Veterinary Parasite

Ah, the joys of farm reproduction - a morning spent with an arm up a cow’s arse, followed by an afternoon watching a caesarean video…what could be better?  Well, lots of things do actually spring to mind, but as far as good practical experience goes, then this week has been excellent so far.  Admittedly there has only been one day so far!

One thing that really strikes me is how important the early years of anatomy and physiology really are.  Of course this is true in all areas of veterinary science, but reproduction really brings it together.  The anatomy of the reproductive tract is basic first year knowledge, long forgotten, but when you’re feeling mush in the back end of a cow, its importance suddenly hits home.  After a fair while of mindless groping, I’m “reasonably” certain I could feel uterus and ovaries, but I wouldn’t be putting any money on it!  A quick look over some anatomy notes tonight, however, and I can go into tomorrow 23.4 (approximately) times more confident!

The part which I really find satisfying is our therapeutic interventions, i.e. manipulating the oestrous cycle.  At first it can seem pretty complex - when should I give progesterone? How about prostaglandin? Why not GnRH?  As usual though, thinking back to second year reproductive physiology reveals the answers.   Simple questions, such as what would normally produce that hormone, at what time in the oestrous cycle, and what are its effects, are all that is needed to see the logic behind each treatment, and quickly build up a picture of what is appropriate and when.

All combined, it makes reproduction and interesting topic - it requires both knowledge of cold hard facts, but also an understanding of them, tied together with a knowledge of the drugs we have available to us, and how we can use them.  Most satisfying of all, it’s an area where a vet can really make a difference to a farm, even to the point of swinging it from a non-viable enterprise into a profitable one (hopefully not vice versa!), and knowing this makes it a really enjoyable way to spend your time!

Bloody hell this blogging lark is harder than it’s cracked up to be!  I came into it thinking I’d whip out a post once a day no problems, but then something comes along to eat every second of your time!  In this case, the time eater was the indubitable pleasure of equine out of hours week.  After starting with a 44 hour out of 48 weekend, work then continued at a mere 16 or so hours a day, so quite relaxing really.  Strangely, this meant that I spent every hour away from the hospital asleep, rather than blogging!

An unexpected nice side effect was getting to see lots of sunrises over the hospital, as well as some truly stunning night skies.  Being an idiot, I obviously didn’t have a camera with me, but I managed to snap one nice sunrise, complete with vapour trails, on my phone, so I present it here for your delectation!

Sunrise Over The Equine Hospital

This week I start with my farm rotations, commencing with herd health planning.  Today was a nice day out in the sunshine, blighted only by the task of getting a condition, lameness and cleanliness score, along with size, yield and rumen fill for over 100 cows!  Still, that’s the data collection phase over, time to see what magic I can work using the power of statistics!

While I was seeing practice over Easter, one of the cases I had responsibility for was an alpaca with a broken leg (contained within an external fixator!).  I have (well had) zero experience with camelids, to the point where I really didn’t know what to expect going to see him for the first time.  Of course, ’twas a joyous experience!  For those of you like me, alpacas are (we decided) a cross between sheep, guinea pigs and giraffes.  The sheep gives it the coat, the giraffe the long neck, and the guinea pig it’s amazing repertoire of noises!

I could regale you with an assortment of alpaca facts now, and despite the boredom it will probably induce in you, I’m going to:

• They have not one, not two, and not even four stomachs (stomach compartments if we’re being picky) - the alpaca has three
• The glandular part of the stomach, which only makes up about 20% of the third compartment, is very prone to ulceration, secondary to non-steroidal drugs, or stress.  So, while hospitalised, they are put on Omeprazole (a proton pump blocker) to reduce stomach acidity, and are always kept with a friend to reduce stress
• They have mainly cartilage instead of a nasal bone, so halters must be very well fitted to avoid suffocating them (they are obligate nasal breathers)
• To control an alpaca, you must control its head!
•  They are very prone to vomiting under anaesthesia

OK, that’s probably enough for now!  As you may have guessed, I was charmed and intrigued by my new alpaca friends - perhaps a career as an alpaca vet beckons?  Well I doubt it, as I don’t think I’d end up with that much work to do!

Just as a bonus, here’s a pic of my alpaca mates

Throughout my undergraduate career, I’ve bought a fair few textbooks, and referred to probably hundreds more. I’ve found that while most are generally good, there are some absolute crackers, and a few that are absolute rubbish. This is the start of several posts looking at books I’ve enjoyed using, starting with anatomy and physiology books.

