Saturday, September 18, 2010

4 weeks down

And I don't even want to count how many more to go... (how long is it until graduation???)

This week's radiology rotation ended much better than it started (thank goodness). After the first couple days, we had all figured out how to set and use the xray machines, how to position animals for chest and abdominal films, how to correct errors we made, and which techs were nicer than the others and more willing to help us hapless juniors.

Actually, other than a bunch of met checks (radiographs of dogs on their right and left sides and lying on their back, to look for metastatic cancer in the lungs), we mostly hung out in the ultrasound department and watched a variety of scans.

Yesterday, we headed over to CCU to pick up what ended up being the saddest little dog I've ever seen, and bring her to ultrasound. This little 6 year old terrier had come in a couple weeks ago because of a tumor growing on her right shoulder. They knocked her out to biopsy the mass, and found out it was a really nasty kind of cancer. The plan was to surgically remove the mass, so they did a CT scan to see exactly how invasive it was, how much tissue they would need to remove, etc. -- so they could be sure they got clean margins during surgery and didn't leave any pieces of tumor behind.

In the meantime, the little terrier was hospitalized for a few days for various procedures. They noticed that she was running a fever but didn't know why, so a couple days after the first CT scan, they did another, and found out she had a pyometra -- basically a really serious infection causing her uterus to fill up with pus. (Get your dog spayed, folks!)

Pyometra basically necessitates spaying the dog, so the terrier went back to surgery and had her uterus and ovaries removed. Now in addition to an ugly incision on her shoulder where the tumor biopsy was done, she had a huge abdominal incision too.

Fast forward a couple more days, and the poor little thing is now in CCU with a very serious infection that has developed in her shoulder biopsy site. Given the aggressive nature of her cancer, its location, and the current infection, the decision is made that this poor dog is going to have her entire right front leg removed instead of just the tumor.

As this point she comes down to ultrasound (complete with multiple IV lines, a urinary catheter, EKG monitoring, and a huge drain coming out of her infected biopsy site). Nobody knew exactly why the ultrasound had been ordered, but in the end they aspirated some lymph nodes and decided she should indeed go for the amputation surgery asap.

What a poor little dog!

Fortunately most of the cases we saw in ultrasound weren't quite that sad. A bunch of them had cancer of different varieties, so we were doing abdominal scans looking for lesions in the liver, spleen, or lymph nodes. There was one dog with a hemoabdomen (abdomen filling up with free blood from an unknown source) so we scanned the abdomen but didn't find the cause. We got to see a bunch of ultrasound-guided needle aspirates of liver, spleen, or lymph nodes. A golden retriever yesterday was being treated with chemo for lymphoma and all of a sudden just wasn't feeling well, so we checked his abdomen.

All in all, ultrasound is pretty darn cool. I've never really seen a live ultrasound before, and it's way different from the still pictures they show us in lecture as demonstrations of various abnormalities.

At the end of radiology, we all took an online exam that was basically identifying various artifacts on sample radiographs -- like a hair stuck on the film inside the cassette, static electricity, the patient moved as the xray was taken, the settings on the machine needed to be adjusted, etc. I breezed through that with a satisfactory 88%.

In other exam news, we had our first ClinSci exams this week. Small animal orthopedics & reproduction (what a great combination) opened on Monday and closed Wednesday. I was pretty worried about that one (we went through about 90-100 PowerPoint slides in each of 15 lectures that the exam covered), so studied a ton and got a 92. Equine orthopedics opened on Tuesday and closed Thursday. By the time I finished the small animal test, I was sort of studied out, so didn't put in quite as much effort on the large animal side as I'd hoped, and as a result squeaked by with a 77. (Okay, 70 is a passing grade, so it wasn't like I really almost failed, but I always feel way more comfortable if I get at least a solid 80. However, at no point in my future career do I anticipate the need to treat a foal with angular limb deformities or a mare with an olecranon fracture, so I'm okay with my 77.)

All of our exams are online this semester -- large & small animal ClinSci, and radiology -- which is sort of nice. With the online exams, you have a much more flexible time range in which you can take them (usually 48-72 hours). You can take them before class if you're better at exams in the morning, or in the afternoon after class, or later at night. You can take them at school or at home. They're all closed book, and it always feels nice to know that the faculty trust us enough to take an exam at home with nobody watching, and still believe we won't cheat.

Upcoming rotations are small animal procedures this week, then client communications the following week (dreading that one).

For this weekend, nothing to study except equine repro (and I am really bad at reading ultrasounds of mares' ovaries and uteri, so wish me luck). Equine repro exam opens Monday!


Rad rotation
Tests

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