A little over three weeks into the treatment the eagle was ready to leave the Wildlife Medical Clinic. He was sent to a rehabilitation facility where he was tested for flight capability and hunting capability before finally, being released back into the wild.
Several veterinary students volunteer to provide behavioral enrichment and husbandry care for our resident birds. Check out this slow motion video of Odin and Nokomis catching food for enrichment!
Video credit: Evan Emmel (vm18)
by Allie Urbanik (vm17)
One day an eastern box turtle was presented to the Wildlife Medical Clinic after being hit by a car. On examination, the most evident and pressing issue was a large carapacial fracture. The fracture involved multiple parts of the caudal carapace, and it was not evident on examination whether lung fields were exposed. Due to the potentially complicated nature of this fracture, radiographs were taken. The radiographs showed possible lung consolidation, suggesting lung exposure or infection. Our next step after taking radiographs was to fix the most glaring problem: the shell fracture.
A shell fracture can be repaired one of several ways. A very common approach is to drill small screws into the shell on either side of the fracture and then wrap wire around the screws, tightening the shell down almost like opposing tissue during suturing. Another approach, and the one taken with our patient, was to epoxy the shell. Layers of epoxy material can be applied to the shell over the cracks as a sealant of sorts. Over time, the bone of the shell will heal. The trauma of the car accident combined with the shell repair necessitated that our patient received medication to control pain and fluids.
After our turtle shell repair, we turned our attention to the fact that our patient had refused to eat since arriving. The stress of handling and captivity, not to mention the trauma of being hit by a car, can cause our patients to lose their appetites. Additionally, inflammation and infection can also cause patients to lose their appetite. Of course, nutrition is vital to the healing process, so getting our little guy fed is of the utmost importance. At this moment we are at a cross roads of sorts. We have just recently been successful at force feeding our patient mealworms and fruits, but it may be necessary to place an esophagostomy tube if our patient stops eating or seems too stressed by the handling. Additionally, at this time of the year, turtles would be preparing themselves for winter hibernation.
With our patient’s shell fracture, releasing her now so that she could overwinter is not an option. As such, she will be a long-term patient in the clinic. Hopefully, we have crossed our most difficult challenges with this patient. We expect a full recovery of the affected shell. The prognosis is excellent. I am constantly astounded by the tenacity and healing ability of our patients. I have no doubts that our little turtle will make a full recovery, and I look forward to releasing her in the spring.
Walk or run the October 26 Omega Tau Sigma Road Race and help support the University of Illinois Wildlife Medical Clinic. 50% of the event’s proceeds will benefit the WMC.
by Malky Weil (VM Class of 2016)
Hello wildlife enthusiasts! Have you ever wondered how we record our treatments for our patients? We maintain a complete medical record, just like at your doctor’s office and use a method called SOAP. Here is how it works:
S/O: Subjective and Objective observations. This is where we talk about a patient’s mentation. We can call them BAR-bright, alert, responsive (if they are moving around in their cage), QAR-quiet, alert, responsive (if we find them resting but still responding to us), or non-responsive (which would be a bad sign with a patient). We also note if there were feces and urine in the cage and with birds of prey if there were casts. A cast is the non-digestible hair and bones of mice or other prey that are regurgitated while the rest of it is digested. As gross as it may seem, it’s important to note when an animal has normal excretory and bowel movements, because if those movements are absent, it can be a sign of gastrointestinal or urinary system abnormalities. We will note if there is food left over from the previous treatment, if the water appears touched, if the patient shredded all of the newspaper in the cage, and any other observation before we have our hands on the patient. Some observations are objective, such as whether or not there are feces in the cage, and others are subjective, such as what the mentation of the patient is.
The next parts of the SOAP are based on a problem list we keep for our patients. I will give an example for a bird with a broken wing as the problem. If there is more than one problem, we label it A1, A2, P1, P2, and so on.
A: Assessment. This is where we talk about our physical assessment of the problem. For the broken wing patient, we may be observing if the bird is holding its wing upright or drooping it or how the wing bandage looks. This is where we would describe how the physical therapy on the muscles is progressing. For example- “We did passive range of motion on the right wing and the muscles are inflamed, stiff, but the extension is better than it was yesterday.” We also talk about the medicine we gave for the specific problem here. With a broken bone we usually give pain medicine, because broken bones are painful. So we might add here that we gave 0.6ml of tramadol (and give the dosage in mg/kg, and concentration in mg/ml). We may also be giving a non-steroidal anti-inflammatory to help with pain and inflammation in the wing.
P: Plan. This is where we talk about what we plan on doing in the future. So for this bird case, we would say- “Continue to monitor posture, continue passive range of motion every other day, continue tramadol, and continue meloxicam until swelling recedes. Change wing wrap in 2 days.”
ADD: Addendum. This is the section we use to add anything else that does not connect to the problems, but still needs to be recorded. For example: “We cleaned the cage and refreshed the water bowl. We checked the feet and did not see any signs of bumblefoot. We left 3 mice (total 27 grams) in the cage. Patient flapped his good wing when we returned him to his cage.”
