18KatrineA – CA Work Experience Program

June 7th- The Last Day

The last day at the Triangle Vet Hospital was pretty uneventful as most of the appointments were rechecks, meaning that they were just coming in to have a quick look by the surgeon to make sure that they were healing well. However, there was a bird that was brought in because it was found on the side of the road, but the bird was euthanized when it came into the hospital because it was almost already dead and there wasn’t much that anyone could do for it. Then, there were a bunch of bandage rechecks and there was a dog that came in to have his bandages changed that actually had been entangled and chopped up by a boat propeller (the wounds were disgusting). In addition, there was the smallest dog that I have ever seen, a miniature chihuahua, that had broken its tibia in the back leg, I believe, but the leg was not healing at all and completely atrophied, making an amputation the best decision for the dog. The dog was so small that the bones on the top of its head had not grown together, meaning that if you were to gently pat the top of its head, you could feel something squishy which was its brain. The day came to a close much too quickly and soon it was time to say goodbye to everyone which was hard because they had done so much for us and we had gotten to know a lot of them well.

June 6th- Puppiiiesssss!!!!!

It was another sad start to the seventh day of the Work Experience program, as the first appointment of the day was for a dog that was extremely sick. The dog had cancer on its belly with open wounds and it was determined that the cancer was equivalent to that of stage four cancer in humans. The owner decided to euthanize the dog to spare it any pain and suffering, making it quite a sad but educational moment. The day improved dramatically after the initial consultation because the next patient that we got to see was a puppy golden retriever who was very curious and wanted to talk to everyone. In fact, while the doctor was going over the course of treatment for the puppy, Madi, Nell, and I were petting the dog in the examination room and giving it lots of love. The day continued to get better as the next thing that we did was go into surgery on a chocolate lab. The chocolate lab had been seen 3 years ago for a tibia fracture and after three revision and correction surgeries and three years later, the leg was still not healing. We know that the leg was not healing properly because when you looked at the inside of the leg, you could actually see the metal plate that was placed in there three years, meaning that the skin hadn’t formed over the fracture, leaving it susceptible to a multitude of injuries and possible infections. Therefore, the dog underwent an amputation of the hind limb. Even though it was sad to watch part of the dog being cut away, the doctors and vet nurses assured us that the dog would feel much better now that it was free of the pain the leg was causing. Despite the sad and tearful start to the day, we learned a lot!

June 5- A Sad One

Many hearts were broken today at the vet hospital as two of the animals in the care passed away throughout the events of the day. Sadly, the cute little fox that came in yesterday passed away at the end of the day finally succumbing to sepsis after a long 24-hour fight. Also, a five-year-old beagle came in but during ECHO it was discovered that he had started to go into heart failure and there was nothing that could be done for him. Madison and I were both deeply saddened by this and it took a toll on both of us, making it for a long and very sad day at work.

However, there was a highlight of the day and that was a little baby goose that was brought in to the hospital after someone had rescued it from the side of the road. On presentation, it appeared as if an animal such as a hawk or fox had grabbed the baby goose by its neck as it had an old wound that was scabbed over. This little goose stayed with us all day, and he was such a character! He was first placed in the same cage that all the other small dogs are placed in but that shortly changed. The little goose started to energetically try and escape the cage that was holding him captive by poking his little, precious head through the metal bars, almost decapitating him! The shenanigans didn’t stop there as when Madison tried to hold the little bird, he jumped right out of her hands and almost broke one of his feet! It was actually a pretty cool thing to see because we learned that young animals, like humans, can come back from things much quicker as the little goose didn’t show any signs for the worse after being dropped a number of feet.

June 4- A Wild One!

Today was both a really good day and also somewhat of a slow day. The good thing about the day was that we hardly had anything to do at the hospital. However, the bad thing about that meant that we were standing around for most of the day. In the morning, Madison and I shadowed how to remove staples from a dog. We learned that it is actually quite simple and that you just need a small little tool and it could take less than five minutes. After this, we shadowed the cardiology department and learned how to read an echo and how to hook up a patient to the echo. In order for a patient to be properly hooked up to ECHO, they have to have three monitors placed on each of their paws, and they have to lie down on a special board that has two holes.

