"What do you like to do outside of school?"
Regardless of what you may hear, vet students don't spend every waking minute either at school or studying. You just CAN'T. You'd burn out and/or go postal before the end of first semester. Sure, we study a lot. We spend a lot of time at school. I have had 12 hour days at school and that was before adding on any extra studying I had to do that night, and I'm not even on clinics yet. So what do we do to retain our sanity? We must have other interests, right?
Well DUH.
I'm probably one of the biggest nerds you'll ever meet. Science fiction, fantasy, video games, I'm a massive Japan-o-phile (in case previous posts haven't tipped you off). I'm not a huge table-top game person, mostly because I suck at them (Who has two thumbs and could lose to a toddler at Settlers of Catan? This girl.)
Doctor Who and Orphan Black (Season 2 April 19!!) take up way too much of my time. I have not one, but two sonic screwdrivers. And I currently have a Tuesday night date every week with Face Off on Space (the Canadian version of SyFy). I'm always glad that exams end as the summer blockbuster season is ramping up. Captain America: The Winter Soldier, Guardians of the Galaxy, X-Men: Days of Future Past, The Amazing Spiderman 2... I will manage to fit in all of these around clinical rotations somehow.
I've actually lost track of how many anime/manga series I've followed through my life. It started when I was a little kid, though I didn't know that's what it was when I was watching Astro Boy. Then Sailor Moon (which I would end up re-watching as an adult to catch all the stuff that was horribly edited out), and in no particular order: Pokemon, Digimon, Mobile Suit Gundam Wing (don't judge me), Tenjou Tenge, Outlaw Star, The Demon Ororon, Chrome Shelled Regios, Darker than Black, Devil May Cry, Princess Mononoke, Yu-Gi-Oh, and most recently, Shingeki no Kyojin/Attack on Titan. I'm probably missing some in there too, but those are the ones that immediately come to mind. Because there's nothing like watching people get devoured by huge titans to remind you that maybe studying chicken viruses isn't so bad.
Addition Japanese obsessions: cosplay, geiko and maiko, food, kimono (I own 10, I think), lolita fashion, J-pop and J-rock, and I own a cheap katana.
Lest you think I'm a typical pasty stuck inside gamer geek (okay, I am pasty...), I am reasonably active. I've been running since December, and I'm doing my first 5k in April, and I've been an avid horseback rider since high school, though sadly separated from my horse since vet school started. I don't play hockey, but I do watch it. Go Penguins!
As you can tell from my blog background, I love the sea. Tall ships, pirates, anything to do with the sea-faring days of yore. I grew up on the Atlantic surrounded by that and I can't imagine living somewhere that I couldn't drive to the ocean in a couple hours.
Finally, as many of my classmates can tell you, I bake. Usually while I'm procrastinating.
Thursday, March 20, 2014
Saturday, March 15, 2014
BToW: The Importance of Diagnostics
"What has been the most interesting case you have seen?"
I'm actually going to talk about my own dog here. 1) Because I can tell you everything without running afoul of confidentiality stuff and 2) because her case nicely illustrates why your vet wants to spend more of your money on things like bloodwork. For all you vet students and/or pre-vets and/or armchair vets, here's your case!
So, meet Baby.
June 2012:
Signalment: 13 year old female spayed Valley Bulldog.
History: Presented for a geriatric pet wellness exam. Lives with an indoor/outdoor cat. No real complaints from owners. Eating, drinking, urinating and defecating normally. Eating a grain-free store bought dry diet, some table scraps. Vaccines not up to date, had her puppy series, but nothing since. Dewormed a few times a year. Dog aggressive, kept away from other dogs at all times, except for an occassional visit from with the owner's daughter (my sister) who has a 2 year old Chihuahua, who is up to date on vaccines.
Physical exam findings: Good condition, 18kg, not over or underweight, some dental calculus, some dandruff, heart and lung ascultation normal, TPR normal. Mild opacity in eye but doesn't seem to cause problems (probably normal age related change and not cataracts.) Slight pot-bellied appearance, but she's a bulldog.
