So far so good.

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!

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:

• 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!

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.

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.

T-minus two days until they let me loose

Cripes, where have the weeks gone? It dawned on me, whilst packing my worldly possessions into my van, that from Monday onward I am a vet. Granted, I will be a vet-in-training, but still a real-life vet. I hope that the first few weeks are gentle and give me a little chance to find my feet again. It's more than a little daunting to be released into the veterinary profession after so many years of lecturing on campus and watching from the sidelines. As my lovely flatmates helped me carry my stuff downstairs after our enchilada feast I felt a little fearful. It will pass. My new life as a veterinary rotations student is about to begin and I need to give myself over to that for a while and concentrate.

On a slight tangent, it seems prudent to remind myself and anyone else who happens to read that Rule #1 of the Royal Veterinary College is don't date anyone at the College. I hate being right sometimes.

On a complete tangent, my Macmillan Cancer Support vest is here (at home) and I am quite excited about going out for a run in it tomorrow. Let's keep the fingers crossed for blue sky and sunshine. I'm running the London Triathlon for Macmillan Cancer Support this year and you can sponsor me (if you so wish) by visiting www.justgiving.com/Hannah-Louise-Jordan.

Student Union

At work again this week because I'm scheduled for introduction to equine rotations track next week. The feedback from the others seems fairly positive. I'm not complaining one little bit; interval training my way back into using my brain suits me just fine.

Last night we had the first Hawkshead SU council meeting. There are many things discussed at these meetings, some are trivial, some are fascinating, some are dull and some controversial. Funnily enough, the latter usually centers around money. The main thing I take away from these meetings (aside from a list of action points) is a real sense of community and a love for the RVC as an institution. I often hear muttered grumbles about the SU and the decisions they make on behalf of the student body; much like national political parties, I really feel you can't complain unless you are involved and giving feedback. We can only represent you if you tell us what you think, so please do tell us what you think!

Whirlwind tour of clinical presentations

The last two days have been pretty packed with lectures and case work. We have skipped through vomiting, diarrhoea, weight loss, epistaxis, pale mucous membranes, jaundice, haematuria, coughing and dyspnoea, weakness-syncope-seizures and last, but not least, PU/PD. This whirlwind tour has been designed to get us thinking again after the Christmas break and aims to get us to consider possible clinical presentations and how we can use the clues from a history, presentation and clinical exam to work logically through cases to achieve a diagnosis. The concept is simple and the feedback from clinicians teaching current final years is that these students are measurably better at clinical problem solving. There is only one problem: I am absolutely terrible at it! Incidentally, the logical approach to clinical problem solving also runs as a CPD course (http://cpd.rvc.ac.uk) and I would recommend it very highly.

Learning about Endnote

I am sat in a computer aided learning (CAL) session which is designed to teach RVC 4th year students how to use Endnote software. The session so far has been informative and a good refresher on just how fabulous Endnote is when you are writing academic reports or essays. However, the delivery was a little muddled and on more than one occasion I found my mind wandering to other things. To be perfectly honest, I think this is more of a failing on my part than it is on part of the instructor who has tried very hard to get the key points across.

Lots of the yeargroup haven't bothered to come to any of these self-help research sessions. When they reach their research rotations block there will be much wailing, moaning and ganshing of teeth about how little help has been provided to them with their project. Once again this will be a case of the help being there and the students failing to take advantage of it, but perhaps that is just the view of a jaded graduate student who doesn't turn down free help with anything anymore. That was a valuable lesson learned on the last degree.

Whether the failing is on the part of the student for not attending, or on the part of the college for not pitching these sessions quite right (too slow and boring or too quick and impossible to follow... it needs to be just right like baby bear's porridge) there is a tangible improvement from the first sessions of these sort I attended. Improvement is not to be sniffed at and I hope that the RVC continues to listen to student feedback and make more positive changes. I feel like this is leading me onto a fairly serious rant about increasing student numbers, class sizes and the detrimental effects this has on small group learning, but I will save that for another time.

Does anyone ever look forward to stats?

Christmas day stroll along the front with my family.

Happy New year! I am sorry that I left things hanging a little two weeks ago. Now I have returned from deepest, darkest France and bonny Hastings I can happily report that I am not dead, I did pass and for the time being a state of normality has resumed. It has been a lovely two weeks without the constant pressure of having to revise, but it did take a few days for my brain to catch on and relax. I'm back on campus now doing some work before term starts again next week. Despite my best efforts I have spent more money than I should have and I need to try and undo the damage!

We start rotations proper on the 13th of February, but we have a few weeks of clinical problem solving and some lectures on how to go about our research projects with something resembling professionalism. I think it may be a little dull, but at least it's a nice gentle introduction. I am not looking forwards to stats. Does anyone ever look forward to stats?

Until next time.

Exam purgatory

When I am grappling with another set of mind-bending exams and trying to shoehorn vast quantities of material into the two weeks allocated revision time I sometimes begin to wonder if I would still have put myself through this degree if I had been in full possession of my mental faculties when I applied. The lifestyle of a veterinary undergraduate means you are almost constantly anxiously chewing your fingernails to stubs in anticipation of the results of the exams you just sat, or you are the shadow of a human being; living like a hermit in a hovel fashioned from books and course notes. I'm not entirely sure how many students are truly aware of this on application; repeated warnings that it is a challenging degree are one thing, but you never really hear things from the horses mouth. 

Pharmacology revision doodles

Today is the eve of my end of fourth year clinical exams. I have been a student here for 6 years now and sat countless sets of exams over this period, but these final years are really beginning to take their toll. At the RVC the third and fourth year of the BVetMed are shortened into two terms each and consequently you sit two sets of major exams in one year with less and less time to recover. This doesn't seem so bad when they tell you, but in practice it damn near kills the average student. For most students here this means an inability to spend time on anything else without being consumed by guilt about not revising. There is a huge spectrum of emotional responses to this sort of stress ranging from suicide through depression to general hysteria. Unfortunately this environment contributed to one of our number taking her own life this term and she will be very sadly missed. The remainder of us have spent the last five days in exam-purgatory and hope all the work wasn't in vain. Please keep your phalanges crossed for us. 

Not quite the all singing, all dancing prodigal child

It is said that if you want to get into veterinary college you must be the all singing, all dancing prodigal child. As a child that grew up in a relatively deprived corner of the United Kingdom, attended the local girls only comprehensive and who wasn't considered outstandingly bright it was safe to say I didn't stand a chance. At least, that's what the careers service told me when I sat in their must office aged 16. I'll reserve my venom and bile about the schools careers service for another time, but I suppose they did do me one favour; they rattled my cage sufficiently that I decided to show them what a determined child can do.

Fast forward through 3 years of A-levels, a BSc (Hons) in Veterinary Science and two and a half years of the accelerated BVetMed degree and that is where I find myself, hunched over a laptop at the Royal Veterinary College and writing this blog. The plan for this blog is to give you a realistic view of veterinary education, the associated trials and tribulations and to prove that to get into veterinary college you do not need to be the all singing, all dancing prodigal child, but you do require a reality check and a healthy dose of determination.