Tuesday, May 24, 2011

That is what is known as irony

I knew I would leave something behind in the town five hours from home where I did my shelter medicine externship. It was just a question of what. The answer: my wristwatch.

I hate wearing watches, but they are essential in the hospital for taking respiration rates and pulses. My friend is bringing my watch back to me this weekend, so I figured I’d try to tough it out watchless this week on large animal medicine. How many heart rates could I have to take? One a day? I could borrow a watch for that.

This morning I received my second patient, a foal aged 20 hours. His mom (a first time mother) was not letting him nurse. If baby horses don’t get a chance to ingest colostrum while their mom is still making it, before she switches to making normal milk, they miss out on essential antibodies and can die of infection. This is not true for human babies, who get their antibodies through the placenta.

We tested the baby, and indeed his IgG level, which is indicative of the amount of antibody in his blood stream, was almost nil. The solution: give him antibiotics, and give him a plasma transfusion.

I was enthused. I had never seen a plasma transfusion! And now I was going to get to actually do one! The tech said a little dourly, “You may find it a little less exciting once you see how it works.”

This is how you do a plasma transfusion in a neonatal foal: you hook it up to IV plasma and make a vet student watch it drip in for two hours. Every five minutes, the student has to — wait for it — take a pulse and respiration rate, to make sure the baby is not getting fluid overloaded.

It turns out that my cell phone doubles as a stopwatch. Not the most convenient thing to use around large animals, though.

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