RMH
trying on a metaphor
Andulka
❣ Chile in a Photography ❣
★
untitled
bliss lane
Aqua Utopia｜海の底で記憶を紡ぐ
oozey mess
ojovivo
I'd rather be in outer space 🛸
Not today Justin
Keni
YOU ARE THE REASON
pixel skylines
sheepfilms
Sade Olutola
Kiana Khansmith
Origami Around
Game of Thrones Daily
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@getmeintovetschool
To anyone out there that has to deal with needle shy horses - vets, owners, trainers, grooms, etc - this is hugely helpful.
BEVA has produced a series of videos on several behavioural issues, to help training the horses and keep the vets safe! Please use them :)
I believe your very curious sounding description of "tetraollogy of fallot" (in the keeshound post) does call for a video - if youre intrested, that is!
That the Tetralogy of Fallot is when you have four things that are Wrong with the heart and they’re all bad but if you didn’t have that specific combination they would just die?
Here’s a video explaining what the Tetralogy of Fallot is:
Specifically, in TOF the aorta is moved into the right side of the heart. Sometimes this is called transposition or dextroposition. This is a problem because you have deoxygenated blood from the body in the right side of the heart, which is supposed to go to the lungs, not the aorta. If we didn’t have the other defects occurring at the same time, the aorta would only receive deoxygenated blood, and that is not compatible with life.
The struggle is real
1. Is that feces,urine, blood or anal glands on my scrubs? 2. Where in the hell is my pen? 3. I think I just stabbed myself. 4. Pretty sure I just skin glued myself to this animal. 5. Wow, isopropyl alcohol is really helpful finding all the cuts I didn’t know I had. 6. Where did that bruise come from? 7. I think that scratch is going to scar. 8. Why is this client here…again…for the third time this week? 9. Does the doc really need to talk about the clients family right now? I’m just down here, on the ground, trying to restrain this 100lb naughty malamute. 10. God, this dog stinks. I really wish I could move my face. 11. Did I log those drugs in the DEA book? 12. This surgery needs to go faster. I need to pee. 13. Shit, I can’t get my scrubs untied and I really need to pee. 14. My nose has to itch right now?! I’m sterile damn it! 15. Oh look! Toenail trimmings in my bra. 16. No shorts or tank tops this week. I look like an abused spouse. 17. Staff meeting tomorrow. 18. Was that the sound of my scrubs ripping?
5 be the realest shit ever
BIOCHEMISTRY BLOOD TESTING
Biochemistry blood test measures the levels of chemical substances carried in the blood. This type of test allows us to evaluate the how well the liver and kidneys are working and how much fat and sugar is circulating in the bloodstream.
Blood Glucose
When carbohydrates are eaten they are broken down and stored in the Liver as Glycogen until the animal needs energy where it is then converted to glucose and transported around the body. We use blood glucose as a monitor of metabolism and physiology.
Normal BG (Canine) - 5.6 to 13.9mmol/L
Normal BG (Feline) - 5.6 to 16.7mmol/L
INCREASED BG - Diabetes Mellitus is indicated however it is recommended that the urine is also checked for Glucose as if present this means the kidneys have reached their threshold and Diabetes is very likely. Note that cats can have stress induced hyperglycemia and so a diagnosis of diabetes should not be made on a single BG reading.
DECREASED BG - Patients that are sick and deliberated often have hypoglycemia. but puppies who have been starved for procedures can also suffer from a low BG. In addition to this hunting breeds that have been working hard for a prolonged time can also suffer from a low BG.
Bun Urea Nitrogen (BUN)
BUN is the by product produced when Proteins are broken down and used within the body. This by-product is excreted by the Kidneys in the urine.
INCREASED BUN - This would mean the kidneys are not working sufficiently and could be an indicator of kidney disease or kidney obstruction that is preventing urine reaching the bladder and therefore build up in the Kidney. Heart disease causing poor circulation to the kidneys could also be a cause of increased BUN.
