Today was my first day on Small Animal General Surgery! I was pretty nervous switching rotations, this is one of the ones that scares me the most. I have very little surgery experience and I haven’t had the anesthesia rotation yet so I’m not super comfortable with running anesthesia. I arrived at school a bit early this morning so that I could take care of my Equine Therio patient before starting my new rotation. Once I did her TPR and made sure she looked okay, I headed over to the small animal hospital, fondly known to the large animal students as “The Dungeon.” Sometimes it seems like the Twilight Zone when you’re in that building, there are no windows except at the far ends of the hallways so you can literally spend all day in there and have no sense of the passage of time. It was bizarre when I was on ER because I could arrive in the dark at 6:00am and leave after dark at 6:00pm (on a short day).
The first thing on the agenda this morning was orientation. After we oriented ourselves, we got ready to take in our appointments for the morning. I was assigned anesthesia for a Malti-poo that was scheduled to be neutered today. This sub-five pound dog’s name was Thor and yes, he thought he was very manly and tough. We spoke with the client, took the pup to the back, and got him all ready for his procedure. I was super nervous about running anesthesia since it has been over a year since Junior Surgery, which was the last time I did it. We were also using slightly different machines than last year, and I didn’t know where any of the equipment was in the general surgery room. It made for a fairly stressful first surgery, especially in addition to the fact that my blood pressure cuff refused to read correctly, and I had issues with the esophageal stethoscope.
I guess to make it more clear I should explain what goes into running anesthesia in small animal patients, since some of you may not be aware. We gave Thor his cocktail of premeds which provided sedation and initial analgesia (pain control). We then put in his catheter, which I rather ineptly placed, making a bloody mess in the process. I did get it on my first try though, which made me feel slightly better. After securing the catheter we gave him his induction drugs, which induced anesthesia and allowed us to intubate him. I passed the endotracheal tube with the help of a larygoscope and inflated the cuff to prevent leaking of anesthetic gas. I hooked the tube to the anesthesia machine and turned on the oxygen and inhalant anesthetic. From that point on I had to monitor and write down heart rate, temperature, respiratory rate, blood pressure (systolic, diastolic and mean), SpO2, fluid rate, anesthesia start/stop, surgery start/stop, flow rate of oxygen, % inhalant anesthetic and general notes about the surgery, with most of those readings being listed every 5 minutes. It’s kind of a lot to remember and it makes me nervous, because in addition to writing down all the numbers you also have to keep track of how your patient is actually doing. You can’t just watch the monitors, your eyes and hands need to be on the patient.
I frantically tried to get everything written down while keeping the patient alive, giving him breaths when his breathing slowed, adjusting the inhalant anesthetic when he got too deep, etc. I think I spent the entire hour on my toes running anesthesia, so I didn’t even get a chance to pay attention to the surgery. We headed back into the general surgery prep room to recover Thor after his operation. I guess I did an okay job on anesthesia because our little patient woke up fine, he just had a little bit of bedhead from his nap:
After we finished up with surgeries for the day, we had some practice time for suturing and suture patterns. Then we were released early and got to head home! I was excited to be able to get some of my never-ending to do list items finished up today. I got all of my state board applications turned in (finally!) and even had time to take my pup out to the dog park, which is always a nice treat for her. It’s even more fun now that they’ve put some dog agility stuff out in the park for people and puppies to play with :)
When we got back from the park it was about time for dinner. I made the taco salad that was on my meal plan for the week, and look! It actually came out pretty:
It was made with spinach, black beans, corn, black olives, sharp cheddar cheese, plain Greek yogurt, Mrs. Renfro’s jalapeno salsa, and a little smoked paprika. So delicious! Definitely one that will stay on my recipe list. For dessert I had two small low carb wheat tortillas with a tiny drizzle of honey on them. They kind of reminded me of sopapillas from Mexican restaurants when I was a kid and hit the spot after my salad. Now I’m just waiting for my coffee to finish brewing so I can snuggle with my pup on the couch until bed time :)