Last day already? Wow time sure flew by and I was sad that today was my last day. I will truly miss the staff at Sardis. They really made me feel like part of the "family." Dr. Powell had apologized earlier in the week for the clinic being "so slow." I told him that it was a good enough pace for me to build upon my skills and the staff were able to give me feedback right away.
I built upon my confidence in blood collection and I realized everyone, no matter what their skill level is, have days where they just can't find that vein. There are times when you just have to "pass the torch" as Dr. Powell described it.
I am still reluctant to answer the phone. I feel like I won't be able to answer a question a client might have or screw up making an appointment for someone. I kind of have to be forced into interacting with clients by someone else because I just won't offer myself up on my own. Me interacting with people is definitely something I will have to continue to work on.
I thoroughly enjoyed my time at Sardis. It was a huge confidence booster for me but, I realize I still have a long way to go though. I am appreciative for the staff and their patience with me. I learned a lot from each and everyone of them. I intend to keep in touch with the staff over the long term. I owe them that and so much more.
Friday, March 11, 2011
Week 3 Day 4
Well my second to last day revolved around a female boxer that came in for a "redo" on her R cruciate. Last fall Dr. Powell did a cruciate surgery on this dog and two weeks later, during her post-op recovery period, she slipped and fell on the same leg. She came up lame, so her owners took her back in to see Dr. Powell. He performed a drawer test and rads were taken of her stifle. The doctor determined that she probably pulled something in the fall and to give the swelling some time to decrease. He sent the dog home with some pain killers and anti-inflammatory meds.
Four months later... The boxer's owners call back in saying she hasn't been putting any weight on the leg since their last visit. Dr. Powell had the dog come in for a "redo" sx.
Once she arrived we had her in radiology to take some rads and to Dr. Powell nothing had changed with the implant in 4 months. Lynn catheterized and induced while I intubated the dog. Lynn also did the prep on the patient. The dog was put on fluids, LRS with a ketamine CRI, maintained at a surgical rate.
Dr. Powell made the incision along the scar from the previous sx. I had asked him prior to going into sx where he was going to make the incision, whether or not he would make it along the old scar. He explained that vets are taught to cut along the scar b/c there are already fibroblasts, etc at the site and supposedly it speeds healing for the second incision.
The doctor spent the next 20 min looking for the implant and had to step away to have another look at the rads. He came back with a better idea of where the implant slipped. Dr. Powell only took a few more minutes to find the implant. The nylon cord had snapped clean. He replaced the implant with a new one and had the incision closed within 15min. Our patient got a dose of hydromorphone just before she was extubated. We left her on fluids for the remainder of the day.
Four months later... The boxer's owners call back in saying she hasn't been putting any weight on the leg since their last visit. Dr. Powell had the dog come in for a "redo" sx.
Once she arrived we had her in radiology to take some rads and to Dr. Powell nothing had changed with the implant in 4 months. Lynn catheterized and induced while I intubated the dog. Lynn also did the prep on the patient. The dog was put on fluids, LRS with a ketamine CRI, maintained at a surgical rate.
Dr. Powell made the incision along the scar from the previous sx. I had asked him prior to going into sx where he was going to make the incision, whether or not he would make it along the old scar. He explained that vets are taught to cut along the scar b/c there are already fibroblasts, etc at the site and supposedly it speeds healing for the second incision.
The doctor spent the next 20 min looking for the implant and had to step away to have another look at the rads. He came back with a better idea of where the implant slipped. Dr. Powell only took a few more minutes to find the implant. The nylon cord had snapped clean. He replaced the implant with a new one and had the incision closed within 15min. Our patient got a dose of hydromorphone just before she was extubated. We left her on fluids for the remainder of the day.
Week 3 Day 3
Today was very interesting. An eccentric client came in with two male cats that were scheduled for neuters. This client is known for footing the bill for many people and has 20+ animals on his account. I brought the cats back and it was immediately apparent that they smelled of urine. They were put into the back kennel area to save our noses.
The first cat was brought to the treatment room and I induced and he was masked down for the neuter. At Sardis the DVMs do the neuters and they use the "Hemostat" technique. This is where the doctor cuts into the tunic and separates the gubernaculum from the testicle. Next they take both the vas deferens and the blood vessel with the hemostat, cuts off the testicle and ties both off with one throw. Once the doctor ensures the knot is tight enough he releases the vessel and lets it retract back into the scrotum.
