Monday, February 23, 2015

It's a dog. Feed it like one.

Disclaimer: The views expressed in this post reflect my opinion based on research. You do not necessarily need to agree with my opinion to read this post, however, I will judge you heavily if you do not. 

Week 6: February 16-22, 2015

It happens quite a bit that the topic I happen to be studying applies itself to real life inexplicably. Or perhaps I’m more aware of the issue and can recognize it? Regardless, nutrition was the topic of study this week, and two cases presented itself that gave me an opportunity to educate clients as well as learn first hand the importance of a balanced diet in a pet’s life.

The first case was Hazel, an 8-week old German Shepherd puppy much beloved by her worried owner. She had done her research before purchasing Hazel, and had purchased her a week earlier from a reputable breeder, who recommended a feeding schedule that included a raw diet. Unfortunately, the owner was unable to find the particular raw food product the breeder was feedings, so she attempted to make her own supplemented with dry puppy food. Her owner had no interest in continuing the raw diet, but when her puppy wouldn’t eat anything else, what could she do? The problem with raw diets is often a lack of balanced nutrition and the risk of pathogens in undercooked, raw, or contaminated meat. Hazel continually snubbed her nose at the puppy food and would eat the meat, resulting in a BCS of 2/5 and bloody diarrhea. A fecal sample was run, and the vet and technician suspected Giardia present, so we kept Hazel in order to collect enough of a sample to send to Idexx for a diarrhea panel. We theorized that the owner unintentionally fed Hazel improperly prepared meat. Upon discharge, we sent Hazel home on a prescription i/d diet for gastrointestinal problems, panacur, and amoxicillin. It will be interesting to see what the results of the send out reveal next week!

Symptoms of giardia infection include vomiting, diarrhea, failure to gain weight, dehydration, and poor hair coat.

Another case involving improper nutrition involved Wiley, a black lab who couldn’t poop. He had a history of anal gland resections and constipation, but this time was worse. Poor Wiley had not had a proper BM in weeks, though he tried valiantly. His owner worried he was in pain, and tried to help him by feeding him coconut oil, which he immediately vomited up. She also fed him pumpkin and tried giving him a prescription laxative, with no relief. His usual diet consisted of pumpkin and limited ingredient, grain-free dry dog food. The doctor who saw Wiley that day felt his diet should have been evaluated when he started having the issues with his anal glands. Wiley clearly needed a balanced diet that would not cause digestive upset and constipation. For the immediate instance, Wiley’s suffering had to be relieved. The doctor performed a rectal exam to check for tumors and to examine Wiley’s prostate. No abnormalities were found, though we all agreed Wiley’s feces and gas smelled oddly like livestock. He did appear to be eating quite a bit of grass…The next step was an enema, much to Wiley’s shock, which yielded some success. He later went home on the i/d diet and instructions to take him for a long walk!

This week highlighted the importance of feeding pets a balanced, nutritionally and medically appropriate diet. I’ve listened to many owners spout the importance of “organic,” “limited ingredient,” “raw,” “vegetarian,” and any number of fad diets. Applying human diets and requirements can be detrimental to our pets’ health as they require specific dietary requirements. In addition, animals with medical needs, such as kidney disease, have different needs than an animal in maintenance. As a veterinary professional, I learned that part of my job is educating clients and how to read food labels and feed their pets appropriate diets. Even if an owner is insistent in their beliefs and will not change, at least they can make the decision as a well informed owner. 

Sunday, February 15, 2015


*SIGH* Just read and you'll understand.

Week 5: February 9-15, 2014

My animals are falling apart.

I pulled up to my house after work Thursday night, and in the headlights I saw my dog in the backyard. When I saw the way he was holding his leg, I yelled, “Noooooo!” in very dramatic fashion. After many months of working at Bayshore and seeing dogs in a similar condition, I knew immediately what was wrong. But of course, I chose to be in denial until one of the vets could look at him. I took him to work with me the next day and explained that he was let outside to potty, and ten minutes later when I pulled up, he was limping on his left hind leg. No one saw what happened, but he does like to run back and forth across the fence barking at the trees. The veterinarian examined each joint starting at the digits, working up to the stifle. He did the “drawer test” by holding the femur and moving the tibia to see if it protruded forward. 

