Barrow Hill Vets – 22nd February 2013

Today was my last day in the surgery and I felt completely happy with the routine of how everything worked. Every 30 minutes or so I checked the washing – taking clean and dry blankets out of the tumble dryer, moving clean and wet washing from the washing machine into the tumble dryer and putting any dirty towels into the washing machine. I knew how to mop the kennels to the expected standard and knew who to ask if I had nothing to do.

This morning, I dressed in scrubs for the final time to watch a dog castrate. This is a very simple and quick procedure which does not even require any stitches. Simultaneously, in the theatre next door a cat castrate was happening which was equally successful. After this, I had the chance to watch another laparoscopic bitch spay. It was good to be able to remember what I saw on Wednesday and helped to ensure that I understood exactly what was happening.

Also in the morning, I went into watch some consults. A couple of clients came in with dogs in need of vaccinations for leptospirosis. Leptospirosis is needed every year whilst hepatitis, parvovirus and distemper virus only need to have boosters every three years. Another dog was brought into the consult to be examined because it was lame. After a number of investigative tests, including bending the leg at the ankle and the knee and noticing for any signs of pain. However, there was no obvious damage so the owners were instructed to let their dog rest and if there was no improvement within a week or so, or any worsening effects, they should bring the dog back in.

After this, a cat which had previously fractured its pelvis, came in for a check up. It had been having cage rest which was the only practical treatment because of the difficulties of the position of the pelvis. Although it seemed to be healing well, it was important to keep an eye on it because of the risk of the canal fusing too small and causing constipation. The cat had not had any bowel movement recently and although this was probably because of the pain caused by the fracture, the cat was given an enema to ease the process. An enema is the procedure of introducing liquid into the rectum and canal through the anus. This means that there is an increased volume so the lower intestinal tract rapidly expands, creating the need for bowel movement. This is much quicker and therefore more effective than a laxative in situations such as these when the vet wanted the cat to keep moving faeces out of its body to help maintain movement and prevent constipation whilst causing as little pain as possible.

On Monday, I saw a fox terrier with a dislocated foot and today I was lucky enough to be able to watch the complex procedure of a tarsal arthrodesis in order to fuse the joints in order to enable it to heal. However, before the process began, an unexpected hazard arose. The dog was given an antibiotic as part of the routine procedure before the risk-filled operation but appeared to be allergic to penicillin. Within minutes of being placed under anaesthetic, the dog’s body was covered in hives. Luckily, this did not effect the surgery or the dog’s health, and a note was made on the dog’s record of the allergy so the same mistake would not be made twice. Although I had to stand outside the theatre, I could observe some of what was happening and I tried to carefully follow the steps in the procedure and the reason for this being done. The vet doing it was a orthopaedic specialist, with extra qualifications in this complex surgery, however it still took a long time. After placing radiographs of the foot on a screen in the theatre, the vet proceeded. The cartilage from the joint was taken out and replaced with bone graft, taken from the elbow. This would then create a length of bone rather than a joint. Screws were then used to hold a plate to secure the tarsal bones in place. This was important to allow the bone graft to be accepted in this position and grow, resulting in healing and fusion. Because of the plate, the foot would remain out the optimum angle for ease of movement when the dog walks. Immediately after surgery, an x-ray was taken to make sure everything was in the right place. Although the vet was unhappy with the positioning of one screw he decided it would be best to leave and allow the dog to wake up as he would have preferred it to be 2mm further from the edge of the bone and this would not be possible because of the existing hole. After this decision was made, the dog’s leg was bandaged using a Robert Jones and the dog was left to recover after a successful operation allowing it continue a happy life on four legs.

Also in the kennels today was a lurcher in for chemotherapy and a jack russel which required a hormone stimulation test because the dog was producing too much adrenaline. In this procedure, bloods were taken then a hormone which should have reduced the amount of adrenaline was injected into the dog. A little while after this, another blood test was taken. The two blood samples could then be compared to establish the effect of the hormone on the levels of adrenaline in the dog’s blood and a suitable treatment could be developed using this information.