The most exciting and saddest part of the day was when a fox came into the ER in the afternoon around 2 pm. The owners that brought him in had rescued him from the breeders who were neglecting him because he did not have a true black stripe down the middle of his back like the breeders wanted. We learned that he is a 14-year-old fox who has been with them for about 11 of those years. The owner showed us pictures of the fox right when he got them and it didn’t even look like the same fox! Sadly, the fox was in poor condition as it looked like he had an abscess that had ruptured on his side and had created a wound that appeared to look like a puncture wound. Therefore, it was decided that the fur around his wound had to be shaved. This did not come without trouble, though, because it is a known fact that foxes have very thin and delicate skin (like a bunny rabbit) and that even if you nick them a tiny bit when you are shaving them, it can lead to a huge gash in the skin. Luckily this did not happen and he didn’t have to worry about that happening to him! At the end of the day, it was decided that he was septic, and he was placed in the ICU for monitoring through the night until the next morning when the owner would return again to assess the condition of the fox with Dr. Nunez. Hopefully, he will feel much better soon!

May 31- Surgery

Today was such an exciting day!! Madison and I got to be a part of our very first surgery and then our second surgery! When we first came to the vet hospital, we had about 15 minutes of downtime before the day began for everyone at the hospital. Then as 8:45 rolled around, morning rounds ensued, and we were treated to a detailed description of the status of the various patients being housed, however, it was cut short by the arrival of an emergency patient who was having what we believe to be a serious heatstroke. We watched as the team gave him oxygen and cooling blankets to monitor his temperature, as his temperature was about 107 degrees Fahrenheit when he came in and it is supposed to be around 100 degrees. After that, Madison and I were told to “suit up” to come into surgery. “Suiting up” requires putting on little booties for protection of the shoes, a cap to cover the hair, and a mask to protect the sterile environment from fluids of the face. The surgery that we were observing was a TPLO which was the insertion of a metal plate into the dog’s knee in alignment with the femur because the angle of the femur to the fibula and tibia was too great at 39 degrees (ideally it would be under 20 degrees). During surgery, we hit a snag as the drill was malfunctioning at one point and did not want to rotate while cutting through the bone, but that problem was looked to very quickly and nothing happened. In addition, during the surgery, Madison and I were allowed to see that part of the ligament had been completely torn off and we were told that the only way to fix that was to remove the tissue because it could not come back together like that of a human. The surgery ended well, and we were on to our next surgery which would be of a beautiful golden retriever.

The second surgery of the day had to do with a white golden retriever who had been losing weight for the past six months. In the span of six months, the dog had lost almost 20 pounds and the owner believed that he may have eaten a stick or a toothpick. After giving him an initial physical examination, the dog was taken for an ultrasound where there was evidence of a foreign object in his body and also disruption of some of the organs inside his body. A few hours later and the dog was brought out to the prepping table and all of his beautiful coat on his stomach was shaven off. During the surgery, Madison and I watched as they removed some of the organs from his body, including the intestines, to run it to see if the foreign object was in there and blocking the path. Unfortunately, Madison and I were not able to watch the end of the surgery as it was running late and there were many people observing the surgery from within the room, but it was an extremely interesting day and I am excited to see how the two surgery patients are doing tomorrow!

Day 2- Dogs, dogs, and some cats

On the second day on the job as a vet, Madison and I visited the Triangle Veterinary Referral Hospital in Durham. I got there promptly at 8 and was fortunate enough to be able to watch the amputation of a cat’s leg while Madison was making the drive to the Durham location from the location in Holly Springs. The cat was getting its leg amputated because it had a sarcoma on its leg, making amputation the best option as it relieves the pain the animal is feeling faster and ensures that it will not spread. After that, Madison and I shadowed one of the head surgeons on the surgery team and got to meet a very lovely bulldog who goes by the name “Petunia”. Petunia was in because she has trouble breathing due to her pushed in face that creates the blocking of the airway because of the two large soft palette that is blocking the airway. Therefore, Petunia was booked into surgery for a plastic surgery on her nose to create larger holes for her to obtain oxygen through and a surgery to remove part of her soft palette. Then, Madison and I shadowed a patient who had injured her knee because she was a very active dog. We learned that knee injuries are the most common leg injury that the hospital sees because of how an animal is built. This is because an animal stands on all fours, meaning that if they tear the joints that are keeping the knee in place, the femur or tibia can actually shift positions. The surgeries that were presented as options to correct this issue was a surgery where if the table slant of the angle of the femur is too slanted, the surgeon will cut out a piece of the femur and put a plate in place with screws that keep the femur from moving like it was before. Another surgery that was presented if the angle was less than 20 degrees was that they would drill a hole into the Tibia and then stretch a suture to the front of the femur in order to keep it in place. The hope with this surgery is that over time, as the suture stretches since it will inevitably, scar tissue will form around the suture, keeping the knee in the correct position. At the end of the appointment, the dog was scheduled for surgery first thing tomorrow morning!

