Done With Ambulatory

Today was my last day being on the ambulatory service for my farm animal rotation.  This morning I went with one of my classmates and one of the horse doctors out to a couple horse farms.  At one, the doctor changed a bandage that was on a horse's leg due to an injury in which the horse actually cut through one of his tendons near his foot.  We also did a couple quick exams on two of the other horses there.  Then, we went to a farm where we did physical exams and drew blood for a blood test, then sedated the horses and floated their teeth, essentially grinding their teeth so that they are smooth on the chewing surface.  It was a lot of fun and I was glad I got to go on the call.  The afternoon was uneventful, just ran some fecal tests on the horses from today to check for parasites and helped out my classmates who were on in-house.

This morning, one of the girls on ambulatory had a family emergency and had to leave.  Well, it just so happened that she was supposed to be on ICU duty tonight from 7pm to 1am.  So, I am now covering her ICU shift.  However, I am also first on call tonight from 5pm-7am.  So, I am covering an ICU shift while being first on call at the same time, which means that tonight has the potential to be a very long and busy night.  I'm hoping that no more patients will come in tonight and that I can leave a little early like I did last time I was scheduled from 7pm-1am.  We shall see. 

5/29

Today I went to a dairy farm where we dried a couple cows off (put antibiotic into their mammary glands and put sealant into their teats so that they will stop producing milk) and also vaccinated some calves.  In the afternoon, one of my classmates and I went to the necropsy floor to see the necropsy of a calf that had died that was seen by my classmate the day before.  Near the end of the day I was down in the farm animal ward when a cria (baby alpaca) and its mother were brought in.  The cria wasn't suckling well from the mother.  So, a couple people ended up milking the alpaca.  During this time, someone started talking about if anyone had ever tried alpaca milk.  No one had but no one really seemed to want to so I said I would give it a whirl.  I sucked just a small amount of the milk out of the cup into a syringe and put it in my mouth.  It was hard for me to really get a good taste due to the small amount of milk I had but at least now I can say I tried it!

5/28

This morning two of my classmates and I went with three doctors to check about 40 cows and heifers for pregnancy.  This gave me some more palpation experience which was nice.  For those of you who don't know, to check cows for pregnancy, most often a hand is inserted into the cows rectum.  When your arm/hand are in the rectum (yes, at times my entire arm is inserted into the cows hind end) you feel down towards the ground as the cows reproductive tract lies just below the rectum.  There you feel for fluid in the uterine horns, a baby (if the cow is far enough along in her gestation), or for various structures on her ovaries. 

This afternoon, one of my classmates and I went with one of the doctors to a pig farm where we helped castrate a 75lb male pig, helped pregnancy check 11 sows using an ultrasound, and learned how to trim pig hooves.  Because we had to knock the pigs out to trim their hooves, my classmate and I also got some experience in injecting drugs into the pigs ear veins.  When you look at a pigs ear, they often have good-sized veins in them.  These veins are often used for injections as they are the most readily accessible veins in pigs.

5/27

Yesterday was a decent day.  I started my farm animal rotation and was placed on ambulatory service this week and then in house next week.  In the morning I ran some fecals to check for parasites.  In the afternoon, I helped ultrasound a bulldog for puppies (one of the large animal vets actually does dog reproduction stuff as well) and ran more fecals.  At around 330pm or so I went out with one of the doctors to a horse farm to help with a horse that had a pretty good laceration on his neck.  Once we got it all cleaned up and sewn we were on our way back to the vet school.  I was supposed to be on large animal ICU from 7pm -12am however because all the patients in the farm animal ward required very little care, the doctor sent me home at 730pm which was awesome!

Well, Here Goes!

Well, my internal medicine rotation is all but over and it's time for me to switch gears to farm animals.  My schedule is going to be kind of crazy the next few days:
Tues:
7AM-9AM: work up transfers for internal med
9AM: orientation for my farm animal rotation and then jumping right into it until about 630pm or so
7PM-1AM: I am scheduled for my first ICU shift so I will not be leaving school until 1AM Wednesday morning (18 hour shift at school, here's to hoping I don't fall asleep!)
1AM-630AM: freedom/sleep
630/7AM: get back to school for day 2 of my farm animal rotation and stay there until around 630PM. 

Luckily, I don't have any extra duties then until Friday evening when I'm on call for the large animal ER from 5PM to 7AM Saturday morning and then again from 8PM Saturday night to 8AM Sunday morning.  Then, if it all works out like I want it to, I am hoping to race to Fairbury for my friends wedding and reception before zipping back to Champaign for my friends graduation party. 

I was told that the farms rotation requires a lot of hours from you, and even though I haven't actually started it yet, I'm a believer. 

On a semi-different note, the farm animal rotation is my last rotation before my rotation in Africa.  Only 2 1/2 weeks until we leave!