The other cat was brought out and Jocelyn noticed some blood on his kennel liner. She went to set the cat on the exam table and he started to urinate but, the urine was free of blood. After we cleaned up I noticed blood on one of his paws. I had a closer look, one of his claws was missing and the toe was full of pus. Dr. Tugui looked at his other toes and there were 3 other claws on other feet in the same condition. He said we would treat them once the neuter was complete. I once again induced and the cat was masked down. The doctor performed the neuter. He then clipped the hair from the toes missing claws and he cleaned the tissues with H2O2. Dr. Tugui also asked Jocelyn to calculate a depo-cillin dose and injected it before the cat woke up.
Cosmo, the handsome yellow lab that came in the week before for rads of his swollen carpus was in today. He had a bone biopsy to confirm Dr. Powell's diagnosis of osteosarcoma. Cosmo was put under GA and Dr. Powell used an 18g needle to take the biopsies. He made 4 slides to send off to Idexx.
After my lunch break I went to check on our patients when I noticed some clotted blood in the kennel of our first neuter. Dr. Tugui happened to be in the back and he asked me to bring the cat out of the kennel. The cat's whole hind end was bloody and there was more blood in his kennel. Dr. Tugui had a look at the cat's neuter site and asked Dr. Powell to have a look. Dr. Powell suggested there may be an open vessel in the tunic or the scrotum. Jocelyn and I masked the cat down again and Dr. Tugui gathered instruments and gloved up. Dr. Tugui explored the neuter site and found that the knot he made to remove the left testicle was not tight enough. He used suture material to tie off the vessels in two different spots and released it back into the scrotum. I cleaned the cat's hind end and I put him back into his cleaned kennel to recover.
Of course Sardis' neuter protocol is different from that of TRU's. I know that there are many different ways to get the same result. What I don't know is whether something like this happens more often using the "hemostat" technique or not. I think three throws are better than just one.
Our last patient of the day was a cat coming in because the owner noticed a change in his behavior. The owner warned Dr. Tugui that the cat may bite and Dr. Tugui asked Jocelyn to accompany him into the exam room. The cat turned out to be very fractious and had to be brought back to the treatment room. The only way we were going to get blood and urine from this cat was to sedate it. It was obvious there was no way he would be masked down. The doctor drew up torb and dormitor. He managed to inject it IM into the back end of this cat and as he was doing that the cat started to urinate. We collected the urine off the table before cleaning up. The cat was still very fractious after a few minutes so Dr. Tugui gave another dose of torb and dormitor but, as he was injecting the cat got loose from Jocelyn's grip and shot off the table. She asked me to grab a fishing net from the back and I came out to the treatment room with it. I caught the cat in the net and drug him into radiology where it was dark and quiet. The fishing net is my 3rd practice tip. The worked very well in this situation. I continued to restrain the cat in the net and he seemed to get a little sedate. We pulled him up onto the table and masked him down. We pulled blood while he was under and I clipped his nails. I also assisted Dr. Tugui with taking rads of the cat's abdomen which apparently showed nothing. We had the cat recover from the anesthetic in a carrier and the owner took him home in it. We did the blood in house and there was nothing abnormal other than a neutrophilia probably caused by stress.
The first cat was brought to the treatment room and I induced and he was masked down for the neuter. At Sardis the DVMs do the neuters and they use the "Hemostat" technique. This is where the doctor cuts into the tunic and separates the gubernaculum from the testicle. Next they take both the vas deferens and the blood vessel with the hemostat, cuts off the testicle and ties both off with one throw. Once the doctor ensures the knot is tight enough he releases the vessel and lets it retract back into the scrotum.
The other cat was brought out and Jocelyn noticed some blood on his kennel liner. She went to set the cat on the exam table and he started to urinate but, the urine was free of blood. After we cleaned up I noticed blood on one of his paws. I had a closer look, one of his claws was missing and the toe was full of pus. Dr. Tugui looked at his other toes and there were 3 other claws on other feet in the same condition. He said we would treat them once the neuter was complete. I once again induced and the cat was masked down. The doctor performed the neuter. He then clipped the hair from the toes missing claws and he cleaned the tissues with H2O2. Dr. Tugui also asked Jocelyn to calculate a depo-cillin dose and injected it before the cat woke up.
