Monday, July 30, 2012

Day 42: Pneumonia, Broken Leg Check-up, Toe Removal

                Today was pretty slow besides some Technician appointments and a few Doctor appointments; there were no surgeries and really nothing unusual today.  A cool/more-so uncommon patient we had today was an Abyssinian Guinea Pig named SuperYou (we haven't had many guinea pigs; we mostly get dogs and cats [companion animals]).  The owner brought him in because he was coughing, having a hard time breathing, and not eating.  Dr. Lou (who sees exotic animals [guinea pigs, rabbits, birds, reptiles, etc.] in addition to companion animals [cats and dogs]) looked at him, and she believes that he has pneumonia.  She prescribed Bactrim (an antibiotic specified towards pneumonia) and Critical Care (a mixture that is ground up and mixed with water to form a gruel, then fed or force-fed to the animal to give them nutrients and to get them to start eating again) for SuperYou (after giving him some sub-q fluids), and let him go home.

SuperYou, the Abyssinian Guinea Pig.

Giving SuperYou sub-q fluids.

                In addition, we also had a returning patient: Pete Pebbles from day 12 (he was the cat whose leg had been broken for five weeks, yet the owner didn’t bring him in all that time).  Pete Pebbles had already been back once for a check-up in between day 12 and today, but it was at a time when I wasn’t there so I was unable to report about the check-up.  But anyways, Dr. Mark took off Pete Pebbles’ cast and looked at his leg, and then moved it around to make sure it moved okay.  He was happy with the results, so he gently pulled the rod out.  However, the outer toe on Pete Pebbles’ foot was dead and nearly half-dethatched from his foot.  I’m not exactly sure how that happened, but the toe needed to come off.  Dr. Mark finished cutting through the rest of the skin to the joint, and then removed the joint.  He then stitched the small hole closed and bandaged up both the toe and leg.  Pete Pebbles was then able to go home.
Pete Pebbles.

Taking off the cast.

Pete Pebbles' leg and toe.

Gently moving the leg around to make sure it's okay.  Part of the rod can be seen slightly sticking out at the knee.

The rod after taking it out.

The half-off toe.

A closer view of the toe.

Cutting through the remainder of skin to the joint.

Removing the joint/toe (this is essentially the same to the removal of the joint in a declaw).

The foot after the toe being removed.

The removed toe.

Re-cleaning the area to be sewn up.

The area after being sewn up.

The bandaged (not casted) foot and toe.

Day 41: Necrotic Tissue

               Today (as normal) we had Technician appointments and Doctor appointments throughout the day.  In the morning, we had a Chocolate Lab named Charlie that had necrotic tissue all over his chest.  His owner had brought him in on Saturday as an emergency, but the doctors were so booked with appointments and other emergencies (life-threatening ones, like bloat/twist); so, since this wasn’t life-threatening, Dr. Todd wrapped the wound and asked the owner to make an appointment for some time this week (which he did for today).  The wound was... pretty gross; as Dr. Todd had said, it covered the middle area of his chest and was bloody, pus-filled, and made up of lots of cysts, dead skin, and bruising.  Talking to some of the other doctors and looking at his chart, Dr. Todd surprisingly found out this is a reoccurring medical issue on Charlie; Dr. Kris had removed something similar to this on his chest three years ago, and Dr. Mark had removed something similar a year or two ago.  They don’t know what causes it, nor how make it stop reoccurring; the best they can do is remove the area and hope it doesn’t come back.  Dr. Todd took Charlie into surgery and removed the area; and after the surgery, Charlie seems to be doing fine, and doesn’t seem to feel as uncomfortable/strange in his chest area as he did before.

Charlie waiting for his surgery, with his bandages on from Saturday.

The wound-area on Charlie's chest.  As I said, it was pretty strange-looking and kind of gross.

Beginning to remove the area.

Finishing the skin-deep incision.

Tearing/cutting through a fat layer in order to seperate the infected area from the rest of the body.

The infected area once removed.

The large area that was taken off (it looks a lot bigger than the area taken off, but remember: skin stretches, so the area taken off looks small while this area looks large).

Begining to stitch up multiple fat and skin layers in order to make the skin opening closer together.

As it can be seen, with continued stitching of layers, the area is getting smaller...

...and smaller. (We had a huge rush of appointments around the end of this surgery, so I was unable to get a picture of the finalized stitching because I was needed to help the Doctors and Technicians.)

