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You know you are a veterinary nurse when...

@ykyaavnw / ykyaavnw.tumblr.com

A comic about the life of four veterinary nurses at a veterinary hospital in Sweden.
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Is it a bird? Is it a plane?

This practice is called creative grooming among other things.

I read up on it a couple of years ago because I wasn't sure how to feel about it. Now I feel like it's pretty much like any other grooming practice.

No toxic colours may be used and the colours can be applied before the competition. On stage the dog is transformed to something like a peacock or why not a tiger?

I would like to talk a bit about the ethical aspects of this. My understanding after reading up on this is that the props used to further enhance the transformation may not hurt the dog at all. If you want to read up on the Creative Styling Rules you can read more about it here.

My thoughts are as follow: If the dog is used to being groomed and is feeling comfortable with it, what does it matter if its owner turns it to a dragon for a day or just gives it a nice show ring cut?

The conversation, maybe, should be this: Is it okay to breed dogs with such coats that they need human intervention to stay comfortable? I do see both cats and dogs with tangled coats that their owners are having difficulties handling.

It is just food for thought and I have not made up my mind as to what I think is a good answer.

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Everybody lies

It is not uncommon for pets, especially dogs, to ingest things they shouldn't, be it the family dinner, chocolate or drugs.

When a patient has eaten prescribed medication the owner will often have full knowledge of what it is the dog has eaten and we can treat it accordingly. When the substance is unknown or if the owners are reluctant to tell us, things may get more difficult.

For some reason people seem unwilling to admit to their pet getting hold of their stash. I guess they fear possible legal consequences.

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Why not both?

We may sedate a patient to perform an exam, an X-ray, ultrasound or maybe as a premedication before surgery.

Sometimes the owners are more nervous than the patients. Some of them are nervous but insists on calming their pet down. In reality this means really showing the patient that there is something to be afraid of.

Some owners know that their feelings of stress affect their pets. In that case we may be able to separate the owner and the patient before doing something potentially stressful, like taking a blood sample.

I guess we all have different tactics. When doing something potentially stressful to a patient I do it calmly but matter-of-factly. Like it is a common, normal procedure, which it is, in our world of veterinary care.

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No pain, no gain.

Cerenia is the worst.

Our cats and dogs have loose skin, at least compared to us, especially at the neck. This area is sometimes called the scruff. It makes it ideal for subcutaneous injections because most patients never react to the needle or the following injection. You may have noticed this during your own pet's vaccination.

Some medications, however, do hurt when injected. Among them Cerenia, which is an antiemetic. Some patients barely flick an ear, others may go so far as to try to take a leap and vocalise. I find that especially cats are prone to express their displeasure.

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Catch me if you can!

In Sweden we have something called fika. It translates roughly to: having something to drink with something to eat. But it is more than that. It's about taking a small break. It's about talking to colleagues, friends or family. It can be a matter of reunion. To a lot of Swedes fika is very important.

At my workplace we have morning fika. This is how we survive until lunch. Veterinarians, like us, have a lot on their mind and a lot to do. Sometimes they wander off in pursuit of more work or to find a moment of peace. Nevertheless we sometimes need to get hold of them, be it to get them to the exam room or to look at the newly taken X-rays. The problem is to find them. Sometimes they won't even answer their phones.

I do not know how you, my fellow colleagues all over the world, go about when you try to get hold of your veterinarians. I have had to work out strategies. Some veterinarians have specific locations they always return to. Some come at the sound of treats. Others, you have to catch by lasso.

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You sneeze, you lose

When a patient for some reason doesn't want to or cannot eat on its own, we must take action. Felines are very sensitive to starvation and can get problems, primarily  with their liver, as a result.

We may try to give the cat something really tasty, like cod or tuna. We can try to heat the food to bring out some more flavour. And of course we try with TLC, tender loving care. We may talk to the patient, brush them, scratch them behind the ear, basically anything they might enjoy.

Sometimes the veterinarian may prescribe some form of antiemetics or appetite stimulants. Some cats may accept to be fed from a feeding syringe or a finger. Some of them really like it. Others will refuse.

When the patient refuses to eat or to be fed a feeding tube may be placed. It can either be inserted through the nose or through a hole in the side of the neck. This allows the veterinary nurse to feed the cat without the possible stress involved. We can also administer some medications through the tube that may taste foul or would otherwise cause discomfort.

A nasoesophageal tube (a tube inserted through one nostril) is often secured with a couple of sutures. However, these are easily removed by a patient so an Elisabethan Collar is most often used. If the sutures are missing, a simple sneeze may dislocate the tube as shown in the comic above.

This is a routine procedure, but it requires people and time.

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Corn cob dog

I do not know why, but the bull terrier and the miniature bull terrier must have the highest track record of foreign bodies found in the gastrointestinal tract.

They seem to be obsessed with eating stuff that will get stuck eventually, and they have no problem repeating this mistake. This is of course a generalisation. We have plenty of patients who have swallowed something that gets stuck, be it pine cones, pieces of a chew toy or a corn cob. Maybe I just notice this breed more since they have very distinct features.

Corn cobs are a recurring find though.

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Mr. Andersson

Not only have I had several patients with the same name, I've even mistaken one patient for another due to one owner not speaking up when called. This generally only happens to mixed breed dogs and particulary cats. In the patient booking information I can, among other things, see the breed. It is not difficult to spot the Great Dane or the Sphynx in the waiting room. When it is a 4kg domestic house cat named Charlie or Felix or Maja on the other hand, things easily get a bit more complicated.

When I have figured out I have several patients with the same name I either try the family's surname or the cause of their visit. For example "Charlie Andersson" or "Charlie who is here to remove his sutures/stitches".

