Wednesday, April 29, 2015

Here's the gross you've been missing

Hey, all! I've been crazy busy with work and school and life, so I haven't had a chance to update the weekly journal blogs. This is one from a few weeks ago that I thought was most interesting and not too depressing. Finals are here, so I'm burying myself in studying and homework until the semester is over. Then I get a couple weeks off before summer session. Yeah, step back because my life is CAH-RAY-ZEE interesting!

Week 12: April 13­-19, 2015 

This was the week of the largest tumor ever. We had a dog come in for an exploratory surgery for a suspected splenic mass. My job was to assist the technician and doctor during surgery, retrieving anything they needed and setting up the room. It was the first time I set up for an exploratory, so I had to learn which instruments were needed. I knew to grab a spay pack (which we use for most surgeries as it contains the basic instruments), a large drape, a bowl and handle, and a laser tip. The technician instructed me to also grab lap sponges, retractors, a suction tip, and the suction machine, which I had never used. Once the surgery started, everything seemed routine, and then the doctor opened the abdominal cavity. There was a lot of fluid and the technician had to apply suction and I had to run for towels so the doctor wouldn’t slip on the floor. My job was to watch the bucket on the suction machine and to switch it out when it became full. I really had to hustle because there was a lot of fluid and blood and the buckets filled fast. If they became over full, there was a risk the fluid would back up into the filter. The technician told me I did a great job making sure the buckets didn’t get too full, dumping the fluid, and then running back to switch them out again. Once the fluid was clear, the doctor was shocked to see how large the tumor was in the abdomen. Oddly, the spleen looked normal, but the liver and pancreas were enormous masses. There didn’t appear to be any tissue that was not infiltrated by cancer. The owner was called and decided to euthanize the dog on the table. It was a sad end to the case, but the instruction was not over. The technician instructed me to watch the ECG while listening to the dog’s heart. Even after the heart had stopped, the machine continued to register a heartbeat for several minutes. It was a lesson in never fully trusting the machine, and to always listen to the heart and lung sounds manually. 

The newest skill I learned was how to perform the Schirmer Tear Test. The patient was a cocker spaniel that had bilateral eye discharge. The eyes were also quite red. We brought the animal back in treatment and I retrieved two test strips, one for each eye. While the strips were still in the sterile packaging, I folded one end, carefully opened the package, and placed the folded end between the lower eyelid and eye. The animal was restrained while the strip remained in place for 60 seconds, then it was removed and the point where the wetness stopped was noted as the basal and reflex tear production. The normal rate in dogs is 13­-25 mm per min. The left eye was in the normal range, but the right eye produced less tears than normal. The doctor theorized that the dog’s ablation surgery of the ear canals restricted the dog’s ability to blink, a fact confirmed by the owner. The dog was prescribed an opthalmic solution to treat the dry eyes. Learning new tasks such as the Schirmer Tear Test is not only satisfying in regards to new experiences, but also in allowing the doctor to concentrate on other things. Freeing up time for the doctor is one of the main aspects of my job, I’ve discovered, so anything I can do to help can be very rewarding. 

The Schirmer Tear Test. The strip is placed between the eyelid and cornea and the dog is held still with eyes closed for 1 minute. 

After 1 minute, the strip is read. Inadequate tear production indicates dry eye. 

An interesting thing I witnessed this week involved a feral cat that was scheduled to be neutered. We participate in a feral cat program that allows people to catch feral cats in their area and bring them in to be spayed/neutered and vaccinated before being returned back into the wild. The program helps reduce pet overpopulation, the spread of disease, and by putting the cat back, prevents more feral cats from taking the cat’s place. The cat was brought in a trap and sedated. Thankfully, it was a male, which meant a quick easy neuter. Or so we thought. Once the cat was safely removed, it was discovered to be polydactyl. A few of the claws on the front paws could not be worn down, and as a result, they had grown into the pads of the feet. The doctor decided it would be best to declaw those toes to prevent further injury as the cat obviously had no owner who could trim the nails. We were shocked to discover the claw in between the two “feet” on the front left paw was so long, it had curled over and over into the foot. Uncurled, it appeared to be at least an inch long! The cat was declawed, neutered, and given injections for pain and antibiotics. It was gross and amazing!

This is a great photo indicating the problem often seen with polydactyl cats. The toe between the two "feet" (circled) cannot be worn down by the cat scratching posts, so it must be trimmed to prevent overgrowth. 

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