Recording our treatments is very important. There are multiple people on a team caring for our patients, and not everyone is there for every treatment. Those not there need to stay current on the case, see how the patient has been behaving, and note if there are any changes to the treatment plan. Having all that information is important when making decisions on the case as well. No one’s memory is perfect, so it is important to have a place to look back on what has been done and how the patient responded. I hope this gives you a little glimpse into what goes into keeping a complete medical record for our patients. The skills we gain doing this important work will be used throughout our careers as veterinarians.
By Maddy Erba, VM17
To the Future Veterinary Students of the University of Illinois College of Veterinary Medicine:
It was a hot day in the middle of orientation week when Dr. Foreman explained the benefits (and setbacks) of joining clubs. It had been several long days of sitting in the classroom, listening to information about my new academic life and wishing I could go outside for a bike ride. Dr. Foreman was cautioning us about joining extracurricular clubs, especially the Wildlife Medical Clinic (WMC) which is operated by volunteer veterinary students under faculty guidance and mentorship. Dr. Foreman listed the many reasons why we should think twice about joining the WMC. He explained that to be a member you needed to go to rounds, meetings, treatments, be on a pager shift, and care for orphans. I recall the phrase “time suck” being used multiple times. The administration gave us a schedule at the beginning of first year, which I have supplied for you. If you look closely there isn’t even time to eat dinner let alone find all this magical non-existent time in the week for the wildlife clinic.
Being new to Illinois and unfamiliar with the curriculum, I heeded Dr. Forman’s advice. However, that didn’t stop me from going to the club fair and listening to the forbidden fruit of WMC. There Jenny Kuhn stood with a great horned owl perched on her arm, Nokomis. She told me the wonderful benefits of joining – how we can practice physical exams, learn to write SOAPS, practice communicating within a team, and care for a variety of species. And those are just a few of the perks. Yes, WMC is a time commitment, but it also solidifies what we learn in veterinary school.
After careful consideration, I decided to join. We were told we could leave at any time if school became too challenging, or if we decided wildlife medicine wasn’t for us. However, as long as we were members, we were expected to do all the work, go to the meetings, and be a team. On my team were five amazing team leaders – Stephanie Zec, Erica Morton, Teresa Schecker, Laure Monitor, and Amanda Kuhl. This group of experienced individuals taught me everything I know about wildlife medicine. We practiced wing wraps, how to calculate medications, how to make a splint. I learned how to put in an interosseous catheter on raptor! I practiced communication skills, something everyone can improve upon. I was applying concepts from school, asking intelligent questions, and learning by doing! By the end of my first year I had gained an enormous amount of self-confidence.
On May 1st 2014, just sixteen days before the end of the semester, I appreciated the fact that I was laying the foundation to be a skilled veterinarian. I was nervous because an undergraduate student and I were the only two people on PM treatments. I was nervous because as the veterinary student, I was in charge, and I don’t normally like taking the lead. Our patients at the time were an opossum with a distal tail amputation, an orphaned squirrel with a maxillary swelling, and an orphaned squirrel with lung crackles that we thought were from aspirating food during a feeding.
We decided to feed the two orphaned squirrels first, because we thought they would be the less challenging patients. We examined the squirrel with the swelling first, and fed him. He looked alright.
It was time to feed the second squirrel. She suckled roughly two thirds of her meal, and then started shaking. We quickly re-heated a rice sock to keep her warm as she ate dinner, and she seemed to be okay after that. But when I auscultated her heart and lungs, I knew there was a problem. The crackles in the left lung field were still present, but the more alarming observation was her heart. Normally you should not be able to count the number of heart beats per minute on a squirrel. I counted about 120 bpm. Normally the heart makes a “lub-dub” sound, but on our squirrel you could only hear the “lub” and the heart sounded like it was struggling to pump blood throughout the body. We also noted a sinus arrhythmia (which may be normal in young animals) but is still worth noting.
What do we do? We call in help from our team leaders. We rallied the troops. It is never wrong to ask for help or clarification. Amanda confirmed our observations. We determined that our furry friend was not dehydrated, and therefore did not need fluids to increase her cardiac output. So we took radiographs, which revealed an enlarged heart. This young animal had signs of a cardiomyopathy, or abnormality in her heart. It is possible that this was a congenital anomaly that had been present all along but became apparent as time went on. It was only through this valuable clinical experience that I was able to appreciate the signs of a problem in this squirrel and apply my classroom knowledge to a real case scenario.
Congratulations on making it into veterinary school. Part of being in a professional graduate program is being able to think critically, and to think for yourself. The Wildlife Medical Clinic provides you with the opportunity to learn from more experienced students. You won’t always have all the answers in vet school, but you should never feel afraid to ask for help. School is what you make of it. Your education is up to you. Learning by doing is not only enriching, it solidifies understanding of classwork. I strongly implore you to consider Wildlife Medical Clinic, take a chance, save a life, and strengthen your veterinary education.