Furthermore, there was an investigation into a case of FIP (feline infectious peritonitis) in a cat. This is very hard to diagnose because no specific test has been developed. However, an x-ray was taken and an ultrasound was used to confirm the presence of fluid in the chest and abdomen, indicating the presence of the mutated coronavirus which causes this fatal disease. Unfortunately for this cat, there is very little that can be done to cure FIP and generally a palliative approach is used.

I have loved my week at Barrow Hill Vets and I want to thank everyone there for helping to make my experience as rewarding as it was with lessons being continually learnt which I will take with me in my future explorations in the world of veterinary medicine.

Barrow Hill Vets – 21st February 2013

Today was my penultimate day at Barrow Hill Vets and I was now used to the routine of the surgery. Once again I got a chance to dress in scrubs and go into theatre. I watched a cat spay. This differs to bitch spays because a flank incision is made rather than one on the front of the abdomen. The cat was about six months old which is the normal, and best time, for having a spay done. The cat spay was a lot quicker and seemed much simpler than the bitch spays I had previously seen and this is because of the smaller abdomen, meaning that the uterus can be found more easily.

At the same time that I was watching this, a boxer was also being spayed. As expected, this operation took longer, but everything went smoothly.

After the surgery in the theatre took place, a miniature schnauzer was prepared for a dental. He had seven teeth pulled out but I was told that animals cope well with missing teeth and the schnauzer would have no trouble eating, despite the lack of teeth. The remaining teeth were also cleaned and his beard was brushed back to its full bushiness.

Another boxer was also in the kennels to today, but his older dog was a lot bigger than the young bitch who had been spayed. This dog was being examined for a possible tail amputation. It continually wagged its tail violently which meant that it had wounded itself from constant hitting. The wound would not heal despite the bandaging because the scars would be ripped back open again as soon as the dog’s tail was allowed to wag freely. This is a common problem with dogs and although the decision was made to give the tail one more chance and not amputate it today, I know a chocolate labrador who no longer has her tail and whilst at Kingsnorth surgery, I observed a tail amputation.

Often, animals are brought into consults after emergencies and have to be admitted into the kennels immediately. In the late morning, a cat was brought out from a consult with a large cut on its leg which needed stitching. The skin on this part of the body was very thin so it was a difficult procedure. The bruised skin had to be cut away so that the skin would heal, worsening the difficulties. Before stitching it was necessary to debride the edges of the skin, but today it was done with scissors rather than the scalpel I saw being used earlier in the week. This is because the skin was too delicate and the scalpel would have taken off too much. After lots of cleaning, the wound was stitched into a Y shape. It required internal and external stitches as well as glue to ensure it would heal as quickly and cleanly as possible. Finally, the leg was bandaged so the stitched could not pulled out early, and the cat was left to wake up from the anaesthetic.

During the day, everyone was driven crazy by a golden retriever in the kennels who barked continuously, despite the towel thrown over its kennel. This dog was a guide dog in training. At 18 months old he was living at home before the strict training regime begun at about 2 years. He had been brought in to have his foot examined because he was limping and in pain. After being sedated, he was x-rayed and the examination went underway. The vet told me how she enjoyed these procedures because you never knew what you might find as you prodded and poked. The x-ray showed no breaks or fractures and the vet could not find any thorns or breaks in the skin. However, she did notice that the painful foot had slight swelling and bruising when compared to the other foot. The fact that most body parts come in pairs is very useful for a vet for it means that comparisons can always be made. Eventually it was concluded that it probably a sprained ligament at the base of the pad. The dog would have to rest for a while and it was decided that it was not worth putting on a bandage as it would not stay on for long on such an energetic dog.