Cosmo, the handsome yellow lab that came in the week before for rads of his swollen carpus was in today. He had a bone biopsy to confirm Dr. Powell's diagnosis of osteosarcoma. Cosmo was put under GA and Dr. Powell used an 18g needle to take the biopsies. He made 4 slides to send off to Idexx.
After my lunch break I went to check on our patients when I noticed some clotted blood in the kennel of our first neuter. Dr. Tugui happened to be in the back and he asked me to bring the cat out of the kennel. The cat's whole hind end was bloody and there was more blood in his kennel. Dr. Tugui had a look at the cat's neuter site and asked Dr. Powell to have a look. Dr. Powell suggested there may be an open vessel in the tunic or the scrotum. Jocelyn and I masked the cat down again and Dr. Tugui gathered instruments and gloved up. Dr. Tugui explored the neuter site and found that the knot he made to remove the left testicle was not tight enough. He used suture material to tie off the vessels in two different spots and released it back into the scrotum. I cleaned the cat's hind end and I put him back into his cleaned kennel to recover.
Of course Sardis' neuter protocol is different from that of TRU's. I know that there are many different ways to get the same result. What I don't know is whether something like this happens more often using the "hemostat" technique or not. I think three throws are better than just one.
Our last patient of the day was a cat coming in because the owner noticed a change in his behavior. The owner warned Dr. Tugui that the cat may bite and Dr. Tugui asked Jocelyn to accompany him into the exam room. The cat turned out to be very fractious and had to be brought back to the treatment room. The only way we were going to get blood and urine from this cat was to sedate it. It was obvious there was no way he would be masked down. The doctor drew up torb and dormitor. He managed to inject it IM into the back end of this cat and as he was doing that the cat started to urinate. We collected the urine off the table before cleaning up. The cat was still very fractious after a few minutes so Dr. Tugui gave another dose of torb and dormitor but, as he was injecting the cat got loose from Jocelyn's grip and shot off the table. She asked me to grab a fishing net from the back and I came out to the treatment room with it. I caught the cat in the net and drug him into radiology where it was dark and quiet. The fishing net is my 3rd practice tip. The worked very well in this situation. I continued to restrain the cat in the net and he seemed to get a little sedate. We pulled him up onto the table and masked him down. We pulled blood while he was under and I clipped his nails. I also assisted Dr. Tugui with taking rads of the cat's abdomen which apparently showed nothing. We had the cat recover from the anesthetic in a carrier and the owner took him home in it. We did the blood in house and there was nothing abnormal other than a neutrophilia probably caused by stress.
Week 3 Day 1
A pretty routine Monday at the clinic today. We had a full morning with 4 surgeries: a cryptorhid K9 neuter, a large K9 neuter, a small K9 spay and a feline spay. I induced and intubated all but one. My confidence in anesthesia has grown very much. I just need to build my own procedure/routine to remember to do all that needs to be done when putting an animal on anesthetic without having to be reminded for the odd thing. My confidence has increased in surgical prep as well. I prepped every patient today for sx.
The large K9 neuter had previously suffered from osteomyelitis. The bacteria entered the open growth plates of the radius and ulna in both forelimbs. Dr. Powell diagnosed it by radiographing the dog's forelimbs. He showed me said radiographs today.
The large K9 neuter had previously suffered from osteomyelitis. The bacteria entered the open growth plates of the radius and ulna in both forelimbs. Dr. Powell diagnosed it by radiographing the dog's forelimbs. He showed me said radiographs today.
Week 2 Day 5
Today was a pretty routine one. We had a brother/sister neuter/spay back to back this morning. They were Boston Terriers. The male's testicles had not dropped into his scrotum. Dr. Moller could only palpate one and anticipated he would find the other one in the abdomen. He was right, he found the cryptorchid testicle in the abdomen "trying" to enter the inguinal canal.
A bulldog named Boss came in today with vomiting, anorexia and lethargy. Dr. Tugui suspected a possible foreign body and us pull blood for some in house blood work and some for a pancreas panel. I used Idexx's VetConnect website to place the requisition for Boss' test. This is my 2nd practice tip. Using Sardis' account on the VetConnect webiste takes the same amount of time as writing on the requisition form and we are able to track the progress of the tests sent in.
