Stuff I did when you weren't looking part 3: The mushy stuff

Yeah, that's right. Here's the post you want to skip if you don't want to throw up in your mouth a little bit.

I'll save you the sanguine details, partly because vomit is gross, but mostly because I feel that words just don't cover how happy life has been. Adventures have been had, and planned, and imagined, and dreamed about. But not on my own.

The summer semester was over and adventure time was about to begin!

Rick and I went on a weekend adventure to Vancouver, BC! Neither of us had been there, so it was exciting researching the area and trying to decide which points of interest we absolutely had to see in the short time we were there. We stayed in a lady's basement apartment courtesy Airbnb, which is a site that connects you to people renting out rooms, basements, or entire apartments to travelers. It was fantastic, not to mention much less expensive than staying in a hotel, and we had an entire apartment including kitchen to ourselves in a cute neighborhood. After we arrived in Vancouver on a Friday afternoon, we walked down one of the many suburban streets lined with shops and restaurants and ate at an absolutely delicious place called Locus just in time for happy hour, so appetizers were half off. The drinks and food were amazing! We shared several appetizers and it was by far one of the best meals we had there. Next, we took the Skyline (which actually went underground) into Vancouver proper. We came out of the station to a crowd of people and skyscrapers as far as the eye could see. I'm not gonna lie, I think I had a minor panic attack and had to sit down for 20 minutes until I could cope enough to move on. My life in a box had not prepared me for the culture shock. 

We spent the rest of the day wandering around exploring the city while my brain adjusted. It was also a very hot day, and to be honest I had consumed a little alcohol at lunch, so that didn't help my mental state. We decided to take a break and have dinner at the Top of Vancouver revolving restaurant, which is kind of like the Space Needle. We had a fantastic panoramic view 553 feet above the city from the restaurant. I had a light meal of escargot. They taste earthy and chewy. 

Once the temperature cooled, it was a little easier to enjoy the city without sweating bullets and wishing I had shorts. Plus, we had hydrated at dinner. It was a beautiful city at night. The people were friendly and there was music on every corner. There were pianos randomly in parks and on Canada Place on the waterfront. The moon was full and bright! It was a wonderful first day in Vancouver and we were excited for the next day's adventure!

The first must-stop on our adventure was the Capilano Suspension Bridge Park  located in North Vancouver. The park is one of the  most popular places to visit in Vancouver, and it doesn't disappoint. The main attraction is the suspension bridge, but first we did the Cliffwalk (pictured at left). 

Yeah, it was freaky. The park describes it as a, "heart-stopping cliff side journey through the rainforest vegetation on a series of unobtrusive cantilevered and suspended walkways jutting out from the granite cliff above the Capilano River." Heart stopping is an understatement. More like heart said, "Nope. Nope. Nope." and jumped right out of your chest to go enjoy a drink somewhere. The walkways are very narrow and sometimes glass so you can see the looooong drop. It took a while, but I did become comfortable enough to say, "Bring it on!" to the suspension bridge. 

 The Capilano Suspension Bridge was built in 1889 and stretches 450 feet across and 230 feet high above the Capilano River. Did I mention it was a suspension bridge? Did you know that means IT MOVES?! Can you see my fear? It's real. Every time it moved, I was convinced it was going to flip over and we were going to plummet 230 feet to the bottom of a canyon. Rick had to give me some tough love to keep me moving and then talk me through walking the entire bridge so I wouldn't have a panic attack. The couple walking behind us were legitimately concerned. They high-fived me when I made it across. 

 

We did not plummet to our deaths! Should have seen the look on my face when I realized I would have to cross it again to get back. 

The Treetops Adventure was on the other side of the bridge. It was reminiscent of the Ewok village with 8 bridges between the trees and little tree forts. It was like being a squirrel in the 250 year old Douglas Firs 110 feet above the forest floor. According the to the park, the "Treetops Adventure was designed to accommodate the continuous growth of the trees. The viewing platforms are attached to an innovative tree collar system that is adjustable and move able and has no nails or bolts penetrating the Douglas-firs." There were great stations for kids on nature walks and an interpretive center with live bird of prey shows. It was a beautiful nature walk! Toward the end of the trail, there was an enormous downed tree that had fallen some years ago during a particularly bad snow and ice storm. It fell right onto the suspension bridge with the force of a 747 and broke in half. The bridge remained, virtually undamaged. With that thought in mind, I was able to cross the bridge again with Rick guiding me (walking backwards the whole way holding my hand, bless his heart) while I chanted, "I believe in science, I trust science, science says this bridge can hold a 747 falling on it." 

