Diary of a Third-Year Vet Student: But How Is The Hemostasis?

It’s a rule of life that we develop rules of life as we go along. One of my rules is, “Never miss an opportunity to pee.” A new rule that I have added since starting my vet school is, “Whenever you encounter really stinky odors wafting out of Necropsy, make a beeline for the viewing gallery and start asking questions—you are bound to learn something.” Death is a constant and significant element of veterinary medicine. Oftentimes, doing a necropsy is the only way to collect a key tissue or fluid sample for analysis. In the case of some diseases in some species, it may be the only way to make a definitive diagnosis. In vet med, being able to perform a proper necropsy is a learned skill that is just as important as doing surgery. During our fourth year clinical rotations, each of us will do a one- or two-week stint in that part of the hospital. I'm looking forward to it.

Necropsy is not what I decided to write about today. I wanted to write about a related aspect of vet school: using cadavers to learn procedures. It's really great when we get live animals to do surgeries on, but for some invasive procedures and surgeries, it is prudent that we practice on cadavers first. 

Despite my interest in necropsy, I detest our cadaver labs. The animals, or their parts, are either still frozen or are melting into goo after being used for a couple of weeks in other labs. Cadaver labs don't have the alluring stink of necropy. They just smell bad. Sometimes I can hardly bring myself to touch the specimens--they are cold, slick with a film of bacteria and ooze, and the texture is so very wrong. 

But last week in our Large Animal Surgery lab, the instructors threw us an interesting twist. We were to perform two procedures that are commonly done on horses to correct growth abnormalities in their legs. Each team had a horse cadaver leg. Just the front leg from below the elbow to the hoof. Here's the twist: the two people in each team who were to perform the surgeries had to scrub in, gown up, do a sterile prep of the surgical sites, do sterile drapes of the surgical fields, and suture up the incisions as appropriate when we were done.

Having us treat the cadaver lab as if it were a surgery on a living animal completely changed the way we all approached it. I thought it was an excellent review of the sterile techniques we are required to learn and put into practice, and a good way to get us to focus on doing the surgery well and not just mess around in a horse cadaver leg. It felt like a real surgery.

We even had to write surgery reports. That's what the title of this post refers to. Hemostasis means controlling blood loss during surgery. Since cadavers don't bleed, there is no need to monitor and react to that but quite a few of us put the statement "Hemostasis was adequate" in our reports for a little dark vet med humor.

Of course, there was a bit of a disconnect when we began the lab by duct taping the legs to the surgical tables.

The magic was quite gone when the legs showed up again for this week's lab. We practiced the common nerve blocks and joint injections in horses that are used to diagnose and treat lameness, injecting saline mixed with a blue dye. After we completed all of the procedures, we had to dissect the legs to see how close we got to the target nerves and joint capsules. My team struggled mightily with one of the joint injections that should have been really easy. We found out on dissection that the horse had proliferative bony growth covering the joint. No wonder we couldn't get a needle in there! It was also likely the reason he was euthanized. It was a long afternoon with a decaying horse leg. But it was a necessary step along the way to becoming a veterinarian.