Cats are not small dogs – Vet Festival 2017

Noel Fitzpatrick at Vet Festival 2017

Sometimes I take for granted how much we now know, and this morning when someone said that when they were learning they were told that if you get cat bones in the same room then fractures will heal I was surprised. This was even more shocking as these words came from Prof Noel Fitzpatrick.

The dog has always been the top priority when it comes to vets, then cats became more popular as more has become known, and now the same thing is happening with the development of rabbit medicine. However this is about cats so back on track…

So Noel gave a tour through the cat skeleton looking at different problems and the solutions including some new ideas of own creation. Also here there was indication that a discussion is needed about the problems involved about getting new ideas out to share them with the world.

Either fortunately or unfortunately depending on the way you look at it there are well established rules within medicine and surgery. A lot of them help keep patients safe, and help prevent surgeons getting into trouble however sometimes they may be relied on too much without an understanding of why they exist – on in fact questioning their very existence. What resonated with me here was Noel saying that rules are there for a reason; however you need to understand when to break them.

This is in reference to a specific rule when it comes to using external fixation (rods and pins outside the body) to put fractures back together again. There is a rule that you can only use safe corridors which avoid muscles and other tissues when placing your pins. This rule means that ideally there are limited places where you can use external fixation as these safe corridors not exist in other places. Noel has tried to publish without success a series of 250+ successful cases where he has used external fixation on the cats pelvis without any complications which breaks the safe corridor rule but shows when done correctly it is successful.

A more light hearted moment was when Noel was told that he could not use the acronym SPIDER for a technique he developed for fixing toe fractures if he wanted to be published. Sometimes the best part of inventing something new is being able to give it a name and so the challenge has now been set for the first person to publish something with a SPIDER acronym…

The philosophy of surgery – VET Festival 2017

Laurent Findji - The VET Festival - Surgical Philosophy

Something that I personally am passionate about is doing the best surgery possible, I honestly respect that there is an enormous learning curve in front of me. This learning curve is about the experience that allows me to understand why and how things are done.

However that does not mean that I should not be trying to be better, and one of the best ways to do this is by learning from others. I’ve recently read the biographies of Dr William Halsted and also Dr Harvey Cushion two of the pioneers of modern surgery who have outlined many of their thoughts on things.

This morning my first lecture was by Laurent Findji who was talking about the philosophy and practice of soft tissue surgery and how this can help you become a better surgeon. This afternoon Laurent is also talking about complications in surgery which I will also be attending however I wanted to make sure I blogged up this first with a clear mind.

So I am going start at the end with a quote…

Good surgeons know how to operate, better surgeons know when to operate, and the best surgeons know when not to operate

Going from this it is something that cannot be taught, and all vets will start at the basic of following recipes to learn how to do stuff. From this an understanding of why should develop and then with this why it enables you as a surgeon to be able to apply the principles without a recipe.

The secret is to choose your patients and your surgeries, there is no point operating on the skin when bone needs to be removed for example. And if you are operating and failing you need to know why as failure is not good for you or your team.

One of the most interesting thoughts from this lecture was about instruments. I’ve seen many instruments being used in the wrong way often, and even going as far as to say that sometimes even for non-surgical uses. Laurent highlighted the following points when it came to intruments:

Safety – if your forceps have been used unscrew a cap, or for holding a needle, can you really trust them? If you then use them to occlude an artery in liver surgery will they hold? Or will you have a blood filled abdomen?

Fluency – sometimes people are fast surgeons, and even worse they are fast without rushing. This is because they understand their instruments, how they are used, and what they are going to do. They will take their instrument into hand and use it.

Economics – are cheap instruments really worth it? Do they give you the performance you need? Do they feel good? Sometimes you really can tell whether an instrument or not with just whether it locks properly or slips.

The top tip from Laurent’s lecture is that you should film yourself operating, then watch this and look at your technique. How much time do you spend thinking? How much time do you spend doing? What can you do better?

Learning in a field with The VET Festival – Vet Festival 2017

Fitzpatrick Vet Festival 2017

I can barely believe a year has gone, my exams are all passed and I am waiting for graduation, and last night I arrived to Guildford for the 3rd Vet Festival.

This is one of the vet conferences where I actually tend to go to as many lectures as possible because they are not available afterwards, and the information shared is not stuff I can just read in a book.

Over these 2 days I will be blogging as I go with a series of microblogs on specific topics to accompany my live twitter feed. This is something I hope to achieve to help me get my notes in better order as last year was so intense and I learnt so much that I struggled to organise it myself afterwards.

These microblogs will be based around the lecture topic, however will also add my own thoughts and opinions onto it so not everything will be from the speaker themselves however I will try to separate my thoughts to make it easy for you to follow.

I hope that you enjoy my highlights of this unique festival even if you’ve not been able to make it yourself. And if you have made it yourself please do say hi!

Chris