Back to The Oaks

While I was home I thought it would be a good idea to see some practice, my first EMS as a vet student, just to remind me why I was at vet school and keep me motivated for the final half of this semester before the dreaded Finals!

I texted a friend who's a small animal vet at The Oaks, the first place I ever saw practice at, asking what days they were open over Easter and if it would be possible to spend a day with them - the reply came quickly that I could go the day after I got home, Thursday.

I arrived at 8am ready for consults to start at 8:30am where we had post-op checks, vaccinations and a dog who had just gone off his feet who Andy admitted for a neurological examination.

I then went out back to once prep and theatre started; the board was pretty full and Brian was doing most of the operations today.

We started off with two Fine Needle Aspirates (FNA's) on dogs, both which appeared to be fatty lumps rather than anything sinister but were sent off to the lab which can help make a diagnosis or rule out more sinister things like cancer.

Brian stressed the importance of taking true representations of the lumps, swap needles between each biopsy and importance of labelling slides correctly!

Next up we had neuters for a local cat charity - two castrates, one of which came in as a possibly pregnant feral cat but turned out to be a quite friendly little man, followed by a spay on a young female who once turned out to be pregnant once we'd opened her up. 

I've seen pregnant cats spayed before so when Brian asked what I thought about the ethics I was ready with an answer; the procedure is being done for birth control purposes so leaving her to have the kittens on the street would only make this situation worse as not only would she have more kittens in the future but so would her kittens continue the cycle as there's no guarantee that she would be trapped again in order to be speyed in the future.

Before he started the spey Brian the vet asked if I'd like him to talk me through the op, I said I'd seen loads before so he was ok, he double checked I was sure, yep... and so said I had to talk him through what he was doing!
Luckily we did the female urogenital tract in Anatomy last week so it was fresh in my mind and I remembered the abdominal muscles as he was cutting through those. He pointed out that I was naming everything in Latin rather than English and I think (hope!) he was impressed that I could name all the structures.
Andy asked me later on about the endocrine system and although I've done it all before it was years ago and I didn't have a clue! Once he explained it came straight back to me and made sense but I wouldn't have been able to come up with the answers by myself...

It looked like they were getting through the ops board just fine when a cat was admitted in a diabetic or hypoglycemic crisis. He looked a lot better than he had at home where he was circling around the living room, but we took a blood glucose and got a reading of 3.2; it should be between 5 and 15.
He was really cold so put in a cat kennel with a heat pad, some warmed smelly cat food to tempt him and we would repeat blood glucose an hour later.

The last op of the day was a dental on an English Bull Terrier with Cushings disease which is an endocrine disorder usually caused by a tumor on the pituitary gland which causes an excess of cortisone in the blood, affecting metabolism. Because of this they wanted to closely monitor her throughout the anesthesia and keep her on a drip to support the kidneys. 

They really struggled to place a catheter to get the drip in, tried both legs, took a break and then tried again - it said in her notes from 2 years ago that they really struggled back then too.

I monitored her heart and respiratory rates throughout the scale and polish and although they were lower or slower than expected, she was stable throughout and recovered just fine.

The diabetic cats blood glucose stabilised and as he was on insulin they adjusted his medication and timing and were going to monitor it closely for a while.

I really enjoyed the day and felt like I was able to help out and be useful rather than getting in the way, holding animals while they were injected or sedated, wiping down consult tables, helping to pre-med animals with the nurses before surgery and cleaning theatre ready for the next op.

Only cats and dogs in the vets today. This morning I was watching surgeries, a dog had a growth removed from his nose, tom cat neuter + cat spay (both were rescue cats had ringworm) and one the the vet nurses cans had its right hind limb removed - there was swelling around the joint and the x-rays and the bone didn't have a clear edge and the vet thought the femur was going to collapse. It was really interesting to watch, the sciatic nerve had to be cut, then the bloody supply, a hack saw was used to cut through the femur.
The cut is made quite high up, so that the animal knows there is no leg there and so that they don't try and use a stump of the leg.
Once the bone was removed and Andy was taking a sample, the bone collapsed in his hand so it was good that they removed it in time and that it didn't collapse under the weight of the cat.

In the afternoon I sat in on consults with Brian, one of the other vets.

