A pretty weird day at vet school

Extracted P3 teeth from dog

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The best way I think to describe today is weird, it’s given me a lot of food for thought and some positives and negatives. Some things here I am deliberately vague on to protect patient confidentially however I am trying to share as much as I can.

So it all started early this morning with the start of my stomatology (aka diseases of the mouth) training. We started in with lecture shortly after 7am which was pretty interesting, started with diagnosis, then onto treatment and instruments with a little bit on how type of food can also affect dental disease. From this we then went straight into practical prepping and carrying out dentals under supervision.

Somehow here I ended up alone with a large breed dog being told that a tooth needed extraction and asked if I wanted to do it. Off course it was an instant yes (I’ve only ever read about extractions before) however there was periodontitis present with the gap between the roots showing  The biggest challenge here for me was working out just how much force I should use, I ended getting the doctor to demonstrate one whilst I did the second tooth alone. This was complicated by the fact that during this time I was also responsible for the anaesthetic and had to monitor the dog whilst doing the extraction as I was alone in the room.

I then jumped into surgery to observe the plating of a tibia fracture in a cat, this went without any problems and the cat recovered nicely with the ability to bear weight on the leg.

Coming out of this surgery it was lunchtime and I walked into a resus of a cat that had stopped breathing which was where my day really got very interesting. The cat was being manually ventilated and had a strong heart rate (mainly due to drugs), I like basics so asked what the temperature was and it hadn’t been checked as there were not enough people. Trying to check this with my thermometer I just got a “Lo” reading so assumed my battery was flat, however grabbing the thermometer from the consult room I got exactly the same thing and realised that there really was a problem.

Now I faintly remember reading somewhere my thermometer reads between 28 – 50 degrees, so for the temperature to register as “Lo” it would have to be below this with severe hypothermia. This started us warming both with peritoneal fluids, IV fluids and external heat sources to start the raise the temperature. This was actually very interesting to be a part of as temperature change did occur very slowly and being the only student in the building I ended up bagging (breathing for) the cat for the next 3 hours until we could get a ventilator working. Now during this time I was also monitoring the cat, and trying to get spontaneous respiration.

I started to do neurological exams as the temperature started to rise as I really wanted something positive to show me the cat would be ok. I got a strong retraction reflex on both the hindlimb to squeezing the toes and reflex when checking the temperature anally. However there were no other reflexes on front limbs, over thorax, or corneal. The weirdest moment for me came when I checked the pupil light reflex for the first time and got nothing.

Often times on TV medical drama’s you get the line “Pupils fixed and dilated”, this was what came out of my mouth here. I had never before today considered that it’d be something I would say, I had never actually considered the possibility that animals could enter a coma like state (we do not have the machine to test for brain activity so I am not comfortable just calling it a coma). The cat was on life support, if we switched of the ventilator the cat’s heart would stop, and the cat would die.

Ethically how far should we as vets go? It would have been possible (with manpower) to keep the cat on the ventilator indefinitely… Yet even with humans coma’s are not well understood. Personally for me, without having the equipment to monitor brain activity, or the knowledge here I feel that keeping any animal in a coma state is crossing a line. However if the equipment is there, then maybe it is only right we do as much as we can?

I’d welcome your comments and thoughts on this…

Starting the new semester

Start of new semester

Today’s Diary is sponsored by Pet Webinars

So today I started classes, this year is going be a little weird to me since I failed parasites last year – I’m basically repeating the 2 semesters of parasitology and taking a few of the 5th year modules at the same time. To be honest its nice to have a chance to breathe, however most of my free time this year will go towards my thesis and research papers in addition to extra time to review everything I have learnt over the past 2 years!

It does however also mean that I have time to keep my diary daily and to look for some additional funding (I need things like dentist, opticians, vaccinations etc) to cover things that I keep putting off. I’d also really like to get started with a video diary this year as well so looking for a decent camera!

Anyways onto today, first class of the new semester is Inspection and Control of Food Production. The lecturer is actually trying to make it fun and interesting (this is really appreciated and slightly unusual here!) however its all about the legislation and legal stuff in food production. Today was a general overview of the subject and the start of looking at the laws and legal framework. It is slightly interesting as we are looking at the EU regulations which for me is weird that the UK no longer has control over its own food production as it is done on a European level.

I guess this is going be a class that is a wait and see, tommorow is however going be a long day with a 7:15am start right through to 4:15pm with no proper breaks so I am going try and grab an early night! Upside is 3 hours of tommorow is all pathological anatomy practical so in the necropsy rooms!