Totally nailed it.  

 We stayed closer to the ground for our next adventure after a lovely lunch at the Teahouse in Stanley Park, the largest park in Vancouver. We rented bicycles for the 7.5 mile bike loop along the Seawall. It was a gorgeous day! The ride was very relaxing with a beautiful view all around the waterfront park including beaches, playgrounds, and a water park. There is so much to do just in Stanley Park that we unfortunately did not have enough days for everything.

The bike ride was a perfect end to the day! 

Our last day in Vancouver was all about becoming cultured by visiting museums. There are many in Vancouver, and I wish we could have spent several days visiting all of them. We narrowed it to two that we felt we could not miss our first visit here, and leaving others that would force us to return. 

Just have to give a shout out to the Vancouver Public Library where we heard had the cheapest parking garage. We went upstairs into the library to head out onto the street and I about died. There were more books then I'd ever seen in one place. It was breathtaking. I wanted to become a resident just so I could get a library card. 

After the shock of the enormity of the public library wore off, we wandered over to the Vancouver Art Gallery, which has a mix of classic art (the "Of Heaven and Earth: 500 years of Italian Paintings by Glasgow Museums," featuring works of art by Botticelli and Titian) and modern art (the kind I have a hard time understanding). 

 My favorite exhibit was the puppet gallery by an artist I cannot for the life of me remember and I can't find any information about it on the website! It was a series of puppets made from fabric and cut out pages from books, magazines, etc to make characters. I could have looked at those figuring out the symbolism and the artist's vision for hours. I also enjoyed an exhibit with cut-outs from a history book placed categorically, for example dictators and medical innovations together. Kinda of makes me want to tackle some book art myself!


The absolutely stunning Museum of Anthropology at the University of British Columbia featured thousands of pieces from every culture imaginable, including massive totems both inside and outside the museum. We were blown away by how much history was inside, and if the artifacts on display weren't enough, there were drawers and drawers of more pieces under the displays. We could have spent an entire day exploring this museum as well as others on the university grounds. One of my favorites were the Native American masks used in dance ceremonies. Some were massive and took years for a dancer to work up to due in part to the heavy weight. There were also exhibitions from popular world artists, the one we saw being from Portugal titled, "Heaven, Hell, and Somewhere in Between."
Please, please, please if you're in Vancouver, do not miss this museum! We loved it and will go back again!



We were sad to say goodbye to Vancouver and even plotted stealing the kids and living there indefinitely. The city is full of activity without feeling crowded and overbearing, the people were friendly, and sites were numerous, especially for nature and art lovers! I feel incredibly fortunate to have an amazing partner not only willing to whisk me away on adventures, but excited to enjoy and plan future ones! I'm not going to say I'm the luckiest woman in the world because that would be too cliche.

But I am.

Stuff I did when you weren't looking part 2: Connecting with the kiddos

One of the main reasons, besides homework, I've been neglecting the blog is I've been trying to live a little bit of life, especially with my kids. Not only are they growing up before my eyes, but I only have them 3-4 nights out of the week. It makes me sad that I miss out on essentially half their lives, so I try to live as much life with them when we're together as possible. This may mean we're jetting off on adventures or sitting around watching movies and having craft time. Either way, when I'm not working, I'm super momming it as best as I can. Now that Roman is in karate and Evie has started soccer, the time we get to spend together is dwindling. I live in constant fear of feeling disconnected from my kids, especially my almost 7-year-old who seems determined to become a teenager in attitude and disposition WAAAAAY too fast! I'm hoping the struggles we have to work through mean I'm getting the drama out of the way for the actual teenage years and that it doesn't mean things'll *gulp* actually get worse once the hormones kick in. At least she isn't listening to Taylor Swift and wearing shorty-shorts and make-up. *gulp* yet.

