Family

By Oneal Peters

Colorado State University

The term multifactorial and poorly understood is a favourite amongst my professors and classmates. Even the very whisper of the word is met with a resounding moan because let’s face it, the reason certain conditions earn this terminology in veterinary medicine is because we have no clue how to explain it so we paste some fancy word to cover up our disillusion and we move on.

Family is sort of multifactorial and poorly understood for me and I suspect many others feel the same way. While I know what family is and what it means to me in my own life, I know that I wouldn’t ever be able to explain how my family is to anyone not directly in our clan.  That’s what’s so wonderful about it. It’s your own secret, something that you don’t have to share with anyone if you don’t want to. But here I am, attempting to explain how my family has helped me not only handle vet school now, but how they helped me prepare for this my entire life.

I can remember my dad telling me about his little sister, even when I was very young. He said that he had encouraged her not to sit around and behave like every other suburban middle class school girl but instead to work hard at school so she could be something one day. And somehow it had worked. She was valedictorian of her high school class and went on to get pristine grades in college. Now she is an executive in a major engineering firm, and owns a significant portion of the companies’ shares. So there it was, a random story about my smarty pants Aunt lingering in my brain as I grew up. I didn’t pay much attention to my dad’s influence on others until the other day when I listened to him talking to my younger sibling. “Everyday,” he said, scruffing up his wild grey hair and pausing while he tasted the words in his mouth, making sure they came out just right “you should either learn something new or make some money. If you do that, your life won’t be wasted.” My siblings just stare and sigh, another speech from their dad to add to all the others. “Yes dad, we know,” they reply, wanting to move past the lecture onto more exciting topics of conversation. I sit and watch, smile, I’ve heard it all before too. I am sure my Aunt did as she grew up, eating up her big brothers advice with a voracious appetite, so eager to please him just for the sake of making him proud. And now I realize what has always been there. The subtle urging of my father, quietly and precisely encouraging you to succeed, at first to make him proud, but as time goes on you start to try your hardest for yourself. Eventually, that’s all there is left and you forget that it all started with small pieces of advice, placed in the atmosphere for those who want it.

Veterinary school has its many challenges, and each member of my family, whether it’s a friend, my husband, sister, brother or mother has helped me get through those tough days, each person helping me in their own unique way. But it’s those moments like tonight, studying (and writing) at one in the morning that my dad is there for me, a steady voice in my head encouraging me to keep going no matter what and do my very best at all times and to always remember nothing worth doing is ever easy. The support from my family is mutifactorial, but perhaps now, after looking back all those years, it’s slightly better understood.

Hard Stare

By Kelsey Shaw

Cornell University

Creative Corner- My Horse

By Brady Thompson

Purdue University

Foot in Mouth- a remake of "Firework"

As you approach your next semester of clinics or classes- let this serve as a laugh and an inspiration :)

Especially for the class of 2012- you can make it! Almost there!

To the tune of "Firework" by Katy Perry

By Julie Kornder

Do you ever feel

Like a fluid bag

Is dripping on your head;

Just hanging by a thread?

Do you ever feel,

Feel so very stressed?

How will you ever sleep,

Pass the boards, and rest?

Can you localize

Where that horse is lame?

Block the nerves and trot.

These x rays all look the same.

Do you know that there’s an ophtho case for you?

Cuz there’s a Vet in you.

You just gotta

Shine your pen light

In the patient’s eye

To localize.

PLR is fine!

I’m gonna wear my White Coat

And finally use my Stethoscope.

Clinics make me say Oh! Oh! Oh!

As I stay up writing SOAPS SOAPS SOAPS.

I’m gonna wear my White Coat

And do a Minimum Database.

Chem CBC UA-A-A

I sure hope that they can Pay Pay Pay.

You don’t have to feel

Like it will never end.

May 2012,

You’ll be a DVM!

If you only knew

How to pay back your debt,

Communication, and

Practice Management.

Maybe the reason why

You do 3 fecal floats

So you don’t miss worms

And then see them with your endoscope.

Cushing Yes or No?

Your head will spin.

Your first emergency!

I just hope that

The barn is quiet.

I’m on call tonight.

A colic arrives!

Adrenal over-drive!

I’m gonna wear my White Coat

And finally use my Stethoscope.

Clinics make me say Oh! Oh! Oh!

As I stay up writing SOAPS SOAPS SOAPS.

I’m gonna wear my White Coat

And do a Minimum Database

Chem CBC UA-A-A

I sure hope that they can Pay Pay Pay.

Boom! Boom! Boom!

Clients already in the room room room!

Pet needs a rectal where’s the lube lube lube?

And vaccines are over-due due due!

I’m gonna wear my White Coat

And finally use my Stethoscope.

Clinics make me say Oh! Oh! Oh!

As I stay up writing SOAPS SOAPS SOAPS.

I’m gonna wear my White Coat

And do a Minimum Database.

Chem CBC UA-A-A

I sure hope that they can Pay Pay Pay.

Boom! Boom! Boom!

Internal Med with Dr Sum Sum Sum.

Boom! Boom! Boom!

No more eating lunch at Noon Noon Noon!

Case Report

By Stephanie Silberstang                      

Cornell University

Signalment: Adult Short-eared owl, undetermined sex

            Case # 702287

Common reasons for presentation of Short-eared Owls include collisions with vehicles or flying into windows. SEO opportunistically inhabit areas with small mammals, they are ground nesting birds and are also vulnerable to attacks by predators. SEO have an endangered status by the Department of Environmental Conservation.