I saw this problem of bandages and lively dogs when the cocker spaniel I saw with the broken foot on Monday was brought in for a rebandage after pulling off the original. The spaniel had to be sedated and then had an x-ray just to check that the foot was still aligned correctly, after this a new bandage was put. The type of bandage was called a ‘Robert Jones’, which is a bulky compression dressing using multiple layers of bandage, wrapped tightly around the dog’s leg, ensuring that the bones are held firmly in place to promote the optimum healing conditions.

Today was an interesting day with a mixture of expected and unexpected procedures. Tomorrow is my last day and I will miss being in the surgery but hopefully I will have a positive end to my enjoyable week with Barrow Hill.

Barrow Hill Vets – 20th February 2013

Although today I saw less animals because I did not observe any consultations, what I did see was brilliant. When I arrived this morning, after taking out the rubbish and mopping the kennels, I was told to put on some scrubs to go into theatre. As well as having all my clothes covered, I had to wear a face mask, hair net and cover my shoes. The hygiene required for even entering the operating theatre seemed extreme but I realised that it was necessary when considering the surgery that would be taking place and the dangers associated with the infections which could be passed to an animal. Standing in the preparation room, I watched the nurse scrubbing down the dog ready for surgery. A patch of fur on her abdomen was shaved and cleaned meticulously with hibiscrub disinfectant, starting with a dilute solution and then finishing with concentrated disinfectant. After the animal has been cleaned, it is very important that this shaved area touches nothing. The vet then scrubbed up, washing their arms with disinfectant and rigorously scrubbing their hands. They could then put on a sterile gown and gloves, similarly, they could not touch anything except the disinfected area on the animal. These leaves it up to the nurse to manoeuvre everything else into place and carefully assist the vet where possible. The first operation I saw was a bitch spay which I had seen previously when I did work experience at Kingsnorth Vets. It was a good opportunity to refresh my memory and mentally test myself to see what I remembered. The procedure took about an hour and all went smoothly. As the dog was under anaesthetic, the owners had asked for another procedure to take place. This was the removal of her dew claws. Before the operation, these had also been clipped ready and the vet proceeded to simply remove them. Dew claws have no purpose but can be damaged, especially in a dog like this who lived on a farm. Therefore, they would be easily removed, causing no harm and preventing any future harm from occurring.

After this operation, there was the opportunity to see another bitch spay, but this was going to be done laparoscopically. This is key hole surgery. As the first veterinary surgery in Kent to get a laparoscope, Barrow Hill were very excited with their investment. They give owners the option as to whether they want their dog to undergo keyhole surgery but currently, about 50% do and 50% don’t. Although laparoscopic surgery is more expensive, it is beneficial because a smaller incision is made, the surgery is quicker, the recovery is quicker and the bitch undergoes less pain. Only two vets at the surgery have had training to do keyhole surgery as it is expensive and a procedure needing a lot of skill. I watched from outside the theatre, but this gave me a fantastic view of the monitor on which the camera was feeding to, as well as the dog’s body. In a lap spay, a large patch of fur across the abdomen is clipped. To begin with, a small incision is made and carbon dioxide gas is used to inflate the abdomen of the so that there is more room in which the surgery can take place. Carbon dioxide is used because it will not diffuse into the cells as oxygen would, disrupting the biological function. After this, a camera is placed into the hole and the entire abdomen can be seen. This was fascinating because when you see the inside of a body in a text book, although it is accurate, it is nowhere near as incredible as the real thing. Every organ has its position in the body and all the different tissues are different colours, indicating the differences in blood supply. The most obvious organs were the large liver and the purple spleen whilst if the camera was pointed up the body, I could see the diaphragm contracting, separating the abdomen from the thorax. This gives an opportunity for the vet to check that everything is clean and in order, highlighting any health concerns and ensuring that the operation could continue safely. Next, a similar incision was made further up the dogs body and a trocar and cannula (hollow cylinder with a sharply pointed end) was inserted through which other instruments could be passed. The dog was then tipped into its side, meaning that the other, more mobile, organs would fall out of the way, giving a clearer view of where the uterus would be. Carefully using the camera and instruments, the vet could quickly locate the uterus and, using a grasping instrument, he could grab hold one of the ovaries and pull it up, against the abdomen wall. At this site, a sharp hook could be pushed through the skin and used to hold the ovary against the wall. Cauterising forceps were then introduced through the incision, securing around the base of the ovary and causing it to break away quickly and cleanly. The forceps continued to hold the ovary so the hook could be removed. The dog was then pushed back onto its back and the abdomen was deflated, reducing the pressure. The ovary could then be carefully pulled out from the second incision. Because the dog was now on its back, if the ovary was dropped it could be more easily found, although luckily, all went well. This whole procedure was repeated on the other side until finally the abdomen could be quickly examined for any bleeding, and the camera could be removed before stitching the incisions.

