Rachael Weiner

11/21/2014

Job Shadow
When I arrived at my job shadow Dr. Stacy Wells Kiefer was taking care of her horse
Willie. Willie had had colic surgery and then a post-operative infection formed between the
peritoneal wall and the subcutaneous. He needed an abdominal sling which is a strip of
ducking and straps to tighten and keep his muscles strong. I helped Dr. Wells Kiefer clean all
the shaving off of the sling, removed the sterile pad over his incision. Dr. Wells Kiefer then
flushed and drained Willies incision and placed aseptic beads inside. Then we replace Willies
sling and pad and tightened it. Then we mucked his stall and we put Willie back in his stall.
Dr. Wells Kiefer then talked about the electronic health certificates over the old paper version.
The state recently introduced a software that will automatically send a copy to the state of
Colorado and whatever state the horse will be going (Kiefer, 2014).
We drove to Campion to visit a horse named Libbie to treat her arthritis and give her
health certificate for her new owner. Dr. Wells Kiefer asked the owner her reasons for selling
her, which where that she was more of a competitive rider and the new owner wanted a riding
lesson horse which Libbie would be great at (Nancy, 2014). Libbie had been ridden four days
in a row that week and had major swelling in the back left pastern, she was lame. Legend is a
joint supplement given intravenously. Dr. Wells Kiefer gave the legend shot and with the
lameness and time since her last hock injections and with her soon to be sold they decided to
do the injections. Unfortunately Dr. Wells Kiefer did not have any of the hock injections in her
truck she had two at home but she needed one more. Instead she decided to drive to
Mountain Valley Vet Supply and buy all three. Dr. Wells Kiefer had to completely reschedule
her day.
On the way to the Vet supply Dr. Wells Kiefer discussed good and bad clients and
how the vet should change their actions accordingly. Dr. Wells Kiefer said That for a good
client she will reschedule her day and buy new Hock injections (Kiefer, 2014).
At Mountain Valley Vet Supply Dr. Wells Kiefer bought the hock injections. In the car
Dr. Wells discussed her type of clients being more of the competitive riders and drivers or very
dedicated people rather than the backyard horse owners (Kiefer, 2014). Dr. Wells Kiefer
called the owner of the next two horses she had on her schedule, who were two geldings.
Unfortunately the owner had broken his hip and was in the hospital along with his wife.
Thankfully he had an automatic gate and he could let us in from the hospital. When we
arrived the gate opened before we even called him. His nurse was there and he let us in, and
we talked with the nurse about how John was doing. One of the geldings needed the legend
shot and both of them needed the rabies vaccine. On the drive to her next client we discussed
rabies shots and how Rabies vaccines are more commonly used in Texas, because it is warmer,
where Dr. Wells Kiefer is from but are becoming more and more common in Colorado (Kiefer,
2014).

Rachael Weiner
11/21/2014

The next client had three horses and we were treating one and examining the other.
The gelding she had was receiving his legend injection. Dr. Wells Kiefer discussed with the
client the recent Cushings test results which had come back negative. Dr. Wells Kiefer said
that The Cushing disorder test is not the most accurate and when it is inaccurate it tends to be
a false negative. All the symptoms still pointed to Cushings but they would have to re-run the
test to be sure (Kiefer, 2014). I did some research on Cushings disorder, The cause of
Cushing's disease in horses is a tumor found in the pituitary gland. This tumor affects the pars
intermedia - the small middle region of the pituitary gland. Sometimes equine Cushing's disease
is also referred to as pars intermedia dysfunction (PID) (MD, 1999).
Then we examined
Lucy. Lucy was chronically lame at only six. Dr. Wells Kiefer examined her hips and could tell
that they were out. However Dr. Wells Kiefer believed the problem was further down in the
leg. Dr. Wells Kiefer stated that she didnt have the diagnostic equipment to tell anything
more.
She suggested taking Lucy to CSU to have her diagnosed and recommended a
particular veterinarian to examine her. Dr. Wells Kiefer also told the owner to work Lucy hard
before taking her in because there was no point in taking her in while she wasnt lame. In the
truck Dr. Wells Kiefer mentioned the mystery behind Lucys lameness. Dr. Wells Kiefer
discussed IV injections and how to tell if one was in the artery or the vein. It comes with
experience mostly, but by lifting the needle slightly if it is in the vein you can feel it. Also by
injecting then aspirating and repeating until all the medication is gone it assures that even if
you are in the artery it is less likely to be an issue. (Kiefer, 2014).
Then we visited a new veterinary supply place called Mountain Crest Vet Supply in
south Loveland which was trying to drum up business. They were having a barbeque and
silent auction in their first few months of business.
Then we returned to the first horse we had visited Libbie, since we had her hock
injections. I helped Dr. Wells Kiefer scrub her legs for the injections. Then Dr. Wells Kiefer
sedated her with an intravenous injection. Toward the end as the sedative began wearing off
Libbie began kicking and stepping back and forth. Even with the sedative Dr. Wells Kiefer had
a very difficult time because Libbie was moving. Dr. Wells Kiefer was very worried about a
hematoma in the third injection site. Then Dr. Wells Kiefer put on standing wraps on her legs.
Dr. Wells Kiefer then wrote up the health certificate on her tablet. With the electronic version
she sent it directly to the state. On the way back to Dr. Wells Kiefers place we discussed
horse and dog breeds. Also we discussed using clients for restraint. In equine veterinary
medicine and mobile veterinarians owners are often the only option.