Class of 2015... How ya doing?

Veterinary Science Graduate Programs from U. of I.
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nyanko said:
dehydrated or do you get to do THERAPEUTIC BLOODLETTING? (the former is less fun)
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PLN.... would suspect renal mass, pulmonary, etc. Didn't seem dehydrated on exam, so I think it's absolute and not relative. Just finished the bloodletting. Pretty cool - went from lethargic and dumpy to "ok, I'm a 4-yr-old lab again and wanna eat and play" with the phlebotomy and a big bolus of fluids.
 
I am currently losing a battle against a DKA in a very sweet 8 year old Shih Tzu. She really needs to be in a 24 hour facility with specialists but owner isn't able to travel 500km for that.
 
Coquette22 said:
I am currently losing a battle against a DKA in a very sweet 8 year old Shih Tzu. She really needs to be in a 24 hour facility with specialists but owner isn't able to travel 500km for that.
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You're not losing the battle, she is. You can only deliver the correct therapy.

It sucks, I know. I'm there pretty much every day, and I'm AT a 24-hr facility. But.... at the end of the day... is what it is. *hug*
 
LetItSnow said:
You can only deliver the correct therapy.
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I think that's the frustrating part. I can't. I can only deliver parts of the correct therapy. We don't have overnight staff. We don't have syringe pumps and fluid pumps. The books say do 'a, b, c, d, e, and f' and I'm like, 'I can do a and c and occassionally d, but we don't have the equipment for b and it'd take three days to get e and f ordered in....' But that's the realities of living where I do. We can only do so much and sometimes that's not enough. 🙁
 
Coquette22 said:
I think that's the frustrating part. I can't. I can only deliver parts of the correct therapy. We don't have overnight staff. We don't have syringe pumps and fluid pumps. The books say do 'a, b, c, d, e, and f' and I'm like, 'I can do a and c and occassionally d, but we don't have the equipment for b and it'd take three days to get e and f ordered in....' But that's the realities of living where I do. We can only do so much and sometimes that's not enough. 🙁
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Well. Part of delivering the correct therapy is delivering what you're ABLE to. I mean. If you have an ARDS patient who needs a ventilator and you don't have one, the correct therapy is the O2 cage you do have, yanno?

I get it, though.
 
LetItSnow said:
Well. Part of delivering the correct therapy is delivering what you're ABLE to. I mean. If you have an ARDS patient who needs a ventilator and you don't have one, the correct therapy is the O2 cage you do have, yanno?

I get it, though.
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Hmm I think the correct therapy for that is actually typically pink, blue or purple... 😉
 
DKA lost her battle on Saturday. And I found out we do have both a syringe pump and a fluid pump, just that no one ever told me and they never get used. Well fluid pump is currently being used to run an HLK drip on a Pug with a shattered elbow until she can have her amputation tomorrow morning.
ETA: This is my first time setting up a CRI since leaving school*. Even with the VASG calculator I was terrified that I'd go back to check on her and she'd be dead. Haven't done this without an anesthesiologist standing over me.

*All of you that did internships and work in ERs can stop snickering now.
 
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that redhead said:
Double spay day tomorrow (plus my other, far less scary surgical procedures) and my awesome surgical mentor coworker isn't going to be there :arghh:
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tiny-potato.jpg
 
Coquette22 said:
DKA lost her battle on Saturday. And I found out we do have both a syringe pump and a fluid pump, just that no one ever told me and they never get used. Well fluid pump is currently being used to run an HLK drip on a Pug with a shattered elbow until she can have her amputation tomorrow morning.
ETA: This is my first time setting up a CRI since leaving school*. Even with the VASG calculator I was terrified that I'd go back to check on her and she'd be dead. Haven't done this without an anesthesiologist standing over me.

*All of you that did internships and work in ERs can stop snickering now.
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Er no, we always use an excel sheet to take the math out of it, but I always have it my head that what if a link screwed up or something...we had a patient that was apparently boluses a ton of fentanyl in surgery this week from a cri (manually) that almost died because the instructions were misunderstood.
 
Coquette22 said:
DKA lost her battle on Saturday. And I found out we do have both a syringe pump and a fluid pump, just that no one ever told me and they never get used. Well fluid pump is currently being used to run an HLK drip on a Pug with a shattered elbow until she can have her amputation tomorrow morning.
ETA: This is my first time setting up a CRI since leaving school*. Even with the VASG calculator I was terrified that I'd go back to check on her and she'd be dead. Haven't done this without an anesthesiologist standing over me.

