Tuesday, September 28, 2010

My Own Animals Are a Great Learning Experience

My kitty, Elli, has a long and sordid medical history (this is my favorite way to start this story! It’s the vet student equivalent of “on a dark and stormy night…”)

The important part of her history is that she has a history of (really severe) reaction to vaccinations. This is really not all that uncommon, though I would argue that the degree of severity she had is out of the ordinary. She also is really freaked out at the vet… she spikes a stress fever and even develops a heart murmur only in the clinic (I can hear it at the clinic and not at home, and she’s even had an echocardiogram).

When we moved back to vet school after a summer at home, I noticed that Elli was coughing. She’d had a coughing spell for a couple minutes a couple times a week. One of those all out cat coughs where they flatten themselves toward the ground and streeeeetch their necks out. I took her home with me to the Banfield I worked at over the summer and we narrowed it down to being feline asthma or potentially an upper respiratory tract infection. We ended up giving her depo-medrol (a long acting steroid) with a presumptive diagnosis of feline asthma.

A week and a half later, I noticed that she has a mass about the size of a pecan right where she got the injection.

I talked to one of the feline internal medicine professors (Dr. Zoran) about her medical history, long term and her more recent. She told me to never ever ever again give Elli depo-medrol, because she’s probably reacting to the substances that make the depo-medrol a long acting steroid. She told me to aspirate the mass and take the stained slides to Dr. Barton (the oncologist/cytologist). I actually went and told Dr. Barton the same story and she told me that she’s never seen/heard of/read about a sarcoma (cancer) associated with depo-medrol (though they are associated with vaccines). She gave me instructions about what kind of sample to take (she wanted a core biopsy.)

My friend Ashley and I pinned Elli down at home and took a core biopsy of the mass. When we pulled the needle out, she oozed out some lemon pudding consistency material. (Don’t you love how pathology uses food descriptions?) So we took an impression smear of that and then decided to try to aspirate the mass.

I stained the slides then looked at them with Dr. Barton. We went over them and found the mass was just full of necrotic tissue, with some degenerating neutrophils and a little bit of the drug.

It’s fun to learn from my own pets! (Though, I hope Elli doesn’t develop any more medical problems for a long time!)

Sunday, September 12, 2010

Surgery

Surgery class is intense. All of the group positions are intimidating in their own way.

The anesthetist is responsible for maintenance and monitoring the patient for the duration of the surgery. This involves taking measurements every 5 minutes for the entire surgery time. That's a lot of measurements. And they're in charge of making sure the animal stays under anesthesia. At the end, they're responsible for euthanzing the animal, which is a weighty and emotionally, if not technically, difficult process.

The surgeon and assistant surgeon are responsible for cutting into the flesh of an animal, maintaining the sterility of the area, and closing the incisions they make. This process is done with various teachers circling around and watching you like a hawk. There's the added problem that you want to ask questions but it often feels like asking questions and having your work evaluated by an already-trained eye (rather than your and your partner's starting-to-be-trained eye) will make you lose points. While we're supposed to be in this to learn to do it right, it's hard for us to stomach earning a 17/25! Most of us are used to much higher grades than that!

Sunday, September 5, 2010

Funny/Interesting Things Professors Say #5

Small animal medicine
“… I have a Bernese Mountain Dog… which is kind of ridiculous.”
“The other thing about cancer cells that’s really dastardly…”
“… well it won’t be available for the dogs that were dead…”
“…cut them off and put it under the mattress with a frog’s leg and it will go away.”
“I’d rather have 6 years with a boxer than 17 years with a Chihuahua”
“3 days later his right atrium ruptured… which is suboptimal”
“he will get revenge… in a multitude of ways… most involving urine and feces.”
“when clients freak out about amputation, I ask ‘how many legs do you have?’ and they say ‘well… 2.’ And I say ‘well, you do pretty well.’”
“and then the reconstruction people will build you a new nose and you and you can go into public.”
“no pet should die without the benefit of steroids.”
“the recurrent laryngeal nerve is something one avoids in surgery if one can.”
“there are lots of important things with long names in there… and some short names too.”
“we’re talking therapeutic radiation, not nuclear destruction…”
“a cure for cancer is to live long enough to die of something else.”
“that’s a surgery for a person really experienced at removing sphincters”
“this is the rectum of a dog… but it’s too close for you to tell that.”
“You can’t just walk up to someone you don’t know and say ‘this is a bad plan!’”
“And no one knew then that cisplatin splats cats…”
“I said ‘I don’t know if this treatment is going to be possible because we need to be able to get the bloodwork faster…’ and he said ‘Oh, ok. I’ll get a plane.’ And he flew in for every chemo treatment the dog needed.”
“perhaps they are smart about some things… but this is not one of them.”

Radiology
“if you think you can slap a cast on any fracture, you’re living in the 1940’s”
“if you’re left with a jaw that doesn’t work… you’re screwed”
“you can use your brain and be right a lot of the time.”
“but my grandma didn’t go to vet school… you did.”
“… I would be correct, and I would be a bad doctor”

Large animal medicine
“no matter what is wrong with a horse, with a heart rate of 120… it’s bad.”
“normal horses are pretty boring”

Animal Models
“Betty White’s writing kind of induces violence.. but she doesn’t do it herself… she’s kind of old..”

Surgery
“He’s young and nice… I’m going to try to fix that… I can’t fix the young…”
“I’m probably not going to bite your head off… almost definitely”

Wednesday, September 1, 2010

Emergency Response and Management

So far, my favorite class is my Emergency Response and Management elective. It's essentially about the process of preparing for and responding to crisis events. Those include any size natural disasters (tornadoes, hurricanes, earth quakes, flood, drought, etc.), infrastructure disasters (bridge collapse, fire, etc.), terrorist attacks, etc.

The grade in the class is based on completing 4 of the FEMA training classes for emergency response (and attendance.) Because of this, the students in this class will be in the first group of people that the vet school response team will pull from for students to take to disaster response.

We're also listening to lectures about the process of preparing a community for disasters- either in their area or what they should plan to do to shelter other communities.

I'm kind of hoping that something happens during 4th year that we'll get called to respond to! I think it would be awesome!



Actually, on this topic, September is Emergency Preparedness Month! You should check out this link and make sure that you and your pets are prepared!

http://www.ready.gov/america/