My Veterinary Assistant students were recently introduced to Jon Metthews DVM. Jon, an equine veterianarian and owner of Matthews Equine Services in Ramona, graciously agreed to share his expertise in equine medicne with my students. Jon's expertise, however, reached far beyond traditional western medicine; he discussed treatment options that utilized such eastern medicine concepts like accupuncture, chiropractic and chi energy methods. Additionally, Jon discussed work he has been doing with stem cell therapies in animals. This technology, as Jon indicated, could revolutionize modern medicine, and yet fundementally uses ones own body to facilitate. I always enjoy and appreciate Jon Matthews talking to my students about veterinary medicine. Thanks Jon! For more information about Matthews Equine Services, follow his link:  http://www.matthewsequine.com/

Today I worked on 2 Amur Leopards. These Russian cats weigh about 30kg (~70 pounds) and are heavily furred with long tails. They were immobilized with a cocktail of ketamine, dexmedetomidine and midazolam. They were maintained under anesthesia with the gas anesthetic isoflurane. The purpose for the exam was that of routine screening; therefore radiographs of the chest and abdomen were taken, blood was sampled for CBC and biochemical analysis, and feline serology was submitted. The endotracheal tube used was10mm; as a comparison, a domestic cat would require a 3.5 to 4.0 tube.

photo from wikipedia

Last night my Veterinary Assisting class had the pleasure of meeting and hearing Joel Beckman discuss animal behavior and training. Joel is a dynamic speaker with expertise in companion animal training including working with Killer Whales during his employment as a trainer at SeaWorld. Joel explained training concepts to my students, dispelled myths about animals and training types as well as demonstrated some basic training behaviors with the use of his Doberman named Bosco. We can't thank Joel enough for generously donating his time and expertise ( for the past several years) to my veterinary assisting students. Joel is the owner of Beckmans Dog Training in Ramona, CA. You can learn more about Joel and his dog training company at beckmansdogtraining.com

Thanks Joel!

Today I worked on a Rinkhals Cobra. This 800 gram (~2 pound) African snake is known for spitting its venom . Keepers use rigid clear plastic tubing to safely restrain venomous snakes; once tubed, gas anesthesia can be introduced into the tube. The anesthetic gas used for reptiles is Desflurane. This anesthetic gas has the lowest blood/gas solubility of all gas anesthetics. This means that inspired/expired concentrations are very similar, depth of anesthesia can be easily controlled, it is unmetabolized and requires low flow rates. The down side is it is very expensive. Desflurane optimizes anesthesia as well as metabolic and physiological differences found in reptiles. Following induction, the cobra was intubated with a size 16 cole tube and maintained for the duration of the procedure. Ironically, an evaluation of its most dangerous area, its mouth, was the reason for the exam.

source-maree-clarkson.blogspot.com

Today I worked on a Buergers Tree Kangaroo. These medium-sized marsupial tree dwelling kangaroos live in rain forests of Australia and New Guinea. Today's case included a screening for mycobacterium; the bacteria that causes tuberculosis. In fact there are many different species of mycobacterium including M avium that affects birds, and in some cases people. M avium appears as a wasting disease in birds and includes symptoms such as lethargy, loose stool and weight loss. Additionally, birds with M avium, will develop lytic lesions of the long bones; these can be seen radiographically. Because of this, the Tree Kangaroo received survey radiographs of all of her long bones looking for TB lesions. Note TB lesions in the wing and leg bones of the bird radiograph below.

Today I worked on a Fairy Bluebird. These are small passerine birds found in Asia and the Philippines. My job was to obtain a blood sample from the bird, and have it evaluated for uric acid content. Uric acid sounds a bit like urea, and in fact, they are very similar. Uric acid and urea are both nitrogen containing waste products from the breakdown of chemicals in the body. All nitrogen wastes, as well as other wastes, are filtered by the kidneys and removed from circulation. In mammals, urea is eliminated from the body in the form of urine, and in birds, it appears as that white stuff splattered on your car. High levels of urea or uric acid in the blood can imply problems with the kidneys ability to filter wastes; build-up of these compounds, known as hyperuricemia, can result in a condition called gout. This painful conditions results from uric acid crystals building up in joints and capillaries. In some species of birds, especially insectivores, uric acid levels can be artificially elevated. In these species, a fasted blood sample is obtained in order to obtain normal levels.

