Wait, I missed that, can you go over it again?

I think I missed the part when clinics ended. It was so sudden. No one went running down the hallways, no formal announcement was made, no one even tried to burn their coat. It just ended. One second we were on and then we weren't.

My last two weeks on clinics were nothing much to speak of. I was on my pathology rotation and didn't like it very much. Well, I should clarify. I liked the clin path portion in the mornings, but the anatomic path in the afternoons was horrible. I hated cutting up people's pets. Removing limbs, ripping off heads, cutting out eyes. Ugh. It was terrible. I know pathology is important but I personally don't believe in destroying bodies like that. Even though the pathologists try to be respectful I feel that the act of a necropsy is fundamentally disrespectful. We only had one cosmetic necropsy and it was on a Cockatoo. The bird died because it was seizuring every 5 minutes so a cosmetic necropsy wasn't likely to help. Everyone was making fun of the owners and saying how stupid they were and I seemed to be the only one that actually sympathized with them. The bird was 35 and probably had the same owners for its entire life. I can understand why they wouldn't want her head ripped off and the brain taken out. Luckily it only took a small incision on the head to find out what happened. The bird hit its head when it was flailing around and had a pretty large compression fracture in the skull. I did the suturing to sew the bird back up. I made sure she was nice and clean and dry so that the owners would be able to hold him before they buried her. I felt like I did a mitzvah. Like I said though, I know its important, I just hope I never have to do it again.

The worst part was that with the exception of a few cases we never found what killed the animals grossly. The worst was doing the horses and the aborted fetuses. They were so smelly and nasty. I got the fun job of running the gut on a horse and when I went to open the cecum I wasn't thinking and cecum gas burst into my face. It was horrible. Then, when I was doing an aborted foal the resident threw the body into a barrel and blood and guts splashed all over my face. It even hit my glasses, which I thankfully had on because otherwise it would have been my eye. I was none too pleased.

I can't believe clinics is already over. It seems like only a few weeks ago we were starting and had no idea what we were doing. I've since seen our class grow and change. We've all become a bit more confident. Some of us have stepped out of our shells. I've seen several people befriend new people in different groups. There are people who I never talked to before clinics that have now become friends. If I hadn't been forced to work with some people I may have gone 4 years without realizing what an awesome person they are. Then there is the opposite end of the spectrum. I still can't stand Damien and working with him in any way was miserable. And Allie, who will always have more drama than I can stand in her life. Who can forget the off-shore students? Paul came into the school and practically took over. Goodwin was awesome too, everyone is so sad that he's graduating and leaving us. And, of course, Glen who I still hate.

Its been an interesting 8 months. I learned so much about veterinary medicine. I actually feel like if I was put on the spot, I might be able to treat a patient on my own. I also learned a lot about myself. I started off with the mindset that I was going to go into equine medicine. Now I'm a small animal surgery girl. I also learned that I need to lay low to keep out of drama. Having drama in your life is not a good thing. It only leads to annoyance and anger. And no matter how tired I get, I am actually capable of still waking up at 5:30 in the morning to go to work.

Its been a long road with a lot of ups and downs but its over now and we can all relax. Now I can focus on our big class New Year's party. Classes start Jan. 2. Not much time to enjoy being free but I'll take what I can get.

This rotation makes me itch . . .

So I've started dermatology. Its alright. The first day we were done at 10am. No joke. We only receive on Tues., Thurs., and Fri. Its nice to not be so busy actually, especially since I'm sort of ready for clinics to be over. To be honest, I haven't even seen many interesting cases. Most of what we see are re-checks and all the ones I saw were doing pretty good. The clinicians are okay. The residents are pretty cool. She's one of the 1st year residents and she has a pretty good sense of humor which I appreciate. Dr. Highstress drives me up the wall though. She is so high stress that it makes me freak out. Everything makes her nervous which in turn makes me nervous. She freaks out over the dumbest things, like me picking up a bag of dog food or having to hold a cat. Plus she talks down to all of us which is infinitely annoying. Poor Mary, on the first day we had receiving Dr. Highstress started baby talking to her and telling her how unprepared she was. I thought she sounded harsh at the time so I said something to Mary later. Turns out Mary wasn't prepared because she just broke up with her boyfriend of 4 and 1/2 years the night before. Poor thing. Relationship troubles are never easy and getting reprimanded doesn't make it any easier.

Mary and I actually had an overnight wards shift together last night. It went by pretty quickly actually. She and I talked most of the night about everything from school to boys to the people we liked and didn't like. It was a nice little gossip-fest. One of the dogs, Maggie, was really sweet and we let her out for most of the night. She slept on one of the mats we laid out and I actually fell asleep for a bit next to her. The only thing about this wards shift was that the tech who rounded with us failed to mention to us that there was a cat in the recovery section. The lights were turned off and there's not usually supposed to be anything in there at night so Mary and I never went in. When the student came in the next morning to take care of the cat we realized that we didn't do anything for the poor thing all night. I was so pissed that he didn't tell us about the cat. I hate looking like a slacker. One of the ICU techs called the clinician for us to make sure we didn't get in trouble. Turns out the same tech forgot about the cat the day before too.

Because the fates are against us we are on primary call this weekend. The derm residents are usually not on call and when they are they hate it. I mean, thats why they go into derm, to not have to do emergencies. I like seeing emergencies so I kind of hope I get called in. Call me a glutton for punishment.

Good-bye barns!

Its over! I made it through large animal surgery! Alright, I'll be honest, it wasn't that bad. This past week was actually okay. We had a couple of interesting surgeries and we worked well together as a team. This rotation was not nearly as bad as my large animal medicine rotation. I had a laryngeal tie-back surgery which was pretty interesting. However, I did spend most of my time as a retractor and my arms were killing me by the end of it. But on the plus side I did get to stand on a stool and be the tallest person in the room for once, and I got to work with Dr. Freds who is so nice and has a great sense of humor. Then today we had to make sure that the tie-back was still in place so we scoped the horse. Dr. Gray actually let me drive the scope! It was so cool! Earlier in the week we had a horse go to surgery to have a tooth taken out. I got the lucky job of sticking my arm in the horse's mouth to show the surgeons where to repel. Then I had to catch the tooth. My hands smelled like horse breath for the rest of the day!

The three of us really bonded over this rotation. I feel like I have two new friends that I wish I had known about over the past two years. We have similar senses of humor, similar outlooks on life and none of us took ourselves too seriously. One of the girls and I sat up in one of the viewing rooms to watch a colic surgery one day and ended up talking for two hours just about life and school and everything else. Turns out she's super cool and I'm sad I didn't get to know her sooner. But after being in clinics and the changes in dynamics between my friends I'm definitely glad to have some new people to call friends.

We did have a little bit of excitement on the last day. A horse came in who was sired by Storm Cat (yes, THE Storm Cat). This horse was worth $500,000 before he was even born. He was colicking so badly he looked like he was just going to lay down and die. Another classmate tried to tell me he didn't look so painful because he wasn't rolling or biting at his sides. I tried to explain to her that he was WAY past that point. I can't adequately describe how he looked, it was so bad. They finally took him to surgery at 8 at night and instead of finding some crazy intussusseption it turns out he had proximal enteritis. Well, now he's got significant ventral edema since he can't hold fluid in his vessels and he has his feet constantly iced. The sad thing is that he was already slotted to run in the Kentucky Derby this year. Unfortunately its not looking like thats going to happen for him. I don't know how the case turned out but it was very sad.

I go onto dermatology next. Then after that pathology. Thank goodness, I'm starting to wind down, my brain is done with this whole clinics thing.

Thanksgiving.

So Dr. Gray was really nice and let us split up coming in over the Thanksgiving holiday. I only had to go in Friday to do 8am and 2pm treatments. My sister came into town. She drove from Charleston on Wednesday and we had a nice time. We saw a couple of movies, hung out, I gave her a tour of the vet hospital, and through it all we didn't really fight. We had Thanksgiving dinner with my synagogues cantor and his wife and their two sons. It was a great night. The food was awesome, we had good conversation and my sister got to talk to their son about doing Teach for America. It was nice having a good visit with my sister. We used to never get along and the thought of us hanging out for 3 days was unthinkable. We've come a long way. Well, I've come a long way at least. She is still hard to deal with sometimes but I was able to let go of my pride and let things slide off my back. Who knew I was capable of such things? It was also a nice break from the vet school thing. Having her around meant I had someone to talk to about different things like what's going on in the world, family, movies, whatever. It was a great visit and I'm glad she came.

Slowest rotation ever.

Large animal surgery has officially started and it is slow. Painfully slow. We found out on the first day that our attending clinician just decided to not come in for the first two days. That means we can't do surgery this week. Not much of a point to being on a surgery rotation and not be able to do surgery. At least my team is great. I'm on a team with two girls who are are really chill and drama free. The other team is a compilation of the most annoying students from my class. Ugh. I would have shot myself if I was on that team. I'm friends with Heather but her know-it-all attitude really drives me nuts. After my LA medicine experience with her I don't think I'll be able to work with her again. So my team and I have spent the first couple of days just trying to keep ourselves from going crazy with boredom. Our resident, Dr. Gray, is nice enough. She moves a lot slower than the other residents so it takes forever to get anything done. But all in all we have a good team.