Also in the surgery today was a rough collie who had damaged its leg by having a log dropped on it. This was very similar to the accident which happened to the fox terrier on Monday, but this collie was a lot luckier. The position in which the log had landed meant that little serious damage was done and after a radiograph of the carpal to the elbow, this was confirmed and the leg was bandaged to allow the bruising to heal with no further risks. Whilst under anaesthetic, the dog also had a dental in which all the teeth were cleaned and several were removed.

Although many procedures are very different in dogs and cats, on of the most similar operations which takes place is a dental. Although the mouths of a cat and a dog are different in terms of the size of their teeth, they both have jaws of a carnivore and both encounter the same dental problems. I could observe these similarities when, shortly after the dog dental, a cat also had a dental. Similarly, all the teeth were cleaned and several teeth were removed. However, the cat’s mouth was in a worse condition than that of the dog because the cat already had some teeth missing and had slight gingivitis in its gums.

Although very little happened today, my experience in the theatre and dressing in scrubs was both fun and fascinating.

Barrow Hill Vets – 19th February 2013

Today was my second day of work experience at Barrow Hill Vets, and after an enjoyable day yesterday, I was looking forward to what the day would hold.

One of the services offered by Barrow Hill Vets, as a large and influential vet surgery, is the Wye Community Vets. This happens every Tuesday when one of the vets goes on home visits around the village of Wye. This is free and ideal for elderly clients who don’t have the opportunity to bring their pets in, owners with lots of animals who spend a lot of money and time on visiting the vets, as well as owners with animals which are terrified of the vets and it is more convenient for the vet to come to the pet than the pet to be forced to the vet. I was thrilled when I was offered the opportunity to accompany the vet on her home visits. On the short drive up to Wye, it gave me a really good chance to ask questions about applying to do veterinary medicine at university as well as hear about some of the controversial issues surrounding veterinary medicine and how it is possible to overcome these in practice.
The first house we visited was a farm with a lady who owned two Labradors. This is where I saw the problems which accumulate with age. The Labradors were suffering with arthritis, making it hard for them to move around, however these problems were being addressed. The dogs were regularly attending hydrotherapy sessions in which they could swim, strengthening muscles and maintaining fitness without exerting there painful and stiff joint by putting weight on them. The owner described these sessions as being very successful because the dogs loved being in the water. I keeps them fit and healthy which essential in any step towards treatment. In addition to this, the dog with more severe arthritis was being prescribed metacam as a painkiller, enabling the dog to enjoy more movement with less pain. But in addition to this, research has shown that metacam is a good anti-inflammatory and therefore a very positive approach to dealing with arthritis, killing two birds with one stone. As well as this, the vet started suggesting that the dogs could take part in a trial of Hills JD Prescription Diet which has a high omega-3 content and previous research suggests that it helps to reverse the effects of arthritis. This was going to be a large scale investigation into the effects of this food across many different dogs to see if it had large scale impact in revolutionising arthritis treatment.
In addition to arthritis, old age brings difficulties with weight and in turn this can cause the occurrence of lipomas, or fatty lumps. These are tumours of fat cells, found just under the skin. They are easy to remove by surgery, although this is often not necessary. Commonly, fatty lumps are benign, meaning that they are only locally aggressive and therefore present no threat to the general well-being of the animal. However, occasionally they are malignant and can spread to other parts of the body, becoming cancerous and dangerous. In these cases, they must be removed.