You just had to open the drawer!

He gave me a look, and I knew: my dog had ruptured his CCL. The overall theme lately is the care for aging pets. My dog and two of my cats are approaching 9, and though I still consider that fairly young, I have to remember that their bodies are aging rapidly, and that I must prepare myself for age related illness. My dog has never had blood work run, so I decided to prepare a Senior send-out to an outside lab for 25 chemistries, T4, UA, and CBC to make sure he’s healthy enough for the next step: surgery. I also have a lateral ear resection for my cat’s left ear to schedule. It’s been a week.

My patient of the week was Olive, a 6yr old Pug that came in for hacking. She displayed the typical pug snort and raspy breathing, and her owner mentioned that she occasionally had respiratory attacks that she had a prescription of Valium for to use as needed. Olive was adorable, with a brachycephalic face that was so smashed in that she resembled a Persian. She was calm, unlike other pugs I’ve seen that are constantly panting and snorting. The veterinarian recommended an x-ray to see if there was anything in her throat. We took lateral and VD thoracic radiographs that included the trachea, and the doctor felt that she should be sedated for a closer look. Once Olive was asleep with doggy magic, a throat exam was performed, and it was discovered that not only did Olive have an elongated soft palate, but that she also had larygneal paralysis. She was reversed with Antisedan and given Dexamethasone for inflammation. As she began to wake up, I noticed she was acting strange and making an odd gurgling noise. I alerted the doctor and she took her heart rate and felt that she was reacting to the Ketamine. She had me hold her in sternal recumbancy while she recovered. I became concerned as the strange sounds continued, so I checked to see what color her mucous membranes were, and saw her tongue was turning blue. I grabbed my technician and we masked Olive with oxygen, feeling that the procedure and her panic had resulted in her throat swelling and cyanotic state. Thankfully, her color began to return to pink, and I was instructed to keep the oxygen on her for a while.

Fifteen minutes later, she had a seizure. I was alone in treatment, so I had to yell for help, and staff came running. It was amazing how they jumped right into action. One technician shaved a forearm while another started gathering catheter supplies and an ET tube and another veterinarian drew up Valium while I held off the cephalic vein. When Olive was settled enough, my technician intubated her so she would have an open airway and we continued the oxygen. The hustle and teamwork was very impressive! A catheter was placed and Olive was hooked up to EKG with me monitoring her for the next 2 hours until her owner was able to take her to an emergency 24 hour hospital for monitoring. Happily, Olive was starting to become more alert and was breathing comfortably without the ET tube when she left, and her doctor felt that she would be okay.

Dogs with smashed in faces are super cute, but unfortunately, the abnormal shape of their skull leads to many health issues related to respiration, skin, and eyes.

Experiencing how well my team worked when a crisis happened made me very proud to be a part of this hospital. Because everyone was on their A-game, Olive was well on her way to recovery even though surgery is likely in her future to correct her anatomical abnormalities. What made the situation more stressful was that the owner was a new client, Olive was a new patient, and this was the first time we’d seen both. The impression we made must have been favorable because the owner said she would definitely be coming back!

Sunday, February 8, 2015

What would Jane do?

I had to channel some serious Jane Austen poise this week. Read about it in this week's journal entry.

Week 4: February 2-8, 2015

In my former life, I owned a coffee roasters and was a barista, so I am no stranger to angry customers. That experience didn’t make this week any easier. This seemed to be the week of angry clients, whether they were unhappy with their service or the price of said service. Luckily, I’ve been able to avoid any serious encounters that ended in yelling and tears, but even quiet anger can be tough to deal with. We had clients with a 16 week old Bulldog puppy with a tear in the tibial growth cartilage that left her unable to use her leg properly. The doctor sent xrays to a specialist, but that apparently took too long for the owners because they took their dog to another doctor and ended up making ours look bad by insinuating that she didn’t know what she was looking at. They insisted at this other doctor’s suggestion that a Robert Jones wrap be placed on the puppy despite warnings that it may not work. So, the leg was cast, and I brought the puppy out to the owner. She was not pleased because the wrap was large and the puppy was wearing a cone. I informed her of the doctor’s instructions to keep the cone on to stop the puppy from bothering it, but she could have it off to eat with supervision. I also told her the doctor wanted the puppy back for a bandage change in a week unless it slipped or became very dirty. Here are a couple highlights of her response:
“Well, of course it will get dirty. It’s horrible outside,” said with great condescension.
“Does she HAVE to wear that cone?” very distressed.
“I just don’t know if this will work. It’s awfully big. Can she even lay down?”
“So, she has to have it changed once a week for three weeks? You mean you don’t know?”
Me, with as much patience as I can muster, “I’m just telling you what the doctor said. Please bring her back if she slips her bandage.”

