Saturday, July 10, 2010

7/9 – day one of orthopedics

Today was awesome.
First we saw a dog who had been bitten by another dog. The doctors wanted us to be super hands on so they had us feel the painful joint and learn what we were feeling for. Since there was no joint laxity there was no ligament involvement with the injury. There was soft tissue swelling, but since the dog hadn’t had radiographs yet, we didn’t know where or if there was bone damage. They sent it to x-ray.

Next there was a cat with a head tilt to the left. They had seen the cat a few days earlier with a draining ear infection, so they knew it had otitis. There was no tenesmus. It was on antibiotics.

The following dog was “blacky” a black dog. He had a luxated patella, and wouldn’t use his hind left leg. The patella was luxated laterally, like it had been a year earlier. At that time it had surgery to correct it, and this time they just told the owners to have the dog have physical therapy.

The next dog had some limb swelling.

They had already sent it to x-ray, so it just needed some bandaging to put pressure on it until they got the x-ray films back the next day. I got to bandage it, and did a fantastically awful job, but I think I’m getting better.

There’s no vet wrap here and since they need to conserve resources things are a little different. They use rolled cotton in giant sheets that they unroll about a foot and half from, then tear that piece off. Then separate it into three layers so they get 3x the use out of it (though it’s so thin it rips and you can’t pull it tightly even a little bit) and then roll it up. Then they rip that in half so you have two 6” width rolls. So for bandaging you roll cotton around the injury and then roll gauze (which has definitely been cut from a long sheet of it into strips so the grain is super wonky) and then tie it into place. Then you use tape to cover any random sticking out pieces.

Here’s another bandaging job – this ace bandage was applied on top of everything else for extra support.

This kitty was not well off.

Here was a dog getting his external fixator removed:


Oh, this was a nasty one: this dog was hit by a jeep

He had fractures in his pelvis and femur. Fun.

Here’s the external fixator dog from yesterday. They’re checkin’ his fixator so we’ve got to remove the bandages so they can take radiographs

See all the cotton fluff... that stuff was stuck to his wound… I felt really bad for him, but he’d been given some more pain meds right before radiology so he was pretty chill and not in pain by the time we helped put the bandage back on.

This guy apparently stuck his head in a hole trying to get either a rat or a rabbit (I had trouble understanding the owner) and then got stuck and hurt his neck. Dogs are the same everywhere.

German shepherd with spine injury. If you look where he’s pointing, you can see a shortened vertebral body and bone from the following vertebrae pinching the spinal cord. The dog had no use of his hind limbs. I think he’s being scheduled for surgery later in the week.

This eye isn’t even the main problem.
He’s seizing.

This poor cat. The owner said he’s been like this for a month and didn’t know what happened. He had some sort of head trauma, and the doctor had him wait on the side and I’m not sure if there was anything they could do. But the guy obviously loves his cat a ton. When he was standing up and holding the cat at his side, the cat just started urinating (and the dude was wearing flip flops and his feet got hit) but he was just so concerned about his cat he didn’t even start freaking out about it or anything. I’m not sure what happened with this case.

Afternoon: Since I’d been in ortho that day, they invited me to watch an IM pinning. It was super awesome. Also, everyone else had to go to parisitology and a boring talk about using animals as models for human diseases that was super technical and discussed the topic from a gene level – and it was about mice. I totally got the better end of the deal.
Check out that femur:

Inserting the pin:

Oh, and they went both retrograde and antegrade. It was weird. They went in antegrade, then took it out and went retrograde, and kept putting it in and out trying to get it in the right way. Then they put the other two tiny pins in at angles so it’d be stabilized.

The surgery theater was all grad students (masters in surgery). They had one as the anesthetist, one as the assistant, and three observers (operated the fluoroscopy unit and non-sterile things like the surgeons’s cell phone and the radio playing music... the surgeon’s wife kept texting asking him to pick up their son – mid- surgery... ha!) They were all super nice – the surgeon too – and we talked a good amount during the fidgety part of surgery when they kept having to adjust the pins a bit and check them with the fluoroscopy unit. They all spoke fantastic English because they were all from different parts of india and so didn’t speak the same Indian languages and had to talk to each other in English.

Here’s the dog at surgery. They maintained the dog at a good level of anesthesia (as opposed to a few other surgeries we’ve seen) and everything was very snazzy. Especially the fluoroscopy.

I had a really great time in surgery and afterwards the students offered to take me out to tea. Unfortunately, I had no idea how to get home from the school since we walked there once and always took the van. Since I would have been somewhere else without anyone’s phone numbers I would have been totally lost, so I had to decline. They offered to take our group out sometime though so hopefully we can take them up on it.


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