We do have a couple of inpatients. I have a mare named Stop Whining who had a failed laryngeoplasty and now has a draining tract. They had to remove the sutures and now she is useless as a racehorse. Poor girl, she's just going to be a broodmare now. Now that her tracheostomy tube is out she's going to go home to heal up and then thrown out in a field to have babies for the rest of her life. I also had an emergency come in today, a horse named Cracker. We were told that Cracker ran into a car but after talking to the owner it seems she found him in the field with his injury. He had an open wound just distal to his stifle. The middle patellar ligament was torn and flapping in the wind and there was a piece of bone floating around that we discovered was his tibial crest. Kind of an important insertion point for some muscles, like, oh I don't know, the biceps femoris for one. Yeah, not so good. We took out the dead bone and sewed his leg back up then prayed. The best part of the story was that the owner had another piece of bone that she found on the car (we can only assume there was a car in the field that he ran into . . . go figure) and wanted to know if we needed it. Umm, not so much.

So hopefully we'll get some cooler surgeries and the rotation will pick up. My sister is coming into town for Thanksgiving, should be interesting.

Ahhh, the joys of Movember.

Yes thats right. I said Movember. You see, something strange has taken over the small animal hospital. The sweet aroma of mustaches is in the air. The romantic tingle of facial hair has captured all of us. This year some of the surgery residents and clinicians, along with several students, techs and several people from other departments has taken up Movember. A month long celebration of the mustache in an effort to raise money for prostate cancer awareness. The men started the month of November clean shaven and at the end of the month they need to have a full blown mustache. People are asked to donate money to their favorite Mustache Man and whoever raises the most money is the winner. This has led to some strange facial hair. Dr. Coomes has a nice handlebar mustache, Phil has a moderate Fu Manchu, Dr. Black has . . . well no one can really define his mustache. The creativity some of the guys are showing is amazing. I will have to post pictures at the end of the month. The best part is that all of these guys are seeing clients while looking absolutely ridiculous. It is awesome.

Neuro has come and gone. Lulu finally went home today. Even though I am now on large animal surgery I went up to meet her owners and say good-bye. Her owners were so grateful for all that I had done that they almost cried when they met me. They tried to convince me to stay in Florida and work for their son (who is a vet) when I graduate. They even bought me Angel perfume for being their own angel. Lulu is doing great. I think she'll be up and walking in a month or so. I'll miss her though, she was a great dog and I got really attached to her.

The last week in neuro was interesting. We had Captain Satellite. No really, that's what's printed on his name badge. He's out there. Way out there. Half of what comes out of his mouth makes no sense. This man taught one of our classes freshman year dressed in a pink bunny suit. Sounds like a cool guy to work with, right? Not so much. He was argumentative, rude, and just an all-around annoyance. He called one of my classmates a scum-sucking loser. Not in a serious way but it wasn't funny either. Not that that particular student was on my good side this rotation (he acted like he didn't even want to be in vet school), but still, he's not scum-sucking. I did have my first back dog though. Charlie. Charlie was this fat dachsund with a ruptured disc at T11-T12. The surgery was awesome. We took so much disc material from the spinal canal. It was like pulling out loads of cheese. Then the resident let me close completely, all the layers! It was so cool!

Speaking of cool. I can't forget to mention the heartworm removal I got to see last week. Cardio pulled 27 heartworms out of this dog through the jugular vein. It was quite possibly the best thing I have ever seen.

Its a weiner wonderland.

I've just spent the past week in the neurology lab. No, it wasn't to evaluate my head, or my cat's (who I'm pretty sure thinks he is a Labrador puppy). I'm actually really enjoying this rotation. Of course, it helps that one of our attending clinicians is hot, has an awesome sense of humor, is fun to hang out with and is super nice. Did I mention that he was hot? I've actually been learning quite a lot and having fun doing it. Oddly enough we've only seen one wiener dog with a ruptured disc this week. Its been incredibly slow.

Well, sort of.

See, the first day I volunteered to take Lulu as my case. Lulu was a mess. Lulu is still a mess. And there is next to nothing we can do for her. See, Lulu came in for hind-end weakness. Some sort of spinal problem right? Not so much. She had already been started on steroids to no avail. An MRI showed increased contrast uptake in the muscles around both hip joints. Odd. She was started on antibiotics to treat for any possible infectious cause of myositis. It would have been all well and good, well, if she would have responded to treatment. They took muscle biopsies from the biceps femoris which just came back as atrophy (which was of course from the near immuno-suppressive doses of steroids she was on). So another MRI was taken. This time the inflammation in the muscles around the hip joints was even worse. The odd thing was that it was uniformly bilateral and only really affecting certain muscles. Over the next few days we managed to rule out every cause of focal myositis that we could think of. Infectious . . . no, titers came back negative. Autoimmune . . . no, there was no response to high steroid doses with azothioprine. Neoplasia . . . maybe, but doubtful because it was so uniformly bilateral. Metabolic disease . . . no, she was too old (3 years) to start showing signs and the rest of her body was unaffected. Then we went in surgically to take specific biopsies of the affected muscles. After waiting for days we finally got our answer.

Lipid storage myopathy.

So we were wrong. Very wrong. It was a metabolic disease. One which has only been documented in 25 dogs. Ever.

And now here's the problem. She has no muscle mass left from being recumbent and on high doses of steroids. She is still incredibly painful. And, worst of all, there is no definitive treatment for this disease. We're not even sure what causes it. All that's in the literature is supplementation with riboflavin, co-enzyme Q10, and l-carnatine. And even that is questionable since its been so rarely documented. So now we have Lulu on a crash course of steroid weaning (since they're probably worsening the problem) and we're praying and hoping she doesn't go into an Addisonian crisis. Maybe, just maybe, if we can get her through this she might be able to make it. But who knows. We're not sure if any case of this has even been successfully treated. Its just a waiting game now.

Lulu is a great dog. She is a sweetie and a real trooper. I've gotten rather attached to her and I don't know how I'll handle things if it looks like she's not going to make it. Its hard enough when you can treat a disease and owners choose not to, but when even the best you can do may not be good enough, well, to me that's even worse. She doesn't deserve this. She deserves a cure and a happy healthy life. But no matter how hard we try our medicine will not be good enough. All we can do is wait. And pray.

I'm not completely sure what happened this past month.

Wait a second, I seem to remember there being a month called October somewhere in there. Where did it go? Oh right, I was on small animal medicine. Seriously though, I have no idea what happened to this last month of my life. It just flew by. Medicine was probably one of the cooler rotations I've been on. They actually force you to think like a doctor and make you come up with diagnostic and treatment plans and then defend them. The first two weeks were incredibly rough, I felt like I was always at the edge of cliff and if it wasn't for my books I would go tumbling down into the oblivion. Then I got my mid-rotation review and guess what, they liked me. They thought I was doing a good job. Amazing. That gave me the confidence boost I needed and the last two weeks went great. I felt like I knew what I was doing (at least a little bit anyway) and, even better, I felt as if I was getting respect from the clinicians and residents. It was amazing. I barely slept and I only came home to eat and pass out, but despite that I think I'm going to miss it. I feel like this was the rotation that was going to make or break me and it sure as hell didn't break me. That's a good feeling.

The social dynamics were interesting. I managed to spend a whole month with Glen and not flip out on him. His true colors came out the last day though when he case-dodged and pissed the hell out of Dr. McCarthy. He felt that him going to the city this weekend was more important than taking a case even though it was his turn to take one. Whatever. I managed to deal okay with James and Kimmi being all buddy-buddy. I think I'm jealous of Kimmi because she is getting his attention now even though I don't like him anymore. Boys are stupid. I developed a little crush on Goodwin this month, even though he's leaving soon, he's not Jewish and he apparently has a crush on my old roommate. Again, boys are stupid. Dr. Lemming managed to only piss me off once by yelling at me for no reason. That was exciting. Dr. Slick had a big Halloween party and I went as Dorothy and had a really awesome time. SCAVMA prom also happened while we were on medicine and that was interesting. Kimmi got so sick because she was determined to get wasted and drink away her sorrows of breaking up with her boyfriend of 7 years. Not a good idea. I ended up taking care of her. After washing her up and getting her in bed I stayed at her place so that she would be able to get to school to take care of her in-patients the next morning. Poor Kimmi, she's still obsessed with Damien and he's nothing but a giant asshole. All in all a lot of fun was had on this rotation.

Some pretty cool cases came my way too. Mad Max was one of my favorites. Just another everyday case of ideopathic immune-mediated hemolytic anemia but this little dog was so cool. He was this little dachsund/jack russell cross and he couldn't have been cuter. His mom was a sweet heart too. She just wanted little Max to get better and she was willing to anything as long as it was within reason (which is why I liked her so much). Mad Max did eventually start to get some red blood cells back and he's doing a lot better. It was pretty rewarding and made me feel good to help out such a happy pair.

