I've seen all sorts of things since I updated last and it would be dead boring to run through a list of them all. Highlights have been an increase in the number of testicles I have lopped off, a dog with onychodystrophy, a labradoodle with epilepsy, some yummy chocolate brownies, an ex-lap to hunt for a cause of cholestasis, an entropion-fixing operation, interesting clients, a necrotic tail tip, removal of the anal glands, listening to gallop rhythm cats, blood glucose monitoring, tooth rasping, a difficult case of mud fever management, cracking lemon drizzle cake and a dog with a ventricular septal defect. I will also never cease to be amazed by the amount of animals which are riddled with fleas or ear mites. Grim!
I have spent an awful lot of time peering into the eyes and ears of all the anaesthetised patients to try and improve my experience of looking into these orifices! It's a lot easier when the patients are anaesthetised and makes me swifter when dealing with the live & kicking ones. Talking of anaesthesia I was 'in charge' of anaesthesia on Friday morning and everything went under and got back up as planned. Words can't do justice to the feeling of relief! I have also worked all week on improving my pussycat handling. Having never had pets as a child I never spent much time manhandling cats or kittens and I think they can sense my cack-handedness. Little triumphs this week include tabletting my first ever cat (something I had managed to avoid until now!), tabletting five more and improving intramuscular jab technique for triple anaesthetic.
Last week I was looking after the family dog whilst my parents were away. Whilst it was a delight to have him around for walks at lunchtime, it was fairly exhausting making sure he & I both got enough exercise. I was relieved when they came back at the weekend.
It has been a really long week, but I really enjoy the work. It's slightly depressing to work all the hours under the sun for no financial reward; I imagine the counter argument to that would involve the experience freely given. Considering we're not able to act without supervision and in some cases we require a lot of supervision, but in other cases I think the practices get very good value for money.
One more week of mixed practice and then we're off to Wales. Tally ho!
Sunday 4 March 2012
Wednesday 22 February 2012
Testicles: 4 pairs and counting
I'll fill you in on what I've been up to tomorrow, I promise. This is what two of the cats looked like when they came around.
Monday 20 February 2012
Full speed ahead...
Long old first day, but a brilliant one. Morning in surgery and afternoon in consults.
1. 2x castrates. One very small set and one average set whipped off (closed technique) and scrotum glued.
2. GA and xray on a terrier with a sore toe. Not broken, but some DJD in the interphalangeal joints.
3. Lipoma removal and spay op on an older dog. Uterus iffy and ovaries all polycystic so better out than in. Lipoma shelled out nicely. I had scrubbed in because we weren't sure what they spay would be like and got to practise my sewing. It was very neat and getting less cack-handed each attempt.
4. Cat spay for charity. Very quick and neat. Flank entry.
5. Ultrasound exam on canine abdomen looking at the liver. Enlarged.
-Brief interlude for clearing up, hoovering, mopping and lunch-
Consults included:
1. 2x castrates. One very small set and one average set whipped off (closed technique) and scrotum glued.
2. GA and xray on a terrier with a sore toe. Not broken, but some DJD in the interphalangeal joints.
3. Lipoma removal and spay op on an older dog. Uterus iffy and ovaries all polycystic so better out than in. Lipoma shelled out nicely. I had scrubbed in because we weren't sure what they spay would be like and got to practise my sewing. It was very neat and getting less cack-handed each attempt.
4. Cat spay for charity. Very quick and neat. Flank entry.
5. Ultrasound exam on canine abdomen looking at the liver. Enlarged.
-Brief interlude for clearing up, hoovering, mopping and lunch-
Consults included:
- Vaccinations
- Re-examination and vaccinations
- Rabbit exam and myxi vaccinations. Also toe clip. Good refresher of how to restrain, exam and vaccinate wabbits.
- Stitch removal for a castrate op.
- Bloods for a doggie with endocrine disease.
- Toe clip for an ancient doggie.
-Afternoon gap for 30minutes (brightened by the introduction of doughnuts)-
- Ear exam and cleaning for a boxer
- Re-exam for lameness
- Ophthalmic re-exam following ulcer therapy
- Unwell and lameness exam
- Stitch removal for lump excisions
- Anal furunculosis re-exam.
