TGIF

I gave my self a break last night from posting, because the week just completely drained me. It's rough to go from a 20 hour a week "desk job" to a 50 hour a week running around like craziness!

Yesterday was kinda fun, though absolutely insane. I was about 3 minutes late due to an important trip to pick up bagels and cream cheese before school. I remain convinced that the bagels maintained everyone's blood sugar at a reasonable level throughout the day and prevent the uber cranky that we've been seeing around noon when no one has gotten to eat since 6 or 7 am.

I had agreed on Thursday night to take the 8am diagnostic appointment, just so that we didn't have to choose first thing in the morning. Fortunately, my owner was a little late, so I had some time to settle in. This poor owner was absolutely hysterical on the phone on Thursday night, including kinda verbally abusing our (amazing) technician. We knew that she was pretty stressed, so I had really prepared myself for coping with the morning.

Her poor puppy had detached retinas due to high blood pressure and uncontrolled hyperadrenocorticism back in February. With blood pressure medicine her referring vet managed to get the left retina to reattach on it's own, but seemed to have limited success in the right eye. Based on the lab results that came with the record from her vet, her cushings has NEVER been controlled, and they haven't really changed the dose either (weird). It also looks like her hypertension is back in full form. Her right eye is completely filled with blood, and we presume that the retina is detached behind it. She is completely blind in that eye (if we can't see in, she can't see out), but the eye is not painful at all. So we prescribed some topical steroids to help resolve the blood, and referred her to the internal medicine service to get her cushings and hypertension under control. At last check she had an abdominal ultrasound that did not reveal anything diagnostic (big liver, spleen, lymph nodes, cystic pancreas, sludgy gallbladder, tubular mineralization in the kidneys... no tumors). I hope they can get her under control, because if they can do it by next week, there's a chance that we can actually resolve what's going on in her right eye and get her partly visual again.

I missed the 9am trip to the raptor center because of that first appointment, but R and J went with all the doctors, and got to see a snake. Apparently there were no birds, and one of the raptor center people had a snake with a retained spectacle (for whatever reason when the snake shed, the "lens" of skin over the eye didn't shed with it). They were unsuccessful in helping it to shed, so they prescribed some warm compresses and misting it with water to keep it moist and bringing the snake back next week.

The rest of the morning was just a series of rechecks that seemed to go on forever. I know that I rechecked a dog with dry-eye (KCS) who was slightly improved. We didn't have the records from the previous visit (grrrr), so I told Dr P that I thought I saw "slight flare" in the affected eye, and she agreed with me! I didn't know it was going to be there weee go me! I saw a dog with bilateral uveitis (inflammation in the front of the eye), that was also doing amazingly better. I helped hold for a couple of appointments that other students had, but I can't really think of what their cases were - I mostly just know the ones that I wrote up.

I finally grabbed a brief lunch break around 1:15 and got to eat my pizza, yummy! Because of the upcoming AVMA accreditation visit (starting today, actually), a group of gullible sophomores were under the Larry's supervision cleaning out refrigerators and microwaves that were REALLY NASTY. I've taken to eating my food at room temperature because if you put them in the fridge they pick up this really ... rancid kinda taste. SO gross. Oddly, reminds me of Boy's dorm room fridge in college at one point :) I totally ruined our leftovers one day.

The students after lunch kinda took the opportunity to regroup and talk amongst ourselves about cases and questions that we had. By the time the doctors found us (we were hiding in an exam room), we had the eye model, a laptop, an ophtho textbook, a set of Ross notes and a set of class notes out, trying to figure out the answers to our questions. Dr K stole R and J to hold the super insane lab that was getting a CERF exam (like OFA for eyes), so P and I just hung out for a little bit. Then Dr P came in and we held rounds for about 2 1/2 hours on eye emergencies. We got through glaucoma and the acutely blind eye. I have soo many pages of notes in my little notebook! It was really interesting, and while pretty similar to the lectures given in class 2 years ago - this time around it made sense! While Dr P was giving a powerpoint presentation, because there were only 5 of us in a very small room, it really played out like more of a discussion.