After this farm house, we drove to a neighbourhood of tiny bungalows. After meeting the elderly owner in her wheelchair about to leave the house she told us that her husband was in the house. The vet warned me that her husband was blind but it did not prepare me for the house we were about to enter. With five cats and a dog, the house was dirty and smelly with the animals living in poor housing conditions. After trying to catch a few of the cats to inspect them, the vet explained to me that they had had many problems but this was just a general check up. The couple evidently loved their animals, as I saw when the man held his cats, identifying them by touch alone. It made me sad to realise that people and animals lived in such conditions, but also I saw the love people have their animals, and having sacrificed their house to their pets they loved them all the more. This is why the Wye Community Vets project is so important. It gives a helping hand to the people and pets most in need of a little extra support and keeps an eye on everything to check all is well.

Back in the surgery I had a chance to see what had been happening. A dog was in the x-ray room undergoing a sinography. This is where a radiopaque liquid is injected into the sinus. However, in this case, the liquid was injected into a lump on the dogs head. It then had an x-ray to ensure that the lump did not protrude into the head meaning that the brain could be damaged during surgery to remove the lump. Luckily, the radiograph showed that the liquid did not enter past the skull and therefore it was safe to proceed with surgery. As I looked on from outside the theatre the vet told me that it looked like the skin had grown inwards for a reason unknown when the dog was a puppy. In this procedure it was even more important than normal to flush out the wound thoroughly because there was hair inside the lump. Although it was a complicated operation to unfold the skin and make sure it was thoroughly removed, it was successful.

Also in the kennels was a saluki cross dog. It had been having lots of fits and with nothing striking indicating why it was having these seizures, various tests were being done. Although it had been determined that it was not epilepsy, the cause was still unknown.

During the afternoon, a cat was rushed out back from the consultation. It had possibly had an ‘RTA’ (road traffic accident) but this was only a guess as the owners had found the cat like this. It had a large wound which was possibly a few days old. It needed to be cleaned and stitched but the cat was distressed and not willing to be injected with an anaesthetic. This is when I first saw the contraption called a crush cage. The sprawling cat put in the cage and one side of the cage was pushed inwards forcing the cat to be crushed, motionless, against the other side of the cage. This gave the opportunity for the vet to safely inject the cat so it could drift off. Although this looked cruel, I realised that this was the safest way for both the vet and the cat. A vet trying to inject a distressed cat is likely to get scratched and bitten whilst the cat becomes more worried, all the time with the problems worsening and the wound not being healed. Once under anaesthetic, the site of the wound was shaved then disinfected with hibiscrub. The wound was opened up and flushed with saline which acts as a disinfectant, ensuring that any exposed areas are clean and will not become infected. After this, the skin around the wound was debrided using a scalpel meaning that there was a fresh site on which healing could take place. These two freshly bleeding sides were then stitched together and the cat was left to wake up.

This morning, a cat that I saw in a consultation yesterday was brought in to be examined more closely. It had been brought in by its owners because they were worried as to why their cat had stopped miaowing. After being placed under anaesthetic, the larynx was carefully inspected and it was concluded that it was fine. However, as the cat was under anaesthetic, it was decided by the vet and owners that it would undergo a dental. During this procedure, ultrasonic vibrations were used to remove tartar, preventing the risk of the gum disease gingivitis. Although many owners may brush their pets’ teeth, this only removes plaque and not the tartar which results from a build up of plaque. After the teeth have had as much tartar as possible removed, they are then polished, removing any scratches which could prevent an environment for bacteria.

