S2 Week 18: ADF Lunch Talk, Dr. Carrie Jurney and Parasites!
Updated: May 21
We are officially down to the final week and are charging towards the finish line at approximately 1,000 miles per hour!
This week started off with a hot yoga session followed by a lecture on intestinal tract pathology. We then learned about the mechanisms of infectious diarrhea and the pathophysiology of intestinal obstructions. These lectures were interesting and super applicable because diarrhea and GI upset are common presenting complaint among many patients in a veterinary setting.
That afternoon we had a fabulous lunch talk from Dr. Lilly, Dr. Recker, and Dr. Royal from the Animal Diet Formulator. After explaining their backgrounds in veterinary medicine, they spoke about how ADF has evolved over time and all of the amazing ways that it can be used to help improve the lives of animals through nutrition. The team then walked everyone through a diet formulation example to demonstrate the accessibility of the software. If you are interested in seeing this software in action, check out this post. We were all super lucky to have the ability to learn from them and as an added bonus, all veterinary students get access to ADF for FREE while they are in vet school! Nutrition plays such an instrumental role in the health of our animals and it is super exciting to see the advances that ADF is initiating in the world of fresh-food diets!
That afternoon I met up with my small group and we finished up our third and final case-based learning session for the block. This case was based on a dog with exocrine pancreatic insufficiency which is a disease that limits the production of pancreatic enzymes that are produced and thus the animal is unable to properly digest and utilize the food that it consumes.
That evening, I had the opportunity to officially teach my first lecture for the KLOHC class! I have been shadowing the current instructors for the past few sessions so this time it was awesome to be the one teaching! Since a majority of these students are planning to go to vet school, I gave a lecture on the application process. All of the students were super engaged and a lot of them had really great questions! I have always loved teaching and had the privilege of TAing 17 classes during my undergraduate career so the ability to be able to do this while being in vet school is something that I am truly grateful for!
Tuesday started off with a nice run with Churro followed by another lecture on gastrointestinal pharmacology. We then had an introductory lecture on parasitology followed by one on intestinal fluid and electrolyte absorption. These lectures were all very different which kept the morning exciting.
I then had another opportunity to shadow the legendary Dr. Yamate! The afternoon started off with an incredibly handsome Doberman Pinscher named Drake! Drake is a fan favorite in the clinic so meeting him was comparable to meeting a celebrity. Here is a little background information on Drake... he is 11 years old and in addition to being famous, he was diagnosed with dilated cardiomyopathy five years ago in 2019. According to the literature, dogs with dilated cardiomyopathy usually live 6-24 months past diagnosis1. As you can see, Drake is an outstanding outlier and has been going strong with the help of Dr. Yamate’s treatment and the amazing dedication of his owner! During Drake’s visit he got some electroacupuncture and chiropractic care. He was an absolute angle during his treatments, and it was awesome to see how relaxed he felt in the clinic. After sitting in on his appointment, I definitely can understand why everyone loves him!
Here is some additional information on Dilated Cardiomyopathy
*Dilated cardiomyopathy, like the name suggests, is a disease that causes the myocardium (heart muscle cells) to become weak which may lead to arrhythmias or abnormal heart heats. This causes the heart to lose its ability to contract and pump blood effectively out into systemic circulation. Since the heart is not pumping blood effectively, blood can “back up” in the heart chambers which causes them to dilate (hence the name dilated cardiomyopathy). This dilation can lead to leaky valves which may result in an audible heart mummer. A clinical symptom of this disease is weakness which can be attributed to the reduced amount of blood being pumped throughout the body. Over time, the heart chambers become more dilated and this makes it harder for the heart to pump. The valves in the heart may also become leaky which can lead to fluid buildup in the chest and abdomen which is also known as congestive heart failure. For more information on dilated cardiomyopathy, here is a great resource from Texas A&M College of Veterinary Medicine!
