Summer 2012--St. Francis Veterinary Clinic Visit #8: Raining Cats and Dogs

Yes, Wednesday was a rather rainy day at the clinic. When I was in surgery in the morning, it was so dark outside that it looked like early night. We were concerned that the power might go out, which would have been really bad, obviously. Wednesday was a very surgery-heavy day. Long story short, I was watching surgeries until 4:30 in the afternoon, and the clinic closes for the night at 6 PM. I like those days, though, because they go by fast and are fairly interesting. We did break for lunch around 1 PM, but still. It was a pretty busy day.

First, I saw a very routine canine spay. It was still interesting, though, because Dr. K is trying a new technique of dripping nerve block on the ovaries and then on the incision site after the abdominal wall is closed in order to help the dogs feel more comfortable before their post-operative pain medications kick in. It was also interesting because Dr. K let me drip the nerve block on both the ovary and the incision site under her direction.

Then, I watched a couple of dentals on two older dogs. They took a pretty long time--over 1.5 hours each. Both had a lot of extractions, which really lengthens the procedure. What was cool was that the second dog had an ankylosed tooth, which means that the tooth is directly attached and rooted to the underlying jawbone instead of being connected merely by the gum socket and some ligaments. Being ankylosed prevents the tooth from being removed from the mouth--not good stuff!

After the first dental, I got to scrub the dental instruments in preparation for the second. Dentals tend to be less sterile than other surgeries, plus the dogs were living in the same home, so it wasn't necessary to use a whole new set of tools from an autoclaved pack.

I also saw a feline declaw on all four paws, which was pretty cool. For some reason, I like the smoothness and relative ease with which the claws can be removed from cats. I understand that declawed cats have an increased tendency to bite instead of scratch, but the surgery seems worthwhile if it gives owners peace of mind and if it means that the household can continue to operate harmoniously. The cats truly seem none the worse for wear.

Perhaps my favorite surgery of the day was an exploratory on a dog that had swallowed some hard plastic piping. Some of it had already come out by the time the dog arrived at the clinic, but the doctors wanted to see if there was any more in the GI tract that might be hurting the dog. Dr. K explained to me that in exploratories, the doctor checks the entire GI tract. She started with the small intestine, pulling it almost all the way out of the dog so that it looked like a neat and almost beautiful pile of coral. Seeing nothing there, she proceeded to palpate the large intestine and to examine the pancreas. It was a great little canine anatomy lesson. Earlier, I got to heat up some IV fluid, which one of the technicians used to flush the area and keep everything clean. The entire exploratory was negative, so Dr. K stitched the dog back up and sent her home to her family, instructing the owners to monitor the dog for continued symptoms of intestinal distress.

After surgery, I got to help with the placement of a urinary catheter in a blocked cat. I held the mask that delivered the mix of oxygen and isoflurane to the cat while Dr. N placed the catheter--an ultra sterile process. She taught me a little more about blocking and its consequences. Blocking occurs when an obstruction in the urethra prevents an urine from being eliminated. As a result, potassium--which is excreted in urine--builds up and cannot be removed from the body. This build-up is very dangerous because it can lower the heart rate enough to stop the heart. When the catheter was placed, the cat was hooked up to an IV drip and allowed to rest in the heated cages of the surgery room. I got to set the drip so that it delivered as close as possible to one drop every 10 seconds.

In the late afternoon, I started following Dr. J to appointments. The first one I saw was for a dog with a hot spot. Now, I had a vague idea about what a hot spot was, but I learned a bit more today. Hot spots occur in patches of skin where a dog or cat has been chewing, scratching, or licking at the skin (perhaps because it itches for whatever reason). It is mostly due to compulsive behavior rather than any kind of illness or infection. The raw skin that occurs can be susceptible to infection by "opportunistic" bacteria that take the chance provided by the open skin to attack the animal and enter its body.

I also learned how to run blood tests on serum on Wednesday. The clinic has all these cool analytical machines that I have never really had occasion to pay much attention to. The technicians have always been in charge of that, and I guess the opportunity has never come up for me to learn. Well, Peej decided that it was time for me to know how to do it. I used two machines called an Idexx VetTest and VetLyte analyzer. The VetTest measures values like bilirubin, glucose, albumin, calcium, and creatinine. The VetLyte analyzer measures electrolytes and ions like chloride, sodium, and potassium. These two machines are often used in tandem for pre-anesthetic blood work or as general gauges on animal health--mostly in reference to the liver and kidneys. After the pet's information is entered into the VetTest machine, the necessary tests are selected, and special disks are inserted into the machine that each measure a different value in the blood serum. Then, a probe with a sterile tip is inserted into the sample and placed in its proper slot in the machine. The machine then takes a small amount of the serum for each disk and goes to work with the analyses. The VetLyte machine works similarly, but it is much simpler because no disks are required. All that is needed is to open the door, introduce the sample to the slim metal probe, and close the door. The probe only needs a very small amount of the serum in order to evaluate it.

Finally, I got to count out some Cephalexin pills for the dog with the hot spot. Basically, I did a lot of really cool things today in addition to my usual duties of taking temperatures, monitoring vitals during surgery, making puppy and kitty packs, and doing some light cleaning, which is always nice. I appreciate these busier, more out-of-the-ordinary days because I really feel like my presence is needed and that I learn a lot more. During a rather noisy appointment with a mother and her three girls, I saw how veterinarians must try to get vital information across to clients amid distractions sometimes. This appears to be a very difficult thing to do, which is why I think having handouts, pamphlets, and paper-based summaries of the visit are important so that clients can learn what they need to know about their pets' health when they have time and are less distracted.

Well, that's it for this blog post. This coming week will be exciting and busy because I will shadow twice again--once on Monday with Dr. J and once on Thursday with Dr. B. I'm looking forward to getting back to VCA Cedar to see some exotics. Emmie is actually going there on Tuesday to have a strange skin lump removed from her belly, right over where her bladder is. We think it's an overreaction to a bug bite--she's been licking at it, too, so it's pretty red. Dr. B looked at it and did an aspiration, from which she found that the lump is full of cells that have too much cytoplasm. She also noted a large number of white blood cells. Hopefully it's not cancerous, so we might have the lump sent out and analyzed after the surgery. Emmie is not really in pain, though, so I'm actually not that worried. I hope none of you will be, either. Have a great week!