My last case though was not so happy. Probably one of the most interesting things I'll see in my entire life though. Timon is an Alaskan Malamute who came in for evaluation of swelling of the nose and between the eyes. Well, when he came in this is what I saw:
Well, needless to say, this was not normal. At first I thought, 'how could these people let this get like this?' But then I heard the whole story. The whole thing started a year and a half ago as just some green lacrimal discharge from the right eye and a small swelling. As soon as they saw something wasn't right they took Timon to the vet and started trying to figure out what was going on. They did everything: cultures, biopsies, antibiotics, steroids, even NSAIDs. They even went to a specialty practice which told them it was a tooth root abscess and they pulled 2 premolars. Well up until about 3 months ago the swelling stayed relatively small and then all of a sudden it grew into the elephant nose that I was seeing. This poor dog was a mess. We immediately knew we had to get a CT and biopsy the shit out of it. Once we saw the CT we knew this was bad. He no longer has any bone on the right side of his face. Both of his nasal cavities are completely occluded. There is an oral mass (which when we biopsied it popped like a zit only it wasn't pus that came out, it was necrotic tissue). And we could see why it was so hard to get a good biopsy/culture sample. It had tons of pockets of necrosis and fluid. Luckily we were able to do a CT-guided biopsy that will hopefully give us the answer. Right now we are banking on cancer. And unfortunately, due to the location and size of the mass and the fact that he has very little bone left, this may not be treatable. At most we'll probably be able to give him a few more comfortable months. Its such a tragedy. All the right things were done but the nature of the disease prevented a diagnosis. Myself and Dr. McCarthy were beyond frustrated.

Actually, I seemed to be the Nose Queen this rotation. I had 3 nasal cases including Timon. The other two were both chronic unilateral nasal discharge, woo hoo! One of them turned out to Aspergillus (fun good times) the other one we're still waiting on tests but my money is on fungal or chronic foreign body. Sill long-nosed breeds sticking their noses where they don't belong!

My final review was awesome. The doctors said they had a really good time working with me. They thought my knowledge level was good for where I am in the program. They also thought I was very enthusiastic and liked that I jumped on taking cases. Overall they think I am doing great and I should be getting ready to be my own vet. A very scary concept.

My cats live here, I'm just visiting.

That's how I feel these days. See, the last two weeks I've been on the small animal medicine rotation. Despite the fact that the service has been relatively slow I have been coming home only to eat dinner and sleep. This rotation is a little different from all the others because we are expected to act as the doctors. We are expected to make our own differential diagnoses and a plan. Then we report to our clinician with what we want to do only to have it promptly smacked down. The first few days were rough, I think we all felt as if we got thrown into the deep end of the pool and didn't know how to swim. I was dumb (or brave) enough to volunteer to be the very first to present at rounds. I didn't know enough about the interrogation I was facing to be scared. I presented a case about a vomiting cat with gall stones. I was not as prepared as I needed to be although I don't remember having that deep feeling of panic. Maybe I was just shell shocked. After that though I was inexplicably afraid to present again.

This past week my team has been on with Dr. Chase and I have been lucky enough to have her on my cases on both receiving days. Dr. Chase strikes fear into most students. She's tough, she'll try to lead you in the wrong direction, she'll let you talk until you back yourself into a corner, she'll make you play hangman if there's a word you can't think of and she'll keep asking questions until she trips you up. However, she's a fabulous teacher and forces you to challenge yourself. Personally, I love her.

My first long term in-patient was a 17 year old Jack Russell named Tas. Tas presented for chronic vomiting. We ran so many diagnostics on the little guy and kept him in ICU for days, we even had him on total parenteral nutrition. He was such a cute little guy, he liked to just wander around the hospital with his IV pole and one of the ICU techs in tow. We worked so hard to try and resolve his vomiting even though we couldn't explain why it was happening (my money is on GI lymphoma). Poor thing had to be euthanized last Saturday. The interesting thing about this story is that it was the first time I really felt like I saw an animal tell us it was time to go. He had been having more episodes of what we could only attribute to dementia (panicked barking, circling, panting, all around anxiety) but was still relatively stable. I thought he was worsening a little bit but when I took him outside and put him in his mom's arms I saw him close his eyes and I could almost feel him give up. I can't adequately describe it, I'm not sure anyone could. And it wasn't as if he gave up in a bad way, he was just telling us that he was old, he had a good life, and he was ready to rest. At that moment I really understood the gift of euthanasia. He was a great dog and he'll be greatly missed, but I know that he's happier now.

My other patients have not been nearly as intensive, or depressing. I actually did a re-check on a cat yesterday that survived a heartworm infection. Its been four months and yesterday he tested negative for heartworm antigen and is doing great. I also had Harvey, a former blood donor cat with chronic renal failure, who came in because he vomited and then passed out. Sounds horrible but he did very well in the hospital. He tried to maul me once or twice when I was messing with his catheter but other than that he was actually a really cool cat.

An interesting case. Yesterday I saw a young kitten (approximately 7 or so months old) with a chronic lymphocytosis (small cell, well differentiated). That's all that is wrong with her. Well, that and her cranial mediastinal mass which we're not quite sure what it is. We're actually going to do flow cytometry on her to differentiate her lymphocytes. Its a strange case because we can't really find an explanation. There have been reports of this in young kittens (random chronic lymphocytosis) but the look of that mediastinal mass is not promising. She has tested
FeLV negative three times already but who knows. Hopefully something cool will come back from the flow cytometery and we will know more.

All in all I'm liking medicine a lot. Its hard, its busy, I'm tired, and I have to work with Glen all day but for whatever reason, I'm really loving it.

Huzzah, no more cows!

So this was probably my worst week of clinics yet. Monday was terrible because I had made myself sick from crying all weekend and we had to go to DPS (or as I call it, the concentration camp for calves). We had to dehorn 106 calves. Thats right. One hundred and six. Luckily we had two dehorners and by the end of it we had a system going that was working pretty well. By the end of the day I was ready to just lay down and sleep for like 4 days.

Tuesday was a short day. We traveled to NF Holsteins, a wonderful operation with happy, clean calves. Over on the adult cow side of things we got to see a cow with unilateral femoral nerve damage. She had atrophy of just her quadricep muscles and couldn't really bear weight on the limb. Our guess is that she slipped or was otherwise injured, its really the only explanation. We were back and out of the vet school by 1. I did a little happy dance.

On Wednesday things started taking a turn for the worse. Not only did we have to go to DPS again I was starting to feel sick. Like wanted to throw up and keel over from pain sick. I think it was when we started doing necropsies on some of the dead calves that I almost lost it. It felt like food poisoning only I couldn't actually vomit, I was just super nauseous. I don't know which is worse. Somehow I survived the day. It lasted forever. Every time we thought we were done they would bring us something else to look at. My favorite was the cow that was 7 months into lactation and her milk production was going down so they thought she had an LDA. Right. Really she was just naturally drying off but these people apparently wanted to suck every last ounce of milk out of her. Then we watched a parturition with dead twin calves. Then we had to go back to the calf field to bleed another calf and figure out some 'mystery medicine' they had. Finally we left and when I got home I spent the rest of the night in the fetal position in my bed from pain.

Thursday. Abdominal pain got worse. Had to go to the DRU to work with calves but there were only a few. Then we rechecked my LDA cow that we did surgery on last week. She was doing so poorly. On rectal they felt large masses that they thought were fibrin clots. So we decided to take her back to the school to euthanize her and submit her for necropsy. It took 40 minutes and 260 mL of euthanasia solution to kill this cow. Her blood pressure was so low and her vessels were so weak that every time we got a bit of the pink juice in her the vein would blow and she couldn't get it circulating. We almost had to do an intracardiac stick. No joke. But finally she passed. On necropsy they found that there was an abscess under her incision site and the abomasum had displaced again. It had become adhered to the left body wall and big fibrin clots had formed. There was no saving her, we did the right thing.

So today my abdominal pain got way worse. Luckily we didn't have to go to any farms and it was just a half day. I took myself to the ER and after some IV anti-nausea medication, a CT scan and some bloodwork the doctor informed me that I have a functional ileus. Awesome. He didn't want to give me anything to force my gut to start moving because I was already in so much pain. He sent me home with some miralax which supposedly will help convince my GI tract to start moving again. Thank goodness I'm going on vacation next. I think I need one.

I wish I couldn't cry

So this weekend blew the big one. Lets begin at the beginning.