Owner's daughter is a vet student (c'est moi, duh) and wants a geriatric blood panel done. Results below with normals in parantheses)
WBC: 8.68 x 10^9/l (6-17)
LYM: 1.46 x 10^9/l (1-4.8)
MON: 0.46 x 10^9/l (0.2-1.5)
NEU: 6.50 x 10^9/l (3-12)
EOS: 0.18 x 10^9/l (0-0.8)
BAS: 0.08 x 10^9/l (0-0.4)
LY%: 16.8% (12-30)
MO%: 5.3% (2-4)
NE%: 74.8% (62-87)
EO%: 2.1% (0-8)
BA%: 0.9% (0-2)
RBC: 5.98 x 10^12/l (5.5-8.5)
HGB: 15.5 g/dl (12-18)
HCT: 43.25% (37-55)
MCV: 72 fl (60-77)
MCH: 26 pg (19.5-24.5)
MCHC: 35.9 g/dl (31-34)
PLT: 406 x 10^9/l (200-500)
ALB: 48 g/l (25-44)
ALP: 964 U/l (20-150)
ALT: 154 U/l (10-118)
AMY: 793 U/l (200-1200)
BUN: 7.4 mmol/l (2.5-8.9)
CA: 3.15 mmol/l (2.15-2.95)
PHOS: 1.68 mmol/l (0.94-2.13)
CRE: 87 umol/l (27-124)
GLU: 5.4 mmol/l (3.3-6.1)
NA+: 144 mmol/l (138-160)
TP: 75 g/l (54-62)
GLOB: 27 g/l (23-52)
A few abnormalities. The big glaring one is the ALP. She's not on steroids or anti-convulsants, she's certainly not a young growing animal, so the other big differential is hyperadrenocorticism (Cushing's). It sort of fits with her bad skin and pot-belly and with the old female signalment, but she's not the classic polyuric/polydipsic Cushing's dog. The monocytosis could be due to that too, but with no lymphopenia, we can't call it a stress leukogram (most offten associated with stress, or with steroids whether exogenous or endogenous).One of the biggest causes of high calcium is humoral hypercalcemia of malignancy; basically some tumors have this weird ability to secrete something called parathyroid hormone related protein (peptide? something that starts with p). The parathyroid gland takes this as a signal that the body is low in calcium, even though it isn't. So it increases calcium by taking it from the bones. One of the most common types of tumor that does this is perianal gland adenocarcinomas. A rectal exam was done, with no masses found.
The rule is, if you don't have a strong suspicion of Cushing's don't test for it, due to the high rate of false positives and the cost of testing. Baby's owners are told to watch for signs and bring her back if they see other signs. Until then, she's put on an EFA supplement to manage her skin problems.
December 2013:
Baby comes back, this time with a presenting complaint of (you guessed it) polyuria and polydipsia. She'd happily drain the bathtub if you let her and her urine looks basically the same coming out as going in. Could be diabetes mellitus, could be a progression of her suspected Cushing's. Oh, and she's had a couple episodes of impacted anal glands. Vet knows that money is a concern and provided the bloodwork doesn't show anything else weird, he's willing to start her on trilostane or mitotane for the Cushing's without doing all the expensive hormonal testing, since vet student daughter is home on winter break and can be in contact with him every few days and monitor the dog closely.
The bloodwork shows no diabetes mellitus, but does show the calcium is high; higher than it was a year and a half ago. It's now at 3.5. Vet does a rectal exam and... there's a small mass.
Given her age, the owners opted for palliative care and treating her polyuria/polydipsia with furosemide to bring the calcium down. She got a few more good weeks, and was euthanized in early February 2014.
The moral: Do the diagnostics. They aren't just to run up the bill.
I'm actually going to talk about my own dog here. 1) Because I can tell you everything without running afoul of confidentiality stuff and 2) because her case nicely illustrates why your vet wants to spend more of your money on things like bloodwork. For all you vet students and/or pre-vets and/or armchair vets, here's your case!
So, meet Baby.
Signalment: 13 year old female spayed Valley Bulldog.
