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What are the odds that my last 2 days of path would involve a tiger and a snow leopard?? More big cats this week than domestic ones, haha. At least the rotation ended well, after week 1 I didn't have high hopes.
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Jul 13, 2013 21:32
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Topoisomerase posted:What are the odds that my last 2 days of path would involve a tiger and a snow leopard?? More big cats this week than domestic ones, haha. It is very hit or miss like that. I'm glad you got to see some cool stuff! In less-than-surprising news from the Great Foxtail State, yesterday I got a foxtail out of a new orifice--it was buried deep in the vagina of a poodle. Ouch. At least she didn't have a pyo, which was everyone's first thought when she presented for bloody vulvar discharge.
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Jul 13, 2013 21:38
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Topoisomerase posted:Yo Khelmar no offense but I find anatomic path tedious. "Steroids and cage rest" is interesting, but "take this apart and actually find out what's wrong with it" isn't? And the whole "path is cake and you get out early and there's no emergency" is really BS. Sure, sometimes that happens, but sometimes you're stuck there until midnight. Ask to see the slides.
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Jul 14, 2013 04:29
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Khelmar posted:"Steroids and cage rest" is interesting, but "take this apart and actually find out what's wrong with it" isn't? If steroids and cage rest mean the dog can walk again it's worth it! And double for decompressing the spinal cord surgically. And I think you mean see what WAS wrong with it.  quote:And the whole "path is cake and you get out early and there's no emergency" is really BS. Sure, sometimes that happens, but sometimes you're stuck there until midnight. I wrote down which ones I'm going to bug the resident about going over with me. I did a GMEM case that I would quite like to see the brain and spinal cord on, even though it wasn't the actual cause of death. That case was a huuuuuge trainwreck. And FWIW, I think it turns out that the resident I was on with had a lot to do with my dislike of the rotation the first week. I wasn't expecting path to be easy, for the record. I am...not fast...at necropsies and anatomy has never been my strong point. But I improved at those things during the rotation and I am actually pretty strong at clinical correlation and pathophys so I definitely think I got what I needed to get out of the rotation, and that's what I'm here for so...
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Jul 14, 2013 07:25
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Dammit dog, you're not supposed to die after I get you back four times and even do a successful precordial thump. That's not the way this works.
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Jul 19, 2013 21:00
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HelloSailorSign posted:Dammit dog, you're not supposed to die after I get you back four times and even do a successful precordial thump. That's not the way this works. Exciting week we're having over there! I saved a cat from heat stroke, but now it turns out she's a stray so I'll probably have to euthanize her anyway. She's sweet, and polydactylX4, but also skinny and covered in fleas and an animal control case.
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Jul 19, 2013 21:04
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It turns out an FHO is an easier surgery to do than a spay.
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Jul 19, 2013 23:57
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Topoisomerase posted:It turns out an FHO is an easier surgery to do than a spay. So is the IM pin and circlage wire placement after you fracture the femur  The surgeon told me to stop tapping on the osteotome and put some force behind it so I did 
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Jul 20, 2013 00:54
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HelloSailorSign posted:So is the IM pin and circlage wire placement after you fracture the femur Got to use power tools. Probably due to what you're saying here. So thanks.
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Jul 20, 2013 01:00
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This morning I got to euthanize an almost-ambulatory IVDD with excellent prognosis and took a septic peritonitis with no platelets and a poor prognosis to surgery (it got euthed on the table). I really really don't get how the world works sometimes.
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Jul 20, 2013 04:10
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I can't imagine why people would want to euthanize an IVDD dog instead of at least trying conservative treatment.
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Jul 20, 2013 04:39
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Heck, even an IVDD dog that's severely paraparetic but still is able to maintain continence does great and looks so loving cute with a cart.
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Jul 20, 2013 04:54
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This week I euthanized a nice horse with a problem that would likely have gotten better with the surgery covered by medical insurance because we wouldn't give her a 100% guarantee that her horse would be okay because there are no guarantees in medicine. I'm sorry, horse 
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Jul 20, 2013 05:18
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Well the the people down the street got a new puppy. I had euthanized their last one for end-stage (as in, I probably didn't even need to use euthasol) Parvo. It's running loose outside playing with their other loose dog. Running up and down the street, no supervision. So happy and playful. It's gonna die. It's gonna be the same story. I am gonna be sad for the poor dying puppy.