- Pregnancy ultrasound. No puppies :-(
I've probably forgotten some, but the small animal consults go so quick that a few slip out of my mind. It was a really good day for learning; the practice I go to are just fabulous at letting me get involved. Definitely a challenge getting my head into small-animal gear though!
Saturday 18 February 2012
Scanner time!
16.02.2012
Only saw one appointment today once I got back from the GP. Disappointing!
Big blue roan chunky boy with bilateral swelling behind the ears. Spongy and seems to communicate. Scanned with ultrasound and the texture looked spongy/soft tissue with no large pockets of fluid. This was the second scan, revisiting because they have flared up again and seem to cause ridden discomfort (head shaking/dropping). Going to go away and increase work to see what occurs and work from there. Diagnosis subnuchal synovial bursitis.
17.02.2012
1. Vaccinations for a grey event pony. Late for appointment due to ridiculous road closure and non-existent diversion. In, out, shake it all about.
2. Bandage change for a lovely bay mare with an injury to her left metatarsus. Wound looks good and has a lovely pink granulation bed. No sign of infection and the wound beginning to contract nicely. Re-bandaged under pressure with an Allevyn dressing and Intrasite gel. Re-bandage on Monday. Also dropped off some Regumate for extremely hormonal little companion pony. She was kyoot.
3. 'Swollen bottom' on an old grey show pony with a very lovely elderly owner. Wasn't sure what to expect from a presentation of 'swollen bottom'; it actually seemed to have oedema around the tail base and anus which was a little pink and warm. It didn't seem to be itchy and wasn't very sore. No obvious puncture wounds. Dispensed steroid cream and bute. Advise to keep a close eye on the old fella.
4. Xrays on a very, very sore 20y/o grey showjumping pony. Was sore in front and now sore all around; constantly shifting his weight. Took lateral xrays on all four feet, but no apparent signs of laminitis upon development. [Must remember to look up basic xray settings...58kV and ?mAs] Advised to soak all hay fed for at least 24hrs and minimise feed to just enough to disguise bute (BID).
5. Back in the clinic xray and scan on the back of a big dark bay welsh x tb following an acutely painful back and poor muscling of the longissimus dorsi muscles. Medicated the facet joints under ultrasound guidance with depomedrone and used needle therapy with saline. Sedated with dom & torb + a little ACP.
6. Last, but not least, an ultrasound scan the left metacarpophalangeal joint of an ex-showjumper which was swollen and painful. Sedated with dom & torb. At the level of the proximal sesamoids (landmark for annular ligament) the annular ligament was absent (possible previous surgery) and there were pockets of fluid and a mesotenon stalk-like attachment between the sheath and the tendon. There were also islands of calcification in the DDFT & SDFT which were showing up with comet trails on the scanner. These can be better visualised with an off incidence (slight tilt) to the scanner. The tendon goes from black to white on the screen and the little patches stand out more clearly - allows you to see more clearly where they are. Following a sterile scrub we drained the fluid and injected hyaluronic acid (anti-inflammatory properties) into the space. We wrapped all this up in a pressure bandage and advised box rest for at least a week to let him recover.
Cleaned up and headed home for the day. Back here in mid-May and I can't wait.
Only saw one appointment today once I got back from the GP. Disappointing!
Big blue roan chunky boy with bilateral swelling behind the ears. Spongy and seems to communicate. Scanned with ultrasound and the texture looked spongy/soft tissue with no large pockets of fluid. This was the second scan, revisiting because they have flared up again and seem to cause ridden discomfort (head shaking/dropping). Going to go away and increase work to see what occurs and work from there. Diagnosis subnuchal synovial bursitis.
17.02.2012
1. Vaccinations for a grey event pony. Late for appointment due to ridiculous road closure and non-existent diversion. In, out, shake it all about.
2. Bandage change for a lovely bay mare with an injury to her left metatarsus. Wound looks good and has a lovely pink granulation bed. No sign of infection and the wound beginning to contract nicely. Re-bandaged under pressure with an Allevyn dressing and Intrasite gel. Re-bandage on Monday. Also dropped off some Regumate for extremely hormonal little companion pony. She was kyoot.
3. 'Swollen bottom' on an old grey show pony with a very lovely elderly owner. Wasn't sure what to expect from a presentation of 'swollen bottom'; it actually seemed to have oedema around the tail base and anus which was a little pink and warm. It didn't seem to be itchy and wasn't very sore. No obvious puncture wounds. Dispensed steroid cream and bute. Advise to keep a close eye on the old fella.
