Kristin Kuntz, Masaya, Nicaragua, May 2014

During our fourth clinical day, I teamed up with a pre-veterinary student from Texas A&M! Though this had been the typical arrangement for most students throughout the trip, I had previously been paired with a fellow U of I vet student. While all of us veterinary students have similar levels of experience (clinical rotations in the CSLC, working in animal hospitals, etc.), the pre-veterinary students had never performed a physical exam,administered injections, or restrained an animal before. This difference in background provided us with the unique opportunity to pass on our knowledge to the pre-vets. For each patient, my pre-vet student, Tim, and I went over a consistent pattern for performing a physical exam, the names and locations of palpable lymph nodes, measuring heart rate vs. femoral pulse, the typical sites for IM and SQ injections, and sites for IV catheters or venipuncture.

Nicaragua2014_D4.1Each case provided good teaching moments for the pre-vet student, but they also presented me with lots of new learning opportunities! For example, though I can name and find the submandibular, pre-scapular and popliteal lymph nodes, I can’t always tell if one feels enlarged or if it is just normal for that size and breed. The veterinarians and veterinary assistants were very willing to provide their input when they weren’t occupied with surgeries or prepping patients. They explained the tick-borne diseases that were likely stimulating the lymph nodes to enlarge, and what antibiotics they would use to treat if they had the resources. I also had my first opportunity to assist in neutering an adult Rottweiler. While I had observed surgeons in Illinois utilizing the pre-scrotal technique, I had never seen a veterinarian use a scrotal approach. The Nicaraguan veterinarian, Jasson, preferred the scrotal technique because it allows for a bit of drainage from surgical site, reducing chance of post-operative infection. This is preferable, since we were about to move on to Diriamba, and would not be back in Masaya to check on these patients. The neuter was also unique for me because it was performed on a 7 year old, 100-pound dog, rather than the typical small, 6-month old puppy we’d see in American general practices. Due to the patient’s size and age, the spermatic fascia and ligament were very taut, thus very difficult to breakdown to get exposure of the spermatic cord. Another challenge we encountered was due to the blazing heat. With the outdoor temperature in the high 90s, we dealt with several patients suffering from hyperthermia. We’ve been taught in school to use heating pads and bear hugger warming blankets to prevent post-op hypothermia, but in Masaya, I learned to combat the dogs’ 104 F body temperature with IV fluids, spraying the body with alcohol and rubbing ice chips along the paw pads. I’m sure this will be good preparation for cooling down dogs during the hot summers back in Illinois!