Vet Tech Skills

Client

owner/main contact person EX: barn manager

Patient

the animal

Triage

prioritizing based on urgency (cases)

the preliminary assessment of patients or casualties in order to determine the urgency of their need for treatment and the nature of treatment required.

Signalment

foundational, permanent description of a patient—specifically in veterinary medicine—comprising species, breed, age, sex/gender, and reproductive status

History

history = (hx)

comprising the owner's observations, the presenting complaint, and the animal's medical background: current medication (long term and short term), lifestyle/environment, diet/nutrition, behavior (changes?), and allergies, etc

Vital Signs

essential, measurable body functions used to detect or monitor medical problems, including heart rate, blood pressure, respiratory rate, and body temperature

*respiratory and heart rate can change depending on the situation, get a true reflection

— heart rate/pulse (beats per min/bpm), counting over 15 secs x 4 or 30 sec x 2), any murmurs?

— temperature (rectal), technique can affect reading

— respiratory rate, movement of side/chest or nostril OR listening to lungs (brpm/bpm = breaths per min)

— capillary refill time (CRT), pressing on the mem and removing our finger, mucus membrane should turn to its pink color in less than 2 seconds (gums, vulva, or prepuce)

— Mucus membrane/MM, accessing color and moisture (hydration), pink and moist is normal

*blood pressure is a vital sign when applicable/NOT common

Listening with a stethoscope

auscultation

Be ____ as possible when taking vital signs, going from ____ to ____

consistent, head to tail

** but depends on situation/animal and safety

Hydration Status can be determined by…

1. skin turgor (skin pinching), grabbing and pinching some part of the animal to see how quick the skin falls into place, the more dehydration the slower it will return

2. mucus membrane (levels: moist, tacky (mild dehydration, then dry)

3. urine by color, volume, and frequency, and USG (urine specific gravity)

4. eyeball position (in ruminants), sunken in/eyeball recession? *BCS can affect this

5. CRT, more for perfusion of those capillaries, but can help with hydration status

Where do you “perform” skin turgor in small animal, equine, and ruminants?

small animal — scruff (between the shoulder blades)

equine — neck/point of the shoulder

ruminants — upper eyelids

Dehydration is what %

greater than or equal to 5% dehydration

greater than 12% is severe and can result in death

What do you check (vital signs, etc) during a visit?

vital signs

coat/skin: missing hair? any wounds? lacerations? external parasites? appropriate coat length for the season?

palpate externally and internally (abdominal, rectal, vaginal palpate.)

joints: ROM effusion (swelling)

have them ambulate/move about to access any lameness/neurologic issues (check for potential incoordination — ataxia?)

EENT (eyes/ears/nose/throat)

ears: waxy debris, normal ear position/movement, ear infections

nose: airflow thru both nostril (nostril flaring?), mucus?

throat: swelling/any abnormalities, lymph nodes swollen? *palpate internal ones

eyes: discoloration (redness), abnormal discharge, cloudiness

mouth/teeth/tongue: fowl order?overgrown teeth? gingivitis? *through oral exam might require sedation

musculoskeletal: muscle wasting? BCS, hoof/claw need care?

reproductive system: pregnant? **medication can affect pregnancies

term for walk/move about

ambulate

Ataxia

poor coordination, balance, and uncoordinated movement (stumbling, staggering, "drunk" gait) due to central nervous system issues,

cerebellar (high stepping, jerky), vestibular (head tilt, circling, falling), and proprioceptive (knuckling, dragging paws)

lymphadenopathy

swollen lymph nodes, refers to the enlargement of lymph nodes due to an immune response to an infection, inflammation, or a cancerous tumor

Terms referring to both sides and one side (affected)

bilateral and unilateral

SOP

Standard Operating Procedure

(Hot Iron) Dehorning is performed…

to permanently disrupt/stunt horn growth in calves to prevent injury to people and other animals

Dehorning using the following SOP should be completed when the calves are between

2-4 weeks of age

can be performed in calves up to 8 weeks of age depending on the size of the horn bud

Why is dehorning not done before or after the recommended age?