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Aug 3, 2013 17:16
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Well it might not be the same exact story. It might get hit by a car or drink antifreeze before it gets parvo!
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Aug 3, 2013 18:51
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Topoisomerase posted:Well it might not be the same exact story. It might get hit by a car or drink antifreeze before it gets parvo! Or shot! or stolen! Or heat stroke. Really, the possibilities are endless.
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Aug 3, 2013 20:39
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Rattlesnake, eaten by other dog(s), or beaten by the dad! ... we need to move.
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Aug 3, 2013 22:00
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I just had to sit in and smile and nod for two hours with owners... but in all fairness their dog has been in hospital for weird poo poo for three weeks and they're just so happy they're gonna be getting her back. Unexplained lymph node abcess that dehisced, then a week and a half later was weeping ridiculous amounts of lymph . I'd attributed it to the honey bandage first just drawing out all the oedema fluid in there but it didn't even stop when we changed to honey. We had to put a VAC device on it for three days before it stopped completely. Then the day of surgery one of her toes blew up to like 4 times its normal size and lo and behold there was a lytic lesion hiding under there, possibly just a pocket of infection that the antibiotics had kept at bay for two weeks until they stopped... None of my cases save for a TECA & BO have been straightforward this week!
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Aug 3, 2013 22:16
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Are there any U Penn students here? I'm looking at doing an externship there next year.
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Aug 4, 2013 14:52
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I got this zuku question today. It made me laugh a lot because clearly zuku should know that the answer is always pumpkin. ALWAYS. Anything else is a rip-off!
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Aug 7, 2013 05:25
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Read some referral info for a dog with sick sinus syndrome who had a heart rate of 24-30 and a systolic blood pressure of 36 mmHg  . I'm an assistant in general practice, we never see anything like that. As expected, he didn't last too many days after.
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Aug 8, 2013 02:25
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Shnooks posted:Read some referral info for a dog with sick sinus syndrome who had a heart rate of 24-30 and a systolic blood pressure of 36 mmHg Not without a pacemaker, he wouldn't, nope.
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Aug 8, 2013 04:55
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Today was my third day on Small Animal Internal Medicine and I was sorta kinda wishing for the sweet embrace of death already. Only 3.5 more weeks. Until November, at least. 
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Aug 8, 2013 06:04
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Topoisomerase posted:Not without a pacemaker, he wouldn't, nope. 16 year old min pin so it wasn't even an option.
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Aug 8, 2013 12:50
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Shnooks posted:16 year old min pin so it wasn't even an option. Age is not a disease. The dog's health other than the heart problem and whether the dog has other concurrent heart diseases are the factors to consider. Sick sinus on its own is basically completely fixed by a pacemaker.
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Aug 9, 2013 06:26
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Topoisomerase posted:Today was my third day on Small Animal Internal Medicine and I was sorta kinda wishing for the sweet embrace of death already. Condolences for your situation.
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Aug 9, 2013 18:38
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Topoisomerase posted:Today was my third day on Small Animal Internal Medicine and I was sorta kinda wishing for the sweet embrace of death already. Congratulations on doing the right thing and taking care of yourself on one of the most intellectually and physically challenging rotations at veterinary school!
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Aug 11, 2013 21:31
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HelloSailorSign posted:Congratulations on doing the right thing and taking care of yourself on one of the most intellectually and physically challenging rotations at veterinary school! I got extremely lucky in that circumstances fell into place such that I could play in 3 out of our 4 games at the hockey tournament (I missed the first game on Friday at 5:30 obviously). 1) our side was not on weekend pickups 2) one of the faculty was out of town Thurs/Fri and new residents started this week so they aren't on their own yet....so we only had 2 recheck appointments on Friday 3) my inpatient from earlier in the week went home on Thursday 4) one of my rotationmates was kind of upset that she hadn't had an inpatient yet as of Thursday night, so on Friday morning when we had 2 pickups from ER I took the one that I figured we could send home by Friday night (and we did), and she took the one that would probably stay longer. 5) no morning game yesterday and no evening game tonight so I could still go in to help my classmates who did have inpatients with their treatments so I don't feel or look like a total slacker so yeah, a ton of luck and a little bit of stubbornness
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Aug 12, 2013 01:14
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So today I learned just how valuable a triage tech is. Admitting multiple respiratory distress cases with nobody to hold the phone and do initial assessments was... brutal. The sad part is I only saw 7 cases in ~5 hours but most had fairly complicated workups. Definitely not sure how the heck people handle three years of this...