Today I worked on an Exuma Island Iguana. These critically endangered iguanids are native to the islands of the Bahamas. These large lizards attain a length of over 3 feet, and weigh more than 4kg (9lbs). These iguanas are herbivores, eating leaves, fruits and flowers. In captivity a variety of produce is offered to supply their dietary needs. In addition to nutrients, iguanas and other reptiles require warmth and ultraviolet light to survive in captivity. Heat sources can provide needed warmth, but if they are placed too close or if timers or thermostats malfunction, can lead to serious life threatening burns to the skin. Many treatments for burns are currently utilized; these include nutrient rich bandages, honey, tissue debridement and laser light therapy. Lasers, directed at injured tissues, are believed to stimulate cell development and tissue healing. As tissues begin to heal, skin contraction occurs. This contraction helps reduce the size of the defect; tissue granulation occurs as healing continues. Burns in reptiles are serious medical problems, taking lengthy time and resources to resolve. If left untreated, infection and death may result. Photo by Jim Austin.

Today I worked on a Giant Horned Lizard. These are large spined lizards that are known for eating ants and squirting blood from their eyes as a means of defense. This animal came up in a stupor-like condition. It had also lost a significant amount of weight. The initial treatment involved giving subcutaneous fluids to improve its hydration. Subcutaneous fluids, abbreviated SQ, can be easily given to animals that have redundant skin; many species don't have a lot of extra skin for SQ access. Lizards can be given SQ fluids, although they tend to have limited space and inflexible skin. Additionally, lizards and snakes have scales, scutes and armor making injections more challenging. SQ injections should be made between scutes and scales if possible, and sometimes in multiple sites. When SQ injections are not feasible, injections can be made directly into the abdominal region; this is call an intracoelomic injection and is analogous to an intraperitoneal injection in mammals. 

Today I worked on a Fossa. These carnivores are indigenous to Madagascar; they are best described as a dog-like cat. Fossas are closely related to viverids (civets and binturong), hyeanidids (hyenas) and herpestids (mongoose) and are the largest carnivore found in Madagascar. Physical characteristics include a brown coat, long tail, cat-like pupillary eye slits and a body weight of about 6-8kg (14-18lbs). Today's Fossa was immobilized and evaluated for inappetence. An IV catheter was placed in the left cephalic vein. This vessel normally sits on the anterior surface of the front limb, however in this species, as with many bear species, lies much more medial than expected. Lactated Ringers were given at 100ml/hr. Skull radiographs showed fractures of the mandibular canine teeth; they required temporary root canals. A hole is drilled into the pulp cavity of the tooth. Nerve and vascular material is removed from the inside of the tooth and filled with a composite material. A 'light curing' composite is used which is durable and easy to instill. Root canals are not uncommon in species that break or wear down tooth surfaces; this ensures that the aesthetics of the tooth are maintained. The Fossa was recovered without complication.

Today I worked on a Lowland Anoa: the Anoa is classified as endangered in its native Indonesia. These small bovids are similar but much smaller than the black and white dairy cows we are accustomed to seeing. They are also called miniature water buffalo. All bovids are characterized by having a multi-chambered stomach which is used to digest plant material. Bovids are often seen chewing and re-chewing their food, a process called rumination; for this reason, we also call these animals ruminants. Rumination requires the need for a lot of water making the ruminant susceptible to fluid aspiration during anesthesia. Aspiration occurs when fluid in the stomach is regurgitated and leaked into the lungs. The consequences of aspiration can be life threatening as digesta can contain large amounts of bacteria. The multi-chambered stomach in ruminants is large but is predominantly on the left side of the body (as with most mammals including humans), therefore placing a ruminant on its right side is one strategy to reduce pressure on the stomach and the potential for aspiration. The Anoa today had a routine exam, hoof trim, dental exam and assorted prophylactic injections. The procedure was uneventful and recovery was ideal.