This dog is wearing a Robert Jones bandage. Now imagine this on a 16 wk old wiggly Bulldog puppy. 

Big surprise, she slipped her bandage. And mom wasn’t happy. We just wanted to yell, “You’re the one who insisted she wear this thing! What did you think was going to happen?!” Dad is a human doctor, which also added to the frustration because he tried to tell the tech how HE would do it.
Later, I had to work with a client who insisted on telling me her life woes and why she was on such a tight budget. I don’t have a problem with people setting a budget, but I don’t need to know it’s because your husband of 30 years left you for a younger woman. While reviewing the price of the procedures we wanted to perform on her dog, she cussed out the price, told us how expensive we were and that she was going somewhere else next time, and that she would pay for everything but we were taking out of her grocery money. I honestly didn’t know how to respond, except to say we were willing to work with her and that our doctor’s were excellent. Above all, I tried to stay patient and understanding. A glass of wine was warranted that evening. Dealing with angry clients reminded me that it’s not just about the animals, but also the people that bring them in. If you don’t have the trust of the client, you can’t treat their animal, so no matter how frustrated or angry they make you, it’s best to remain calm and noncombative. Otherwise, you might risk the health of a pet who needs your help.

The biggest part of the week was assisting in the surgery of my own cat, Brautigan. Braut had horribly itchy ears, and it turned out they were full of bacteria, yeast, polyps, and inflammation. My poor guy was miserable! The doctor recommended a lateral ear resection for both ears. We did the right ear Thursday. I helped the technician place an IV catheter, intubate, and then I shaved and cleaned around the ear for surgery. After we moved him into the surgery suite, the tech showed me how to hook him up to the anesthesia machine and I placed the leads, BP cuff, and esophageal thermometer. I then monitored his vitals throughout the surgery and helped the tech assist the doctor. After the surgery was complete, I moved him into treatment, performed therapeutic laser on the site, applied eye ointment, and monitored his recovery. When I observed the swallow reflex, I removed the ET tube and placed him a cage with blankets and hot water bottles to keep him warm. I checked on his progress to make sure he was breathing well and waking up without difficulty. 


I’m happy to report that he did great and is recovering well, though he doesn’t appreciate the comfy cone!

"I believe you can go fuck yourself."

Sunday, February 1, 2015

What if it really is all about the bass?

In writing these journals, I've noticed a startling trend: I spend way too much time in animals' rectal area...

Week 3: January 26-February 2, 2015

This week was a mixture of the routine, excitement, and disappointment. Basically, your average week working in an animal hospital. The main skill I had opportunity to practice was anal gland expression. From taking anatomy, I know the location of these malodorous glands, but I’ve mainly been observing or restraining for the procedure. This week, I felt confident enough to step up and try the technique myself. I started by expressing glands on anesthetized patients so I would get the feel of where the glands are and what they feel like full on an animal that wasn’t struggling. I then was able to practice applying the correct amount of pressure and squeezing technique and feel the glands emptying and observing the discharge, again at my leisure since the animal was asleep. I then moved on to patients that were awake. I found I like to equate the procedure to milking a cow in that I start at the bottom of the gland and “milk” the discharge out by applying pressure with my thumb against my index finger on the inside of the rectum. I try to exert the least amount of pressure as possible to prevent injury to the animal, but I’ve encountered a few glands that were “plugged” and needed a little extra work. After those expressions, I like to wash the perianal region with cool chlorhexidine to ease any discomfort. This procedure is the epitome of, “it’s a tough job, but somebody has to do it.”