Anatomy & Physiology

• Veterinary Anatomy - Dyce, Sack & Wensing
  • This is my bible of veterinary anatomy - it contains all you will ever need to know on the main species. It’s reasonably well laid out, although it divides things into a general overview, then species specific sections which I find unnecessary, and a touch confusing. It also goes into massive detail, so picking out clinically relevant details can be tricky, but in conjunction with lectures it’s ideal.
  • Definitely one to buy, you will use it all the way from first to final year.
• Guide to the Dissection of the Dog - Evans & de Lahunta
  • A great book for canine anatomy, with really descriptive advice on actual dissection technique. Anatomy-wise, it covers no more than Dyce, Sack & Wensing, but it has the added bonus of the dissection guide. I found it extremely useful during dissections, but have never really referred to it since.
  • Probably one to borrow from the library, or buy as a cheaper alternative to Veterinary Anatomy. Just try not to get it covered in blood!
• Principles of Anatomy & Physiology - Tortora & Grabowski
  • A human book, but really nicely laid out, with great pictures and excellent narrative. Some sections of it do become a little redundant in the veterinary world, and some of the clinical advice doesn’t hold true, but it is worth having as a physiology text.
  • I used this a lot in first and second year, and still occasionally look back to it. It’s relatively inexpensive, and well worth having on your shelf in my opinion
• Veterinary Reproduction - Noakes, Parkinson & England
  • I’ve included this here because it does have great sections on the normal physiology of reproduction, as well as being good for the clinical side of things. It was irreplaceable during reproduction lectures and tutorials, covering all the major species in good depth.
  • I used it a lot in second year, and it’s coming into its own again now. Expensive, but if you can afford it then definitely buy it.
• Horse Anatomy - A Pictorial Approach To Equine Structure
  • I’ve got a horse anatomy book on the way, just to work through as a bit of a refresher, and see things from another point of view. I’ll update this to a full review when it arrives and I’ve read it.

Many more sections to come as soon as I find the time to write them up! Also coming soon, some equine cutaneous neoplasms - fun fun fun!

Work on my TPRMyHorse project continues (slowly - I have an equine practice rotation to fit in somewhere as well!), and I have come up with a logo. I’m posting it here for comments, criticism, and general public lambasting! Let me know what you think:

This week’s rotation. equine practice, is really good fun. Getting to do plenty of things, see lots, and spend a nice amount of time sat on my backside in the car! It’s also reasonably convinced me that this is where I’d like to work when (I’m being confident!) I qualify. As a side project, we also have to prepare a presentation on equine dermatological conditions. I’m taking on the neoplastic section, so expect a post on the evils of equine sarcoid soon.

Edit: Here’s a revised version with new feet

It’s your worst nightmare - you’re walking your dog out in the park, and a small child approaches him and starts to prod/poke/squeeze and generally annoy.  Being a lovely young dog, he puts up with it for a while, but eventually he growls at the irritating youngster, who runs off crying.  As you’re a responsible owner, you quickly tell your dog off for growling at a child.  Over the next couple of weeks this scene plays out a few more times, until seemingly without warning, your dog bites the child.  And it’s bye bye doggy.

This is a situation that, happily, doesn’t occur too often, but it does occur.  With a bit of understanding of canine behaviour we can make sure it never happens to you.  Dogs are pretty simple creatures really - if you let them know a certain behaviour brings positive results (a stroke, a treat, etc.), then they’ll do that behaviour more often.  If you let them know the behaviour brings negative results (a telling off, a smack, etc.), then they’ll do it less often.  This is the basis of most training techniques, but we use the same methods unconsciously with our animals every day.

Let’s look at the situation from a dog’s point of view: “I was unhappy with a situation, so I expressed my natural warning behaviour, and growled.  I was then punished.”  We can see that following our rules from before, the dog’s expression of growling behaviour is likely to reduce in frequency.  The problem is that growling in this situation is entirely appropriate behaviour for a dog.  The growl is the lowest form of aggression a dog can show, so to express it means he does not want to bite, but would still like the annoying child to go away!  If we punish the growl, then he will eventually stop growling - unfortunately, the annoying stimulus of a prodding child is still there, and the dog still does not like it.  So what does the dog do?  He takes action to get rid of the annoying stimulus - as he can’t growl, he moves up the aggression ladder, and bites.  We have inadvertently trained our dog to progress straight to biting when he wants to express his unhappiness/fear at a situation.

