Cardiology

I was lucky enough to have two weeks off over Christmas and my birthday and I went home to Utah to spend time with my family. It was fabulous and as always, hard to come back to school. Fortunately I got to ease back into my clinical rotations with cardiology, a two week rotation. There were three other students on this rotation with me and it was great! (Usually there are only 2 students) The first week was a little slow because of the New Year's holiday but we enjoyed being done early in the afternoon and having New Year's Day off. 

Echocardiogram machine and table

On this rotation I got more confident at hearing heart murmurs and classifying them. I also feel more confident about reading ECG's and treating various arrhythmias. I enjoyed watching echocardiograms on dogs and cats and thought it was fun when we were allowed to try our hand at  it ourselves. It's pretty cool to use the ultrasound probe and be able to see the heart beating and identify all of its chambers and great vessels. All of the techs, residents, and cardiologists were great and very committed to helping the students learn. 







We were lucky to watch a balloon valvuloplasty procedure where they insert a balloon through the jugular vein and into the heart and inflate it over a narrowed portion of the heart valve to try to open the valve up for better blood flow. The dog is under general anesthesia and they use fluoroscopy (real time x-ray) to visualize what they are doing. 

A ECG strip showing 2nd degree heart block

A chart to help identify heart structures on echo

We saw quite a few dogs come in with pericardial effusion (fluid build up in the sac around the heart) and it was neat to see how it looked on ultrasound and how the fluid is removed using a catheter and syringe. This is something I will see in general practice so it was good to have exposure to it now. 


I enjoyed this rotation a lot and feel like I learned a lot. 

Me practicing echo technique on a techs dog.

Currently I'm in the middle of my second rotation at Oregon Humane Society (OHS). I decided to go back for two more weeks of preceptorship credit. I'm loving it! Cute pictures to come in my next update!

Still waiting on the results from the NAVLE. Hopefully I'll be able to say that I passed it in my next update. Fingers crossed!

Dentistry

Last week I had a week of small animal dentistry. Well it actually ended up being only 4 days due to the 8 inches of snow and the subsequent snow day on Monday. That was an adventure because snow plows are scarce in Corvallis.  This was my first elective rotation and it was graded pass fail. The others actually have a letter grade associated with them.

Ultrasonic Scaler

Dogs and cats were brought in by students, technicians, and faculty. Each animal was examined and pre-anesthetic blood work completed usually the day before their scheduled procedure. Each animal was anesthetized for dental prophylactic cleaning, dental radiographs, and some procedures like tooth extractions.  Each day we had a different veterinary dentist available to help us. Students were divided into groups and would take turns doing the anesthesia or the dental procedures. I got a lot of extra anesthesia practice. I got to extract a few teeth (1 incisor, 1 premolar, and 1 canine root).

Before dental cleaning - DOG

After dental cleaning

My goal with taking this elective was to get more comfortable with extracting teeth and making flaps. I feel better about it but doing one flap hardly makes me confident. I feel better about shooting dental radiographs now. That took some getting used to but there was time to practice on this rotation and that was helpful. Overall, it was a good rotation but some improvements need to be made for the future. 

Tooth chart

Before dental cleaning - CAT

After dental cleaning and premolar extraction.

Now I'm relaxing at home in Utah with my family and dogs. It's been wonderful so far and I am so blessed to have vacation time corresponding with Christmas. I'm still waiting to receive my results for the NAVLE. Hopefully I'll find out next month sometime.

Small Animal Medicine & NAVLE

Last week I finished my month long small animal medicine rotation. Overall it was a good rotation speckled with times of stress and difficulty. It was especially stressful as I was trying to study for the NAVLE (North American Veterinary Licensing Exam) which I must pass in order to graduate from vet school and become a vet.The good thing about the medicine rotation was that it provided a great way to study for the exam. I would study up about my cases each day before they arrived and during slow periods I was able to work on some study questions (Zuku review was a great online study tool). 

The waiting area for clients. Six exam rooms on the right.

Most days I had 1-2 patients. Over the 4 weeks I had a total of 24 patients.  This may not seem like much but a lot of them needed advanced diagnostic imaging such as CT scans, ultrasound, radiographs, or endoscopy. This often meant that they would be in the hospital for a good part of the day. We would also do blood work and urinalysis on almost every patient. A few of my patients were even hospitalized. I learned how to use a feeding tube and give food, water, and medications to a very sick dog. This dog was my most time consuming patient and I grew very attached to her. I learned patience as I waited for her to show improvement. This patient tested my desire to become a veterinarian and in the end also reaffirmed that desire as I saw her improve and the gratitude expressed by her owners for all that we had done to help her. She continues to improve and her feeding tube was removed this week. :)

The hours I spent at the hospital were fairly decent. I averaged around 50 hours per week. I had a patient in the hospital for two of the weekends during the rotation. Compared to my surgery rotation I had a lot more free time. Free time however was mostly spent studying up on cases for the next day or studying for NAVLE. The week of Thanksgiving was a 3 day week for receiving patients. I had a shift in the ICU on Thanksgiving day from 8am to 4 pm. It was pretty slow but I enjoyed the slow pace of things and helped make snow flakes to hang up to replace the leaves. :)

I cant take any credit for the Rudolf clock :) That was all a tech's doing

Once again putting my bandage scissors to good use

I enjoyed getting to know a lot of the hospital staff better by getting to know their pets who were my patients. In fact I think a good majority of my patients belonged to students or technicians. It was awesome! I liked personally knowing the person whose pet I was taking care of. As part of this rotation we also got to do what is referred to as the preventative health program. This entails doing wellness examinations, administering vaccinations and giving out flea/tick/heartworm preventatives. This will be a huge part of what I will actually be doing as a practicing veterinarian.