The summer is coming to a close. School starts next week and my drama queen daughter will be in the 1st grade, which she's really excited about I'm happy to say. My little man will be starting his second year of preschool. We had many adventures this summer, full of memories and sunshine. They fill my heart with joy and a little wisp of sadness because I know it may not always be so sunny. Eventually, the kids will want to do their own thing, go off to camp or trips with friends, maybe even Europe like I did. And I'll wish them well, but inside I'll be missing them terribly. So for now, I'll be selfish, and kindle those adventurous spirits where I can share the memories, too.

JUNE
 "What are we doing today, Mommy?"
"We're going back in time, kids."
This is the conversation we had when I decided to take the kids to Fort Clatsop, the sight of the winter encampment of the Lewis and Clark expedition. They have a great museum there, trails, and a replica interactive fort. The kids had a blast pretending they were Lewis and Clark and discovery adventure!

JULY

Coffenbury Lake, located in Fort Stevens State Park, a former military installation from the Civil War to World War II. The kids are little fish and they had a blast swimming in the sandy bottom lake. It brought back memories of my own lake experiences at Badger Lake in Cheney, WA.  

Willapa National Wildlife Refuge established in 1937 by FDR to protect migrating birds and their habitat. It provides habitat for over 200 bird species in addition to chum salmon, Roosevelt elk, and a dozen species of amphibian. Located off Highway 101, we pass the entrance to the refuge every time we head north to visit family in Seattle and never stopped in during the 9 years we've lived here. One day, the kids and I decided we should check it out. We all brought our sketchbooks and had a great hike! We even rescued a barn swallow the kids found trapped in netting under the eves of one of the buildings!  

AUGUST

Fort Columbia Historical State Park located just before the Chinook tunnel was a military installation guarding the mouth of the Columbia River from 1896 to 1947. It was also home to the Chinook Indian Nation and was explored by the Lewis and Clark Expedition. Many of the military buildings and batteries still remain in the park. We've explored the fort quite a bit, but one day we decided to check out the beach since the tide was out and had a great time beach combing, hiking, and using our imaginations!

The kids run after adventure at Leadbetter Point State Park at the northern end of the Peninsula! Leadbetter was great for day hiking and beach combing. Evie found many shells and Roman claimed sticks he used to practice his Jedi/Ninja skills. 

Another visit to Fort Clatsop for a hike turned into an unexpected canoe ride! How you may ask? We walked up past the trail head to see if there was a place we had to pay for parking and lo and behold, the National Parks Service was having a party! There was music, painting and other crafts, and canoe rides, which the kids were ecstatic about doing! Spontaneous adventure anyone? Evie took to it like a pro, but Roman took some convincing once he got into the boat because he was afraid it would tip over. Took some tough love and a lesson in science, but pretty soon the little man was paddling with the rest of us just like Lewis and Clark!

International Kite Festival in Long Beach. Every year, Long Beach plays host to kite fanatics and people who just enjoy a good festival with food, fun, and activities. These littles were a little too small for the activities, except for a pony ride! Also, sno-cones and elephant ears happened. 

We had a wonderful summer and are excited about the upcoming school year. It has flown by fast, and we didn't do half the things I wanted, but there's always next year!

Stuff I did when you weren't looking part 1: Work in progress

Hey! I've been very busy and important, so I have not been updating the blog, even though I had weekly journal uploads for school. Honestly, they wouldn't have been interesting to anyone other than my professor and not as humorous as the previous semester. My work practicum 2 prof did not appreciate my sense of humor as much as my work practicum 1 prof. Lame.

Needless to say, the summer semester was crazy busy and I learned and practiced many skills. I have another week before fall semester starts, so I just want to share a few updates. This week is all about work. It's been busy! We are the busiest we've ever been in the history of Bayshore. One day we saw 68 patients. This means we all have to be on our A-game to ensure the best quality care for each patient that walks, crawls, or skitters in the door. It can be overwhelming and stressful, but at the end of the day, I still cannot imagine doing anything else. I've officially been a Bayshore employee for a little over a year and have received my first raise!

I went through my weekly journals to find some highlights of the semester to share with you, and I found one story in particular that warms the heart with feels. So here it is!