Not done before 2-4 weeks of age because they’re neonatal and are susceptible

Not done after because procedure would be more invasive (method is different)

Describe the dehorning procedure, step by step

1. attach butane can to the hot iron dehorner and turn on (allow it to heat up)

2. catch and restrain calf (using the gate, place their head through the window) then locate the horn buttons on the poll and if they are no horn buds felt, sire of calf is likely polled. If present, clip the hair that is overlying/surrounding each horn bud for visibility and reduce risk of hair catching fire.

3. perform a regional lidocaine block of the corneal nerve on both sides of the calf. Drawing up 10 mL of 2% lidocaine using a 12 ml syringe. Locating the divet, place the need (18 G 5/8-7”) under the skin at a perpendicular angle (90°) and with the bevel of needle facing up, should feel like a release of pressure/a pop when the needle has gone through. Aspirate by pulling back the plunger of the syringe, making sure there is no blood present/not in a blood vessel. If there is blood, gently pull needle back out partially and redirect it at a different angle, re-aspirate before injecting in a new location or if the calf moves/struggles. Deposit 5 ml of lidocaine under the skin. If difficult to inject, re-direct and re-aspirate before depositing more lidocaine. Repeat this procedure for the other side so that both horn buds are desensitized.

   *use a new needle when drawing up lidocaine from the bottle and for calf. Do NOT reuse needles, change them between calf. Syringes can be reused if no blood has entered the syringe during aspiration.

4. Give meloxicam by mouth before leaving the hutch and preparing the next calf. Dose: 3 tablets of meloxicam ( 15 mg/tablet) per 100 pounds of body weight

5. Repeat the produce above down a line of calves of appropriate age range that have yet to be dehorner

6. ** Dehorner MUST be very hot prior to use and care must be taken to avoid thermal injury. Properly restrain the calf for the safety of both the animal and the handlers. Place the hot dehorner over the horn bud (with the base of the horn bud completely contacted by the dehorner) and provide direct, firm pressure while rotating the dehorner in a circular motion for 3 seconds at a time. Be sure to NOT apply the dehorner for longer to prevent thermal injury to the skull or/and brain of the calf. Dehorning should be continued in segments of 3 seconds at a time until there is a complete separation of the skins surrounding the base of the entire horn bud. A copper brown ring around the base of the horn bud will first appear, but nearing completion, a white ring represents the separation of the skin 360° around the horn bud.

7. If the horn cap comes off and bleeding occurs, please the dehorner directly on the horn bud to cauterize the area and stop the bleeding.

8. Repeat the process for the second horn bud.

9. Place/spray the dehorned sites with aluminum spray completely covering the horn bud and the ring of separation that was created. Care must be taken to NOT spray into the eyes of the calf.

10. Apply a light coating of catron IV fly spray over the poll of the calf to repel insects

11. Release the calf and observe for a few minutes to monitor recovery. Observe calves for bleeding, lethargy, fever, inappetence/lack of appetite, or abnormal behavior over the next 12 to 24 hours.

Corneal Nerve (what does it supply and where can it be found)

nerve that supplies sensation to the horn bud

there is a divet/depression adjacent to the lateral canthus (corner) of the eye

Lidocaine is what type of medication and MOA?

Medication used as a local anesthetic/numbing agent (causing a temporary loss of sensation or awareness)

It blocks sodium channels in the nerve endings, preventing pain signals from reaching the brain

Why do we not want lidocaine in the bloodstrean?

can pose a life-threanting condition and lead to local anesthetic systemic toxicity though cattle have a high blood tolerance for lidocaine

What is the bevel and why would you want it facing up?