Hey, ya'll, you're lucky I didn't post a picture of a dog getting it's anal glands expressed. That's how much I care about you keeping down your lunch. For the rest of your life. Instead, here's a picture of a dog scooting, a common indication that it needs it's anal glands expressed. Should I say anal glands again? Anal. 

We perform quite a bit of blood work, and we’ve recently started using new machines for CBCs and chemistries. Generally, we aren’t running more than one animal’s blood at a time, but one day this week I was handed tubes for three animals that were ASAP. I got to work putting the tests into the Avimark system, which then put an order into the lab machines. The green tops were spinning and the lavender tops were rocking when an error message pops up on the Catalyst screen. It was time for a crash course in troubleshooting the new machine. Knowing similar problems have occurred in the past, my first step was to empty the waste tray. It was full, which often results in the slides not being able to load into the machine properly. The error message still appeared, so I then opened the front of the machine and took all the slides out. It was terrible to waste them, but the number one priority was getting the machine to run! After running an initializing process, I set the machine to run the blood work again and crossed my fingers it would work. It did! I then worked efficiently to systematically load the plasma and slides into the machine to run in succession. Even though most of my job is working with animals, I learned it was also important to understand how the equipment we use works so that we can fix it when it doesn’t. After all, without our lab equipment, we can’t diagnose illnesses and maintain patient wellness. 

I love our lab equipment...when it works.

The hardest lesson I learned this week was that no matter how much you want to save the world, oftentimes the world has other plans. One of our vets was in an extremely optimistic mood when it came to two unanticipated exploratory surgeries. I had checked both patients in as appointments, and the doctor determined both required immediate surgeries. One had a hard mass on the right side of his abdomen, and we were hoping it was his spleen or something equally operable. The doctor went into surgery with hope, and unfortunately discovered that the dog’s entire right kidney was enveloped in a large, football shaped mass that grew against the spine. His disappointment was furthered by the next patient that hadn’t been eating and was vomiting. They were hoping for an obstruction, but what they found was an abscessed mass which necessitated the dog be euthanized on the table. My heart goes out to the owners when things like this happen, but I try to help them take comfort in the knowledge that they did everything they could to make their animals well, and so did our dedicated doctors. When sad outcomes occur in quick succession, it’s difficult to find the silver lining and the mood in the hospital can become sour, and we have to remind ourselves why we’re in this field. Our deep love for animals pulls us through and helps us come to work everyday.

Puppies help, too.


Sunday, January 25, 2015

Everybody poops. And pees.

It's the end of another exciting week! Here's the exciting highlights! They're exciting! And gross!

Week 2 Journal Entry: January 19-25, 2015

This week at my clinic was all about bodily fluids. I have long since accepted that my job will never make me rich or famous, it isn’t glamorous, and I often go home and my dog plays the, “what’s that smell?” game. In my last entry, I talked about discussing parasites with clients, namely heartworms. This week, I had ample opportunity to perfect my fecal flotation technique.
Sometimes it’s easy: a client suspects they see worms so they bring in a sample. Other times, it’s not so straightforward. A patient comes in with diarrhea and the doctors of course want a fecal sample to analyze. Of course, no one has advised the client to bring one in, so we have to get it ourselves. Enter the fecal loop. 

Bend over!

I enter the exam room or take the dog (or cat) back into treatment with the fecal loop, a tool about twelve inches long with a tapered end with keyholes in them, apply sterile lube, and insert it into the rectum. I twist the loop gently and pull it out hoping to have enough sample to run a test. If I do, I then take the sample to the lab and retrieve a Stat OvaTube. I put the sample in the tube and fill it halfway with Fecasol, stir it, add the topper, and fill all the way with the Fecasol. I then place the tube in the centrifuge for 5 minutes, twist down the topper, place a microscope coverslip on top, and set a timer for 3 minutes. I then examine the sample under the microscope for parasite eggs. When I first started working, I had to consult the staff or books to identify anything unusual, but now I can quickly identify roundworms, hookworms, and coccidia under the microscope and tapeworms in fecal samples.

You can't imagine how sad it is to examine unexciting poop.