During the day, I saw lots of animals come round from anaesthetic. When the animals are waking up, the nurse always sits with them. This is because it is necessary to make sure that the animal safely comes through the anaesthetic without needing an additional injection to wake it up, but also because the pipe in the trachea needs to be removed. It is interesting to see the recovery of different reflexes in an animal and how this determines when the windpipe is removed. The blink reflex wakes up before the swallow reflex and therefore it is important when waiting for a cat to wake up that the pipe is removed when the blink reflex returns. This is to ensure that the pipe is removed before the swallow reflex returns because of the sensitivity of the larynx. In dogs however, the pipe is never removed from the trachea until the swallow reflex is heard, ensuring that the dog is awake enough to safely return to consciousness.

Once again, today was very interesting, but what struck me most was the importance of a vet within their community as I saw from the Wye Community Vets. It has made me resolve to become a vet not for my own love of animals but for benefit of those less fortunate than myself who are dependent on their animals for love, companionship or a livelihood.

Barrow Hill Vets – 18th February 2013

Today was my first day at Barrow Hill Veterinary Hospital on a work experience placement lasting 1 week. I am working from 9.00 am until 4.00 pm, allowing me to gain the view of an average working day of a vet. A few weeks ago I had an induction session and a surgery tour in which I was shown around and some general rules were considered. During this time I was able to compare Barrow Hill Vets, Ashford, to Cinque Ports Vets, Kingsnorth, where I did work experience last year. The first thing that struck me was the difference in size between the two surgeries. Barrow Hill was a lot bigger and as a result, calls itself a veterinary hospital, whilst Kingsnorth is only a centre. At Barrow Hill, there is separate accommodation for dogs and cats with air conditioning, and although these rooms are smaller than the kennels at Kingsnorth, the blood tests and other small procedures are completed in the very large prep room, rather than the kennels. In this prep room, there are three tables and endless storage space providing opportunity to complete dentals and cat castrations as well as the routine blood tests etc. At Barrow Hill there are two operating theatres and an imaging room for ultrasound and chemotherapy. Both Kingsnorth and Barrow Hill have an x-ray room, which are very similar. Interestingly, Kingsnorth has a larger staff room. Despite these differences, including the more staff at Barrow Hill, I don’t pass judgement as to which is better for they both accommodate similar services and use the site they have to their greatest advantage. Most importantly, they both have brilliant morals behind what they do and an excellent team of staff to ensure that everything is done considering both the animal and its owner.

I had a chance to watch some consultations both this morning and this afternoon, observing different vets. I could see some differences in how they worked, especially in their interaction with the client, but overriding this, I could see the similarities in how they affectionately treated all of the animals, encouraging the owner to have pride and love for their pet. I first saw two cats and a dog having routine vaccinations. Dogs should be routinely vaccinated against:
•Canine parvovirus
•Canine distemper virus
•Infectious canine hepatitis
•Canine parainfluenza
Whilst cats should be regularly vaccinated against:
•Feline infectious enteritis
•Feline herpes virus
•Feline calicivirus
•Feline leukaemia virus
It was brilliant being able to compare the fuss humans make at having injections to simple naivety of the animal who has not a care in world as to the needle being stuck in their back.

A dog was brought in who had being having occasional seizures in which his front leg would freeze until this would shake down to the back leg. We were told that it had been having them about twice a day with no obvious indicators as to what caused them. However, the vet reassured the owners that random was almost a routine in itself. It is really hard diagnosing problems such as these as the pet rarely shows symptoms at the vet, so the owners were told to try and film the seizure when it next happened as well as keeping a diary as to possible connections which could be associated with them happening. This could give the vet a clue as to whether it is muscular or neurological and depending upon this, the right course of action can be decided on.

Next, a cat with a limp was brought in. After feeling the leg and paw, the vet decided that it had broken its toe as she could feel the two pieces moving within the foot. The owner had two options as to what could be done and although this is initially their decision, I could see the way in which the vet presented the two ideas was leading so the most appropriate option would be chosen. The first option was for the cat to have an x-ray so that the break could be confirmed and the alignment would be known. If this was out of place, it could be operated on to insert a screw to hold it in place and aid healing. However, this would be very expensive and as most owners are cost concerned, the second option was chosen as the vet advised that it could be perfectly adequate. This was to leave the toe untouched, give the cat metacam as a painkiller and ensure that it is kept indoors and left quietly to heal by itself. In a situation such as this clean break of one toe, it is unnecessary to do expensive and time consuming procedures.