So what should we do?  Well, firstly, reward your dog for growling.  This promotes the behaviour, making it less likely that he will progress to the next level - biting.  Secondly, remove the annoying stimulus.  I would argue this should involve giving the little kid a smack round the head, but unfortunately we may have to resort to taking our dog away.

Bottom line: Growling is natural behaviour for a dog, and expressing it makes them less likely to bite.  Don’t stop your dog from expressing its natural behaviour.

Over the last few weeks, I’ve taken a lot of horse’s temperatures, lots of times. Most of these occasions were, if not enjoyable, then at least safe and uneventful! Unfortunately, a certain few horses seem to have a real problem with it, to the point of kicking out, or posturing like they were going to. This is a real problem when you’re trying to monitor a horse with an infection, as the temperature is one of they key parameters when judging if it is under control. Thanks to judicious use of twitches, and a lot of shouting, I remained unkicked, but life would have been much more pleasant had the horse not been so resentful of what is a painless, if slightly uncomfortable, procedure.

This leads me to my point, which is that if you are a horse owner, you should endeavour to take your animal’s temperature on a daily basis, from a young age. Digital thermometers are cheap and accurate, and provided you are sensible, can be used with little risk to you or the horse. A quick eBay search and they’re available including delivery for £3.48.

Regular monitoring of your horse’s temperature has some real benefits. Firstly, it means that should your horse ever have to be hospitalised, or regularly have it’s temperature taken for any other reason, he/she will be accustomed to it, and will cause no problem to the temperature taker. Believe me the vets/nurse/students will thank you for this! It also benefits the horse, as, for example, in an infected wound, the last thing we want is a horse jumping around or moving suddenly, as it might cause a wound to break down.

Secondly, regular monitoring of your horse has real preventative health benefits, even when your horse is healthy and well. If you can pick up that your horse’s temperature is increased one day, then you can ring your vet and get them to check it out - before the problem becomes any more serious. This is especially important after your horse has been in high risk situations, such as travelling, meeting new horses, etc. The stress of the situations can lead to decreased immunity, and the number of horses from different stables all in one place provides a perfect environment for the exchange of infections. This isn’t intended to put you off showing, but just to make you aware that there are some risks, but these are risks that can be minimised by careful, and easy, monitoring.

Other parameters that can be easily measured are pulse rate, and respiratory rate, and these can also be useful, although they can be a little more difficult to interpret. An increased pulse and resp rate can be associated with pain, or a variety of other conditions, but could also just be due to excitement, or recent exercise. Due to the ease with which they can be taken, I would still recommend taking them daily, and keeping records along with temperature. Here’s a quick guide on how to take them:

In the photo, the young lady’s hand is feeling for the facial artery, which runs on the medial aspect of the mandible bone. If you run your fingers over the area, then you should feel a small tube like structure. Lightly rest your fingers on the artery and you should feel the pulse. Make sure not to use your thumb, or you may inadvertently count your own pulse, not the horses! My preferred site for taking a pulse is actually the transverse facial artery, which runs across the face, below the eye, as indicated by the black line in the photo. In some horses you may be able to see the artery, but if not then run your fingers vertically down over the area, and you should feel the vessel. Both sites can be tricky to use if the horse is eating, as contractions of the muscle will confuse things, so try to take them at a time when the horse is not.

Alternatively, you could buy and inexpensive stethoscope (it doesn’t need to be a good one), and listen to your horse’s heart directly. The drum of the stethoscope should be placed on the chest wall, approximately level with the horse’s elbow, and pushed forward under the leg. The loudest point can be quite variable, so just move the stethoscope around a bit. Initially the heart beat can be tricky to hear - it is a deep sound, and your ears need to “tune in” to it. When you’re counting, a “lub-dub” counts as a single beat.

You can count pulses over a full minute, but generally counting over 15 seconds, then multiplying by 4 is adequate. Perhaps if you were concerned about a higher heart rate, then count over a longer period to make sure the increase is real.

