Saturday, April 26, 2008

i bet you never thought you'd hear these words out of my mouth

equine surgery isn't that bad.

*take a deep breath now, recover from the shock...*

maybe it's because i know this is my last rotation ever. maybe it's because equine surgery takes all the lameness cases, so i spend a good 2-3 hours outside every day doing lameness exams on horses and basking in the glow of the late april sunshine. maybe it's because we have the new senior students - who are taking essentially all of the cases now. maybe it's because the clinician gave me and my fellow rotation-mates (class of 2008) the entire weekend off AND guaranteed us that we'd also have next weekend. most of us aren't taking cases as the primary student anymore but hanging back and letting the new students take the cases. we oversee them, help them figure out the paperwork, order tests, organize their time efficiently, etcetera. i'm still working all day, but as more of a supervisor than anything. the resident (whom we spend 90% of our time with) is excellent. he enjoys teaching, he's always in a good mood, he loves students, and he's very pro-senior. he's made sure to let us off for senior events like the making of our roast video and the honors convocation.

speaking of the honors convocation, i was awarded the Ophthalmology award this year. i feel gratified that of all my classmates, i was chosen for this award. mainly because it was my very first rotation as a 4th year veterinary student - an entire year ago - and they remembered me all that time. there were some surprises at the honors convo - some awards didn't go to those we all expected. i suppose that's the politics and BS of vet school, though.

the kitten i took in 3 weeks ago (see older post) is thriving. he was so young then, i didn't really think he'd make it. but he's hanging in there and has gotten to be a fat sassy little thing. his name is metan (pronounced mi-tan).

i went shopping today and bought my graduation dress and shoes. it's only 11 days away.


Sunday, April 20, 2008

my nights as a vampire

have come to an end. tomorrow morning heralds the start of my last 2 weeks as a veterinary student. equine surgery begins. we also get the new seniors (class of 2009). they start tomorrow at around 9:30. i expect them to be bright-eyed and bushy-tailed. the perfect foil to the frayed around the edges class of 2008.

14 days. i've been keeping this blog since 1st year - and here it is - the end of my veterinary schooling (for now at least).

i didn't mind the overnight rotation in the least other than never seeing the husband. i slept all day, worked all night. i've been generally depressed lately, so i think the schedule was conducive to submerging the depression. i was working or i was sleeping. there wasn't a whole lot of time to think about anything else.

speaking of working, our last night on ECC brought quite a nice surprise. we were sitting around waiting to do hourly treatments when the clinician informed us that 5 horses were on their way to us for emergency health certificates. there was much eye-rolling and huffing at the thought of an "emergency health certificate" until the clinician informed us that the horses we were going to see were the "world famous" lipizzaner stallions. i almost fell out of my chair. i knew they were in town for an exhibition...but now - now i was going to get to touch not 1 of these magnificent horses - but 5!! i have pictures, but i left them on the computer at school - so i'll have to post those later. needless to say, they were impressive.

otherwise, life proceeds at a normal pace. i'm wondering how difficult the transition from being awake 14 hours all night to being awake 14 hours all day is going to be. we'll see...

Tuesday, April 15, 2008

enough with the cows already

i don't know why but of all the animals with which i have "played" cows manage time and time again to be the most disgusting.

in case you missed it - this is another gross and possibly offensive post about cows.

ECC has been steadily busy. we've had an emergency every night save one (monday). 4 of the 7 have undergone general anesthesia, which is no small task in large animal medicine. so it's been hopping around here - what with surgeries and a barn full of horses, cows, llamas, crias, pigs, goats, and 1 lonely karakul sheep to attend to on the hour.

at any rate, when this dairy cow presented for a dystocia (what is it with me and dystocias?) i figured it would be a run-of-the-mill calf pulling or c-section. you'd think i'd learn at some point. this cow had been in labor for 12 hours, with no evidence of the calf appearing. she weighed a whopping 1800 pounds and barely fit into the chute. after everyone and the homeless guy from down the road palpated her - it was determined that she had premature placental separation. that's exactly what it sounds like. the calf was dead. and big. and way way way down in the abdomen. so far down that there was no way the calf was coming out via the birth canal. F-A-B-U-L-O-U-S. to surgery we went.

