“If you’re going to bake, you should do it properly.”
There is an unwritten rule that, at the end of each clinical placement (or, in some cases, every Friday), veterinary students are expected to produce some sort of edible creation for staff at the practice that so kindly opened its doors to them.
The cop out (and to be quite honest, more expensive) option is a box of chocolates, which, while quick and easy, can be quite pricey depending on the size of practice you’re catering for.
Another quick(ish) fix is packet baking, which usually requires the addition of a couple of ingredients, sticking in the oven and “bang”, tray bake for the whole practice. While some people swear by these – and if you buy the right one, they can taste pretty good – I feel it’s cheating somewhat. If you’re going to bake, you should do it properly.
Plus, sneaky packet baking can leave you open to awkward questions about the recipe or how you made it, and vet students are already subject to awkward daily grillings on placement, so any that can be avoided if possible would be a bonus.
So that leaves actually baking…
Now, I’m no Mary Berry, but I can whip up a good brownie or some decent cupcakes at 11pm on a Thursday night if need be.
My personal go-to recipe is for coffee cupcakes – it’s simple, involves normal cupboard stocks, is fairly quick to whip up, yet has an impressive edge. After all, most vets live on coffee, so why not add a little more to their Friday?
12 Coffee Cupcakes
INGREDIENTS:
100g butter
100g caster sugar
2 eggs
100g self raising flour
1.5 tsp instant coffee granules mixed with 1 tsp warm water
METHOD:
Heat oven to 180 degrees celcius
Mix the butter and sugar
Beat the eggs in a bowl and add the coffee/water mix to the beaten eggs
Add eggs and flour to the mixture bit by bit and mix
Spoon into cake cases and bake for 15mins
Lift the cakes onto a wire rack to cool
Coffee Buttercream
INGREDIENTS:
100g butter
220g icing sugar
1 tsp instant coffee granules mixed with 1 tsp warm water
METHOD:
Mix the above until they form a paste consistency
Once the cupcakes have cooled, spread buttercream onto the cupcakes or pipe a swirl for a more professional finish.
So, when you sit down to watch the The Great British Bake Off this week, spare a moment to think of the veterinary students up and down the UK burning the midnight oil trying to concoct something even passable in an effort to persuade their vets they know how to do something right.
The “suck it and see” approach can be perfectly reasonable depending on the situation. Photo: Freeimages.com/T.Rolf
“Prognose, prognose, prognose” is a phrase uttered regularly by a vet I’ve spent a lot of EMS and pre-uni work experience with.
Anyone would think he’s trying to drive the point home.
But it makes a lot of sense: although we have myriad diagnostic tests available to us, they won’t always give us a definitive answer, and the owner of an animal, for whatever reason, will often choose the option of “we’ll try this and see” before resorting to getting a clear answer, if necessary.
Suck it and see
Although many vets (and future vets) are perfectionists by nature who would, ideally, want to establish exactly what’s going on before throwing anti-inflammatories (for example) at an animal, it’s not always possible or cost effective to do that – and that is something we have to accept.
The “suck it and see” approach, however, can be perfectly reasonable, depending on the situation.
In my vet’s words: “half the time I haven’t got a bloody clue what’s going on” – and that’s okay. You can’t always get to the bottom of why and what is occurring in your patients, but symptomatic treatment is often both a reasonable and successful approach.
His advice is that you don’t necessarily need a diagnosis, but you MUST give a prognosis. You must forecast what you expect to happen with the treatment given (and give time frames) and inform the client that if there isn’t a marked improvement, if things go backwards or the disease process/condition behaves in an unexpected way, they must bring the animal back for reassessment ASAP. That way, the client has the responsibility to judge for themselves whether something more needs to be done.
Red light green light
This vet also promoted the use of a simple “traffic light” system, through which you decide – on a case-by-case basis – whether you’d rate them a “green, amber or red”.
Green – you know exactly what is wrong with the animal, you have treated accordingly and expect if to make a recovery (or, in the case of things like diabetes or atopy, can manage the condition successfully long term).
