Random Stuffs

[finnickthedog]

yes yes yes yes

I shadowed derm a while back and I think I scared them because I came in with so many questions about apoquel and cytopoint and also a staggering level of enthusiasm

So... wanna take my derm exam this week?

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[Squeaksmom]

Do you think it's worse this year? I've heard a couple people say that

Far from you, but it was worse for my dog... and also for me!

 

[genny]

Do you think it's worse this year? I've heard a couple people say that

.... I hear that every year, lol.

ETA: probably a biased sample, as the people who already have their dog's allergies under control (i.e. on meds) don't think it's any worse, but the people who have dogs who have never needed meds are coming in to see me saying that it's so much worse this year than it's ever been before.

 

[Skimble]

apoquel is magical

No, cytopoint is magical. Rumor has it that cytopoint for cats is in the works.

 

[genny]

No, cytopoint is magical. Rumor has it that cytopoint for cats is in the works.

We’ve had several dogs in the past weeks that don’t respond to cytopoint, but partially respond to apoquel (fully if we add temaril P). So they’re both magical. Or at least more magical than Benadryl.

 

[genny]

Also I will kill whoever needs to be killed to get cats cytopoint. For reals.

 

[mmmdreamerz]

yes yes yes yes

I shadowed derm a while back and I think I scared them because I came in with so many questions about apoquel and cytopoint and also a staggering level of enthusiasm

I am so so glad there are people with that level of enthusiasm for derm. Itchy dogs are my worst nightmare.

 

[mmmdreamerz]

apoquel is magical

Cytopoint > apoquel. I’ve unfortunately seen two scary cases of immune suppression stuff with apoquel, which has dimmed the level of magic for me.

 

[twelvetigers]

I have mixed success in clinic with either one (more good than bad of course but some need both and it gets a bit crazy) - but, for my own itchy dawg, one Cttopoint injection and she has been good through the whole summer since then. Like, 4 months now. I’m happy with it for sure.

 

[killerleaf]

I have two itchy dogs. apoquel was awesome for Gracie, she is now itch free, and off of the meds for a month. We are thinking that whatever she is allergic to has died off now. (It started in February and ended just last month, so some type of wildflower/thistle probably) Max on the other hand...is a small disaster anyway. He's almost 13 and still has acne like a teenager...awww, the joys of a not so great bloodline! Apoquel has helped with the itching, and the constant licking. He is also not allowed to lay on the living rug anymore, as I discovered this past week that it has a wool content...and he appears to be sensitive to it. He is doing better. Besides, that means he gets to lay in the chair with me and snuggle.

 

[PippyPony]

yes yes yes yes

I shadowed derm a while back and I think I scared them because I came in with so many questions about apoquel and cytopoint and also a staggering level of enthusiasm

If you ever want a good but low-key derm externship, hit me up. My old boss is SUPER nice and I bet she would absolutely love to have a student nerd out with her about derm stuff for a couple weeks.

She loves dermatology as a specialty, btw. Made me consider it even though I'm allergic to fleas haha

 

[Trilt]

Cytopoint does not freaking work reliably in my hand. I want to like it, truly, as I barely take my own meds and its awesome to guarantee compliance. But apoquel is so, SO much more consistently effective to me. Add in it's significantly cheaper for most animals with my clinic pricing and I don't use a ton of cytopoint.

Also allergies are in full freaking swing recently here... I'm so tired of itchy dogs all day erryday recently.

Yesterday the gods laughed and threw me an itchy mouse and guinea pig with lice and a puppy with ear mites and I'm still feeling creepy crawly 24 hours later.

 

[SkiOtter]

Yesterday the gods laughed and threw me an itchy mouse and guinea pig with lice and a puppy with ear mites and I'm still feeling creepy crawly 24 hours later.

I got a squirrel at the wildlife clinic last week with sarcoptes and I have been creepy crawly and itchy since

 

[Lawpy]

@Coopah @Barkley13 @britzen @MSUcvmHOPE @capri1722 @RespectTheChemistry19 bump!

