Today we spayed Halley, another cat. Everything went very well, and very smooth. Everything was the same as yesterday in terms of procedures and protocols and tasks the students did. At the end we graded the students.

Today we started the cat spays. We spayed Electra. The difference between the cat spays and the dog spays is that we use different induction drugs. The premedication is the same, we use Butorphanol, acepromizine and glycopyrrolate (see drug list for dosages). However, for induction we use a combination of ketamine and Valium instead of propofol. Everything else is the same, they need to do a physical and obtain the pre-op blood work, draw up their drugs and have them checked by either myself, Maura or Kim; administer the premedication, place a catheter after the medication had taken effect and then induce and intubate, hook the animal up to the anesthetic machine and prep the animal for surgery. When the cat was intubated, a drop of 2% Lidocaine was placed on each laryngeal fold to prevent laryngeal spasms and then each of the anesthetists intubated the cat. Then they move the cat into the surgery suite and hook all of the monitors up and monitor the cat while Dr. Young performs the spay. Today went fine, the students did very well with the cat, and after the cat was recovered enough for the students to leave, we graded them and left. (See procedures for further explanation)

Monday’s lab is still two weeks behind. Today they helped neuter Comet. Comet was a unilateral cryptorchid. Dr. Young had no problems finding the testicle in the abdomen. Everything went very well and there were no abnormalities. We graded them and left.

The first lab spayed Cassiopeia which went fine. And the second lab is a week behind so they castrated Taurus. Everything went the same as all of the other surgeries except I had to place Taurus’s catheter. At the end, we graded both classes and went home.

Today we spayed Callisto. Everything went very well, no problems at all. After we graded the students we left.

Today we started spays, we did Andromeda today. Again, everything is the same in terms of what the students do, except they have to shave and scrub more; they shave from the xiphoid process down to the bottom of the pelvis and across to both sides. They also try to express the bladder; other then that, everything went very well. We graded the students and left. (See procedures for further explanation)

Monday lab started surgeries today. They castrated Phoenix. Everything went well; we graded them and went on our way.

The first lab we castrated Pluto and the second lab was Neptune. Both went very well and there were no huge problems. Again, we graded the students and went home.

Today was Triton, a bilateral cryptorchid. Everything went well, and nothing was out of the ordinary. Then we graded the students, checked on the dog and went home.

Today was Nash, who was a unilateral cryptorchid. A cryptorchid is when one or both of the testes has not dropped down and the doctor has to go into the abdomen and find it so it does not cause issues later in life. In terms of the tasks of the students, nothing changes except the area where they scrub. The area scrubbed is all the way from the xiphoid process down do the end of the scrotum and all the way to the sides, like a spay. Then we graded the students.

Monday’s lab is two weeks behind, so we finished their lab practical today. Maura and I both stayed late to help people finish and to go over a few things with some students who had to come back to repeat a few tasks.

Leo was the first castration of the day, which went very well. The only difference from the previous days was that I had to place the catheter since the circulating nurses could not. Then we graded everyone and were about to let the next class in, but the USDA showed up and we canceled lab. Maura and I went over to the rat lab to clean up a bit, and then came back to help Kim.

Today was the castration of Krypton. Everything went very well, pretty much the same as yesterday. The only difference was that we had the circulating nurses autoclave some of yesterdays supplies to keep up with everything. At the end, we graded the students and made sure everything was off and put away.