The last consult of the day, was a cat brought in because it had stopped miaowing. A cat miaows using its larynx, but this could not be easily seen whilst the cat was conscious and fidgeting. Therefore, the owners have to admit it to the hospital tomorrow. During the time it is in the surgery, it will be put under anaesthetic so that the larynx can be sufficiently examined. If the larynx looks abnormal, a swab will have to taken and sent to a laboratory for investigation. Although this will give results as to whether it is cancerous or not, it will not be very reliable. This is because the sample is too small to be a valid representation of all the cells in the larynx, however there is nothing more that can be done a the larynx of a cat is too small to have a biopsy taken from it, which would be the chosen and most reliable method in other areas of the body. The vet explained to me afterwards, the importance of weighing up the cost and implications of obtaining a diagnosis and the cure which will be able to result from this. For example, if the examination of the larynx was not conclusive, more procedures could be carried out. But these would be very expensive and potentially dangerous. If the only information which was obtained was that the problem was superficial, it would be a waste of time, money, and most importantly, it would unnecessarily put the cat’s life at risk as the cure would be no different to if these procedures had not been carried out. This cat also needed a dental, which will be carried out tomorrow if no swab is taken from the larynx, for a cat’s larynx is too sensitive for any other procedures to be carried out once it has been touched.

A boxer had been in a road traffic accident, though luckily it was not too hurt, with only a few cuts and bruises which although would have been painful they will heal quickly. The cuts were cleaned thoroughly using hibiscrub (skin disinfectant used for many purposes throughout the surgery) and the dog was given medicam as a painkiller to help the dog recover as quickly and as comfortably as possible.

One of the most enlightening patients in today, was a fox terrier whose foot had been stood on accidentally. It was in to be sedated and x-rayed. It was found that the metacarpal bones had all become dislocated from the dog’s ankle. This was a serious incident and meant that all the ligaments would also be torn through and the foot would not heal itself. This left the vets with only the choice to operate, with the easiest option being to amputate the leg from above the knee. However, alternatively, a complex operation could be undertaken to fuse the bones in place meaning that although the joint would not work, the dog would adjust and learn to walk ably again. But this procedure would be very expensive as the dog was not insured, it would also have many risks associated to it and be a very long operation. Contrary to the beliefs of the vet, when the owner was phoned they proclaimed that they would rather the dog was euthanized than three-legged, this was because of the sadness they would feel at seeing their dog without a leg, and knowing that it was because they had stepped on it. However it was only an accident and many of the vets admitted that they had trodden on animals many times. This lead the conversion on to a survey done in America where over 60% of people with three-legged dogs had been confronted in public as to the cruelty they were putting their dog through. Nevertheless, all the vets agreed that young dogs, such as this 18 month old fox terrier, coped extremely well when missing a leg, especially if it was a hind leg – and it was. After consideration, the owners decided that they would pay for the long and complicated operation as they believed that this would give their dog the best quality of life. This causes me to question opinions of amputations and what it is best for the dog, owner, and vet in a situation such as this.

A very similar accident happened to a cocker spaniel in which a log was dropped on its foot. But luckily the break was lower down and meant that the bones had not dislocated and the ligaments were less damaged. The foot would heal by itself, however, it needed bandaging. This would be done every two weeks although the dog would have to be brought in every week to have the wound checked. This is because when cuts and grazes are covered for long periods of time by a bandage, they can become easily infected without anybody realising, leading to many more problems.

