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Thread: A crash course on survival vetrinary medicine

  1. #1
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    Jul 2007
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    A crash course on survival vetrinary medicine

    First let me start off with saying that I am nervous about posting this, knowing full well we are fortunate to have an expert on the topic in house. Nonetheless, I reckoned it would allow some discussion, given we all acknowledge (based on the content of the book) that Vet Medicine has a clear roll in Survival Medicine when you are relying on animals for work / food in the remote, austere, wilderness and third world environment.

    As many of you know, I have been involved in survival medicine curriculum design periodically. The topic came up recently as to how long it would take someone who has a basic understanding of medicine (EMT-P / PA / RN / MD) to gain a basic understanding of survival veterinary medicine via the apprenticeship learning model. It is far to assume that the medical practitioner likely only has cursory experience in surgical assist, lab medicine, dentist, radiography, operative obstetrics. The agreed upon solution a 42 day practicum, which I propose for debate, is as follows. It can be taken in modules as real-life time allows. It is important to remember that no "short-course" will make you an expert on anything... then again, the practice of survival medicine is that of the great generalist.

    Day 1-10 - Working the Animal Hospital Ward. (10 days)

    Goals:

    - Getting used to being around animals 12 hours a day.
    - Learning how an animal ward is structured and run.
    - Learning how to properly clean and disinfect the animal ward.
    - The physical examination of animals
    - Feeding / nutritional support of animals on the ward.
    - Cleaning and grooming animals
    - Dressing and bandaging wounds
    - Animal physiotherapy
    - Giving veterinary medications
    - Administrating enemas
    - Urinary catheterization

    Day 11-17 - The Operating Room (7 days)

    Goals:

    - Learning how an animal OR is structured and run
    - Preparing the OR for animal surgery
    - Preparing the surgical team
    - Preparing the animal for surgery
    - Veterinary surgical instruments, use and care
    - Veterinary surgical assist
    - Sterilization of equipment post surgery

    Day 18-21 - Special Topics ( (4 days - could be one day modules depending on condition volume)

    Goals:

    - Assisting in C-Section and Hysterotomy
    - Animal dentistry
    - Suturing
    - Wound care

    Day 22-26 - Veterinary Anesthesia (5 days)

    Goals:

    - Pre-anesthetic animal evaluation
    - Veterinary anesthetic machines
    - Veterinary anesthetic systems
    - Endotracheal intubation
    - Administering and monitoring general anesthesia in animals

    Day 27-32 - Veterinary Radiology (6 days)

    Goals:

    - Learning how animal radiology is practically done.
    - Selecting exposures
    - Animal positioning
    - Processing X-Rays
    - Evaluating X-Rays
    - Contrast studies

    Day 33-36 - Veterinary Emergency Medicine (4 days)

    Goals:

    - This could go on forever, but a few days of managing whatever comes through the door.
    - Emergency assessment of animals
    - Fluid therapy
    - Choosing a solution
    - Blood therapy, including donor collection
    - Calculating rates
    - Monitoring effects
    - Emergency procedures
    - Cardiac arrest management
    - Manual ventilation
    - Oxygen therapy
    - IVs
    - Airway obstruction management
    - Tracheotomy
    - Stomach tube

    Day 37-42 - The Veterinary Laboratory (6 days)

    Goals:

    - Learning how an animal laboratory is structured and run
    - Veterinary blood tests
    - Veterinary urine tests
    - Veterinary fecal tests
    - Veterinary bacteriology
    - Veterinary dermatology tests

    There you go... feel free to discuss / use / ignore.


    AN

  2. #2
    Join Date
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    Iowa, USA
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    Very interested in following this. I like the concept, personally. That from a guy who has difficulty trimming his cat's claws.

    RR
    Knowledge shared is learning gained by both teacher and student.

  3. #3
    Join Date
    Mar 2016
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    Great post, AN! I am not opposed to the idea in the least but rather think it's intelligent. Happy you feel comfortable discussing on this forum, I am grateful for the chance to chime in given as much as you have helped me in the past. Hoping others will benefit and chime in too. It is important to remember that I may be an expert but I am not all knowing by any stretch of the imagination.

