Veterinarians are trained as generalists. Unlike MDs, we are not required to do an internship and residency, although those programs are available. As a result, we learn a little bit about everything. We go through classes ranging from large animal reproduction to exotic animal medicine. It can be extremely challenging to be a good veterinarian for this reason. Everyone has their strengths, and certainly, everyone has their weaknesses.
My biggest weakness is definitely orthopedics. I don't like bones - broken or intact. I don't like trying to localize vague lamenesses. Palpating for a cranial drawer sign (as found in a torn cruciate ligament) is a challenge for me. When I see a dog present for "limping" - I automatically get nervous. Unless it is an obvious, traumatic fracture, these can be very difficult to sort out. There are a variety of reasons for this. First, we are an emergency service. As a result, we do not have the time to do extensive, multiple views of legs as is necessary sometimes for complex orthopedic problems. Secondly, it can sometimes be very hard to sort out bony pain from soft tissue pain. There are fractures, tendon tears, ligament tears, muscle strains, tendon strains, and every variant in between. In the frantic pace of the ER, sometimes sorting this out is just not possible.
If I can't determine the source of lameness, I generally prescribe an anti-inflammatory for pain, as well as tramadol (Ultram) for pain control. I then recommend the owner cage rest the for X amount of days, then follow up with their veterinarian. After all, as an ER doctor, there isn't much I am going to be able to do unless the leg is broken and needs a splint. I don't do orthopedic surgery.
Tonight, I am relaxing on the couch with my orthopedic notes from vet school (how sad, I know!) and reviewing common orthopedic problems of the dog and cat. I'm then going to brush up on my blood types and the like, as I realized my brain is starting to forget a lot of the things I used to know. I'm not sure if this is "baby brain" or just "old" age.
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