm her, she was fed up. Unfortunately, this coincided with me using an incorrect grip to secure her paws (I was holding them in one hand with a finger in between and trying to control the head with the other hand) and she managed to get free - though we did get the pill in her first. This led to a bit of a rigmarole, as I didn't think I was going to be able to handle her, but we equally couldn't do much with her running around the consult room. One of the senior vet nurses came to the rescue with a large towel, and after a bit of effort we managed to get her back in a carry cage, though myself and the other vet nurse got scratched a few times.
After that, the vet kindly showed me a much more secure grip for when someone else is able to control the head, which basically has the cat on a table in front of you, with your left hand around its upper left foreleg, and your right hand around its upper right foreleg, with thumbs basically in the armpits and fingers around the front, extending over the elbow joint. Paired with your elbows blocking in the side escape routes, and your chest preventing a backwards escape, this grip was a lot more secure than the one I was trying to use, as long as the cat didn't want to start biting. Using that, we managed to pill, worm, and vaccinate all three other cats with minimal trouble.
Overall, it was an interesting day. I think I learned from my mistakes, and the new grip for pilling should come in very handy - hopefully it will help me prevent other cats from making a bid for freedom.
In a few days, I have my first rotation at the specialist clinic, and I'll be in the medicine department. This will be a big step from my external clinic work, as it will involve animals that are in fairly poor condition, and need to be cared for correctly, with no errors, to prevent unnecessary stress on animals that may not be able to handle it. I have to admit that I'm more than a little bit nervous, but we've been given some preparatory material to look over as an introduction to the department, and I'm planning on studying the areas I'm not very familiar with over the weekend. I've already started going through fluid therapy, as this is a major component of hospital care for long term patients, but we're also expected to take a jugular blood sample, which will be the first time I've stuck a needle anywhere except subcutaneously. I'm hoping for a large dog with nice big veins so that I have a big target, but it will be interesting, to say the least, to see how it goes.
We had a bitch spey on a Cavalier cross puppy, who was pretty cute, though she did tend to scratch at the cage door if you left her alone. Her surgery went okay, but we had a few problems with the endotracheal (ET) tube's cuff not being inflated to the correct size, meaning that there wasn't a good seal in her trachea, and she wasn't getting as much isoflurane as she should have been - as a result, she definitely felt the first incision, though we remedied that pretty fast. She also had a bout of hypotension, but a small increase in fluid administration rate helped clear that up, and the doppler signal was clear and strong, for her heart rate.
We also had four cats come in for boarding, who all came from the same home, were all strays, feral, or otherwise homeless at some stage, and were all in need of vaccination, worming, and flea treatment. The first of these was not a very friendly cat, and she resented being held quite a lot, and by the time it came to worm her, she was fed up. Unfortunately, this coincided with me using an incorrect grip to secure her paws (I was holding them in one hand with a finger in between and trying to control the head with the other hand) and she managed to get free - though we did get the pill in her first. This led to a bit of a rigmarole, as I didn't think I was going to be able to handle her, but we equally couldn't do much with her running around the consult room. One of the senior vet nurses came to the rescue with a large towel, and after a bit of effort we managed to get her back in a carry cage, though myself and the other vet nurse got scratched a few times.
After that, the vet kindly showed me a much more secure grip for when someone else is able to control the head, which basically has the cat on a table in front of you, with your left hand around its upper left foreleg, and your right hand around its upper right foreleg, with thumbs basically in the armpits and fingers around the front, extending over the elbow joint. Paired with your elbows blocking in the side escape routes, and your chest preventing a backwards escape, this grip was a lot more secure than the one I was trying to use, as long as the cat didn't want to start biting. Using that, we managed to pill, worm, and vaccinate all three other cats with minimal trouble.
Overall, it was an interesting day. I think I learned from my mistakes, and the new grip for pilling should come in very handy - hopefully it will help me prevent other cats from making a bid for freedom.
In a few days, I have my first rotation at the specialist clinic, and I'll be in the medicine department. This will be a big step from my external clinic work, as it will involve animals that are in fairly poor condition, and need to be cared for correctly, with no errors, to prevent unnecessary stress on animals that may not be able to handle it. I have to admit that I'm more than a little bit nervous, but we've been given some preparatory material to look over as an introduction to the department, and I'm planning on studying the areas I'm not very familiar with over the weekend. I've already started going through fluid therapy, as this is a major component of hospital care for long term patients, but we're also expected to take a jugular blood sample, which will be the first time I've stuck a needle anywhere except subcutaneously. I'm hoping for a large dog with nice big veins so that I have a big target, but it will be interesting, to say the least, to see how it goes.