Friday.
Party sucked, didn't end up going out. And then Damien acted like a dick, as usual. A bunch of my friends and I were all supposed to go and get tattoos together once my best friend's boyfriend said it was okay (don't ask). Well, he finally gave the go ahead and we were going to go, it was just a matter of when. The thing is, I can't get a tattoo, its a religious thing, I just can't do it. But, I really wanted to go with my friends when they got one because I was always curious about the experience and thought it would be fun. Then I found out at the party that they already decided when they were going and not only didn't tell me but now Damien was invited. I asked if I could still come and Damien asked if I was getting a tattoo. I of course said no because of my religion and he said, "then you can't come. This trip is only for people getting a tattoo. Why are you being such a pussy and not getting a tattoo?" Needless to say, now I feel completely uncomfortable and don't really want to go and feel unwelcome. Damien crossed a line calling me a pussy because my religious beliefs preclude me from getting a tattoo. And the worst part, no one stood up for me. Not one of my friends. That sucked. A lot.

Then my best friend reveals to me that she has a crush on Damien (she has a boyfriend, by the way). wtf. I hate that kid, she knows he's an asshole, but she said he "has his moments." No really, he doesn't. He's just an asshole.

Saturday.
Despite telling everyone that I wanted to tailgate with them before the game even though I didn't have a ticket, I was left out yet again. No one called me and I couldn't get a hold of anyone. I found out right before the game that my friends had tailgated all afternoon and just forgot to call me. Well, that sucked but I'll get over it. So I watched the game with my best friend, Kimmi, and we hung out and had a decent time. Then Kimmi's phone rang. She was giggling and then told whoever it was that she would call them later. I asked if that was her dad (it sounded like she was talking to him) and she said, "no, it was James."

Wait . . . what? Surely it could not be the James that I was dating earlier and who was a moron and dropped me like a hot cake because he didn't want a relationship? (Side note: I found out later that James made it a habit of hitting on every single girl in the vet school and being an all around douche bag.) So I said, "James who?"

"James R."

Yup, same James. Crap. So it turns out they've been friends for a while and they hang out, just the two of them, a lot. He was calling her because he was lonely. wtf. Then she showed me her phone and I saw that he's been texting her with suggestive messages a lot (just like he did with me). She seems to see no problem with this friendship. I feel kind of hurt. Kimmi was one of my best friends, we've been through a lot together and I've been there for her during some pretty rough times. I would have thought that she would have been like 'hey, this guy was an ass to my best friend, maybe he's not such a nice guy.' Apparently not. I feel betrayed. Maybe I'm over-reacting but of all the people I know I would have never expected this from her.

Sunday.
I talk to my mom about everything that went on this weekend and somehow she turns it around and blames it on me. I proceeded to cry for a long time.

I hate this bullshit. I wish either people didn't suck so much or that I didn't care so much.

No one ever said anything about blogging drunk

We partied tonight. In our own special way. My friends and I were supposed to go downtown and dance and have a grand old time but we decided to stop by the house where three of our classmates live before venturing out. A half hour stop turned into a long ordeal. Long story short: we never made it to any club downtown, one of my friends/classmate got into a big fight with a guy in our class, and I wasted the wearing of a perfectly hot shirt to just hang out with some peeps. Not completely true. See, the guy my friend was fighting with, also happens to be the guy in our class that I have a major crush on. Only problem is that if he knew I liked him I think he would run in the opposite direction. I'm just not one of "those" girls. You know, the popular and pretty ones. He's a member of our "fraternity". I use the quotes because its not a real frat, just a clique of people in our class that I don't actually belong to but hang out on the fringe of, kind of like the 3rd to last person that gets picked for the kickball team if that makes any sense.

Who am I kidding? Boys are stupid. Maybe I'll feel different tomorrow when I've slept off the alcohol.

Hey now, we may be smart but we vet students are awesome at consuming our alcohol.

A cow's life is not for me

So oncology has come and gone. The second week was rather uneventful we had only a few appointments because the clinicians were lecturing that week. I really had a lot of fun on that rotation. The techs were awesome and although being the only student was hard I liked the one-on-one attention. Learning about chemo was pretty cool too. Its amazing what we're doing in veterinary medicine these days. Whats even more amazing is how well the animals tolerate it. Animals do so much better on chemotherapy than humans, its crazy. We can't cure cancer but we sure as hell can make it go away for a while. Some of our patients are going on two years in clinical remission of lymphoma. It'll catch up to them some day but those two years are like an extra 15 for a person. Its amazing.

I've moved onto the food animal and reproductive medicine rotation (FAMS and we lovingly call it). I don't want to kill myself yet but I'm getting there. I was late the first day and it was Dr. Ram that was there to greet me. Dr. Ram has no sense of humor and his first words to me were: "We start on time here." Well crap, there goes that grade. Truth is, they never told us what time we had to be there and my friends all told me we didn't have to get there until 8:30. I tried to get there by 8:00 just in case but traffic was horrible so I didn't get there until 8:05. I felt like an ass. Oh well, no sense in beating myself up over the past right?

The field trips on FAMS have been . . . . interesting. Its hot, there's a lot of cow crap, and the smell of the silage makes me want to vomit. But it could be worse. The residents are all pretty cool. We joke around a lot and have a good time. My first day we did an LDA surgery and I got to scrub in. It was awesome. I had my arm inside the cow and was feeling the abomasum and everything. Although the face I'm making is less than flattering. They even let me close the incision. Unfortunately when we came back today the cow was looking very dehydrated and she had a 'ping' on her left side again. Even though we did a really solid omentopexy she may have displaced again. We'll recheck her in a few days to see what we need to do next.

The calves have been both the best and the worst part. One dairy farm we went to yesterday had this field full of hutches almost as far as you could see. The hutches were small and dirty and the little roofs barely gave the calves enough shade. They all looked small and sick. I almost cried when I saw it. Many of the calves had pneumonia and I know that last month a lot of their calves died from heat stress. We took blood from about 60 calves to test their total protein and 30% of them were at an inadequate level, only 40% were in a good solid range. The calves we saw today were in a better situation. They were in a clean and dry area with sand, a barn to shade them and plenty of fans to keep them cool. They seemed happier (if a calf can be happy). A lot of them were jumping up and down and wanting to play, it was very cute. We had to dehorn some of them. I didn't like that. Not because it was cruel, they couldn't feel it because we blocked them, but because I was terrified of missing and burning part of their face off. We used this tool that gets really hot and burns the cornual epithelium. Not something to mess around with. But all in all today was a better experience than yesterday with the calves.

Today we also got to lance an abscess. Finally, after months of being on clinics I got to see some good 'ol pus!! A cow were were removing sutures on had a big lump on her neck. We stuck a needle in it and pus just started dripping out. Dr. Mendle lanced it and pus just started to pour out of her neck. It was amazing. I got video of the whole thing. Then, when we thought there was nothing more that could possible be in there, Dr. Mendle pulled out this:
Just a gianourmous thing of fibrin. It was amazing. I couldn't believe my eyes. That poor cow must feel so much better now, I can't imagine having that much pus in me just stretching out the skin. It was so satisfying to take it all out of her.

So I have one more week of FAMS and then vacation. I can make it through one more week. I hope.

Oncology . . . cancer is keeping me busy

So I've been the only student on the oncology rotation this past week. Its been crazy. I've been staying mainly with the surgery side of the department for this week, next week I'll focus more on medicine. Its a great rotation, everyone is super nice and the department head, Dr. Miles, is hilarious. I walked in on him dancing to the song 'Gettin' Jiggy Wit It' the other day. I almost died of laughter. The cases are crazy. Some of these clients have been told there is no help for their pet and then they come here and we give them an option. A women came in with her dog, Tabasco, who had just been diagnosed with osteosarcomma. The dog has bad hips and stifles so the owner didn't want to do a limb amputation. We offered her stereotactic radiosurgery to treat the cancer. Turns out we're the only place in the world offering that for animals. How cool is that?

I had another crazy cat lady this week. Well, really, a crazy cat couple. The husband was scary. Dr. Fray likened him to Norman Bates. No really, he might murder us if the cat dies. The cat has a liver mass. Most likely its benign but the owners want us to take it out. Fair enough. Trying to get a history from these people though was like pulling teeth. I somehow managed to get the history of the cat's entire family. Don't even think about asking how many cats they have, they don't even know. The best part was when the wife taught me a song I had to sing to the cat when he got his asthma medicine. The entire oncology department has been trying to get me to sing it. Not going to happen. Later in the week I had to call them with the results of their ultrasound and fine needle aspirate (which the woman tried to tell me was the same thing as a biopsy . . . not so much). That was when I screwed up. She asked if we were going to do a clotting profile and cross matching on the cat prior to surgery. I said that I didn't think so but that we could do it if it would make her more comfortable. Apparently she was really upset by this and told the referring vet that she was losing confidence in us. Turns out, I found out later, that we always do a clotting profile on liver lobectomies. Luckily my clinicians weren't too upset with me because they think she's crazy anyway. I'm dreading when this cat comes in on Wednesday for surgery.