The bevel is the sharp, angled tip of the needle and if facing up, it allows for a clean, low resistance puncture and minimizing pain

Meloxicam

nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation (Cox 2 selective)

single dose 1mg/kg

If you do not completely dehorn the whole bud, results in

spurs

Cranial Nerves (I)

Olfactory Nerve: sensory

sense of smell

can do scent test

Cranial Nerve (II)

Optic Nerve; sensory

eye sight

menace response: checking CN II and CN VII, checking if they blink, can be an issue with sensory or motor (some neonates will not have a menace response because they have yet to learn the consequences of not closing their eyes when something is close to their eye, depends on their environment)

Cranial Nerve (III)

Oculomotor Nerve: motor

movement of eye (includes all eye muscles except those supplied by IV and VI)

check by pupillary light reflex (PLR), constricting of the pupil in response to the light in the eye directed at but not in the other eye (in which light is not being directed at)

(motor of blinking, CN III but sensory component of CN II, optic senses the light)

a REFLEX, done unconsciously, NOT a response

Cranial Nerve (IV)

Trochlear; motor

eye movement from superior oblique (dorsal) muscle, moves the eye upward and inward

strabismus — eyes are not at rest, an abnormal resting position

Cranial Nerve (V)

Trigeminal; motor and sensory

function: face sensation and muscles of chewing (maxillary, mandibular, ophthalmic)

Palpebral reflex; tapping near the eye, animal should blink but they may see the action and will have a menace respond (sensory: CN V and motor: CN VII)

Cranial Nerve (VI)

Abducent;  motor

function; eye movement from external rectus (lateral) muscle, retractor bulbi muscle

engaged with blinking and pulls eyeball outward

the eye would look crosseyed/eyes would go inward

Cranial Nerve (VII)

Facial; both: motor and sensory

function: face movement/expression (muscles to eyelids) and sensory in front of tongue (rostra) and soft palette

Cranial Nerve (VIII)

Vestibulocochlear; sensory

function;  hearing and balance

Seeing how that animal moves and how they carry their head, may have a head tilt 

Cranial Nerve (IX)

glossopharyngeal; both motor and sensory

function; swallowing with pharyngeal musculature and taste + sensation of the back of the tongue (caudal)

gloss- tongue AND pharyn– pharynx

Cranial Nerve (X)

vagus; both motor and sensory

 function; (goes beyond CNS) swallowing reflex, includes heart, lung, bronchi and gastrointestinal tract

Cranial Nerve (XI)

Accessory/Spinal; motor

function; movement of shoulder, including the muscles of the shoulder (and neck and head)

Cranial Nerve (XII)

Hypoglossal; motor;

function; muscles of tongue and movement of the tongue

Testing the strength of the tongue, manipulate the tongue gently, should not be hanging out of the mouth–limp, and strong enough to move it away

What are the types of white blood cells that you would find in a BLOOD sample? 

Basophils, Eosinophils, Neutrophils, Lymphocyte, and Monocytes

The components of a centrifuged blood sample collected in a purple top tube include the _____ (liquid layer), the ____ _____ (middle, thinnest layer) that is composed of ____ and _____ , and the packed red cells, which are also known as

_______ (medical term).

plasma, buffy coat, thrombocytes and leukocytes, erythrocytes

The process of neutrophils leaving the circulation and entering tissues in response to an inflammatory or infectious stimulus is called

diapedesis

In a caprine patient that is severely anemic, you would expect the FAMACHA Score to be a

5

Lymphocytes primary function

Play a key role in the adaptive immune system

Neutrophils primary function

first responders of the immune system

Eosinophils primary function

Increase in response to parasitic and allergic conditions

Monocytes primary function

Amplify a local response to a systemic (body-wide) response

Basophils primary function

Discharge granules that contain heparin; play a role in allergic responses

What elements comprises blood? And what comprises those?

cells; and cell fragments; platelets

plasma; water + dissolved solvents: proteins, electrolytes, nutrients (glucose, lipids, proteins), gases, cell metabolic products and waste, enzymes, hormones, ion, etc.