Our clinic works with the local shelter to treat and care for impounded and surrendered animals in order to prepare them for adoption. A few days ago, I cat came in that was possibly pregnant. The doctor confirmed, and a spay was scheduled for Monday. It sounds grim to think of performing an abortion, but unfortunately the number of unwanted pets is so high that population control is often necessary. It also prevents overcrowding at the shelter. On Saturday, the cat was extremely vocal and destroying her cage. At the end of the day, the technician feeding her noticed a discharge coming from her vulva. We suspected that labor was imminent, so I volunteered to take her home to monitor her. Before I left for the evening, we took an x­ray to determine approximately how many kittens she had. 

We counted skulls and spines and guessed there were five at the most. I took her home and set up a quiet place with a blanket and box plus food, water, and litter. Then I left her alone and periodically checked on her throughout the night. At 10pm, I noticed she was restless, licking her vulva, and possibly having contractions. Thankfully, the queen was comfortable enough to allow me to be present in case she needed assistance. The first kitten was born at 10:12pm and did not appear to be moving. I took the kitten and wiped its face, carefully tore the umbilical cord and ensured the whole placenta was present, and commenced resuscitation. I rubbed the kitten gently yet vigorously, blew gently in its face, and turned it upside down in an arc to try and clear the fluid from its mouth and lungs. Unfortunately, my efforts were in vain. At 10:50 the second kitten was born alive and so I did not interfere. The third kitten was also healthy, but the 4th and 5th were stillborn. Interestingly, they did not appear to be fully developed, possibly due to the malnutrition of the mother? After the 5th kitten was born, mom relaxed and was nursing the healthy two. Suddenly, she cried out and appeared to be birthing another. Simultaneously, her kittens cried out. She appeared quite stressed by the time the 6th kitten was born, but she cleaned it and it moved and cried out. I thought all was well until I looked closer a few minutes later and noticed something off. I picked up the last kitten and saw that it was eviscerated either due to the mother or a hernia. I contacted our on­-call doctor and brought the little family in on emergency. The 6th kitten was humanely euthanized and a radiograph was taken of the mother to make sure she was finished giving birth. She was thankfully, and I took her home to relax. It was an exhausting experience, but one I will learn from the next time I bring a whelping animal home! Mom is doing great and is attentive to her kittens, who are nursing well and seem to be stable.

Two healthy kittens!

Happy family. I called mom, "Tess," while she was with me. She was very sweet and I was sad to see her go back to the shelter to be placed in a foster home. 

Update: We recently saw both mom and the orange kitten at the shelter to be spayed in preparation for their adoptive home! It was wonderful to see them and to know they were being placed together. I hope to see the other kitten going to a new home soon!

This week I was pooped on twice but that isn't covered in this post

The summer semester is here and that means more weekly journal updates of life as a veterinary assistant! Who's excited to hear more about poop?!

Also, just want to put a plug in for a new (to me) artist I've been listening to lately. Thank you, YouTube, for finally suggesting something good to listen to after months of poop:


Week 1: May 18-­24, 2015
The clinic I work in is Bayshore Animal Hospital, a small animal clinic offering general exams, surgery, and diagnostics including in house blood work, digital x­ray, and ultrasound. I am an assistant who does everything from checking client to running lab work. In order to gain as much experience as possible, I put my nose into everything, learning as much as I can through asking questions, observation, and by hands­on practice. Sometimes I fail. I get frustrated, I feel like I’m not cut out for this job, I fear I will never become a technician. Then I try again, and when I succeed, it gives me the confidence to move forward. Everyone has a bad day, and I’m learning that I can’t allow the failures to make me give up. 