Today I worked on a Schmidt's Spot Nosed Guenon. They are known for their very characteristic white spot on the front of their nose. In their native Africa, they are also known as red tailed monkeys, for their, you guessed it, beautiful long red tail. Anesthetic induction was facilitated with a ketamine and midazolam injection mixture; isoflurane was used to maintain surgical level anesthesia. An intravenous catheter was placed in the posterior saphenous vein. This vein is located on the back side of the calf muscle, running from top to bottom down the center of the leg. In primates, this vein is easily accessible and fairly robust; in the event that the catheter must be maintained for an extended period of time, the leg can be bandaged in such a way to secure the catheter from being disrupted by the patient. IV flow rates can generally be estimated to be about 10ml per kilogram of patient body weight. IV catheters provide secure venous access in the event of an anesthetic emergency, or as a means to counteract the hypotensive effects of general anesthesia.

Today I worked on an Allen's Swamp Monkey. These old world monkeys, also called guenons, are found in Central Africa and spend a lot of time foraging for fruits, plants and bugs in swampy areas. Today's patient was given a preventative medicine exam which included whole body radiographs, blood work and routine vaccinations. In addition, she received a MGA implant. Melengestrol acetate (MGA) is a birth control method often used in wildlife. MGA is implanted under the skin and affords long term birth control rather than daily medications typical in human females. In primates, MGA implants are generally placed under the skin in the intrascapular region; this area tends to prevent over grooming and trauma to the incision area as primates tend to be more prone to this type of behavior. The implant, about the size of pencil eraser, can be easily placed with a minimal surgical incision. Birth control is one method of managing captive populations of animals and assuring the genetic diversity within a species is maintained.

Today I worked on a Baja Pronghorn. This was the same antelope that I worked on several weeks ago. Today it presented with lameness of one of its back feet. Normally ungulates like Pronghorn, walk on their toe tips; when ligaments break down or get injured in this area, these animals will tend to knuckle down and pop their toes up leaving them to walk on their palms or heals. In baby hoofed animals this condition is a result of loose or underdeveloped ligaments and is usually corrected with leg bandages or casts to stabilize the limb. In some animals the cause can be the result of trauma or an injury to the nerves in the leg. The largest nerve in the rear limb is the sciatic nerve. This nerve leaves the spine and travels around the femoral head, dives deep into the muscles of the leg and continues down the leg along the length of the femur. Damage to the sciatic nerve can be temporary, as is the condition called sciatica in humans, or more serious leading to paresis of the limb. In veterinary medicine, one of the biggest concerns with giving intramuscular injections in the rear limbs is inadvertent injury to the sciatic nerve. Care should always be taken when injecting into the rear limbs for this reason. In general, injections should be made perpendicular to the muscle body, and well away from the path of the sciatic nerve. We took radiographs of the Pronghorn to ensure there were no fractures to the limb, followed by a fiberglass cast to help stabilize the limb while it heals.
 

 

Today I worked on an African Spoonbill. These aquatic birds have a very characteristic 'spoon' shaped bill that is used for foraging and sifting for small aquatic creatures in the shallow water. This bird had an injured hallux that was radiographed and repaired. Tha hallux is analogus to the thumb of other animals including man. The orientation and shape of birds toes relates to the function of the feet and the environment in which the bird lives. Aquatic birds have webbed feet for swimming or long slender feet for wading and walking on aquatic plants. Raptors (birds of prey) have 3 forward toes with the hallux in the back; these birds use the hallux to help grasp its prey item. Some birds have very small hallux digits that have little function as with the dewclaws of dogs and cats. Just as in dogs and cats, the digits of birds are counted from the thumb to the pinkie, the thumb being digit 1. A bird, such as the spoonbill, has a hallux (digit 1) and 3 additional forward facing toes. The next time you count the number of toes of an animal, don't forget the hallux or dewclaw.

