Wednesday, August 27, 2008

The things I spend my time doing all day

Today I am going to spend time with my arm up a cow's rectum while I try to wiggle a tiny little metal rod through her cervix to deposit an embryo inside a certain horn of her uterus. You gotta love modern technology. It's called Embryo Transfer (ET for short) and it's really cool. The downside? You have to thread something you can't see into something you can't feel and pass the various obstacles that present themselves. Cool, huh? :)

Monday, August 25, 2008

That "other" time

I was in vet school on the equine surgery service. This mare comes in for us to fix a perineal laceration. These occur usually during foaling when the foal comes with it's legs a little out of position. Basically, this mare had no tissue between her rectum and vaginal vault anymore. Yes, she was pooping out her vulva.

So, our goal was to reconstruct this shelf of tissue between the rectum and vaginal vault. This involves long hours spend with long handled tools. And I mean LOOONNNNGGG handled tools. I'd never seen a scalpel handle 18 inches long before!

Remember that this procedure is literally right up the rear end of a horse. We had put a cotton "tampon" up her rectum to keep her from pooping on our parade. But remember, in horses the urethral opening is inside the vaginal vault. I'll never forget the sight of our equine surgeon standing with 18 inch instruments with his face 2 inches from the rear end of a horse and his mouth open in concentration. He was standing right like that when the mare urinated. On his face. With his mouth open. Twice.

That was such a good day.

Of poo poo and more poo poo

This incident happened when I was on my preceptorship right before graduating vet school. It kinda illustrates one of my views on life: if you stand around long enough, poo will fall on you.

So, I was on my preceptorship with my mentor, SuperGirlVet (Super for short) when we go to a farm with a few Hereford cows. A few moments to comment on Super. Super was a great mentor, very smart and intelligent, and I learned a lot from her. She has one interesting habit/trait that I always kinda thought was strange for somebody who spends half her life around cattle: she is a neat freak. Not in a bad way, but her truck and all her tools/toolboxes always had to be clean and neat. Her person as well, which is important later. She carried three or four complete changes of clothes in her truck.

So, we went on this call to see a Hereford steer that had not been defecating or eating for several days. We walk up to his pen and, being the insightful veterinarians we are, immediately see his problem: he has a prolapsed rectum. This is actually a pretty common problem in Hereford steers. The only real treatment for one that has gone for several days like this one is to amputate the dried up prune of his rectum that was sticking out and connect the two ends. Yuck, huh? So, we sedate him a little, give him an epidural, and stick a 60 mL syringe plastic cover into the rectum to provide a needle stoping point. The goal was to suture the two layers of the rectum together and then cut off the dead part, creating an anastamosis between the two pieces (sorry, I can't get much more technical without pictures and don't feel like searching for them right now). So Super starts suturing. I, the ever helpful student, am outside the chute cutting her suture and opening suture packs as needed. About this time the steer starts to wake up a bit and decides he doesn't like the syringe case up his rectum. Apparently our epidural hadn't taken so good...

He gives a gigantic push and a stream of blood and diarrhea (yes, that had been up a cows butt for two days) erupts all over the front of Super. She just stood there while dripping liquid off her chin and front. The look on her face was priceless! But, the show must go on! So she puts the syringe case back in and starts to put in the last few sutures. And there he goes again!!! Keep in mind, he hasn't been able to poop for about two days and had a lot to make up for! She puts in the last few sutures, cuts off the diseased part and pushes the whole mess back in. All the while dripping blood and cow diarrhea off various body parts.

Needless to say, I drove back to the clinic while she sat on a bunch of towels. Then she got a shower. Actually, three showers.

I laughed a lot and she just glared. Reminds me of another time....

Friday, August 22, 2008

Tying up loose ends

So, as so often in medicine, something that you thought you'd really messed up turned out very well.

My horse's eye looked 100% improved by 36 hours later. I re-stained it and found more very superficial ulcers, but the deeper one I'd been trying to heal was almost gone!! It looked sooooooo good. So, a happy ending.

Sorry about the lack of posts lately, been really busy but not much interesting has come in. I'll have to pull from my store of saved in my head stories.


Monday, August 18, 2008

Ok, that's a big oops.

So sometimes you mess up. Sometimes you do something just plain stupid and mess up. Sometimes I do that. And I did it yesterday.

So I've been treating a horse for a superficial corneal ulcer for over a month now. Corneal ulcers don't happen all that often in horses, and thank goodness, because they are a pain in the butt when they do. Not because they are hard to heal. On the contrary, they heal wonderfully on their own. However, you have to treat with broad spectrum antibiotics and anti fungals when they occur because of a horse's propensity to stick it's head into places filled with fungus and bacteria.