Thursday, July 26, 2012

Day 40: Vestibular Syndrome Description

Not too much happened today—lots of chores were completed, and some Tech appointments were carried out.  We had a new patient in the recovery room as well: a Golden Retriever named Rosie who has Vestibular Syndrome (The vestibule is a cavity in the inner ear canal that maintains balance with the help of the semicircular canals).  Vestibular Syndrome causes the dog’s head to continuously tilt, throwing off the dog’s balance, as well as causing rapid and crazy eye movement, body rolling, falling, and circling. The cause is unknown, but it’s assumed that part of the side of the cavity is damaged, causing the balance to be thrown off.   Vestibular Syndrome is treated based what is causing it (ear infections, head trauma, nerve damage, etc.), and the causes are decided by the test results (blood work, physical examinations, neurological exams, X-rays, etc.) obtained by the Veterinarian.  Vestibular Syndrome isn’t enjoyable at all for the dog; so it’s important for the owner to remain patient and help their dog as much as they can throughout this process (as they should with any issue their pet is having).
Rosie, the Golden Retriever with Vestibular Syndrome.  As it can be seen in the picture, her head is tilted, and her eyes look a bit dazed.  Her eyes were also darting around a lot.

Monday, July 23, 2012

Day 39: Tubing Description, Dentals, Vaccines

                Today was similar—nothing too much besides Tech appointments, a spay, and a couple of dentals.  The dentals were done on two long-haired Dachshunds named Mamota and Fey.  Lauren taught me how to tube an animal for surgery/dentals today; after the animal has been given its anesthetic injection (Propofol or Ketamine Valium) and relaxes/slips into unconsciousness (happens pretty much the second the injection is given), we sit an animal upright and, while another Tech or doctor opens the mouth and pulls the tongue out, the person tubing the animal takes an endotracheal scope (basically a flashlight with a tongue blade), pulls down the epiglottis (the flap at the back of the throat that leads to the trachea), and slips an endotracheal tube down.   The animal will cough/wheeze a couple of times when we do this, but that’s a good sign; that means we have the tube in the right spot down the throat, and it also means that the animal has a correct/normal reaction to this process (so no problems are arising).  The tube is then quickly tied to the animal’s muzzle or head (so the animal can’t cough the tube out), the cuff is inflated (to act as a seal between the tube an muscle tissue of the trachea, and to prevent minimal leakage/exchange of fluids or air [that aren’t in/from the tube/anesthesia machine] in the trachea during the surgery), and the animal is hooked up to the anesthesia/oxygen machine; after the anesthetic injection is given, all of this is done within about thirty seconds.  While Lauren performed/showed me how to do the dental(it’s pretty much the exact same procedure as a human teeth cleaning/check—scrape off plaque, check for bad teeth, rotted areas, gum problems/pockets, etc. and then place fluoride on the teeth.  If any problems arise, the Technicians tell the Veterinarian, and the Veterinarian decides whether the tooth/teeth have to be removed or not.  In most cases, teeth are removed), she also showed me how to set up the tools/machines (something I already sort of knew how to do from watching past dentals) and let me mix and inject the booster and rabies vaccines.
Mamota, the long-haired Dachshund I helped work on.

An endotracheal scope (basically a flashlight with a tongue blade), and an endotracheal tube.

An endotrachial tube with a cuff (the bubble-like part towards the bottom end that does into the trachea).  All endotracheal tubes need this cuff.  The thin tube sticking out of the right side is the sube that all ows the cuff to be inflated and deflated, by a syringe (as shown in the picture).  The top plasic part of the tube is connected to the tubes from the anethesia/oxygen machine.

Diagram of a dog's mouth, nose, and throat.  The parts circled in green are the epiglottis (from side and top views), which is the flap in the back of the throat that covers the trachea, and needs to be pulled down with the tongue blade of the endotracheal scope so the endotracheal tube can be put in place.

An example of two Technicians tubing a dog.  One Tech is holing the top of the muzzle/mouth up and pulling the tongue down so the mouth can be wide open, while another tech pulls down the epiglottis with the endotracheal scope and inserts the endotracheal tube into the trachea.