4. Xrays on a very, very sore 20y/o grey showjumping pony. Was sore in front and now sore all around; constantly shifting his weight. Took lateral xrays on all four feet, but no apparent signs of laminitis upon development. [Must remember to look up basic xray settings...58kV and ?mAs] Advised to soak all hay fed for at least 24hrs and minimise feed to just enough to disguise bute (BID).
5. Back in the clinic xray and scan on the back of a big dark bay welsh x tb following an acutely painful back and poor muscling of the longissimus dorsi muscles. Medicated the facet joints under ultrasound guidance with depomedrone and used needle therapy with saline. Sedated with dom & torb + a little ACP.
6. Last, but not least, an ultrasound scan the left metacarpophalangeal joint of an ex-showjumper which was swollen and painful. Sedated with dom & torb. At the level of the proximal sesamoids (landmark for annular ligament) the annular ligament was absent (possible previous surgery) and there were pockets of fluid and a mesotenon stalk-like attachment between the sheath and the tendon. There were also islands of calcification in the DDFT & SDFT which were showing up with comet trails on the scanner. These can be better visualised with an off incidence (slight tilt) to the scanner. The tendon goes from black to white on the screen and the little patches stand out more clearly - allows you to see more clearly where they are. Following a sterile scrub we drained the fluid and injected hyaluronic acid (anti-inflammatory properties) into the space. We wrapped all this up in a pressure bandage and advised box rest for at least a week to let him recover.
Cleaned up and headed home for the day. Back here in mid-May and I can't wait.
Wednesday 15 February 2012
Small, but perfectly formed.
A couple of days of notes to catch up on...
14.02.12
1. Castrate on a 7m/o little bay Irish Draft fellow. Sedated with dom & torb and injected lignocaine locally around the goolies (testicle, neck, skin of the scrotum). Sterile scrub of the area. Clamped on emasculators for 4mins for blood vessels & another 4 minutes for testicles. Emasculators go on nuts to nuts for first clamp. No trouble, nice and quick. Small, but perfectly formed.
2. Scanned RF tendon on a 20y/o bay connemara. We were hoping for ALDDFT damage as it is simpler to repair, but actually saw a lot of damage to the SDFT. Poor boy was very sore and swollen. 6months of box rest & support bandages to look forward to. Re-scan in 1 month.
3. Gorgeous gorgeous gorgeous little Welsh Sec A driving pony. Lateral xrays on both forefeet (I did them!) History of laminitis; concussion from driving may have played a role as not actually that fat for a pony. In Imprint shoes and doing really well. Farrier wanted to see xrays to have an idea of how much he could take off the toe. Was first time I saw Imprints go on; really clever little shoes.
15.02.12
1. Vaccinated another 13hh bay driving pony. Checked heart. More regular than my heartbeat (see below!) Pinch skin of the neck and inject under the skin. Not Proteq as she'd had a bad reaction to that last time.
2. Re-application of Liverpool ointment to a small nodular sarcoid on the right forelimb of a lovely little coloured mare. Job jobbed.
Cut my afternoon short here because unfortunately the funny arrhythmia I'd been experiencing for the last few days got worse and I ended up spending 5 hours in casualty having tests. Yippee. Not dead yet though. Must try harder. I learned was that I am very fit and that I don't have a murmur, electrolyte disturbances or thyroid problems. Woohoo!
14.02.12
1. Castrate on a 7m/o little bay Irish Draft fellow. Sedated with dom & torb and injected lignocaine locally around the goolies (testicle, neck, skin of the scrotum). Sterile scrub of the area. Clamped on emasculators for 4mins for blood vessels & another 4 minutes for testicles. Emasculators go on nuts to nuts for first clamp. No trouble, nice and quick. Small, but perfectly formed.
2. Scanned RF tendon on a 20y/o bay connemara. We were hoping for ALDDFT damage as it is simpler to repair, but actually saw a lot of damage to the SDFT. Poor boy was very sore and swollen. 6months of box rest & support bandages to look forward to. Re-scan in 1 month.
