My RAVS Trip

I’m back from North Dakota, sleep-deprived and happy. We worked really hard the last week, the days were every bit as long as we expected! It was such an awesome and profound experience, so I’m going to try and do it justice. In order to truly appreciate it, you should just do a trip! I will be recommending it to every vet student I talk to, because it was such a great thing to be a part of and I learned SO much.

ND looking beautiful from the plane

First Day
We drove to our first stop: Cannon Ball, ND. We also went to Fort Yates, ND and McLaughlin SD during the week, but Cannon Ball was the site of the first clinic. When we got there, the children and the dogs flocked to watch us put tarps down and unload the boxes from the horse trailer. It still amazes me that a whole high functioning clinic comes out of one trailer.

The truck that holds it all.

All set up and ready to go in Cannon Ball!

We got assigned our own boxes to open and set up, and we did inventory on every item. Once the clinic was set up, we got some orientation and then moved to the surgery test. I was passing everything up until the final loop knot in my line of continuous suture… when I threw a dreaded granny knot. I was pretty proud of the rest of the work, and I wasn’t as disappointed as others that didn’t pass. I then knew I was going to be on the receiving team or the anesthesia team during the week. We got our assignments for the next day, and I was on anesthesia, which sounded so daunting to me.

Me… trying not to look intimidated

Anesthesia
I kind of hoped that receiving would have been my first assignment… talking to people and doing physical exams was something I knew how to do! I had never given any sort of injection before, much less place a catheter or intubate an animal. With the help of the amazing techs, I was able to do all of these things by myself. It felt SO good to be able to do these things, I felt a rush from doing something new about 10 times that day. The nice thing is, they prompt you to learn by DOING… so as much as I would have liked to sit back and watch something be done first, I found that with the right teaching I was able to do things myself. Anesthesia students stay with their client from pre-induction, to catheterization and induction, we monitor TPR throughout surgery and change our gas levels and fluid rates or administer other drugs depending on how the patient does. We then move to recovery and take TPR every 5 minutes to make sure vitals stay stable. We battled with hypothermia a lot this week, (a temp lower than 96 degrees fahrenheit) which caused several long recoveries. Our animals had to walk, be at a good temperature with stable pulse and resp rates, and have eaten a small snack before they could go back to their cages and wait for discharge. I learned a ton from the techs in anesthesia and it was a lot of hard work. It was very rewarding to see your patient go home, tail wagging, at the end of the day.

Me doing some monitoring in recovery! Photo credit: Humane Society of the US – North Dakota

We did some surgeries other than spays and neuters if the situation was appropriate. There were several quill removal surgeries on dogs that decided to fight a prickly animal, as well as some hernia repairs.

This was our quill patient. She was quite painful so we had 2 people restraining her head while I quickly took her temperature and gave vaccines. Photo Credit: Humane Society of the US – North Dakota

We made sure that we had suitable days remaining on the trip for follow-up care, and that the client could provide appropriate after-care for any patients that were a little out of the ordinary. They weren’t afraid to say “no” if they thought the animal wouldn’t have the best outcome from having the surgery.

Wellness Days
In each of the 3 communities, we did one surgery day (2 in the bigger community of McLaughlin) and one wellness day. The wellness days were able to end a bit earlier and surgery days, so then we were able to pack up and move somewhere new at a decent time. These days worked similarly to receiving, with a full physical exams, vaccines, Revolution application and deworming; just without the necessity of clearing an animal for surgery. We saw plenty of clients that had previously had their pet neutered with RAVS and were keeping up with yearly vaccines, so that was nice to see. People started lining up at 7 am and we usually went straight to 2 pm.

Our patients were very good! Photo Credit: Humane Society of the US – North Dakota

Owners were generally very attentive to their pets and were able to give detailed histories about even the most free-roaming outdoor animal. Like pet owners everywhere, they loved to chat about their animals. A lot of the animals were very friendly and socialized to people and were generally well adjusted. On wellness days we got to see a wide range of animals, clients, and problems. I got to hear heart murmurs, discuss allergies, examine hit by car cases, learn about mange, find fleas, and get sprayed with liquid pyrantel more times that I’d like. We also had a lot of paperwork to do… but the fact that it was so thorough will help in the future when RAVS staff get calls about patients we have seen.

