A Special Student

 

 

-"Are you a vet student from NC State?"

-"No - I am just a high school student taking a gap year before university."

- "Really! I would never have guessed...."

 

            And thus my externship began at TVRH, and not once have I regretted my decision to spend a year under the guidance of Dr. Grafinger and his admirable team.  Spurred by my interest in biology and medicine, I began shadowing Dr. Grafinger in May 2012 during my senior year at Durham Academy.  Keen on learning how medicine and science are truly applied in the world around me, I viewed shadowing at the hospital as a way to explore the realms of emergency surgery while gaining work experience with animals and exposing myself to the atmosphere of an emergency hospital.  Barely eighteen and inexperienced in the field, I knew that to be granted such a special opportunity was rare and invaluable.  Dr. Grafinger took a risk by allowing someone as young and untrained as myself behind-the-scenes in such a hectic and unpredictable field, and, everyday, I hope that he and his team have not been disillusioned by their choice. 

            From the moment I began working with the vets and techs at TVRH, I have felt welcomed in every single way.  Rather than viewing me as an intrusion or burden, everyone at the vet has embraced my presence and demonstrated kindness, sincerity, and patience - qualities that I have found absolutely priceless.  Knowing their willingness to help me understand, I feel free to ask questions without the worry of being judged or criticized for my ignorance.  Even when procedures are so new to me that I am at a loss of questions, I have found that simply watching in silence can be the most valuable way to learn.  Thus, whether shadowing in surgery or helping to restrain an animal, I experience everything as though I were a student with a personal mentor; from the preparatory work of anesthetics and sterilization to the actual incisions and operations, I am continually exposed not only to various techniques and procedures, but also to the importance of teamwork and trust between colleagues, and the dedication and strength required to work under demanding conditions.

            By the time June arrives and it is time for me to leave, I will have learned so much more than anyone will ever realize.  Every day, I think to myself how thank you seem such empty and lifeless words compared to the gratitude I feel towards everyone at the vet, and I wonder how I will ever repay everything that I have received over this wonderful year.  Yet, for now, I will let myself relish every priceless moment I spend with TVRH because, thankfully, I know I still have many months ahead of me. 

           

 Submitted by: Simone Robinson

Vet Tech Week

We all come from different backgrounds, different places….but chances are we were the little kid who loved animals and were always trying to bring home another one, even the sick ones, because we wanted to make them better.  We are veterinary technicians, veterinary assistants, animal health care workers….whatever the title, we are caregivers.  We are the ones who care for your pets when they are in the veterinary hospital or clinic. 

Most people don’t really know what a veterinary technician does.  What you see is not necessarily what you are getting.  You may think we just hold animals, or take temperatures and weigh them…..but what goes on behind the scenes is what makes us who we are.  We are nurses, phlebotomists, anesthesiologists, surgery assistant’s lab technicians, x-ray technicians, pharmacists, client educators, nutritionists, cage cleaners, groomers, a warm touch when they are scared.  We often work long hours, staying late when we’re needed, we often think about our patients even after we’ve left work.  We are the ones who keep them healthy and nurse them back to health when they are sick or injured.  We get attached to them, we get excited when they get better and we are sad when they don’t. 

It doesn’t matter what part of veterinary care we are involved in, zoos, academia, research, small animal, large animal….. we all want what is best for them.  We all want to make a difference and help provide the best quality of life we can for our fuzzy friends and regardless of how many backaches, headaches, or heartaches we endure in our challenging job, this is still such a rewarding career.  We love what we do.  We take pride in our work and truly enjoy being caregivers for your pets.  We are veterinary technicians.

Michelle Schoepper RVT

 

Dr Grafinger's sea turtle adventure

 I was recently invited to NCSU school of Veterinary Medicine to perform surgery on a Loggerhead sea turtle rescued off the coast of North Carolina.   The sea turtle had a crushing injury to her carapace and a severely lacerated right front flipper.   Her carapace or shell injury was the likely result of a boat collision.  Her flipper laceration was secondary to becoming entangled in a crab pot line.  The turtle’s name is Nichols and she was rescued by the Karen Beasley SeaTurtle Rescue and Rehabilitation Center.

damaged right front flipper

damaged carapace

 

The Karen Beasley Sea Turtle Rescueand Rehabilitation Center (KBSTRRC) is a nonprofit organization staffed by volunteers lead by Jean Beasley, in Topsail Beach, NC. Their mission is to successfully rehabilitate and release injured or sick sea turtles from the wild.  Since 1996, 152 sea turtles have undergone successful rehabilitation at the center and have been released. Currently, the Karen Beasley Sea Turtle Rescue and Rehabilitation Center has the capability to treat and care for ~15-20 injured or sick sea turtles at one time.   They are currently transitioning into a new facility where they can house and treat many more injured turtles.  The facility is now under construction.

The most common sea turtle species found off the coast of NC include: Loggerhead (Carettacaretta), Green (Chelonia mydas), and Kemp’s Ridley (Lepidochelys kempi).

Kemp's Ridley

The Kemp’s Ridley is considered the world’s most endangered sea turtle, and has been listed as an endangered species since 1970.  An adult Kemp’s Ridley measures 24 to 28 inches (62-70 cm) in carapace length and weighs between 77 and 100 pounds (35-45 kg).  The Kemp’s Ridley is the smallest of the local N.C sea turtles.