Amber – you don’t really know what’s going on, but it isn’t immediately life-threatening and diagnostic tests aren’t urgent at this stage. The “suck and see” approach, by treating symptomatically or “just letting it run its course”, is appropriate for these patients (e.g. an unexplained episode of vomiting or diarrhoea).
Red – not necessarily life-threatening but the patient needs diagnostic tests ASAP or admitting to the surgery for supportive/palliative care (e.g. suspected parvo, 10/10 lameness).
This simple system helps students (and vets) assess the severity/urgency of conditions seen in the consult room there and then, whether they have a diagnosis or not.
Importantly, he also said you can’t have two “ambers” in a row – if a patient sent away with symptomatic treatment returns a week later with no improvement, you must take further action and start testing.
There’s a limited amount that can be done in a 10-minute consult and the key is to be able to make a quick judgement on what the next step is during that time.
Even if you don’t have a diagnosis, prognose, prognose, prognose!
Despite expecting a purely equine placement, I’ve had a bit of a crash course in camelids over the past two weeks.
As alpacas and llamas continue to increase in popularity throughout the UK, more and more first opinion vets are having to apply their knowledge from other species to these slightly odd creatures.
Having had no previous experience with either of them, even just handling and trying to read their behaviour was a bit of a challenge.
Being social animals who get extremely upset when alone, one in-patient (a llama) was accompanied by two of his friends to minimise stress levels.
Sadly, said llama didn’t make it, but his acquaintances were able to travel home together, considerably less stressed than a lone llama forced to leave its dead friend behind.
Drugs done different
I also accompanied two of the vets to go and castrate eight alpacas, which thankfully went smoother than expected. In addition to learning the procedure itself – which is very similar to castrating a dog, apart from leaving the incision open and only using local anaesthetic – I learned how some drugs must be used differently in these animals. For example, lidocaine has to be mixed with sterile water rather than used straight.
Luckily, we had plenty of help and most people involved were experienced handlers, which made the whole operation run fairly smoothly, even if everyone did get splattered with blood and alpaca spit.
I found out the hard way that alpacas have extremely powerful legs and sharp claws, having had one narrowly miss my face but leave a considerable scratch along my neck, and another tear straight through a pair of very hardy waterproof trousers, in addition to leaving me with numerous bruises.
The point of an alpaca
What’s the point of an alpaca?
Having also been to castrate a llama that day, this sparked a discussion about the purpose of camelids in this country.
Llamas are sometimes kept as guard animals for flocks of sheep, and alpacas for their wool – but, other than being expensive pets or “field ornaments”, what is the end market for breeders?
A breeder present for the mass emasculation expressed his support for castration since, as the popularity of these South American natives grows, so does the number of unwanted individuals.
This discussion on the welfare of unwanted animals reminded me of Princess Anne’s suggestion that a UK horse meat market would decrease the number of unwanted horses.
Could the same be said for camelids? Would an alpaca meat market in this country help the problem, and would it ever take off anyway? Being a very lean meat, I think there could be a market in a nation of people yearning for a healthy lifestyle.
Having visited South America in 2013, I’ll admit I was more inclined to try alpaca steak than another of their native dishes – and believe it far more likely to take off in the UK than guinea pig.
Wildlife veterinary medicine is more than being a good shot with a dart gun and knowing what anaesthetics to fill the darts with.
I know this because I was part of a group from Glasgow vet school that visited the Shamwari Game Reserve in South Africa to find out exactly what wildlife medicine entails.
Minimal intervention
Generally, as the animals on the reserve are considered wild, the main aim is to keep veterinary intervention to a minimum.
The majority of the veterinary work is translocation (involving mainly sedation and/or anaesthesia) but there are a few exceptions, which are often dealt with in the reserve’s rehabilitation centre – particularly if the animal in question is rare or highly valuable.
Although we learned a lot about anaesthetics (which was surprisingly easy to relate to practice at home), there’s far more to it than meets the eye.
In-depth knowledge
During our two-week stay we learned that an in-depth knowledge of animal behaviour, among other aspects of conservation, is the vital foundation of the veterinary work.
For example, the length of time an animal will spend in transit and whether the animal will be woken up in the field will have an impact on drug choices – a prey animal needs a complete and rapid recovery in the field to avoid showing weakness to the herd or any predators in the vicinity, whereas an animal travelling halfway across South Africa would require longer lasting sedation.