So, I've been treating this mare for over a month. This ulcer just won't heal all the way. It's almost healed, but not quite. So, I decide to do a procedure called a grid keratectomy on it, where you scour across the ulcer and the cornea with a needle to create a fresh bed of injury to stimulate healing. I also decided to use some iodine to chemically debride the ulcer site. So, in I squirt iodine. Instant disaster.

It was 7% tincture of iodine instead of a nice 1% solution like it should be.

So, no said horse has very swollen eyelids and conjunctiva and a cornea missing the top layer of epithelium. And we're having to put eye meds in every two hours. It's a good thing these clients like me. I still may get sued over it, though.

Hopefully the cornea doesn't decide to turn into a melting ulcer. Then we win a visit to Big Teaching Hospital down the road.

That thunking sound you hear? It's me hitting myself over the head with a 2 x 4. Thunk. Thunk. Thunk.

A tie maybe?

Read Purple Stinky Onion's post about poo here. Than tell me who has the grosser stories. I'm not sure myself, I think it may be a tie. Enjoy!!!! Thanks Purple Stinky Onion!

Thursday, August 14, 2008

Darn clients!

Typical conversation with a frustrating client:

Me: Well, you know, Foo Foo should really be on heartworm prevention all year round...
DumbClient: Why? I've never had any of my umpteen million farm dogs on heartworm prevention before? Why should I start now?
Me: You've probably had dogs die unexpectedly on you right? Well, them having heartworm may be a possible explanation.
DC: I ain't ever seen no worms in their poop.
Me: Heartworms live in the heart (hence their name, HEARTworms). They don't come out in feces.
DC: Well, my dog ain't ever outside, and isn't around any other dogs, so they can't get worms. (Yeah, and in the next breath they ask me if fleas are contagious)
Me: Heartworms are carried and spread by mosquitoes, so they don't have to be around any other dogs to get them. And even the most well trained dog has to go outside with the mosquitoes to potty sometime. Also, mosquitoes can get in the house!
DC: Well, I ain't ever done it before and I don't see a reason now... ok, how much does it cost?

So we talk about cost some. Then, just when I get the battle almost won...

DC: Ok, I don't really see the need, but go ahead.
Me: Well, before we put them on prevention we need to test them to see if they already have heartworm.
DC: What, how much is that going to cost me?!? I only brought $0.14 with me and I don't have a credit card, a checking account, savings account, or a piggy bank. I can't be spending all this money on a darn dog!
Me: Well, then how were you going to pay for your vaccines????
DC: Uh...

Ad nauseum. The only thing worse than the heartworm talk is the spay/neuter talk or the Lyme's disease vaccine talk. Though, oddly enough, more people will go for the Lyme's vacc.

I should just tape this and record it when clients walk through the door. I probably have this conversation about 50 times a week.

Course while we're talking about client stereotypes...

Nahh. That's for tomorrow. :)

Wednesday, August 13, 2008


Ya know, if you work in a veterinary clinic and have just started in the last few months, it behooves you to not go rushing around messing with any animal that comes in.

As in, rushing to pet and reassure that animal.

Because then you get bit. A lot. As in three times in the last four months, two of which needed an ER visit. That's three more times than I've been bit in the last six years. I've NEVER (knock on wood) had to go to the ER for a bite. Only once has something gotten me and even broken skin.

Now, I admit, since moving out of the technical field into the doctor field, I am usually the do-er, not the holder. In my opinion, the holder is much more at risk than the do-er to get nailed. In addition, my reflexes are honed to a fine edge.

Also, cats have five sets of weapons, dogs only one. You control a dog's head, you have the dog. A cat is a little more complicated.

And a muzzle is our friend. Both with cats and dogs, although the previous caveat applies to cats. Towels and leashes are also appropriate, as well as the rabies pole on occasion. And chemical restraint/sedation. Better living through modern chemistry.

Don't just try to pet any old strange dog. Watch for your visual cues. And don't get bit.

Monday, August 11, 2008

I can do better than that...

MonkeyGirl had a great post earlier about a visual image that is so good. Please view that post here.

I can do sooooo much better than that.

Parvo poo (picture GI bleed on steroids) with tapeworms and roundworms that are MOVING. Tapeworms look like little grains of white rice and roundworms look like spaghetti.

Get THAT picture out of your head folks!

Signed, your friendly neighborhood gross-out-your-readers specialist.

Sidenote- I can't spell spaghetti. Gotta love spellchecker.

Saturday, August 9, 2008

Short interlude

Sorry, have a few family matters to deal with- new posts probably late Monday or Wednesday. See ya then!

Thursday, August 7, 2008

Some procedures...

