Upon completion of the BWBP placement (Feel free to see the previous post), came a little bit of free time before my next week of early morning endeavours.
The time was spent rather unwisely gaming away and dining out, but these small pleasures need to be taken when they can, 'cos God knows they won't be an option when second year starts!
So my final, and favourite (ever) placement was completed 3 days ago (5th Sept.) and it was one of the hardest places to leave. I was only there for a week and I fell in love with the place, the people, the clients and the animals; of course it wasn't all plain sailing, as you'll no doubt find out- but every fairytale has it's villain(s) and every dream has an awakening.
The week consisted of some pretty incredible sights and experiences, we had tough owners, PTS potentials, bovine surgeries and bewildering equine callouts galore. I'd love to share all the stories with you guys but your attention span can only stretch so far, and I always like to keep a little something to myself!
EQUINE OPTIC CLOUDING..
So the first case I'll let you in on was potentially our most simple in terms of client and treatment. We were presented with a pony, freshly returned from a years leasing, with a bloated belly and clouded eyes. Initial thoughts from the owners were regarding a potential facial trauma as the pony had shared a field, for quite some time, with a large and boisterous horse- this however was ruled out as no physical signs of trauma were existent, and a horse's kick would most definitely have left it's mark in a very obvious way.
DOWNER COW..
We saw our fair share of downer cows during the week but one of them stuck out for me, more than the rest.
I wish I could start by saying it's a happy one, but I can't. This case humbled me, somewhat- I really got close to it, probably too close.
So we attended a farm for a downer cow previously seen by the same vet, diagnosed with phosphorus deficiency (it was a "creepy crawler" and demonstrated all other trait of phosphate. Bloods supported).. We found it in a field, alone, one carpal joint swollen, still displaying signs of a phosphorous deficiency... We dosed it up with intravenous phosphate solution and some pure glucose solution in hopes of the cow getting a boost to get it on its feet. The issue was whether or not the phosphorus, the foot or something else altogether was the cause of the 'downer'.
We were to return later on, for a verdict. Do we emergency cull the animal or give it our all and treat it for whatever mysterious ailment it had? The latter offering up a large risk for the farmer as his cow would essentially be worthless unless the meds fully fixed her up, but he could fetch a few hundred pounds for her in emergency cull?
The news came at 4.37.. she wasn't standing and the kill order had been sent through, we had to be present, legally, for the culling.
The drive up was decent enough, my handler discussed the situation and we talked about the whole idea of culling and the meat trade etc. He showed me the official documentation that had to be completed for the cow and it was phenomenal. So much detail and little room for error, any lie or falsification would lead to my handler being struck off the rcvs register..
In summary of the following events- we showed up and remained there for a whole 3 minutes. Mostly for documentation.. The culling process was 45 seconds maximum. I stroked her between the eyes beforehand, feeling like she knew what was coming and pitying her..
The bolt gun was placed where my hand had been, and with a pop she was unconscious. Instantly, the blade was thrust in to her clavicle region and through the throat (2 incisions).. I take solice in the fact she was unconscious for the process and felt nothing, but I couldn't help but think about a future she no longer had.
The blood in the grass was washed away and her body taken away, then we departed..
I never flinched during the process, my younger self would have been in tears. But I've matured- this is life. The farmer needs to consider his livelihood and we had to conifer the ethics of keeping her alive and suffering in that field whilst we attempted to blindly fix her..
She'll always remain in my memory's, a sweet cow. Most are nervous but she seemed to welcome contact and attention.
STAFFY HEPATIC FLUID..
This was the first of the three consultation cases i'll share with you, it holds my interest because it taught me about the bond of dog and owner more so than most cases have.
This relatively well built gentleman walked into our consult room with a little porky Staffordshire Bull terrier with glistening eyes and a nervous tone.. I'm still not sure if he was nervous of the situation or for his dogs health (I've witness a lot of people's nerves break down just trying to communicate with vets.. baffling!).
His dog presented with a swollen tummy, some vomiting and diarrhea (V+ and D+). She was eating well, though. Initial suspect was colic, but palpation of the patient brought up another worry.. There was no superficial pain but when palpation of the viscera occurred, pain was noted.