*All of you that did internships and work in ERs can stop snickering now.
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I'm liking the bit about your CRI. No syringe pump for us but we do have a couple fluid pumps. I wish I could get up the balls to make up a CRI but most things that painful get referred or euthed. Although boss did a forelimb amp a couple months ago without much at all.

At our next meeting I'm requesting hydromorphone in our drug box. Torb or very expired morphine is not enough.
 
that redhead said:
I'm liking the bit about your CRI. No syringe pump for us but we do have a couple fluid pumps. I wish I could get up the balls to make up a CRI but most things that painful get referred or euthed. Although boss did a forelimb amp a couple months ago without much at all.

At our next meeting I'm requesting hydromorphone in our drug box. Torb or very expired morphine is not enough.
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I don't think I could practice without hydromorphone. (You know, for my patients, not in a House MD vicodin sort of way.)
 
Coquette22 said:
I don't think I could practice without hydromorphone. (You know, for my patients, not in a House MD vicodin sort of way.)
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There are a lot of things I thought I couldn't practice without and have, unfortunately 🙁 As much as my boss drives me up the wall, he's usually pretty receptive to drug requests, although he was a bit "burned" when another doc requested a particular drug and it wasn't used. But I needs it and I will be using it a bunch. We have an upcoming meeting too, so yay 🙂
 
Just spent the last hour and a half stress cleaning my house. It's sparkly. One of these days I will adjust better to my new life (otherwise this is going to be a loooooong miserable 3 years...). Grad school classes start tomorrow at 7am. Good thing I am off tomorrow because I don't know a regular day on top of that would go so well on 5 hours of sleep. Can it be end of Sept/oct yet?! Ugh. Would love to know what my circulating cortisol levels look like, it must be absolutely terrible.
 
So do any of you have to feign "I love Rosco! He is the best pomskipoopenfluffle I've ever met!!!" in the exam room?

I ask because I like my patients, but I don't feel myself having trouble with the "you can't love patients more than their owners do" thing that a lot of vets face. I know everyone is different, blah blah blah, but I wanted to see if anyone else feels this way.
 
scb44f said:
So do any of you have to feign "I love Rosco! He is the best pomskipoopenfluffle I've ever met!!!" in the exam room?

I ask because I like my patients, but I don't feel myself having trouble with the "you can't love patients more than their owners do" thing that a lot of vets face. I know everyone is different, blah blah blah, but I wanted to see if anyone else feels this way.
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i definitely do not love every animal i meet. i love mine, and i tolerate the rest (some better than others). so yes, i feign a lot of enthusiasm. for me, the whole cant love em more comes mostly when owners elect to do something i whole heartedly disagree with. usually in AMA situations.
 
jmo1012 said:
i definitely do not love every animal i meet. i love mine, and i tolerate the rest (some better than others). so yes, i feign a lot of enthusiasm. for me, the whole cant love em more comes mostly when owners elect to do something i whole heartedly disagree with. usually in AMA situations.
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Yeah, I can understand the latter. What I guess I mean is I don't get irked when people decline anything. Yes, I get frustrated when it impedes my medical decision making, but not on an emotional level regarding the dog.

Thanks for the response!
 
scb44f said:
Yeah, I can understand the latter. What I guess I mean is I don't get irked when people decline anything. Yes, I get frustrated when it impedes my medical decision making, but not on an emotional level regarding the dog.

Thanks for the response!
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It doesn't bother me if people decline things, but it's a little harder when they refuse to treat or euthanize a septic patient with evidence of multiorgan dysfunction syndrome and want to take it home to die. Those are the cases where I feel really bad for the pet who is going to suffer immensely due to stupidity or ignorance or whatever
 
scb44f said:
So do any of you have to feign "I love Rosco! He is the best pomskipoopenfluffle I've ever met!!!" in the exam room?

I ask because I like my patients, but I don't feel myself having trouble with the "you can't love patients more than their owners do" thing that a lot of vets face. I know everyone is different, blah blah blah, but I wanted to see if anyone else feels this way.
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Ehh, I don't feel the need to enthuse over how much I love whichever patient, especially if it isn't true. I do tell people when their animal is really sweet or well-behaved though.

Like jmo said, I tend to feel bad when there's more I can do from a comfort or care perspective that the owners refuse, not like they declined removing a mass or something. I know this is more difficult for others but I can compartmentalize pretty well.
 
I don't feign love for a pet, but for general vaccine and wellness appointments I do go out of my way to find something to compliment the pet on. "Wow, what pretty eyes Princess has!", "Toby's teeth look great for his age!", "Skye is a fantastic weight." Sure, there's a few train wrecks that I can't find anything about (usually Shih-Tzus...) but those guys aren't usually there just for wellness or vaccines. I do genuinely like most dogs that come in, I'm a little less enthused by other people's cats.