Our day did not end there, however, as we soon moved into the ER and Radiology wing of the hospital. In the ER wing of the hospital, we encountered one of the most ferocious chihuahuas that I have ever come across. I even helped put the muzzle of the biting and growling dog! In addition, we were also presented with a dog who showed lameness when he was walking, and the doctors asked us if we could identify which leg was lame. Some pointers and tips that were given in aiding our diagnosis were that usually if a dog is lame, they will bob their head up when they put pressure on that leg and they will walk lighter on that paw. Therefore, we were able to make the correct diagnosis of the front left! In this case, the dog was lame because of some problems with his back where discs were pushing against each other, causing his leg to have spasms at times. As we transitioned to the Radiology wing of the hospital, we studied multiple ultrasounds where we learned to identify internal organs such as the kidney and the liver. The kidney was the easiest for me to find as it much resembled that of a bean shape. Overall, it was a very fun and educational day!

Day 1- NCSU Oncology Department

On the first day of the Work Experience Program, Madison S and I visited the Oncology branch of the NC State Vet School which deals with all things cancer –such as diagnosis and treatment. We quickly learned that the Oncology department is one of the slower departments of the Vet School as we had an hour of downtime in the morning before morning rounds began. However, once the hour of learning everyone’s name and talking a little bit more about what goes on in the Oncology ward of the hospital, morning rounds began. During the morning rounds, all the doctors and lab technicians in the room discussed the schedule for the day which would include two new patients—Mochi and Bailey—who were suspected of having tumors. The morning rounds took about an hour to complete and then we were ready to meet our first patient of the day: Mochi. Mochi was small pug who had previously had a mast cell tumor excised from his scrotum with passable margins (only 1 cm, not the ideal 2 cm) but presented with a new mass on the upper part of his scrotum. A mast cell tumor is a tumor that is malignant and is the most common form of cancer in dogs that can be treated with excision. Mochi was then admitted to the hospital in order to aspirate his scrotum to put some cells under the microscope to determine the proper diagnosis of mast cell cancer. While looking under the microscope at the cells gathered from aspiration it was clear that there were concentrations of cells surrounded by elevated red blood cells, indicating a tumor. During Mochi’s stay at the hospital, many of the veterinarians discussed several possibilities for the mass on the scrotum if pathology confirmed that it was not malignant. However, pathology reports came back confirming that it was, in fact, a malignant tumor of mast cells.

After the diagnosis and treatment plan for Mochi was finalized, Madison and I were given a tour of the veterinary hospital by one of the senior residents on call. While traversing through the different areas of the vet hospital, I was struck with the realization that it much resembled that of a hospital for humans. We got to see areas such as the Surgical, Radiology, General Hospital, and ICU wings. While touring the hospital, we learned that some cats with MTC can present with elevated and remarkable CBC/Chem panels, but once the spleen is removed, these numbers often drop to within normal limits. However, the senior resident said that the reason for the decrease in the numbers due to a splenectomy is unknown, it is an unknown mystery. The second patient of the day was Bailey, a 9-year-old English Springer who had a mass on her spleen and decreased appetite and energy. Bailey—the dog—was admitted for new blood work, repeat ultrasounds, and a chest x-ray to see if the tumor on her spleen was benign or a lymphoma which the vet doing the consult was leaning towards. The vet did suggest aspiration of the liver and the spleen in order to determine the type of tumor on the spleen, but the owners strongly refused due to worrying over possible complications. However, after several hours and after all the tests, the results came back inconclusive and Bailey is coming back to the hospital tomorrow to have her liver aspirated! Overall, it was a great day and very informative about the different types of cancer in small animals.