Rosco's adventures with "Vet Day" on the hill

Today, I got to see a dog's ovum. Ova. Whichever form is the plural.

So this is because my downstairs neighbor is the president of the animal group at Ross (called PAWS), and apparently they couldn't find an alternate venue for the vets to do their work. And they did plenty of work.

At 10, all the vehicles show up; the vet and his two vet techs, along with a security truck with campus dogs in tow. Once the table area was all set up, the vets got to spaying and neutering, generally 2 at a time (it was a sizable table). Once the girl dogs were done, they were brought back to the kennels and the boys were brought up, followed by some cats that a student is caring for. All in all, it took about 5 or 6 hours.

During all this time, Rosco went through a cycle of emotions: "Hey, there's stuff outside! It sounds new! I want to meet/sniff them! <whimper>". Then we go outside. "Hi! Hi! H- wait, who are- you're a big dog that I've never seen before...um, hello sir." Then he sees the vets working on a dog. "Oh. W-what is going on up there? Something smells weird. Why is that dog sleeping like that? <sits down away from the action, occasionally trying to climb into my arms>". 5 or so minutes pass. "...I want to go back inside now." Once inside, he would just doze for half an hour or so before doing this all over.

Overall, I think it went well. Rosco got to practice meeting new people in a relatively controlled setting, and the dogs and cats all seemed to do well with their surgeries. The one concern is that one of my neighbors dogs who got spayed today ran away during her bathroom break this evening, and as far as I know, she hasn't come back yet. Here's hoping she makes it!

Also, make sure you all wish Melissa a happy birthday on Friday! I know that technically it's not the 29th - since we don't have one this year - but you can still think of her birthday as being "the day after February 28th".

Have a good one!

-Eric

Guest Blog: Melissa Answers the Neuro Question

Hey everyone! Here's the answer to this weeks round of Neuroscience trivia!

The answer is E - Dry mouth.

The key was to establish which cranial nerves were controlling the symptoms presented. Another hint was that the surgery was to repair his internal jugular vein. the left shoulder weakness and inability to turn his head left against resistance suggests damage to the sternocleidomastiod muscle, which is innervated by Spinal Accessory nerve (CN XI). A flat soft palatal arch leads one to think there may be damage to the vagus nerve (CN X) which supplies most of the pharynx, larynx, and palate. The lack of gag reflex really gives it away, since the gag reflex receives efferent (motor) input from CN X and afferent (sensory) input from Glossopharyngeal nerve (CN IX). Once you have established that CN IX is involved, it is easy to distinguish the correct answer of dry mouth, since it is known that CN IX innervates the visceral efferent branches of the parotid gland which supplies saliva to the oral vestibule. Why does this matter you may ask? Because cranial nerves IX, X, and XI all exit the jugular foramen alongside the internal jugular vein. These nerves were probably severed when the original trauma occurred. Or else his surgeon should start looking for a new job...

Why are the other choices wrong?

A) Ptosis (sagging eyelid) on the left side that disappears on upward gaze would suggest a problem with sympathetic innervation, which is not present with his other symptoms.

B) Profound ptosis on the left side would be produced by an Oculomotor nerve palsy (CN III) which exits out of the superior orbital fissure (within the eye socket), which would not satisfy the other symptoms presented.

C) Dry eye on the left side would be produced by severing the lacrimal nerve which goes to the lacrimal gland. This wouldn't have happened during this surgery because the fibers from the Facial nerve (CN VII) which add into the fibers of the Opthalmic division of the Trigeminal nerve (V1) at the ciliary ganglion, do so within the orbit.

D). Gustatory sweating over the left parotid gland is actually a condition called Frey's syndrome. This is most often caused when one undergoes surgical resection of the parotid gland (found anterior to the ear within the infratemporal fossa). The surgeon may accidentally sever some parasympathetic fibers within the gland, which then heal and fuse with sympathetic fibers. Thus, when the person thinks about food and salivates, the sympathetic innervation that once told the gland to supply saliva to the mouth when food was about to enter, now tells the skin of the cheek to release sweat. Weird right?

Whew. That's a long one! I wanted everyone to see a typical test question, and then see the typical explanations of the wrong answers that can be found in most books I am studying from. Hopefully you stuck with me this far! 

I love you all and I can feel the encouragement flowing every day. I am so blessed to be here doing exactly what I've always wanted to do. It's hard work, but I wouldn't have it any other way.

Love and blessings,

Melissa

A taste of what Melissa will go through on Wednesday...

Hey again,

So as you may know, Melissa finally takes her first Mini this week. Yes, we are halfway through the semester, and she is just now taking a test. It will be a long one (over 3 hours I believe), but Melissa has been working really hard to build up the endurance and make sure this Neuro block is embedded deeply.