The rest of the afternoon’s treatments involved some additional acupuncture appointments and a laser treatment. All of these patients had unique backgrounds and were benefiting from acupuncture. I think it is easy to associate acupuncture as only being useful for mobility issues but just by being in the clinic with Dr. Yamate for two days, I have seen that literally everyone can benefit from this type of treatment. While acupuncture definitely helps with musculoskeletal issues, it can also help with a variety of other conditions (cancer, neurologic issues, skin issues, etc. the list is practically endless) and it has been amazing to see the patients react to their treatments in such positive ways! Dr. Yamate is so intentional with her care and her commitment to patient wellbeing is remarkable. There are so many of her patients that I have either seen with my own eyes or heard about that frankly should not be alive. Their conditions were considered death sentences with a pretty short timeframe but due to her diligent care and owner compliance, these animals are living much longer, and their conditions are even improving. They have a wonderful quality of life, and they actually enjoy coming into the clinic. It is such an exciting thing to witness and I am so grateful that I have the opportunity to learn from such an amazing person!
Tuesday evening finished up with a nice long walk with Churro followed by some studying.
Wednesday morning began with a hot yoga session followed by a case-based learning session focused on exocrine pancreatic insufficiency (EPI). EPI is a disease where the pancreas is no longer working and since pancreatic enzymes are key for digestion, EPI leads to malnutrition. This disease is more commonly seen in dogs such as German Shepherds and Rough-Coated Collies but can occur in any breed. The underlying mechanism of EPI varies but in young dogs it is commonly due to pancreatic acinar atrophy. This leads to underdevelopment of the pancreases resulting in a deficiency of pancreatic enzymes. In cats, the specific pathogenesis is not completely understood but there seems to be a link between the development of EPI and chronic pancreatitis. With proper treatment and the use of a pancreatic enzyme supplement, many patients with EPI can live a fairly normal life. This session was super interesting and was a fun way to clinically apply the knowledge that we have been learning in the GI block! The rest of the morning was filled with a lecture on parasites specifically focusing on nematodes (round worms) and trematodes (flukes).
During lunch Priscilla and I met with Dr. Stanley Marks to discuss some plans for the Canine Medicine Club. Priscilla and I are the incoming club presidents and Dr. Marks is the faculty mentor so it was great to get together and brainstorm some ideas for the upcoming year! We are super lucky to have the support of Dr. Marks who makes time to prioritizes students even though he is extremely busy (triple boarded, and constantly traveling in and out of the country to speak at conferences). I am super excited to work with this team to execute some of the exciting plans we talked about during the meeting and am looking forward to the upcoming year!
The rest of the afternoon consisted of another parasite lecture followed by a histopathology lab. This lab focused on different pathology of the intestine and was organized into four different stations. These stations were mini case-studies and were a great way to solidify earlier lectures. It was also super fun to be in smaller groups and talk through multiple cases.
That afternoon Churro and I had some solid frisbee time on the field and finished up the night with a long walk!
Thursday started off with a run with Churro followed by a three-hour parasitology lab! The purpose of this lab was to help cement lecture material as well as learn how to perform fecal floats. We used llama feces from our blood donor llamas and were able to see some interesting things under the microscope! The rest of the lab was spent looking at different parasites under the microscope and trying to work through their clinical relevance. This involved understanding their life cycle, the stage that they are infective, and how they infect their host. Another key part of this lab was understanding which parasites are zoonotic meaning that they can infect humans.
Thursday afternoon consisted of a lecture on intestinal motility, the gut microbiome, and species differences in nucleotide salvage. I have always been extra fascinated in the gut microbiome so I absolutely loved this lecture. If you are interested in learning more about the gut microbiome, click here to read my previous post and see the results of Churro's microbiome test!
That evening I had the opportunity to join the Sacratmento Valley Veterinary Association for their monthly CE event. The event was held at Dontello’s Speakeasy and Dr. Carrie Jurney was the presenter! For those of you that do not know, Dr. Jurney is a boarded neurologist (one of only about 300) and is also president emeritus of the non-profit organization Not One More Vet. NOMV is an organization focused on supporting veterinary professions and providing them with resources to address mental health issues. Veterinary medicine professionals have been seen to have a higher suicide risk than the general population and NOMV is determined to provide support to those in need and remind them that they are not alone in their struggles.