Analyzing blood components; What components are in a pcv tube and what % are they of the whole blood?

plasma (55% of the whole blood), buffy coat (<1% of the whole blood), and erythrocytes (45% of the whole blood)

What does CBC stand for? And what does it include? What else is it referred to as?

complete blood count, includes RBC, WBC (includes each type of leukocytes), thrombocytes (platelet numbers), and determination of total protein

also known as hemogram (a routine blood test to term the above)

Fibrinogen

An inflammatory protein

Erythrocytes are _____ _____ (shaped)

biconcave disks

Erythrocytes are made in

bone marrow

Erythrocytes’ life span…

varies among species…. 2 months in feline, 3 months in canids, and 5 months in equids

Erythrocytes function

transport oxygen from the lungs to body tissues using hemoglobin and carry carbon dioxide waste back to the lungs

RBC morphology (form/shape) and size….

varies among species

FAMACHA

a diagnostic tool for sheep and goat producers to identify animals with anemia (the severity) caused by Haemonchus contortus infection in small ruminants by comparing the color of their conjunctiva

bright pink — optimal (not concerned of parasitic burden) and pale white — fatal (likely linked to heavy parasitic burden)

What are the types of white blood cells?

granulocytes: neutrophils, eosinophils, basophils

agranulocytes: monocytes and lymphocytes

The term referring to when WBC are higher than normal:

Leukocytosis

The term referring to when WBC are lower than normal:

Leukopenia

Neutrophils are

lobulated, highly segmented nucleus

Neutrophils move based on

chemical gradients: chemotaxis

Neutrophils morphology…

varies among species

____ are immature neutrophils, and when this is present, its called a ____ _____

bands, left shift

Bands in neutrophils are seen when the body experiences…

overwhelming inflammatory signals and bone marrow can’t keep up with demands (such as significant infection)

How do neutrophils kill microbes?

Cytoplasmic granules fuse with the phagosome and discharge lethal components into direct contact with offending microbe = “respiratory burst” or “oxidative burst”

Neutrophils circulate…

only briefly/only for hours before migrating into tissues

Neutrophils enter the tissue… and? This process of leaving the circulation and entering tissues

do job, are destroyed and turned over by macrophages. Diapedesis

Diapedesis

the process where white blood cells (mainly neutrophils and monocytes) pass through intact capillary walls into surrounding tissue to fight infection or injury

Neutrophil interaction with

endothelium

Neutrophils leave the circulation to

emigrate to sites of infection

PMN surface and endothelial cell surface are studded with

adhesion molecules

Neutrophil granules destroy

anything—even host tissues

Accumulations of neutrophils =

purulent discharge or “suppurative exudate”

Granule contents (in eosinophils) are

active chemicals

Eosinophils increase in response to

allergic conditions and to parasites

Eosinophils are not

phagocytes

Eosinophils kill by

exocytosing granules (not by ingesting/engulfing microbe and fusing granules)

Exocytosing

an active transport process where cells move large molecules out of the cell by fusing internal vesicles with the plasma membrane

High eosinophil numbers seen with

parasitism, allergy, and some neoplastic diseases

Neoplastic diseases

abnormal, uncontrolled cell growth resulting in a tissue mass called a neoplasm (tumor)

Rouleaux formation

the stacking of red blood cells (RBCs) into columns resembling coin stacks, driven by increased plasma proteins

Monocytes are in the ____ while macrophages are in ____

 in the blood system, in soft tissue

When Neutrophils counts are higher than normal

↑ neutrophilia

When Neutrophils counts are lower than normal

 ↓ neutropenia

When eosinophils counts are higher than normal

↑ eosinophilia

When eosinophils counts are lower than normal

↓ eosinopenia

basophils are called so because

their cytoplasmic granules stain blue/purple

Basophil numbers increase in response to

some allergic conditions

Numbers of basophils are usually

low in animals

Granulocytes basophils vs mast cells

when in circulation = basophils and when in tissues = mast cells

basophils are sited at

portals of entry to contain invaders and referred to as mast cells

Discharge granules that contain histamine …. and heparin do what?

histamine = dilates blood vessels

heparin = prevents blood clotting

Monocytes are

phagocytes

Monocyte secrete

many of the molecules that lead to the feelings of illness: fever, arthralgia, myalgia, chills

arthralgia

joint pain or stiffness

myalgia

muscle pain or soreness arising from injuries, overuse, infections

Molecule that lead to the feelings of illness: fever, arthralgia, myalgia, chills are called ____ and secreted by _____

cytokines, monocytes

Monocytes amp the ___ response

immune response/ amplify a local response into a body wide systemic response