We had another dog come in, Rocky, who is a doberman with an oral sarcomma that takes up the front of his mandible. The other vets they went to see said they couldn't do anything for it. Our surgeons looked at him and told them that we could help them. Granted, he'll have to relearn how to eat but he'll be sarcomma free . . . at least for a little while. Its a very aggressive tumor and will most likely show up again in some form. It should be an awesome surgery, unfortunately I won't get to scrub in on it. Oh well, such is life I guess.

Our surgery day this week was ridiculous. We started off with Bart, who was supposed to have a liver lobectomy. Well, when we got in we realized the mass was too close to the hilus and next to some nasty large vessels. So we opted for not trying to kill the dog and tried to remove as much of the mass as possible without bleeding the dog out. Despite all our efforts he still bled a lot and needed a transfusion, he made it though. We still have him because he decided that peeing on his incision was a good idea and now has an infection. He's still having trouble with the whole peeing outside thing, which makes taking care of him kind of a pain in the ass. Plus, he won't eat for us. I think he needs to go home at this point. He'll eat there and his incision looks 100% better.

So after that surgery, which took longer than expected, and getting Bart settled into ICU, Dr. Cane told me to grab something to eat quick because we had to get started on the next surgery. I grabbed a bag of chips and was halfway through before Dr. Cane and Dr. Fray started moving into the OR. So much for lunch. So we started the next crazy surgery. Poor little Dexter had a peripheral nerve sheath tumor on his sciatic nerve that extended up to nerves L5, L6, L7, and S1. So we had to do a coxofemoral disarticulation, hemipelvectomy, and hemilaminectomy in order to remove the leg and the nerves at their origin on the spinal cord. It was such a cool surgery, they even let me use the cautery to transect the muscles of the hind leg! Dexter actually did really well after surgery. He recovered like a champ and was running around on his three little legs like nothing ever happened. It was awesome.

Not everything is so happy about oncology though. Not surprising. Molly is this sweet cat with these owners that are just the nicest people. She came in to start a new protocol to treat her GI lymphoma and hemangiosarcomma (very rare in kitties). We did an ultrasound before treatment and unfortunately found that her hemangiosarcomma grew despite the treatment we had been doing. Since HSAs are such resistant tumors we decided that it would not be in the best interest of the cat. We had to tell the owners that it was now about end of life care and providing a good quality of life while we can. It was so sad, the wife was crying and the husband was being so supportive. You could tell that he was trying to keep it together for her. It broke my heart.

There wasn't much time to be sad though because I had to wrastle Marmaduke, an ill-behaved Great Dane. It was like trying to wrestle a foal. Litterally. He was huge. We had to give him medetomidine before we could give him his chemo.

Next week should be busy since we have to fit five days of appointments into four. Stupid labor day. I still have to go in on Monday to take care of Bart, the amazing peeing wonder dog.

Ahh . . . the soothing sounds of a ventilator.

I ran today. Not long. But hard.

This past week has been almost the complete opposite of last week. Last week I felt lost, confused, frustrated, pissed, and stupid. This week I felt like I may have actually known at least something about what I was talking about. Dr. Robert was on this week and, bless her heart, she talked to us like we were equals. She didn't make us feel stupid, or ask trick questions, or make us doubt ourselves when we were talking during rounds. Its amazing the difference a professor can make on a rotation. She liked my ideas! When I told her I wanted to use midazolam and morphine as a pre-med for a cat having major surgery she said okay! She said, go and try it, see how it works for you. She let us try things so we could see their effects. Of course, if we tried to use thiopental in a greyhound she probably would have said no, but still, it made me feel like a real doctor making real decisions. It was empowering.

I kicked ass on the test too. Only got 2 out of the 45 questions wrong, Dr. Robert said it was the best she ever saw anyone do. Thats pretty freakin' awesome.

Only bad part about anesthesia are the long surgeries when nothing happens. We had a dog under anesthesia for 6 hours yesterday and it only had a hypotensive episode early on that was quickly corrected with a dopamine CRI. The best part about that one was waiting 45 minutes in the middle of the surgery for cytology results to come back. Today we had a dog under for 5 hours and the surgery only took 40 minutes. What was the reason for that? One of the surgeons dropped the $10,000 scope and broke it. We spent wasted time waiting for the large animal department to stop whining and bring us their scope. The dog also needed radiographs which meant more time spent with Dr. Shay running around and tangling my monitoring equipment. He did steal me a cookie though from the radiology techs' office. That was nice. We spent our wasting surgical time watching the most uneventful monitor ever (this dog could have monitored itself) and reading Redbook and doing the crossword puzzle. Dr. Shay does not understand why American women read that magazine. I couldn't really explain it to him.

So all in all, anesthesia was a successful rotation. I liked it actually. I felt like I was challenged and that I learned a lot. Always a good feeling to have at the end of a rotation.

Diazepam? Yes please!

Its been a week of anesthesiology. I'm surprised it took them this long to make me cry. If you want to feel like a moron constantly, feel like you're going to kill an animal, and get treated like a five year old then anesthesiology is the rotation for you! This week has been long and scary. I mean, I've been drilled in rounds before but not like this. We present our cases and then give our anesthesia plan and try to explain the drugs we want to to use. Only problem is that most of the time we really have a wide array of drug choices we could use and its hard to pick one over the other. Do I really think that it matters whether or not we give diazepam or midazolam to a dog we're about to spay? No. And most people wouldn't care either. But these damn anesthesiologists know every nuance of the drugs and if you don't know that there was one study done at this place 3 years ago that showed that this breed of dog will get hypotensive if you give this specific formulation of this drug well then, you might as well quit vet school now. Dr. Barney is the worst with that. He knows everything. I mean it. Everything. I mean, its good and all but it make rounds exceedingly stressful because I know nothing. Okay, maybe not nothing but it sure feels that way.

We had a case come in last night to have an emergency spleenectomy. Well, the spleenectomy turned into a giant-basketball-sized-tumor-of-the-ureter-ectomy which then resulted in a rapid loss of 30% of this dog's blood volume. Needless to say, all the anesthesiologists within a 50 mile radius panicked. I tried to do my best to help push fluid boluses and monitor its blood pressure (the mean was close to 40 mmHg most of the time . . . not good) and Dr. Barney is standing there grilling me on calculating fluid replacement therapy and total blood volume. I told him I didn't know (which I didn't at the moment) and he told me that an animal's body was 8% blood and then asked me to calculate that volume. I stared at him for a good 45 seconds that felt like an hour and finally asked if I could use a calculator. What did he say? "Okay, but I'll be disappointed." I wanted to punch him in the face. Then I wanted to cry. But there was no time for that because thats when the blood transfusion arrived and I had to figure out how to ask how to set that up without sounding like too much of an idiot.

The dog is fine. He made it and is happy being tumorless.

Its not all bad. I've found a kindred spirit in Dr. Shay. He's this funny man who tries his best to make students afraid of him. I just find him hilarious. He is always yelling and telling me to not pull out the catheter he just placed or asking me if I've killed the animal yet. His favorite thing is to tell us about the things we'll need to know IF we graduate vet school. I just come right back at him with some sort of witty comment and we get along fine. I think he actually likes me and may in fact enjoy working with me on cases. Thats always good. He told me that he was impressed with my knowledge on acetylcholine. (I did a little internal victory dance when he told me that.) He actually told me that he and and another doctor used to make bets on which one of them could make the most students cry. They even had two criteria of judging: number of cries and quality of cry. Some would find that cruel. I find it hilarious. But maybe thats because I don't think Dr. Shay could ever make me cry. Which is a good thing.

I think I'll have more to say about anesthesia, but right now I'm exhausted.

My new escape

So there are only a few days left in my vacation until I have to go back to the slave labor that is clinics. I want to say that I'm really excited to go back but really, I've had such a relaxing time on vacation that I kind of want another week off. I think once I get back in the swing of things it won't be so depressing. Its not the work that I'm not looking forward to, its the people and the drama. My new resolution is to stay out of trouble and out of drama! You heard it here first. Now lets see if I can actually do that. Lets ask the magic 8 ball:

"My sources say no."

Crap.

Well a girl can try can't she? A friend from college used to say: "drama free is the way to be." Thats going to be my new motto.

Actually, I'm kind of excited about the group that I'm going into Anesthesiology with. They're all people that I know I get along with.

Right now I'm sitting in a little coffee place near my apartment. Its my new safe haven. So far it seems like few undergrads frequent the place which is awesome. Its an older and more hippie crowd. I'm not really a hippie but I do appreciate the quiet atmosphere. Although, fall semester hasn't started yet and once September hits everything might change. But for now its a nice place to study anesthesiology and listen to my Jason Mraz albums.

Vacation and other things not related to clinics

Vacation is so much better than anticipated. Right now I'm sitting in the airport in Charlotte waiting for my connecting flight that will take me home to Connecticut. I am desperate to go back to New England. The south is hot, humid, and filled with people that hate Yankees. And let me tell you, I am a Yankee through and through. Born and raised in Connecticut, it doesn't get much more northern than me. I've also been desperate to run as far away from the vet school as possible. I think my soul is slowly being sucked out of me one SOAP at a time.