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Aug 12, 2013 04:26
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Don't worry Solis, if/when you get out into private practice you'll have a nice busy day of 13 appointments to end up having five (5) of them not even show up to their scheduled appointment and need to be called to find out wtf they are doing to find out: they forgot (but scheduled it yesterday!), they want to reschedule, they didn't want that appointment anyway, etc. What the gently caress. This is not a rare thing either. At least two people a day cancel their appointment or don't even bother to show up. I'm not talking about canceling your afternoon appointment three or four hours in advance, I'm talking calling at your appointment time to say you can't be there. You just found that out? Godammit there are other people who could've used your appointment! Better yet, the walk in that just wants a quick check (but not be charged) because they just want to make sure they don't need to be seen right now but instead can be seen later. So wait, let me get this straight, you want me to give you my opinion (for free) on something that (usually) requires a full exam to be sure that the dog doesn't need to be seen on emergency (thus saving you money)? Oh and by the way, the thing has been there for at least a week so how is it an emergency right now but not an emergency yesterday? Or could you even bother calling? I checked it anyway because I'm bad at making money as a vet Uggggghhhhhhhh  However, yes, a good tech is worth their weight in gold. Especially true in ER where EVERYONE has got to be on the top of their game for things to run smooth. You need to know you can trust your ER techs so your brain can be figuring out how to fix things while they know how to keep it alive until you decide what to do.
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Aug 13, 2013 04:32
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Any tips on venipuncture? I'm just starting to learn now and I'm having a lot of difficulty keeping the needle steady and everyone makes it look really easy.
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Aug 17, 2013 02:38
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Shnooks posted:Any tips on venipuncture? I'm just starting to learn now and I'm having a lot of difficulty keeping the needle steady and everyone makes it look really easy. Practice makes perfect, so keep sticking things. Depending on what you are sticking, you may be able to steady your syringe with the hand that's not doing the poking, but ideally, you'll learn to stick the needle in and draw back on the plunger with the same hand, without having to reposition yourself, by using your ring finger and pinky to draw back. What I did to learn this technique was carry a syringe around in my pocket and play with it all day. Just get used to holding the different sizes you might use (probably just 1, 3 and 6ml) and moving the plunger back and forth without changing your grip.
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Aug 17, 2013 02:44
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Dr. Chaco posted:Practice makes perfect, so keep sticking things. Depending on what you are sticking, you may be able to steady your syringe with the hand that's not doing the poking, but ideally, you'll learn to stick the needle in and draw back on the plunger with the same hand, without having to reposition yourself, by using your ring finger and pinky to draw back. What I did to learn this technique was carry a syringe around in my pocket and play with it all day. Just get used to holding the different sizes you might use (probably just 1, 3 and 6ml) and moving the plunger back and forth without changing your grip. I'm trying  Today I did my first medial saphenous draw on a cat and got at least a half cc before I collapsed the vein  . My coworker told me to use a 6cc syringe and I forgot about suction. All the doctors are pretty independent where I work so they don't like the techs to draw blood for them, so I'm trying to poke whenever I can.That's a good idea with the syringe, though. My hands are small and I have a slight tremor, so I have all sorts of difficulty figuring out how to draw back with one hand right now.
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Aug 17, 2013 02:47
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Shnooks posted:Any tips on venipuncture? I'm just starting to learn now and I'm having a lot of difficulty keeping the needle steady and everyone makes it look really easy. I'm coming into my final year of Tech school this Fall, and this Dr. Chaco posted:learn to stick the needle in and draw back on the plunger with the same hand, without having to reposition yourself, by using your ring finger and pinky to draw back. What I did to learn this technique was carry a syringe around in my pocket and play with it all day. Just get used to holding the different sizes you might use (probably just 1, 3 and 6ml) and moving the plunger back and forth without changing your grip. is really great advice, and a tip I picked up before we started being able to try blood draws. Getting a good grip that allows you to isolate the "finger drawing back" movement from any other hand wiggling is really key. So get a few syringes of different sizes (1 and 3 are the most common ones we've used in lab so far) and just play with them, all the time. Draw water (no needle, of course) from a running faucet. It isn't the same as trying to hit a vein, but it will help you to get used to moving the plunger (with your ring/pinky finger[s]) back while keeping your hand (as a whole unit) relatively still.
