New Dog & London

Pippa has been on Burns High Oats since Easter and I think she has lost a bit of weight. She palpates well now and I don't want her to lose any more. She looks bigger than she is due to all the hair and she has quite a big chest area too so that gives the illusion she is bigger than she is. I shall of course ask the opinion of the vet at a later date :).

Me- tentatively NOT touching the exhibit :)

I've also been to London overnight last weekend which was really nice with the boyfriend. We went to the British Museum where I really liked looking around the Egyptian artefact section. They also have the Rosetta stone here. I have always had an interest in ancient history and Egyptology would have been the degree I would have done as my degree if I went a non science related route earlier on in life. I just find it all really interesting. 

Tower Bridge :)

We also had dinner at a lovely restaurant at the Britannia International Hotel at the Canary Wharf. It was the nicest Indian ever and I had chicken tikka masala. We then ventured out at nighttime on a night bus tour at London. We saw a lot of the major landmarks so it was one of the best overall things for our overnight trip to London. The next day we visited the Royal Mews and were a bit disappointed we didn't get to see the changing of the guards. We then went to the Tower of London which I've been interested in visiting after watching the White Queen and the Princes in the Tower legend on the BBC recently. The crown jewels were every bit as impressive as you are lead to believe, but there was a distinct lack of jewellery or simpler tiaras which I was also expecting! We had over an hour wait to see these, and I think the Tower would be a day visit if you wanted to explore every part thoroughly! 

Me and the boyf with Tower Bridge in the Background :).

We also saw the Conjuring at the local cinema. It was very scary. It is based on a true story and I had to leave halfway through as I cannot deal very well with ghost stuff! Worth a visit as the storyline is gripping and will leave you with a chill! 

Grey's Anatomy

My new fad at the moment episode wise is Grey's Anatomy. It's pretty awesome as it combines romance with medicine! I'm doing my annoying habit of skipping episodes though :(. I'm currently towards the end of season 2, so I have another 7 seasons to go score! I'm watching episodes because I'm severely lacking in reading books at the moment. Going to dig out my library card as I'm in need of a dire trip to the library at the end of the road to get my fix over the next three weeks when I don't have as much to do now I've finished my first five weeks of small animal placement. 

Other things I am watching at the moment are the white queen, pretty little liars and switched at birth. Might have mentioned these before. I really like switched at birth as it adds a new dimension with it introducing a lot of deaf characters and their lives. I don't think the second season is quite as good as the first, but its still slightly addictive. Pretty Little Liars keeps me addicted because I want to know who 'A' is. I like the characters again and my favourite is hanna. I'm not too keen on Emily or Spencer at the moment! I think they should reveal a bit more about who A actually is. The White Queen is really good. I love history documentaries, and Edward in this is really dashing. I've always been interested in this history period especially about the princes who disappeared in the tower, and this series lets you understand the history in a really communicative way! I would recommend all of these but especially the white queen and greys :). 

I also read Fifty Shades of Grey recently. Its actually not really that outrageous.. and not very skilfully written... The background story is vaguely interesting at the beginning until the plot entirely disintegrates into sordid scenes..I wouldn't recommend it. At the moment I like reading the History Mills and Boon series. Yes, I quite like romance books :D. 

If you want to know about vet stuff.. you're reading a vet blog right? The things topical with me at the moment are which flea stuff to use with the lungworm increasing, the pet passport scheme and a few other things. 

For dental care I generally brush my dogs teeth everyday with an enzymatic based toothpaste and small ended toothbrush and add plaque off proden to her food. Not sure how good the proden is because the brushing is meant to be the single most effective thing you can do to safeguard oral health. You can also get things to add to the dogs water as a mouthwash which are clorhexidine based which are also meant to be effective (I don't use as I don't want to overload doggy with stuff) and interestingly this is the stuff used in humans corsodyl mouthwash against gum disease administered by your dentist! I also learned that smaller dogs are more prone to dental health problems (I knew this before), but with the teeth roots stabilising the jaws, a broken jaw is actually a moderate risk in routine dental procedure! Not something I was aware of, but something I will be very wary about in future!

The pet passport scheme is something I did an essay about last year, and whether the drastic measures of six months quarantine was actually necessary as there was a lot of speculation around it. Interestingly, the vet was filling in an export for a dog to go to Japan the other week, and we have to get blood tests now in this country alongside the 21 days wait which is generally imposed because a number of countries consider us to actually not be rabies free due to our laxer pet passport restrictions! I also saw an animal which had somehow got through customs without a rabies vaccine stamped in their passport at all as proof, the animal just merely had its tapeworm treatment.. figure that one out! The vet also had a lot of trouble trying to get through to any department to figure out what he had to do with the case. There didn't seem to be any sort of process in place to act against a dog with possible rabies threat being loose in the country! The response was at least 24+ hours. 