 

[that redhead]

@Trilt I’ve had better success with cytopoint lately- even using it in my own (mildly itchy) dog although I have to give it pretty close to monthly. I think i saw more failure at my previous clinic because we would use it on our apoquel failures who were perhaps less likely to respond to anything overall. At my current place, there are plenty of dogs on cytopoint who just like the convenience and I’ve had a lot more success. A couple like TT’s dog who get one and are good for months.

 

[dyachei]

@Trilt I’ve had better success with cytopoint lately- even using it in my own (mildly itchy) dog although I have to give it pretty close to monthly. I think i saw more failure at my previous clinic because we would use it on our apoquel failures who were perhaps less likely to respond to anything overall. At my current place, there are plenty of dogs on cytopoint who just like the convenience and I’ve had a lot more success. A couple like TT’s dog who get one and are good for months.

also remember some dogs need both

 

[JaynaAli]

I use Cytopoint for Winston. It doesn't stop his flares, but I do think it helps get things back under control faster. I give it every 2-3 months. I don't have experience with apoquel, but in my brain the MOA of cytopoint makes me feel more comfortable...those jak-stats you're blocking with apoquel do lots of other important things. But I have heard good stories and stories of non-response with both.

 

[that redhead]

also remember some dogs need both

The cost of that must be...pause-inducing

 

[Animal Midwife]

 

[DVMDream]

So the clinics I was working at when Cytopoint came out and by "came out" I mean, before it was available for just any veterinary clinic to call up their supplier and order it. We were able to get early hands on it before it was even called Cytopoint and it was still going by Immunosomething or whatever.

We had a lengthy CE on "cytopoint" from the reps, we were shown the studies, etc, etc.

In my experience, their studies do not correlate to what I have personally seen clinically. They had much higher efficacy rates than what I was seeing in clinic. I would say I get anywhere from a 60-75% response rate. In those that I do get a good response, a percent of those will stop responding to it over time. It is almost like they are becoming immune to the cytopoint and neutralizing it before it can have an effect. That is my best guess.

For those dogs it works well in and continues to work well in, I am all for it. I do still try to get people to try it as a first line (with a few exceptions for severely affected animals with severe flare ups, let's be honest cytopoint has ZERO anti-inflammatory ability, these animals need apoquel or roids).

Apoquel, however, I find works about 90% of the time, BUT it does have some of its own side effects. In some animals, I will actually reach for steroids over apoquel, just depending.

It really is just a matter of individual differences and patient needs/differences. I have had a couple pets that have needed apoquel, cytopoint, low dose roids and regular anti-fungals because their allergies are THAT bad (read: bulldog).

 

[twelvetigers]

I definitely didn’t expect it to work as well as it did in my dog. I just figured I’d give it a shot before going back to apoquel.

I’ll see if it works as well next year...

 

[Teepster87]

Do other schools graduating class give a senior gift to the school? We're getting to the point of thinking about it, and most of us don't even have any idea what it is, or what other classes have done

 

[MixedAnimals77]

Do other schools graduating class give a senior gift to the school? We're getting to the point of thinking about it, and most of us don't even have any idea what it is, or what other classes have done

We do- last class donated to our clinical simulation lab, one class donated a bench outside the VTH, some donate art pieces. Hope that helps give you some ideas!

 

[that redhead]

Do other schools graduating class give a senior gift to the school? We're getting to the point of thinking about it, and most of us don't even have any idea what it is, or what other classes have done

Yep. We got some squishy gel mats for the junior surgery suites and also made a big indoor play area thing for our teaching beagles

 

[cdo96]

I used some 9-0 today!

I used 6-0 today with the magnifying goggles and I looked like one of those dogs who just got booties put on it for the first time.

Also, I was curious- do y’all do temporary tarsorrhaphies in humans? (And with what indication??)

(Yes I could google it but that would show me pictures of a human eye and that’s a no no idea)

 

[Doctor-S]

Also, I was curious- do y’all do temporary tarsorrhaphies in humans? (And with what indication??)

