Bronchitis, Bootcamp and Bovines

Now that I've finally gotten over my Bronchitis, I have started Bootcamp with 2 friends from vet school. It's this fitness camp that meets Monday-Friday from 5:30-6:30am and each day we do something different. Thursdays are hike days where we hike up a mountain in the dark and watch the sunrise over L.A and then hike back down. Heres a link if you want to sign up: http://www.inlandempirebootcamp.com/

This week I had a rotation at the Cal-Poly Bovine Unit where I practiced my physical exams on beef cattle. The picture above is of a fistulated cow. The hole leads to rumen.

The Diagnosis

So I was right....the diagnosis is chronic renal failure.
It has been such a long day of classes today:
8-10am Parasitology
10-12 Molecular and Cellular Biology
12-1pm Shelter Club Meeting
1-3pm Problem Based Learning
3-5pm Grand Rounds
5-? Study, study, study.

On a lighter note here's the parasitology joke that my professor told this morning....
One Sunday a pastor gave this sermon to his congregation:
When you take worms and place them in a jar filled with smoke and close the lid, the worms die. When you take worms and place them in a jar with sperm and close the lid, the worms die. And finally when you take worms and place them in a jar with alcohol the worms die. Now what does this teach you?
A woman in the back of the church raised her hand and answered...."As long as you drink, smoke and have sex you won't get worms."

What I'm Learning This Week

This weeks Problem Based Learning Case is really interesting. It's a 16 year old male, neutered domestic short hair cat named Rambo. Rambo presented with inappetance and losing weight over several weeks duration. In recent weeks he has also become PU/PD (drinking a lot of water and peeing a lot). His owner has brought him in because he has stopped eating, drinking, urinating and defacating the past 2 days. So far we have submitted and are awaiting results of a full blood profile and urinalysis along with a urine culture and sensitivity (results will be back tomorrow). In the meantime we have taken survey radiographs and noticed that his kidneys are smaller and irregularly shaped. Also their are crystals on the radiographs that appear to be nephroliths and ureterliths. So far I am guessing that this is a case of Chronic Renal Failure (CRF). CRF is one of the most common diseases to affect older cats. The bloodwork results that I get tomorrow will hopefully confirm my presumed diagnosis.
I have spent the past 2 days learning all about renal physiology (how the kidneys function) and researching how I should treat Rambo if indeed this is CRF. On physical examination Rambo was 10% dehydrated, so I have also been researching what type of fluid therapy would be appropriate in this situation. One of the things that I have found really interesting so far is that dehydration causes a decrease in tubular flow rates which would then result in increased Blood Urea Nitrogen(BUN), even before glomerular filtration rate is decreased. Basically what I've learned is that the BUN can be falsly elevated due to dehydration and that CRF patients may have a better prognosis then I would originally expect by just looking at the BUN alone. From what I've read so far, you should first re-hydrate the patient and then re-evaluate the bloodwork to truely measure the kidneys ability to remove urea from the blood and to give a correct prognosis. Interesting stuff, hugh?

Back to School

After a relaxing 2 weeks off I went back to vet school. Unfortunately I was pretty sick during the first week of classes and had to miss 2 days due to Bronchitis and possible Pneumonia.
Our first case of this block was Mariah, a young stray cat. The whole point of the case was to learn basic wellness care. Mariah was Feline Leukemia positive and then had a secondary toxoplasmosis flare up due to her immunocompromised state.
It has been sunny and in the 80's the past few days which is making studying a lot more difficult, but I'm doing the right thing and keeping up with my school work.
Oh, I forgot to mention that we were given our new PBL room and group assignments for the next 8 weeks and I was lucky enough to get one of the big rooms and have a great group!