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“Looking at the animal is key, not just focusing on the numbers the machine gives us”

15 November 2018, at 1:57pm

It had to come to an end sometime, I guess. Janice and I had been together for years – she had accompanied me wherever I went. But eventually I’m afraid to say she ended up just getting on my nerves. Her requests were becoming more and more abrupt.

“At the next junction, turn left” without a please or thank you was OK, but often now her demands were simply unreasonable. “Where possible, perform a U-turn” just wasn’t appropriate halfway down a dual carriageway – surely she could tell that such a manoeuvre would not be achievable for the next few miles. And yet I had come to depend on her in a way I would have thought ridiculous 10 years ago, when a map spread out on the passenger seat was quite sufficient.

This reliance became particularly obvious when Janice wouldn’t respond any more. Pressing “A” on her yielded no result, so trying to head for Abacus Avenue in Aylesbury became an impossible task. Eventually, I had to ditch Janice and choose a new travel companion. And truth be told, I liked Candice from the get-go: her calmer voice and more reasonable requests. Thanks, by the way, to Brett, a vet student working with me during that tricky transition, who gave Candice her name.

Realising how dependent I had become on this electronic gadgetry made me consider the wider veterinary world. I’ve just had the delight of hosting two veterinary surgeons from India who run a trap, neuter, vaccinate, release scheme with tremendous benefits on reducing dog bites and rabies. We were watching a dog with a tumour have a CT scan before radiotherapy. They said that their clinic was fortunate to have a plain X-ray machine; they managed quite well with that. How, they asked, did we teach students what to do when advanced technologies weren’t available, or funds didn’t allow expensive diagnostics?

The vet school runs the RSPCA clinic in town and provides veterinary services for the Blue Cross too, so students get to see the routine cases presented to general practice and those where finances are more constrained than the cases referred to our second opinion clinic.

We want to teach students “gold standard” care in all types of practice, and that means, for instance, that anaesthetised patients have pulse oximeters attached and end tidal CO2 monitored together with a host of other bells and whistles I don’t even understand! But we do need to remember to feel a pulse as well – sats of 97 percent won’t tell me if that pulse is weak and thready or strong and bounding, will it?

Just as my reliance on Janice or Candice can be insufficient when there is an accident up ahead or a flooded ford in my path, we need to teach students not only how to make best use of all the modern technology that is available but also the basics of using their own senses in diagnosis. Looking at the animal is key, not just focusing on the numbers the machine gives us.

It’s just the same in my field, ophthalmology. I need a slit lamp and head-mounted indirect to make it look as if I know what I’m doing, to affirm the owner’s buying decision as market-speak business language tells us. But Keith Barnett, who first enthused me in ophthalmology, said you could see all you needed with a standard ophthalmoscope if you knew how best to use it.

We need to remember to utilise the most up-to-date technology for sure, but maybe not to rely on it as much as we currently do.

Associate Lecturer, Veterinary Ophthalmology at St John's College, University of Cambridge

David Williams, MA, VetMB, PhD, CertVOphthal, CertWEL, FHEA, FRCVS, graduated from Cambridge in 1988 and has worked in veterinary ophthalmology at the Animal Health Trust. He gained his Certificate in Veterinary Ophthalmology before undertaking a PhD at the RVC. David now teaches at St John’s College, Cambridge.

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