Shoutout to one of my colleagues who told me about a cat named Elvisp. It translates to electric mixer in Swedish. Good name for a cat. Guaranteed to be unique.

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O Charger, where art thou?

It is important to take care of your body. Work in a comfortable position and place your patients at a suitable height when able. There are so many situations where we have to adapt to the patient's needs, be it a dog who needs comfort during feeding time or a cat who has hidden under a table. Sometimes we need to almost bend over backwards, metaphorically as well as literally speaking, because a patient decided that it was their way or the highway.

We got height-adjustable tables where I work that run on a rechargeable battery pack. At some point it is bound to stop working though, and it is always when I got a big dog on the table. Nothing else to do but to bruise your knees by taking the blood sample or removing the stitches with the patient on the floor.

In the unfortunate event that this happens, you can easily solve the problem by getting the battery charger. The table will start working in a couple of minutes. The difficult part is to find it since the charger-table ratio is somewhat ... off.

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That cat is fat

I've run a small weight loss clinic at my workplace and also written about two feline body condition scoring methods as my bachelor's thesis during my time at the Swedish University of Agricultural Sciences. This work is primarily written in Swedish but with a summary in English. You can read and download it here.

Depending on which study you look at, the prevalence of obesity varies. In 2005, American veterinarians looked at no less than 8159 cats, and of those 35,1% were overweight or obese. This is a huge problem with many health risks involved, much like in humans.

In my personal experience, the primary reason for obesity is free access to food and that the interaction between patient and owner is primarily through food. Attention-seeking is sometimes misinterpreted as hunger. Many cats just want to cuddle or play.

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Beach Body 2015

Bruises, scratches and hairless knees, due to crawling around on the floor with your patients, are always present decorations of your body in this profession.

During summertime, the season of less clothing, all of our battle scars are put on display.

I put a lot of thought into this picture. How to draw my characters in a civilian outfit while still making them recognizable? How do I portray them in a healthy manner? Personally I am not a fan of the pressure a lot of people around me, myself included, feel during summertime of having an attractive beach body. I feel a healthier way to think of it is: If you have a body and you're going to the beach, you have a beach body.

In the end I chose to keep a lot of the characters' accessory colours. Each character has a colour associated with them which appears on most of their accessories such as blue shoes and nurse clock for Luxor. I also kept their personalities. Ginger, being fair-skinned and sensitive to the sun got to be a bit grumpy and provided with a parasol. Ewald brought his two shelties along.

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They see me rollin...

Most of our patients shed, especially when they are a bit nervous. For some procedures, such as surgeries or ultrasounds, we need to remove hair. Thus we tend to get covered from head to toe in fur. 

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A pet’s pe(s)ts.

2 weeks and 1 day too late, here is finally an update. The delay was due to the whole family moved to a new apartment. Now, we are back on track!

I like abscesses and pus, much like most of the veterinary nurses I know, but I cannot stand intestinal parasites. Maybe it has something to do with the time I went through a patients vomit in order to find all the items it had digested. Among those I found what I thought was a piece of screwed pasta. That was until I picked it up and it unfolded like some miniature monster. I screamed. My colleagues laughed. I screamed some more...

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Bad Hair Day

In order to locate a vein and prepare the injection site we usually shave our patients. This is something we do not only to easily gain access to the vein but for hygiene reasons. Removing a small square of fur is sufficient. After cleaning it with disinfectants a peripheral venous catheter is placed. This is the procedure we use for patients that will stay at the nursing facility.

Reasons for not wanting fur removed may vary but is most often associated with the patient competing in beauty pageants. If a patient has long fur it may take several months before it has returned to its former glory. Even if that is not the case, if a patient is ill enough to be hospitalized, getting back to the show ring might take a while.

When taking simple blood samples I do make exceptions as long as I can locate the vein properly.

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The Schnoodle

The record is 4 out of 4 breeds in a single patient guessed correctly. 

There are lots of mixed breeds in our practice, and though many may not think twice about their ancestry, I find it can provide valuable knowledge when it comes to temperament and sometimes hereditary conditions.

I thought I made the name Schnoodle up, but after a quick Google search I realised this is an actual thing. Here I thought this name even beat “the Bull Shit” (mating between a bulldog and a Shih Tzu).

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Deaf Ear

Edit: There is now a YKYAAVNW Facebook Page for those of you who are interested! One gene that produce white coat-color, W, is also connected to hereditary deafness in cats. It might affect one or both ears, and this defect is more common in cats with one or two blue eyes. For further reading I suggest this article by Dejan Cvejić, Congenital sensorineural deafness in client-owned pure-breed white cats, which is available online. My own cat, a Norwegian Forest Cat, named Illidan is affected. His sire was white just like him, and he has light green eyes. I did not buy him for his beautiful appearance, on the contrary. He was, truth be told, rather skinny and in relatively poor condition when I took him in. A week or so before Christmas several years ago, a friend contacted me and told me the story of this wonderful cat who was going to be put to sleep unless someone would take him in. And she sent me pictures. Worth mentioning, I was preparing to move to Skara, a small town halfway across the country of Sweden in order to become a veterinary nurse. I really wanted some company. And so, with the help of my grandmother, Illidan moved in with me and has stayed as my companion ever since. How I love that cat! His deafness is not a weakness. He sleeps without waking up when I get home or get out of bed. We can be as loud as we want without it bothering him. He doesn’t come when I open the fridge. We can take walks outside without him being distracted by noice. We’ve even taken walks in central Stockholm! And yet, despite all this I highly recommend not encouraging the practice of breeding white cats. They might be beautiful, but I do not think it is ethically correct to have such a high prevalence of a known defect. There are, of course, alternatives. White Siamese Cats for example, have a different set of genes that make up their white coat-color. Some basic understanding of it can be found here with great keywords for further research if you find it interesting.

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