Dr. Tugui also asked for xrays on Boss to see if there was an obstruction. There was no foreign body apparent so Dr. Tugui had Coreen had Boss swallow barium and took a series of xrays over a 5 hour period. Those xrays showed nothing. So Boss went home for the night to wait for his test results to come back.
A bulldog named Boss came in today with vomiting, anorexia and lethargy. Dr. Tugui suspected a possible foreign body and us pull blood for some in house blood work and some for a pancreas panel. I used Idexx's VetConnect website to place the requisition for Boss' test. This is my 2nd practice tip. Using Sardis' account on the VetConnect webiste takes the same amount of time as writing on the requisition form and we are able to track the progress of the tests sent in.
Dr. Tugui also asked for xrays on Boss to see if there was an obstruction. There was no foreign body apparent so Dr. Tugui had Coreen had Boss swallow barium and took a series of xrays over a 5 hour period. Those xrays showed nothing. So Boss went home for the night to wait for his test results to come back.
Week 2 Day 4
The morning started off with a dental with Lynn on a 8yr old chihuahua named Tio. He was adorable (I kind of have a soft spot for chihuahuas and corgis) but a little snippy. He was muzzled while I took blood for a pre anesthetic panel. I got his jugular on the first poke. His BUN, ALT, K, CL and Na all came back within normal range so it was onto prepping for his dental. I tried to induce Tio using both of his saphenous veins and was semi successful. We had to mask him down to get him where I could intubate him. Once he was intubated I tried placing a catheter in Tio's left cephalic vein and the catheter ended bunching in the vein. I had to pick a 24g 0.75" catheter for Tio's right cephalic vein and it worked. I got to take command of the dental once again and it was going smoothly until I tried to extract a wiggly incisor. I didn't elevate the tooth enough, used the extraction forceps and broke a portion of the root off. Lynn had to go in a elevate the rest of the root out. I felt bad and learned my lesson. Lynn allowed me to extract another tooth and I did it right. The rest of the dental was pretty routine.
Later in the day Dr. Powell brought back a handsome yellow lab that had a hard swelling over his right carpus. The doctor ordered x-rays of the carpus. Lynn and I were set to task and the xrays showed a lytic lesion on the distal end of the radius/ulna. With osteosarcoma evident in this dog Dr. Powell wanted a chest xray done. The xray showed the lungs were clear but, it is anyone's guess how long this dog has.
Later in the day Dr. Powell brought back a handsome yellow lab that had a hard swelling over his right carpus. The doctor ordered x-rays of the carpus. Lynn and I were set to task and the xrays showed a lytic lesion on the distal end of the radius/ulna. With osteosarcoma evident in this dog Dr. Powell wanted a chest xray done. The xray showed the lungs were clear but, it is anyone's guess how long this dog has.
Week 2 Day 3
Nakita's blood work showed that she does not suffer from Addison's dz and that only leaves kidney failure. Nakita's owners came in somewhat unannounced before Dr. Tugui could call them with the results. He took them into an exam room to explain Nakita's current situation and her options with having kidney failure. During that time I disconnected the fluids from Nakita and wrapped the catheter up in anticipation of her owners taking her home to spend time with her and make their decision. Dr. Tugui hopes to hear from them tomorrow.
Today was the day for Pixi's cystotomy. The Bichon that came in last week and we found a large urolith during what was supposed to be a ultrasound guided cysto. Dr. Tugui performed the sx and the urolith (composed of struvite) extracted was the size of a mentos mint. As soon as the sx was completed we took Pixi into radiology and took a lateral view of her abdomen the bladder was clear of uroliths.
A couple of hours before the end of the day Dr. Tugui had an odd appointment. A couple brought a cat in for a "sexing." The wife was convinced the cat was a male going so far to name the cat Maximus. The husband had an inkling that the cat may be a female (and pregnant!) after noticing a growing belly. After a routine exam performed by Dr. Tugui it was official, Max the cat is in fact a pregnant female. The doctor opted to take the rest of his afternoon to perform a pregnant spay on Max. We got right into prepping for sx. We got Max into sx quickly and Dr. Tugui removed 5 nearly full term kittens and spayed Max in the process. Cleaning up after the sx took me right up to the end of my day.
