Class of 2020... how you doin?

Veterinary Science Graduate Certificate from UofI
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Last quiz is this Friday. Then 2 weeks till Finals. At least we have days in between each final (unlike midterms T.T)
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Cephal0pod said:
FREAKING RENAL WORMS, YOU GUYS.

:barf:
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WildZoo said:
Giant kidney worm!!!
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GIANT KIDNEY WORMS?

30a95ff451104f19ea5655406e874a84.gif


I already hate the kidneys enough as it is
 
Trilt said:
Oh man they're so cool though.
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SO COOL!

If I ever set down and created a vet med bucket list of things I wanted to see/do, encountering a gigantic kidney worm is like number one. :laugh:
 
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Had parasites last year, why did I never hear about this one?
 
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Trilt said:


^I would just diiiieee if I saw that on ultrasound lol.
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okay beyond the ridiculous idea of GIANT KIDNEY WORMS, that female laid eggs all over the omentum surrounding the pancreas. They didn’t explain it in the video, how’d they get rid of those??

I would also die if I saw that on ultrasound, but not from excitement lol
 
It's hard writing a "pick me because I'm better than everyone else" type essay



Like I know its true, but its hard to put into words
 
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Teepster87 said:
It's hard writing a "pick me because I'm better than everyone else" type essay



Like I know its true, but its hard to put into words
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So many people in my class are finishing the Zoetis essay today during lecture...:D
 
cdoconn said:
okay beyond the ridiculous idea of GIANT KIDNEY WORMS, that female laid eggs all over the omentum surrounding the pancreas. They didn’t explain it in the video, how’d they get rid of those??

I would also die if I saw that on ultrasound, but not from excitement lol
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I'm curious about that, too.

Also I've never seen a surgery use an incision that large. :wideyed: Is that normal for exploratory cases?
 
flameshock said:
So many people in my class are finishing the Zoetis essay today during lecture...:D
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Ha, I wasn't even thinking about that one. I'm trying to finish one for a usda thing
 
PrincessButterCup said:
I'm curious about that, too.

Also I've never seen a surgery use an incision that large. :wideyed: Is that normal for exploratory cases?
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We have those (giant kidney worms) here in the wildlife population (Minnesota). I can't remember details (paging any DVM... any DVM.... dumb-ass ER doc needs smarter DVM), but I think it's some sort of weasel. @JaynaAli ?

I practically live for the day I go to FAST scan some ER patient and see a right kidney full of giant kidney worm. That would be the best day of my life. Especially if the owners consent to treatment.

That said, it'll never happen. It's too rare even here where we have them. Sigh.

Regarding large incisions (incoming rant, because tiny little "explore" incisions are a pet peeve) - yes, for many types of explores, we make incisions that large. It's easy to get too focused on what you expect the problem to be and forget that the point of an explore is to explore the whole abdomen. If I'm doing a traumatic urinary bladder rupture from a dog diving from the boat to the dock (I had two of those in one day last summer), I'm not going to just make a caudal abdominal incision to visualize the urinary bladder - I'm going to open the abdomen stem to stern so I can evaluate for other damage that I didn't pick up on rads or ultrasound. How would I look if I went and fixed the urinary bladder and didn't notice some other correctable trauma? Our surgeons definitely believe in big explore incisions.

A little tiny spay incision in a healthy young dog/cat is pretty darn reasonable. There's no reason to expect or worry about some other pathology, and less incision means less pain, less risk of dehiscence, etc. But in a middle-aged or older dog ... (personal opinion) it's always better to go as large as necessary to make sure you evaluate the entire abdomen for other pathology than what you were expecting. You're going to look dumb if you spay a newly-adopted 8-yr-old dog and one month later another doctor notices a splenic mass on ultrasound that you missed and now the owners have to take their dog to surgery again when you could have just removed it and sent it off to histopath. Been there, dx'd that, and the owners were pretty pissed at their GP.

I once got yelled at by a lady in an exam room - she was presenting for her dog's 5th foreign body surgery. She opened the conversation with "make sure the incision isn't so big this time." I explained why it was so big last time (boarded surgeon did it, btw). I pointed out that the large incision had allowed the surgeon to catch some liver pathology that was biopsied and successfully treated. Didn't matter to her that the large incision had led to better care for her dog! She got mad that I defended the large incision, declared that her dog didn't like me, so she didn't like me, and so I went and got her another doctor. *shrug* People be bat**** crazy about that kind of stuff.