For flea and worm treatment at the moment I'm still using advocate which I really like. Its a bit pricier than normal wormers etc but it does everything but tapeworms and the main thing is it also protects against lungworm. The main ingredients are moxidectin and imidacloprid. In addition to this, the only other preventative against lungworm (angiostrongylus vasorum) is milbemax which contains milbemycin oxime (I believe). It has only just been licensed and needs to be given every month. 

The downsides to being a vet..student...

The image presented of being a vet is a fluffy one. They get to treat animals, earn lots of money and heal animals! How bad can that be? Earning top MONEY and loving the job you say? What really is masked is the downsides that also accompany this job vocation. 

Being on work experience has led me to appreciate the upsides and downsides of possibly being a first opinion small animal vet. I know I want to do small animals- its the one thing I've ALWAYS been interested in. Major upsides for me are the interesting cases, seeing how the animals get better with the treatment the vet gives, and being able to make an actual difference to the life of that animal and be an influence. Some owners are extremely dedicated to their pets, and a few of them have really made me smile over the past few weeks (although in the same breath some really make me despair at pet owners!). I think that I'd have to perhaps specialise in this environment though as I'm not sure I'd be satisfied with just doing first opinion work. 

The downsides to me so far have been a few things. Owners are limited by money, which is understandable, and this is one of the major dilemmas a vet faces. I can understand if an owner has to plump for the cheaper treatments rather than the more expensive radiographs etc but when an owner can't even afford the yearly vaccinations and consultation fees it makes me slightly angry as to why they have a pet when they really can't afford treatment for it, however, this is something that we can be faced with numerous times as an ethical dilemma in general practice. 

Other downsides for me have been the amount of routine appointments and the long hours the job demands. I knew what I signed up for certainly, but through the endless bitch spays and same old anaesthesia combinations- I think I'd want to be faced with something new, maybe more cutting edge everyday? Y'know, the consultations are where its at for me at the moment. The surgery is interesting but when you work out the medicine and management of a complicated case- I think my interest might be towards medicine and working things out rather than surgery. We already know I have an interest in neurology- I think! This works out perfectly for me as many cases are managed medically rather than surgically! 

The long hours are a major downside for me. I have too many dreams outside being a vet. Yes I love the job, the learning, and I don't want to just go home and forget about a case... but on the flip side I want a family (preferably before I'm 30), and time to do other things- horseriding maybe, but especially dog training and owning a dog. The work-life balance is something I'm struggling to accept at the moment, and with many days being easily 8-7/8 and that doesn't count overtime or out of hours, when am I going to have time to fit ANYTHING in. To be fair though, being a vet opens a lot of doors. Maybe the general practice and time it demands isn't for me? I guess we'll see about that one, or just maybe, I need to find something where I can be flexible and get what I want. 

Someone once told me- if there isn't your perfect job out there, you can always create it. I believe in this, and just maybe this is what I'm going to have to do :). Chow for now. 

Vaccinations???

As a student, my view on vaccinations is a bit of a mixed one... I've not had enough experience in general practice to be able to tell you about the amount of adverse reactions to vaccines I have seen, although many of the vets I have spoken too list the reactions to vaccines as rare. I've seen many puppies cheerfully coming through, alongside booster dogs, and whilst some of these can have skin issues (another commonplace thing in veterinary practice) we can't actually be sure that the skin issue is related to vaccines! Half the time I hear the cry that the itchy dog has been caused by overvaccination. Perhaps it has, but without proof, how can you say?? 

My view on vaccines at the moment. I'm not too sure on homeopathic vaccines and the use of them in normal practice isn't commonplace, neither is the view on them a great one. However, again, I've not had any experience of them to formulate an opinion.. perhaps this should be something I read into at some point. I find that hollistic medicine is often a minefield- many of the articles seem very biased and not very evidence research based. Hence I am hesitant with this sort of medicine at the moment, as well as the fact that it is hard to find solid scientific facts. 

Personally I would take two approaches to vaccination for my own dog at the moment, as it just isn't worth the risk of some of the horrendous disease we vaccinate against; 

I would get all the vaccinations for my puppy and the one year booster. You may/may not want to include the optional parvovirus top up vaccine. I believe this is reccomended in the larger breed dogs, and may be a good idea. My dog didn't have it and was fine but if I was in a parvo outbreak area I think it would be a good idea. After this I would go onto the three year vaccination schedule. 

This involves the DHP vaccine in the first year- distemper, hepatitis and parvo, and then the following two years you only vaccinate against strains of leptospirosis that are common to your area (or should be these strains, not just some random strains). Interestingly, there has just been a license for a four strain leptospirosis vaccine as newer strains are gaining more weight. Classically the lepto vaccines have canicola and icterohaemorrhagiae (I think). These are the guidelines by the WSAVA currently. I believe they also recommend the third parvo vaccine as a puppy. 

