Week 3: Internal Medicine Rotation, Ethics and "Foodieland"
This week was the official start of the “nitty gritty” material. Monday began with a basic anatomy lecture that got everyone up to speed on directional terms and proper orientation. We then pushed through some biochemistry review and finished the afternoon up with a few ethics lectures on the moral status of animals, roles of animals globally, and the human-animal bond. I found it fairly interesting that only 11 states mandate reporting suspected animal cruelty/abuse (California being one of them) and in California, there is immunity against liability. This means that if a veterinarian were to report suspected animal cruelty and the claim proved to be unfounded, the veterinarian would not be reprimanded for reporting the case. The remaining lectures worked through different animal abuse scenarios and solicited tips on how to recognize abuse and ways to report it.
For those of you that are interested in some statistics here is some data on animal abuse*:
· Skull fractures are 15x more common in abuse cases compared to hit by car (HBC)
· Rib fractures (often bilateral) are 4x more common
· Old, healed rib fractures are more common
· Cats are more likely to be abused than dogs
· Small animals are more likely to be abused than large animals
· Young animals are more likely to be abused than old animals
*Abuse statistics were taken from Dr. Barry Kipperman’s slides which drew the information from the article Characterization and Comparison of Injuries Caused by Accidental and Non-accidental Blunt Force Trauma in Dogs and Cats. Intarapanich NP, et al. J Forensic Sci. July 2016
This week we also took a fun dive into genetics and explored a multitude of genetic conditions that commonly affect some of our favorite breeds. Dr. Danika Bannasch, a veterinary geneticist who specializes in canine and equine genetics, gave some incite as to how breeding has impacted the health of our current dog population and also spoke about the potential future of dog genetics. For those of you that are interested in learning (or reviewing) common genetic mutations such as BCAN, VPS11, MDR1 etc. you can download these notes:
Thursday was my first day in the Veterinary Teaching Hospital and I was fortunately placed on a small animal internal medicine rotation! As first-year veterinary students we have two “mini rotation” days per semester where we are randomly placed on a rotation and work alongside a fourth-year student. The internal medicine unit had a packed schedule, and it was exciting to be on a new intake case that presented with a fever of unknown origin. The day was spent running from different imaging suits (radiology and ultrasonography) to treatment and the ward. Our lovely patient was in the hands of some great fourth-years, residents, and an overseeing veterinarian. By the end of the day, he had seemed to have taken a turn for the better and we believed to have found the fever’s origin. Another case we saw was a kitten with FIP who was in for a recheck
appointment and appeared to be responding well to treatment!
Friday started with a lecture on how to approach and work through a clinical case. We learned the DAMNITV scheme and then used it to brainstorm some ideas and come up with a list of differential diagnoses for a case later that day. For those of you interested, here are the components:
D: Degenerative
A: Anomalous (Congenital)
M: Metabolic
N: Neoplastic/Nutritional
I: Inflammatory, infectious, immune-mediate, idiopathic, iatrogenic, inherited
T: Trauma/Toxin
V: Vascular
That afternoon we were presented with a case and worked through it with our small groups. This case involved a horse that was unable to rise. Everything on physical exam was fairly unremarkable besides some muscle fasciculations. We were also given a chemistry panel which showed hyperkalemia, hypocalcemia, and hyperlactatemia. With that information we were instructed to work together and come up with a problem list, differential diagnoses, and a treatment plan. This was a fun way to utilize the DAMNITV technique and come up with some ideas of the potential root cause for this horse’s inability to rise.
The last activity of the day was a critical evaluation of literature workshop. As a class, we went over information on how to properly site medical literature and some important things to note while doing research with the intent on presenting it to a client or fellow colleague. Earlier in the week we had been given a list of topics to choose from and formulate our “professional opinion” while backing it up with scientific evidence. We dissected those topics as a class during the workshop and ultimately came up with the conclusion that each of these controversial issues have more than one correct answer. The key point is backing it up with evidence and clearly communicating the potential pros and cons with the client so that expectations can be managed. I chose the topic based on the efficacy of the Rattlesnake Toxoid Vaccine and whether or not I would recommend it to owners. If you are interested in reading my response, click here.
The weekend was kicked off with a movie night with my housemates. One of our professors had recommended watching the movie Togo during a lecture earlier in the week so we went along with her recommendation and were not disappointed. I was also able to get a solid 42-mile bike ride in and explore some of the country roads around Davis. I can honestly say that I have not ridden in a more peaceful area, and I look forward to exploring more routes!
My housemates and I wrapped up the day by eating some interesting food and deserts at the "Foodieland” festival in Sacramento. All in all, it was a great weekend and Davis is slowly starting to feel more like home!
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