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Aug 17, 2013 03:41
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One thing I always found helpful right before drawing blood is to use my steadying hand to "play" with the vessel (doesn't work well with jugulars though). I'll move the vessel back and forth a little, seeing how much it can move. I give it a little sproing to see about how deep I can go, and then I shift the vessel slightly towards the hand with the needle, basically trying to remove as much of the rolling as I can pre-stick. I then make my move to enter the vessel. Suction can definitely be a jerk. It takes awhile to get the knack for knowing how much suction is bad, and when you've got someone watching, want to move fast enough to avoid clotting, or an animal that wants to leave/kill you, you end up pulling too much. If I happen to pull too hard, I'll rest for a sec and gently pulse the foot (if it's a leg) to try and get things going.
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Aug 18, 2013 04:29
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HelloSailorSign posted:One thing I always found helpful right before drawing blood is to use my steadying hand to "play" with the vessel (doesn't work well with jugulars though). I'll move the vessel back and forth a little, seeing how much it can move. I give it a little sproing to see about how deep I can go, and then I shift the vessel slightly towards the hand with the needle, basically trying to remove as much of the rolling as I can pre-stick. I then make my move to enter the vessel. What helped me with SA venipuncture is to have topoisomerase as my moral support. Team Nyan 4 lyfe. SA venipuncture really stressed me out because I'm large animal, but with good restraint and relaxing and not being rushed or yelled at I did fine. Just take a deep breath and do it slowly. I'm on externship at a place I really like at the moment so what do I do? gently caress UP MY BACK PUTTING ON MY CLOTHES. I work out like a crazy person on a constant basis and this is how I cripple myself? Seriously, wtf? One of the vets did me a solid and gave me a bunch of robaxin so today I'm mobile but I feel like a total tard. No one wants to hire a gimp for their internship
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Aug 21, 2013 13:06
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Enelrahc posted:I'm on externship at a place I really like at the moment so what do I do? gently caress UP MY BACK PUTTING ON MY CLOTHES. I work out like a crazy person on a constant basis and this is how I cripple myself? Seriously, wtf? One of the vets did me a solid and gave me a bunch of robaxin so today I'm mobile but I feel like a total tard. No one wants to hire a gimp for their internship What have we learned? Never wear clothes. Ask if they have one of those nifty cold laser thingies. Or acupuncture.
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Aug 21, 2013 15:32
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HelloSailorSign posted:What have we learned? Never wear clothes. I figured I was pushing my limits asking for robaxin. They did have an inversion table in the unfinished surgery room - that sure was an experience...upside down with a bunch of techs peering at me going "IS THAT BETTER?!?!" My life man, it's a sitcom.
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Aug 22, 2013 12:53
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Thanks for the advice. I brought home some syringes and I've been playing with them at work to get the pulling back motion right. I pretended to draw blood from my pillow and then a stuffed animal I have, too . Yesterday I drew blood from a dog's cephalic vein perfectly, except then the doctor I work with shamed me because she NEVER, EVER draws from a cephalic vein just in case they need an IV. She's an ex-ER vet. Whatever man I got 2ccs on my first try and didn't blow the vein  Edit: Also never using a 6cc syringe unless I need 6cc's of blood on a cat. Wtf was my coworker thinking.
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Aug 22, 2013 14:55
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Enelrahc posted:I figured I was pushing my limits asking for robaxin. They did have an inversion table in the unfinished surgery room - that sure was an experience...upside down with a bunch of techs peering at me going "IS THAT BETTER?!?!" My life man, it's a sitcom. We were at a local veterinarian meeting presentation thing and one of the other vets admitted to using Adequan IM. Shnooks posted:Thanks for the advice. I brought home some syringes and I've been playing with them at work to get the pulling back motion right. I pretended to draw blood from my pillow and then a stuffed animal I have, too I use cephalics all the time... In the right patients. Being ex-ER probably makes her hyper vigilant about it, and it's something I always think about - am I expecting the need for an IVC on this patient? If no, then cephalics. If yes, then saphenous or jugular I will almost never use a 6ml syringe for blood draws unless I've got numerous panels or really want some extra on hand and I've got a 40lb or greater patient. For almost everything else, a 3ml works fine.
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Aug 22, 2013 16:02
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