DECREASED BUN - As the liver breaks down Protein a lower level of BUN could indicate that the liver is not working as well as it should and isn’t breaking down protein as well as it should.
Creatinine (CREA)
Creatinine is solely filtered out of the blood by the kidneys.
INCREASED CREA - Impaired Kidney function
Calcium (CAL)
Calcium is a mineral that is found at a consistent level within the blood. It’s needed for muscle and nerve function and without it death can occur.
INCREASED CAL - Some types of cancers and medications can cause an increase in Calcium.
DECREASED CAL - Some animals can experience low calcium levels during pregnancy, post partum and during lactation. This condition is called Eclampsia.
Total Protein (TP)
The measurement of two blood protein molecules: Albumin and Globulins. Albumin is produced by the Liver and levels are often decreased when the animal is going through a period of poor nutrition. Chronic infectious disease will also cause low Albumin levels.
Globulins include immunoglobulins which are used by the body to fight infection. Certain diseases such as FIP can cause an increase in this.
Bilirubin (BIL)
Haemoglobin is found inside red blood cells, it carries oxygen to tissues around the body. When RBC’s die or are destroyed and the haemoglobin is broken down, bilirubin is a by product of this process which is then excreted by the Liver.
INCREASED BIL - An increase can be seen when the Liver is diseased and is can’t clear the bilirubin efficiently. A liver or bile duct obstruction can cause bilirubin to build up thus resulting in high levels in the blood so this should also be considered.
Alkaline Phophatese (ALKP)
This is an enzyme used to assist with various chemical reactions within the body. The normal levels vary from animal to animal but in dogs, an increase could indicate some forms of cancer or Liver disease.
Atanine Amino Transferase (ALT)
This is an important enzyme for adequate Liver function. An increase in this enzyme would indicate that Liver cells are breaking down, this could be because of cancer, cirrhosis, or liver congestion due to heart failure.
Cholesterol (CHOL)
INCREASE CHOL - Inadequate Thyroid function
DECREASE CHOL - The animal has been through a period of starvation or is not having their nutritional requirements met.
SODIUM: POTASSIUM RATIO
These levels are almost always interpreted together. Their levels can be affected if there is a disease of the adrenal glands, heart, or kidneys.
INCREASED RATIO - Not clinically significant
DECREASED RATIO - Primary Hypoadrenocorticism
When evaluated on their own:
INCREASED K+ - Acute kidney failure, Chronic kidney disease or Addisons disease.
DECREASED K+ - Chronic kidney disease, or lost through vomiting and diarrhoea.
INCREASED SODIUM - Dehydration through vomiting and diarrhoea
DECREASED SODIUM - caused by severe vomiting and diarrhoea or can be seen if the patient has been on diuretics.
I’m sorry this has taken so long to do and that it’s so rushed :(
Harry Potter and the Cranial Nerves
So I figured I’d bring this back since we just started Neuro here. I couldn’t find the post in my archive so I’m just making a new one.
So there’s 12 cranial nerves, they all go in a specific order, and they’re either sensory, motor, or both. It’s easiest to remember them (in my opinion) with a mnemonic, and I found Harry Potter based ones a long time ago.
On, On, On They Traveled And Found Voldemort Guarding Very Ancient Horcruxes
Severus Snape Meets Malfoy, But Mad Bellatrix Stays Behind Bushes Misusing Magic
I. Olfactory - Sensory (smell)
II. Optic - Sensory (vision)
III. Oculomotor - Motor (pupil constriction)
IV. Trochlear - Motor (downward movement of eye)
V. Trigeminal - Both (jaw movement, sensation of face and neck)
VI. Abducens - Motor (lateral movement of eye)
VII. Facial - Both (facial expression, taste)
VIII. Vestibulocochlear (aka auditory) - Sensory (hearing and balance)
IX. Glossopharyngeal - Both (swallowing, taste)
X. Vagus - Both (swallowing, speaking, plus a ton of other things)
XI. Accessory - Motor (flexion and rotation of head)
XII. Hypoglossal - Motor (tongue movement)
What I Thought Clinical Rotations Would be Like:
What clinical rotations are actually like:
African Grey Parrot with severe dermatitis
This African Grey Parrot was presented with a drooping left wing. On clinical examination severe edema was noted in both wings. A fowl smell was present and originated of the skin, which already made us think about something. Cytologic examination confirmed our thought: severe dermatitis, caused by Malassezia and bacteria.