Today was the day for Pixi's cystotomy. The Bichon that came in last week and we found a large urolith during what was supposed to be a ultrasound guided cysto. Dr. Tugui performed the sx and the urolith (composed of struvite) extracted was the size of a mentos mint. As soon as the sx was completed we took Pixi into radiology and took a lateral view of her abdomen the bladder was clear of uroliths.
A couple of hours before the end of the day Dr. Tugui had an odd appointment. A couple brought a cat in for a "sexing." The wife was convinced the cat was a male going so far to name the cat Maximus. The husband had an inkling that the cat may be a female (and pregnant!) after noticing a growing belly. After a routine exam performed by Dr. Tugui it was official, Max the cat is in fact a pregnant female. The doctor opted to take the rest of his afternoon to perform a pregnant spay on Max. We got right into prepping for sx. We got Max into sx quickly and Dr. Tugui removed 5 nearly full term kittens and spayed Max in the process. Cleaning up after the sx took me right up to the end of my day.
Week 2 Day 2
I assisted with the two surgeries we head this morning. I induced and intubated both patients. I chose the etube size for both dogs which were small breeds, a pug x and a min pin. The tubes both fit well and they went onto iso easily. Both neuters went well and finished quickly. On the min pin I was asked to do a deep skin scraping. This dog had been treated previously for demodex and Dr. Powell wanted to do a recheck. I performed my first skin scraping while the dog was under GA and the slide revealed no demodex. Dr. Powell will treat this dog one
more time before resolving it.
For my first practice tip I would like to talk about Dr. Powell and his use of lidocane. Ever since the birth of his youngest child, Dr. Powell uses lidocane on his patients for nearly every sx. This idea came to him while witnessing his wife's c-section and both the nurses and the doctors almost always had a syringe of lidocane in hand to treat his wife pre-op, during the sx and post op to manage her pain. So now during his surgeries he uses lidocane whenever he can to manage pain pre operatively and during the procedure. He has had me squirt lidocane into a spay incision just before he begins suturing. Today with both neuters he injected lidocane into each testicle and SQ right along where he would make the incision for the sx. This was done just before I did my final scrub on the patient.
Nakita the rotti x that came in yesterday for rads and bloodwork was back again today. Her BUN and creatinine was elevated. Dr. Tugui talked to Dr. Powell and they suspected either kidney failure or addision's dz. Dr. Tugui asked for us to perform a ACTH stim test and to get her on some IV fluids. She was to stay overnight on the IV and wait for the test results to come in the morning.
more time before resolving it.
For my first practice tip I would like to talk about Dr. Powell and his use of lidocane. Ever since the birth of his youngest child, Dr. Powell uses lidocane on his patients for nearly every sx. This idea came to him while witnessing his wife's c-section and both the nurses and the doctors almost always had a syringe of lidocane in hand to treat his wife pre-op, during the sx and post op to manage her pain. So now during his surgeries he uses lidocane whenever he can to manage pain pre operatively and during the procedure. He has had me squirt lidocane into a spay incision just before he begins suturing. Today with both neuters he injected lidocane into each testicle and SQ right along where he would make the incision for the sx. This was done just before I did my final scrub on the patient.
Nakita the rotti x that came in yesterday for rads and bloodwork was back again today. Her BUN and creatinine was elevated. Dr. Tugui talked to Dr. Powell and they suspected either kidney failure or addision's dz. Dr. Tugui asked for us to perform a ACTH stim test and to get her on some IV fluids. She was to stay overnight on the IV and wait for the test results to come in the morning.
Week 2 Day 1
Monday was a good day. I got to do a dental prophy with Lynn supervising me and checking my work. I had fun and Lynn said I did a good job 
I really do enjoy dentistry.
The majority of the rest of my day was spent cleaning and organizing the cupboards and sx pass through in the treatment room.
A female rotti x came into Dr. Tugui with diarrhea. He ordered xrays and Jocelyn assisted him with that. I was busy with a euthanasia with Dr. Powell. The cat we euthanized was very icteric and anemic and very close to passing away on his own. Dr. Powell suspected catastrophic liver failure. The poor kitty was in rough shape and had been sick for a long time before this point. After the euthanasia I was asked in to radiology to pull blood on the dog. I had a bit of trouble initially with Dr. Tugui hovering over me and my confidence plummeted. The last couple of times I have tried to pull blood on other patients I have had difficulties and my confidence is waning.