The classic answer to 'how large should my incision be' is 'as large as it takes to do the job right and no larger'. In an explore, you're exploring the whole abdomen, so your incision needs to be large enough to visualize all the structures to your satisfaction. I had a post-op FB transfer once that had a 1" incision on a pretty good-sized dog - just large enough to exteriorize the bowel segment involved. I'm betting that doc felt proud at his tiny incision. I'd argue, though, that he didn't do a thorough job.
 
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LetItSnow said:
We have those (giant kidney worms) here in the wildlife population (Minnesota). I can't remember details (paging any DVM... any DVM.... dumb-ass ER doc needs smarter DVM), but I think it's some sort of weasel. @JaynaAli ?

I practically live for the day I go to FAST scan some ER patient and see a right kidney full of giant kidney worm. That would be the best day of my life. Especially if the owners consent to treatment.

That said, it'll never happen. It's too rare even here where we have them. Sigh.

Regarding large incisions (incoming rant, because tiny little "explore" incisions are a pet peeve) - yes, for many types of explores, we make incisions that large. It's easy to get too focused on what you expect the problem to be and forget that the point of an explore is to explore the whole abdomen. If I'm doing a traumatic urinary bladder rupture from a dog diving from the boat to the dock (I had two of those in one day last summer), I'm not going to just make a caudal abdominal incision to visualize the urinary bladder - I'm going to open the abdomen stem to stern so I can evaluate for other damage that I didn't pick up on rads or ultrasound. How would I look if I went and fixed the urinary bladder and didn't notice some other correctable trauma? Our surgeons definitely believe in big explore incisions.

A little tiny spay incision in a healthy young dog/cat is pretty darn reasonable. There's no reason to expect or worry about some other pathology, and less incision means less pain, less risk of dehiscence, etc. But in a middle-aged or older dog ... (personal opinion) it's always better to go as large as necessary to make sure you evaluate the entire abdomen for other pathology than what you were expecting. You're going to look dumb if you spay a newly-adopted 8-yr-old dog and one month later another doctor notices a splenic mass on ultrasound that you missed and now the owners have to take their dog to surgery again when you could have just removed it and sent it off to histopath. Been there, dx'd that, and the owners were pretty pissed at their GP.

I once got yelled at by a lady in an exam room - she was presenting for her dog's 5th foreign body surgery. She opened the conversation with "make sure the incision isn't so big this time." I explained why it was so big last time (boarded surgeon did it, btw). I pointed out that the large incision had allowed the surgeon to catch some liver pathology that was biopsied and successfully treated. Didn't matter to her that the large incision had led to better care for her dog! She got mad that I defended the large incision, declared that her dog didn't like me, so she didn't like me, and so I went and got her another doctor. *shrug* People be bat**** crazy about that kind of stuff.

The classic answer to 'how large should my incision be' is 'as large as it takes to do the job right'. In an explore, you're exploring the whole abdomen, so your incision needs to be large enough to visualize all the structures to your satisfaction. I had a post-op FB transfer once that had a 1" incision on a pretty good-sized dog - just large enough to exteriorize the bowel segment involved. I'm betting that doc felt proud at his tiny incision. I'd argue he didn't do a thorough job.
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That makes sense! I've only ever seen the abdomen open like that on necropsy, so it looked strange to me. Surgeons I've watched have definitely prescribed to the 'smallest incision is the best incision' opinion.
 
LetItSnow said:
We have those (giant kidney worms) here in the wildlife population (Minnesota). I can't remember details (paging any DVM... any DVM.... dumb-ass ER doc needs smarter DVM), but I think it's some sort of weasel. @JaynaAli ?
Click to expand...
Sorry...that is a long way from where I went to vet school, so I'm not up on parasites of Minnesotan wildlife, haha. A google search says maybe mink? I am not the smarter DVM you are looking for.

