Journal 1

    I didn't realize I hadn't written for a long time.  I have been keeping a blog on MySpace, so if you're interested you can go read about my adventures there.  Update - I have been working as an intern for about 5 months now.  That means we're almost halfway through the year!  Pretty exciting.  We have 1.5 more intern rotations and then we repeat them all over again (8 rotations, 3 weeks each). 

    Right now I'm in the midst of the "SVSS" rotation.  This means I'm spending 3 weeks at Sacramento Veterinary Surgical Services (a VCA hospital).  2-4 days out of the week I spend shadowing a board certified veterinary surgeon.  2 days a week I spend shadowing a veterinary cardiologist.  Occasionally I also get to do surgery or other procedures with the emergency and GP vets.  I kind of like this varied schedule, but I do prefer surgery to cardiology.  The surgeon I am shadowing is really funny and entertaining.  I get to scrub in on his surgeries and help out (more like "pretend" to help out because I have no idea what he needs).  I also have to do most of the paperwork for him, like writing in the medical records.  I have to also do the physical exams on his patients and write this in the record. 

    So far during this rotation I have scrubbed in these surgeries (that I can remember): pyometra, TPLO (tibial plateau leveling osteotomy), cruciate ligament extracapsular repair, wound repair (cat), and arthroscopy of a shoulder to treat OCD (osteochondrosis dessicans).  One of the vets there has been watching out for spays/neuters and helps me do them, and this past week I spayed one dog (with a LOT of help...this was a difficult one on an old fat dog) and neutered one dog.  I am very thankful to this vet, as I really love surgery but feel so deficient in spay/neuter experience. 

    On cardiology days, we see a variety of cases.  Most cases have had mild to moderate heart disease.  Sometimes we see some for screening purposes and they have no heart disease at all.  But usually the animals come in due to their regular vet finding a heart murmur, or due to having been treated for congestive heart failure at their regular or emergency vet's.  The cardiologist finds a diagnosis within 15-20 minutes using echocardiography (an ultrasound of the heart) and sometimes an ECG (electrocardiogram).  It's interesting to a certain extent...but looking at ultrasounds all day can be boring (and restraining the animals) after a while.  Last night we had a really cool case (but not in the animal's view!).  It was a young dog with ascites, cachexia, visible jugular pulses, cold extremities, and a mild (grade II/VI) murmur.  Outwardly the dog was bright, but not its normal self.  We found a pericardial effusion - and a possible mass between the right atrium and ventricle.  We tapped off most of the fluid, allowing the heart to beat with its normal strength.  Hopefully the ascites will go away now, but it will come back if the pericardium fills up again.  We are trying to find out what the "mass" is - it could be a foxtail embedded in the heart, or it could be a tumour.  The foxtail would be the best case scenario, the tumour the worst.  We sent the fluid off for cytology at the lab.  So in cardiology so far, I have seen mostly HCM in cats and degenerative mitral valve disease in dogs (and occasionally something different, like arryhthmogenic problems in Boxers).

I better go to more surgery!  Fun!