Species differences are also important to consider; drugs that are highly dangerous in some animals may be the sedative of choice in others.
Additionally, the reaction to being darted needs to be carefully evaluated in terms of both the animals’ and the staff’s safety. We were particularly aware of this when working with buffalo and having to judge the right amount of sedation reversal to allow them to wake up completely, while giving ourselves enough time to dash into the truck and put a safe distance between us before they did so.
A different perspective
The team at Shamwari were eager to give us a practical, hands-on experience – which was great.
Image courtesy Shamwari Conservation Experience.
Not only was it an awe-inspiring couple of weeks, but it was also incredibly useful in terms of consolidating knowledge and practical application of pharmacology – particular anaesthesia.
Experiencing all aspects of conservation in addition to the veterinary work also gave a different perspective to veterinary medicine.
It was exhilarating to be working with such beautiful and potentially dangerous animals – I could certainly feel my heart going through the roof when taking blood from a lion whose snores sounded suspiciously like growls.
We do get taught about pigs at uni, but they are seen so irregularly in practice that the “P” word sends a shiver of fear down any vet’s neck.
Having a pig farm in the family gives me a bit of a distorted view on the world. For example, I’m a complete pork snob and would rather go without then eat crap sausages.
However, I find it bizarre vets start panicking and fervently flicking through dusty textbooks on the practice shelf before going out on the incredibly infrequent pig call.
When I think about it, though, it isn’t so bizarre. I can’t remember the last time we had a vet out to the pigs. My step-grandad has been looking after them and developing his own bloodline for 50 years – if there’s anything he doesn’t know about pigs, it’s not worth knowing.
The UK pig farming industry has been declining over the years to the point where there are very few pig farms around, and those that still exist rarely need a vet because the farmers know what they’re doing.
We do get taught about pigs at uni, but they are seen so irregularly in practice that the “P” word sends a shiver of fear down any vet’s neck.
But what about the pet pig? I went on one pig call while on placement at a mixed practice, and finding out we were going to see a Gloucester old spot (one of the breeds we have at home), I was intrigued. As it turned out, the pigs were “rescued” from going to slaughter and the pig we had been called out to was lame, but still weight bearing.
Pigs: nothing to be afraid of…
Suspecting a mild break or soft tissue damage after a compromised examination (a quick manipulation before the sow decided she was walking off), the vet gave an anti-inflammatory and advised re-examination a few days later.
On discussing the case with my step-grandad, he disagreed, and muttered something about mycotic lameness or remnant erysipelas. His advice was to “bang in some penicillin” (farmer’s favourite) or lincomycin.
However, on the re-examination, the pig had improved and the owner was given oral anti-inflammatories to continue with.
After relaying this advancement, the pig expert then retracted to: “Well, it could have caught its leg”.
Either way, the pig has improved.
Even though pigs are rare in practice, I think it’s important not to be scared of something you don’t know much about (the same also applies to exotic pets) and to always know the books are there for back up. Failing that, in my case, my step-grandad is a phone call away – even if the second opinion is to be taken with a pinch of salt.
I spent a couple of weeks at a mixed practice on extramural studies. It was a placement of firsts – first experience at a very “young” practice (lots of newish graduates), first clinical farm experience and first surgery experience.
It gave me an insight into the difference between older, more experienced vets and new grads – from the way they approach consultations and cases to the time/skill difference in surgical procedures. Obviously, a lot of this comes with experience, but it was reassuring to know I’m not quite as lost as I thought I was (and it also helped me recognise areas to work on).
I did work experience at farm practices before uni, but hadn’t been to one as a proper student. It entailed the bread and butter of farm practice – being shoulder deep in a cow’s rectum.
My younger brother found it particularly fascinating, always asking me when I got home each night how many cows I’d seen. Appealing as it sounds, I found reproductive physiology and pharmacology began making a lot more sense.
One day we were called out to castrate 34 calves, which turned out to be a day of avoiding hailstones while the vet cut, twisted, pulled and I injected. Nearing the end of the never-ending stream of beef calves, the vet invited me to have a go. A few minutes later, covered in blood, cow poo and sweat (it required a surprising amount of elbow grease), I had performed my first surgical procedure.