History and clinical presentation:

The owl presented to the Wildlife Health Center on 11/21/10 after it was found on the side of the road on 11/20/10. Physical examination revealed dehydration, a thin body condition (3/9), and an open fracture of the right humerus. A contaminated wound was also present. No other abnormalities were revealed.

Presenting problems:

Open transverse fracture of the right humerus

Dehydration

Thin body condition score (3/9)

Differential diagnoses for the thin body condition included inappetence due to a metabolic disturbance, inability to apprehend food, neoplasia in the gastrointestinal tract, pain, sepsis, weakness, parasites of the gastrointestinal tract, or an inability to find food due to adverse environmental conditions.

Triage plan

Subcutaneous fluids were administered to combat dehydration and promote cardiovascular stabiliy.

Enrofloxacin was administered to treat infections of gram positive and negative organisms. This antibiotic is concentration-dependent and does not treat for anaerobic organisms.

Clindamycin is a broad spectrum antibiotic administered to treat many anaerobes, gram positive aerobic cocci, Toxoplasma and other organisms.

Butorphanol is a partial opiate agonist/antagonist used as an analgesic in birds. The action of butorphanol is thought to occur primarily at kappa and sigma receptors, which is effective for birds because they have a majority of kappa receptors. This analgesic is more effective in birds than morphine which target mu receptors.

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) administered to reduce inflammation and pain through its inhibition of cyclooxygenase, phospholipase A2, and inhibition of prostaglandin synthesis. Meloxicam is considered COX-2 preferential and should be used with care in a dehydrated animal due to the possibility of increased renal toxicity.

Diagnostic plan:

Complete blood count (CBC) and chemistry panel to determine overall health by observation of red and white blood cell morphology and relative counts, and the extent of inflammation.

Radiographs to determine the extent of the fracture and to reveal any other internal injuries the owl may have acquired.

Fecal evaluation to determine if certain internal parasites are present in the gastrointestinal tract.

The results of these tests provide initial evaluation of the owl’s status. In addition, they provide a data point for monitoring the animal over time. Blood work should be rechecked after treatment has had time to take effect to monitor for improvement or if no apparent improvement is observed. Radiographs should be repeated to check for bony callus formation that indicates proper healing of the fracture site. In birds, callus formation is expected after about 5 weeks, but a prolonged healing time is expected in open and contaminated fractures.

Results of the CBC showed a packed cell volume of 39% and a white blood cell count of 17,100/uL with 13,900/uL heterophils and no band heterophils. No toxic changes were observed. Results of the chemistry panel revealed an elevated uric acid of 16.1 mg/dL.

Results of the radiographs confirmed a mid-diaphyseal fracture of the right humerus.  

Isospora and Capillaria revealed on routine fecal examination

These results revealed a parasitic infection that was likely the primary cause of the Short-eared Owl’s thin body condition. Open mid-diaphyseal transverse fracture of the right humerus was confirmed.

Iatrogenic/Nosocomial problems:

Increased body condition score (~100 grams over average weight for female SEO)

Early signs of bumblefoot

Surgery:

This mid-diaphyseal humeral fracture was surgically repaired in an attempt to restore the owl’s ability to fly. An alternative way to manage this case would have been partial amputation of the right wing distal to the shoulder joint. This would have avoided the risks encountered in placing an IM pin including spreading infection throughout the medullary cavity and having open wounds that communicated with the medullary cavity where the ESF pins were placed. Disadvantages of this procedure would be that the owl would no longer be able to fly, although this may also be true with a repaired fracture. Prognoses for fracture repair can range from poor to excellent based on many factors. Factors such as open, comminuted, infected and fractures involving a joint decrease the prognosis. Factors such as closed, simple, aseptic fractures and fractures not involving the joint increase the prognosis. Humeral fractures in birds have a lower prognosis than in mammals because the humerus in birds is pneumatic and is in direct contact with the air sacs. If a fracture becomes infected which is common in open fractures the infection can spread into the air sacs causing air sacculitis, significantly decreasing the life expectancy of the bird. This airsacculitis can appear as a diffuse whitening of the coelomic cavity in the regions of the air sacs

Monitoring:

This owl was monitored by checking the bandage for discharge and inspecting the incision and fractures sites for any signs of infection or deterioration as should be performed with all surgical incisions . Because the humerus was repaired with an external skeletal fixation device and an intramedullary pin, inspection of the device for bending, breaking or displacement of the pins was done during routine bandage changes. The skin around the wound healed after about two weeks as was expected. This owl had an intramedullary pin that needed to be cut and removed which was performed about three weeks post-op. Radiographs are used to monitor bone healing. A bony callus is expected to be seen approximately three weeks post-op, however, this owl took longer to have a callus observed on radiographs. In addition, the radiographs also revealed poor coelomic detail with air sacculitis being the main concern. Antibiotics can be discontinued after the wound appears to be closed and healing well with no signs of infection.

References:

Plumb, Donald C. Plumb’s Veterinary Drug Handbook, 6^th Edition.  PharmaVet Inc. Stockholm, Wisconsin. 2008.

Cascades Raptor Center. “Resident Raptor- Short-eared Owl.” http://www.eraptors.org/rr_shortEaredOwl.htm. Eugene, Orgeon. 2011.

New York State Department of Environmental Conservation. http://www.dec.ny.gov/animals/7080.html.