... you just love to do. You know the type, you get this gratifying glow of satisfaction, either because it's fun, or done something good, or whatnot. Some procedures just are like that.

I have two of those that I just love to do. One is castrations. Now, I'm not a feminist nut thinking everything must be castrated (however, just why does your dog need his testicles, anyway?) but I do immensely enjoy the procedure. Mainly because of this gratifying POP feeling/sound as you squeeze the testicle out of your incision and free it from the surrounding fascia. It is soooooo fun. Lots of people look at me weird when I say that, but it's kinda like popping a zit, or squeezing a grape out of it's skin.

Another procedure I really like is shaving maggots. Not because I enjoy maggots, but because it gives me a nice glow inside to finish and then see an area that was nasty and dirty and full of the little suckers and see a clean wound with no wriggly things in it.

Another is lancing abscesses. I think we all like those. I like doing aural hematomas, too. Those really like to fly!!! Course, all of the above except for the castration are procedures you definitely want to keep your mouth closed while doing.

My assistant found that out the hard way the other day.

Oops. :)

Wednesday, August 6, 2008

Some days you just gotta dance...

Every one has them. I have them, you all have them, every person in the medical profession from time immaterial has had them at one time or the other. Of course, I am taking about...

A Bad Vein Day Dum dum duuuummmmmmm... (play evil sounding music here)

So, I was trying to draw blood for a heartworm test. No big deal. Tuberculin syringe, a little bitty 25 gauge needle. A big hosepipe vein that I can SEE popping up at me. So I poke. The dog moves. So I poke. The dog moves. I poke again... the dog doesn't move this time. But no flash in the syringe. No satisfying gush as the syringe is filled with the pitifully small 0.2 mL of blood I need for this test. So I move the needle around a little more. And a little more. And a little more. Try the other arm. Move around a little, move around a lot, that's what it's all about... Oops, wrong song...

So, four of those later, I am faced with a sick cat. The cat seriously needs some IV fluids, IV antibiotics, IV everything. And an emergency surgery. Cat has a fever of 104.5F, about 10% dehydrated. The whole nine yards. So, we prep for an IV catheter (Terminology difference: we call them IV catheters, most of the human medicine types I tell this too think urinary catheter. No, it's an IV). Anyway, stick this teeny dehydrated vein with a 22 gauge, get a flash (hallaueigh!), feed the catheter- vein blows. I try the other arm and can't even get a flash. Go figure. We end up doing subQ fluids just to get her going. and SQ antibiotics. Not as good, but something at least. Later my boss gets one in with a cut down.

The next day I hit every stick I tried first time. Even the tiny furball who weighed 3 pounds.

Try getting blood out of a ferret. That is challenging.

Tuesday, August 5, 2008

A couple of different subjects

First of all, thank you to the flurry of people that have left comments the last couple of days. A big Thank You, as well, to EE for the link and the nice intro and shout out at your blog. Go give her a read, she is sooooooooo funny. Although she did get one detail wrong- I'm a GIRL. Though I never posted that, so that's ok. I also still get carded to attend R rated movies.... :)

I got bit the other day. Now, getting bit is part of my occupational hazard. Bit, scratched, kicked... This is well known in my profession, and we tend to regard getting bit as an EMT may regard getting yelled at, or an ER professional may regard getting bled on. There are few diseases I can get from my patients by saliva, with rabies being the biggie. With the result that I am the only person in my family that can say I've had my rabies shot(s). Gee, hear my tags ring? Anyway, I got bit the other day. I have a huge bruise on my arm with some paired teeth marks. You may ask, was it a mean dog? A cat? A horse? No, I haven't been bit by a cat, dog, or horse in a while. This was the mean bunny rabbit. And it wasn't at work, it was at home, where I raise rabbits. However, the result of this bite? I spent all day at work explaining to clients that no, a big, mean dog did not eat me, but a cute, fluffy bunny wabbit. Go figure.

Monday, August 4, 2008

Thank you, thank you

Two hardy souls have come foreword to comment and prove that this blog is, in fact, read by more than the search engine robots. Thank you to those two individuals. Therefore, since I am not posting in vain, we shall carry on...

Not much going on this last week. We're getting ready to synchronize a group of cows to receive embryo transplants. It's a cool process, and it's amazing to me that we can freeze and thaw out not only seman, but embryos as well. I also saw some alpacas last week in addition to my normal dog, cat, and horse patients. And got spit on for my troubles. Nothing stinks like llama and alpaca spit. Go figure. For once, I'd like something in my profession to small NICE. Wouldn't that be a great feat? "Wow, ma'am, Fluffy's diarrhea smells just like fresh lemons!" Yeah, not going to happen EVER. Oh well, I digress...

More to come! Keep the comments coming! I like comments!