This week I’ve been jumping whenever possible to practice my blood draws, especially for cephalic venipuncture. I feel fairly confident drawing from the jugular, but for some reason I have trouble with the front leg. The technicians are really helpful at guiding me with proper placement and don’t judge when I have to step away. I generally only give myself two tries with a dog and one with a cat because I don’t want to hurt the animals with too many failed attempts. One technician suggested I ask to practice on sedated patients so I can concentrate on technique without worrying about the animal struggling. I am also practicing my catheter placement. The other day, I was getting very frustrated because I could not place a catheter in a cephalic vein. I tried on two different dogs and I was getting frustrated. We had a patient that was having a vulvoplasty (a Great Dane), and even though the veins were large, I was having trouble positioning the catheter. The doctor showed me that I needed to enter the skin at a 30 degree angle and then level out into the vein. She said once I have a flash of blood, advance a little more and then push in the catheter while withdrawing the needle. She had watched me struggle and advised me to trust that I’m in the vein and not to second guess myself. With this in mind, I chose a vein and placed the catheter on the first try. It felt great to finally get it right and also to hear all the support and encouragement from my colleagues. I was a non­-scrubbed in assistant for the procedure in addition to the certified technician, which was exciting not only because I wanted the experience but also because I had not observed this surgery before. I try to observe any procedure I’m not familiar with so that I know how to assist the doctor in the future. After she was sedated, I placed the ET tube and hooked her up to the anesthesia machine. For the vulvoplasty, the patient was placed in sternal with her legs almost off the end of the table. Her tail was taped up out of the surgical field while I attached the leads, BP cuff, fluids, SpO2 monitor, and esophageal thermometer. A surgical laser was used and I was in charge of suctioning the smoke without contaminating the sterile field. I also retrieved anything the doctor needed while also monitoring the patient. It was a great experience and I look forward to assisting more surgeries! 

One of the things I love most about the clinic I work at is the staff’s devotion to patients, especially those that have been valued clients for years. Many of the staff members will go out of their way to deliver meds and pick up or drop off patients. One of our clients have taken their pets to us for years. As an elderly couple with a large dog, they pick him up and carry him if he were to have a seizure. On Friday morning, he collapsed seizuring and the owners called us for help. Without hesitation, a coworker and I climbed into my car and went to pick the old dog up. Later that day, a client called about his sick cat. He was advised to bring the cat in, but mentioned he would have to scrounge up enough money for a cab before he could. The doctor, wanting to help both the cat and the owner, asked the manager if someone could pick the cat up. So, my car became an ambulance again that day, and at the end of my shift, I brought the cat back home. Going the extra mile for an animal and owner in need reflects the best positive image on a clinic and its staff because it shows that our first priority are the patients regardless of the owner’s financial circumstances.

Adventures in Cooking: Chicken Hearts

Today Roman and I were at the store debating on what to cook for dinner. As a joke, I started grabbing weird items off the shelves and asking his opinion. In the meats section, I held up a package of chicken hearts and smilingly asked, "What do you think, bud? Chicken hearts?" After getting over the initial disbelief that yes, there in fact were real chicken hearts in the package, he emphatically affirmed that yes, he wanted to eat them for dinner. Thinking that he was playing along, I put them back. A few seconds later he looked in the cart, and seeing that they weren't there, asked where they were.
"I thought we were playing, Roman. I'm not really making chicken hearts tonight."
Tears. No bullshit. He was so upset that he cried.
What could I do? As a mother I want my children to try new things, especially foods, and here was my 4 1/2 year old son begging me for chicken hearts. I couldn't quash his adventurous spirit.

So, I bought a package.

And the adventure began.

I've never cooked chicken hearts before (shocking, I know), so I had no idea how to proceed. Thank goodness for Google. I browsed different cooking sights for suggestions, filing good tips away while disregarding those that would not apply today (namely, those that involved grilling. Not possible on a wet, May day at the beach). All the while I tried not to allow visions of giant chicken hearts beating ever closer, growing to enormous sizes, and waiting to devour us all, to invade my subconscious. Honestly, I feared Bill Cosby had ruined the tiny organs for me indefinitely. Had I endangered my children? Was I adequately armed in case of attack? Thankfully, I remained calm enough to decide on a game plan for cooking the tiny, seemingly harmless, ex-blood-pumpers.

Since I had time, I decided to marinate the hearts in olive oil and chopped garlic. 

This was a new food for the kiddos, and new foods are met with suspicion and fear, so I had to have a few back-up side dishes that I knew the kids would eat so they wouldn't starve. 

The plan: sauteed chicken hearts with diced potatoes in bacon and couscous. And of course, wine for me!

