One of the reasons I love this university is how practical it is, and how you are pushed to think for yourself. We were left with a bull calf with a large lump on its neck and told to come up with a diagnosis in diseases of ruminants this morning.
This was a very large lump almost the size of a basketball hanging below the jaw on the right side. Now when dealing with lumps it is important to consider the location in relation to the structures that anatomically occur in that area. Then it is how the lump feels, and what it is attached to. Considering what diseases can affect that area of the body. Sometimes it is worth looking at a ultrasound scan of the lump, or taking a biopsy from it to examine in pathology.
The lump on this bull however is most likely from trauma and a massive haematoma which is like a bruise. All this blood had collected inside a capsule under the skin.
The afternoon we headed out to the farm for a reproduction practical – it is always interesting on these trips as we rarely know where we are going or what we are going to be doing. When we got there we found that we were ultrasounding sheep and goats for the diagnosis of pregnancy.
We ended up on a farm with a large number of sheep and goats, we set up the ultrasound machine and got started. Apparently once we are qualified we don’t get the time to play with ultrasounding fetuses and have to decide within seconds whether the animal is pregnant or not. Today however we had the time to look properly, and attempt to find the different parts of the fetus. It was actually even possible to find the heartbeat of the fetus on the ultrasound along with the different organs.
Normally though when ultrasounding for pregnancy we take any sign of pregnancy as a positive pregnancy – this can be the cotyledons (attachment of placenta to uterus), the amniotic sac, or part of the fetus. Once we see this we mark the animal as pregnant and move onto the next, usually this occurs at the same time as milking to reduce any stress to the animal.
The image above is of the fetus of a goat inside its mother who is very pregnant.
The bang from the captive bolt gun startled me as the bull dropped to the ground with a thud. Maybe because I’ve worked with cows more that pigs, or it was a bigger animal but something moved inside me.
I was at the slaughter house again; however today was cattle and this time we were there in time for the stunning and killing. Maybe it was because we were just stood discussing something, and it surprised me, however I was out of my element and didn’t know what I felt. This left me on edge for the rest of the session.
Thinking back I believe it was because the other times I have been at the slaughterhouse has been after the killing had already started. Today I went from standing in a quiet room to being surrounded by the sounds of slaughter. It really was a new experience, the bluntness of slaughter when compared to euthanasia.
Looking at the bull it was still, that single shot having induced unconsciousness the bull was hung and then bled. Though the bull is unconscious the heart is still working, and so when it is cut to bleed the blood simply gushes straight out. Death then follows very quickly from the massive loss of blood – without the animal feeling a thing.
I know the importance of meat as a food source, and the vet’s role in ensuring the safety of this for humans. However I am glad that I felt something and I hope that I never reach the stage where I can see the slaughter of any animal and feel nothing.
I walked into surgery today not to fix an animal, but to stop that animal’s pain. Sometimes that is all that is possible, however personally I believe that no animal should suffer so this option is better than leaving the animal in pain.
This surgery is listed in the textbooks as a salvage procedure, a surgery of last resort when nothing else has worked or is possible. It is for the hip joint when there are such severe arthritic changes that it is just pure pain with every movement. The options with damage to this joint in mild cases is for pain management via medication, however when it gets to a severe stage the only option becomes total joint replacement.
Total hip joint replacement is an option that is very real within the UK, and within specialist referral veterinary hospitals a common procedure that takes place on a weekly basis. However this can be an expensive procedure, though if you do have pet insurance may be covered under this so it is worth checking if you have pet insurance.
When total joint replacement is not possible, then the only option when pain medication fails tends to be the femoral head and neck ostectomy. This is a surgery where the top part of the femur (the thigh bone) that forms the joint connection to the hip is removed. The movement of this bone against the socket in the hip is what usually causes the pain, so the removal of this part of the bone stops the movement and so stops the pain.
