Sunday, June 24, 2018

Brown Equine Hospital: Week 5

I apologize for the lateness of this post! It has been a busy week for me, yet again (there seems to be a theme here..) This week comprised of mainly appointments and patient care, but I will try and provide the highlights!

A horse presented to the clinic for dental work. The horse was 20+ years old and had a history of quidding. Quidding is when horses chew or ball up their hay in their mouths and fail to swallow it. This can lead to the formation of hay balls in their stalls, these are referred to as quids. Quidding can be a result of the inability to chew or swallow their food. This can be due to dental issues. In this horses’ case, they had little to no grinding surface on their molars, had molar 308 missing and some sharp edges on their teeth that needed work. Horses teeth are numbered based on location (see the attached photo).  


(photo credit: https://en.wikipedia.org/wiki/Modified_triadan_system ) 



With molar 308 missing, there was no tooth to oppose the maxillary molar (208). This is important in horses because their teeth constantly erupt throughout their lives. Their upper and lower molars will oppose one another and naturally ware each other down through chewing. With 308 missing, 208 grew unopposed and caused some issues with chewing and helped contribute to the horses quidding. With dental care, it can be addressed over time. Quidding can be an issue because it can lead to body condition changes due to lack of nutrition. This can be mitigated by adding a complete feed to the horses diet. While the horse was getting its teeth worked on, the owners wanted the veterinarian to look at a mass on the right inguinal area of the horse. While the veterinarian was palpating it, she put an ultrasound probe on there to see if it was heavily vascularized and to determine if the horse was a surgical candidate. After she was done ultrasounding the mass, she determined that the horse was a surgical candidate and that there may be more than one mass. The horse was sent to surgery the following day. The surgeon successfully removed the mass and identified four more additional masses. We took some samples of the masses and sent them off for further identification. We have yet to hear back on the results and I will try to post them as soon as I find out! Here are some before and after pictures so you can see for yourselves!

Before: 

After:



Another highlight of my week was a castration. There was nothing unusual to note about this castration besides the fact that I got to scrub in! I was so excited. The technicians taught me how to put on my surgical gloves sterilely. Once I had those on I was able to assist the surgeon. I served as the surgical technician by handing the surgeon the tools they needed and assisted during the surgery when needed as well. I was also able to use the emasculators! Emasculators are a common tool used during castrations to remove the testicles. There are two sides to these tools, a cutting side and a crushing side, therefore, it is important to ensure that you place this tool properly. You want to ensure that the crushing side faces away from the testicle (toward the body wall) while the cutting side faces the testicle. This helps to both crush and cut the spermatic chord, arteries and veins that supply the testicles. The crushing action is important because it helps to occlude the spermatic artery and prevents life-threatening blood loss. The surgeon told me that you normally want to hold the emasculators closed (tightly!) for about 2-3 minutes. Once this is done, you can use a Kelly hemostat to hold onto the remaining tissue to check for any bleeders once the emasculators are released. If there is no bleeding present, you can release the tissue. The horse recovered wonderfully and was discharged home two days later. 


The rest of my week consisted of me caring for inpatients. I was responsible for their 8 a.m. and 2 p.m. medications, TPR, feeding, watering, haying and picking stalls. The more time I spend in the hospital the more responsibilities I am given. I am really enjoying the responsibilities that I am given and I enjoy the challenge. I am getting much better with placing catheters, which is great! I have a tendency to rely too heavily on my safety blanket (the techs!) and they are slowly taking it away from me, which is good. This allows me to depend on myself and my intuition, which I am learning to trust. 

We will see what this next week brings me! Good night!


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