Clinics so far

This was 2010's first day on clinics. In this picture we are in ICU learning lots of things. Thats my yellow elbow in the corner!

I have been on radiology for 2 weeks now with 2 weeks left in the rotation. It's been fun... as long as I'm getting cases to radiograph. It's not just dogs and cats, we also do large animals, wildlife and exoticsand. It's also not just simple xrays- we do fluoroscopy, bone scans, CT and a new MRI will be installed in March! I'll be off radiology by then, but I'm still excited about it.

This is a blue and gold Hyacinth Macaw. His name is albert, and he is BEAUTIFUL!


Sometimes when we get bored, we travel over to visit the farm animal people. This is a 2 year old bull that fractured his third metacarpal. I took a radiograph of it and oh my gosh... it was shattered! Three pins were placed to try to stablize the limb, but the pronosis for return to function is not good. Since he has a red coat, we all called him Red Bull. :)


This is a baby goat that belongs to the anesthesia tech. She is sooo cute!! She would butt heads with me if I lowered my head down to hers!

This is an owl that came in a couple days ago needing a full body exam, and also a radiograph of the right wing. Possible subluxation of the right wing.


Here we are in action. I know, I know... I don't have my lead apron on yet- but trust me.... I always wear it!!


Here is something pretty impressive. This is a horse that I radiographed last week, but in this picture he is back for a CT! He presented last week after having a seizure. No recent trauma could be found in the c-spine or skull, but the radiologist recommended CT to further evaluate. I don't know the results of this scan.


A Chinese Crested!!! So cute! Apparently I'm the only one that thinks so....

First week of clinics

This week has been so crazy. The class of 2010 started clinical rotations on Monday, and we are in full swing. I'm on radiology first, so I'm taking a bunch of radiographs. I watched a fluoroscopy on Tuesday; the dog had urethritis. I've seen a bunch of awesome cases. One of them is a cocker spaniel I actually just saw on Sunday at the emergency clinic that I work for. The dog came in on Saturday straining to urinate, and when he did manage to urinate it was bloody. We did a urinalysis and the blood spun down to a pellet, cbc and chem panel was WNL. Abdominal radiographs were also completed in order to rule urinary calculi.

This is not the cocker's radiographs, but this is an extreme case of bladder stones. We thought we might see one or two small ones, but we saw nothing.

When I came in Sunday morning, the urine was still bloody, but not quite as dark and it actually cleared up thruoughout the day. Around 5pm the urine was again very dark brown.
(urine is on the left: suggestive of hemoglobinuria or myoglobinuria, serum is on the right, the red color is expected with to correlate with hemoglobinuria)

We again centrifuged the urine, but this time the color did not spin out, and a RBC pellet was again found at the bottom of the tube. This led us to think perhaps this cocker spaniel was experiencing hemoglobinuria or myoglobinuria. In order to test for this we then drew blood and spun it down and also began to run the CBC and chem panel. If it was hemoglobinuria we would expect the serum to be pink (b/c of hemolysis) and the hemoglobin levels to be low. If it were myoglobinuria we would expect the serum to be clear, and hemoglobin levels to be WNL. Creatinine Kinase would also indicate myglobin release, but our lab at the emergency hospital doesn't test for this enzyme. So the results.... Hemoglobin is LOW! but the serum is clear!! very weird. So next I drew more blood to do a slide agglutination test which tests for IMHA (immune mediated hemolytic anemia), and it looked like this....

The red blood cells have clumped together, suggesting that they have antibodies on them that are recruting more and more cells to come attack the red blood cell causing them all to stick together.... this cockers blood did this... again... how does it fit in!? This dog did not have pink serum which goes hand in hand with IMHA, nor was the dog anemic. Actually- I take that back. I did a PCV 3 times on this dog. I got two different PCV readings from the SAME TUBE OF BLOOD: one was 45, one was 30. Then the machine told me the PCV was 25.

So anway- I left Sunday night in a bit of a confusion. As I was trying to fall asleep Sunday night I kept thinking about this dog. I got up to read all my notes to see if I could put the puzzle together, but I just couldn't make it work. I couldn't sleep very well that night, which was unfortunate since I was to begin clincis at 8am the next morning. (I was so sad to think that I may not see this case reach resolution.

On Wednesday guess who came to LSU-SVM?! That's right!! That cocker spaniel!! He came to radiology for thoracic radiographs to rule out metastatic dz that may indcate some primary tumor that was ill-defined on abdominal radiographs. He also went to ultrasound. This is where it got good. The gall bladder was HUGE! Larger than the kidney. It also had a mucocele in it!!

The spiney projections are the mucocele. (none of these pictures are from this case, just examples)

There was also a clot in the urinary bladder, not a true mass, just a clot. The dog went to surgery today.They removed the gall bladder, and took a biopsy of the urinary bladder They also took a biopsy of the stomach wall, and small intestine too becasue there was a medium size area of inflammation in the area of the duodenum. I can't wait to see what comes back!!