Friday 4 March 2011
Orientation
I had my orientation today, which went really well. Our timetable for practical work has changed slightly, but from what I've seen so far it looks reasonably doable as long as the work's put in. We also got to meet some of the people from the specialist clinic, and hear a little more about what we'll be expected to do while we're in the clinics.
There are three main areas in the specialist clinic, which are Medicine, Surgery, and Radiology. All patients are referred to one particular area of the clinic, although Radiology may do x-rays or ultrasounds for the other departments. They also do some work for outside practices, which will send a patient in for radiographs and then receive the radiograph and patient back at their own clinic to continue the case. Medicine is in charge of the sick patients, or ones that need constant monitoring - mostly cases that aren't surgical in nature. Surgery takes care of the operation side of things, and have a lot of osteopathic equipment for setting fractures, which is an uncommon operation for most patients.
The staff that talked to us were very friendly as well, though there's a definite feeling that they won't stand for any nonsense. They've set up some quite thorough standard operating procedure manuals for us to read at home, which should allow us to get at least a handle on the basics before we start practicals. We were also warned strongly that dress should be appropriate - apparently the G-string population of last year was a bit too high, and as such, people showing them off this year will be "named and shamed", which should be entertaining to watch, though most people I've worked with have dressed appropriately anyway.
Apart from the practical work, it appears that the rest of the year should go fairly smoothly, with more information going up online as the course coordinator organises the information she's receiving from all the other departments. There's just over 50 people in the second year of the course, and all except one is female, so the exception's either really lucky or really unlucky, depending on your view.
We also received our case reports from the previous year, which was exciting. Marks had been handed back previously, but mine was selected to be used as the model case report for this year's first-year students, as I got 94.5%, which was fantastic. There's also a possibility that mine may be able to be altered slightly (mostly word-count based) and published in the NZVNA journal, which would be an amazing success for my first case report, though they do try and include student work where possible. More on that later, hopefully! -crosses fingers-
There are three main areas in the specialist clinic, which are Medicine, Surgery, and Radiology. All patients are referred to one particular area of the clinic, although Radiology may do x-rays or ultrasounds for the other departments. They also do some work for outside practices, which will send a patient in for radiographs and then receive the radiograph and patient back at their own clinic to continue the case. Medicine is in charge of the sick patients, or ones that need constant monitoring - mostly cases that aren't surgical in nature. Surgery takes care of the operation side of things, and have a lot of osteopathic equipment for setting fractures, which is an uncommon operation for most patients.
The staff that talked to us were very friendly as well, though there's a definite feeling that they won't stand for any nonsense. They've set up some quite thorough standard operating procedure manuals for us to read at home, which should allow us to get at least a handle on the basics before we start practicals. We were also warned strongly that dress should be appropriate - apparently the G-string population of last year was a bit too high, and as such, people showing them off this year will be "named and shamed", which should be entertaining to watch, though most people I've worked with have dressed appropriately anyway.
Apart from the practical work, it appears that the rest of the year should go fairly smoothly, with more information going up online as the course coordinator organises the information she's receiving from all the other departments. There's just over 50 people in the second year of the course, and all except one is female, so the exception's either really lucky or really unlucky, depending on your view.
We also received our case reports from the previous year, which was exciting. Marks had been handed back previously, but mine was selected to be used as the model case report for this year's first-year students, as I got 94.5%, which was fantastic. There's also a possibility that mine may be able to be altered slightly (mostly word-count based) and published in the NZVNA journal, which would be an amazing success for my first case report, though they do try and include student work where possible. More on that later, hopefully! -crosses fingers-
Wednesday 2 March 2011
A Day At My External Clinic.
