Day 15

6-11-10

I was wrong. I should have volunteered to borrow a key and come in to feed the fawns overnight like my gut told me to, but I didn’t. When we arrived this morning, both fawns were extremely hypoglycemic and unresponsive. I was pretty upset with myself, but now I know when to go with my gut. I’ve been the primary caretaker for enough baby animals to know when they need to have around-the-clock care, and next time, I won’t make the same mistake. We did everything we could this morning to revive the fawns, but unfortunately, the little female was just too weak. After a couple of hours under intensive care, she died. It’s possible she would have died regardless of her overnight care, due to aspiration pneumonia, sepsis, or even some brain damage that occurred due to the severe hypoglycemia she had before arriving at the clinic yesterday, but it was still discouraging. The little male was still hanging in there so we devoted all our attention to him. We re-did everything we started yesterday and added some oral electrolytes to his tube-feeding. He came around very quickly when we got his blood sugar back to normal but he still didn’t have a suckling reflex, which worries me.

This afternoon, Dr. Leo had a bone surgery! I was pretty excited! A client brought her rabbit in for a broken leg. However, when we examined it, we learned very quickly that the leg had been broken for weeks. It was completely fractured, but it was a closed fracture, so the client didn’t realize that it was an emergency when it happened. This is my biggest frustration with private practice. Too many people either don’t notice when their pets are sick, or decide for themselves that the issue is “no big deal.” There was a lot of fibrous scar tissue around the break, and Dr. Leo was unsure whether it can be surgically repaired or will have to be amputated at the joint above the break. Amputating a rabbit’s hind leg is a risky business because rabbits have to sit up on their back feet in order to groom their face and head properly. They also use their back feet to clean out their ears regularly. With only one back foot, they have trouble balancing and grooming their face, and their ear on that side generally has to be cleaned out regularly by the owner. Suprisingly, many rabbits with amputated limbs find a place in their cage or around the house that they can sit in or against to balance themselves and groom regularly. Exotic animals are especially good at overcoming adversity, so it’s very likely that this rabbit, an otherwise healthy, middle aged animal, will do just fine with an amputated leg.

During surgery, Dr. Leo tried over and over again to place an intermedullary pin in the two pieces of tibia bone to line them up, but the fibrous scar tissue around the ends of the bone made it impossible to align them correctly, and without good alignment, the break would never heal. Dr. Leo chose to amputate. First, she had to have permission from the client who had left to run errands during the surgery. Dr. Leo asked me to call her and get the ‘ok’ to amputate. The client was very adamant about saving the leg and asked Dr. Leo to try again to align the bones. Dr. Leo took a deep breath and said she’d do her best. She tried three more times to wrench the bones into position, but the opposing ends just would not line up. They were almost at completely right angles to each other, and the large ball of scar tissue around them prevented her from placing them in a straight line opposing one another. Again, we called the client, and again she asked us to keep trying, against the advice of Dr. Leo, who told her that it MUST be amputated. Dr. Leo began to get agitated because the animal had been under anesthesia for an hour and a half at this point with no progress made on the surgery. She finally called the client back and told her she was either going to amputate the leg now, or close up and wake up her rabbit with a very painful broken leg. After about a ten minute conversation, the client finally agreed to let her amputate. Dr. Leo opened the leg slightly farther up to the femur bone, used lidocaine to block the sciatic nerve, and cut the bone in the middle. She also injected lidocaine into the end of the bone, which she said not only helps with pain, but also minimizes the phantom limb effect. She then sutured the ends of the muscles together around the cut end of the bone with horizontal mattress sutures for support. She closed her incision with a continuous intradermal (under the surface) suture so that the rabbit would not chew on the incision as they often do with external sutures. The rabbit recovered well and truly didn’t miss a beat. It seemed much easier for it to move around once we amputated that dangling foot, and was much less painful with all the drugs on board.

At the end of the day, the male fawn was doing great! He has begun suckling and is urinating and defecating normally while standing up in the outdoor pen. His navel looks much better and is drying up like we had hoped, and he even bounced around a little outside today. Now that he is suckling the full 90 mL of formula, he is ready to be sent to the rehabilitation center, where they can raise him to adulthood.

Just before closing time, we had a call from an iguana breeder that wanted to bring his iguana that had recently died for us to do a necropsy and determine the cause of death. He brought it in a large cooler, and when we pulled it out, it was enormous! Dr. Leo began her incision carefully so that we could close it back up, because the breeder wanted to take him back when we were finished.

When she opened him up, she extracted about 2 liters of blood tinged serous fluid from his abdominal cavity. He also had multiple focal nodules in his lungs and liver, but other than that, we found no additional pathology leading to his sudden, unexpected death. We took samples and preserved them in formalin to be sent to the lab, which will hopefully help us to obtain a more definitive diagnosis and to determine the cause of death.

After we were finished, it was my job to close the incision, which was about two feet long from chin to tail. His scaly, tough skin required some heavy-duty cutting needles to puncture it. I placed each suture a little less than 1 cm apart and, to my surprise, finished fairly quickly! I was happy with my suturing and I was glad to have the practice. Hopefully the junior surgery program this year won’t be too much of a nightmare now that I have had Suturing 101 ad nauseum today!

Well, it’s the end of my last day at Avian and Exotic Animal Care, and I had a phenomenal experience. I learned so much from the doctors and the technicians, and I know that the information I learned in such a short time will be very beneficial in the years to come. I even learned things I never expected to learn about practice management, people skills, and public relations from Dr. Dan and his wife Mrs. Sandy. Needless to say, I feel confident that I can care for sick or injured neonatal wildlife with much less guidance than before, and I am much more proficient in the safe handling and restraint of some of the more dangerous pets. Most importantly, I came here to get some experience working in a private practice exotic pet clinic because I wanted to know if I would enjoy this as much or more than zoo medicine. I have always wanted to be a zoo veterinarian, but I chose this internship to keep an open mind about my career. I discovered that although I loved the people and animals at AEAC, and learned a lot in a very short time, my passion still resides in the zoo.