The reality of canine CPR… (and equine wound healing)

Marie - Was adopted today yay!

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Well today was another 8am start with the Equine service with wound checks for the hoof injuries and bandage changes. This has been fascinating for me as I have attended some very interesting lectures on equine wound management with The Webinar Vet which talked about the different treatment options. This has given me the theory, however experience is very important here, and so being able to see the healing progress is very interesting.

Equine wounds can look extremely nasty especially when covering large areas, and as owners seeing a wound each day the differences are miniscule so it is hard to believe that it is in fact getting better. Something that we as vets are recommended to do with the advent of camera technology is to take photo’s to compare the wound to – personally I think this should be extended to owners as well so you can remind yourself just how much better it is with each week. Now wound healing comprises different stages, however one of the most important factors is contraction which is where the wound gets smaller as it heals. This means that a large wound may eventually (months or even years later) leave a little tiny scar.

After this I then ended up in the Small Animal Clinic again, this time was going to be different however I discovered that Marie (aka Monkeycat) was being adopted today which I think is really cool as she is such a cutie (really struggled not to adopt her myself!)!

Marie - Was adopted today yay!Anyways there was routine stuff happening until I am about to leave at around 5:30pm when I get asked to help bring a emergency in. Now this is a neuro case and I was working with one of my favourite doctors who really can explain things so that they are understood. I cannot say anymore about the case however monitoring the patient during stabilisation the heart stopped. Luckily I had both the the doctor and a senior student in the room with me when this happened who both swung into action immediately. Whilst I started chest compressions a ET tube was placed into the trachea to keep the airway open and emergency drugs were administered. Sadly the patient didn’t make it despite our best efforts – it’s the first time that I’ve been involved in a patient dying this way so was a new experience. The thing that got me the most was that the owner had stepped outside just before it happened, and returned halfway in… Though I couldn’t understand the words I could understand what they were feeling, yet because of my lack of Slovak couldn’t say anything to her.

I’ve learnt several lessons from this, including some of the more important words in Slovak that are used within a veterinary clinic!

Equine Castration and a James Herriot morning….

Veterinary Equine Castration Emasculators

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Well following on from yesterday this morning I was also with the Equine service and we had a castration scheduled for a young stallion followed by a visit to look at some hoofs. Now I know a few of you have read/watched the James Herriot series (if you’ve not you should!) and seen the way he speeds around the dales in his car. I know I’ve said about Slovakia being beautiful before however this morning has been amazing…

Now last night it was a big storm so I wasn’t sure what it’d be like this morning so had wellies, overalls and also waterproof overalls with me today. However meeting with the doctor on campus it started to get sunny, and with four of us in the car we went driving off along a road I’d never been down before. Hills and tree’s on either side, over rivers and along streams trying to miss all the pot holes in the road. The sun really started coming through now and a little while later we arrived on the farm with the young horse for castration.

Now there’s always a little confusion over just what castration is, in horses it is the removal of the testicle along with the epididymis. A common misconception is that just the testes are removed. This is because some people believe when males make sperm in the testes (testicles) it then comes straight out, however when sperm leaves the testes it is immobile and immature and instead spends around 10-15 days travelling through the epididymis where it matures and becomes motile. Whilst most people link the teste and epididymis together they can actually occur in separately within the body development.

I’m pretty new to equine practice (well horses full stop) which is why I am trying to see as much as I can at the moment as it all helps (and helps me with my studying as well as I will remember something I see or do more than something I am told or read!). At the farm we met up with the rest of the veterinary team who were going be responsible for the anaesthesia, and prep started with all the drugs being prepared along with all the instruments and equipment that was going be used. I remembered an episode of All Creatures Great and Small where James Herriot is called to castrate a horse, loads of ropes are used and no monitoring is carried out. This was the complete opposite and it was impressive to watch, a pre-med was used to sedate the horse before the anaesthetic was administered and the horse’s fall was controlled. Pre-meds are useful because it allows drugs to be used in combinations so less of each drug is needed which means that the side-effect risks of each drug are minimised.

Here everyone swung into action, rolling the horse onto his back and position him using sacks, because he was unconscious there is no muscle tone so the legs simply folded up against the body with gravity. The anaesthesia team started to place a catheter in the jugular vein to allow administration of drugs and fluids along with attaching a pulse oximeter (to measure the pulse & amount of oxygen in the blood) to the nasal septum. In addition they looked after the eyes keeping them moist as with anaesthetic the eyes remain open (ever wonder why eyes have tape on them in tv medical drama’s?). Whilst this was happening the surgical team cut into the scrotum and through the tunica vaginalis (the inner sack) to get to the teste.

Veterinary Equine Castration Emasculators

A pair of emasculators were then used to crush and cut the spermatic cord at the same time, after this was done forceps were used to control the bleeding whilst the testicular vein and artery along with the nerves and tunic were cut with a scalpel. This was then ligated (suture material is used to tie the ends of all these vessels closed and then the clamps slowly removed to make sure it was completed ligated. Now whilst it looks like both the testes are simply in the scrotal sack the scrotum has a division in the middle meaning that the testes are actually in separate compartments so each teste has to be removed seperately through its own incision into the body wall.

Once the testes were out the scrotum was stitched closed with antibiotics injected into the muscle and the anaesthesia team prepared for the horse to wake up removing the catheter. Now when coming around from anaesthetic there is a lack of body coordination and unsteadiness on the feet so the horse was held down simply by the owner sitting on the shoulders. The basic test for when an animal is ready to be allowed to stand is whether it can hold it’s head up by itself, and it took a while for this to happen. During this time as it was a really hot day the anaesthetic team monitored the horses temperature to ensure it did not exceed 38.1 (it stayed around 37.5 degrees celsius which is in the normal range for horses).

Now the horse finally regained its muscle control and was helped to stand where we then left in the car for our next visit which was the trimming of some hoofs. Now hoofs are like human nails in that they keep on growing, now in the wild these were worn down by the distance the horses travelled, however when a horse is kept in a soft field with rubber mats in the stable these are not worn down and so need to be trimmed either by a vet or farrier. This is done in part with a hoof knife, and in part with some clippers with both the shape and foot structures considered in the process.

It was then back in the car along the mountain roads, and across the bridges back to uni and to return to the real world of physiology revision for tomorrow’s exam….