REVIEW: Animal Abuse and Unlawful Killing (Ranald Munro & Helen M. C. Munro)

Animal abuse and unlawful killing book review

I randomly came across this book tucked away in the corner of the university library. Sadly with social media I am reminded of the bad things in the world on a daily basis. I felt that as a vet student it was my duty to take the time to educate myself here (yeah there’s not really a class for it yet!) and as it looked like a quick read, and very practical in nature I decided to borrow it.

So I’ve only just started studying my pathology modules, yet this book made perfect sense with the limited knowledge that I had. It breaks down the different possible “causes” of pathology resulting from abuse or unlawful killing including an introduction to the subject, how to do forensic examinations and what is expected with respect to non-accidental injury as well.

Despite it being under a 100 pages long, there is an absolute wealth of information packed in; each page I read left me with things to think about and consider. Whilst it is not the nicest subject to read about, having the extra little things to consider will I believe help me in my duty to animal welfare.

In addition to the topics I mentioned about the book includes chapters on neglect, wounds and injuries, thermal injuries, firearms injuries, asphyxia and drowning, physical agents, traps and snares, bite injuries, sexual abuse and poisoning. Also there is a discussion on the estimation of time since death which is a really big topic in humans, however with the range in body size across species still remains an area where extensive research is required for animals.

I would consider this book to be essential reading for every vet, vet student, vet nurse and vet technician that has any contact at all with animals.

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The end of my marine mammal summer school

dolphins jumping

Well I am currently writing this as I sit on the train on my way to Munich to then keep going back towards Slovakia. There is a little stress as my train was delayed by 30 minutes which meant I would miss my connection to Budapest, however the previously delayed train arrived as the station staff were debating what to do with me. So at present I am on an delayed earlier train which is pretty much running at the same time as the train I am scheduled to be on.

So anyways, sadly my week long marine mammal summer school is over, I’m exhausted now (if I make my Munich connection I got a 9 hour journey to sleep!) however my brain is still buzzing with all the information that has been packed into it. Today was more about the studbook and population management programs. This is where the zoo environment can play a role In bringing species back into the wild. For example one of the first programs was for the black footed ferret which went extinct in the wild towards the end of the 1970’s. In 1985 a captive breeding program using 18 captive animals allowed the species to be reintroduced which I think is pretty cool. Obviously this was only possible as the environment for these animals was still there (unlike the environments now wiped out because of palm oil or deforestation).

The next talk was one I was pretty excited about, we had international marine mammal veterinary consultant Geraldine Lacave to teach us as much as she could about reproduction. Now this is an interesting topic, and one that uses a lot of specialised techniques. Salt water is actually lethal for sperm, and so dolphins for example have evolved a cervix which prevents the contamination of sperm with water. A lot of reproduction is monitoring and this is usually done with ultrasound – because of the size of muscles and blubber layers there are very specific acoustic windows that must be used for this on each species.

We then finished up with a look at the zoo’s and the public which was very interesting to get an inside perspective on. Whilst people have a right to protest, the question here was when it came to people protesting animal welfare, where did the staff welfare stand?

When marine mammals need fresh water too…

Medical training of dolphins for temperature measurement

So today was all about nutrition, animal training and communication. When they say Wednesday is hump day this is exactly what they mean, I am sad the week is halfway over, yet I am exhausted as I struggled to sleep last night.

Anyways onto nutrition this morning we looked at the comparative anatomy between different marine species to start which was pretty amazing. I thought the differences between ruminants, equine and carnivores was crazy however the differences between seal species makes it seem like it was easy! We then moved onto nutrition with a very fast but comprehensive review of the different sources of nutrients and how preparation is also important before moving onto clinical nutrition. This was especially interesting as marine mammals suffer pretty similar diseases to terrestrial mammals in cases of low and insufficient minerals or vitamins, however too much can also be fatal through toxicity so it really is a balancing act.

What I think surprised me most was that marine mammals can suffer dehydration from not drinking enough! I guess I always thought as they live in water they are ok, however with dolphins for example their kidneys cannot desalinate (remove the salt from salt water) so without fresh water they suffer dehydration and the consequences of this. Now you may ask where they get fresh water from if they live in the sea, the majority of this actually comes from their food that is metabolised and broken down.

Something else that I also thought was very cool was that some seal and sealion species do not chew, when they are fed fish they swallow it headfirst. They even use their tongue to turn it around in their mouths if it is in the wrong direction! It has been suggested that in the wild dolphins will “chew” on a puffer fish to release the toxins which appear to be pleasurable for them.