I’m also learning what to look for in urinalysis. We collect urine in several ways: free catch, cystocentesis, or urinary catheter. I then take the urine to the lab area and grab the refractometer, a Stat Spin tube, and a urine dipstick. I put one drop onto the refractometer to find the specific gravity and a drop on each square of the test strip. I then put the rest in a tube and spin it in the centrifuge. I record the findings on a sticker noting the specific gravity, pH, and the presence of bilirubin, urobilinogen, nitrates, ketones, blood, glucose, leukocytes, and protein. After the urine is spun, I pour off the urine and put a drop of stain into the tube and mix it with the sediment before putting it on a microscope slide. The staff are teaching me what to look for in the urine, such as WBCs, rods, bacteria, and the other day I found crystals! 

Refractometer and dipsticks: if not for a physician in 1797 saying, "I need an easier, faster way to test urine," we might not have these tools today.

I’m very fortunate to work with doctors and staff that challenge me. The other day, the veterinarian gave me a pop quiz, which she often does.
“Hey, Mandy. I have a 25lb dog that comes in having trouble breathing. It’s turning blue, but it still has a pulse. What would you get for me?”
It’s a little scary being put on the spot, but I know she’s testing me not only to see what I know, but to educate me on what I don’t. My first response was that I would get her an ET tube and the oxygen machine. She agreed and then asked what drugs I would give her and where they were. I said I didn’t know. She didn’t either! (Note: she’s a newer doctor at the clinic). The technician showed us the Crash Kit in the surgery room and the doctor explained the drugs inside and when and how I should give them. It was a great learning experience and it gave me confidence if I was ever in a situation where the doctor had an emergency and I was the only one available to help. It was applicable because we had a patient in the hospital having trouble breathing, and I just learned about a medication I had never filled before that was a bronchodilator.

As always, I was reminded this week that no matter what happens, don’t forget to have fun. A dog that was very dear to a staff member was brought in to be euthanized and the mood was somewhat bleak. Then a shaggy border collie came in that had some mats that needed to be brushed out and shaved. The technician shaved off a big mat off the dog’s tail, and she observed that it looked like a troll doll. She ended up dressing it up and turning it into the clinic mascot. If I can end every day at my job with a good laugh, I believe I can do this job forever!

I think we ended up naming it Troll Michaels. 

Sunday, January 18, 2015

It's gross and it's wonderful.

My life, that is! Oh, man, I'm not even sure where to start. I'm entering my second semester of the Veterinary Technology program at St. Petersburg College and it's exciting and stressful while also amazing. I ended last semester with straight A's! Woot! No pressure...I'm so thankful for this period in my life. My kids are healthy and happy, and so am I. While I have seen sadness and had heartaches, every step of this journey has been worth it. I know this blog has been sadly neglected, but I am sure whoever is out there reading will forgive me the life I am living.
Have I mentioned recently how much I love my job? It feels so wonderful to say that after so many years of dreading going to work. I love being a veterinary assistant at Bayshore Animal Hospital. The people and animals are awesome and I'm learning so much being there. It's really helpful working in an environment you're studying. Applying real life to my studies and vice versa has made an incredible difference in the ability to retain information and do well on exams in addition to allowing me to succeed in my job. Every day when I get up for work I go:

One of my classes is a work practicum class where I have to journal my work experience for that week. I thought, how awesome would that be for the blog? Two birds, one stone, boom! So, here is week 1, with illustrations for your visual pleasure and because I like to be as gross as possible. My job is so awesome :)

Journal Entry #1: January 12-January 18, 2015

My time at work is busy, often stressful, and sometimes events jumble so much I can’t remember what happened when. I am a veterinary assistant at Bayshore Animal Hospital in NW Oregon. Our practice has three veterinarians, four technicians, and three assistants as well as three receptionists and a kennel technician working with an average of 30 clients daily, and this doesn’t include the work we do for the local animal shelter. We mainly see cats and dogs with the occasional pocket pet. Our days begin with checking in the drop offs, which are animals scheduled for surgical procedures, sedation, or sick patients needing in hospital exams and care. During rounds, we explain and plan the day's cases and establish teams, which consists of a doctor, a technician, and an assistant. As an assistant, my job is to check in rooms, fill prescriptions, restrain for procedures, and the list goes on!