Today I worked on a Bornean Binturong. This 7kg (15 pound) viverrid, also known as a bear-cat, is made up of catlike and bearlike features. Viverrids include civets and genets which are very cat like. Binturongs are nocturnal, arboreal and omnivorous with a long bushy prehensile tail. The scheduled procedure was a castration or neuter in which the testicles are surgically removed. This is compared to a vasectomy, where the testicles are left intact, but the pipes are disconnected. Surgical induction included ketamine, dexmedetomidine, midazolam and butorphanol; anesthesia was maintained with isoflurane. A 22gauge IV catheter was placed in the cephalic vein and fluids where administered during surgery. Pain relief was managed with meloxicam, a NSAID (non-steroidal anti-inflammatory drug). Recovery was uneventful. Here is a photo of an adult Binturong, the kid I worked on today is pictured with me in my 'about me' profile.

Today I worked on a Pesquet's Parrot. These medium/large sized psittacines weigh just under 1kg or about 2 pounds. Pesquet's Parrots are not your typical parrot as they have a much longer beak and head. Also called the vulturine parrot, these birds have a distinct vulture head shape with black featherless facial skin. Parrots in general can be very noisy when restrained; they are also equipped with a formidable beak capable of breaking open seeds and fingers! Parrot restraint involves immobilization of the head (the weapon), while containing the wings and feet. Parrots have somewhat delicate skin tissue on their heads making effective restraint difficult without injury to this tissue. Another factor with any bird restraint is being careful not to limit the movement of the chest. Birds lack a diaphragm, which in mammals is used to drive respiration. Birds must use movements of the chest to facilitate respiration. In larger species of birds such as the Pesquet's Parrot, I like to use an ice cream cone hold where one hand contains the feet, tips of the wings and tail, and the other hand holds that vulturine head.
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Today I worked on a Polar Bear. These large top predators are known for eating seals, but also eat vegitation. The bear today weighed 220kg (440 pounds) with paws as round as basketballs. Anesthesia was induced with an injectable anesthetic called Telazol. Anesthesia was maintained with isoflurane and respiration was supplimented with mechanical ventilation. As you might imagine, a bear of this size has a fairly large lung capacity or tidal volume. To calculate the tidal volume of an animal, it is assumed that 10-20ml of oxygen is required for each kilogram of body weight (10-20ml/kg). Using this relationship, the tidal volume for this bear would be between 2-4 liters per breath. An adult human, for comparison, has a tidal volume of between 0.7-1.4 liters per breath. Oh yeah, she required a 20mm endotracheal tube!

Today I worked on a Harris' Hawk. These medium sized raptors weigh approximately 1kg or 2.2 pounds. Just as a comparison, your average domestic cat, about the size of a Harris' Hawk, might weigh 3kg. Birds are actually much lighter than they look. This bird needed a blood sample; it was taken from the right jugular vein as expected (if you have been reading my blogs). I find that taking blood samples from birds while they are in an upright position is less stressful for the bird and causes fewer hematoma formations. A hematoma is simply a blood filled mass; this occurs when an animal bleeds from the vessel where the blood sample was taken. Hematoma formation can be minimized when the vessel is held off after sampling and an appropriate sized needle is used. Hematomas can be life threatening in small birds as it can lead to significant blood loss. To calculate the safe amount of blood that can be removed from a mammal or bird consider the following: In general,  an animals blood volume is ten percent of its body weight in grams. In general, it is safe to take ten percent of an animals blood; therefore we can safely take one percent of the animals weight in grams. This means we can take 1ml of blood for every 100g of body weight; we could have taken 10ml from the Harris' Hawk.

Today I worked on a Black Duiker. This medium sized ungulate (hoofed animal) weighed 20 kilograms or about 44 pounds. Duikers are in a group of animals called ruminants. Ruminates such as deer, cows and duikers spend a lot of time eating and re-eating their food. Their stomachs consist of 4 chambers, each chamber aiding in the digestion of food. Part of the digestive process in ruminants as well as other herbivores is the ability to pulverize the plant material effectively enough so the plant can be digested. These animals use their teeth to grind their food, and can often times be seen moving their lower jaw across their upper jaw in a sideways motion. In order for them to be able to make this motion, their teeth must be fairly flat without any sharp edges or points. Horses require periodic teeth grinding to remove sharp points from their teeth; this procedure is often called 'floating' of the teeth. The Black Duiker had this procedure done as well.

