Continuing my education.

I know it is not the focus of my blog, and I don't bring it up very often, but I have a "job". The kind you go to, and get paid for. The quotes are because, I have several jobs, but there is only the one the IRS cares about.

 Greater Columbus Convention Center. My home away from home of the past week.

I am a Veterinarian. Even nearly 20 years after receiving that degree, it sounds a bit braggy. As a profession it can be rather unwieldy. I mean that being a DVM means you can treat a pet kitty with intestinal lymphosarcoma (cancer...so, doing oncology) or spay a black bear from the wildlife preserve (wildlife or zoo medicine). You are just as likely to read the cytology from a unidentified mass on the ear of a German Shorthair Pointer (dermatologist, or oncology again if it's cancer, but in any case, a cytologist...reading microscopic cell pathology) as you are to explain the steps to getting a 7 year old kitty to start using the litter box again after several months of peeing under the dining room table (behaviorist). In any given afternoon, you might need to diagnose intestinal obstruction on the Labrador that ate his owner's tube socks- and then open the pooch surgically, remove the socks, and put him back together,( radiologist, internist, surgeon) or talk a young couple through the unexpected death of their Jack Russell, who dashed out of the house, and got hit by a car and is brought by a devastated owner in tears and bare feet (emergency medicine followed by compassionate authority and human being- not always taught in Veterinary School).

When I was licensed in Oklahoma, I had to take a written exam, then when that is passed, have an oral examination by members of the Oklahoma Veterinary Licensing Board. I sat at a table one-on-one with each member while they questioned me about different parts of the profession in which they expected proficiency. The guy that specialized in equine medicine and surgery asked me questions about horse colic and lameness, the small animal internist asked about diagnosing Addisons disease and treatment, the small animal surgeon asked me what I would do when confronted with an open fracture and a broken jaw, and so on. Each member asked about their own specialty, including the exotics specialist, who asked me a dozen questions about emus. Really? Emus? C'mon! I felt like I'd been cranked though an old fashioned washing machine. I passed, but in the subsequent years, when the Oklahoma Veterinary Medical Association would bellyache about the shortage of Veterinarians in Oklahoma, I had to say it was no mystery to me.




You can't know about it all. Each one of those specialists wanted to know what I knew about their specialized area, and I know the Emu Dude was very disappointed with me. This is why specialization came about in the first place. In human medicine it is not new. You don't go to your Primary Care Physician and expect them to remove your colon and give you a colostomy bag. You don't expect a PCP to treat your cancer, or your cataracts, your diabetes, your rheumatoid arthritis. You hope they will identify these problems and refer you to the person who will help you treat your disease/injury/rehabilitation.
And, specialization in Vet Med isn't new either. Huz is a Radiologist and he does a bang up job. But don't ask him to read your cytology, or give a vaccination to your cat, because he doesn't. Fortunately, he also doesn't expect me to be able to read a CT on an emu. At the same time, he does expect me to be able to read x-rays with reasonable accuracy. Thankfully, on the ones that stump me, he's happy to help. Still, most general practice veterinarians are expected to wear a whole lotta hats.

This is where Continuing Education comes into play. I spent 4 days in lectures this week trying to absorb. And sometimes, it's really frustrating. The lectures are given by the top specialists in their field. And, there are a LOT of fields. So, I pick and I sit and with poised pen, listen, write and try to move forward in my knowledge without kicking myself too much about not already knowing that fillintheblank.   Why have I never thought about the effects of calcium on the thyroid???
Shoot! I did give a Cox2 inhibitor to a dog that might by Cushinoid. I have never heard of the ManicMouse 360! I thought cats with chronic renal disease benefitted from a low protein diet- and now that's not true any longer? And, so on.
Surgery, feline medicine, behavior, equine, endocrinology, radiology, small ruminants, exotics, pocket pets, small animal internal medicine, holistic and integrative medicine, cytology, dermatology,  so numerous- how to choose, how to learn it all? I can't.

                                                           
Day 2, I plopped down in a seat just behind an older practitioner, who informed me that this spring he would have been in vet med for 50 years! I was musing at the experience he must have! Then he told me about a nifty little book his wife had picked up in the exhibit hall. As he described it, I was amazed to realize he was describing a formulary. This is a book full of medications, with uses, doses, side effects, contraindications, pharmacology, etc. I use it everyday, about a billion times, for nearly every drug I pull off the shelf, for every patient. Formularies have been available since 1778.
Thank you, oh wise and experienced veterinarian, for giving me great hope. Even if I haven't thought about the need for supporting riboflavin and thiamine levels in coprophagic dogs , at least I know how to find out. Another lecture, another nugget of knowledge. And, I already know stuff.



  

Happy Valentine's day!

 

Happy Valentines Day!!

 

 

 

 

 Yesterday's unexpected, warm weather snowfall gave us an opportunity to get on our ponies! It wasn't -6 degrees, with awful winds, and it wasn't raining, and it wasn't icy.... it was the first time in a long time. Middlest's other horse is still in the recovery phase from a pasture injury, so we didn't let her come. Poor baby. These two had a fine time, mine prancing and blowing, and Middlest's ambling along (thus my saddle and her bareback..).

Eldest trudged outside in her robe and Huz' MuckBoots to snap some photos.

Heaven!

Little  on a horse ......





 

Little off a horse.

Middlest good-naturedly gets teased a bit about her size. (Which in reality is quite normal, but in relation...)