Our practice is currently working to go paperless, so even though we still have files, much of what we do is centered around the computer system, Avimark. It took some time for me to navigate this system having never worked with medical charts or programs before. We can schedule, put in charges, make estimates and drug labels, follow-up with patients, see lab work, clock in, and I’m still learning all this program can do. The first thing I do when I walk into an appointment is to login to Avimark and open up the patient file. I then put in charges that I know will occur before the doctor even walks into the room. Some things were easy, such as exams and scheduled vaccinations, but it took time and intuition before I was able to predict what else I knew would be charged. For example, if an animal was coming in to check the ears, I know the doctor will do an ear swab and slide and will charge for that. I also know to take an ear swab and prepare a slide, which makes less work for the doctor and saves time. After I enter charges, I go into the lobby and call the client in. I like to introduce myself as the assistant and explain that I’ll be taking vitals and a brief history because then the client doesn’t get confused as to why I’m not performing a full exam. I’ve had clients think I’m the vet and then wonder why I’m not going more in depth with the patient! I weigh the pet then TPR them, that is I take the heart rate, respiration rate, and temperature. I then take a brief history of the complaint if there is one and ask general health questions such as if the pet is eating/drinking, any vomiting/diarrhea, are they on any medications, and so on. I then inform the vet of who is there, what room they are in, why they are here, and if I have prepared any slides whether it’s an ear/skin swab, fecal, or urinalysis. I also draw up vaccinations and place them in the room for the vet.

As an assistant I am not authorized to dispense medical advice, but I can educate clients on products and services we offer, vaccination protocols, and preventative care. One of the main issues I educate clients about is flea and worming. We had a client bring her dog in for an exam that she had adopted from the local shelter. We had previously treated the dog for heartworms and it was having a recheck appointment. The owner had many questions about heartworms, what to do if the test was again positive, and what she should do to prevent her dog from getting heartworms again. I explained that heartworms are transmitted by mosquitoes, which inject the larva into the host and the worms mature in the heart and lungs. I explained that we recommend Heartgard as a preventative against heartworms as well as roundworms and hookworms. I later explained to another client that we often recommend worming cats and dogs who have fleas because they often ingest the fleas while scratching and then develop tapeworms.

Just be thankful I didn't post a picture of worms bursting out of an overloaded heart. This shiz is nasty, folks. 

One of the biggest challenges I face is venipuncture. I think I stress unnecessarily because I want very much to excel. I feel I'm improving when drawing from a jugular, but I struggle when drawing from the cephalic vein. We brought the above mentioned dog back to treatment for her heartworm SNAP test, and the technician handed me the needle. I have been lucky to work with people who have been really supportive in helping me practice procedures and helping me learn, but I was nervous! I told her I had trouble drawing from the leg, and she gave me a few pointers as far as needle position, and I hit the vein on the first try! I got my sample, prepared the test, and set it in our lab machine that runs CBCs, chemistries, and SNAP tests. Thankfully, the test was negative!

This sight terrifies me. Hit that vein, Mandy! No pressure!

One thing I do a lot of as an assistant is clean and treat ears. We use a product called EpiOtic to wash the ears and then use cotton to clean away any debris. We are careful not to use cotton swabs except around the pinna so we don’t ulcerate the inner ear and potentially puncture the eardrum. A medication we use often is the EKT ointment, which is a thick ointment when warm and then solidifies in the ear. It releases medication over a period of two weeks and treats a variety of ear infections. We use it quite frequently and the clients like that they don’t have to do daily medications and weekly cleanings.

I love that my job challenges me and that every day I learn and see something new. The other day, the receptionist said we had a drop off coming in that was a cat with rapid, shallow breathing. The other assistant, who is also going to school to be a technician, and I decided to bet on the diagnosis. She quickly theorized a heart condition and I said it was fluid in the thoracic cavity. The cat came in and it was clearly having difficulty breathing. An x-ray was taken, and sure enough, there was so much fluid in the chest you couldn’t see the heart! I felt bad for the poor cat, but excited to have guessed the correct diagnosis! I have learned that in working in a field that can oftentimes be incredibly depressing, one has to find humor and joy anywhere you can, even if it seems callous. 