During today’s events I saw how much harder cats are to work with than dogs. This was clearly seen when a cat needed dematting. Its fur was in a terrible state because of its thick density. The owner had been brushing it but only the very top and because there was just so much of it, the cat could not keep itself groomed, and neither could its owner. This cat hadn’t visited the vets for a year, and during this time its fur had become one huge mat, covering its entire body. It was so great that when holding on to the cat’s ‘leg’, I suddenly realised that this was a mat, not a leg. As the vet tried to shave off its fur with a nurse clinging on to the cat, it became more and more stressed. For every 10 minutes it was groomed, it had to be left for half an hour to recover. They realised that this procedure could not be completed in one day with a cat of this temperament. Therefore, it either had to be given many ‘minors’ over a series of days, or be sedated and given a ‘major’, in which all the fur which needed removing would be done so. From this, I was able to see the need for sedatives in animals and how this contrasts so greatly to the use of them in humans.

An English Bull Terrier was in the kennels who was suffering with mange. To treat this he had to be given a minimum of four baths in a chemical which kills the mites, once every week. This chemical was very dangerous and although I was not allowed in, I could see the precautions the vet and nurse had to take, dressed in disposable aprons to cover their entire bodies and masks covering their face and hair. On asking, I found out that a dog with mange can have up to 6 baths in total and it is important to take a skin scrape before stopping the treatment to ensure that there are no mites left. If there were mites left which caused the mange to worsen again, the whole process would have to be repeated from the beginning once again.

Also in the kennels was another terrier but this was a Staffordshire Bull Terrier, renowned for their fighting personalities cultured through English history, this dog, although mild and friendly, proved that some of these connotations are true. This dog lived with her son and although they had had many scraps in the past, this was by far the worst. Having been brought into the surgery yesterday, she had sutured scars covering her body. She was exhausted and could hardly move so was attached to an intravenous drip in an attempt to keep her alive and recovering. However, if she did not improve she would have be put down.

Although during parts of the day, the surgery became very quiet with few consultations and surgery finished, everyone always has something to be doing. This gave me the opportunity to accompany a nurse in one of her jobs. This was the first time I had seen inside a veterinary laboratory, and although it was on site so it was very small, it was fascinating. Its primary purpose was analysing blood samples which I had seen taken during the day. To begin, the test tube of blood was put into a centrifuge which spun it very quickly until the plasma separated from the red blood cells. The plasma was a pale yellow colour which is surprising as it makes up the liquid of blood, but actually the red colour comes from the pigment haemoglobin, used to transport oxygen around the body in the red blood cells. Two different machines were then used, with probes being placed in the plasma, testing for the amounts of a variety of minerals and substances. It astonished me just how many different mineral ions we have in our blood and how the imbalance of any of them can be potentially fatal. For the cat whose blood this was, the only indicator to why it was ill was a high white blood cell count. This suggested that it had an infection and as a response, its body was fighting the infection by producing more white blood cells. This was positive news as an infection could be treated with antibiotics, and the information gained from the blood tests assured the vets that there was very little other concern.

Another piece of interesting equipment I saw today was an ultrasound machine. By emitting ultrasound waves and detecting the reflections, this machine can construct an image of the inside of the animal’s body. Ultrasound is reflected at boundaries between different density media so the time the wave takes to be partially reflected is recorded and because the speed of the ultrasound wave is known, the distance these boundaries between media are from the transducer can be calculated, forming an oscilloscope which in turn constructs the image. With the use of saline gel, the air boundary between the emitter and the dog’s skin does not reflect back all of the ultrasound, meaning that we could see inside the sedated dog’s chest to observe what was causing the heart murmur, heard through the stethoscope. Using the ultrasound, the vet revealed that there was a leak in a heart valve. This meant that whenever the heart contracted, there was a high pressure jet of blood going from the left ventricle to the left atrium, which the valve should have prevented. With this knowledge, the vets could consider what to do. However, with heart surgery not at a pinnacle in veterinary medicine, there was very little that could be done to cure the heart murmur and as a result the dog would suffer with a weak heart and increased risk of heart failure.

I have really enjoyed today, and with so much happening, it has been brilliant to document it and save everything that I have learnt.