 

 

The "G" gen of Lambs.

The story of the birth of our first lambs of 2013 starts with Lassie saving Timmy from the well.
Or, "same difference".( That was an 80's expression, still not sure exactly what it means). It was bedtime- well, for me, bath time. So I was in the clawfoot tub adding the hottest water the hot water heater can churn out, about mid-knee deep in "hog-scald" as my friend Amber puts it, when a flighty Huz appeared on the other side of the glass bathroom door. Now, friends, if you know Huz, you understand this is not a normal state of appearance. His first students at Oklahoma State University nicknamed him "Underwhelmed", and it continues to suit. So when he looks a bit panicky, one must take notice. He was so excited he forgot to open the door and just yelled "Lamb!" To which I replied "What?" This went on for a few attempts before he opened the door. Then, I was out of the tub and on my way to the barn.
 The part of the story I was missing was- how did Huz know? Lassie told him.
While I retired to the tub, Huz had let the dogs out for their last nighttime constitutional. Only, Tucker wouldn't come back in, and was making short barks. So, Huz went outside to evaluate the problem. Between the coyote pack speaking at the creek to the southwest, he heard a high pitched "maaaaaaahhhh"! So, he dashed towards the barn, to find a newly birthed, black lamb had somehow fallen out of the sheep pen and into the snow.
 I say "somehow", but this was possible, courtesy of the Ram, who, upon contemplating a 200 year old oak stall door had realized it must die, and had ram-rammed it until the 2' iron straps broke. The door has been replaced by a steel gate, but it allows a gap underneath, certainly big enough for a little lambie to roll out.
So, newborn lamb in the snow. Bad. Huz saving it by giving it back to the momma and coming to find Middlest and myself. Good. Tucker letting Huz know there was saving to be done. Phenom.

The three of us arrived at the barn with our warm towels and sussed things out. The lambing pen had not been completely prepared, so Huz helped with water bucket extension cords and rigging up the heat lamp while Middlest worked on getting the baby dry, and I worked on getting Dolores ready to feed the newborn. The baby had gotten a bit chilled which is death to baby lambs, so needed some calories asap. I stripped the wax plugs from her nipples and we got the baby nursing- not easy to do. How sheep live without the help of a shepherd is a miracle. I curled up and got my head down to the ground and finished "crutching" Dolores with a  pair of scissors. This is trimming all the bits of wool that could confuse the baby lamb. They will starve by trying to nurse wool instead of a milk producing nipple. The baby was a natural colored girl ( sheep speak for black sheep). She was big, and hardy and started standing and trying to nurse (D-lo's neck, tail, trailing placenta..) But, was there another lamb in there?

 Soon, Dolores laid down and started pushing again, and out popped a little white foot. Two more big pushes, and no more than one little white foot came out. So, I put on an OB sleeve and went in to find out what was happening in there. The baby had it's chin tucked to its chest and had one front leg back, out of the birth canal. So, I pushed him all back inside, lifted his head and pointed his feet in the right direction, gently moving the feet together out of the sheep,  and cupping my fingers behind his ears to move him along. Out slipped an orange lamb. Not the best sign. They have had a hard time of it when they come out all covered in orange. I got him breathing easily, dumped him upside down and cleared some mucous from his mouth, and Dolores went to work cleaning him. We rubbed him with towels, and got the heat lamp right there to warm him- so darn cold in the barn tonight! And, he was content to just sit in Middlest's lap. Not interested in nursing. I couldn't get him to latch on, and he didn't really want to stand. I gave him Vitamin B Complex, I gave him Nutridrench, I gave him Cal-Dex..... not perky. So, after working for a while in an ineffective fashion, I gave up on that method and went for the beer.

I found a Bud Light ( not Huz' favorite- he had gone to bed some time ago, and wouldn't have begrudged the baby a Blue Moon or Sam Adams, but quite happy to share a Bud Light), and emptied it into the sink, rinsed the bottle and filled it up with hog-scald hot water... oh, my bathtub was going to feel GREAT when I got back to it! I stuck a nipple on the bottle of really hot water, and put it in my jacket. My hands were happy for the hot water, by now they had become stiff and a bit swollen with the cold. I was thankful for the bottle nipple- a hand me down from friends who had stopped this crazy sheep-raising business. Back to the barn, in the cold dark of the next morning.  I dumped out the hot water, and milked Dolores into the bottle, getting about 3 warm ounces of colostrum at a time, and then gave it to the little ram lamb. It didn't take long after the first bottle to have him looking a bit alive. The next 3 ounces produced a standing lamb, and the next three produced a nursing lamb.

It soon became apparent that the two babies were doing pretty well now. So, I deserted Middlest with a list of tasks - make yourself tea, give the babies probiotics, make sure they are warm and full, and keep hay in front of Dolores. And I went to the tub, washing off the night, and the sticky, and trying to melt my bones. But, I don't do late nights, let alone early mornings, so gave up and went to bed, dragging myself up in a few hours to go to work, leaving Middlest to care for the barn and it's inhabitants. I called the Absentee Hotline at the school and left the message in a froggy foggy voice "Yes, my name is Mom, my daughter is Middlest, and a freshman. She will not be at school today due to lambing."
After hanging up, I realized that the message probably would actually make sense to whomever was listening, and in the computer attendance log, next to my daughter's name would go the word "lambing". And, she wouldn't be the only one.