PHC Assessment and General End Of Semester Ramblings

I think I've officially impressed people (but at the same time I don't want to get complacent and stuff it up). I'm not entirely sure if I've talked about this before, but at the start of the year, one of my lecturers put my first-year case report in to a journal publication. There were some minor things to change, but they were mainly just a few clumsy sentences and removing specific times and such from the report. That came out about two weeks ago, and my report came out really nicely.

About a week ago, the same lecturer emailed me about an assessment that we need to do later on in the year, which is basically a preventative health clinic (PHC) where we look at people's pets that are either well and getting a yearly checkup, or their owners are just starting to notice that their animal's doing something kinda weird. What we need to do is take the history, examine the animal, talk with the vet, collect samples for diagnostics where appropriate (eg we'll do a blood draw but not a cystocentesis), analyze those samples, and then talk with the vet about the case, with some basic recommendations about what we need to do to confirm or deny likely possibilities. We're not expected to diagnose the animal ourselves, and it is completely up to the veterinarian to say what gets done, but obviously the more knowledge you have, the better. After that we'll need to talk to the client, explain the findings and the recommendations, give them a sample bag of select goodies that are relevant to their case, and follow through with sending off lab samples etc if it's needed. This is all supposed to be done in September, and I think we also need to do a bunch of advertising and stuff on the clinic to drum up our customers.

Well, this lecturer's cat was starting to look a bit poorly NOW, as opposed to in September, and she also got the go-ahead to choose her very own student to do their PHC assessment early, on her cat. She chose me, which is rather flattering, and told me that she didn't think it'd affect my marks if I did the assessment early, but that it'd probably be easier to do it early as well, seeing as it'd just be me in the clinic, rather than me and twelve other people and twelve other clients and twelve other pets. There was also the plus that she'd be holding and I'd trust her to properly restrain just about anything. She also knows what I SHOULD be doing, but wouldn't construe things completely wrong, either. She sent me a marking schedule, and it all looked reasonably do-able, so I went for it. I was in VSG on Tuesday, at my external clinic on Wednesday, and then did the assessment, so I got to do a practice blood draw on a cat at my external clinic which was good, since before this, I'd only drawn blood from one dog (the total is now one dog and two cats and one nonproductive stab).

Basically I met my lecturer at the clinic, and examined her cat. I didn't take an awesome history (I got most of the basics, but did miss some important stuff) and my examination was also a bit more patchy than it should have been (I missed some bald patches from fur-pulling, a small sore in her mouth, a rather large heart murmur which was probably present when I listened, but may not have been as loud, and soreness in the hips and left forearm) which was a bit frustrating. I didn't have a sheet, so I was doing things completely from memory, but I should still have picked up on at least some of those. I did manage to do the blood pressure monitoring quite well, and figured out that the cat did better with her head covered so she didn't have to look. We gave her a few breaks because she was a really timid cat, and then came back to get blood samples and a urine sample if we could. It worked pretty well - her collar had rubbed a ring of fur off most of her neck, so I didn't have to clip, and her jugular was large and easy to find. I drew one sample pretty well but slightly fumbled the syringe and couldn't get all the volume out at once, so had a second try and didn't quite get it, so the vet drew up the remaining volume from the other jugular. Apparently the right side is usually larger, too. The lab tests went quite smoothly, though my blood smears were rather shabby. The cat had elevated ALT and creatinine, so we asked the lab to include a CBC in with the T4 test they were already doing( (we actually JUST missed the lab courier, which is annoying, but the forms did say to hold the other samples, so it should be fine - they'll just get told with the afternoon pickup.My explanation was okay (I did get some time to read through a five-minute consult book that gave information about each thing on the biochemistry test, and about what an increase paired with other increases meant, etc. ) and they actually started asking me harder questions as well, to see if I could answer them. We tried again for a cystocentesis sample but her bladder was still too small, so we weren't able to get a urine sample. The vet seemed to be impressed with me overall, and told me that the extra work I was putting in was really showing, which made me pretty happy. I'm glad to do the extra, and I enjoy learning about stuff, but it is nice to see that other people have noticed it too.