I enjoyed working with the clinicians, residents, and my classmates on this rotation. There were 4 other students on the rotation with me and, for the most part, I thought we worked well together and helped each other out.

Courtney, Andrea, Dr. Reina, Els, and myself. What a fun group!

This week I had the week off to study for the NAVLE which I took on Thursday. The testing center was about an hour away in Eugene, OR. I drove down the night before and stayed in a hotel to help cut down on my stress level. The exam was computerized, multiple choice with some images. It took me a little over 6 hours to complete counting two short breaks that I took to recharge. Each time you entered the exam room you had to turn out your pockets, roll up your sleeves and pant legs, and wanded down with a metal detector. It was the real deal! It was a long and draining test. I can't say that it was easy for me but I am hopeful that I passed.

Next week I have a 1 week rotation in small animal dentistry! I will get to become a pro at cleaning cat and dog teeth and maybe get to do some tooth extractions. Then I'm headed home for a little while to enjoy the holidays with my family.

Overnights are Over!

Tonight is my last night of a 2 week long rotation of overnight shifts. The first week was in the large animal hospital and the second week was in the small animal ICU. I feel like I've been living in an alternate reality though it has gotten easier as time as gone on. What may be difficult now is switching back to a regular schedule for my next rotation which starts on Monday. 

First night on Large Animal Overnights

Large animal overnights was a good introduction to the large animal hospital since I have not yet had a large animal rotation. I became more comfortable doing physical exams on horses and goats. There were plenty of patients in the hospital and myself as well as another student and a technician provided hourly treatments and checks for each patient. I was fortunate to have Jacquie, another student on this rotation with me. Usually you are flying solo on overnights but it was sure nice to have another student because we helped keep each other awake and hourly treatments went faster. Shifts started at 8 or 10pm depending on the day and ended the next morning between 8-10am depending on what was going on.

The Large Animal Hospital

There were many horses in the isolation unit while I was on. This meant that in order to go into the stall with these horses you had to first gown up and put on gloves and plastic shoe covers. You could not take in any of your own stuff like stethoscopes and thermometers to decrease the risk of spreading potentially contagious diseases to other horses. You also had to make sure you were prepared with everything that you might need otherwise you would have re-gown. After you were done you would de-gown and wash your hands. It wasn't so bad but it sure got time consuming when you had 3 animals in isolation that all needed treatments. 

My desk in between hourly checks. Studying for NAVLE

We had one afterhours emergency while I was on. A horse came in with pretty severe abdominal pain (colic). We sedated the horse to be able to do a belly tap, ultrasound, and rectal exam. I got to place a jugular catheter (my first in a horse) and after the resident was done ultrasounding she let me try and find the same things she had pointed out. The next morning I had to present the case to a bunch of students and clinicians and that was kind of nerve wracking but I think I did okay. 

Good to wear scrubs again for ICU overnights

Small animal ICU overnight in my opinion were much better. The hours were 12-8 am every day. There were more people around which made it easier to not get sleepy. All the technicians were fabulous and had entertaining stories stories to share. I didn't get as much studying done but I sure had fun.

Putting my bandage scissors to good use :)

 
Some of the technicians wanted to decorate the ICU for November and Thanksgiving and I had a blast helping cut out paper leaves and hanging them from the ceiling after people had written things that they were thankful for on the back of them. We also made a countdown chain to thanksgiving and put up a series of turkey tracks leading to turkey facts on the walls outside the ICU. Did you know turkeys can fly 55 miles/hr? I also helped make the wall clock into a turkey. I think the result was awesome and I'm so glad that I was able to help out. The first part of the week was a little slow since there was only a couple patients but it picked up by the end of the week. It was sure nice to be working with dogs and cats again.




Halloween was weird this year because it began for me at midnight. I baked some sugar cookies to share and brought them in. They turned out pretty cute. Tonight is actually daylight savings and while the rest of the world will get to sleep an extra hour I will be working an extra hour. It's going to be weird actually being awake when the clocks turn back. 
 
Well, I survived overnights! I got a lot of studying done for NAVLE and I worked a bit on my senior paper. I was able to sleep pretty good during the days and stay up without too much trouble during the nights. I am glad to return to a more normal schedule though! Next up is a 4 week rotation in small animal medicine. It's going to be busy especially because I will also be frantically studying for the NAVLE exam that I'll be taking on December 5th. It's going to come fast I'm sure! 

Hooray! I survived overnights!