Veterinary Internship: Day 20: Diabetes Mellitus, Cushing's Disease, Pancreatitis, Hemorrhagic GastroEnteritis, Unfortunate Death, Corneal Ulcer, Lymph Node Cancer, and a Baby Bird

The recovery room was much more packed today (as opposed to yesterday); there was a Retriever/Lab mix named Kobee in the corral, a Yorkshire Terrier named Rudy, a Retriever mix named Bailey, and Jett and Tex were both still in there as well. Kobee has diabetes mellitus (a common form of diabetes) and Cushing’s Disease (caused by Cushing’s Syndrome [which is high levels of the hormone cortisol in the blood], with high levels of Adrenocorticotropic hormone [released in response to stress] from the anterior pituitary gland). He had a fever symptoms (odd hot/cold temperatures and was drinking lots of water), so was receiving insulin and Covonia, which helps fight cold and flu-like symptoms. Rudy has pancreatitis, which is an inflamed pancreas. The pancreas releases digestive enzymes, helps neutralize the acid in the upper gastrointestinal tract, and releases insulin into the bloodstream to help regulate the cells’ intake of glucose. When the pancreas is inflamed, it releases those digestive enzymes prematurely (which can cause all sorts of problems), and it doesn’t neutralize or release insulin the way it should be. He is on Buprenorphine to help ease pain, and he is also taking Cerenia to help stop his vomiting. Bailey has HGE, which is spontaneous release of diarrhea (typically smelly, bloody diarrhea). She was leaving when I arrived, and the poor dog had an episode of HGE right as she was leaving. She was going home with some antibiotics, so hopefully she’ll be better within the next couple of days and her episodes will stop. Tex was continuing the same treatment as yesterday, and he went home in the afternoon (we didn’t think he was ready to go home, but we think that the owners didn’t have enough money to keep him at the hospital under treatments any longer).

Kobee, the Retriever-Lab mix.

Rudy, the Yorkshire Terrier.

Bailey, the Retriever mix.

Jett was also receiving the same treatment as she had been yesterday, and she was in the closed cage receiving saline nebulizer treatment when I arrived. She was walking around and acting, for the most part, fine. Around mid-morning, Jen took her out to go for a walk, and she collapsed and aspirated in the hallway. Jen rushed her back to the main area, and she, Pat, Nancy, and Dr. Todd hooked her up to breathing machines and monitors, I helped grab materials and do whatever they needed me to do or get whatever they needed me to get, and Jen and Pat began giving her CPR; Jen gave her chest compressions while Pat used an oxygen machine to pump oxygen into Jett’s lungs (at appropriate intervals relevant to Jen’s chest compressions). After a minute or two, they were able to get her heartbeat back, but it was too late; her brain was already gone so it didn’t make any difference. She had a lot of bloody fluid coming out of her mouth (the fluid that was in her lungs), so Dr. Todd took a sample of it and was going to look at it later to see what kind of infection it was. It was really sad, though. That was the first time I’ve seen a true emergency (trying to bring an animal back to life, I mean), and since she seemed to be doing fine before it was a shocking and unexpected happening. It was a difficult thing to watch/help with because everyone was doing everything they could to bring her back, but when it came down to it there was nothing that could be done. I felt completely helpless…and that was a hard thing to experience. I realize not every animal can be saved, though, and I’d rather have this happen than her be in a lot of pain.

Everyone frantically working with/around Jett to bring her back to life (this was taken after I had done all I was able to do).

Other patients we had come through today were a Poodle named Missy, a Domestic Long-Haired cat named Lycan, and a bulldog named Buddha. Missy was getting a recheck on her left eye, which was healing from a corneal ulcer. Dr. Karen let me look at it through the ophthalmoscope after she did, and I could see all the blood vessels on her cornea; Dr. Karen told me all the blood vessels meant the ulcer was healing (as I said on day 14, the doctors would numb the eye that had a corneal ulcer and then gently scrape it with a needle to draw blood vessels to the ulcer, which would make it heal). Lycan had rashes on his body from most likely an allergy (Dr. Roberta said it was most likely a food allergy). She took some hair samples from the areas of the rash and placed them in a fungal culture to see if he had ringworm, and she also took him into a dark room and looked at the rashes with a UV light to see if the rashes were caused by ringworm (some forms of ringworm cause the hair in the rashes to glow). The fungal culture and light test both came back negative, so it most likely was an allergy. She sent Lycan home with some antibiotics, and told the owners to be careful with what they feed Lycan (like Dr. Todd did with Booshka’s owners on day 9). Buddha originally came in to receive vaccines, but when Dr. Karen was doing a quick check-over on him she discovered that he had lymph node cancer; his lymph nodes were huge! Dr. Karen said that a lymph node is very tiny (the size of pea, give or take a bit smaller or larger [depending on the size of the dog]). They can’t be seen or felt, but Buddha’s lymph nodes were at least the size of golf balls! His owner had no idea about it, and he was really torn up when he found out about it. Because of this, Dr. Karen didn’t give him vaccines and instead talked to his owner about treatments and such. When she finished her appointment with Buddha, she took me to her desk and showed me a book about lymph node cancer, which included a normal lymph node (mostly small lymphocytes) and the different kinds of lymph node cancer that an animal can have, such as Eosinophilic Lymphadenitis (small lymphocytes with medium lymphocytes and eosinophils [white blood cells containing granules]), Pyogranulomatous Lymphadenitis (inflammatory cell with degenerate neutrophils [neutrophilic white blood cells] and macrophages [large bacteria-absorbing cells]), and having a reactive lymph node (abundance of lymphocytes, both small and medium-sized, with plasma cells). Also, one of the night techs found a baby bird (don't know what breed) sometime yesterday, so they brought it in and were trying to keep it warm and fed. It was in a small box with a rubber glove filled with warm water, a blanket of tissues on top of the glove, the bird on the tissues, and a tissue folded as a blanket on the bird. Tracey took it home when she went home to try and see if she could raise it and keep it from dying, but the bird was so small and fragile no one is sure what would happen; most of us think it will probably die before tomorrow. But we will wait and see what happens and hope for the best.