Today I worked on a Lesser Kudu similar to the one pictured above. These large antelope have 2 toes on each foot making them an artiodactyl animal, but if you have been following along, you already know that. The juvenile I was working on was a 2 week old male whose mother didn't know how to take care of him. We call this a failure of passive transfer, because in cases like these, the infants don't receive needed nourishment and antibodies from mom. These antibodies are important for a young animal to be able to fend off diseases. Colostrum, also known as first milk, is full of these important antibodies; if a kid is unable to nurse, for whatever reason, the antibodies are not transferred. My role today was to take a simple blood sample so that his blood cell composition (CBC) and biochemistry values could be determined. Being a young kudu, he was easy to handle without any sedatives or anesthetics, but when he grows up that will not be possible. Thanks to ARKIVE.org and James Warwick for the picture of the kudu. ARKIVE.org is a great resource for pictures and information on many of the species of animals of the world.

Today I worked on several passerine birds. Passerines are the largest bird group, accounting for more than half of the over ten thousand bird species in the world. These birds include sparrows, swallows, thrushes, and tanagers to name a few. As a Registered Veterinary technician, my role in a bird procedure usually includes anesthetic induction and maintenance, diagnostics including radiography as well as sample collection. Bird blood sampling can be obtained from several vessels, the most prominent is the jugular vein. Why didn't I say veins?, because birds have streamlined several of their anatomical structures including the jugular veins. In birds, the jugular vein can be found on the right side of the neck; the left jugular is vestigial or absent. In most birds, like passerines, the jugular vein can easily be seen due to a featherless track in that area. In some birds such as ducks and geese, there is no featherless tract, making sample collection more challenging. So, if you are a vampire, go for the birds' right jugular vein!

Last week I had the pleasure of graduating my tenth Veterinary Assistant I class. The wonderful students spent nearly 90 hours with me learning about veterinary medicine. They had to endure a lot of new concepts and a few of my old jokes. Some were able to spend time in veterinary practices while they were taking the class; this  was a great way for them to apply classroom didactic with hands on experience. One student became gainfully employed as a result of this program; to her and all her classmates I congratulate you! In case you didn't notice,  I had the students dress in surgical 'caps and gowns'!

Today I worked on a Eurasian Lynx. This large felid, weighed in at over 26 kilograms or about 60 pounds. This species is native to Europe and Asia but has a appearance very much like our local bobcat. Dental work was performed on this cat, as well as radiographs, bloodwork and routine vaccinations. I placed a 20 gauge intravenous catheter in his cephalic vein and provided him with fluids during the procedure. IV fluids are a great way to provide hydration and help maintain blood pressure during long anesthetic procedures. Because of the dental work being done, it was important to intubate him with an endotracheal tube. Endotracheal tubes are used to provide a patent connection from the patient to the anesthetic machine; if needed, the patient could be mechanically ventilated easily by having this tube in place. An 8.5mm endotracheal tube was placed in the lynx. For comparison, your domestic cat would require a 3.5-4mm tube.

Today I worked on a Baja Pronghorn. These medium sized antelope are endemic to North America and are known for their great speed and are considered the fasted land mammal of North America. Pronghorn are among a group of animals with even numbered toes; a condition known as artiodactyla. This animal received a routine exam that included anesthesia, radiographs, physical exam, and a variety of preventative medicine drugs to protect it from disease. After initial induction with injectable drugs, anesthesia was maintained with isoflurane, a gas anesthetic. This anesthetic gas is commonly used in veterinary medicine because of its ease of use and relatively low cost. Blood samples were collected from the jugular vein in order to evaluate cellular composition, also known as a complete blood count (CBC) and biochemistry profile. Blood was collected with the use of a vacutainer; this is the same equipment used when you have your blood taken. After the procedure, the Pronghorn was quickly recovered without complication.