The world of vaccines is an interesting one and controversial. This is my current stance and as a student I'm not very versed in the world. I'm sure my view will change and be moulded as I gain more experience in my practice years. Chow for now :)

Flying by.

I've been a bit naughty recently. I've not been updating my blog as much and I've not been as stringent with the note-taking. Whoops! 

I got to do half a dog and cat castrate today with someone showing me :D. Really made my day, alongside being asked to a party this Saturday. Should be fun as I've been on work experience only the last two weeks! I've also had a go at a few injections (although I'm terrified of hitting a blood vessel or a nerve or bone or something) and been shown fluids and bandaging etc :D. We've had some interesting cases-today we had a corneal sequestration in a persian x cat and a few other things such as a grass seed stuck in a dogs paw causing a lot of trouble!

I've learnt a lot the past two weeks I must say. I need to be a bit firmer with myself and actually go look up the drugs which are used and what they actually do. This is my plan starting from next week- strict strict strict! Thing is- the evenings are too short by the time I get home. I write this and its already nearly 10. After I've walked my dog, had tea and helped my boyfriend  a bit- time is nearly gone and its bedtime again! 

Beach and a moon- again. How pretty is the picture. 

Signing off now :). Will update again soon.

A whizz few days.

Cruciate Sutures for Skin Closure

The first thing to start my blog off is to remind myself of the following video and suture pattern. My vets mainly use this technique to close skin- it looks nicer and it holds the skin better :). They use a continuous simple stitch for the muscle layer so far I believe. 

Seen a lot of things of which I need to write a lot of it up from my book. On the first note the tetralogy turned out to be just a ventricular septal defect- still not brilliant but perhaps a tad better than the other prognosis from the scan. Perhaps I'd better start with today and then update on other things later on- maybe tomorrow. 

Today I saw a toy poodle. The poodle had some kind of abdominal muscle hernia which was easily palpable so came in overnight with fluids and a blood test. The dog was given vetergesic (buprenorphine) was a premed alongside ACP. The main induction drug this practice uses seems to be propofol. The dog had already been diagnosed with a ovarian adenoma (cyst???) before the surgery so the bloods were slightly essential. In surgery the dog had about 300ml of a straw brown watery fluid, adhesions between some of the gut walls to the kidneys, a slightly rounded and small liver and a mottled, nodular spleen. Not sure overall what is wrong with the dog as tests cannot be carried out. An interesting case to watch!

Next, there was a dew claw removal on a collie which had ripped the nail somehow. I didn't see much of this operation as I was busy watching the toy poodle. The post mortem on a cat that came in revealed a hypertrophic cardiomyopathy with secondary pulmonary oedema. The walls of the heart were visibly thickened. No other lesions were seen at the post mortem. I also got to practice a bit of suturing today- hence the link to the video above. So exciting! In addition I've been tutored in giving a few basic injections- all of which could have gone better but I'm hoping my technique will improve with time. 

Other interesting things about the inpatients today included a pigeon which had a broken leg, a bichon frise castration, rabbit molar rasp and a cat in respiratory distress from earlier in the week which appeared to be doing a lot better :). Interesting consultations today including a case of atopic dermatitis in a  Japanese Akita, chemotherapy injections for multicentric canine lymphoma in a rottweiler and also drugs for arthritis in a WHWT with suspected beginning Cushing's disease. 

First Day of CEMS

My first day was for definite a mixed bag of cases. What I really learnt is I need to actually carry my notebook around with me to jot down stuff as I really can't remember everything. A quick point before I forget it- an xray for the chest should be ventrodorsal, heart dorsoventral (not sure on this one entirely). The main cases outstanding to me were:

a) Tetralogy of Fallot- a congential heart condition that is pretty rare. Pictured above with the four heart conditions. Found in a nine year old cat- cat was asymptomatic. Seen via ultrasound to diagnose without sedation. Also crosses with the colour doppler machine which can picture blood flow with blue and red streaks. 

b) Cat with respiratory distress. Bronchoalveolar lavage for a sample and xray was performed. Xray showed little donut shapes in the bronchoalveolar pattern. Vets main differential was cat asthma- or an allergy. 

c) Staffy with auricular haematoma- leech therapy was used but didn't work as the leeches wouldn't attach as the owner didn't want a general anaesthetic due to the dog having an aggressive urothelial carcinoma. Drained without sedation with a needle (larger) and syringe. Inner ear aspect. Local pain relief used. 

d) Bulldog- suspected brachycephalic syndrome. Six months old dog with an increasing cough, off food and water especially in hot weather. Given antibiotics and NSAIDS as an injection. 

e) Cat which had a erythrocytosis disorder with too many rbc and a high PCV. Seemed cured via leech therapy. 

Just a documentation of the cases I saw and some of the outcomes to reflect on at a later stage. :).