The following day I found myself being told to scrub up, then was guided through a cat castrate. It was a bit surreal, because the vet started off with “cats are a bit like calves…” I couldn’t help wondering how many students castrated a calf before a cat…
A few days later, the same vet supervised my second unassisted castrate. I had a real sense of achievement, having been able to perform the procedure without being told what to do. I know it’s a simple surgery and may seem like peanuts to a qualified vet, but it was quite a step for me – and everyone has to start somewhere.
I also scrubbed in on an exploratory laparotomy on a ferret, which was unusual to say the least, especially when the huge mass we were investigating in the abdomen turned out to be fluid filled and exploded slightly after a needle was stuck in. Since it was attached to the uterus, the vet decided to spay the ferret, which sparked the conversation of why ferrets aren’t often spayed and the resulting hormonal changes involving the adrenals.
Overall, I had a tiring couple of weeks, but felt the vets were eager to get me involved and my clinical skills certainly progressed further than I expected.
As veterinary students (and probably later as vets), we have a very distorted view of “normal”.
Exam season (for Glasgow) is now over, but during revision, the social media stakes noticeably increase. While many of my non-veterinary friends share photos of their piles of notes captioned “T-minus 2 weeks”, “Revision hell” or the like, in return they get photos of me gloved and gowned up or an “animal” (cuddly toy of some description) draped up (in tea towels) ready for “surgery”.
This isn’t just me playing vet for their entertainment – these skills were assessed in our practical exams – but my friends still find it bizarre it counts as revision.
The student halls I lived in during my first year had a high proportion of veterinary students, as they were sited very close to the vet school. Being in catered halls, we all ate dinner together, and soon there were a few “vet tables”. If we’d all come in from anatomy practicals, with no second thoughts about discussing the intricate details over dinner, it was no surprise no one else regularly ate with us.
Even when you restrain from comparing the consistency of some body fluid or other to the pasta sauce you’re eating while out with friends, you’ll probably notice something in your hair that could easily be either blood or poo. If your friends notice, they’ll either laugh or be disgusted, but to you it’s just a normal occurrence after a day on a veterinary placement.
Teddy has been prepped and draped, ready for “surgery”.
Every so often, a comment snaps you back into the non-veterinary world and makes you realise we really are quite strange.
While back home and studying, my five-year-old brother (in order to evade bedtime) decided to “help” me revise and was fascinated by a picture of a dissected lizard, which in his opinion was “a turtle with it’s shell taken off so you can see its insides”.
Thankfully, he wasn’t too bothered by it, but I was slightly concerned about giving him nightmares.
It’s easy to take the weird and wonderful world of veterinary life for granted, especially when you’re surrounded by like-minded people during term time. My family think I’m insane when I tell them I was watching postmortem videos at 3am on the day of my pathology exam.
Aside from the gore, there is also the stress element. Every round of exams, various friends or family members ask how I’m doing. When I reply “terrible”, “convinced I’m going to fail”, “will get no sleep during exam week”, their response is “you always say that, and you’re always fine. Just get an early night”.
When I relay this to my vet friends, the response is “what’s an early night?”
It’s examination time and vet students across the UK are frantically trying to fill their heads with long, complicated words they can’t even hope to spell.
With exams comes stress (which can manifest in many different ways), but as a professional bad-sleeper I wanted to share some advice on surviving an old adversary of mine: insomnia.
Loosely, insomnia means “poor sleep” and could mean anything from having trouble dropping off to waking repeatedly throughout the night.
If you see a doctor complaining of chronic sleep deprivation, they’ll give you a lovely printout describing “the science of sleep” and some advice along the lines of:
Don’t drink caffeine after midday.
Switch entirely to decaffeinated tea/coffee.
Get up and do something if you haven’t fallen asleep within a certain amount of time.
Read in bed.
DON’T read in bed.
Don’t look at a TV or laptop screen for at least half an hour before sleeping.
Make sure the room isn’t too hot.
Take a relaxing bath before bed.
Use your bedroom only for sleep.
Don’t eat too much or little before trying to sleep.