Don't get me wrong, I love vet school . . .

At least thats what I keep telling myself.

I mean, really, vet school sucks, there's no getting around it. But someday it will all be worth it when we've gone over the rainbow and can be called a doctor.

Enough of me trying to wax poetic.

On our last day of therio we made a video of a client stallion being collected. It was filled with Dr. Plain shouting things like: "He is a very dirty boy!", "His penis is very small!" and Jack
giving commentary with a helmet on on how the stallion was having difficulty with the phantom. You can't do equine repro and not have a sense of humor. Hopefully Amber will edit the video and we can post it or at least have it so we can show it for senior skits. I'll miss Dr. Plain, she was one of the only good things about being in the large animal hospital.

Saturday I got my vacation started off right. Jon just started a new club at the vet school called the Veterinary Sportsman's Club. Its a club for students who want to go out and do things not related to vet school. Our first trip was out to the Gulf of Mexico to go scalloping. It was awesome! We went to 4 different sights and caught our limit of scallops. It was just a fun day of hanging out with new people and old friends and just swimming and having a good time. One of our residents, an anesthesiologists, is from England and had never been snorkeling before. He apparently had also never seen the sun before because by the end of the day he was purple. One of our other attendants, a future clinician, updated me on all the administrative dirt in the hospital. It was such a good time, but I got so sunburnt. Apparently its advisable to wear a shirt when swimming in the Gulf because the sun is so strong. Despite putting sunscreen on 3 times during the day I still got a massive burn on my back. Its 3 days later and it still hurts.

It was nice to get away from the drama and high stress for one day. I hope there will be more chances to do that since I'm sure there will be more drama.

In other news I hung out with my ex-boyfriend Dave last night. We had drinks last week just to catch up. Last night though he was hanging out with a friend who lives in my apartment complex and I got an invite. Later he walked me home, met my cats and then proceeded to make out with me. As nice as it was to be kissed it wasn't right. We tried the whole 'friends with benefits' thing a year and a half ago and it didn't work then. I don't think it will work now. I think he understood.

Boys, who needs 'em right? I don't, I have Murry and Lexy . . .

High school has got nothing on vet school

No interesting cases this week from therio. Not surprising since the breeding season is over. Although we did have a mare that had an ovarectomy the other day. The biggest excitement though wasn't the surgery but the drama associated with it. This pony mare was scared to death of people. Dr. Plain had been working with her and I had gotten to know her a bit as well. When surgery came to give her an injection I held the mare for them since she knew me. Well the mare still acted up (which we expected) and all of a sudden everyone had to put in their two cents on how to make her stop. The techs got a bit rough but what could I do, talking back to the techs is a cardinal sin in the large animal hospital. Then all of a sudden one of my classmates, Tami, came and just grabbed the horse from me, as if I wasn't doing a good enough job at restraining it. I left the stall so that I wouldn't flip out. When we (repro) took the mare back I told Tami I could take it from there. Then she starts giving me this whole song and dance about how she took the pony so that I could go do other things. I just snapped. I basically told her that I didn't buy it and that I didn't appreciate having any animal grabbed out of my hands. Later I found out that the surgery techs were complaining that I was being snippy in the stall. That was when I really lost it.

I cried for a good 15 minutes in the bathroom.

You see, its been a whole month of me being told how to hold a horse, that you have to smack the horses around to make them behave, that all the horses in the hospital were stupid and ugly and I just finally had it. I can't take the bully mentality that most of these horse people have about the animals. This one mare I wanted to protect. And when she was grabbed out of my hands I just got so angry that I snapped. And even though all I was trying to do was protect her everyone made it look like I was the asshole. It didn't help that half of Tami's family is currently in the hospital and her horse died last weekend. All of which I wasn't really thinking about at the time. Yup, I'm that asshole.

Dr. Plain saw I was upset later and we had a talk. She totally understood and knew that I was just trying to do the right thing. I love Dr. Plain, she's one of the few genuinely nice people in the large animal hospital. She actually likes horses. You would think more people that work there would feel the same.

And then today Glen confronted me. Apparently I made a comment to someone about him being an asshole (which he is) and that person told Glen I was telling people that he was a bad person. Glen wanted to know why I was telling people this and why I didn't like him so much (as if cheating on my friend wasn't enough). He doesn't understand what he ever did to me or Haley. I told him that no, I didn't like him and that I didn't care to get into a conversation about why. I also told him that I wasn't going to lie to people when they asked me what I thought about him (although now I'll be more careful about who I say things to). It was then he told me that we weren't in high school and that I should be more professional.

We're not in high school? No, we're in something far worse than high school. Everyone knows everyone's business, even the clinicians and residents are involved. People talk about crossing a line but I'm not even sure there's a line drawn to cross.

I started vacation today. Not a moment too soon.

Look at me being all computer-smart! (There's a good medical story in this post I promise)

So when I was on large animal medicine this cow came in that had tetanus. She could walk when she came in but it was stiff and stilted, her ears were retracted, she couldn't move her mouth and she couldn't eructate which caused her to have horrible bloat. We initially managed her with tetanus toxoid, antitoxin, penicillin and acepromazine (to relax her muscles a bit). We even did a rumenostomy procedure so we could feed her directly into the rumen. She didn't get better but she didn't get worse. Until 3 days after admission that is. I found her totally recumbent with all 4 legs extended and having tetanic contractions every few minutes. We gave her IV magnesium sulfate to try and help relax the muscles but she didn't respond the way we wished she did. So I took some great video of this and finally figured out how to post it on YouTube. Take a look at it here. Tetanus is pretty rare in adult cattle. In this case we couldn't find any injury so we haid to assume she got it from a build up of the bacteria in her GI tract (which I didn't know happened until I had to research tetanus for this case).

This case didn't have a good outcome. The owners came to visit her a day after we found her like that. The owner was this old woman and her neighbor who took care of the cow (whose name was 'Boo' by the way). The neighbor was this little old man who was totally in love with this cow. When he got in the stall and started crying I almost lost it. It was so hard for him to see Boo like that. Later when we had to euthanize her Dr. Flip said "Here, go give this, I have to check that alpaca" and then handed me the 'pink juice' and left me. On one side of the stall my friends were chatting like nothing was going on and on the other side the animal techs were waiting with the forklift to take Boo to pathology. I was somewhere between crying and not knowing what to do. But instead of freaking out I collected myself and gave the euthanasia solution. How's that for a first euthanasia?

Some neat pictures of cases

So I realize that I've been very lax in posting pictures with my blogs so I'm making it up for it now with pics of some of the cases I've talked about.

This is Speedy. He's one of the resident gopher tortoises in the zoo med department. He had a broken ulna so we made a makeshift sling for him out of duct tape. He was not very happy about it!





The next few pictures are of Buddy, the dachsund who I wrote about earlier (under the post "Buddy's Story". The most recent news with Buddy is that he's home doing very well with very grateful owners!
This is the chop job that buddy had done by the emergency vet. You can already tell that there is something nasty going on with that skin.






The picture to the left was taken intraoperatively (duh). You can see we're holding back the liver and oh, whats that? Oh yeah, thats a rib in the abdomen. Not good.







Here is Buddy after the surgery. He had so many tubes coming out of him for a few days. He basically just stayed like this for 3 days. It was heartbreaking.








This is after we removed the vacuum bandage. Look at the beautiful granulation tissue!









And then this is Buddy a couple of days after we removed the vacuum bandage. Look at him standing all on his own!!





And now for my favorite picture yet! A pic of me doing CPR on a foal. I was such a rockstar!

Makin' babies

LA Medicine has come and gone and I'm now about to start my second week of LA Theriogenology. We basically spend our days palpating mares and collecting stallions. Its very easy going, we get out early, and we have a bit of fun. I'm enjoying it actually. We've taken a couple of repro courses during the first two years but I never understood anything from them. But on this rotation I feel like I really do understand everything we're doing. Everything they talked about in class all of a sudden makes sense. Its a good feeling. I've also started improving my palpating skills and do pretty well with the ultrasound. The joke around the barn is that I'm a rockstar, which started with the CPR I did on that foal during medicine. Dr. Chris calls me Shakira.

We also get to play with the mare's babies all day. Which is awesome.

Why am I not one of the pretty ones?

We went out last night. I started off the night confident and cool, nonchalant, looking hot, and just wanting to have fun with some friends. And then the same thing happened just like every other night. Soon I found all the guys paying attention to all the other girls, I was being pushed out of circles, dancing by myself. My ex-roomate, who was with us, was getting all the attention. There was this one resident, a nice guy, kind of a dork, smart, funny, cute accent. He wanted to be hooked up with her. Her. Of all the people. A girl who thinks she's too good for anyone and the hottest shit on the planet. She wouldn't appreciate someone like him. She's too superficial. Not that I really would be interested in dating a resident or clinician myself but its nice to get some attention once in a while. Just once I'd like everyone to pay attention to me. I want to be that girl just once.