    My first question is what is your goal for these people, or what/where do we envision them working? Is this an immediate post-disaster scenario, where help is being given to injured animals? Or is it more in preparation for long term disaster, where the initial year or so of chaos has settled, people have figured out how to live in small communities and farm to survive. This person has been trained ahead of time and will be responsible for the care of people & animals in the community. Also, is this primarily the US or worldwide?

    I will mull it over the next few days and give a better response from a computer. Also, is there some similar course that goes the other way? To teach a vet about people? :-D

    AD

  4. #4
    Join Date
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    Location
    oregon
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    Would be great training with lots of crossover skills gained for austere human medical management as well.

    Medicine is worthless without food water and shelter.
    The ability to not take losses in animals is important.
    The ability to have familiarity with veterinary care and be a valuable assistant to a vet is a great skill to pick up.

    I would consider this a excellent secondary rotation after spending a week a month for a year on a permaculture farm learning how to sustain food production.

    As usual, nice work AN


    pa4ortho

  5. #5
    Join Date
    Mar 2016
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    271
    Here is my humble opinion:

    The listed course seems reasonable if the goal is to teach these people modern day small animal medicine. It correlates well with human medicine, I believe. Many of the same diagnostics are performed & treatments may be similar.

    If the goal is to produce a well-rounded physician & veterinarian for a long-term, grid down survival situation then I think the focus needs to be aimed at large animal medicine, especially food producing animals. The species covered will vary based on geography and what animals do well there. Worldwide, small ruminants (goats, sheep) seem to be the mainstay of production, as they can be slaughtered & eaten before the meat spoils without refrigeration. Their gestation is also shorter than cattle, allowing them to raise more young per year. I have not studied this topic in-depth in a while, so correct me if I'm wrong on the species here.

    Equine medicine will also be important if we go back to relying on them for transportation and, well, horsepower in the field. One might dabble in rabbit & poultry medicine, but these animals are easier to replace because they give large litters & gestation length is very short. Cattle are suited to certain areas of the US, but again given their large size and 9-month gestation, along with age of weaning at 6-7 months and current day slaughter at 18 months, I don't see them being a mainstay of survival animals.

    With the above discussion in mind, the topics I would suggest for teaching are:

    1st- Basic Animal Science
    animal behavior (flight zones, reading body language & cues)
    animal husbandry (proper care of animals - housing conditions, etc)
    basic nutrition (protein, carbs, etc. knowing local forages is helpful too)
    animal restraint techniques - making rope halters, knot tying

    I would imagine these people are used to patients who listen (at least moderately well), especially if they expect to get medical help. Making the leap to working on animals who are not so cooperative is going to be difficult. One would hope that the caregivers of said animal would be prepared to make the vet's job easier, but it's usually not the case. (When I say vet here, I mean whoever is giving medical care to the animal, whether DVM, MD, or lay person.) The vet needs to be prepared to restrain the animal with whatever facilities & tools they're given, and in a manner safe to them and other people. This probably falls into your first 10 days of teaching, but I wanted to emphasize how important this portion will be.

    I'd have to agree with pa4ortho. There is a lot about animals that can't be taught in a classroom and ideally you would immerse these people in working with livestock and around knowledgeable people as much as possible.

    Once the foundation of animal science is laid, the remaining topics can be discussed.

    2. Basic Anatomy
    ruminants (may include some physiology about the rumen here)
    equine
    other monogastrics (swine, dogs & cats, likely all close to human anatomy)
    include in this discussion the clinical application of anatomy: breakdown of most oral medications by the rumen, surgical applications/limitations due to anatomy

    3. Most common diseases, organized by system
    reproduction - dystocia, c-sections, infertility, infectious & non-infectious abortion, periparturient disorders (esp post-partum)
    lameness - debridement of sole ulcers, abscesses, bandaging extremities
    parasites - internal (blood borne & gastrointestinal) & external (lice, ticks, flies)
    hematology (esp blood-borne parasites & pathogens)
    respiratory
    urogenital
    gastrointestinal - medical management of colic, equine founder
    dermatology (abscesses)

    4. Toxicology
    local plants
    other environmental toxins - lead, waste, etc

    5. Public Health / Zoonotic Diseases
    This will be a brief section, as it will cover many things already discussed. Delve into disease treatment & prevention, esp of vets & animal caregivers. Talk about food safety & food handling. Cleanliness & health of animal workers when milking, butchering etc. Common zoonotic diseases & their transmission (brucellosis, tuberculosis, rabies, just to name a few. Most causes of abortion are zoonotic). Specific diseases will vary based on geography.