Today was the first day of surgeries! We neutered Dipper. We arrived early so that the students could get a head start. First, we checked the anesthetist’s drug calculations for Torbugesic, acepromizine and glycopyrrolate for the premedications and then Propofol for the induction agent. Then they could draw up the drugs, and have either myself, Maura or Kim check the syringes, and then mix the premed into one syringe. Then the circulating nurses performed their physical exam and did a big four; blood glucose, BUN, PCV and a total solid. After Dr. Young checked the exam and the blood work, the anesthetists could give the premed IM.
While this is going on, the surgical assistants are preparing the surgical suite by turning the table and heating pad on, setting up all of the monitoring machines and getting out their gowns and gloves for after they scrub.
I then changed the scrub containers according to the correct procedure.
When Dipper was sedated enough, the circulating nurses attempted to place a catheter. They tried three times, so I had to put the catheter in.
Once the catheter was placed, the anesthetists induced him with the Propofol over 60-90 seconds. Then they intubated him, connected the tubes, inflated the cuff and turned on the oxygen and Isoflurane. Then they clipped the surgical area and scrubbed him.
While Dipper was being prepared for surgery, the surgical assistants scrubbed, gowned and gloved. Then they moved into the surgery suite and had a circulating nurse sterilely open the surgical pack.
Once Dipper was scrubbed, he was moved into the surgical suite and hooked up to the anesthesia machine and monitors, as well as tied to the table.
Then the surgery began, with one surgical assistant passing instruments, and the other helping Dr. Young. They switched half way through. The anesthetists monitored Dipper throughout the surgery, adapting the anesthesia according to what was going on with Dipper.
After the surgery was over, everyone cleaned up and the anesthetists recovered Dipper, giving him his pain medication; Buprenex; when his temperature was up to 97. They also decided who was going to give the rest of the pain medication.
A recovery sign was put up and the catheter was removed. The surgical packs get cleaned and repacked to be autoclaved for tomorrow’s lab, along with the gowns and drapes. The surgery suite is cleaned and mopped and the monitors are cleaned as well.
*please see procedure section for a more in depth description of all of these tasks

I came back after Maura to finish sterilizing everything.

Maura and I came in to autoclave everything before surgeries start on Tuesday. We folded and wrapped all of the gowns and then rewrapped all of the individual drapes and instruments in autoclave sleeves. Then we sterilized as much as we could and decided to come back tomorrow.

Maura was sick for the first lab, so I did all of the same things as before, and hers as well. This included wrapping gowns and packs, folding gowns, assembling packs and how to clean certain parts of the anesthesia machine and tubes. For the second lab, Maura was there so I just did the tasks I had done yesterday and Tuesday. I was done early so I started fixing the spay packs to prepare them to be autoclaved before surgery starts on Tuesday. Maura and I also put the surgical gowns and hand towels into the laundry to prepare them as well.

Today was the same as yesterday, going over the same tasks as well.

I came in for a student who wanted some extra time before their practical tomorrow. I went over all 20 tasks with this student and she knows them very well.

The second part of the lab practical started this week. We split up the 20 tasks up between Dr. Young, Kim, Maura and I. My tasks are using the autoclave, scrubbing, gowning, and closed and open gloving.
To use the autoclave, the students have to turn it on in the back, and with the power button. Then they have to select the correct mode depending on what they are autoclaving. Then they have to check the water level and tell me where to fill it too and with distilled water. Then they have to show me what button starts the cycle, and then how to unload it without burning themselves.
To scrub, they have to tell me what they would be wearing before they started to scrub; cap, gown and mask; show me where the scrub is kept and then they can start scrubbing. First they need to rinse their hand with water, and then get a general lather with the scrub. Then they use the nail pick to clean out their nails. They have to show me how many plains are on each arm, and how many strokes to scrub, 20. I have them demonstrate on a few fingers and their hand and arm how they would scrub, making sure they did not touch any part of the sink. Then they rinse by keeping their hands above their elbows so the water runs down their arms.
To gown, they first need to dry their hands with the towel. Then they need to pick up the folded gown and step away from the table. Letting the bottom drop and unrolling the arms until you find the holes is the next step. Then they put their arms in the gown, without letting their fingers out of the cuffs. I then tie them in on the back of the gown.
To closed glove, I open the gloves for them. Then they pick up whichever glove they are picking up first, and line it up with that hand. Cuff to cuff, and the thumb down. Next, they use their fingers through the cuff to fold the top part of the glove over the hand. Once the fingers are in the fingers of the glove, they can start the next glove. They line this one up the same way, and flip it over as well. Then they pull the folded up cuff down over the arm of the gown, and go back and pull the opposite cuff down as well.
To open glove, their hands can be outside of the gown. They pick up one glove by the bottom of the folded part of the cuff with the opposite hand and slide your hand in the glove. The other glove is a little trickier; you need to slide the gloved fingers in between the cuff and fingers of the other glove to protect them, and then slide the ungloved hand into the opening. Then the cuffs can be unfolded down over the gown.
If the students miss any part of these tasks, I take off points accordingly.

Today Maura and I corrected the lab practicals of all of the previous labs, as well as todays. That took up the whole lab.