Carpentry

Today’s Vet Story is brought to you by Dr Ugg, a newly graduated small animal only vet with a penchant for surgery. Don’t be shy, leave him a comment.

A Hip Replacement as seen by Dr Ugg

A month or two back while procrastinating instead of studying for final exams, I wrote a few paragraphs on surgery and how it’s not that complex. Two weeks ago I started work, and I’ve been scrubbed in on a fairly major surgery: a dog with an infected uterus and breast cancer. It’s not necessarily specialist stuff, but involved. Just gaining a neat closure was a struggle, and I’m rapidly learning about all the little things that were going on that as a student I was unaware of, such as managing incisions early on to your life easier when it comes time to close, making sure your sutures are the same as the other vets in the clinic so clients are happy and have no reason to suspect that maybe one vet had to leave midway and the second half of the surgery was done by another, and the struggles of not having fancy equipment. But I’ve left a list on the boss’s desk and new surgical  toys are starting to appear!

Orthopaedics and surgery in general are areas of interest of mine, particularly as surgeons are the (typically male, slightly egotistic :p ) rock-stars of the veterinary world. There are a lot of problems animals get where medical management will do something for them, but surgical repair or removal is the only real way to go. Unfortunately, many of these have resulted from excessive breeding pressures, either inbreeding or breeding for appearances that just aren’t conducive to life. Other problems may be degenerative, such as cruciate disease.

Just like footy players, skiers etc, dogs can do their cruciate. The have pretty similar findings of knee instability (if the dog will let us prod and poke) and arthritis later in life. Repair of these problems is varied, there are multiple options based on the size of the dog, how active the dog is, how much money can be spent etc, but they’re all aimed at getting stability in the knee again. There is even research being done towards making the exact same repair as is used in people, which should be interesting! I’ve become quite familiar with one procedure in particular for repair, and it became a good training ground for the mindset an assistant should have, in that I became a more active participant, learning the procedure, memorizing what was used and in what order, predicting the next few steps etc. It was as much became a practical lesson in getting a more ordered mind and becoming more methodical with things, which I’m sure will help out in more general ways too as I move into work.

Spinal problems are typically seen in breeds that just aren’t the right shape (such as daschunds, nice as they are), and in older dogs that wear out their back, just like humans. The disc degenerates slowly and bulges out over time, pressing on the spinal cord, or suddenly bursts through, causing bruising as well as compression. It’s pretty straight forward in theory: there’s  a problem with the spinal cord, work out where the problem is, then remove it. Except just like in people, there’s then rehabilitation to help get an effective recovery. These surgeries can be quite nerve-wracking for the surgeons and assistants, because you are going in with a high-speed drill, going through bone and you come out almost blindly through the bone right next to the spinal cord. Things are measured in fractions of millimeters, and tens of thousands of RPM on the drill.  Numbers like that could go very badly very quickly. I’ve been scrubbed in on many of these now, and I don’t think I’ll ever get over it.

Fixing broken bones is a lot like carpentry. Yeah, we might use radiographs or a CT scanner to help you out along the way, and it’s all sterile, but you’re just finding something that’s broken and putting it back together using plates, screws, wire and the like. Power tools are fun J I’ve had the privilege to help with the reduction (term for grabbing the bits of bone and twisting or pulling on them until they line up properly) of a number of fractures, and its pretty strenuous. One that stands out was a large dog with a fracture of the femur, lots of muscle around it. There wasn’t much finesse involved. It was basically two full-grown blokes grabbing the dog through the drapes, one at each end of the leg, and cranking on it to stretch things out enough to realign the fragments.  I was quite thankful for the air-conditioning that day!

Anyway, the world of work is intimidating but fun so far, and I’m sure in the near future I’ll fill another of the dear Dr’s pages with a case or two.