This led to us scanning the abdomen where we discovered a fluid build up around the liver. Bloods were issued and came back almost within nomad ranges, strange?! We told the owner who, for a lack of funding, could only afford basic treatment. We sent her home with medication to try and normalise bloods, with the aim of monitoring the issue, in case something sinister was behind the fluid build up (hepatic cancer, heart failure etc.) Though initial symptoms were not severe and our thoughts were not towards anything malicious based on results.
FAD CAT/OWNER
FAD is an abbreviation of Flea-allergic dermatitis, it can be quite common and in this case was made a lot more difficult than it had to be.
The case itself was easy to treat! The cat weer was unaware that most flea treatment was to kill only, not to repel.
We prescribed meds for the cat to, both, kill the fleas and treat the dermatitis.
This case taught me about client communication, primarily. The client wasn't happy about a previous description of what was wrong and what to do regarding the cats scabs and bites, but seemed a lot happier with my handlers description.. She made sure to trust the owner on his observations with the cat and showed sympathy for his agitation as he had been, potentially, given some previous bad advice or maybe he simply misunderstood..
Either way, both owner and cat went home relatively happy, an issue arose regarding payment of the consultation fee due to precious advice etc. He felt he didn't deserve to pay the fee twice in however long it had been, though this issue went up the higher levels to practice manager.
SUSPECTED CKD CAT/OWNER..
This consultation case baffled both me and the clinician, not because of any complex issue but because of the curious personality of the owner! What is it with the positive correlation of craziness and cat ownership!
A cat was brought in with weight loss and "odd behaviour". The owner had registered that the cat was no longer willing to sleep in her room and instead opted for outdoor lifestyle.. This prompted the owner to make claims of animal welfare and quality of life- the cat apparently had no quality of life as it wasn't sharing her room with her, so she questioned whether PTS was an option for her?!
This was insane, the cat was old with suspected CKD (owner paid for minimal bloods) and had simply, in its old age (probably) changed demeanor. Cats are notably unloving at the best of times, unless it suits them.
The cat went home with some more meds for the kidneys and advice for the owner.. The fate of the cat remains unknown to me and I will never know.. I'm hoping she is alright and enjoying the new outdoor lifestyle she has adopted.
HEIFER FOETOTOMY/CAESARIAN SECTION..
This on-call case was by far my favourite three hours of the whole week. It was an adrenaline filled mix with some tough decisions and a bit of a sad twist (quite early on), really. The cliffhanger ending can never be resolved, as is the way of such circumstances as these really.
We arrived, early evening, to an emergency call regarding a tough calving of a heifer. We showed up with news of the calfs death, with two front legs crossed over and it's rostrum visible, we set to attempting manual removal.
The calf was huge and wedged within the pelvis of its mother. . 20 minutes of manual pulling passed by before the call to perform a foetotomy.. This gruesome procedure involves intrauterine dissection of the calf and then pulling it out, piece by piece.
We got the head off with some wrestling but any further attempt at dissection was futile as the shoulders were well and truly wedged in the pelvic region.. We had to resort to a caesarian section to remove the wedged calf corpse.. By this point the cow had lost a tremendous amount of blood, suffered trauma to the uterine walls and was writhing on the floor in such immense pain, I had never heard a vow make any noises like this or writhe in such pain.. We had to be quick, or we faced losing her too. She was getting very weak and quiet by the time we made the incision.. A second vet had appeared by now, to assist in the process.. It went relatively quickly from this point on, aside from a few near misses with the cows feet flailing.
The time came to pull the calfs corpse out of the mother, the struggle was unwedging the shoulders from the pelvis.. It took strength from both sides to free the calf. It's body had barely slumped lifeless on the barn door and the focus was instantly back on saving the mother, we had a job of stitching her up due to the abomasum swelling under gaseous pressure and occupying the abdominal space.
The stitching went flawlessly and the job was a good'en. Now for the cliffhanger- the cow was still down by the time we left, she was direct weak and it was hit and miss as to whether we'd lose her too.. so we left, not knowing whether she survived the cold night or not.. I'd like to think she did, she was a fighter for sure and will no doubt be mother to healthy calves in the future!
I really hope you've enjoyed reading up on my clinical week- I know I've summarised the case studies, if you'd like more detail or to comment on them etc. I more than welcome it!
Hope your night/day is going well,
The student rambler.
@_davidjwalsh
No comments:
Post a Comment