cow c-sections are done in a standing position, so after prepping her - we draped the area and began. on opening the abdomen, we couldn't immediately locate the uterus. it was deep within the sizeable belly of this cow. all was going -- ok enough -- when the surgeon stepped away for a second, leaving me staring into the muscles and viscera of a very large, very belligerent, very NON-RESPONSIVE to pain medications cow. at that precise second the cow elected to cough. for no good reason that i could determine, small intestines came spraying out of the incision, missing my wide-opened eyes by a hairsbreadth. stunned but still trying to think quickly, i grabbed the misdirected loops of jejunum and frantically started stuffing them back into the cow (where they belonged). the cow herself turned to look at me because (i imagine) it feels strange to have ones intestines outside of ones body - and handled so roughly. again, she coughed - and again jejunum sprayed out, bringing with it a healthy dose of mesentery. i tried to keep the panic out of my voice when i hollered for the surgeon, who came back at a run - just as wonder-cow honked again - and more intestine slithered into my overfull hands. the surgeon screamed up and shoved her arms into the cow, attempting to hold the guts in while simultaneously yelling for another surgeon to scrub in - all very animal ER.

the other surgeon did indeed join us shortly - after her mandatory 5 minute scrub. while i and the resident held the unruly guts inside the cow, she patiently located the uterus. it was - as i said - deep within the cow. there was no simple exteriorizing of the uterus. nope, not happening. instead, the surgeon located a hock or a tail or some other extremity of the calf and made the uterine incision somewhat blindly. that part went well enough - and lo and behold a large dead calf popped out. since the resident and i were both somewhat preoccupied with holding the entire gastrointestinal tract inside the cow - we couldn't catch the calf. it popped out and slithered to the floor -where the skull cracked loudly on the concrete. luckily, it was already dead.

the rest of the surgery proceeded uneventfully, although the cow seemed to have an incredibly high tolerance for lidocaine. despite receiving massive doses, she continued to rock and plunge from side to side in the already overstrained chute. it was all we could do to suture her without poking ourselves in the eye/hand/arm. you'd think a dairy cow that's handled twice daily would have some manners.

after all of that, we let her out of the roundabout and herded her back to the stall. on checking on her a half an hour later, we were dismayed to see the bottom half of her incision hanging open to the world. it was only the skin suture that failed- the jejunum had elected to stay inside the body this time. depressed at our bad luck, we again placed her in the too small chute and proceeded to re-suture her skin incision.

this time - it stayed.

after graduation, i will never touch a cow again. if it isn't dead and rotting calves, it's unbelievably poorly behaved intestines that have no business being outside of the body...

Monday, April 14, 2008

this blog is all me all the time - so now for something entirely different.

saturday night, my brother's girlfriend went into labor. at 12:38am, lola beatrice joined the world. mom did great through the labor, so did dad. completely predictably - we had a surgical colic show up at 11:30. surgery wasn't over until 4am. so i missed the excitement. when my shift ended, i went home, showered off the llama/horse/goat/cow smell and went to the hospital to see my new and first niece. she's perfect and beautiful. her eyes are huge, and i haven't heard her cry once. she just looks at you with her big blue-green eyes. i'm in love!