Anyways, the purpose of this post is to show you what a typical question will look like on this exam. Ready?

An 18-year-old male presented to the emergency room bleeding profusely from a deep cut in the left occipital triangle of his neck and undergoes emergency surgery to repair his internal jugular vein. He survives his injury but he is found on neurological examination to have left-sided weakness in shrugging his shoulder, cannot turn his head to the left against resistance, has a flat left soft palatal arch, and lacks a gag reflex on the left side. What additional clinical sign would be expected in this patient?

A. Ptosis on the left side that disappears on upward gaze

B. Profound ptosis on the left side

C. Dry eye on the left side

D. Gustatory sweating over the left parotid gland

E. Dry mouth

...Yikes. Well, for me, I think there's only about 7 words I don't recognize. Although my favorite of those words might just be "gustatory". Sounds invigorating.

So there you go. Feel free to post your answer in the comments so we can try to piece together the answer to this conundrum. And don't forget to think about Melissa on Wednesday morning! Or really, any time before lunch, because she's probably still testing.

Take care!

-Eric

New Rosco Pics!

Since it's been a little while since you've seen the little guy, here are some new pictures of Rosco! 

Here's what he does when he first sees me take out the camera. You  might be able to see a couple of the wrinkles he gets on his forehead when he's confused about something. Also, you can't see it, but I have a wicked tan line on my foot. Under the straps, my feet are albino white.

Here's one from a better angle. He doesn't even seem to mind getting his picture taken, even with the flash! A couple days ago his ears were a little uneven on the floppiness, but the left one finally caught up.

More of  a profile shot, and also you can see what his eyes actually look like. It would be kind of cool if they were blue like that, but alas. I think he was looking at Melissa right here. Again, not really minding the camera.

Here you can see his sweet tail, in all its curliness. He was hiding behind the fridge and I was trying to catch him as he came around to eat, so that's why he's off the bottom of the frame. But look at that crazy tongue! Heh.

Eatin's some foods. The tiles on the floor are about a foot across, so I'd say he's standing at about 16 inches to his back, and 20 to his head. But I could be way off there. I think he'd look like a bloodhound puppy if it wasn't for that crazy tail of his. Mutts are great.

Here's just a cute one of him sleeping on his pillow with his towel. I didn't even have to set this one up; he put the bone down and fell asleep like this.  

So as you can see, he's doing pretty well. I'm due for a trip to Roseau to pick up some more treats for him so we can get back to some regular training (we're on the very last of the "Bakon Curlz", and I'm trying to ration it appropriately). But he's starting to figure out when I need him to go in his kennel, and he hardly cries when I leave him for a little while. So basically, he's the best.

In Melissa news, she has a mini next Wednesday. It's going to be a long one, like I've said before, but she's been definitely putting in the time it takes to get all this information nailed down for long-term use (compared to the cramming that some of her classmates utilize). She's like the epitome of work ethic, I can proudly say. 

Welp, I hope you're having a great Valentines Day! Peace out!

-Eric

Puppy Tricks

I guess tricks is probably the wrong word. More like commands. I'm working on teaching Rosco some basic commands.

So far, I think he has a pretty good mastery of "Sit". It was a little tricky to get him to sit after I told him, rather than it being his default position when I talk to him. Then today, I decided to teach "Down" as a combo move with Sit (yes, I know I'm a nerd). And he learned it in like 5 minutes! My dog is a genius.

Of course, when we go outside to play/bathroom time, it gets a little dicey. I think the extra stimulation makes it harder for him to recognize what I want him to do. That, and he accidentally peed on the deck downstairs because he couldn't stop playing in time. My dog is dumb.

On the other hand, he hasn't peed inside for almost a week (I think? Hard to keep track). Genius again.

But he still tries to eat everything. Dumb.

Although he is patient when he's waiting for friends to come out. Genius. 

Still humps his pillow. Dumb

Waggles his leg when I scratch his tummy just right. Not genius, but awwww...

Anyways, he and I are building a good rapport. I have to pick my spots for teaching him commands, because if he's too tired/energetic, it's basically a waste. He shall learn, in time.

In Melissa-related news, she's got a week and a half left before her mini. As you may know, the more lectures covered, the longer the mini, and this is her first one of the semester, so I think she's in store for a 4+ hour test. No joke. It'll be epic. 

Just today she had her first SP session. Last night I did a short walkthrough as a sickly headache patient to see how she'll approach the real case. By all accounts, it went well. Plus, she got to wear nice clothes and her white coat, which I could tell made her happy. She looks good in that thing!

I don't start my training for SP until later this month, but I got the same case as last semester. Which is good because I already know it, but I was really hoping for a less strenuous assignment. Oh well, gotta get back in the habit of writhing in pain while holding my flank and moaning. All in a day's work.

Ok, take care!

-Eric