Some of my classmates told me today that I just have to be confident. I am confident. At least, I usually start off the night like that. But when I see all the guys going after the skinny girls with perfect hair and perfect smiles that sort of throws me off a little. I just wanted to tell them that maybe if it hadn't been for perfect plastics like them treating me like crap my whole life maybe I would be more confident. Most of us can't be born with perfect looks and smiles and amazing confidence. Some of us can't play "the game". Some of us are just trying to get by and want just one person to think they're cute every now and then.

She's giving boys what they want, tries to act so nonchalant,
Afraid they'll see that she's lost her direction.
She never stays the same for long,
Assuming that she'll get it wrong.
Perfect only in her imperfection.

She's not a drama queen,
She doesn't want to feel this way, only seventeen but tired

She would change everything for happy ever after.
Caught in the in between, a beautiful disaster,
But she just needs someone to take her home.

One more down.

Large animal medicine is coming to a close and I don't really know how to feel about it. There were a lot of positives. I liked the medicine and the procedures we got to do. CPR on Sarah's foal, a respiratory function test on Smart Sugar Badger, converting atrial fibrillation in Ball in the Family. Even treating tetanus, and eventually failing, with Boo.

I loved working with the horses. I'm happiest when I'm with a horse. Always have been.

I got to make new friends. Who knew that I would get along so well with Veronica, or that I would find a new friend in one of the seeniors. I even got along with Kristy.

Unfortunately, there were also a lot of negatives. For as much as I love horses I hate horse people. Being around that environment again brought back memories and feelings I never wanted to have again. The politics and the negativity surrounded me. I hadn't thought this much about Rich and Jay in years but everyone seemed to remind me of them. Everyone had to put in their two cents. Everyone knew better. And no one really treated the horses right. Even Haley. My best friend. I couldn't stand her during this rotation. She was the worst of all of them and the biggest suck up.

As a result I changed my tracking. I am now on the small animal track. My goal is to work as a small animal vet and own a horse someday. Not make horses my whole life. I think things will be better this way.

I need to capture this feeling

Tonight I did something amazing. A mare with a ruptured prepubic tendon was induced to foal and out came a 1 month premature foal. After Dr. Flip and Veronica intubated her we realized her heart wasn't beating. When someone asked who would start CPR I just jumped right in and started compressions. Veronica and I got a rhythm going and amazingly enough the heart started beating right under my hands. It was amazing. I brought her back from the dead. And then her heart stopped again. Without even being asked I started compressions again. And miraculously we got her beating again. I started her heart not once but twice. Twice. I can't even begin to describe the feeling of accomplishment that I got. Unfortunately the foal didn't make it. She couldn't breath on her own. But I still think I did something amazing and I'm never going to forget that feeling.

Buddy's Story

This is just one of those crazy stories that has to be told. Bear with me, its a long one.

Buddy is a Daschund that came in on Tuesday as an emergency. He had been attacked by a dog (a German Shorthair Pointer) the past Saturday. The owners took him to the vet on Saturday night. This vet diagnosed a diaphragmatic hernia and decided to fix it. Buddy had a large wound on his back. The vet made an incision into the thorax that extended from the dirty wound. He fixed part of the hernia but couldn't reach to other part and since Buddy started crashing he felt it best to close and send him home. Couple of problems. The wound on Buddy's back had been sutured but not clipped or properly cleaned. The incision site now looked necrotic. Buddy was sent home with nothing but an NSAID for pain.

When I saw him Buddy was surprisingly still walking. His blood work showed a degenerative left shift. We immediately realized that this was an emergency and that we had a septic dog on our hands. After negotiating with the owner and deciding to make him a teaching case we went to surgery. We clipped and scrubbed the area of the wound and then went in through the abdomen to fix the hernia. During the exploratory that we did we found a severe case of chronic pancreatitis. We also happened to find one of Buddy's ribs protruding through the diaphragm into the abdomen. We fixed the hernia and moved on to the wound. The skin over Buddy's back and left side was necrotic. We also found that the vet had only done a one layer closure on the skin and underneath there was still a gaping hole in the chest cavity. We could see the heart and lungs. Not good. So after we debrided and flushed the wound and chest cavity thoroughly we apposed the ribs and put a vacuum bandage over the open wound.

Buddy lived with the vacuum on for three days. He had 4 syringe pumps attached to him at all times, sometimes 5. He had fluids and a urinary catheter. He also had a jejunostomy tube with all of his nutrients being pumped directly to the small intestine. We measured his CVP, intra-abdominal pressure, systolic blood pressure, PVC/TP, and urine specific gravity several times a day. He was on 2 antibiotics, 2 constant infusions of pain meds (fentanyl and lidocaine), plasma, anti-emetics, heparin, and even got a dose of packed red blood cells. We also had a chest tube in place so we could drain the fluid for him. Long story short: Buddy had tubes coming out of everything. Oh, and how could I forget the nasal oxygen? It was an intensive case to manage.

Finally we were able to take Buddy back to surgery on Friday. The wound looked amazing when we took the vacuum bandage off. There was just granulation tissue everywhere. During surgery we were able to completely close the wound. Since then Buddy's care has gone down significantly. He is no longer on any pain meds, we pulled the chest tube and urinary catheter, discontinued the plasma, discontinued the nasal oxygen, and stopped all of his intensive monitoring. He is definitely feeling better. He tries to bite the techs when they mess with him. Not out of pain, more out of being pissed off that he's there. We went on a walk today, it was amazing. And I think we have the sepsis under control now.

Unlike everyone else he rarely tries to bite me. We've gotten used to each other. I move slow and in return he lets me do what I need to. I also spend time with him when I don't have to do anything to him. I think we bonded on the very first day. Dr. Lemming wanted to see how he walked so she got down on the floor and called him to her. He looked at her for a moment and then trotted right over to me. I feel like his guardian angel. He is doing so well now. I thought for sure he was going to die as soon as he got here. Now it looks like he's going to make it. Words can't express how happy it makes me.

Has it really been 10 days?

This has been a long rotation. I feel like so much happened that I wanted to write about but I just didn't have the time. I never left the hospital before 9. I would come home and sleep just to wake up in another six hours to do everything all over again. But it was amazing. I never thought I could be so happy working so hard. Almost all of my clients hugged me and told me how much they appreciated what I did for them and their pet. Taz, the dog we did a TECA on, had a mom that was so worried about him. I talked to her 3 times a day about her dog. But when I got to give him back to her and she thanked me for keeping her so informed it was great. Then there was Dylan. Dylan has mesothelioma and was building up fluid in his pericardium. We took out a portion of the pericardium (via thoroscopy which they let me drive the camera on!) and gave him some chemotherapy. I talked to his mom so much, she just absolutely loved me. And then, when we reunited them, she told me that he looked like a brand new dog and that she couldn't begin to tell us how much she appreciated the care he got. She was upset when she found out that I wasn't going to be there in 3 weeks when he comes back for his chemo treatment. I told her to have her student page me so I could come say hi. And of course there is Buddy. Buddy will get his own blog tomorrow because I have to write down his story. Buddy should have died, but we saved him. He needed such intensive care and I've been working so hard to take the best care of him possible. And today the owners told me that if it wasn't for me taking such good care of him that he wouldn't be here. That meant a lot to me.

Its an amazing feeling when you know you've really helped someone. These clients are so appreciative of everything we do for their pets. Its like treating their children. And it gives me such great satisfaction to know I've played a part in making them happy. Its hard to describe. I don't make many of the medical decisions. But what I do is just as important, I am the face of the hospital to the clients. I'm the one that lets them know how their pet is doing. I'm the one they can talk to about how they're scared and upset. And I'm the one thats there to console them.

I've also come into my own with this whole clinics thing. Thanks to Buddy I know how to run every machine in ICU, can fill out all the paperwork, and can trouble-shoot and manage the syringe pumps like I've been doing it all my life. I rocked on this rotation.

I ate a chocolate bar today . . . a big one

It is 9:15 pm on day 3 of SA surgery. I am tired, drained, excited and want to cry all at the same time. We received patients yesterday. I saw a hypercalcemic cat who probably doesn't have a parathyroid tumor. Which sucks. I kinda wanted to see one cut out. We're still not sure what we're going to do with it. Then I saw Checker who has blocked at least 10 times and needed a perineal urethrostomy. The owner of this cat is crazy. She puts regular crazy cat ladies to shame. She has a ziplock back filled with her cat's shaved hair from 3 years ago in the cat's binder. She tape recorded herself talking to be played when the cat is in wards. She feeds a mixture of 6 different natural cat food brands. We did the surgery yesterday (after the random blackout that completely screwed up our day). After which I had ICU duty until midnight.

So today I ran on 4 hours of sleep. But to make up for it I got to scrub in on a coxofemoral disarticulation on a leopard that had chewed its foot off after getting caught in a wire. It was amazing. I was so lucky to get to work on that case. I was on fire too. I was able to identify everything that Dr. Black pointed out to me. I asked intelligent questions. I even made people laugh. Although, apparently my suture cutting technique needs some help. I also got to watch part of a PDA surgery. I saw a live heart beating on the table in front of me. It was amazing. I almost wanted to cry. But I got to do that later.