Wednesday, April 9, 2008

it's not that bad.

you're probably thinking "hold the phone! what??"

yes, i might have mentioned my general abhorrence of the barn and all things barn-related...however i'm on with one of my closest friends in the class. it was originally supposed to be just the two of us - but that's kind of insane - so they switched another classmate onto our rotation. and she happens to be someone with whom i've been on 6 other rotations. we get along well. it's not been busy either. the barn is steady - about half full on equine and the farm animal side. we had one emergency last night and one the first night. other than that - we do hourly treatments and that's it. in between hourlies - we watch movies and study. last night, it was radiology night, so we studied radiology cases on the veterinary radiology site i found. we watched 'the descent' the first night - which kept us all entertained. my rotation-mates because they hadn't seen it and me because i kept laughing every time they jumped out of their seats and screamed. since horror movies do well to keep us all alert, we watched "from hell' last night - which isn't as good as i remembered it being. in the theme of johnny depp and gore, i feel i will rent 'sweeney todd' (yay!!) on the way to school tonight.

the up all night thing doesn't bother me in the slightest now that i'm sort of on the right schedule. the only thing it throws off is my eating habits. my days are essentially reversed, but i'm not sure how to eat at appropriate hours. so i wind up eating once in 16 hours. it's weird, but i suppose i'll grow accustomed to it shortly. maybe i'll lose some it's good practice for working emergency on my internship in 2.5 months. the real bummer is that i've seen the husband for about a cumulative 30 minutes in the last 2 days. and it won't get any better because this is six days a week. i have sunday off thankfully. i'll probably spend most of it sleeping.

in other news: i've reached new levels of suckerdom (See picture). he's only 7 days old. his eyes aren't open yet. i'm calling him tuft because he's just a little tuft of kitten. i'm NOT keeping him. just like i didn't keep the last 4 cats/kittens that came through my house. i am merely fostering him until he's old enough to find a home.

25 more days.

Thursday, April 3, 2008

goonies anyone?

we euthanized a sad little kitty today. it was an interesting case. "one-eyed willy" (as i called her in obvious homage to the greatest teen flick ever) presented last week. she was previously diagnosed with hypertrophic cardiomyopathy (kitty heart disease), chronic renal failure, and retrobulbar lymphosarcoma (big cancer mass behind the eye - in layman's terms). the cancerous mass and its associated eye were removed. the remaining eye later developed a raging cataract (hypermature). a hypermature cataract happens when the lens of the eye has become so diseased that it ruptures and spills lens material out into the eye.

poor willy weighed a mere 4 pounds. she had an esophagostomy tube in her neck so that she could be fed (a tube that comes out of the side of the neck, so her mom could feed her slushy food). when she came in, mom mentioned that in the last 2 days she had begun dragging her rear legs.


first off - in a cat with heart disease - you start thinking that kitty threw a clot to the aorta and now there's no blood flow to the rear limbs. however - on physical exam - kitty's rear limbs were warm, there were pulses present, and the nailbeds were pink and oxygenated looking. yay!! right?

wrong. very wrong. if kitty's paresis (weakness) was not due to a clot...then what caused it? in a kitty with a history of lymphoma (cancer) and a cataract...the diagnosis couldn't be good. see - cats - unlike dogs and people - don't develop cataracts secondary to diabetes. when you see a cataract in cat - you look for anterior uveitis and chorioretinitis (inflammation of the deep structures of the eye). AU and CR almost ALWAYS represent systemic disease -- especially cancer in an older animal (other diseases are also possible). so we had a cat suddenly down in the rear end, with a history of lymphoma, and a cataract. our suspicion was that the lymphoma was back and it was in the spinal cord.

we stabilized willy, replaced her e-tube, and sent her home so that mom could say goodbye (last week). she came back this morning. a tiny, soft, sweet, blind little grey tabby - i had fallen in love with her in the brief day she was my patient. when she came back this morning, i was sad to see her go, but i knew it was the right thing for her.

necropsy confirmed the presence of a large mass in her spinal cord - exactly where our neuro exam localized it. pending histopathology, we hypothesize lymphoma. it was gratifying that the owner was very pro-necropsy - agreeing that examining her kitty's body was important for research and learning. and it was fantastic to see that our diagnosis was bang-on.

it was still very sad to see one-eyed willy leave us.

otherwise, i am very very sad that in 3 days, i will pass through the gateway to hell. there lies madness. i