This bird was a long time Psittacine Beak and Feather Disease patient. Therefore, his immunity was severely compromised. This made him more prone to secundary infections, like the dermatitis. This case was already so severe that we advised euthanasia.
Can you name these cells?
Chicken presented with lethargy. On clinical examination ascites was suspected due to swollen and undulating abdomen. Final Needle Aspiration showed bad-smelling cloudy fluid and owners opted for euthanasia. On necropsy carcinomatosis was found, present on all the internal organs.
WHEN THE ATTENDING COMPLETELY AGREES WITH YOUR PLAN OF CARE
Hi Dr. Ferox. I'm a new grad, and I'm in a bit of a pickle: dog speys scare the absolute pants off me. I got so paralyzed with fear during a recent one that a senior colleague had to come finish for me. I do fine right up until I try to break the ligament, and I get so scared of tearing a vessel that I just freeze. Do you have any tips for getting over a surgery fear? I can handle castrates and cat speys fine, it's just dogs that freak me out.
Good news! Being scared of dog spays is perfectly normal! If you’re not a bit scared you’re not paying attention.
It’s also pretty common for most of us to get bailed out of a surgery by a senior colleague at least once. That’s what that new graduate phase is for, for having your hand held that bit longer after graduation so you can gain experience. I wouldn’t worry about that either.
To be honest, I sometimes don’t break the ovarian ligament, because I get nervous about tearing the pedicle too. Sometimes I just stretch it until I’ve got enough room for my clamps, if I don’t need to break it then I just don’t.
Dog spays do get easier with time, and feeling a bit worried is normal, but worrying so much that you’re paralyzed with anxiety is not a useful thought pattern.
You’re always going to be thinking about what might go wrong during a surgery, that’s part of our job. We do it so that we can take precautions and prevent them. That’s the purpose of your worry. It’s there to make you prepared for a worst case scenario.
And you can be prepared. You have been trained in what to do if you drop a pedicle. You open that puppy up and you find it. That’s easy for me to say, but it does get easier after you’ve done it once or twice.
I would acknowledge the fear. Recognize that it’s there to make you prepared, not to make you freeze, and if it is no longer being a useful emotion, try to let it go. Consider your worst case scenario, make your plan to address that if it happens, and then go ahead with the surgery. It gets easier with practice, and it gets easier with the knowledge that you can fix it if a pedicle drops. Unfortunately, sometimes that has to happen before you learn that you can handle yourself in an emergency.
Have you ever worked somewhere that sends sympathy cards to clients whose pets have passed? What do you think of such a practice? I know some people view them as more of a sad reminder than anything, but there are also plenty of people who benefit from the sentiment
I’ve sent them at every practice I worked at.
At the first there was no template, I had to think of what to say afresh each time, which was really difficult to do. There is certainly an art to writing a good sympathy card. At the second we had a template, but we vets were expected to write them and only the treating vet was supposed to sign and send it. At my current job we have a series of templates to guide us, and all staff sign the card. I prefer this method personally.
You want to send the card fairly promptly, a couple of days after the event is ideal. Leaving it for weeks is too late, and that is likely to open up wounds.
I think most people benefit from the sympathy cards, because it gives them some sort of assurance that it’s okay and normal to grieve for the loss of a pet, especially if other people are saying things like ‘it’s just a cat’ or ‘its only a dog’.
Clinical Burn-out
Most of the time, I enter the veterinary teaching hospital excited to learn and possibly save some lives.
Most of the time, I am enthusiastic about my cases and will eagerly research things I don’t know.
Most of the time, I understand that I won’t know everything and that I will grow with time and practice.