At the very end of my day Helen came to the back and asked if I would talk to the owner of the dog I did a dental on. Lynn was unavailable. So I went up to the front and talked to the client. I stumbled through a bit but, I think I explained all I needed to her in terms she would understand.
I really do enjoy dentistry.The majority of the rest of my day was spent cleaning and organizing the cupboards and sx pass through in the treatment room.
A female rotti x came into Dr. Tugui with diarrhea. He ordered xrays and Jocelyn assisted him with that. I was busy with a euthanasia with Dr. Powell. The cat we euthanized was very icteric and anemic and very close to passing away on his own. Dr. Powell suspected catastrophic liver failure. The poor kitty was in rough shape and had been sick for a long time before this point. After the euthanasia I was asked in to radiology to pull blood on the dog. I had a bit of trouble initially with Dr. Tugui hovering over me and my confidence plummeted. The last couple of times I have tried to pull blood on other patients I have had difficulties and my confidence is waning.
At the very end of my day Helen came to the back and asked if I would talk to the owner of the dog I did a dental on. Lynn was unavailable. So I went up to the front and talked to the client. I stumbled through a bit but, I think I explained all I needed to her in terms she would understand.
What was supposed to be Week One Day 5
I had some issues with Moodle on Friday so to update you on the sick cat that came in Thursday afternoon. I discussed this cat's situation with Dr. Powell on Friday morning. Dr. Powell suspected kidney failure but, he could not speculate as to why. This kitty was only 7 years old. Dr. Powell called the owners after talking to me and informed the owners of their cat's situation and suggested that he be put down. Dr. Powell did not expect the cat to get better but, to get worse overtime. Euthanasia was the best option for the cat. The owner had to talk to her husband and called back a couple of hours later to give us the go ahead to euthanize the cat.
I also wanted to state two goals for my time here:
-to become more comfortable talking with clients both in person and on the phone. I find I am a bit awkward at both and because of that I am reluctant at interacting with clients.
-to become much more confident in blood collection. I still find myself very nervous when it comes to this routine procedure.
I also wanted to state two goals for my time here:
-to become more comfortable talking with clients both in person and on the phone. I find I am a bit awkward at both and because of that I am reluctant at interacting with clients.
-to become much more confident in blood collection. I still find myself very nervous when it comes to this routine procedure.
Thursday, February 24, 2011
Practicum Day Four
Day 4 - It was much busier today. The morning was full with 2 cat spays, one mature dog spay with lumpectomy and a dental on a beagle. I floated between them all, spending most of my time with Lynn and the dental. Dr. Powell called me over to the sx patients to do cystos on the prepped (anesthetized) patients. I did a successful cysto on a yorkie and on one of the cats. Eventhough they were anesthetized it was still a confidence booster and a chance to hone my skills. I also expressed the bladders on the two cats and Dr. Powell showed me his technique which was very efficient.
I helped out Lynn with her dental on a 9yr old f/s beagle with "sewer mouth." This dog had some advanced periodontal disease. There were many extractions which Lynn did all but one. She saved one for me to do, a very loose canine which didn't require much elevating to get it out. The tooth was in poor shape and it looked like the root had abcessed. We left that empty pocket open to let the body work the bacteria out instead of suturing it in. I like helping Lynn with the dentals because I have an interest in dentistry. Lynn told me I could do the majority of a dental with her next week and I'm pretty excited.
We had a few interesting cases come in today. I was helping with a ultrasound guided cysto on a Bichon Frise when Dr. Tugui found a large mass in the dog's bladder on the ultrasound screen. He immediately wanted radiographs so Jocelyn and I took Pixi into radiology. We took a lateral view of her abdomen. Dr. Tugui saw it on the screen and told us we didn't need to take a VD. The urolith in the bladder was very apparent and she will need a cystotomy to remove it. Another case involved a f/s ragdoll with hindlimb ataxia. Dr. Tugui ordered radiographs and it showed decreased bone density that was especially apparent in the femurs. The doctor learned that this cat is on a raw food diet that consists of meat and really nothing else so he suspects she is suffering from mild hypocalcemia. He suggested a addition of calcium into her diet. I not sure what exactly he suggested to the owners. Our last case for the day was a 7yr old m/n DLH cat with leathargy and vomiting. Dr. Powell wanted blood chem, a cbc and a u/a done on this cat. I tried pulling blood twice from the jugular and was unsuccessful so I asked someone else to do it. They also were unsuccessful pulling blood from the cat's jugular so they collected from the femoral vein. Dr. Powell did the cysto and I ran everything through the machines. This all got done at the end of the day so I wasn't able to go over the results with Dr. Powell. The cat is staying with us overnight. So I'll know more ion the status of this cat tomorrow.
