MCT update

The histopathology results of the mast cell tumor biopsy brought good news and bad news. Which do you want first?

Good News: The tumor was completely excised! The margins are clean by at least 2cm all the way around. Yay!!

Bad News: The grade of the biospy showed a high grade 2 tumor. Not good in a 2 year old.

I recommended that the family seek the guidance and treatment of our local oncologist. I pray they make an appointment.

Encouraging Oncology

iCat

From Gung-Ho to Takin-it-Slow

I've never been one to make decisions slowly. So it's no wonder that I when I decided I was ready for veterinary medicine to start.... that meant I was ready. Not just partially ready, but full-steam-ahead ready. My hospital has a different mindset, however. I'm advised to "take things slow," and "don't bite off more than you can chew," or "avoid becoming burnt out in 6 months..." That one I hear loud and clear. It wasn't until my boss explained the epiphany he had one day.... This was it. This day-to-day routine that he had going on, would continue to keep going on. So with that advice (and after a consultation with my mother and husband- separately- about whether or not I could slow my roll), I'm going to finally take. things. slow.

maybe.

Taking a Chill Pill

iCat

Check Lump on Side

Yesterday I began to see appointments. It was only Day 2 on the job, but I felt confident enough to begin to see my own appointments and hopefully start building clientèle. It started out easy enough: a handful of vaccine appointments followed by a handful of dermatology appointments. Piece. Of. Cake. Then I pick up a chart that reads "Check Lump on Side." I check the age of the animal.... 2 years old. The lump is just caudal to the last rib and soft but immobile. The client informs me that this lump has been much bigger before, and today appears significantly smaller. She also tells me that another lump was seen along the dorsal midline of his back. This lump is absent.

Ok, so I begin to think of differentials: bug bite, inflammatory process, some kind of blunt tissue injury, hematoma..... and of course (although less likely due to such a young age)... neoplasia. The client consents to a fine needle aspirate, which I immediately perform. I get a surprisingly decent sample, very bloody, and smear it onto a slide and submit it to the pathologist. Without much more thought of the "Lump on Side," I go home for the evening.

First thing today, I asked a veterinarian of 10 years what he believes to be the cause of this "Lump on Side." First question he asks: "Is the dog microchipped?" hmmmmm.... I didn't even think to ask that. He begins to explain to me that the tiny, rice granule-sized microchips can occasionally migrate making a reaction similar to what I was seeing. Seemed like a no-brainer to me. That provided a very logical explanation for this type of lesion in this age of dog. So all I needed now was a cytology reading of "inflammatory cells" to make the conclusion.

WRONG.

Well differentiated mast cell tumor. I was so so so sad. I just sat and read the pathologists description over and over again. The words never changed. I couldn't believe I was going to have to call this woman and tell her that her 2 year old dog has cancer. Luckily, the call went very well. The clients were very receptive to all the information I had and opted to proceed with surgical removal of the mass tomorrow morning.

Crossing My Fingers for Clean Margins

iCat

"Hi, I'm Dr. iCat"

I cannot begin to explain how difficult it has been to remember to introduce myself as "Dr. Lastname." I am meeting so many new doctors, receptionists, technicians, and kennel workers, and I introduced myself to each and everyone as "Hi, I'm Firstname." It was only after one kennel worker asked what he should call me that I realized... I'm no longer just Firstname. I'm Dr. Lastname. Alrighty then.

My first day started out by signing all the PLIT (professional liability insurance) forms. Once that was finished, I was ready to start! As the newbie, I was thrown into the surgery suite to perform enough spays and neuters to sterilize all the animals of a small town in Nebraska. Surprisingly my right thumb and right forefinger did not swell and blister, even though it seemed as if they were actually being sawed off. I finally sat down for lunch at 3pm, which lead me to decide that I must bring lunch/snacks/survival food that can be eaten in increments.

After my 10 hour day, I am still on a high but am exhausted too. Luckily, I didn't feel overwhelmed today. I think I'll catch on quickly. This is going to be a good year.

Learning to Say Dr. iCat

iCat

13 days until DVM!

Since the last post, I've somehow managed to calm my nerves about my new job as a new veterinarian. I have a feeling this is short-lived since my tactic was simply to forget the upcoming responsibility and pretend my future days will be spent jogging and taking my energetic pooch to the dog park. Those tasks are a bit (a lot) easier to swallow.

I did, however, reach out to a colleague to ask her advice on how to make this adjustment. Her proposal was the following:

First Key: Confidence!

Second Key: Fake it till you make it!! (aka don't act as if you don't know, take a minute to refresh the mind).

Third Key: Take a DEEP breath, and lastly believe in yourself! Your school taught you well!

Luckily, I've never been one to lack confidence. I have always maintained a healthy sense of assurance, but I want to be certain that I always feel comfortable checking myself. I don't think this will be a problem considering all the heavy, expensive books that stand proudly on the shelf. They don't go without attention, that's for sure.

Breathing and Believing

iCat

Graduation is Imminent

There are only a few weeks left until my graduation from veterinary school. Days really. It has been my life-long dream to be a veterinarian, and as this day creeps closer and closer I realize how scared I am of my first day on the job. Will I see patients or just get to know the clinic and staff? Will my first client know that they are my first? Will I remember how to diagnose something that should be relatively simple? How long will it take until I am completely comfortable... if ever?

Stay tuned to see how I fair against veteran veterinarians.

Learning to Adjust

iCat