Day 38: Hypertension

                Today there were a few Tech appointments, as well as a spay, a couple of neuters, and a dental; but really nothing besides that.  Another interesting case that we had today, though, was a Bassett Hound named TK.  He was coughing a lot and having trouble breathing, so his owner brought him in to get looked at.  However, Dr. Todd did many tests on him and couldn’t figure out what was wrong; his blood work, X-rays, ultrasounds, etc. all looked fine.  Finally, after a while of preforming multiple tests and finding nothing wrong, Dr. Todd took his blood pressure; discovering that TK had hypertension (high blood pressure, usually caused by some sort of stress).   Unfortunately, sometimes certain problems can be hard to detect, such as in this case.

Sunday, July 22, 2012

Day 37: Lump Removal and Blocked Urethra

                Today, in addition to some Technician appointments, we had two new patients in the recovery room: the first named Beefcake, who is a Border Collie mix, and the second named Adonis, who is a Domestic Short-Haired cat.  Beefcake was in for a well-needed lump removal; he had a huge lipoma (a harmless growth of fatty tissue) on the outside of his back right leg that covered nearly the entire area of the outside area of his thigh, which Dr. Mark removed during the afternoon.  Adonis was an emergency patient who came in sometime early morning.  He had a blocked urethra (from bladder stones), and he couldn’t urinate because of that.  As a result, his bladder was extremely large because it kept filling up with urine that it wasn’t able to get out.  Dr. Mark performed surgery on him as well (though during the early morning), and by the time I saw Adonis, he was recovering in his cage with a catheter draining urine from his bladder into a small IV bag.  His urine was very bloody, but this is normal for the time being, since he had had so many problems with his bladder and with urinating before he had his surgery.
Beefcake, the Boarder Collie mix.

The lipoma that was removed from Beefcake's thigh.

Part of the large area that the lipoma took up on the thigh (picture taken after it was removed).

Adonis, the Domestic Short-Haired.

Adonis was a bit chubby, but very cute and suprisingly friendly for being in as much pain as he was in.

The IV bag that was collecting his bloody urine (this was taken during surgery and right after the bag had been emptied).

Flushing the urethra to ensure all the bladder stones were out.

Adonis a bit after his surgery; he felt so much better!  He was able to sit up and walk again without being in a lot of pain, and he wanted to be pet and played with.

Sunday, July 15, 2012

Day 36: Severe Poisoning

                Today was slow again.  Chores and a few technician appointments took up most of the day.  We had two new patients in the recovery room: a Pug named Charlotte who was recovering from her pyometra surgery, and a Persian cat named Frisco who was having seizures and heart problems.  Both of them went home during the early afternoon.  In addition, during the later afternoon, we had an emergency that came rushing in; a six year old Lab/Dane mix named Scruffy who was seizing, twitching when he wasn’t seizing,  having bloody diarrhea, foaming at the mouth, etc.  Catherine and one of Scruffy’s owners rushed him into the back area where we work on a blanket, and Dr. Kris and Dr. Lou began rushing around trying to figure out what was wrong with him and what to give him (medicine-wise) to calm him down.   Dr. Lou started by giving him valium to stop the seizing (which it did, and nearly as soon as she injected it), and Dr. Kris went to talk to the family to see what they knew and try to figure out what exactly was going on.  When she came back, she said that Scruffy’s problem could be a number of things and she really didn’t know what it could be.  Heat stroke, Isoloma (a plant that causes problems when ingested), poisoning (from a palm, gum, etc.), bacterial growth, etc.—they didn’t know.  He was still breathing heavily, and he had a blood sugar of 20 mmol/L (extremely low), a heart rate of 180 BPM, and a temperature of 104 degrees.  Dr. Lou had me give him Dextrose solution so his blood sugar could rise, Ampicillin to fight off any bacteria in his respiratory tract, stomach, and/or urinary tract, and IVs and sub-q fluids to hydrate him and cool him down (after a little while his blood sugar rose to 105 mmol/L, and his temperature went back down to 98 degrees).  While the doctors were trying to figure out what was going on, I sat by Scruffy for over an hour and a half—making him comfortable with blankets and pillows, stroking his head, wiping his saliva and tears, giving him the fluids and antibiotics the doctors asked me to give him, etc.  Scruffy was in a lot of pain (as I said, he was crying), and he was whining and crying out the entire time.  I felt terrible for him… and I felt even worse because I didn’t know what I could do.  Since I’m not a doctor, there’s nothing I really could do; that’s why I was sitting by him and taking care of him, since that was the only thing in my power that I knew I could do for him.  I absolutely hate the feeling of helplessness, and that’s how I felt while I was sitting with him. But at the same time, even though I feel awful for the animal during times like these, it’s also these times that I remember why I want to become a Veterinarian.  I absolutely adore these animals, and I want to be able to help them.  I don’t want them to be in pain or suffering in any way; I want them to be healthy and happy.
Frisco the Persian.  He was a bit cranky. 

