The last class…

Mom watching over my shoulder during treatment of the foal

It feels like forever ago that I was excited for my first day of vet school (you can read about it here) and what a feeling it was. I’m a little nostalgic as I read over my diary as I was so much younger and way more naïve back then.

It is the opposite today though, I am coming towards the end of my time as a vet student and that is scary. Today was my last ever class as a vet student so I am going finish as I started.

My last block of vet school is equine, and today was rescheduled from one of the earlier bank holidays this month. The class today was the examination of the distal limb of the horse.

We started with nerve blocks and the anatomical location of the nerves and where to inject the local anaesthetic to block the nerve. This can be used as a very useful tool to identify where a problem is in a horses leg as when you block the pain the lameness will decrease or vanish completely. This allows you to start with nerve blocks lower down moving higher up until you get rid of the lameness and tells you where to focus the rest of the exam whether that is radiography, ultrasound or arthroscopy.

After this we moved to dissection of the leg, looking at all of the important structures and how they connect together with the muscles tendons and ligaments. The equine leg is pretty impressive with how much strength it has and how fast it can move. This is largely due to the structure of the tendons which act almost as springs when they are loaded with a force.

The class finished with a live horse to do ultrasound of the tendons within the leg. This is one of the most common exams in horses and one of the easiest ways to look for problems with the tendons. It is possible to see many of the structures of the leg on the ultrasound machine and for any injury to the tendon is an extremely accurate way to determine the degree of damage.

It was a great last class, which combined theory with practice.

A vet students (non)summer – Part 1

My first day in the Small Animal Clinic

Today’s Diary Entry is sponsored by Spikes World Wildlife Foods

Now this really is a post that I don’t know where exactly to start, I’ll apologise in advance if some details are vague however I do have to protect client confidentially for some patients. So over here in Slovakia, when it comes to summer exams you can schedule your own timetable within 2 periods (15th May-15th July and 15th August-31st August) and its your responsibility to ensure that you pass everything to be allowed to progress to the next year of study. With the fundraising I have been doing for tuition last year I’d let some of my revision slip, and did very few exams at Christmas so was left with nearly a years worth of exams to do within this period.

Now at the same time I also wanted to get as much practical experience as possible, so I decided to attempt to do an exam a week along with as many clinics as I could get into. Knowing nothing about equine I decided this would be a good start if I was ever to get over my fear of horses (they have a reputation of dying very easily) so started with equine. I was told to get some dark scrubs and then come – apparently white coats freak the poor animals out – this wasn’t easy though as nowhere in Kosice sells scrubs (I even tried the hospital) and I had to order from the UK in the end. It is about working your way up here, and for the first couple of weeks I was solely watching and handing things over. This suited me fine as I was trying to pass Anatomy at the time so gave me time to study as well.

So fast forward a couple of weeks, we had a horse arrive for some dental treatment. Basically within the horses mouth you have a large gap between the front teeth (incisors) and the (pre)molars at the side which are used for chewing. Sometimes a horse may have a small tooth in front of the molars in the top row known as the wolf tooth. Now this extra tooth which does not really have a purpose now can get in the way of the bit when riding so is usually removed. To be honest I was pretty surprised that the roots of these teeth were so small as I know the other teeth have very large roots (the entire tooth was around the size of a 5p!). The next stage of a equine dental is to make sure all the surfaces used for chewing and grinding line up properly, and that there are no sharp edges which can cause damage to the tongue and cheek – this is where the rasp comes into play! It’s really important to remember that horse teeth keep growing, and that if the surfaces wear down unevenly then the tooth will also grow unevenly. And finally once finished with the molars(cheek) teeth it is time to look at the incisors which are the teeth at the front.

Incisor overbite in equine dental examAs you can see with this horse the upper teeth protrude in front of the lower teeth which is known as a overbite which is where the incisive bone is slightly longer than the mandible (jaw bone). This causes uneven wear on the upper teeth which increases the bite and so these have to be ground down by a equine dentist or vet on average every year. The opposite which is a underbite is where the mandible is in front of the incisive bone and is most common in brachycephalic dog breeds! I was lucky to see a few dental cases over the summer, including one which had a retained part of the root after a previous fracture which made its way to surface a few months later.

During this time I was also popping in and out of small animal clinic as equine only operates during the morning unless it’s a emergency. I got thrown in the deep end here as well with a crash course in the common procedures over the first few weeks such as managing IV’s, canula’s, giving meds, doing clinical exams and more. This was where I learnt one of my three biggest lessons from the summer, never make any assumptions. Just because a patient has a history or is being treated for one problem does not mean that there is not a more immediate life threatening problem that is still undiagnosed. Definitely is a lesson that I will remember for ever, and I am taking every chance I get to examine every animal as thoroughly as I know how. Animals cannot tell us what the problem is, or where the pain is, so even when presented with a case that I have seen already I will do a complete clinical exam.

My first day in the Small Animal ClinicNow that I’ve covered my first major lesson this summer I think I will leave this diary entry here for now. Obviously trying to write about everything at once is difficult and is enough to fill a book, however in my next post I will introduce you to my first experience with a foal, some experience with artificial insemination, and some of my surgical patients!

The end of my first week of clinics….

Endoscopy Gutteral Pouch Empyema in Horses

Today’s Diary Entry is sponsored by Supreme Pet Foods

What a week! I am actually starting to feel like a vet student now and not only have started to apply knowledge that I have learnt over the past year but also from my previous degree! In addition to this I have also managed to pass two exams this week (Veterinary Physiology on Wednesday and Animal Hygiene this morning)!!!

So this morning started with an exam, it still feels weird to me having to dress formal for exams however dressing smart also gives me a boost of confidence so I do like it. I now have a week to prepare for my Anatomy exam on the 24th June – this will be my second attempt as I failed my first one back in January as I had no clue what to expect on the question paper. Basically you are expected to just list the different parts of the bone instead of trying to write a description of how it looks 🙂 Hopefully I will do better this time!

Now this week has been pretty cool, I’ve got through a lot of Equine stuff, seen a castration, endoscopy, and wound management. Today I was slightly gutted as I arrived late after this mornings exam to find that they had done emergency surgery on a corneal ulcer (a ulcer of the eye) in a sports horse. I arrived just in time to see the movement of the horse from the operating table to the recovery box. This was interesting as when animals wake up from anaesthetic they are unsteady on their feet (same in humans but we have the ability to know what is going on and that we should lay there) and usually struggle to stand. On Tuesday for example the horse was held on the ground until he had recovered enough to stand, and then was supported with people at the head and tail vertebra. The rest of today’s surgery went to the wound management of the hoof injuries, and endoscopy lavage for the guttural pouch empyema (the bump in the image below is a large swollen abscess).

Endoscopy Gutteral Pouch Empyema in HorsesStandard treatment for corneal ulcers is applying a graft which helps healing whilst also preventing the eye from rupturing, and whilst I missed this I got to watch something else pretty cool. Now administering eye drops to a big horse is not something I had ever considered before, thinking about touching a painful area and the legs flying towards me I realise that it does require careful thought. In this case a supraorbital (above the eye) lavage system is used. Basically a small incision is made into the upper eyelid and a tube passed through this which is then fixed in place along the head. This allows a syringe to be connected and drugs to be applied directly to the eye which I think is pretty cool and makes it easier.