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.