5/23

Yesterday my patient from Wednesday, the border collie, came back in.  We knocked him out and stuck an endoscope (a long, thin tube that has a camera and also a hole through which fluid or other tools can be passed) down his throat to look at his larynx and then down his windpipe and into the smaller pipes within the lung.  It's really cool watching on the screen as the scope goes through all the bronchi, it's like a bunch of tunnels with lots of forks in the road.  At the same time, it's kind of crazy to think that you are viewing way down into the dog's lung.  We also did what is called a bronchoalveolar lavage on the dog.  This is essentially when we take sterile saline and flush it through the endoscope (through the hole I mentioned earlier) and into a part of the dog's lungs.  The fluid is then sucked out.  This way, if there is any bacteria or cells that shouldn't be there, hopefully we can get some and be able to identify them.  Anyway, we didn't find much on the dog so that was kind of disappointing.

Today, I had a mixed breed dog that was very painful when we would palpate her bladder.  Turns out she has bladder stones.  She went home on a diet to try to dissolve the stones.  If that doesn't work, she will end up needing surgery to remove the stones. I actually got to perform my first cystocentesis on this dog today.  A cystocentesis is when a needle is put through the animal's body wall and directly into their bladder to collect urine.  I used an ultrasound to find the bladder and then guided the needle right into it.  It was pretty neat since it was my first time doing it.

Now, the weekend is here.  I still need to be at school at 7AM tomorrow and Sunday morning but hopefully I should have most of the day off later on.

Finally A Patient of My Own!

Today was the day I finally got another patient of my own.  My patient is an older border collie who has been coughing recently and seemed to be having trouble swallowing.  We did an exam, took radiographs of the dogs entire airway, ran bloodwork, and also did a swallow study.  In a swallow study, contrast material is fed to the dog and then fluoroscopy (essentially a live, continuous x-ray) is used to watch the material being swallowed by the dog.  The rads, bloodwork, and swallowing study all turned out normal.  So, we plan to to a laryngoscopy +/- a bronchoscopy tomorrow.  This means we will put a scope down to the dogs larynx and check it out and if we feel we need to we will stick the scope down the dogs windpipe and into his bronchi, the tubes that carry air into the lungs.  Should be cool to see if we find anything!

Where are my cases?

Well, I was assigned two appointments yesterday.  However, there was never any patients assigned to my appointments so I never had a patient yesterday.  Last night, I signed up as number 1 on the transfer list since I hadn't had my own case since Wednesday.  We have had transfers almost every day.  This morning I checked the transfer list and what do you know, no transfers.  So, for the fifth straight day I have no patients of my own.  Oh well, something will come along at some point for me.

Here's a couple pictures from this past weekend at Tom and Julianne's wedding:

Weekend

Well, this was a whirlwind of a weekend!  Saturday morning I was at school at 7am to help with cases.  I left later Saturday morning and hung out at my cousins in Eureka before heading to a graduation party in Gridley.  Yesterday morning my alarm went off at 330AM so I could catch a 605AM flight out of Champaign.  I landed in CT at 1035AM and got to church around 1120AM, just in time to hear my buddy Ben get announced to Ashley.  That was a great surprise.  The wedding was really nice and the reception was nice as well.  I left the reception around 520PM to head to the airport to catch a 7PM flight back to Illinois.  I landed in Champaign around 945PM.  Now, I'm back at school, been here since 7AM.  However, it's looking like it might be a slower day as there is only one appointment and it's not mine. 

One More Year!

One year from now I will graduate!  The class of 2014 just graduated this evening from vet school.  So, I am officially a 4th year, or senior, vet student.  It seems like just yesterday I was looking up to those senior vet students as an underclassman in vet school.  Now I am one of them.  Hard to believe. 

Yesterday and today I did not have a case of my own so I just helped out my classmates with their cases.  I was largely involved in a 6 year old golden retriever that ended up having to be put down due to cancer that was causing blood to seep from his skin along his abdomen and right rear leg.  It was too bad to see him suffering like that but he was such a good sport as we poked and prodded him.

Wednesday 5/14

Today my patient was yet another cat.  The cat has a large mucus plug plugging up the airways leading to one of its lung lobes.  It presented for coughing, and after doing radiographs we decided that the only thing we could really do for it today was send it home on antibiotics (which it has had before and they seem to help).  The plug is quite large and in order to really treat the plug, the entire left cranial lung lobe would have to be removed.  Tonight was Communion at church.  It was nice to put school aside and focus on what Jesus did for us.  So often, for me anyways, I get so busy that I don't think about His sacrifice for me and everyone else nearly enough. 

Tuesday 5/3

Yesterday was pretty laid back for me.  I was on transfers and I did end up with a tiny stray kitten that was brought in to the ER.  All I had to do was a physical exam on it when I got in and then call animal control so they would come pick it up.  The good news is that there was a client in the waiting room when the kitten who was brought in who had just lost a cat and they decided to adopt the kitten.  So, hopefully the kitten should only be at animal control temporarily until the new owners pick it up!  Other then that, I was just helping out the students who were on appointments. 