The crazy cat lady made me cry. She insisted on spending time with her cat in the wards. On her 2nd (yes, second) visit I told her she only had 15 minutes because I had a lot of work to do. After 20 minutes and several warnings she threw a fit and accused me of not caring for her cat properly. It was a scene. Luckily Jim witnessed the whole thing and said I did everything right. The lady even flipped out at Dr. Lemming later. Dr. Black will be doing all of the communication with that case from now on. I cried though. I think it was mostly from exhaustion and hating confrontation. I know she's crazy and its not my fault. I just couldn't deal with it at that moment.

So that explains the chocolate bar. It was necessary. Everyone agreed. Even Checker.

Adventures in surgery day 1

I started small animal surgery today. I thought I was going to cry the entire morning. I was supposed to be on orthopedics but then Dr. Emmett threw me a curve ball and switched me to soft tissue instead. Which meant I had to do a neuter today. And I hadn't reviewed anything. I don't know how I did it but I muddled through. I was even semi-confident. I had no idea where anything was all day, didn't know what to put in the clinicians orders, had no idea how to write an operative report, and was completely afraid that Dr. Lemming was going to eat my face off. And yet, despite all of that, I still managed to kick a little ass in rounds. Or at least kick more ass than those around me. This is going to be a hard one. But I think I'll be able to manage.

Just when I got used to how things worked in zoo med they take it all away and toss me head first into surgery. I just hope I don't kill anything these next two weeks.

Not to be cliche, but . . .

On Thursday we had to put the fawn down. It was the right thing to do. It didn't stop us from tearing up. I would have cried had I not been so tired. Perhaps it was the fact that she was so cute, or that we had become attached but it was so painful to watch her die even though we knew it was absolutely the right thing to do. She was so innocent and pure. The symbol of helplessness. She had no control over her injuries or the disease taking hold of her. And there was nothing we could do to help her. There's nothing worse than being helpless to help those that can't help themselves.

And as if some higher being was trying to teach me a lesson about life and death the very next day Jayson was released to a wildlife center for rehabilitation and release. The little blue jay that came in looking like it was going to die had made it. And I was the one that nursed it back to health. It was an amazing feeling to see a case from beginning to end and for the end to be such a happy one. I know its just a blue jay, but after a week of working with him he was more than just some random bird. I got attached. He had a personality and such an attitude. No, he wasn't just a blue jay, he was an individual.

So my epic two weeks in the Zoo Med ward is over. I know I'm going to miss it. The five of us bonded. Hell, I bonded with everyone back there. Dr. Wells and Dr. Adams taught me so much. It made me want to see exotics when I'm out in practice. I think I'll take this rotation again. Where else can you do surgery on a chicken?

Sleep deprivation does a body good.

Last night my cats felt they needed to have my attention about once every hour. Problem was I was already deprived of precious sleep and needed to be up at 4am. We went to a local zoo today to take care of some of the animals. Casey and I got to the vet school super early to get our treatments done. I'm not sure how I actually picked myself up out of bed. It was worth it though. Our day was amazing. First thing we got to do was observe a trunk wash and get to feed and pet their two elephants. Then we knocked out a Siamang (a type of gibbon) to clean its butt off. IBS diarrhea badness. It was so cool, I got to do the anesthesia and listen to its heart and touch it! It was amazing. There were all sorts of animals today. A barn owl, opossum, cotton mouth, long-nosed viper, hedgehog, even a baby miniature zebu. To be able to touch and examine these animals that are so rare and interesting was amazing. It was every animal lovers dream.

Today made me think for just a moment about going into the zoo medicine field. Just for a moment. It would be so cool to be a zoo vet but the competition is ridiculous. There are several people in my class alone who want to go into zoo med and who have real experience with it. If they're lucky one of them will get a residency. I may satisfy my need to see exotics by seeing them in small animal practice. People are always looking for someone to see their birds and bunnies and guinea pigs. This rotation has been an eye-opening experience for me. It really has made me want to branch out from just dogs, cats or horses. And that's going to be an asset for me. I think.

Last night we got the best message ever from the phone room. "Beta fish. Bloated, not eating, floating at the top of the tank." When read this Casey replied: "So its dead?" That person must have loved that fish to call the vet school about it. Or he was crazy. Probably the latter.

James has tried to make contact again via a MySpace message. I guess I'll throw the guy a bone and respond. I still think he's an idiot.

Wildlife medicine has been keeping me busy

Has it really been over a week since I last wrote something? I feel like its flown by. Since I started the zoo med rotation I have been home only to sleep and maybe eat. I feel like I have been thrown into the belly of the beast. When we started I was handed some cases, allowed to read up on them for half an hour and then asked to round on them and be able to answer everything about them. I was so scared. I didn't remember anything about drugs or diseases, I felt like child lost in a department store. But as the week has gone on I've gotten used to being put on the spot and doing the whole medical thing. I can actually write a discharge now without staring blankly at the screen.

'George' the chicken came in on Monday. He is quite possibly the best chicken ever. Him and all of his flock mates had elevated white blood cells so he was in to have some diagnostic work done including a biopsy of his liver. We tried to do it via laproscopy on Monday but that didn't work so much because his giant spleen was in the way. So instead we opened 'George' up and did a celiotomy on Wednesday. After much difficulty, some unintentional ripping of the liver, and 3 hours we were finally done with 'George'. Dr. Wells let me close the incision. I was practically shaking I was so scared. I'd done closures before but never on a client's patient. And somehow it seemed like there was more pressure on me since I was now "on clinics". But Dr. Wells was incredibly encouraging and told me I did a great job. 'George' is now back home harassing his sister and doing extremely well. Yay 'George'!

I also had a peacock ('Henry') that had a corrective osteotomy done on its tibiotarsus. I know. Who would do that? Apparently his owners. He was cool. He didn't like me so much but that's probably because I was always shoving a tube down his throat to give him meds. He always glared at me when I looked into his cage.

The worst part about dealing with clients is when they don't want to do any work-up on what could potentially be a really cool case. Like this guy with this Solomon Island Prehensile Tail Skink, 'Kira'. She had a mass on her maxilla that was probably an abscess and she needed radiographs and a culture done. But this guy just wanted to be given his antibiotics and sent on his way. How cool would it have been to really work up an oral mass on a skink? Or this lady with a 65 year old Amazon parrot. 'GB' came in for bloody diarrhea that had been going on for a week and that antibiotics hadn't been able to cure. We did a CBC/chem and found that his cholesterol was off the charts and that he probably had an infection. Turns out the bird has severe atherosclerosis. He really needed to be hospitalized and worked up but this lady absolutely refused. I think she thought we were going to try and kill her bird.

The wildlife that comes in is amazing as well. We have 4 gopher tortoises right now. My tort, 'Rose', is ready to be released. Currently she is trying to dig to China through her plastic bin that she calls home. We also have a red tail hawk and a red shoulder hawk. I am taking care of a baby blue jay that we think may have either a ruptured tympanic membrane or vestibular disease. He can't sit upright and sort of just uses his wings to push himself around his incubator. I named him 'Jayson' and despite the fact that he looks dead all the time he's kind of cute.

My first day I was on emergency duty and I had a possum come in that had to be euthanized. It was attacked by something and its leg was necrotic. I did the actual euthanasia which was a strange experience. I didn't cry or feel sick like I thought I would. I just knew it was the right thing to do and moved on. I wonder if it will be the same when I have to do it to cats and dogs.

What did make me sick this week was the animal cruelty case that came in. A rabbit came in on Thursday that had a wound on its neck and it looked like someone had stuffed construction paper and fabric softener into it. We cleaned up the bunny, thought, "oh, that's strange," and moved on. Then the next day another bunny came in with the same wound and packet in its neck except this time it had been sewn in with thread. Turns out, this guy had found both of these bunnies and he has a neighbor from Haiti (or possibly Jamaica). The way the wounds are packed with the packets that reek of some strange incense makes the animal cruelty officers think that the neighbor is practicing voodoo and trying to put a curse on the man that keeps finding the bunnies. One of the officers thinks the material that makes up the packets is actually dyed pig skin. The scary part is that the woman just built a barn on her property. Who knows what animals she may have in there for ritual sacrifice or voodoo. I almost couldn't handle hearing about this yesterday. We have been doing bandage changes on the bunnies and taking care of them and they seem to be doing very well. Aside from the large piece of skin that has been cut out of their necks of course.

So its been a long week. We arrive at 6:30am and leave at 8 or 9 at night. All I want to do is sleep from now until Monday morning. But I love it. I love having patients. I love talking to clients. I love figuring out what's wrong with the animals and then fixing them. I really think the next few months are going to be amazing.

Oh, and on a side note. James texted me Sunday night asking if I was upset with him. I replied with: "I'm not upset, I'm just over you." Booya biatches!