34. Record Your "Seeing practice"

Seeing Practice

This article is written for a young man who wished to be a vet.


I may be mistaken, but this slim beginning Year 4 veterinary undergraduate from Murdoch University typifies the "obsessive to-be-thin to be attractive culture" of young adult girls. The thin no-fat body is reinforced by in the various slimming advertisements of Singapore's newspapers almost every day.

Kitty needed to "see practice" for 2 weeks before starting Year 4 at Murdoch University. 4th year will be the most demanding stressful year. Real clinical and surgical work. Crash course compared to the honeymoon years of Year 1 and 2. It is a pity that the University could not spread out the clinical years of common surgeries to Year 2 and 3 so that the lectures become "alive" before the student goes to Year 4. I may stand corrected as I am out of touch with the undergraduate teaching.

"Castration, now called neutering of the male dog is a common surgery," I said. "Do you know the closed and open techniques?"

It was not a fair question as she had not started Year 4.

"I will demonstrate gas mask anaesthesia, but the vet must be extra vigilant. Endotracheal intubation to deliver anaesthestic gas is the preferred method for brachycephalic breed because oxygen can be given directly to the lungs via the endotracheal tube in an anaesthetic emergency.

"I will show you the 2 methods of neutering - the closed and open techniques," I said.

I might as well speak Greek to her.

Kitty put the face mask onto the tranquilised Shih Tzu. After a brief struggle at 8% gas anesthesia, he was anaesthesized. The gas was kept at 2%.

"When the anaesthesia is stable, you can hear the dog snoring loudly," I said. "The brachycepahlic (short nosed) breed has a regular snoring sound. This means that the anaesthesia is not too deep or too light."

The Shih Tzu was breathing as Kitty could see the rebreathing bag moving. But there was no sound. She put her head onto the chest of the dog. The only sound was the whirl of the air conditioner.

Was the anaesthesia too deep?

"Touch the eyelids with your fingers," I said. Kitty put one finger onto the eyelids.

"The eyes did not blink," Kitty said.

"See the eyeball's sclera (eye white). Is it rolled downwards so that you see more of the sclera?"

"Yes," Kitty said.

"Reduce the anaesthesia to 1%," I advised. Still no snoring. The dog was all right as his tongue colour was reddish, as seen through the transparent cover of the gas mask.

I started surgery. The open technique involved opening the sheath and separating the cremaster muscle from the spermatic cord. "One disadvantage is the slight bleeding from the cutting of the cremaster muscle," I showed her the clot."

Then I used the closed technique which involved tying up the whole sheath.




For brachycephalic breeds, monitoring the dog during the period immediately after surgery and ending of anaesthesia is important. Many have difficulty in breathing. Sure enough, this Shih Tzu's tongue turned purplish blue.

What to do?

"Pull the dog up by the hind legs with your hand. Pull out the tongue and massage the chest to stimulate the heart beating with the dog upside down," I advised.

I demonstrated. Kitty might need some weight training. The dog appeared too heavy.

What to do?

"Squat down. Put the dog onto your lap, with the head downwards and tongue pulled out and massage the chest."

This must be her first time. She squeezed the chest with the palm of her hand, but there was no breathing sound from the dog. It was important that the student gets hands-on experience when seeing practice. That was why she had to do things to gain the necessary experience.

The dog was not in danger at any time.

"Ok, stand up," I put Kitty out of her misery. "Put the dog on the operating table."

I showed her how to give cardiac massage. The dog gave a loud rasping breathing sound every 3 time I massaged the chest. The tongue took some time to change to a pinker colour. Kitty waited till the dog stood up before putting him into the cage.

"Don't you record your seeing practice experiences?" I asked Kitty. "When I saw practice in Scotland 30 years ago, I scribbled on small notebooks. In the end I had so many books!

"Now, the internet generation has the blog. It is so much easier to read the journal in a blog than for me to go through the hundreds of small books to refer to the cases."

Veterinary students in Murdoch University see practice with practising veterinarians from the beginning of the 4th year. But you should "see practice" as early as the first year so that the lectures comes "alive." However, you must record your experiences in a journal, so that you can refresh your memory and understand in depth when you go into the 4th and final years. Otherwise, when you see practice as an observer, you do not retain much information and skills. Nobody will tell you to record your "seeing practice" experiences.