Monday, May 30, 2016

Week 2 in the Ambulatory department of Rood & Riddle


            

            These last two weeks have gone by so quickly. Just about every day has been more than 8 hours, but it doesn't seem like it. We're always moving, always doing something. Even on the "slow" days, we still have several hours of work and we go at the usual speed to have a little more time off. At this point, I'm loving every minute of it!
           Sunday was a sad day. We lost two foals overnight. I rode with Dr. Friend and the other student. Our day went pretty smoothly despite the rough night for a couple clients. We started treating another foal that was starting down the same path. I learned that threading a needle for a Caslicks procedure is not quite as straightforward as it sounds. The suture has to be fed through the loop twice so that it is secured to the needle and will not fall off as the doctor manipulates the suture. We went out for breakfast at noon and palpated our last mares 1 p.m.
Image result for caslicksThis is a picture of a finished Caslicks. The top of the vulva is sutured closed to prevent fecal contamination of the uterus as well as air flow into the vestibule. This is commonly done in race horses and mares with poor conformation. During the breeding process, the Caslicks is typically placed after breeding and removed before foaling.
          Monday was another early start with Dr. Jordan Kiviniemi-Moore. The morning started out with us washing out a 45 day old aborted fetus. We were able to see the little sacs that protect it as it grows. Unfortunately, it had been dead for a few days and had deteriorated a lot, so we weren't able to see what the little critter had looked like. I was able to place a couple lavage tubes myself later in the day and run the fluid. These are done to wash out the uterus either before breeding to make sure it is a clean environment for the semen or after breeding to get out the semen that didn't make it up to the oviduct to fertilize the egg. As it turns out, semen is irritating to the uterus and can prevent a pregnancy from being retained. This is an even larger risk when doing artificial insemination because there is usually extender added to the semen. The extender used for frozen semen is the most irritating. The post-breeding treatments can be done as early as four hours after breeding and can continue for up to five days. At the five day mark, the embryo will arrive into the uterus. At this time, it is no longer safe to do lavages without being set up to catch an embryo for transfer to a recipient mare. Back to the day's events. Towards the end of the day, I watched Jordan remove a pair of wolf teeth. The roots were much longer than expected. Unfortunately, there wasn't much space so I couldn't really tell what she was doing in there. We also ran a couple bags of fluids to a mare that had tied up during her training session earlier that day. We only did a small percentage of the fluids that would have been run to her in the hospital setting. Unfortunately, we were in the barn setting and did not have the time of equipment to run the proper treatment. We decided that it was better to do part of the fluid treatment than none. Our last stop was an emergency diarrhea foal. He and his momma were both a handful! We placed a catheter, ran a liter of fluids, and administered a cocktail of medications. The owners did not feel comfortable doing this on their own, so we saw them twice a day for the next few days. Monday was my first late night. I got home at 11 p.m. and started Tuesday at 5 a.m.
           Tuesday was another long day. I got home at 10 p.m. after the 5 a.m. start. We found several little black dots (early pregnancies) which allowed for a good start to the day. I did several blood draws and got to operate the ultrasound probe for a lung scan. During a vaccination appointment, we diagnosed a case of bilateral fibrotic myopathy- part of the muscle in the back of the hind legs had become fibrotic and lost their elasticity. This leads to the horse having a tell-tale gait abnormality. Unfortunately, we had to advise the client not to sell the horse for a long trail horse because the lack of elasticity makes walking take more effort than it should. We were sent out on a colic emergency. It turned out to be an older mare with cellulitis in one of her hind limbs. This had led to a fever and dehydration. These are suspected to have caused the drier stool and mild impaction colic. We gave some drugs, palpated, refluxed, gave oral fluids, and sweat wrapped both hind legs to pull the edema out. 
        I had Wednesday off, so I slept in. It was really nice outside, so I sat on the porch and played on the internet for a while. I have collected a list of local restaurants to try out, so I found one for dinner. Vinaigrette Salad Kitchen was a tasty choice. They have soups, salads, and signature lemonades. Unfortunately, the lemonades had already been cleaned up for the day. The soup and salad I had were delicious though. I had to stop by Walgreen's and get some allergy medicine. My nose was starting to run like crazy! Overall, a very relaxing day.
            Thursday, I was back to the grind with Jordan. We started a tad later and ended a little earlier than we had at the beginning of the week. The day was pretty routine until we were called out to look at a lame horse. Jordan found a heel bulb abscess and wrapped the foot up to help soften the tissue to allow it to pop and relieve the pressure. The sad part of the day was that we missed the castration party because the time kept getting moved on us. It's starting to be difficult for me to remember what days things are happening because we are doing so much. Some days we feel like we've just been driving in circles and don't realize how much we've done until we get to the clinic to restock the truck and do the billing paperwork. Even thiough it gets boring to wash lavage tubs, make up the cotton, and mix more DMSO flushes, that's when I really see how much we've done. Then Jordan shows me the stack of bills that she has finished annotating. It makes me happy that we are doing so much without realizing it. 




     Friday, Jordan had an ambulatory intern party in the evening, so we tried to keep it to an early finish. We moved along at a good pace and had even finished a bit early. Of course, that's when you get silly emergency calls. This client had called for lacerations, but the horse just had a few skinned spots on its legs. Nothing major at all. Jordan wrapped the legs just to make them happy that we had done something other than just give Bute.

        Saturday- end of week 2... Saturday felt almost like two days instead of one. I rode with Jordan. We moved at a pretty quick pace to get as much done as we could before she had to go work the show at the Horse Park. The morning was very routine. She dropped me off just in time to get to the Horse Park at 11 a.m. I only worked about four hours. That left plenty of time off. When I woke up from my nap, I was startled by the AC repairman outside the hallway window. After he fixed our cooling problem, I went to the store for some more groceries. It took much longer than I expected to work out doing laundry at the neighbor's. I'm glad most of my chores got done. Laundry still needs to be put away, but at least it's clean.

That marks the end of my second week! Even though the hours are rough and causing me to run back into the caffeinated world, I wouldn't trade it. I still have a long way to go, but I think this will be a very enjoyable summer.

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