I started with cooking the bacon and potato together since they would take the longest. Since I only had two slices of bacon, I also added a little butter to help the potatoes cook. And because you can never have enough fat. I seasoned with pepper and a little bit of salt.

The different colored potatoes looked and smelled delicious!

Then, I prepared the couscous as directed. It would only take 8 minutes total. After the potatoes and bacon were cooked, I used the leftover butter and grease to cook the hearts in. 

Mmmm...I love mixing dinner with science. 

The only extra seasoning I used was fresh ground salt and pepper. They might look a little intimidating, but it actually smelled pretty good!

The big moment: tasting. Evie was pretty unprepared since she wasn't at the store with us, so she met the plate with a mixture of disgust and disbelief. 

Roman was very excited to try, but Evie was less convinced. Still, she gave it a good bite, and declared, "YUCK!" Roman on the other hand...

LOVED THEM!!

I was very proud of my little minions for trying something new and weird. Honestly, they mostly tasted like dark meat chicken. 

Next time on adventures in cooking with the Metzgers: gizzards?

Nah.

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. 

You know you love your job when...

You get excited over fecal samples. Read about it in this week's journal entry!

Week 11: April 6-­12, 2015

 The highlight of this week is that I intubated my first patient! We were preparing a dog for spay and the technician handed me the ET tube and said, “You place it.” I was so excited because I have never done this before even though I had observed and assisted in the procedure hundreds of times. The technician told me that I should learn how to do the one ­handed technique because there might come a time when I either don’t have help or it’s an emergency and I won’t have time to wait. She showed me how to pull the tongue out, “like you’re going to rip it out of the dog’s head.” (Not really; it was a strong pull, but not enough to injure the dog). I held the dog’s tongue in the last three fingers of my left hand and then placed my index finger behind the canine tooth and used my hand as an elevator to pry open the mouth. She showed me the epiglottis at the back of the throat and used the end of the trach tube to gently lower it to reveal the larynx. She said, “ You see that V? You want to hold the tube slightly on its side and place it between the V into the trachea.” I placed it on the first try! She showed me the dog’s breath coming through the end of the ET tube and explained that if I felt the throat, I should only feel one hard tube. If I felt two, the ET tube was most likely in the esophagus. Since we determined the tube was placed correctly, I inflated the cuff and tied the strings behind the dog’s head in a bow to help keep it in place before hooking up the anesthesia machine. A technician told me never to hook an animal up to a dead machine, so I turned on the oxygen first, hooked up the rebreather, and then turned on the iso anesthesia. She later explained that cats sometimes are more difficult than dogs because their larynx is easily reactive, so you oftentimes have to “spear” the larynx really quickly or use a tiny drop of lidocaine to relax the throat. It was really exciting to learn a new technique that I can use to assist the doctors and technicians on future procedures. 

This has been another week in trying to work out the kinks of going paperless. One of the doctor’s in particular is having trouble adjusting because she relies so much on writing things down. She also admitted she’s not computer friendly in general, so having to work with the computer system at work was frustrating. She dreaded seeing appointments because of the stress, so my job became to hold her hand and make the process as easy as possible. The hospital manager instructed the receptionist to schedule all her Saturday appointments for 30 min instead of her usual 15 so she wouldn’t fall so far behind trying to figure out a system that worked for her. I had to channel my mom patience, but we made it through Saturday, and at the end of the day, she was excited and on board with going paperless! There are a lot of aspects I like about going paperless, namely that everything is recorded where anyone can look up information without having to find a file. Every communication with the client is at hand, every test, drug administered, and prescription can easily be accessed. The next step is to get scanners for things that have to stay papered, such as consent forms. I hear there’s talk of a new x­ray machine that will allows us to transfer radiographs into AviMark. I’m just excited about the prospect of having an x­ray machine/program that won’t randomly decide to die on us. 