Most of the time, I enjoy educating clients and discussing cases with other vets.
Most of the time, I embrace scary or new situations because I know I will learn from them.
Most of the time, I am okay with doing paperwork until 11 pm or cleaning things when needed.
Most of the time, I am fine with getting up at 5:30-6:00 every morning.
Most of the time, I am content with being busy and not having much social or downtime.
But sometimes…….
Sometimes, I dread or get nervous to talk to clients or attending veterinarians.
Sometimes, I get frustrated at not knowing something or frequently forgetting things I try so hard to remember.
Sometimes, I’m dread waking up at 11 in the morning, let alone 5:30 am.
Sometimes, the last thing I want to do is to take even one step into the veterinary teaching hospital.
Sometimes, I am so overwhelmed with things to know and things to do that I become paralyzed and don’t feel like I can do anything.
Sometimes, I anguish over how unfair it is that I am doing more paperwork and cleaning than I am actually learning for my career.
Sometimes, I get depressed and upset that I am spending such much time at the hospital instead of being a normal, happy, and mentally well, human.
Sometimes, I have massive amounts of anxiety over preforming new procedures or doing something outside my comfort zone.
And sometimes, I am so burnt-out that I can’t see the light to this tunnel that is vet school.
And that’s okay. Because everyone can, and is allowed, to become burnt-out sometimes. To anyone else struggling with me, know that this is temporary, and that there are ways to find recovery, and ways to reach out and help one another. You are not alone, and we are all going to get through this together <3
What I Learned On My Cardiology Rotation:
-> ECGs can be stupidly hard to read, and take a really long time to understand. Don’t beat yourself up for not getting it right away!
-> Pacemakers in vet med are a thing!
-> When you take a Doppler blood pressure in an animal, the basic principles are to hear the animal’s pulse on the machine (by placing the crystal on the animal’s leg), puff up the cuff until you don’t hear the pulse, lower the pressure until you hear it again- and bingo, that number is your systolic blood pressure! The only problem is it can be hard to hear the pulse…. but I found using my stethoscope on the machine itself can pick up soft pulses!!
-> Correcting heart defects such as PDAs or placing pacemakers are fun to watch on the fluoroscope (a “video” x-ray, if you will). It looks like below, only the machine is placed by the chest!
-> Heart disease is funny. Some patients with raging congestive heart failure that present almost dead can turn around with medications and do great for 3 years. Then you will get a case of a dog dying within a week of starting treatment. You just never know.
-> Three of the main indicators of congestive heart failure on a chest x-ray include: 1) Enlarged pulmonary veins 2) Enlarged heart/heart chambers 3) pulmonary edema
-> Echocardiograms (ultrasounds of the heart) are the bread and butter of cardiologists. So many hours were spent in a dark room wondering if that black hazy area was the pulmonary valve or the left atrium or the aorta.
-> Owners will swear their dog is having “a seizure,” when in fact it was syncope! (Falling over/passing out, commonly due to heart disease). It can look very similar (they can go rigid and even extend their legs and shake a bit), and can be hard to tease apart just by history alone.
-> If you see a Cardiologist look at an ECG, echocardiogram, or x-ray and say “OH SHIT!” you are in VERY. BIG. TROUBLE.
In honor of today’s festivities, here are the bones of one of the most influential, legendary horses of all time, Eclipse. Undefeated in 18 starts and able to be found in the pedigree of most thoroughbreds of today, Eclipse was foaled during and named after the solar eclipse that occurred on April 1st, 1764.
Eclipse by George Stubbs
His skeleton and two statues of him are at the Royal Veterinary College Hawkshead Campus. We have a building named after him too!
BIOCHEMISTRY BLOOD TESTING
Biochemistry blood test measures the levels of chemical substances carried in the blood. This type of test allows us to evaluate the how well the liver and kidneys are working and how much fat and sugar is circulating in the bloodstream.
