Dear god, I hope that's the last exam I ever have to take. 6 hours of multiple choice questions is TOO MANY. I think it went okay, though- I felt like I knew more than half of the answers, so it could have been worse. Of course, I don't get the result until February, so I'm just going to forget about it until then.
Ugh, my veterinary licensing exam is next week, and I am utterly unable to find motivation to study for it. It covers pretty much everything about every species, which is pretty daunting, but it's almost so overwhelming that I don't feel like spending one more week studying will help with anything. I think if I don't know this by now, I never will, but I'll feel really silly if I don't study at all and then fail the exam :(. I will probably have a major stress attack the day before and wish I had studied more, but eh.
I've been off clinics for a month (since my last rotation was all dead things and lab work) and it's starting to make me crazy.
One of the coolest things I got to see on my last medicine rotation was a bronchoscopy on a dog- basically a tiny camera on a cord fed down through the trachea and in to the bronchi while we watched the images on a screen. It was on a dog with a chronic cough and we wanted to look inside his lungs and take some biopsies. It was really neat to see the branching of the bronchi into the lungs, but the coolest part is watching how everything moved as the dog breathed :). It's really strange to gain as much knowledge of the body as you do in a medicine program; I learned basic organ function in high school, but between my undergrad courses and vet school, I've taken apart pretty much every part of the body, step by step, right down to the cell level (if you count chemistry, then right down to the individual carbons). It's awesome to actually watch those things working from the inside!! It's also a little disturbing to look at something living and be able to dissect it in your head, which I pretty much do all the time now.
Still, lungs are pretty cool.
One of my patients from a couple of weeks ago died this morning :(. I was far more invested in him than most of my patients- he was in the intensive care unit of the clinic for nearly two weeks, and his owners visited every day; I've stayed in touch with them since he went home. His prognosis was always guarded ("guarded" generally means "we don't know what's going to happen, but it's probably not going to be good"), but he had been doing well, and we had hoped he'd last a bit longer. He had some neurologic problems, very likely a brain tumor based on his outcome (we were never able to get him and MRI, so we don't know for sure). I can't help gravitating toward neurologic patients, even though the outcomes are never good. For a little while, I didn't think he'd ever even get out of the hospital, so I'm glad he got to spend a few happy weeks at home, but I'm still pretty sad he didn't get more time.
On the up side, the little husky puppy I had seen with hydronephrosis was back yesterday for a re-check and is doing great, so I was pretty excited about that. She hadn't done well after her first surgery to remove the bad kidney, and her second kidney started to fail. She had to have a second surgery to save it, but it seems to have been successful! I was probably due for some bad news today.
I'm off medicine and on to diagnostics, which is mostly necropsy, so all of the animals I see are already dead. Significantly less depressing, in an odd sort of way.
I have a super crappy case in the clinic right now that has pretty much swallowed my whole week/ weekend :(. It's a really lovely cat with pancreatitis who just doesn't seem to improve no matter what we try. Treatment options for pancreatitis are pretty much limited to pain/ nausea control and the outcome is pretty variable. Some cats do okay, others just waste away and die. I'm afraid that every day this little kitty doesn't improve, she's sliding closer and closer to the latter category. Her owner is a really sweet older lady who's devastated that the cat is sick, but now that this has been dragging for so long, she's starting to worry that the cat will never get better. If this kitty doesn't start eating by the end of the weekend, she's going to need a feeding tube placed to keep her going, and I don't think her owner can financially or emotionally handle that :(. I've spent a really long time with both of them and I just really, really want this case to have a happy ending.
The down side of medicine in a referral center is that nothing comes here that isn't about to die from some horrible disease, since the easy cases just get handled by the regular vets. A lot of our patients have had poor outcomes just because they come in with such critical illnesses. My last two patients were euthanized this week- a six year old cocker spaniel with end stage liver failure (seriously, don't get cocker spaniels. They always end in tragedy), and a beautiful, less than two year old border collie with lymphoma (that one was absolutely awful; the owners tried chemotherapy to get the dog a couple of more months, but he didn't respond). On the upside, I had a puppy go to surgery yesterday to have a kidney removed, and she's doing well, so hopefully I'll have at least one happy ending this week.
I am pretty bad at updating this, it turns out. I guess my last rotation was pretty uneventful anyway (it was radiology- I find x-rays brutally difficult to interpret, but there's not much I can write about them that would be interesting!).
I'm on companion animal medicine right now (ie. cat and dog hospital) which is a little more along the lines of something I will probably do as a career. So far it's going pretty well- I've definitely settled into the routine of the hospital a little and I'm much better at managing my time than I was in my last small animal rotation, so that's helping. Sadly, two of my three intensive care patients coded and died after fairly intense CPR efforts. I guess I'm pretty comfortable with dog CPR now, as a result? This is what I get for grabbing the neurologic cases. Most people are intimidated by neurologic diseases, but I love the diagnostic process involved with them, so I keep volunteering to take them. Unfortunately most of them don't end well and neither of these dogs had a very good prognosis from the beginning :(. Fortunately, my third case is a little puppy with gastroenteritis and he's doing great.
Also, I got a dog! I adopted a teaching beagle from school, since I feel like I owe them something. She's doing pretty well so far! She's very happy to be out of school and in a home :).
So I ended up having a really awesome time on my large animal rotation :). I'm definitely still a small animal person, and I have no interest in practicing horse or cow medicine, but I have to be honest, the small animal hospital at school kind of drives me nuts. It's always a bit of a madhouse, with people and dogs and noise everywhere, and the large animal hospital is just so quiet and relaxed. I really liked being there and I think I'm actually going to miss it (especially the late shifts! There was this one shift from 5-11pm, where the student would be the only person in the hospital. It's actually super relaxing to just hang out there in the middle of the night with a couple of cows mooing and the horses just eating quietly; it reminded me how much I actually do like being in barns). Plus, my absolute favorite clinician was overseeing our rotation, so that helped keep things interesting. I definitely feel waaaaay more comfortable working with horses and doing basic procedures with them, so I pretty much accomplished my goal for the rotation. I even had some patients that I got pretty attached to, so that was progress on the horse-appreciation front (I don't dislike horses at all, I just have difficulty really being attached to them, due largely to the fact that most of the horses I've known up until this point were batshit crazy). I keep ducking into the hospital to check on the patients who are still there :).
I'm on radiology now, which is pretty relaxed. We just take x-rays, then sit and look at them. The small animal clinicians can take there own x-rays if they have to, so it's a 9-5 kind of rotation, with no weekends or on-call. Pretty nice :). I feel like I've definitely improved my radiology skills over the last three years, but I don't know if I'll ever feel really confident with x-rays and ultrasound- it's so hard!! I'm definitely improving with practice, but it's definitely been the hardest thing for me to learn in vet school (broken bones are pretty easy most of the time, but we also look at internal organs on x-ray, which is way less clear-cut).
In super exciting news, I'm moving to a new apartment next week, which means I get to take my dog home soon :D.
I just saw some pictures posted on Facebook of my past junior surgery patient (the medical disaster who had a tumor removed, then subsequently developed a drug-resistant infection and had her whole leg amputated after spending about a month in hospital). It looks like she's doing really well in her new home, so that's pretty exciting news! That poor dog went through so much, I'm glad she got a happy ending!!