Practicum Day Three
Day 3 was a bit slow. We had a substantial snow fall in the Fraser Valley overnight and it caused some traffic issues.
Two of our morning appointments were cancelled by clients so that left us with just one sx for the morning. I assisted Dr. Tugui (a recent vet grad from Quebec) during the induction, intubation and neuter. I got to learn a bit more about him.
As soon as I came this morning Jocelyn told me that Jake crashed when Dr. Powell came in last night to check on patients and he was euthanized. It was nice to know that the owner was able to say goodbye before he passed.
With the slow day I did a lot of organizational things, which I enjoy doing. I see a lot of organizing to do in the clinic and I hope I am able to complete some of, if not all of it while I am here. I am used to a highly organized, compartmentalized clinic from where I worked at last summer. The tech there was very organized which I like to be as well. Sardis has limited space and to have more organization would utilize that space more efficiently. Of course I am asking Jocelyn before I set to task with anything.
Tomorrow I am supposed to meet the 4th tech working at the practice and it should be busier.
Practicum Day Two
Day 2 - I am happy with my practicum site already. I do a lot and learn a lot. I know this is not the case in other placements. Don't get me wrong, I am not doing everything perfect but, I'm learning from the mistakes I've made so far. I placed a catheter in a patient using Lynn's technique. I helped her with her dental today. I did a thorough cleaning of the patient's ears and expressed his anal glands. I again pulled blood, induced and intubated patients. I can feel my confidence increasing with every procedure I do. It feels good.
As for Jake, he did not improve overnight nor did he get any worse. I never heard anything of the blood work we sent to idexx yesterday, it may not have showed anything so that is why it wasn't mentioned. He had another 1L bag of LRS hooked up to him today but, without the added KCl. I pulled more blood from Jake with Lynn's help and ran it through the VetLyte. His K was back to normal and his Na and Cl was a bit elevated. Other than that we really didn't do much with Jake today. Dr. Powell called his owner to give her a prognosis on Jake. Dr. Powell believes Jake will not improve and his pneumonia will probably get worse as he continues to aspirate what he vomits up. With this poor prognosis Dr. Powell leaves the decision up to the owner whether to continue on with treatment or euthanize him. She stopped by for a visit to see Jake in his current positon and possibly to sway her decision one way or another. I found her crying next to him and Lynn came by to console her. Dr. Powell also came by to talk to her at length about his condition and plans for the next step. I will have to see tomorrow what decision the owner made.
Practicum Day One
Well day one went by fast. Jocelyn and Lynn (the techs) are eager to have me participate in anything. I pulled blood, induced, intubated and assisted in a spay with Dr. Arden. It was much more than I had anticipated to do in my first day.
We had an interesting case come in, a 13 yr old, m/n shelti presenting with laboured breathing, vomiting, and lethargy. Dr. Anvik ordered rads of the chest. The lung fields looked a little congested and rads of the abdomen were ordered next. The patient's stomach was distended with air but, no other findings. The dog vomited while in radiology and had a few coughing spells. Lynn pulled blood next and I ran the panel in house. Our patient turned out to be very hypokalemic and Dr. Anvik had one of the techs set up some fluids with added KCl. The fluids were hooked up to the patient after Dr. Anvik ordered a Barium swallow and rads. Both Dr. Anvik and Dr. Powell agreed that this dog had megaesophagus but, they couldn't agree on why. Dr. Powell asked Jocelyn and I to take more blood and send away for a TSH/T4 panel from Idexx. He found some research stating that sudden onset megaesophagus can be related to hypothyroidism. The dog remains on fluids overnight in clinic and the results from idexx will come tomorrow.
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