History: Presented for a geriatric pet wellness exam. Lives with an indoor/outdoor cat. No real complaints from owners. Eating, drinking, urinating and defecating normally. Eating a grain-free store bought dry diet, some table scraps. Vaccines not up to date, had her puppy series, but nothing since. Dewormed a few times a year. Dog aggressive, kept away from other dogs at all times, except for an occassional visit from with the owner's daughter (my sister) who has a 2 year old Chihuahua, who is up to date on vaccines.
Physical exam findings: Good condition, 18kg, not over or underweight, some dental calculus, some dandruff, heart and lung ascultation normal, TPR normal. Mild opacity in eye but doesn't seem to cause problems (probably normal age related change and not cataracts.) Slight pot-bellied appearance, but she's a bulldog.
Owner's daughter is a vet student (c'est moi, duh) and wants a geriatric blood panel done. Results below with normals in parantheses)
WBC: 8.68 x 10^9/l (6-17)
LYM: 1.46 x 10^9/l (1-4.8)
MON: 0.46 x 10^9/l (0.2-1.5)
NEU: 6.50 x 10^9/l (3-12)
EOS: 0.18 x 10^9/l (0-0.8)
BAS: 0.08 x 10^9/l (0-0.4)
LY%: 16.8% (12-30)
MO%: 5.3% (2-4)
NE%: 74.8% (62-87)
EO%: 2.1% (0-8)
BA%: 0.9% (0-2)
RBC: 5.98 x 10^12/l (5.5-8.5)
HGB: 15.5 g/dl (12-18)
HCT: 43.25% (37-55)
MCV: 72 fl (60-77)
MCH: 26 pg (19.5-24.5)
MCHC: 35.9 g/dl (31-34)
PLT: 406 x 10^9/l (200-500)
ALB: 48 g/l (25-44)
ALP: 964 U/l (20-150)
ALT: 154 U/l (10-118)
AMY: 793 U/l (200-1200)
BUN: 7.4 mmol/l (2.5-8.9)
CA: 3.15 mmol/l (2.15-2.95)
PHOS: 1.68 mmol/l (0.94-2.13)
CRE: 87 umol/l (27-124)
GLU: 5.4 mmol/l (3.3-6.1)
NA+: 144 mmol/l (138-160)
TP: 75 g/l (54-62)
GLOB: 27 g/l (23-52)
A few abnormalities. The big glaring one is the ALP. She's not on steroids or anti-convulsants, she's certainly not a young growing animal, so the other big differential is hyperadrenocorticism (Cushing's). It sort of fits with her bad skin and pot-belly and with the old female signalment, but she's not the classic polyuric/polydipsic Cushing's dog. The monocytosis could be due to that too, but with no lymphopenia, we can't call it a stress leukogram (most offten associated with stress, or with steroids whether exogenous or endogenous).One of the biggest causes of high calcium is humoral hypercalcemia of malignancy; basically some tumors have this weird ability to secrete something called parathyroid hormone related protein (peptide? something that starts with p). The parathyroid gland takes this as a signal that the body is low in calcium, even though it isn't. So it increases calcium by taking it from the bones. One of the most common types of tumor that does this is perianal gland adenocarcinomas. A rectal exam was done, with no masses found.
The rule is, if you don't have a strong suspicion of Cushing's don't test for it, due to the high rate of false positives and the cost of testing. Baby's owners are told to watch for signs and bring her back if they see other signs. Until then, she's put on an EFA supplement to manage her skin problems.
December 2013:
Baby comes back, this time with a presenting complaint of (you guessed it) polyuria and polydipsia. She'd happily drain the bathtub if you let her and her urine looks basically the same coming out as going in. Could be diabetes mellitus, could be a progression of her suspected Cushing's. Oh, and she's had a couple episodes of impacted anal glands. Vet knows that money is a concern and provided the bloodwork doesn't show anything else weird, he's willing to start her on trilostane or mitotane for the Cushing's without doing all the expensive hormonal testing, since vet student daughter is home on winter break and can be in contact with him every few days and monitor the dog closely.
The bloodwork shows no diabetes mellitus, but does show the calcium is high; higher than it was a year and a half ago. It's now at 3.5. Vet does a rectal exam and... there's a small mass.