Moving onto the afternoon session we started looking at training, now a lot of people still mistaking believe this is just for “circus tricks” when in reality it is so much more. In the zoo veterinary world medical training is used as an alternative to sedation, anaesthesia and immobilisation – it allows safe and stress free veterinary care of potentially deadly animals. For example have a look at this photo…

 Medical training of dolphins for temperature measurement

Here is a dolphin, the body is mainly muscle so it’s very strong, yet it is laying there on its back in the water to allow for the temperature to be checked. I believe this is pretty amazing, medical training is something that can be used anywhere but seems to mainly be used in zoos. Just imagine if all the dogs and cats that vets see could do this, just stand whilst the temperature was checked, many pets visiting the vets are so stressed and petrified just being in the building before anything is even started!

So going on from this we did a practical session of training each other, it was really interesting as without language it is very difficult to communicate exactly what you want an animal (or someone else) to do!

Under the skin when things go wrong in marine mammals

Vet summer school with dolphins

So this morning we did our anaesthesia and immobilisation workshop, unfortunately there were no procedures required in the marine mammals so we got a wild horse instead that needed x-rays and hoof trimming. Slightly disappointed but a great speaker and I’ve taken away pages full of tips and tricks that will help me with future anaesthesia in different species. So after lunch with these guys…

Vet summer school with dolphinsWe started with the pathology of marine mammals, this is a pretty special area and we had one of the top vets in the world taking the afternoon. We covered so many disorders including diseases and parasites not seen in normal animals that I finished with a headache, and a ton of notes to go over. Then we got to try our hands at histology of marine mammals as well, this was interesting especially as I have not finished veterinary pathological anatomy yet biut was well worth it to get a good explaination of just what was going on as well as a demonstration of just what can be achieved using simple histological stains.

The evening then went to scientific writting, with us being given blood data for the past few years for all the dolphins here to look at which was pretty interesting. Before we finished for the day we decided to check out the directors claim on Monday that night boxes were not used here and animals were left outside at night – he was telling the truth and it was interesting to be able to see how some animals sleep at night.

The start of a marine mammal education on dolphins and manatees

Manatee having lunch

Well today has been long, lectures started at 8am this morning and we stopped to go out to dinner at 7pm (though the debates kept going). Now tommorow morning is anaesthesia and immobilisation, and debate is still going on here so I can only afford to take 15 minutes away to give a quick update here!

So this morning started with the zoo director talking about concepts of animal behaviour, this was pretty interesting and I learnt absolutely tons. What is cool here is that the director is not afraid to challenge the “norm”, and so this zoo is one of the few where animals are allowed to stay out at night, or where options are given so the animal can choose their preference of nesting box.

Now a nesting box may not seem important, and traditionally this has been placed by the keepers. However animals recognise that a keeper will come each day into that part of the enclosure whether to clean or feed them and so at one zoo the animal decided to raise their cubs 1 foot in front of the public fence. This was because the animal felt safe, no one had ever come over or through the fence into the enclosure yet the keeper kept coming in the keepers door. This changed the thinking here so that nesting boxes are no longer put near entrances to the enclosure.

With the dolphins here they are kept with the sea lions in a new purpose built outdoor laguona. This has over 6,000 million litres of salt water, and was constructed with new thoughts in dolphin behaviour so as to reduce stress and improve welfare. This project cost around 30 million euros with nearly 20 million euros spent on the backend life support systems to maintain the salt water! This was then followed by a tour of the rest of the zoo including the manatee’s with behaviour and enrichment implementation explained which was really cool!

Manatee having lunch

We then headed back into the classroom after lunch where we went over anatomy and physiology of marine mammals. Now this is extremely interesting as there are extreme differences between species, and these differences affect the medical treatment of these animals. For example the trachea in true seals is long with short bronchi with loads of loads supported only by muscle which makes them susceptable for lung collapse whilst the eared seal has cartiledge here so does not suffer from this problem.

We then looked at the physiology of the dive reflex which is really cool and will get its own diary entry when I am back next week!

Next up was a lecture on tuberculosis (TB) which as many know affects cattle, it also can affect zoo animals including elephants. Its a big problem currently in India with temple elephants, and we looked at treatment here and its occurance also in marine mammals. Coming onto that we looked at Avian TB which isn’t a real tuberculosis but a mycobacteriosis that is still a problem in zoos. Recently in Europe there has been problems with penguins with it which was also interesting as it showed that it could not be detected on xray, but by CT with loads of images of this to look at.

This was followed up by a talk on what it is to be a zoo vet, which was interesting before we then started into a debate session on some of the issues mentioned during the day. As potential vets we have to understand the ethical and moral aspects of what marine mammal and zoo medicine really is about and several issues were actually discussed here. We then moved onto the design of research projects and how to write a scientific paper which is really important in zoo and wildlife medicine but something not really taught well in vet schools.

Finishing up we then moved to town for dinner where the debate resumed. What a day!