Always being attentive to our paperwork. Photo Credit: Humane Society of the US – North Dakota

The closest vet clinic to any of the communities we visited was over an hour away. This makes regular vet care difficult and usually comes down to a crisis situation. It was not abnormal to have 8 month old puppies with no previous vaccinations because they were waiting for the RAVS clinic. There were posters up everywhere advertising when we were coming which was great to see. We were also told that the unemployment rate of the Standing Rock reserve was about 71%, and of the percentage of employed people, something like 61% is under the poverty line. Knowing this just reinforced the importance of our work and propelled us to see as many patients as we could every day.

The Staff
I can’t speak highly enough about the veterinary professional staff and volunteers. The vets and vet techs were so amazing and patient and dedicated to teaching. Their skills were incredible, and sometimes even just observing was enough to learn. Often if we had a complex case, a vet would say “find me at the end of the day and we can talk about this more.” During the day, our priority is getting patients through, but at night I ended up having several conversations about interesting things we’d seen that day. Write down your questions for later! I’ll also share my favourite “field medicine” tip of the week: (plain/original) Men’s SpeedStick deodorant can be used in place of bitter spray on incisions – I guess someone found out that it’s bitter enough to deter licking!

Tips for how to make the most of your RAVS trip:

Work hard: RAVS was every bit as much work as I was expecting. The days sometimes went from 6 am to 10:30 pm. But working hard all day will allow you to see more patients, serve more people, and get your hands on more animals in order to learn more. You will also probably get to bed at a decent hour. I also felt so grateful to the staff that I wanted to work hard and prove myself. So take that extra anesthesia patient, start cleaning up without being asked, check with people to see what can be done, help in the kitchen. You will feel so much more of a sense of pride when the week is through.

Take a new anesthesia patient… they could be as cute as this!!

Get sleep when you can: the myth is true, sleep is limited. However, I found that I was working so hard that by the end of the day, sleep came pretty easily.

Sleep where you work

Don’t worry about what you have or haven’t done: I knew coming in as a first year, I would know the least. But lean on the more experienced students… ask them to help you place a catheter, listen to them talk to clients the first time you have a wellness appointment, watch how they handle fractious cats. Don’t be scared to try new things and ask questions… you learn quickly on the trip so be honest about how limited your experience is and then try and learn. Your attitude will get you further!

Pack what you need: I found that by packing just one bag and a backpack, it made packing and repacking easier.

Ask more questions and complain less: Ask, ask, ask. Always… you will never have more willing teachers at your disposal so make sure you never go to bed with a big question bouncing around in your head. Complaining gets you nowhere and it makes people less likely to want to work with you.

Take advantage of the vet:student ratio. It is probably the lowest here that it ever will be in your schooling career. Our first night of surgery, I had been on a long day of anesthesia. Our nightly rounds were quick, and it was about 10 pm and we were told some of the vets were going to stay up a bit longer for suture practice. I was exhausted, but knew that I needed some guidance after teaching myself from only videos before the trip. It totally paid off, and I was glad I did it. Now suture labs this year will definitely seem less daunting with my new tips!

Ask what can be done and snoop out interesting stuff: You will have a great reputation if you are proactive and ask people if they need help with anything. Being a willing person puts you in good light. Also don’t assume that there is nothing to be done… If it’s 10 pm and there are still patients, ask a leader if there’s anything that you can do – mostly likely the jobs will be covered – but they will be thankful that you thought to ask. I also followed one of the vets outside when I saw her grab gloves because I figured there was an infectious disease case. I was right, we had a possible distemper case, so I asked if she needed anything. Luckily I got to assist her with the appointment and got to see the management and communication of a probable infectious disease case. So don’t be afraid to jump in and try and get involved with interesting cases!

Inevitably, exciting and different things happen on a trip like this, so tomorrow I am going to highlight some of my favourite stories from the trip!