 

 

Green

Green sea turtles are another endangered species found around the world.  They nest in significant numbers on the east coast of Florida, as well as NC. The green turtle is the largest member of the Cheloniidae family. An average adult female green turtle can have a three foot carapace length, and weigh close to300 pounds. The largest green sea turtle ever found was an adult male with a carapace length over 5 feet.

 

Loggerhead

Loggerhead sea turtles are the most prevalent species in NC waters and they are the most common species treated at the Karen Beasley Sea Turtle Rescue and Rehabilitation Center. While all other species of sea turtles found near the U.S. coastline are listed as endangered, the loggerhead is classified as threatened.  Adult loggerheads weigh up to 350 pounds when fully grown, with a carapace length of ~32 to 41 inches long (82-105cm).

        Sea turtles spend the majority of their life in the ocean, and only come ashore when they are nesting or sick/injured.   They are often injured by boaters, because sea turtles must surface to breathe.   In NC, boating injuries seem to be most prevalent in the late spring to early fall.  Female turtles migrate closer to shore to nest during this time.  Boating accidents frequently result in severe carapace or plastron fractures, flipper lacerations, head trauma, etc.   Turtles also frequently become entangled in fishing line, crab traps, rope and fishing nets, which can result in severe lacerations or even amputations of flippers.    

      Complete or partial flipper amputations were the most common forms of treatment for severe flipper lacerations in the past.   If the amputee is a male sea turtle, the prognosis for losing a rear flipper is better than losing a front flipper since they hold onto females during breeding. On the contrary, females are better off losing a front flipper since the rear flippers are essential for digging nests in the sand.   Female turtles can not dig a hole of appropriate depth with only one hind flipper.  It has been shown that navigation and swimming is not affected by the loss of one flipper.   

I have been involved in multiple surgical sea turtle procedures for KBSTRRC.  Shell or carapace fractures are treated by stabilizing the shell with stainless steel plates and screws.  Many times the broken shell becomes nonviable or necrotic and is debrided along with dead soft tissue.  Overtime the healing new shell and soft tissue fill-in the space.   Head injuries are also addressed by repairing associated soft tissue or applying bone plates to the skull.  I have also repaired or salvaged severe lacerations in these turtles instead of complete or partial amputations.   Primary repair of a severe flipper laceration gives the turtle the best chance of success once released in the wild to nest or breed.  It is probable the same turtle could have another injury to a flipper over time. 

I have reconstructed two flippers in Sea turtles in the past.  I repaired a near full thickness back flipper laceration on a Loggerhead turtle (Bunswick II) who was completely rehabilitated.  He was released approximately 1 year post-injury with nearly normal flipper function.    A partial amputation was performed on a Kemps Ridley sea turtle (Briggy) because the end of the flipper could be preserved.  However I used some of the viable skin to create a skin flap to reconstruct the remaining flipper.  He was rehabilitated and released nearly a year later as well.   Both cases were reported in the Journal of Zoo and Wildlife Medicine in 2009.  The journal discusses each case in more detail, and is listed below.

 

I recently repaired Nichols flipper laceration in the same manner as Brunswick II. His bones were pulled together with suture (Toggled) and then the soft tissue was repaired. My counterpart in surgery Dr. Roe debrided and cleaned his Carapace injury. The carapace wound will be allowed to heal by second intention (allow his body to repair the wound over time). Last report is he has been doing well. However, some of the sutures have loosened which toggled his bones back together. I suspect it will continue to stabilize with scar tissue over time, and hopefully he will be released as well. 

Simon and Grafinger viewing CT results

CT of flipper

Nichols after surgery

 

You can check on status of Nichols if you visit the www.seaturtlehospital.org website; just click on Nichols.   You can also review past histories of the other turtles rehabilitated (Briggy, Brunswick II, etc.).  Consider adopting a turtle and contributing to the sea turtle hospital by volunteering or making a financial donation.    They do wonderful work and continue to give each and every sea turtle a fighting chance. 

 

Mike Grafinger, DVM, DACVS

 

_________________________________________________________________________

 

J Zoo Wildl Med. 2009 Dec;40(4):744-51

Surgical repair of severe flipper lacerations in a loggerhead, Caretta caretta, and a Kemp's ridley, Lepidochelys kempii, sea turtle.

Church ML, Grafinger MS, Harms CA, Lewbart GA, Christian LS, Beasley JF.

Source

Department of Clinical Sciences, College of Veterinary Medicine at North Carolina State University, Raleigh, NC 27606, USA. dr.fauna@gmail.com

Abstract

A loggerhead, Caretta caretta, and a Kemp's ridley, Lepidochelys kempii, sea turtle were presented to the North Carolina State University, College of Veterinary Medicine for evaluation of distal flipper injuries. The goal for both animals at presentation was to preserve limb function and avoid complete amputation. A severe full-thickness flipper laceration was successfully reapposed in the first case, and a rotational flap was used to cover exposed tissue in the second case. Limb function was improved and complete amputations were avoided in both turtles.