Given her age, the owners opted for palliative care and treating her polyuria/polydipsia with furosemide to bring the calcium down. She got a few more good weeks, and was euthanized in early February 2014.
The moral: Do the diagnostics. They aren't just to run up the bill.
Thursday, March 6, 2014
BToW: Why I chose the Gentle Island
"How did you choose which school to attend? What things do you like and dislike about your school's location?"
Well, I didn't. The system in Canada is a little different from in the USA. There's only 5 colleges in Canada and one is francophone. The system is strictly regional. In the USA, many (all?) schools take out of state students. They have a smaller chance of getting in compared with in state and they pay higher tuition, but they can apply. In Canada, you can't. If I were to apply to Saskatchewan, or Alberta, or Ontario, as far as I know, they wouldn't even look at my application. This was very frustrating after my first rejection from AVC; I can't tell you how many people told me to apply to Ontario.
There are other options; we can apply to any American school and the overseas ones (Edinburgh, Dublin, etc) and the caribbean schools. But you need seriously deep pockets. In the USA, students are guaranteed the cost of attendance in loans for accredited schools (as is my understanding). In Canada, no such luck. Between federal and provincial government loans, I can get just over $14,000 a year; and banks are pretty tight fisted. Tuition at the other schools starts at $30,000 a year and goes up.
So it was AVC or bust.
My standard response when people ask me if I like the island is, "I love AVC. I hate PEI." Don't get me wrong, PEI suits some people very well. It's pretty in the summer, there are some great restaurants in Charlottetown and there's all kinds of festivals and events during the tourist season. The faculty at AVC are great. Additional benefits are that it's still in Canada, and it's the closest option to my parents' house. I can be home in about 5 hours. Oh, and I can still get cheap lobster and really good fish and chips.
But it's small. Really small. I did most of my undergraduate studies in Halifax, NS and I am very much a Haligonian* at heart. While Halifax is hardly a metropolis itself, I am constantly comparing Charlottetown to a city 10 times the size. It's less diverse. It's less convenient. It's less walkable. The public transit is one step above non-existent. Things close early. Mail is slow here. Electricity is expensive. Hell, everything is expensive on account of needing to be brought from the mainland. There is no Second Cup. I once needed dental wax at 12:30 on a Saturday night**. In Halifax, I ran down to the 24 hour pharmacy. Here, I would have been stuck until noon the next day.
And the weather. May-September is pretty nice. It can get into the 30C+ range (often 35+ with the humidex), but usually it's good. But winter does not screw around. I wasn't prepared. Everyone said, "Oh, it's so windy!" Really, the wind is no worse that Halifax. But the temperature difference? And the snow difference? No one mentioned those!
If you like small towns, don't mind snow and cold, and like seafood and potatoes, give PEI some consideration. If you can't, then do what I couldn't, and apply somewhere else.
With all of that said... If I could apply anywhere, I probably still would have ended up at AVC. Finances just made anywhere outside of Canada unfeasible, and besides, I love my country and I'm reluctant to leave it. My dad was a stroke survivor and not in great shape when I matriculated. My mom isn't that severe, but isn't the healthiest of people. So I'd be really reluctant to go anywhere that I couldn't get home easily and quickly. For me, the convenience factor outweighs the other stuff.
*Isn't that a great word? No one knows where it came from.
**Tooth broke while watching a movie and eating a Skor bar at home. It left a sharp point that I kept scratching my tongue on. Nothing weird.
Well, I didn't. The system in Canada is a little different from in the USA. There's only 5 colleges in Canada and one is francophone. The system is strictly regional. In the USA, many (all?) schools take out of state students. They have a smaller chance of getting in compared with in state and they pay higher tuition, but they can apply. In Canada, you can't. If I were to apply to Saskatchewan, or Alberta, or Ontario, as far as I know, they wouldn't even look at my application. This was very frustrating after my first rejection from AVC; I can't tell you how many people told me to apply to Ontario.
