Saturday, July 10, 2010

7/8 – Last day in Small Animal Medicine Ward

7/8 – Last day in Small Animal Medicine Ward

People are starting to get sick. Fortunately, I’m not one of them… (knock on wood). People are starting to get GI upset and today Jen was sick with a fever and was COLD – you’ve got to be pretty sick to actually be cold in this country. She stayed behind at the hostel while the rest of us went to the animal hospital.

As you may have noticed, there are quite a few dogs with distemper here. Since there’s nothing we can do for these animals, the recommendation is to euthanize, since within a few days they will quickly get worse and worse. Dr. Subbiah told us that often owners will not euthanize these animals – whether it is because they have religious objections, want to care the for animal at home themselves, don’t believe the doctors, or can’t afford the 20 or so rupees it costs to euthanize.
Today when we went to the hospital we saw a dog who had been diagnosed with distemper the day before. He had been abandoned at the hospital overnight, through a pretty big rain storm. At first we thought he was just sitting there waiting for his owner to check in, but then Carrie noticed the temporal twitching and asked Dr. Subbiah about it. We then noticed that he was covered in flies and got concerned. Several of us offered to pay for euthanasia, since it was the appropriate and humane action, but the hospital can’t do this because it is an owned animal and they don’t have the owner’s permission, even though it is obvious that the dog was abandoned.

Later when we were in our respective wards Dr. Subbiah came around and told us that they had called the Blue Cross, an SPCA type place, that takes care of these kinds of animals, among other things, like taking in healthy strays. Also, a woman who works at the hospital stood outside, watching the animal. I am not sure if it was for the animal’s welfare or for others, since distemper is spread through body fluids, and if another dog came over to it and was unvaccinated it would end quite badly. By the end of the day (5pm) it was gone.


This is Xene. He has involuntary leg movement, maggots in his paw and above his eye, nephritis, oral ulcers, horrible halitosis, pus in the inguinal area, and leptospirosis. Even if they treat the lepto, he won’t recover from the hind limb movement issues. He was examined in small animal med and then moved to small animal surgery where they did some maggot removal and hopefully fixed up the pussy areas. His prognosis is guarded.

In india, it seems like everyone has a very specific job. Well, there are people whose job it is to simply clean off the tables and wipe the floor if there is a mess.
I honestly don’t see it happen every time, but it certainly happens. They use a bleach solution, especially since they see so much parvo and distemper.

This is Benny:

He had a fever of unknown origin and was just feeling generally cruddy, an ADR (ain’t doin’ right) if you will. I believe they gave him some antibiotics and sent him home.

Next we saw Pinky:

Look at that back! And that wasn’t even the problem. She kept having epileptic seizures so they prescribed Phenobarbital along with another anticonvulsant.

Oh man, this one is a doozie:

This dog had an extremely distended abdomen (ascites). She went for an EKG and was found to have an inverted p-wave which was indicative of premature complexes, which she certainly had. But the p wave wasn’t always inverted and there weren’t consistent VPC’s. A CBC and chem. Were done as well as an echocardiogram. Pretty much everything that could be wrong with a heart was wrong with hers.


(one of the more obvious things you can see is the ruptured chodae tendenae – so at one point in the echo, you can see one of the mitral valve leaflets (the one towards the middle of the heart) flapping backwards.) Also you can see the fluid in the pericardium pretty clearly. Which makes me wonder how much fluid you need to have there to get cardiac tamponade.

Anywho, the next case was a cat who presented with continuous urination and straining to urinate.

The student who was in charge of the case did a cursory PE and then couldn’t figure out what was wrong so he called one of the doctors over. The doctor felt the abdomen, had me feel the abdomen (which was super full of poo) and then asked if I felt it. He asked the student if he had felt the abdomen (which he hadn’t) and then super smacked the kid on the back and called him an idiot. It was kinda harsh but in a tough love sort of way as opposed to a malicious sort of thing. But still... Anyway, the kitten had become impacted and then was actually straining to defecate and so was also straining to urinate. Afterwards the clinician quizzed me on reasons cats get impacted and I could think of 4: improper diet, a mass, foreign body, or some sort of muscular/neurological/nerve damage kind of thing. Apparently there’s another: lack of litter. Cat doesn’t want to defecate so it wont’ and then things get stopped up. Who knew. (though if it was a horse, I totally would have guessed that it was just being stubborn and trying to die, so maybe I should just think of cats as small horses and I’ll do better next time)

Next we had the most typical sort of US private practice case I’ve seen thus far. A little white dog came in because it was semi-reluctant to eat the past four days. Everything else was within normal limits and the dog looked bright and alert. The doctor told the clients to wait and see what happened. All I could think of was that in the US, I think a lot of vets would just prescribe something to make the owner feel better. Plus, then they could take credit for dog getting better. But maybe here with the inexpensive appointment fee, people don’t get as upset when a doctor just tells them to wait it out.

Lastly was a German Shepherd who looked awful!

He is owned by a high ranking official apparently but he was one of the most neglected-looking dogs I’d seen so far. The strays look healthier and cleaner than this dog. He was caked in dirt and mud, had awful otitis – and had an awful head tilt as well as nystagmus. He also had a serious number of maggots in his butt. Poor dog.

Since the owner was someone important, this dog became a VIP-dog. A ton of doctors were swarming and observing his care.

The owner won’t get in trouble for neglect or animal cruelty either. Apparently these laws aren’t well enforced, because the original laws about cruelty are from the mid 1800’s so they don’t often hold up in court. There’s a newer bunch of laws being enacted by some richer people with familial government connections who run an animal welfare group, so I hope those can change some things. This was ridiculous.

At lunch we came home, as usual. I definitely needed dish soap, since I wanted to wash my water bottle out, so I walked to the store. On the way I saw a wedding. Or a least the groom’s family. They were preparing the horse and there was some traditional music and the groom was all dressed up. When I came back from the store he was on his horse and the family was getting ready to go.


That afternoon we saw the end of an orthopedic surgery where they were putting on a hybrid external fixator on a dog’s radius. The dog had an open compound fracture of the distal metaphaseal radius and ulna. It wasn’t a pretty break. They used a linear fixator and a circular fixator. We got there for the end suturing, so we didn’t get to see much. But after that we stood there and talked to another surgeon from ortho about things to see in india. As exciting as it was, my feet were freakin’ killing me from standing there in socks for 2 hours, so I was really shifty and couldn’t stand still or on my heels. Eventually we went home.

We then went shopping, which was fun but by the end I was so dead and tired and my feet super hurt… it wasn’t good. But I did get some nice gifts for people.

The mall!

Stay tuned for my first day in orthopedics – it was awesome!

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