(Yes I could google it but that would show me pictures of a human eye and that’s a no no idea)

Yes (although ophthalmology is not my gig) @cubsrule4e.

Thinking ... done in connection with certain severe ocular surface disorders/corneal defects (as an aid to healing), some facial nerve dysfunctions (CN VII).

 

[WildZoo]

@cubsrule4e

 

[cdo96]

@cubsrule4e

I already had quoted cubs in my question...

 

[Coopah]

I already had quoted cubs in my question...

Clearly three tags are not enough
@cubsrule4e
@cubsrule4e
@cubsrule4e
@cubsrule4e
@cubsrule4e

 

[cubsrule4e]

Does this mean i need to duplicate my answer 9 times?

Temporary tarso gonna be mostly for something like a non-healing erosion (something like a neurotrophic ulcer) or an acute/subacute exposure keratopathy or the risk for developing it (like after a bells palsy and the eye cant completely close, or if theres lid trauma or like a burn, you can do that temporarily until they are well enough for a lid reconstruction surgery). Obviously once ulcer heals or lid functionality is regained you can undo it. Sometimes those neurotrophic ulcers become impossible to fully heal or are rapidly recurrent, and if the vision potential is poor then you can do a permanent one or something like a Gunderson flap (take the conjunctiva, make a flap, and sew it down across the cornea, so that theres no longer any corneal exposure and its a little better cosmetically not having to keep the eye sewn shut.

Now enough work for today, everyone get to the beer or whiskey thread!

 

[cdo96]

Does this mean i need to duplicate my answer 9 times?

Temporary tarso gonna be mostly for something like a non-healing erosion (something like a neurotrophic ulcer) or an acute/subacute exposure keratopathy or the risk for developing it (like after a bells palsy and the eye cant completely close, or if theres lid trauma or like a burn, you can do that temporarily until they are well enough for a lid reconstruction surgery). Obviously once ulcer heals or lid functionality is regained you can undo it. Sometimes those neurotrophic ulcers become impossible to fully heal or are rapidly recurrent, and if the vision potential is poor then you can do a permanent one or something like a Gunderson flap (take the conjunctiva, make a flap, and sew it down across the cornea, so that theres no longer any corneal exposure and its a little better cosmetically not having to keep the eye sewn shut.

Now enough work for today, everyone get to the beer or whiskey thread!

I did one yesterday and I despise the Meibomian glands of darkly pigmented eye skin. Because... I couldn’t see them to place my suture, so I just had to wait for a little meibum to pop out when I did it.

Do y’all place stents when you suture them? Yesterday we used rubber bands (IV tubing is also a possibility but we didn’t have them) but I feel humans might object to that specifically because it looks pretty silly.

 

[cdo96]

Also I appreciate the fact that I have a network of SDNers to be like

“... wat?” and also “... do they do this in humans?????”

 

[twelvetigers]

I despise the Meibomian glands

I swear human doctors decided to call them tarsal glands just to f*ck with us. Noticed while teaching and like, calling it the wrong thing.

 

[battie]

tarsal glands

If I didn't know better, I would think that's a special name for a gland on the tarsus. But maybe that's just me.

 

[WildZoo]

I already had quoted cubs in my question...

He hadn't responded yet so I thought he might have missed it!

 

[cubsrule4e]

I despise the Meibomian glands

Do y’all place stents when you suture them? Yesterday we used rubber bands (IV tubing is also a possibility but we didn’t have them) but I feel humans might object to that specifically because it looks pretty silly.

I swear human doctors decided to call them tarsal glands just to f*ck with us. Noticed while teaching and like, calling it the wrong thing.

Dont forget the glands of Zeis and Moll!! "Molly is a sweaty ape" --> Moll glands are apocrine sweat glands --> the insane lengths we go to to remember things that 10 years later are completely irrelevant! (But look how good the mnemonic worked!!)