There are other options; we can apply to any American school and the overseas ones (Edinburgh, Dublin, etc) and the caribbean schools. But you need seriously deep pockets. In the USA, students are guaranteed the cost of attendance in loans for accredited schools (as is my understanding). In Canada, no such luck. Between federal and provincial government loans, I can get just over $14,000 a year; and banks are pretty tight fisted. Tuition at the other schools starts at $30,000 a year and goes up.
So it was AVC or bust.
My standard response when people ask me if I like the island is, "I love AVC. I hate PEI." Don't get me wrong, PEI suits some people very well. It's pretty in the summer, there are some great restaurants in Charlottetown and there's all kinds of festivals and events during the tourist season. The faculty at AVC are great. Additional benefits are that it's still in Canada, and it's the closest option to my parents' house. I can be home in about 5 hours. Oh, and I can still get cheap lobster and really good fish and chips.
But it's small. Really small. I did most of my undergraduate studies in Halifax, NS and I am very much a Haligonian* at heart. While Halifax is hardly a metropolis itself, I am constantly comparing Charlottetown to a city 10 times the size. It's less diverse. It's less convenient. It's less walkable. The public transit is one step above non-existent. Things close early. Mail is slow here. Electricity is expensive. Hell, everything is expensive on account of needing to be brought from the mainland. There is no Second Cup. I once needed dental wax at 12:30 on a Saturday night**. In Halifax, I ran down to the 24 hour pharmacy. Here, I would have been stuck until noon the next day.
And the weather. May-September is pretty nice. It can get into the 30C+ range (often 35+ with the humidex), but usually it's good. But winter does not screw around. I wasn't prepared. Everyone said, "Oh, it's so windy!" Really, the wind is no worse that Halifax. But the temperature difference? And the snow difference? No one mentioned those!
If you like small towns, don't mind snow and cold, and like seafood and potatoes, give PEI some consideration. If you can't, then do what I couldn't, and apply somewhere else.
With all of that said... If I could apply anywhere, I probably still would have ended up at AVC. Finances just made anywhere outside of Canada unfeasible, and besides, I love my country and I'm reluctant to leave it. My dad was a stroke survivor and not in great shape when I matriculated. My mom isn't that severe, but isn't the healthiest of people. So I'd be really reluctant to go anywhere that I couldn't get home easily and quickly. For me, the convenience factor outweighs the other stuff.
*Isn't that a great word? No one knows where it came from.
**Tooth broke while watching a movie and eating a Skor bar at home. It left a sharp point that I kept scratching my tongue on. Nothing weird.
Sunday, March 2, 2014
Some days you just don't get it
Friday was one of those days.
So Friday was our Diagnostic Radiology midterm. Topics covered: equine distal limb (knee/hock down), small animal urinary system and small animal reproductive. We have an hour looking at cases on computers, and then an hour long written portion. I'm going through the computer part, doing reasonably well, when I get to about the 11th or 12th case. Which goes a little like this
And I thought, hey no big deal, it's an OCD lesion, distal intermediate ridge of the tibia. But what the hell does "sitting on the fence" mean?! Did he try to jump the fence and missed? Is it some awkward way to describe how he's standing? But I ignore it and move on.
Later, I'm talking to a classmate during the traditional post-exam debrief/bitching session, and lamenting that I had no idea what that meant. His reponse, "It was the horse's name."
That makes so much more sense now...
So Friday was our Diagnostic Radiology midterm. Topics covered: equine distal limb (knee/hock down), small animal urinary system and small animal reproductive. We have an hour looking at cases on computers, and then an hour long written portion. I'm going through the computer part, doing reasonably well, when I get to about the 11th or 12th case. Which goes a little like this
"Sitting on the fence" 3 year old Quarter Horse stallion, lame left hind legFollowed by an image like this:
And I thought, hey no big deal, it's an OCD lesion, distal intermediate ridge of the tibia. But what the hell does "sitting on the fence" mean?! Did he try to jump the fence and missed? Is it some awkward way to describe how he's standing? But I ignore it and move on.
Later, I'm talking to a classmate during the traditional post-exam debrief/bitching session, and lamenting that I had no idea what that meant. His reponse, "It was the horse's name."
That makes so much more sense now...
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