I agree that small incisions have their place just like large ones do. When Winston had his adrenalectomy the surgeon ended up extending her incision to have room to dissect the adrenal gland + inspect a nodule in the body of his pancreas and even had to do a diaphragmatic advancement (layman's terms: open the chest a little and move the diaphragm attachment up a little bit) to give themselves more room! The incision heals side to side not end to end, and even though owners don't always like it, it's for the good of the patient the majority of the time. A surgeon at my internship routinely commented that she was jealous and amazed by GPs who were able to do keyhole spays, because she really felt like she needed big incisions to be able to visualize everything for ones she was doing (usually pyometras).
 
LetItSnow said:
I practically live for the day I go to FAST scan some ER patient and see a right kidney full of giant kidney worm. That would be the best day of my life. Especially if the owners consent to treatment.
Click to expand...
I honestly get a little thrill even thinking of it. I'd be so excited and all of our techs would be rolling their eyes so hard at me. Come on that's ****ing awesome.
 
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Trilt said:
I honestly get a little thrill even thinking of it. I'd be so excited and all of our techs would be rolling their eyes so hard at me. Come on that's ****ing awesome.
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Oh no doubt. I would be an amusing image: an older normally grumpy ER doc squirming on his stool squeeing and saying "oh my god oh my god oh my god this is so cool!"

My techs would probably be slowly backing out of the ultrasound room.
 
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LetItSnow said:
We have those (giant kidney worms) here in the wildlife population (Minnesota). I can't remember details (paging any DVM... any DVM.... dumb-ass ER doc needs smarter DVM), but I think it's some sort of weasel. @JaynaAli ?

I practically live for the day I go to FAST scan some ER patient and see a right kidney full of giant kidney worm. That would be the best day of my life. Especially if the owners consent to treatment.

That said, it'll never happen. It's too rare even here where we have them. Sigh.

Regarding large incisions (incoming rant, because tiny little "explore" incisions are a pet peeve) - yes, for many types of explores, we make incisions that large. It's easy to get too focused on what you expect the problem to be and forget that the point of an explore is to explore the whole abdomen. If I'm doing a traumatic urinary bladder rupture from a dog diving from the boat to the dock (I had two of those in one day last summer), I'm not going to just make a caudal abdominal incision to visualize the urinary bladder - I'm going to open the abdomen stem to stern so I can evaluate for other damage that I didn't pick up on rads or ultrasound. How would I look if I went and fixed the urinary bladder and didn't notice some other correctable trauma? Our surgeons definitely believe in big explore incisions.

A little tiny spay incision in a healthy young dog/cat is pretty darn reasonable. There's no reason to expect or worry about some other pathology, and less incision means less pain, less risk of dehiscence, etc. But in a middle-aged or older dog ... (personal opinion) it's always better to go as large as necessary to make sure you evaluate the entire abdomen for other pathology than what you were expecting. You're going to look dumb if you spay a newly-adopted 8-yr-old dog and one month later another doctor notices a splenic mass on ultrasound that you missed and now the owners have to take their dog to surgery again when you could have just removed it and sent it off to histopath. Been there, dx'd that, and the owners were pretty pissed at their GP.

I once got yelled at by a lady in an exam room - she was presenting for her dog's 5th foreign body surgery. She opened the conversation with "make sure the incision isn't so big this time." I explained why it was so big last time (boarded surgeon did it, btw). I pointed out that the large incision had allowed the surgeon to catch some liver pathology that was biopsied and successfully treated. Didn't matter to her that the large incision had led to better care for her dog! She got mad that I defended the large incision, declared that her dog didn't like me, so she didn't like me, and so I went and got her another doctor. *shrug* People be bat**** crazy about that kind of stuff.

The classic answer to 'how large should my incision be' is 'as large as it takes to do the job right and no larger'. In an explore, you're exploring the whole abdomen, so your incision needs to be large enough to visualize all the structures to your satisfaction. I had a post-op FB transfer once that had a 1" incision on a pretty good-sized dog - just large enough to exteriorize the bowel segment involved. I'm betting that doc felt proud at his tiny incision. I'd argue, though, that he didn't do a thorough job.
Click to expand...

Incisions heal side to side, not front to back.
 
HR is trying to not let me work over winter break for some BS rule, that's apparently based off of a powerpoint slide. I'm about to burn this place to the ground.
 
Only 3 exams left. But they're spread out all the way until Dec 21.... but also kind of thank goodness for that because they're fitting 25 path lectures into 1 1/2 weeks.
 