Normal cat chest x-ray. Notice you can see the organ structures.

X-ray of the cat with pleural effusion (fluid in the chest cavity). 

helped the technician prep the cat for a thoracocentesis, which involved shaving a 4x4 square on each side of the chest over the last few ribs. We then sterilized the area as if preparing for surgery, and the doctor put a needle between the ribs and started drawing off fluid with a 20cc syringe. 

This is how we do.

The fluid was purulent, and the doctor said that was the best scenario for treatment. If it was red or yellow, it could have signaled a big problem. After drawing off more than 320ml of fluid, the cat was breathing much better. It was incredible! The cat came in weighing 12lb 5oz and left weighing 11lb 5oz. It lost a pound of fluid! The doctor had me take some of the fluid for analysis on our CBC machine, which was fun because I had only run blood on the machine before. In fact, no one else had run anything other than blood either, so I demonstrated in front of the other assistants what settings to change and then we looked at the printed results together. Later, the doctor wanted me to prepare fluid for a send out to an outside lab, and the other assistant and never prepared pleural fluid before either or requested the specific tests, so we learned together how to fill out the paperwork and she taught me how to put charges in the computer for labs that weren’t listed. It was a very informative day!

One of my favorite aspects of my job is being held solely responsible for the care and treatment of cases. It makes me feel good that I am trusted enough not only to carry out the tasks, but to ask questions and communicate concerns to the certified staff. This is especially rewarding when I perform the discharge for that patient later as I know every aspect of the care they received, can explain the medications they are going home with, answer questions, and feel that I have established a personal relationship with the client through their pet. It’s very rewarding when a client sees me and remembers my name and smiles because of the care I gave to their pet and the help I gave them. I always said I wanted to work with animals because I’m not very good with people, but I’ve learned that the people skills are just as important because they own the pets and their pets are their family. Building a trusting relationship with the owners means a great deal to me, and I’m trying to do that through respect, care, and attentiveness. Every day I go home and no matter what happened that day, I love my job!

Sunday, August 24, 2014

It followed me home!

It was a beautiful, sunny day perfect for a hike, so Rick and I took all the kids into Ilwaco at the base of the Discovery Trail and prepared to wear the little devils out. With a couple bags of snacks and healthy energies, we set out to enjoy nature and some exercise. Aside from a few minor incidents, the hike was uneventful, until all four kids stopped behind us and declared, "We hear meowing!" Rick and I looked at each other and said, "I hear it, too." So, I started calling out, "Here kitty, kitty, kitty," as I walked along the treeline and sure enough, two little faces poked out of the bushes. We crouched down so we wouldn't scare them and I tentatively reached out my hand to touch them. To my surprise, they were friendly, which is not typical feral cat behavior. We had to conclude that these kittens were used to people and were most likely dumped in the area. I looked up at Rick and said, "You know what I'm going to do, right?" and I picked the little ones up. We emptied the snacks into one bag and put them in the other. (Please note: this was a highly permeable cinching bag, so they were able to breath comfortably. In case you were worried about that.)
So, what do you do if you find kittens in the woods? The obvious answer would be to take them to a local shelter where they can be cared for and re-homed. In our case, this was a Sunday, and the shelter would not be open until Tuesday. If you're faced with a similar dilemma, here are some tips for caring for stray kittens:

1. Limit your contact. Since you don't know where they came from, you don't know what they were exposed to. Besides worms and fleas, there isn't anything they could give to people that would be worrisome so much as what they could give to your other pets. I have two cats at home, and I didn't want them to contract one of two highly contagious diseases: feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). FIV is spread through bite wounds and prevents the body from fighting off infections leading to severe illnesses. An infected cat, with proper care and management, has the possibility to live for many months or years. FeLV is spread by saliva and nasal secretions and kittens can contract it in utero from their infected mother. The immunosuppression caused by the virus eventually leads to the virus infecting all body systems and predisposing them to a variety of infections. Less than 20% of cats diagnosed with FeLV live more than three years. There is no cure for either virus.
There is a preventative vaccination for both FIV and FeLV as well as a simple blood test to determine if they're infected. I would have to wait until Monday morning when work opened, so for the evening we set them up with food and water and a heater in the shop.