Blood Glucose
When carbohydrates are eaten they are broken down and stored in the Liver as Glycogen until the animal needs energy where it is then converted to glucose and transported around the body. We use blood glucose as a monitor of metabolism and physiology.
Normal BG (Canine) - 5.6 to 13.9mmol/L
Normal BG (Feline) - 5.6 to 16.7mmol/L
INCREASED BG - Diabetes Mellitus is indicated however it is recommended that the urine is also checked for Glucose as if present this means the kidneys have reached their threshold and Diabetes is very likely. Note that cats can have stress induced hyperglycemia and so a diagnosis of diabetes should not be made on a single BG reading.
DECREASED BG - Patients that are sick and deliberated often have hypoglycemia. but puppies who have been starved for procedures can also suffer from a low BG. In addition to this hunting breeds that have been working hard for a prolonged time can also suffer from a low BG.
Bun Urea Nitrogen (BUN)
BUN is the by product produced when Proteins are broken down and used within the body. This by-product is excreted by the Kidneys in the urine.
INCREASED BUN - This would mean the kidneys are not working sufficiently and could be an indicator of kidney disease or kidney obstruction that is preventing urine reaching the bladder and therefore build up in the Kidney. Heart disease causing poor circulation to the kidneys could also be a cause of increased BUN.
DECREASED BUN - As the liver breaks down Protein a lower level of BUN could indicate that the liver is not working as well as it should and isn’t breaking down protein as well as it should.
Creatinine (CREA)
Creatinine is solely filtered out of the blood by the kidneys.
INCREASED CREA - Impaired Kidney function
Calcium (CAL)
Calcium is a mineral that is found at a consistent level within the blood. It’s needed for muscle and nerve function and without it death can occur.
INCREASED CAL - Some types of cancers and medications can cause an increase in Calcium.
DECREASED CAL - Some animals can experience low calcium levels during pregnancy, post partum and during lactation. This condition is called Eclampsia.
Total Protein (TP)
The measurement of two blood protein molecules: Albumin and Globulins. Albumin is produced by the Liver and levels are often decreased when the animal is going through a period of poor nutrition. Chronic infectious disease will also cause low Albumin levels.
Globulins include immunoglobulins which are used by the body to fight infection. Certain diseases such as FIP can cause an increase in this.
Bilirubin (BIL)
Haemoglobin is found inside red blood cells, it carries oxygen to tissues around the body. When RBC’s die or are destroyed and the haemoglobin is broken down, bilirubin is a by product of this process which is then excreted by the Liver.
INCREASED BIL - An increase can be seen when the Liver is diseased and is can’t clear the bilirubin efficiently. A liver or bile duct obstruction can cause bilirubin to build up thus resulting in high levels in the blood so this should also be considered.
Alkaline Phophatese (ALKP)
This is an enzyme used to assist with various chemical reactions within the body. The normal levels vary from animal to animal but in dogs, an increase could indicate some forms of cancer or Liver disease.
Atanine Amino Transferase (ALT)
This is an important enzyme for adequate Liver function. An increase in this enzyme would indicate that Liver cells are breaking down, this could be because of cancer, cirrhosis, or liver congestion due to heart failure.
Cholesterol (CHOL)
INCREASE CHOL - Inadequate Thyroid function
DECREASE CHOL - The animal has been through a period of starvation or is not having their nutritional requirements met.
SODIUM: POTASSIUM RATIO
These levels are almost always interpreted together. Their levels can be affected if there is a disease of the adrenal glands, heart, or kidneys.
INCREASED RATIO - Not clinically significant
DECREASED RATIO - Primary Hypoadrenocorticism
When evaluated on their own:
INCREASED K+ - Acute kidney failure, Chronic kidney disease or Addisons disease.
DECREASED K+ - Chronic kidney disease, or lost through vomiting and diarrhoea.
INCREASED SODIUM - Dehydration through vomiting and diarrhoea
DECREASED SODIUM - caused by severe vomiting and diarrhoea or can be seen if the patient has been on diuretics.
I’m sorry this has taken so long to do and that it’s so rushed :(