Do some exercise throughout the day (but be careful with timing – the gym “high” after a workout can sometimes keep you up too).
Do eye exercises to tire your eyes.
Try breathing exercises to aid relaxation.
Try natural remedies.
Try writing down your thoughts.
Sleep wearing earplugs.
Try to clear your mind with meditation.
…and probably many more.
Having battled insomnia for the best part of 10 years, I have tried all of the above with varying degrees of success. With that in mind, here are some of my personal findings.
For me, cutting down on caffeine is completely out of the question, especially at exam time. I drink a lot of tea and my body is used to it; I will often have a tea just before bed and sleep just “fine” (for me, that is). That said, I have tried cutting down and switching to decaf, but it doesn’t make a difference and, quite frankly, tastes foul.
At exam time, I tend to switch to a combination of coffee, Pro Plus and energy drinks in order to say awake following a bad night of sleep. But the main point is to know your limitations – don’t take two Pro Plus at 8pm if you’re not used to caffeine and then expect to be able to sleep straight away at 11.
My main problem is that I overthink things, and once I have thoughts racing through a brain that can’t switch off, I’m in for a night of no sleep. However, I’m much better at managing my sleep now than I was a few years ago, and I think the main reason for this is that I aim for less sleep.
While there are a multitude of studies that claim “X amount of hours is the optimum”, I’ve found I sleep more fully the less hours I get. If I stay up until 1 or 2am and completely crash, the sleep I do get is generally of a much better quality – and it’s far better than trying to go to bed at 10pm and only achieving three hours of sleep because I’m simply not tired enough.
For me, quality of sleep is more important than quantity. I know some people swear by nine hours sleep, but for me, five or six is about normal, so find your personal optimum and work with it – don’t try and force yourself to comply with an “official” optimum recommended by some study or other.
But what about those killer nights when sleep will just not come?
Bach’s Rescue Remedy can work wonders for some people suffering from insomnia. Image courtesy The Italian Voice, via Flickr [CC BY-2.0]When I first experienced bad sleep, I used to write down my thoughts, no matter how nonsensical or ridiculous they might appear should anyone ever read them. This helped a lot as a way of channeling them and “emptying” my brain a bit.
More recently, I’ve been using the natural Rescue Remedy. I wouldn’t say its an absolute quick fix for everyone, but it does work wonders for some people. My partner has always slept soundly but recently suffered a bout of stress-related insomnia. After a few drops of Rescue he was out like a light every night!
If you’ve had a bad night’s sleep, the worst possible thing you can do is sleep in in the morning or nap during the day.
Tempting as it may be, the quicker you kick your body back into a normal sleep pattern, the better. It’s far better to force yourself to stay awake than nap in the afternoon and find yourself wide awake the next night too.
I often go through a few weeks of “normal” sleep and then have a few nights when I get about an hour at most. But if I force myself to stay awake during the day, after three or four horrendous nights, my body/brain crashes and restarts itself into it’s normal rhythm. You’ll be surprised how well you can function on less sleep than usual.
Doctors will only prescribe sleeping tablets if you’ve tried absolutely everything else, but even then I’m sceptical – I’ve tried them before and they simply don’t work for me, so if it does come to this, don’t expect miracles.
Insomnia can be incredibly frustrating and often upsetting for those not used to it – and often, for those who just have the odd bad night, something from the list of recommendations given by a doctor may work.
My final bit of advice would be that, when insomnia does strike, try not to get frustrated – you’ll only go round in circles and get yourself even more wound up. Just hold on to the fact that your brain has to rest at some point, and sleep will come, even if not as sufficiently as you’d like for a few days.
With the general election fast approaching, there’s been a big push to encourage 18 to 25-year-olds to vote, since a huge proportion of us didn’t last time.
I’m not well versed in the intricacies of politics, but general consensus among young people after the last election was disappointment with regards to the tripling of university tuition fees.
This time round, the topic seems to have been swept under the carpet a bit, with Labour promising to reduce them again (but not quite as low as they used to be) and UKIP promising to abolish them for degrees in certain fields. But little has been mentioned on the matter by the other parties.