The other parameter you can easily take is a respiration rate. This can be seen in several ways. I find the easiest method is watching the ventral (bottom) part of the abdomen - it will move slightly up and down as the horse breathes in an out. You can also watch for expansion of the rib cage, or movements of the nostrils. On a cold day, the easiest method is often to actually watch for streams of warm air coming out of the nostrils, and count those! For respiration rate, I prefer to count over at least 30 seconds. 15 seconds is not really adequate, as the respiration rate is much lower than the pulse rate.

Some normal values:

Temperature: 36.7 - 38.3 C

Pulse: 36-40

Respiration: 8-16

These are not absolute values, however. For example, if your horse’s temperature is normally in the range 36.8-37.4, which you know because you take it every day, then a temperature of 38.1 could represent a fever, even though it lies within the normal range as a whole. This is yet another advantage of doing daily TPRs on your horse - you can establish a normal range for your individual horse. Pulse rate can actually be as low as 28 in very fit horses without being abnormal.

With all this in mind, I plan over the next couple of weeks to add a new section to the site - TPRMyHorse. This will be a place to record daily TPR values for individual horses, as well as any daily comments. The system will then plot them as graphs, so that any trends or changes can be identified. It will also provide suggested normal ranges for your animal. This saves having hundreds of scraps of paper with numbers on (I’ve been there!), which mean nothing! I’ll keep you posted when it’s ready to be unleashed!

Disclaimer: The information in this article is for guidance only. If you have any concerns about your horse, be it because of the TPR values, or any other reason, you should not hesitate to contact your vet. While we hope that the information here will help you to look after your animal, it is in no way a substitute for proper veterinary advice from your own vet, and should not be taken as such.

The last five days has flown by, and the first week of my clinical rotations is over! I suppose this effectively means I now know all I need to know about diagnostic imaging of horses…which is a little concerning really. Well, at least I can safely say I know a lot more now than 5 days ago!

Next week is Equine Practice, our first opinion week. Looking forward to it all round, as I can see myself doing this when I graduate. Also, it’s an easy going week, and we get to do a presentation to the rest of the equine people at the end of the week - and I’m one of those people who loves doing publix speaking type things!

No posts in over two weeks is pretty poor form in anyone’s books, so I can but offer my excuses.  I’ve been away at the Royal Veterinary College in London doing equine work, and internet access has been limited (as well as my waking hours away from their hospital!)  I should be back to a proper posting schedule now, starting with some words about my excellent two weeks away!

Other news from the last two weeks is exam results - good news all round, I passed them all, with 67% in Equine, 66% in Small Animal, and 60% in Farm.  Obviously very happy with the results, especially as it means a resit free summer!

I’m trying to think of some ways to expand my writing on this site beyond just a blog. After all, my life isn’t that exciting, there’s only so much I can rave on about unnecessarily, and I’m just not that good a writer! Anyway, here they are:

• Your Pet Problems - Anyone can email/post with a specific problem their pet has, or with any concerns they might have. It might be that getting to a vet is difficult, or maybe they just don’t think it’s a big enough problem to warrant a visit. Hopefully I’ll be able, (with the help of notes and book!) to answer the majority of these questions. This has three really good outcomes that I can see:
  • People get specific help with their problems
  • Provides a repository of answers to some probably common questions
  • Gets me to revise and research specific problems

  I’m pretty certain I’m going to go with this, but any comments would be great. Also, I’ll need a few questions to get started with, so if you have any then ask, or if you know anyone who does then direct them here! If you leave an email address with a question in the comments of this post, I promise to email you when I get an answer online.

• A Parasite A Day - Going with the title of the blog, and one of my big interests, provide a different take on a new parasite each day. I resat parasitology twice, after finding it excruciatingly boring. Only on my third go through did I realise just how amazing these things can be! (see here), and my interest really peaked. I’d hate to see others bogged down in the subject like I was, so hopefully a clinical perspective, with a not entirely serious narrative might help them out.

• So You Want To Be A Vet - I’ve literally lost count of the number of times I’ve heard “Oooh, you’re a vet student, my [son/daughter/niece/nephew/obscure relation] wants to be a vet. “  Generally followed by extensive questioning on either grades required, work experience needed, which uni is best, or what the interview was like.  Creating a section of the site which gave all the advice I had to give, neatly divided into sections such as UCAS form, interview, etc., would not only save me repeating myself, but hopefully be reasonably useful to anyone with veterinary aspirations.

OK, so there are my two ideas - comments, questions and suggestions below would be gratefully received!