Poultry with a slice of emergency surgery

First GDV of 2016 xray

Thursdays for me is either protection of the environment which is about cleaning things so I am confused as to why it is in my 5th year of vet school or poultry medicine which is more what I think 5th year should be like.

This Thursday was a poultry day and spent in the exotics department learning about chickens. Something I know a little about but still have a ton to learn. The chicken industry is big business with the only economical operations being industrial – however that is a topic for another day.

After finally getting home and sitting down to read up on stuff for tomorrow my phone goes – its emergency surgery for a GDV. Now a GDV is Gastric Dilation and Volvulus – often referred to as bloat or twisted stomach in dogs. The body of the stomach twists around so that the contents are trapped in a pocket of the stomach with no entrance or exit channels. As gas is produced from the breakdown of food material this pocket then starts to swell.

The swelling stomach then starts to squash other organs within the abdomen due to its increase in size – it has nowhere else to go and the abdomen is a limited space so this can also put pressure on the diaphragm and limit the lung space. This includes the blood vessels and finally the vessels and tissues that make up the stomach wall and lining are compressed as well. This leads to what is called pressure necrosis which is where tissue doesn’t get enough blood supply because all the blood vessels inside have been squashed so the tissue starts to die and turn black.

I’ve been in surgeries where pressure necrosis has been so great that the entire stomach is black and there is no way for us to fix the patient so it can survive.

The second complication of the increased pressure inside the abdomen is for the distribution of blood in the body. When we release the pressure from the stomach we need to have fluids ready so that we can help the body rebalance its blood fluid to fill the now empty blood vessels where the stomach was compressing them.

However tonight’s patient is a weird presentation. It was referred from a private vet for a suspected GDV, however there was no dilation when it arrived – and the dog was relatively stable. However when it made it into xray it would not lie on its side so the only radiograph we could get was the one with it on its back (ventral-dorsal position) which is here.

On this xray you can see that it is like a shape of a 8 with loads of gas (dark areas) within the abdomen. This line going across splitting the image is common with GDV presentations.

Taking the dog into surgery it was a successful repair to the stomach, however we found some haemorrhage around the spleen vessels so performed a partial splenectomy as well. The dog recovered very well.

The satisfaction and the pain of being a vet student

An exhausted vet student

Since last Wednesday I have barely slept, have been in surgery long past midnight on several nights, and have had the pleasure on one day of seeing the sun rise as I stumbled home to take a shower before heading back in to more surgery.

It’s been a sleep deprived rollercoaster of emotion, I’ve seen some things I wouldn’t wish upon my worst enemy, yet have seen patients recover right from the edge of deaths door. Through a lot of the surgeries during this period I have taken the role of anaesthesiologist. When I first started in clinics one of the equine surgeons told me that I should learn anaesthesia, as without anaesthesia there cannot be surgery. This is something that I listened to and have become reasonable at, I’m capable of selecting and calculating drugs to put an animal asleep, keeping them asleep through the surgery and then waking them at the end. It’s been a very steep learning curve, however now I am looking at anaesthesia in different circumstances which is getting more interesting. However my goal is to become a great surgeon, anaesthesia has given me a way to find my way into really cool surgery which is pretty cool though.

Anyways the past 5 days have been very educational, yet have for me have pushed me to my limits both mentally and physically. One minute I was doing CPR on one dog, the next I was doing anaesthesia for emergency surgery on the next. After just getting home after food I was called back in at 11pm to run anaesthesia for an emergency surgery and arrived at the same time as another patient that had just been hit by a car that just randomly showed up.

Coffee has become my best friend, my feet and legs ache, my hands feel like lead but I still performed to the best of my ability. I like to be pushed, emergencies tend not to be a normal thing here, and I do not know why all of a sudden it went so crazy however it was an amazing experience and one that I wished repeated on a weekly basis.

From one very tired vet student, goodnight.