What does it matter to us anyway? We’re already at uni, with our fees fixed from our enrolment date. So perhaps it doesn’t, and perhaps the young voters, already in further education, should prioritise other issues when musing over the various policies.
But students, often skint (especially at this time of year, with eight days until Student Finance comes in – not that I’m counting), like to know they’re getting their money’s worth. Instead of standing in a supermarket, deliberating whether its okay to spend an extra quid on branded cereal, maybe we should think about what we’re paying for in the long term.
Whether we’re paying nothing (the Scottish), £3,000 (friends in my school year were the final students to have these fees), £9,000 (most undergraduates now) or even more as postgraduates, is it worth it?
You could discuss the philosophy of investing in your future, and whether spending so much on education will be worth it for a fulfilling career, higher wages or being able to achieve the dream of being a vet, but what about the face value? Per year, term or even day, what do we get for our money? A lot. That’s what.
Vet students get 9am to 5pm, five-days-a-week contact time with lecturers who are leaders in their respective fields
Some of us may be paying a staggering total of £45,000 for tuition alone, but what is that paying for? Almost 9am to 5pm, five days a week, contact time – and not just with anyone. Many of our lecturers are leaders in their respective fields; extremely experienced clinicians with more letters after their names than the alphabet itself. Plus practicals – labs, dissections, animal handling/examination and clinical skills sessions.
Without putting a price on practical sessions, it already sounds like we’re getting a fair bit for our cash, especially when you compare our course to a non-science degree, such as English or history. These often comprise just a few hours’ teaching a week, and yet can cost the same as the veterinary degree.
Involvement in the organisation of Association of Veterinary Students Congress earlier this year opened my eyes to the cost of basic equipment for practical sessions, such as needles and syringes.
One particularly costly element was paying for the actor for a communication skills section of one of the practicals. The veterinary school employs these actors for teaching purposes because they contribute to a more realistic scenario than just practising communication with our classmates.
As such, when we had a revision practical, with boxes of syringes, catheters, blood tubes, fluid therapy giving sets and fluid bags left out for us to practise as much as we needed, I couldn’t help but feel that the veterinary degree is one of the best value for money.
In a previous blog, I alluded to the feminisation of the profession. Here, I speak very carefully to avoid confusion of this with feminism.
I’m not going to preach equal rights or pick holes in generalisations, but the facts are unavoidable: feminisation of the profession is happening and we need to find the best way to embrace this.
57% of practising vets in the UK are women[1.Source: http://vetfutures.org.uk/resource/vet-futures-literature-review/], and this balance looks set to tip even further in the female direction. However, I don’t feel this accurately reflects the male presence in veterinary education, which is significantly lower.
Less than a quarter of students embarking on their veterinary degree in 2012 were male and – upon discussion with other students – it is evident that some schools are worse than others.
So why is the gender imbalance significantly worse in education than in veterinary practice?
It has been shown that men are likely to stay in the profession for longer than women, with more women than men opting for part-time work, so the suggestion that males are being put off the degree because it is seen as a less “manly” career choice seems a bit absurd to me – especially as sexism is still extremely prevalent, despite the female shift.
In one of my interviews for veterinary school, it was suggested the reason males are declining in veterinary education is simply because females are outperforming them academically and so they just aren’t achieving the grades needed to make the offer for a place at vet school.
You can speculate as much as you want to try and discover the reasons why, but feminisation is happening and the profession is changing as a result. Corporate chains of veterinary practices are increasing in number, bringing with them rock bottom prices that individual James Herriot-esque practices can’t compete with. But is the attraction of part-time work and “normal” working hours that the corporates offer more attractive, especially to vets (particularly female, but also male) with children?
I think many of the fairytale illusions that some of us entered the veterinary world with are long gone. The profession is changing rapidly, and must continue to do so in order to accommodate for things like feminisation and increasing graduate numbers.
While corporate practices may be a short term aid, and potentially offer a better work-life balance, I don’t think they are the ultimate answer.
![Bach's Rescue Remedy can work wonders for some people suffering from insomnia. Image courtesy The Italian Voice, via Flickr [CC BY-2.0]](http://www.vettimes.co.uk/app/uploads/2015/05/rescue-remedy-flickr.jpg)