The muscles around this joint are pretty strong, and during the months after the surgery the space will be filled with new tissue and the surrounding muscles will develop more. However this surgery does mean that the animal will be permanently lame and have a limp. In some cases the leg may even appear a little shorter than the opposite leg, however there will be no pain, and the patients I have seen with this surgery have recovered well to become very active again.
This is also a different surgery in a different way, as after the surgery instead of restricting the animal to cage rest the animal should be lead walked straight away to help the development and strengthening of the muscles. The difference with patients that I have seen from before surgery and a week later has been remarkable. However I hope that one day total hip joint replacement will become affordable for every animal in every country.
Something that they don’t tell you when you start on the road to become a vet is the amount of death that you will see. This week I have seen everything from the euthanasia of a 1 hour old puppy, through to the emergency slaughter of a cow that could not stand.
This morning started with an owner and a fellow student carrying in the limp body of their dog, this is where you go from 0 to 60 in seconds. I was sat with 3 doctors talking about eyes, yet within seconds eyes were forgotten. One was taking care of getting an airway into place with intubation, another worked to get a IV cannula into the dog, another started chest compressions and I prepped emergency drugs. Unfortunately today we had an unsuccessful outcome.
Here in clinic we do not have a defibrillator, and sometimes I wonder if we did would we see better outcomes in resuscitation attempts… There are not really any real statistics in veterinary medicine on the survival with defibrillation. However in human heart attacks where CPR is given using a defibrillator within the first minute gives a 90% chance of survival with this decreasing by 10% every minute after. If defibrillation is not performed within 10 minutes of the cardiac arrest then the survival becomes just a measly 2%.
With this knowledge from the human field you can understand why I wonder about our veterinary patients. Is it the same?
Waking up this morning it was white out with thick fog, however I had a coach to catch to the farm at 8am for a practical class in ruminants. Making it to the bus on time we were told that the heaters were not working. Basically it was warmer outside than in.
Practical class today was scheduled to be on hoof correction as part of our training in cow orthopaedics, however after the first 2 patients this was interrupted with a request for us to go to a downed cow. Now a downed cow just means that the cow cannot stand up – whether it is because of broken bones, nerve damage, neurological problems or electrolyte problems within the body.
The first step therefore was for diagnosis of the problem, the cow had given birth the day before and apparently had been down around 18 hours before we were called. Because of the length of time spent laying there is the potential for major nerve damage and muscle problems. These then compound what could have been a simple problem. As a group we managed to turn the cow to the other side to examine both sides and the neurological responses.
The problem with cows is that they are very big, messy and heavy. I struggled to restrain the head whilst we tried to give the fluids, a man vs a 500Kg animal generally indicates that the animal will win unless specific techniques are used. So to nurse a cow that is down it needs to be turned every 3-4 hours, and requires special equipment for lifting and also for milking. This is something that just doesn’t exist on most farms – and then the manpower doesn’t exist either.
Unfortunately this cow had a very bad prognosis however we tried to give intravenous fluids with glucose and then some calcium. After this the cow managed to stand on her own for a few minutes before collapsing again. We gave it more fluids, and left instructions with the farm workers to watch her for the next few hours before if necessary going for emergency slaughter.
Coming back to the university around lunchtime I somehow ended up getting called to surgery to run anaesthesia on a dog that had prolapsed its eye. This was a high risk patient as it was a brachycephalic breed where the face is squashed flat like with pugs and was also a small dog with a low bodyweight. This causes compromise in the respiratory system so I wanted to run this anaesthesia using a ventilator in case there was problems with the breathing.
This was a very interesting patient as the globe part of the eye was outside of the socket with all the muscles that normally hold it in place torn from it. The eye was so far forward that we also suspected that the optic nerve had been torn as well. The only treatment in this case as the eye is dead is for enucleation. This is where the eye globe is removed from the socket and then the skin closed over the socket.
The patient here recovered from the anaesthesia well, and I was very happy with how it went.