Charlotte the Pug.

Scruffy when he first came in; Dr. Lou was injecting the Valium to get him to stop seizing (Catherine was holding him fairly still so Dr. Lou could inject it without hurting him or missing the vein).

Scruffy when he started to calm down.

 Around the time that Scruffy came in, it also started to become really busy; the doctors were starting to have appointments scheduled so lots of animals were starting to be brought to the back and the doctors were trying to do the appointments as well as take care of Scruffy.  After taking care of a couple appointments, Dr. Kris went back in to talk with the family again.  When she came back, she had a pretty good idea that something had poisoned Scruffy—the lady has a palm plant in her house (which she had also just trimmed yesterday, so maybe he ate a piece off the floor rather than off the plant), and Scruffy also likes to go through one of the son’s garbage bins (in his room), which he throws gum into a lot.  Therefore, Dr. Kris and Dr. Lou believe that he may have ingested gum or part of the palm plant.  They gave him some antibiotics and some charcoal to make him regurgitate, and Nancy and I moved him to the corral so he could rest there and let the medicine and charcoal do their jobs.  After this incident I went home for the day, and I hope he’s doing okay.  I’ll have to check on him again tomorrow!

Day 35: Chronic Heart Failure and Constipation

               Today was another slow day, filled with a lot of chore responsibilities. We had a few technician appointments again, but no surgeries or any emergencies. There were two new patients in the recovery room that came in sometime last night: the first was a Pomeranian named Zoey (who has a lion haircut—adorable!), who has Chronic Heart Failure, and the second was a Domestic Short-Haired cat named Trixie who was constipated. Zoey was very tired and seemed to be having trouble breathing, so she was placed in a special cage with a plastic window-like door what was hooked up to an oxygen machine, so she would be able to be in the cage and receive the oxygen without any oxygen escaping and/or mixing with the air in the hospital. She began to become more lively as the afternoon came around (and she started to really want pets and attention), and she was, in fact, able to go home later on in the afternoon. Trixie was in a lot of pain, and she was walking around her cage  slowly and in a strange position; either sort of squatting down with her back legs parted, as if she was trying to go to the bathroom as she was walking, or slowly walking on her tip-toes with her back legs stick-straight.  The doctors had been observing her and trying to help her get the stool out of her colon by massaging/pushing her colon while trying to pull the stool out, the same way Dr. Todd had helped Faith from Day 13 (though Trixie wasn't nearly as constipated as Faith had been).  They seemed to be able to get most of the stool out, so she was given some sub-q fluids and was sent home with lots of wee-wee pads covering her carrier (even though they had gotten most of it out, she was still a little constipated and was dripping; however, the doctors said she should be able to get the rest out on her own, which is why she was able to go home).

Zoey, when she first arrived, in the special oxygen cage.

Zoey as she started to feel better later on in the morning (she began picking her head up, looking around, and wagging her tail).

Zoey as she began to feel even better in the sfternoon (she was now getting up, eating, and craving attention and pets).

Zoey as we were getting her ready to go home (patient release).

Trixie, the poor constipated cat.

Day 34: Recovering Patients

Today went back to being a slow day—most of it was spent cleaning around the hospital, doing chores and cleaning tools/equipment.  There were a few nail trims and wellness tests we attended to throughout the day, but not very many.  When I wasn’t helping with these few appointments, I was washing food and water bowls, litter boxes, and cages, sweeping and mopping the floors, washing/disinfecting surgical tools, and cleaning the stray cat ward and giving all the cats and kittens new blankets, food, water, and toys.  Ippy and Mack were both still in the recovery room recovering from their surgeries yesterday; both of them seem to be doing a lot better!  They both were still resting, of course, but they both seemed a lot happier than they were yesterday.  We also had a little terrier named Roxy come in sometime last night who has pancreatitis.  She must have been doing very well, because she was able to go home later in the morning.
Mack right after waking up from a nap (his tail is wrapped because he was having bloody diarrhea [common happening after a dog gets its stomach un-twisted], so we wrapped his tail so that the mess wouldn't get on his tail).

Ippy resting in her cage.

Roxy the Terrier.