Internal Medicine

Today was my first day on my internal medicine rotation which will last this week and next week.  It went pretty well.  I receive appointments on Mondays, Wednesdays, and Fridays and receive transfer cases (cases that come into the ER but then are transferred to internal medicine) on Tuesdays and Thursdays.  Today, my appointment was a cat that was coming in to be rechecked after fighting pancreatitis, hepatic lipidosis (fat accumulation in its liver), and diabetes.  It was doing excellent, so we sent them home with instructions to return in 2 weeks to recheck bloodwork.  My case was in and out within an hour and then it was just a matter of getting the paperwork done.  Nice and easy! 

Happy Mother's Day

Happy Mother's Day to a top-notch lady that I happen to have the privilege of calling Mom!  Hope your day is special and that H, E, C and Dad spoil you like they should.  I love you and appreciate everything you have done for me in my 25 1/2 years!

One More Day at Purdue!

Tomorrow will be my last day at Purdue.  Hard to believe that the two weeks are almost over!  Yesterday was a "procedure day" which means that instead of seeing appointments we have surgeries.  However, there were no surgeries, so we went out to breakfast and had journal article discussions at Panera Bread, ate lunch at Chipotle, and hung out outside a lot of the afternoon before leaving early.  Today was just a few appointments, less than normal and we left around 330pm or so.  Tomorrow is another "procedure day" and we have one surgery.  It is a small mixed breed dog with a patent ductus arteriosus (a connection between the large artery leaving your heart to bring blood to your body and the artery leaving you heart bringing blood to the lungs to get oxygen).  It is normal for fetuses to have this connection but it should shut down shortly after they are born. If it doesn't, it usually has to be surgically shut down.  Then, it's the weekend yet again!

Tuesday 5/6

Well, my dog that I was in charge of today is still living!  He was stubborn in that he didn't want to go where we wanted him to but we were able to get everything done with him that we needed to.  We actually ended up putting a Holter monitor on him.  This records the electrical activity of his heart for a full 24 hours.  Tomorrow afternoon, the owners will send the monitor back to us at cardio and the monitor will be sent out for analysis.  Here is a picture of a dog with a Holter monitor on:

http://www.apexboxers.com/electrode.html

The dog came in around 1130 AM and we didn't send them on their way until 430PM and I was busy the whole time the dog was there, between talking with the owner, taking a blood pressure, doing paperwork, helping put the Holter monitor on, etc. Being that busy made the day fly by which was nice! 

Now tonight, I had to read an article for our "journal rounds" tomorrow.  Each of us students had to pick a research article involving cardiology and get ready to discuss it for tomorrow.  Mine is entitled "R-R interval variations influence the degree of mitral regurgitation in dogs with myxomatous mitral valve disease."  Not exactly the most fascinating reading I have done in my life but it could be worse!

Monday 5/5

This past weekend was pretty laid back.  I did head to Indianapolis Saturday evening and met up with one of the Brittanys and her family for dinner and then ice cream.  Sunday I was in West Lafayette for church and then last night I got some volleyball in which was fun.  Today was uneventful at Purdue.  Tomorrow morning at 1145AM I will be taking my first case.  The clients are new to Purdue cardiology and are actually coming from the University of Illinois teaching hospital to have their dog's heart checked out.  So, I will already have a connection with them!  Here's to hoping I don't get sick and miss out on my own appointment again!

Friday 5/2

Today I got to see another dog get his heart ballooned (as described in nauseating detail in my previous post).  Other then that, we really didn't have a ton going on, we even went out to lunch since we were slow.  This evening I got to spend some time with some of the guys from Purdue young group so that was fun. 

Purdue

Well, I am surviving being at Purdue!  This week has gone by pretty quickly.  The first day (Monday) I was slightly overwhelmed at school as I didn't know anybody, didn't know my way around, and the students I am with are all graduating in a couple weeks so are more advanced than I am.  However, as the week has gone on, I have gotten more and more comfortable.  The Dr's are awesome which is nice and the students have been pretty friendly to me too. 

Yesterday I got to see a balloon valvuloplasty.  I am sure most of you know exactly what I am talking about.  But, just in case, here's what happens.  Sometimes animals are born with a problem where there is a narrowing of the heart right where the blood is supposed to leave the heart and go to the lungs.  This makes it hard for the heart to push the blood into the lungs and can lead to heart problems.  So, a catheter with a balloon is put into the jugular vein (the big vein in the animal's neck) and passed through the vein and into the heart.  When it is put in the right place, the balloon is inflated, thus pushing open the narrow part.  It actually tears the tissue so that hopefully it will remain wide.  The balloon is then deflated and the catheter and balloon then pulled out of the animals vein.  It was really neat to watch.  They can see where they are going in the animal's heart using a machine that essentially takes a continuous x-ray so you can watch it live on the screen which is really cool.  Here is a picture showing what the balloon is doing:

http://www.fairview.org/healthlibrary/Article/89090

Today, I was supposed to have my first case.  However, my intestines decided to work real hard to push my food through faster than I would like them to so I ended up spending much of last night and some of this morning on the toilet.  So, it was hang out and sleep a lot today for me!  Tomorrow I should hopefully be back at it!