    6. Practical Surgery
    Commonly performed procedures - castration, standing c-section, laceration repair, enucleation
    Correcting a dystocia (abnormal presentation of a kid/calf/foal) and/or fetotomy (removal of a dead fetus piece by piece)
    Surgical preps - clip the hair, then clean as best you can and scrub it. It's very basic compared to human med - these animals are tough and, admittedly, the surgical suite is usually in the middle of a field at night
    Local anesthesia techniques - epidural spinal for dystocia, nerve block for c-section

    In practice, complete anesthesia is almost never performed on large animals. The challenges are just too great - the size of the animal makes moving them while asleep difficult; ruminants produce copious amounts of saliva making aspiration likely; comparatively, ruminants have a very small thoracic cavity because they are prey animals & the rumen is very large which further restricts respiration. Horses just don't do well in general with the drugs. Waking them up is the difficult part, they tend to go crazy and injure themselves, their facilities & their handlers. Modern equine facilities use padded rooms to prevent injury and even then it's not uncommon for a horse to break a leg recovering from a colic surgery. The exception is the use of ketamine to do a quick field castration.
    Overall, wound repair & other surgeries in large animals only require good restraint & use of local anesthesia. Know the toxic dose of lidocaine for ruminants, it's easy to overdo it.

    7. Euthanasia
    When it should be considered & how it's done. Methods include the use of drugs & others.
    Here is a link to the AVMA's humane euthanasia guidelines: https://www.avma.org/KB/Policies/Doc...euthanasia.pdf
    You may also discuss appropriate methods of killing an animal for slaughter. People generally figure this out on their own, but it is sometimes brutal.
    Disposal of carcasses

    If time allows:
    8. Small Animal topics
    Restraint & handling
    Wound repair
    Surgery & anesthesia - ovariohysterectomy, castration, c-section

    9. Ultrasonography & radiology


    To conclude - I think your proposed idea is a good one. The material could be taught in a month or two and you would have a good shot at helping animals. Prepare them well for the most common diseases/problems and they will be a valuable asset to their community.

    -AD
    Last edited by AnimalDoc; 02-28-19 at 09:19. Reason: include local anesthesia

  6. #6
    Join Date
    Mar 2016
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    271
    Well, I certainly didn't mean to shut down this thread or act like a know-it-all. I was careful in my response and did not mean to step on toes. Merely wanted to help share my knowledge and give back to a forum that has done so much for me.

    I hope your course goes well, AustereNurse.

    -AD

  7. #7
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    oregon
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    Following closely, this is good stuff.
    pa4ortho

  8. #8
    Join Date
    Jul 2007
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    514
    AD,

    No shutting down the thread. Your input was valuable and incorporated into discussions at work. Just got busy (like most things) and could not keep at it.
    The stuff on euthanasia (and the link) were valuable as it was not given the proper thought in the original curriculum model.

    Interesting stuff, just wish I had more time to pursue this sort of stuff. About to change jobs in July / Aug so I am expecting to have a little bit of a more balanced lifestyle and have some more time for family and personal interests like this sort of stuff.

    I remember when I was working in Sir Lanka after the Tsunami and there was an organization called Veterinarians Without Boarders working there. Good people doing some good work. In the rural areas animals are such a large part of peoples ability to survive day-to-day.

    Cheers and thanks for the input.

    AN

  9. #9
    Join Date
    Mar 2016
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    271
    Cheers to you, AN, and glad all is well. Happy to provide something useful for all.

    I wish I was in a position to do some relief type work such as that. I always thought it would be great to be boots on the ground helping people & communities. I have a feeling it is soon coming to a town nearby, though...

    -AD

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