Growing up, I had always had an interest in animals. Unfortunately, I’ve never had any pets of my own, but many of my close friends did. In my eyes, I never thought there could be something wrong with their dog or cat. On the outside, they looked perfectly normal. Yet, my young mind never thought about problems occurring within the body. As I got older, this sparked my interest in zoology and anatomy. I wanted to understand how the bodies of animals functioned and how they responded to diseases. I wanted to see if there were any similarities between animals and humans too. My internship allowed me to do just that.
For four weeks this summer, I interned at MSPCA-Angell in Jamaica Plain, where I had the opportunity to work with the internal medicine department. Most patients seen in this department have chronic illnesses like Addison’s disease, cancer, and diabetes. Working with Dr. Crouse, I was able to oversee appointments, watch multiple scopes, and listen to lectures.
Most days started off in the clinic. Dr. Crouse’s specialty technician, Bryanna, would go out into the waiting room to get the patient. Then depending on the kind of animal, she would weigh the patient on the larger scale outside the clinic, or in the small one in the appointment room. In a similar procedure to what happens at your own doctor's appointment, Bryanna would ask the owner some questions:
What type of food are they eating?
Are they eating and drinking well?
Have they been vomiting or having unusual stool?
Has their behavior changed at all?
Building off of those questions, Bryanna would then start going over the medications the patient takes, seeing if there have been any changes in dosage since the last visit. Once done with this routine, we would leave the room and call Dr. Crouse.
When you exit the appointment room, you enter the clinic. The clinic is where we brought the patients to have blood drawn and receive their vaccines. Blood is drawn to check for any new or current diseases a patient may have by measuring electrolytes, liver values, and kidney values. It is also meant to measure the red and white blood cells and platelets in the body. Some typical vaccines given are rabies, lyme, DHPP, Bordetella, and Leptospirosis. Similar to the flu vaccines we receive, these vaccines help the pets build immunity, or a tolerability to these illnesses. Part of my job was to draw up vaccines and put labels on blood samples for patients.
Drawing a vaccine Putting away blood samples
While observing, I noticed that, sometimes, the special techs and doctors would struggle to give pets vaccines. Some pets tended to squirm and whine, making it difficult to draw blood and give vaccines. Dr. Brum’s technician, Hannah, told me that most of the pets tended to be extremely nervous, as the vet’s office can be a traumatic place for them. In their minds, the pets see the vet as a bad place. The pets don’t understand that the vet is there for help. Due to this nervousness, it was important for us to have patience. I saw first hand that giving a vaccine or drawing blood isn't easy. From what I observed, the best solution is to stay calm and try to carry out the task, but don’t force it if the pet doesn’t want it. For example, Bandit was a calmer dog. Bandit is 14 years old with a chronic cough and a possible collapsing trachea. While Bandit was a little shaky, he was compliant and easy to work with. In other cases, pets tended to whine and squirm, revolting against the technicians and doctors.
In addition to helping with drawing vaccines and blood samples, during my internship I had two projects I worked on when there were no appointments. My first project involved doing inventory for the fluoroscopy room. Organizing the internal medicine cabinet, I created a spreadsheet. On the spreadsheet were the names of the items along with their measurements and quantity. Going shelf by shelf, I removed the items and reorganized them by size. Fixing the cabinet made the items more accessible and visible for the doctors. Doing this project emphasized the importance of organization within the workplace. If items are not where they should be, or are hard to find, this can slow down a procedure. Doctors want procedures to be done in a timely manner, especially if they have more than one. Spending too much time searching for tools isn't beneficial for anyone, slowing everyone down. This can create unnecessary stress within the workplace.
My second project was a presentation about the similarities and differences between diseases that affect pet and human adrenal glands. The adrenal gland is meant to produce a hormone called cortisol, which is meant to regulate your body’s stress response. If you have Addison’s disease, too little cortisol is being produced. If you have Cushing’s disease, too much cortisol is being produced. Over the duration of my four weeks, I did research on both diseases. Then, on my last day, I presented my research to the internal medicine department.
While most appointments are annual checkups, some are more serious than others. Especially when a dog or cat is extremely sick, and there comes a time to have a discussion about putting a pet to sleep. The doctor and the owner must assess the patient's quality of life, as neither the doctor nor the client wants the pet to be in pain. At some point, medication may not help, and further treatment can only last for so long. In these cases, the quickest and most painless way to relieve the patient's pain is through euthanasia. When it is time, the doctor will use an anesthetic called "Fatal-Plus" or pentobarbital sodium, which causes the pet to fall asleep, passing away peacefully within a minute. The body is then brought to the clinic, put in a bag with name tags, and placed in the morgue. Finally, the bodies will be picked up and cremated. A client can choose to witness the putting to sleep process (PTS), or they can be out of the room. They are also encouraged to do any final goodbyes after the euthanasia. For many people, their pets are like children to them. The hardest part for anyone is seeing someone they love suffer. It's the worst when you have to say goodbye. This goes for the doctors and techs as well, as they have built a strong bond with the patient and their parents. Bryanna, Dr. Crouse’s tech, sees euthanasia as her final service to the pet. On my last day, I was able to observe the euthanasia process for one of Dr. Crouse’s patients, a dog named Sofie. While I was not in the room during the procedure, I was able to watch the aftercare process. Seeing the lifeless dog was heartbreaking. In my head, all I could think about was what the client might be going through. In a way, I wanted the dog to come back—I wanted Sofie to live a little longer, so the clients didn't have to grieve. However, I knew I couldn’t reverse the process. At that moment, Sofie was in a better place, with no pain or suffering. Part of Angell’s mission is to relieve their patients’ suffering, and euthanasia is one way to do that.
Thank you to all the doctors I got the chance to meet and work with at Angell. I had such a great time shadowing and getting to see what you all do. I’ve learned more than I could have imagined. These four weeks have shown me what it means to be a good person, working for the betterment of the people and animals around me. Your office has only deepened my interest in medicine.
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