Every Wednesday, I help out at a nearby vet clinic, to complete my work experience requirement of 120 hours by the end of November. So far, I've completed 22 hours over the last two months, which is a good start to the year without doing too much too early. I've been a little rusty the past few weeks, but I'm getting back into the swing of things. I'm finding that a lot of the things I had trouble with last year aren't so much of a problem, but I'm doing a lot more things that I haven't learned in detail yet, which will be helpful for class because I'll have some background to go off, but it's not so helpful now, when I feel like I SHOULD know things, but have a lot of trouble with them.
At my external clinic, there are two major vet nurses, who we'll call Hannah and Maria (Not their actual names), a clinic cat named Ivy, and several alternating vets. The major one I work with is a man called Bernard. He's a bird specialist, so I'm getting quite a lot more experience handling birds than most other people in my class, I suspect. They're all very helpful, and happy to show me things, which really helps.
Today, we had a corgi in for lump removal and a dental, and a rabbit in to be neutered. The rabbit was the first rabbit I've handled during treatment, and he was rather jumpy. It was quite difficult to place the catheter for his anaesthetic because he'd twitch his head even a little, and the needle would slip out. It was quite interesting watching the other vet nurses place it eventually, though, since rabbits are one of the only animals that have large enough veins in their ears to make it a viable catheter site. He was recovering very well when I left, and had already munched through a good deal of the lettuce from the vet's salad during recovery. Since rabbits have such a high metabolism, and have evolved as constant grazers, it's very important that they aren't off their food (for whatever reason) for too long - they're not fasted for more than a few hours before surgery, and they're offered food as soon as they're awake afterwards.
The corgi was very well-behaved, so we were able to get her catheter in promptly, despite a bit of difficulty holding her stubby legs. The usual hold for a catheter involves the holder extending the elbow and holding off the cephalic vein, but that was quite hard with her (as opposed to a longer-legged dog), as her elbows were tucked close to her sides, and corgi forearms aren't very long either. However, she didn't protest much at all, so it was merely a mechanical difficulty. Her lump removal went fairly well, though the doppler probe and blood pressure cuff were also playing up - again, part of being a corgi.
Some of my new textbooks for next year arrived in the post today, which will help a lot with the problems I'm having with remembering the different testing methods. Added to my books from last year, I'm getting quite a good little reference library going, which I hope I'll be able to continue to use for some time, depending on how fast they go out of date. At any rate, they'll make it a lot easier to do assignments, and I have the chance to get in a little bit of advance reading on tough spots in the next week or so, before classes begin.
At my external clinic, there are two major vet nurses, who we'll call Hannah and Maria (Not their actual names), a clinic cat named Ivy, and several alternating vets. The major one I work with is a man called Bernard. He's a bird specialist, so I'm getting quite a lot more experience handling birds than most other people in my class, I suspect. They're all very helpful, and happy to show me things, which really helps.
Today, we had a corgi in for lump removal and a dental, and a rabbit in to be neutered. The rabbit was the first rabbit I've handled during treatment, and he was rather jumpy. It was quite difficult to place the catheter for his anaesthetic because he'd twitch his head even a little, and the needle would slip out. It was quite interesting watching the other vet nurses place it eventually, though, since rabbits are one of the only animals that have large enough veins in their ears to make it a viable catheter site. He was recovering very well when I left, and had already munched through a good deal of the lettuce from the vet's salad during recovery. Since rabbits have such a high metabolism, and have evolved as constant grazers, it's very important that they aren't off their food (for whatever reason) for too long - they're not fasted for more than a few hours before surgery, and they're offered food as soon as they're awake afterwards.
The corgi was very well-behaved, so we were able to get her catheter in promptly, despite a bit of difficulty holding her stubby legs. The usual hold for a catheter involves the holder extending the elbow and holding off the cephalic vein, but that was quite hard with her (as opposed to a longer-legged dog), as her elbows were tucked close to her sides, and corgi forearms aren't very long either. However, she didn't protest much at all, so it was merely a mechanical difficulty. Her lump removal went fairly well, though the doppler probe and blood pressure cuff were also playing up - again, part of being a corgi.
Some of my new textbooks for next year arrived in the post today, which will help a lot with the problems I'm having with remembering the different testing methods. Added to my books from last year, I'm getting quite a good little reference library going, which I hope I'll be able to continue to use for some time, depending on how fast they go out of date. At any rate, they'll make it a lot easier to do assignments, and I have the chance to get in a little bit of advance reading on tough spots in the next week or so, before classes begin.
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