I'm also in the compartmentalize camp. An owner's inability or unwillingness to do something usually doesn't bother me. My job is to do what I can with the resources I have, and owner compliance and finances are part of those resources. I refuse to carry anything with me when an owner has limited my ability to treat their pet.
 
Coquette22 said:
Sure, there's a few train wrecks that I can't find anything about (usually Shih-Tzus...) but those guys aren't usually there just for wellness or vaccines.
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Really? Most of my train wreck shih-tzus come in for "wellness"or "rabies only" because "everything is normal for Fluffy-poo". And then my wellness appointment turns into an hour long consult on KCS, atopy, otitis, periodontitis, mitral valve disease, PU/PD +/- IVDD and a discussion of why we really need to do labwork prior to a dentistry, oh and yes that dental will cost more than $100.
 
Also, one of my favorite "compliments" for the wild, out of control dogs that owners think are well behaved... "Well, I'm glad someone is happy to see me today" as said dog is jumping all over me. My staff snickers every time but the owners totally think I'm serious.
 
cowgirla said:
Really? Most of my train wreck shih-tzus come in for "wellness"or "rabies only" because "everything is normal for Fluffy-poo". And then my wellness appointment turns into an hour long consult on KCS, atopy, otitis, periodontitis, mitral valve disease, PU/PD +/- IVDD and a discussion of why we really need to do labwork prior to a dentistry, oh and yes that dental will cost more than $100.
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Preventive care is less than common around here (municipality doesn't require rabies so they don't even come for that), so most of my trainwreck Shih-Tzus are "ear infection (again)", "bad smell from mouth", "scratching a lot (again)", "check eyes"...
 
Coquette22 said:
Regular client of mine comes in tonight for vaccines. "And how are you doing, Dr C? You look stressed. I brought you a cinnamon roll. *pause* Wait, maybe I left it on the counter. Well, I meant to bring you a cinnamon roll..."
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That is adorable :laugh:
 
Coquette22 said:
Regular client of mine comes in tonight for vaccines. "And how are you doing, Dr C? You look stressed. I brought you a cinnamon roll. *pause* Wait, maybe I left it on the counter. Well, I meant to bring you a cinnamon roll..."
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Meanwhile, your front desk person is sitting up there like "Mmmmmmmmm that was great."
 
Been a tough couple weeks for me at work with various cases. Feels like everything I touch goes wrong or is circling the drain. Logically I know these things are not my fault (though I get particularly frustrated with the cases that were due to follow up or declined work up only to end up in the ER) but I feel like I've been very wrung out emotionally lately. I have a staycation lined up in a few weeks and this weekend off, though, so there is that.
 
that redhead said:
Been a tough couple weeks for me at work with various cases. Feels like everything I touch goes wrong or is circling the drain. Logically I know these things are not my fault (though I get particularly frustrated with the cases that were due to follow up or declined work up only to end up in the ER) but I feel like I've been very wrung out emotionally lately. I have a staycation lined up in a few weeks and this weekend off, though, so there is that.
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Take care of yourself, TR. *hugs*

Had a heartbreaking case tonight. Beautiful sweet 2 year old Boxer HBC. Just too much damage. 🙁 That one hurt.
 
Thanks, guys. I am concerned when people don't seem to grasp the severity of the situation. What I said was a bit confusing, even for me to think through. I have been in kind of a funk with SA practice and feel like I know nothing.

Each day gets better but headaches are a constant on days I work, and I find myself unable to sleep until I've reviewed literature pertaining to cases, or replayed conversations in my head for the thousandth time.

I think I have made the decision not to get worked up when a client hasn't had their pet on flea preventives, or declines a HW test because everything else is far more taxing. But then I feel like I'm not being a good advocate for my patients, even though I DO recommend that stuff to everyone. Bleh... I guess I'm just stuck in my own head.
 
scb44f said:
Thanks, guys. I am concerned when people don't seem to grasp the severity of the situation. What I said was a bit confusing, even for me to think through. I have been in kind of a funk with SA practice and feel like I know nothing.

Each day gets better but headaches are a constant on days I work, and I find myself unable to sleep until I've reviewed literature pertaining to cases, or replayed conversations in my head for the thousandth time.