:shrug:
but also, I almost don't even feel like it's that bad. It's the only class we have to focus on after monday (except for one other final that shouldn't be too big of a deal). I feel like I'm just so used to studying like this at this point that it could be worse.
 
supershorty said:
I really like clin path. I really, really, really like clin path.

Did not expect to find it as interesting as I do.
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Pure curiosity: Do they talk much about indirect/unconjugated bilirubin vs direct/conjugated in that class? Or do they just sorta stick with total bili?

We don't usually measure IBili/DBili (just TBili, because at the end of the day, having the split doesn't really practically change much), and I saw it on some rDVM bloodwork recently in a patient with TBili of 32 and it occurred to me that I didn't remember the last time I saw it broken out.

And then I had flashbacks to pathways of unconjugated non-water-soluble albumin-carried bilirubin being conjugated with glucuronic acid to become water soluble and ...

... my eyes glazed over and I went and got a beer and turned on Netflix.
 
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LetItSnow said:
Pure curiosity: Do they talk much about indirect/unconjugated bilirubin vs direct/conjugated in that class? Or do they just sorta stick with total bili?

We don't usually measure IBili/DBili (just TBili, because at the end of the day, having the split doesn't really practically change much), and I saw it on some rDVM bloodwork recently in a patient with TBili of 32 and it occurred to me that I didn't remember the last time I saw it broken out.

And then I had flashbacks to pathways of unconjugated non-water-soluble albumin-carried bilirubin being conjugated with glucuronic acid to become water soluble and ...

... my eyes glazed over and I went and got a beer and turned on Netflix.
Click to expand...

Does that indirect/unconjugated/conjugated BS really matter? I mean there's only so many things that make bilirubin increase, right?...I really don't remember any specifics regarding that crap, I just see elevated total bilirubin and start thinking of the things that make it increase.
 
LetItSnow said:
Pure curiosity: Do they talk much about indirect/unconjugated bilirubin vs direct/conjugated in that class? Or do they just sorta stick with total bili?

We don't usually measure IBili/DBili (just TBili, because at the end of the day, having the split doesn't really practically change much), and I saw it on some rDVM bloodwork recently in a patient with TBili of 32 and it occurred to me that I didn't remember the last time I saw it broken out.

And then I had flashbacks to pathways of unconjugated non-water-soluble albumin-carried bilirubin being conjugated with glucuronic acid to become water soluble and ...

... my eyes glazed over and I went and got a beer and turned on Netflix.
Click to expand...
They mentioned it briefly in our class but really glazed over it since it's so rarely reported separately.
 
DVMDream said:
Does that indirect/unconjugated/conjugated BS really matter? I mean there's only so many things that make bilirubin increase, right?...I really don't remember any specifics regarding that crap, I just see elevated total bilirubin and start thinking of the things that make it increase.
Click to expand...

I personally don't think it matters much because let's face it - with a significant TBili elevation once I've ruled out some sort of hemolytic differential, which is simple 'nuff, it's liver+gallbladder and I'm sending it to ultrasound where I'm getting a better dx than I was going to get from bloodwork.

But in the world of ClinPath, I would guess they love their indirect/direct since they can in theory utilize it to narrow down the differential list.
 
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LetItSnow said:
I personally don't think it matters much because let's face it - with a significant TBili elevation once I've ruled out some sort of hemolytic differential, which is simple 'nuff, it's liver+gallbladder and I'm sending it to ultrasound where I'm getting a better dx than I was going to get from bloodwork.

But in the world of ClinPath, I would guess they love their indirect/direct since they can in theory utilize it to narrow down the differential list.
Click to expand...

Summon the pathology peeps..

@JaynaAli @WhtsThFrequency
 
raf2769 said:
Only 3 exams left. But they're spread out all the way until Dec 21.... but also kind of thank goodness for that because they're fitting 25 path lectures into 1 1/2 weeks.
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Not being done until the 21st sounds terrible. :( Our last final is the 15th and I'm already beyond ready to be done and enjoy Christmas stuff.
 
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WildZoo said:
They mentioned it briefly in our class but really glazed over it since it's so rarely reported separately.
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We have clin path fall semester of 1st year so it's been a little bit, but I believe it was given a similar degree of emphasis in our class as well.

I also really liked clin path. The faculty who taught our class were fantastic and made it a great (though certainly still challenging) experience. I got a lot out of that class.
 
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