Dr. Jurney gave an amazing talk that highlighted some of the key mental health issues in veterinary medicine along with some ways that professionals can cope along with her hope for the future. She shared some personal stories about her own struggles in addition to a lot of eye-opening information. As a neurologist, Dr. Jurney does not have the pleasure of seeing the happy puppy or kitten appointment, all of her patients come into her clinic because they have something seriously wrong. While sharing her personal experiences, she highlighted the importance of developing and maintaining solid coping mechanisms now, while we have the time, because life outside of vet school only gets busier!
I had always been told that veterinarians had a higher rate of suicide than the general public but did not realize that veterinary technicians were just as (if not more) affected, primarily due to low wages. A lot of these paraprofessionals are unable to make a living wage despite working long hours and as a result they have to pick up other jobs or additional hospital shifts just to make ends meet.
The last few things that Dr. Jurney highlighted were from the 2023 Merck Veterinary Wellbeing Study which is a comprehensive veterinary wellbeing study that partners with the AVMA to examine progress made in the areas of wellbeing and mental health of US veterinarians. This is the fourth benchmark study and last year it took a deeper dive into veterinary team members (technicians and office managers). She also touched on the “Big 5” personality traits which is a list of traits that many contemporary personality psychologists believe make up the basic dimensions of personality. These traits are extroversion, agreeableness, openness, conscientiousness, and neuroticism. While it has been shown that veterinarians’ personality profiles are not much different from the profiles of average Americans there was one exception, and it was neuroticism. Veterinarians were seen to have higher levels of neuroticism which means that they may have a greater vulnerability to stress, more experiences of anger, anxiety, sadness, and self-conscious emotions such as shame and guilt2. Out of the Big Five traits, neuroticism was the strongest predictor of wellbeing meaning that those with a higher level of neuroticism had reportedly lower levels of wellbeing. Initially this sounds pretty terrible, especially if you are a veterinary professional, but it is important to take a step back and realize that to some degree, neuroticism can be a beneficial trait as long as it is balanced out with the other traits. Critical thinking, understanding the consequences of your actions, and being realistic are all things that make a good doctor. On a positive note, the trait that they found to be predictive of high levels of wellbeing and low levels of burnout was resilience. This is a trait that we can all work on developing and as a result we can help increase mental wellbeing and resistance to burnout! For more information on this study click HERE!
Friday started off with a hot yoga session followed by a nice swim! We then had a comparative anatomy lab that was broken into three stations. These stations were species-specific and included equine, bovine, and avian gastrointestinal tracts. It was super interesting to be able to physically look through all of these digestive tracts and find the similarities and differences. The rest of the day included one lecture on ketogenesis followed by a three-hour imaging/pathology correlates discussion. During this discussion we walked through eight cases with different diseases involving the liver, spleen, pancreas and gastrointestinal tract. We were first given the signalment and then an ultrasound video of the affected organ. After the video was over, we discussed our potential differentials and then we were given the gross pathology images. This lab was a fantastic way to tie together past concepts and help everyone prepare for the upcoming final exam!
The rest of the day was spent hanging out with Churro!
Saturday morning started with a quick run with Churro followed by a hot Pilates class! My friend Ari joined me, and it was the perfect start to the day! The rest of the day was filled with studying and multiple walks with Churro.
Sunday started off with a nice run with Churro followed by getting some things done around the house. The rest of the day was spent studying and preparing for the last week of school!
Quote of the week: “Don't forget the second part...I'm not much of a surgeon, but I do know that if you don't do the anastomosis it gets referred to me." -Dr. Woolard (pathologist)
References
Freid, Kimberly J et al. “Retrospective study of dilated cardiomyopathy in dogs.” Journal of veterinary internal medicine vol. 35,1 (2021): 58-67. doi:10.1111/jvim.15972
John Volk, Ulrich Schimmack, Elizabeth Strand, Veterinarians’ Personality, Job Satisfaction, and Wellbeing, Advances in Small Animal Care, Volume 4, Issue 1, 2023, Pages 123-131,
I learned a lot in this post. Thank you for sharing!