3. Gorgeous gorgeous gorgeous little Welsh Sec A driving pony. Lateral xrays on both forefeet (I did them!) History of laminitis; concussion from driving may have played a role as not actually that fat for a pony. In Imprint shoes and doing really well. Farrier wanted to see xrays to have an idea of how much he could take off the toe. Was first time I saw Imprints go on; really clever little shoes.
15.02.12
1. Vaccinated another 13hh bay driving pony. Checked heart. More regular than my heartbeat (see below!) Pinch skin of the neck and inject under the skin. Not Proteq as she'd had a bad reaction to that last time.
2. Re-application of Liverpool ointment to a small nodular sarcoid on the right forelimb of a lovely little coloured mare. Job jobbed.
Cut my afternoon short here because unfortunately the funny arrhythmia I'd been experiencing for the last few days got worse and I ended up spending 5 hours in casualty having tests. Yippee. Not dead yet though. Must try harder. I learned was that I am very fit and that I don't have a murmur, electrolyte disturbances or thyroid problems. Woohoo!
Monday 13 February 2012
Many dark bay geldings
First case this morning was stitch removal on a 17hh dark bay handsome old boy. Stitches were snipped out from a wound on the medial tarsus which the patient had managed to align right over his vein and I am reliably informed 'pissed blood everywhere' when he came in. Vet kept head right up next to stifle when leaning over to do the stitches. Thought this was pretty sensible for general kick avoidance. Also vaccinated their little shettie field mate who had a simply adorable pink hearts fleece rug on and was quite a character.
Second in was a set of forelimb radiographs on another big 17hh bay gelding with a history of laminitis. Radiographs were to check for changes in the feet consistent with laminitis or founder. No changes were present, but some osteophytes possible on the proximal interphalangeal joint. Took obliques to check out the osteophytes. Nothing major.
Got stuck in loads of traffic after a horrible accident where a lorry and a car seemed to have tangoed up the central reservation. The car had come off worse and the central reservation was all over the wrong side of the road. Grim.
Eventually made the visit, albeit late, to another dark bay gelding, 25y/o, for a general once over. This consisted of a mini-vetting (vet had to borrow my pink stethoscope - he worked it!); eyes, skin, heart, lungs, palpation etc. Some swelling was present over right stifle and tendon sheath of the right hind. Watching the movement he seemed to be dropping his hip more on the right hand side and at trot was visibly lame. Lameness worse to flexion, seemed to isolate to the fetlock (flexion rarely exacerbates stifle lameness). Took blood. Further appointment made.
Last, but not least two dentals. One on a gorgeous gray mare. No sedation required although she did fidget a little.Used power tools. Very good; had a feel of before and after and the difference is remarkable. Did teeth on a huge coloured 6y/o showjumper next. Sedated with Domosedan to take the edge off (he tried to rear a few times) and then did teeth with power tools. Had a few ulcers from sharp points on his teeth. Re-do in 6months. Got to have another cheeky feel. Love being out. Learning things!
A good day.
Second in was a set of forelimb radiographs on another big 17hh bay gelding with a history of laminitis. Radiographs were to check for changes in the feet consistent with laminitis or founder. No changes were present, but some osteophytes possible on the proximal interphalangeal joint. Took obliques to check out the osteophytes. Nothing major.
Got stuck in loads of traffic after a horrible accident where a lorry and a car seemed to have tangoed up the central reservation. The car had come off worse and the central reservation was all over the wrong side of the road. Grim.
Eventually made the visit, albeit late, to another dark bay gelding, 25y/o, for a general once over. This consisted of a mini-vetting (vet had to borrow my pink stethoscope - he worked it!); eyes, skin, heart, lungs, palpation etc. Some swelling was present over right stifle and tendon sheath of the right hind. Watching the movement he seemed to be dropping his hip more on the right hand side and at trot was visibly lame. Lameness worse to flexion, seemed to isolate to the fetlock (flexion rarely exacerbates stifle lameness). Took blood. Further appointment made.
Last, but not least two dentals. One on a gorgeous gray mare. No sedation required although she did fidget a little.Used power tools. Very good; had a feel of before and after and the difference is remarkable. Did teeth on a huge coloured 6y/o showjumper next. Sedated with Domosedan to take the edge off (he tried to rear a few times) and then did teeth with power tools. Had a few ulcers from sharp points on his teeth. Re-do in 6months. Got to have another cheeky feel. Love being out. Learning things!
A good day.
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