2. Check for hydration. This is done by a simple pinch test. Gently pinch the skin and release. If it springs back quickly, the cat is well hydrated. If it sinks back slowly or tents, the cat is dehydrated and will need fluids.
Performing the pinch test. 

Notice how the skin on this cat has remained "tented" after letting go of the skin? This cat is dehydrated and should receive fluids immediately.

Luckily, our kittens were only mildly dehydrated, so in that case I purchased some Pedialyte for them to drink that night. I mixed it with a little bit of turkey baby food and they scarfed it up! 

3. Check the mucous membranes. Lift up the lips and check the color of the gums. Are they slick or sticky? The gums tell us a lot about the health of an animal, but the main concern you will have is anemia. 
These are healthy gums. They are pink and shiny. 
These gums are pale, a sign that the cat has depleted blood cells. 
Our kittens' gums were a little pale, which wasn't surprising because they were covered in fleas. 

4. Check for injuries including bite wounds and broken limbs. Thankfully, our kittens had neither. If you find an injured kitten, take them to the vet immediately! If your regular vet is closed, they will often have the number for an emergency hospital or a vet on call. Also, do you notice sneezing or weepy eyes? This is evidence of an upper respiratory infection common in cats and it requires medication. Our kittens, one in particular, unfortunately were sick.

5. Keep them warm and secure. Since there was no rush to get them to a vet that night, we made sure the kittens had food and water, towels to snuggle in, and a heater to keep them warm. I kept them in a large carrier. Remember to keep them away from your other cats to prevent the transmission of diseases and parasites! 

6. Does the kitten need to be bottle fed or can it eat solids? Definitely something to consider if you find an orphaned kitten. This is great guide to tell how old a kitten is, but here's a quick version: 

Eyes closed until about 7-10 days old and cannot walk. This kitten is a newborn and needs a milk replacement such as KMR.  
At 2 weeks old, the eyes are open but the ears are floppy. Wobbly as she moves around and beginning to grow teeth. This kitten is still nursing.
This 3 week old kitten is reacting to noises and beginning to explore. At this age, they still need milk, but at about 4 weeks when kittens are steadier on their feet, they can begin to try solid foods. 
At 5 weeks old, kittens are playful and have pre-molars. They will lap from a dish and learn to use a litter box by watching mom/other cats. 
At 6-7 weeks old, a kitten's eye color will change from its original blue (unless you have a blue-eyed kitten!). They will be very active and have all their baby teeth. They will weigh around 1.5-2lbs. 
Kittens are generally weaned around 6-8 weeks of age. If you find an active kitten weighing around 2 pounds with all its teeth, you're safe to feed it solids. Start with soft food to be sure. As I stated earlier, I mixed Pedialyte with turkey baby food, but if you have access to it, mix a little milk replacement with canned Science Diet a/d. Offer dry kitten food. I suggest free feeding them.

We determined that our kittens were around 6-7 weeks old, so it was okay to feed them solids. We also checked and discovered they were both girls! 

The next day, we took the kittens to the vet for their all important FeLV/FIV test!
All it requires is 3 drops of blood and 10 minutes! 
The only dot you want to show up is the positive control. Even a smidgen of another dot indicates a positive result for FeLV or FIV. 
The kittens were pretty good for their blood draw and after 10 minutes, their results looked like this! Negative! 

After we determined the kittens, named Sarah and Sparkles by the kids, were negative for FeLV and FIV, they were given topical flea medication and dewormed. They were also checked out by the vet and prescribed antibiotics for the URIs. Once we gave the flea treatment 24 hours to absorb into their bodies, we gave the kittens baths and trimmed their nails. A week later, they are happy, bounding kittens that are almost done with their meds and fully litter trained! 

I hope this post helps if you find yourself in a similar situation! Remember, knowledge is power!

And I know you're probably wondering if we'll keep the kittens. The answer is no. We're going to find homes for them. I swear...
Sarah (l) and Sparkles (r) spend all day (and night *grumble*) playing. The little darlings are sweet and affectionate and super fun to watch romp!