I dont do much with lids anymore aside from simple injury repair since my first year or two, I suppose you could put a stent (not really the word im familiar with as far as what we'd use, more like lid protector or buttress or conformer) although dont see that too much for tarsorrhaphy, moreso for a lid reconstructive procedure. Theres usually a name for the type of suture technique that implies that youd use a "stenting" mechanism - like for an entropion you'd use a Quickert suture and place some tiny bit of tubing or foam padding in order to put extra pressure on the lid to hold it more firmly in the direction youre trying have it heal.

 

[cubsrule4e]

If I didn't know better, I would think that's a special name for a gland on the tarsus. But maybe that's just me.

I need to get my tarsal glands expressed soon... been too long, giving me bad blepharitis!

 

[Melchizedek]

Dont forget the glands of Zeis and Moll!! "Molly is a sweaty ape" --> Moll glands are apocrine sweat glands --> the insane lengths we go to to remember things that 10 years later are completely irrelevant! (But look how good the mnemonic worked!!)

MEIBOMIAN GLANDS ARE MODIFIED SEBACEOUS GLANDS


I’m ready for Step 1 now

 

[cubsrule4e]

MEIBOMIAN GLANDS ARE MODIFIED SEBACEOUS GLANDS


I’m ready for Step 1 now

YAAAAAAAAAAAASSSSSSSSSSSSSSSSSSSSSSSSSSSS!!!!

 

[Lawpy]

@Coopah @Barkley13 @britzen @kcoughli @MSUcvmHOPE @capri1722 @RespectTheChemistry19 bump!

 

[JustPaws]

https://reddit.app.link/pI3qr5aXA0

 

[Trilt]

https://reddit.app.link/pI3qr5aXA0

dog.exe has stopped

 

[Squeaksmom]

When you're trying to study for your emergency & critical care midterm but you keep recognizing yourself in the head trauma lecture.... (it's been 2 weeks and I'm still quite concussed) Oh... Cushings reflex... so that's what that was.... <sigh>

 

[Lawpy]

@Coopah @Barkley13 @britzen @kcoughli @MSUcvmHOPE @capri1722 @RespectTheChemistry19 nap bump!

 

[deleted676737]

When you're trying to study for your emergency & critical care midterm but you keep recognizing yourself in the head trauma lecture.... (it's been 2 weeks and I'm still quite concussed) Oh... Cushings reflex... so that's what that was.... <sigh>

Sorry, friend. Concussions suck.

Have been wondering how you're doing. Hopefully you're at least getting some good rest?

 

[RTC19]

When you're trying to study for your emergency & critical care midterm but you keep recognizing yourself in the head trauma lecture.... (it's been 2 weeks and I'm still quite concussed) Oh... Cushings reflex... so that's what that was.... <sigh>

I'm sorry, hon. Concussions are the worst.

Hang in there.

 

[Squeaksmom]

Sorry, friend. Concussions suck.

Have been wondering how you're doing. Hopefully you're at least getting some good rest?

I'm sorry, hon. Concussions are the worst.

Hang in there.

Thanks both! Concussions mess with sleep. Concussions mess with moods. Lack of sleep messes with moods. Frankly, I'm a bit of a mess! And I'm only up to half days of lecture, less if it's a lab, and can't read or look at a screen for very long. But I can't fall behind because I'm writing midterms. Sorry for sounding whiny, but this sucks! Do I at least get an A for effort?

 

[RTC19]

Not whiny at all, @Squeaksmom! You should get an A for effort. You are in a position right now where you need to use the organ that's hurt and that's so hard.

I admire your bravery for trudging through and going on with school.

You are stronger than you think you are and YOU CAN DO THIS!

 

[Squeaksmom]

Not whiny at all, @Squeaksmom! You should get an A for effort. You are in a position right now where you need to use the organ that's hurt and that's so hard.

I admire your bravery for trudging through and going on with school.

You are stronger than you think you are and YOU CAN DO THIS!

I actually really needed to hear that tonight... thank you!!

 

[KCgophervet]

@Coopah @Barkley13 @britzen @kcoughli @MSUcvmHOPE @capri1722 @RespectTheChemistry19 nap bump!

View attachment 282895

Honestly I'm pretty sure my cats are the ones in the house that have been the most entertained by our activity mat