Training Day 1

Today was the first day of training for the surgical team. Following a 30 minute motorcycle ride that brought me from the south end of Kathmandu, all the way through the city up to the northwest corner of the city. After navigating through crowded streets, we emerged to see this beautiful landscape. I've been in the city since my arrival, so this is the first glimpse I have had of the "real" Nepal, as my mentor describes it. 

The surgical team consists of 3 veterinarians. Dr. Thapa is the head veterinarian with the most experience. In the past he worked at KAT He told me the number of animals he sterilized while working for KAT was around 10,000 animals! 

The other two vets are recent graduates and are being trained by Dr. Thapa. 

The lucky patients for the day. The street dogs are fairly interbred, as one would expect given their free range. So a fun game I play with these dogs is: Name My Breed. (I know what you're thinking, "Jess is such a nerd," "She's so weird," "Only she would find this game fun." Maybe so, but here, let me give you an example.) This dog that is standing in the picture on the left, it looked like a mix between a terrier of some sort, with German Shepherd mixed into the bloodline somewhere, and possible border collie or maybe Spitz. So, what breed is he? Mutt? No, don't use that cop out. He's a Tergeritz. Terrier + German shepherd + Spitz. A tergeritz. More technically, he is now a neutered Tergeritz. 

View from the surgery room. I seriously just turned around after taking the picture above and snapped this one.

The clinic, with a pretty fantastic backdrop. 

The surgery room is the next room off to the left of the frame. 

Prep Station

• Hexinol for scrubbing the patient
• atropine for induction
• straight razors for clipping, since no power = no electric clippers
• Other meds for pain management
• butterfly catheters
• tape

Patient #1 of the day. 

All animals are on fluids, but the drip rate is so slow, that I don't believe it makes any difference whatsoever. Still, it's a start.

All sterilized animals, both male and female, receive an ear notch. This is a universal sign that is recognized throughout the valley that this animal has been sterilized.

 

Each animal also receives a tattoo in its ear. This way we can identify which animals were sterilized by us, and it is also a way to identify the dogs.

Finished product: MHG 1

It is the standard here to do a flank spay. This is very different from the U.S. where the standard is a midline approach. A flank spay, as you can see from the picture, is approached from the side of the animal. A midline spay it performed with the animal on its back and the incision made low on the belly of the animal. Flank spays are definitely more difficult, but also have their advantages compared to a midline approach. 

Cutting through the abdominal muscles

Searching for the uterine horns and ovaries

Bingo! Found it.

One animal we spayed was actually pregnant, in very early gestation. Those two purple bumps are developing fetuses within the uterus. I acknowledge that this may be upsetting to some and is a controversial topic. Just keep in mind the welfare of the mother dog and the kind of life these puppies would have if the pregnancy continued to full-term. If we don't spay this female at this time, we may never have the opportunity to spay her again, allowing her to have many more puppies than just those in this litter.

This video is for my vet school peeps. Have any of you ever seen this method to end an interdermal pattern? It was new to me.

All closed up.

Dr. Bikash's turn

Sorry if these pictures disturbed you, but I am not going to refrain from posting them in the future. Consider this your warning. It was great to get out of the city for a day and to have my education expanded by observing this new procedure. Fingers crossed I will have the opportunity to get my hands dirty in the next couple months.