Day 2

Second day at the vets this week.
This morning I saw a tom cat castration, 2 dog eye surgeries - one dog had a lump on its lower eye lid that needed to be removed and sent for biopsy, the other had a lump on its eyelid that needed to be removed on one eye, and the other eye had an ucler and the eplithelium wasn't forming right and not binding to the surface of the eye. So they used a flourescent dye to stain the eye, they used a scalpel to scrape away the epithelial layer, then a fine needle to create a grid on the surface of the eye to help it heal and bind together. Next the guinea pig was in from the consultation yesterday and it had its growth removed, some investigative surgery on a dog and a ferrel cat spay was done - the cat was still in the trap and the vet nurses had to use grabbers to get it out.

Back at the vets

I've been at the vets in Bourneville today.
Surgeries this morning, then I sat in on consults this afternoon with Andy one of the vets.
There were cat dentals, and one had 2 teeth removed.
There was a tom cat thats been in for a week with bladder problems that hasn't been passing water, so they performed a perineal utherotstomy - a cut is made around the cats penis and using forceps, slowly forcing away the tissue to get to the muscle, then carrying on another few cm's. The muscle is cut, and as the catheter is left in the urethra, a cut is made down the urethra, catheter removed, and once the urethra is wide enough to pass water, it is sutured to the skin to form an opening wider than the penis for the cat to pass water. The end of the penis is removed, and the urethra sutured all the way around the skin - it was really delicate surgery to watch.

This afternoon was routine vaccinations, booster vaccinations and post op check ups.

More Practice

I've done a few days of work experience this week at a vets in Bourneville, about 35 minutes away from me. My mom has been dropping me off there, because she works in Birmingham so it's not too far for her.
It's been really good because I've known one of the vets there for years, so I've been able to ask him questions and things like that, and then he offered for me to go there and see practice with him in March, and now I'm back again.

I've seen a lot of operations and sat in on consultations with a few of the vets. There were a lot of castrations/spays, and lots of people coming in for booster vaccinations.There was only really 2 emergencies which came in, a puppy with parvo virus, and a spaniel with its leg cut open. The parvo case was interesting, as it was a new puppy to the owners, and they bought it in, it was kept in overnight and treated with a drip. It had runny/bloody diarrhea and the bloods sent off to the lab had low white blood levels. We were having to disinfect everthing as we went as it was so contageous, and wear gloves and the puppy was kept in isolation so the risk to other dogs was really low. Unfortunately it died and the owners contacted the breeders, who didn't accept responsibility.
I saw a few animals being put to sleep, which isn't nice, but has to be done. If they're in a lot of pain, sometimes its the kindest thing for the animal.

2nd Day in a Vets

Today was the 2nd day I've spent observing practice - I got in at 8.30.
This morning I observed consults, and after each consultation I cleaned the consult table which needs to be done so that no germs or bacteria are left on surfaces or equipment. Cross contamination can cause big problems, so it needs to be stopped.
Then I went and observed surgeries - I was shown how to insert an endotracheal tube into a dogs wind pipe (trachea), which is used to give the animal anaesthetic gas. I then got to insert an endotracheal tube into another dog.
I saw an operation on a cats hip which was interesting.
When the cat's operation was finished, straight away a border collie which had been run over came in. It has a dislocated hip and a crushed foot, so the kindest thing to do was to euthanize it.
Another cat was bought in which had to be euthased.
After the rush I cut up some blue surgery cloths and folded them into bags. All of the surgery equipment and tools needed for each operation is sorted out and packed into bags and sterilised in the autoclave.
A cat castration pack contains surgery cloths, all the equipment and tools required, surgery gloves, a mask and surgery cloths.
I left at 7.30, so today was a really long day.

1st Day Seeing Practice

Today was the first day I've spent observing in a Vets Practice.
The place where I went is in Bourneville - about 40 minutes away. I got there at 8.30 and met the Vet Nurses and Vets and then the patients started being checked in.
I saw a few Cat and Dog spays (female) and castrates (male) which are done for different reasons including preventing pregnancy and tumors.

I also looked at the X-rays of different patients and then sat in on the consultations with owners.

Not having one myself, I learnt how to sex a cat today! It's quite easy though.

I saw my first euthanasia - it was a female Rottweiler with a huge bone tumor called an osteosarcoma on her shoulder. I was sitting in the corner while the consult was going on and understandably the family were really upset and loud when she was put down.
Her muscles relaxed after she was PTS so she messed on the floor, I helped Andy the vet clean up, put her into a big yellow bag and then she was sent off for cremation.
It wasn't really what I expected to happen, and it wasn't nice, but I was ok with it.