Thursday I had the most exciting fecal sample of my life. And I think its awesome I get to say that in my line of work. We had a client drop off a fecal sample for a patient that kept having horrible bloody diarrhea and they couldn’t find out the answer. The dog was on metronidazole and the doctor suspected the food might be the culprit. I set up the fecal sample as usual, took a sample and mixed it with Fecasol, spun it in the centrifuge for 5 minutes, then allowed it to sit with a microscope cover slip over the top for 3 minutes. I placed the cover slip on a slide and placed it under the microscope. I usually start on the lowest objective, but in the interest of time I went straight for the 10x. Immediately I saw hookworm eggs, a heavy load of hookworms, up to 15 in a field at least! Then I saw this strange critter that looked like a mite. I pointed it out to the technician and she thought perhaps it was something that had crawled on the pooped when it was on the ground. But there were several! I excitedly showed the doctor and he theorized they were grain storage mites. We decided to send the rest of the fecal sample to an outside lab to find out exactly what they are. I can’t wait for the results!

The oval shape is a hookworm egg. The eight legged creepy thing? STAY TUNED!

And then puppies happened.

Hey! Been a crazy few weeks since I posted last. I had a "Spring Break" (in quotations since technically I didn't get a vacation and had one professor still assign homework *grumble*). Work and school have been busy. The kids are getting involved in activities, including karate and archery, so my schedule is full and the coffee is constantly flowing! Somewhere in there I have a date night with Rick so I don't forget what his face looks like. I periodically message him pictures of mine so when some random girl walks up and hugs him, he'll remember it's his girlfriend and not to be frightened.
Anywho, here's what I was up to at work this week!

Week 9: March 23-29, 2015 

Recently I’ve been preoccupied with learning as many new skills as possible that I didn’t stop to make sure I was proficient at the ones I know. I decided to make an effort to slow down and practice acquired skills and to allow the new ones to present themselves without stressing about it. My main goal was to become better at venipuncture. There are certain veins I feel less confident in, so when we had anesthetized patients, I would practice cephalic and lateral saphenous venipuncture. In addition, I didn’t hesitate to jump in and do blood draws myself instead of handing them off to someone with more experience because I was nervous. I figured if I don’t hit the vein by the second poke, I can hand it off and still get the practice. I had many opportunities to practice jugular and medial saphenous and hit the vein on the first try each time, which has given me confidence to move forward with blood draws and eventually other skills as well. I would really like to learn how to perform cystocentesis since it’s a procedure we do very often. 

Cystocentesis is the introduction of a needle into the urinary bladder for the purpose of extracting urine. It's the best way to collect urine for sterile lab send outs. 

The best part about this week was puppies. Puppies make all the stress, anger, and heartache just fade away into warm, cuddly fluff. We work closely with the local shelter and they had a stray mother with four puppies they were trying to catch. They were able to retrieve the pups, but the mother remained elusive. The four puppies estimated to be about 35 days old were brought into the hospital and put under my charge. I weighed, took TPR, assessed mucous membrane color, and performed a PE to check for any obvious injuries or abnormalities. I also obtained fecal samples from all four for microscopic examination. They had fleas, but were otherwise in great condition: active, vocal, and chubby! They were given names and numbers for the shelter and placed in a kennel with plenty of blankets. A fecal flotation resulted in roundworms, which wasn’t a big surprise, so they were given 0.5ml Strongid each with instructions to follow­-up with 1ml each in 10 days. There was no way of knowing when the puppies had last eaten, so I then prepared to feed them both with replacement formula and canned food mixed with formula in a bowl since they were over 4 weeks old and able to begin solids. I offered each puppy a bottle with formula and when I had them excitedly eating, I offered the canned/­formula mixture. They were all eager to eat off my fingers, so I then directed them into the bowl. Most of them ate great this way and settled in well together for a nap. Later, we received a phone call that the mother had been trapped and the shelter manager was bringing her over to reunite with her pups. She was scared and a collar that she was wearing had slipped under her arm on one side had been digging into her skin causing a wound. The puppies were very excited to see her and she seemed content to have them back. They were set up in a run with plenty of soft bedding. Mom was given water and plenty of food. Lactating mothers require a lot of calories and it was clear she wasn’t receiving enough to maintain her own body weight though her pups were in great condition. Puppy food is the best for lactating moms, so we gave her both dry and canned free feed. It was really heartwarming to see the family reunited, happy, and on the road to healthy. The next step is to see them go to forever homes!

The feels! 

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. 

*FACEPALM*

*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!

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. 

Franken-cat.

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."

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.

IT'S SO FLUFFY I'M GONNA DIE!!