I think I have made the decision not to get worked up when a client hasn't had their pet on flea preventives, or declines a HW test because everything else is far more taxing. But then I feel like I'm not being a good advocate for my patients, even though I DO recommend that stuff to everyone. Bleh... I guess I'm just stuck in my own head.
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This isn't a profession where we get to insist on gold standard care. You gotta let go of that. The best you can do is recommend good care to the client, give them a good reason for it, and then follow through on what they want. *shrug*

I euth'd a lepto dog yesterday that owners didn't want to try treating. Sent home with essentially zero treatment a 4-week old kitten halfway dead from flea bite anemia. Sent home with literally zero treatment a 6-yo intact female dog with a really huge vaginal mass (the owners 'knew' from googling that it was a prolapse, so they decided I didn't know what I was talking about since I was telling them it wasn't actually a prolapse - google wins every time). Sent home what is likely a bad pancreatitis case with no more treatment than tramadol. All because all four of those owners weren't interested in what good therapy is and insisted on zero or absurdly limited care.

It is what it is. You can't force an owner to do something.

I dunno. 1 year out and I don't really care anymore. The cases with good owners I invest myself in and I share their grief or celebration when the case goes well. The other 85% of cases I forget when they leave the ER.

It's no wonder everyone burns out in this industry. It's almost abusive. Maybe it is abusive. I dunno.
 
LetItSnow said:
This isn't a profession where we get to insist on gold standard care. You gotta let go of that. The best you can do is recommend good care to the client, give them a good reason for it, and then follow through on what they want. *shrug*

I euth'd a lepto dog yesterday that owners didn't want to try treating. Sent home with essentially zero treatment a 4-week old kitten halfway dead from flea bite anemia. Sent home with literally zero treatment a 6-yo intact female dog with a really huge vaginal mass (the owners 'knew' from googling that it was a prolapse, so they decided I didn't know what I was talking about since I was telling them it wasn't actually a prolapse - google wins every time). Sent home what is likely a bad pancreatitis case with no more treatment than tramadol. All because all four of those owners weren't interested in what good therapy is and insisted on zero or absurdly limited care.

It is what it is. You can't force an owner to do something.

I dunno. 1 year out and I don't really care anymore. The cases with good owners I invest myself in and I share their grief or celebration when the case goes well. The other 85% of cases I forget when they leave the ER.

It's no wonder everyone burns out in this industry. It's almost abusive. Maybe it is abusive. I dunno.
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So much this. I dunno if it's because we went out into practice without another year in the ivory tower of internship, but I feel the exact same way. Would my professors scowl at some of the stuff I do? Certainly. But I do what I can with what I have available to me. @scb44f please please please don't let these little things like declined heartworm test or vaccines get to you - you will never sleep another wink if you do. At the end of the day you can only do what the owner allows you to do, and the vast majority of the time it is no where near what we did in school.
 
there are always going to be frustrating and sad cases. Like the people that told me heartworm prevention was a ploy by the vets to get rich because she'd only ever met 1 dog with the disease.

But then there are the people that, although they can't afford specialty care, are taking care of a paraparetic cat and expressing her bladder daily. And thanking us because we used creativity and worked with them where we could
 
It's hard to explain what I'm feeling. I actually am perfectly fine with whatever decision someone makes for their pet. We do it with livestock all the time.

I think I feel off because the SA vets I've been around get worked up about a dog not being on hw prevention, or a client declining a fecal and I don't get worked up about it.

The routine stuff is getting me right now because I haven't handled a vomiting dog in 2 years, you know? So I'm more concerned that I'm offering the standard of care than what the owner elects.
 
Lol rereading the comments, it seems as though I'm not clearly explaining what is wearing me out. Basically I feel like it may come across as though I don't care about my patients as much as other vets because I don't dwell on any decision an owner makes. It's not true, but that's where I feel myself having to feign concern sometimes. Either way, I'm fine. I'm not actually getting caught up in the little things, and I appreciate your guys' concern.
 
scb44f said:
Lol rereading the comments, it seems as though I'm not clearly explaining what is wearing me out. Basically I feel like it may come across as though I don't care about my patients as much as other vets because I don't dwell on any decision an owner makes. It's not true, but that's where I feel myself having to feign concern sometimes. Either way, I'm fine. I'm not actually getting caught up in the little things, and I appreciate your guys' concern.
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I think I was misunderstanding 🙂
 
Cria in SA ICU... Wasn't my idea but was a smart one. Let's hope for a miracle.
 
that redhead said:
So much this. I dunno if it's because we went out into practice without another year in the ivory tower of internship, but I feel the exact same way.
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I don't get the "ivory tower of internship" thing. At most internships you feel like cheap ER labor (even if in the end, you did learn a ton). You know what happens in the ER? 90% of what you recommend gets declined and you have to come up with alternate plans or send a patient home to die if the owner doesn't believe in euthanasia etc.
 
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