RANT HERE thread

Veterinary Science Graduate Programs from U. of I.
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LetItSnow said:
People are giving it to blocked cats now, too? For what purpose? I feel so old skool with my boring unblock, fluids, bupe, prazosin, and go home on a new diet approach. I didn't know I could just give them Cerenia and their cystitis would magically go away.
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Substance P inhibition, using it as an adjunct pain med. People are using Cerenia for an -itis these days.
 
Rwwilliams said:
Substance P inhibition, using it as an adjunct pain med. People are using Cerenia for an -itis these days.
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I am aware of the mechanism of action, but thank you. I'm also aware of people using it for add'l pain support. Really, my question was somewhat meant as snark - there's no evidence (that I'm aware of) to say it really helps with obstructed/post-obstructed cats. Bupe should be *plenty* to control their pain once they are unblocked. There's no reason to think they're nauseous. And the anti-inflammatory activity (with regard to cystitis) is speculative at best. I was asking her if, in her experience, it actually helps.

A lot of doctors now throw Cerenia at just about anything, without really bothering to stop and think "Is this actually necessary?" and "Is it going to help?"
 
JaynaAli said:
I think they're combo smoke/CO? It was just strange that the beeps were so far apart. When the one that had to be replaced 2-3 months ago started to beep it was doing it every 10 minutes or so. And they were hard wired with no battery backup so I unplugged it, wrapped it in a towel, and sat it out on the balcony until it quit beeping then the apartment came and replaced it two days later. It was also at 9pm so I was a little less grumpy haha. I suspect that it's the old one in the living room and will just need changed soon. Hopefully it'll go out during evening hours instead of 1-2am if it's going to.
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Wait, the alarm shut itself off after being put outside? As in, stopped alarming once in fresh air, or completely ran out of batteries?

We had the combo alarms. For about a month they would randomly go off. Normally just a chirp or 2 at a time and then they would hush for over a month. Then they slowly started going off more often. We figured it was batteries, but they are those ones you need to replace.

Property management took forever to come replace them and we kept just having them go off occasionally (and it was normally the 3 beeps, if that is the battery alarm vs the 4 fast beeps for the CO alarm, but those would sometimes happen).

Then, one Saturday, the one that had been silent went off, full CO alarm. We called the property management company, they told us just to put it outside until it stopped. It went off again as soon as I brought it back in, and wouldn't shut up if it was too close to the door of the house. So I called the fire department.

They read the CO levels as poisonous. Said our alarms should have been going off long before. Most of the CO from our busted furnace was pumping into my kid's room.

Since then I am much more touchy about the alarms and trying to figure out if they are actually trying to tell me something.
 
LadyOtheFarm said:
Wait, the alarm shut itself off after being put outside? As in, stopped alarming once in fresh air, or completely ran out of batteries?
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I think drained itself of remaining charge? Apartment complex said they don't have batteries at all but it definitely kept beeping after I unhooked the wires so I don't know. None of the other ones ever went off, and the one that was making noise in that instance was hung up in 2007, so they told me it was just at the end of its lifespan, replaced it, and that was that. I know some people who had four young kids under 5 years old that all got super super sick years ago from CO (the adults too) so I don't ignore alarms, but intermittent chirping is different than a sustained alarm in my mind. Last night I couldn't figure out if it was one of the two remaining 10 year old ones or a new one, so I opened the bedroom window just in case, but none of them ever made any more noise. I don't have any air conditioning or heater on (and haven't for 2 months), wasn't using the stove or dryer, etc. I think it was an annoying false alarm. Actually the one in the kitchen is super sensitive. If my oven is at or above 425F or if I cook burgers in a skillet the smoke alarm part goes off. So I have a box fan on top of my refrigerator to blow the air around and prevent accidental alarming while I'm cooking. I hear my neighbor's go off occasionally too around mealtimes and a friend in another building has the same problem. I guess too sensitive it much safer than non-responsive in the long run though. I have a separate CO monitor too courtesy of my dad, and that one has been fine.
 
JaynaAli said:
I think drained itself of remaining charge? Apartment complex said they don't have batteries at all but it definitely kept beeping after I unhooked the wires so I don't know. None of the other ones ever went off, and the one that was making noise in that instance was hung up in 2007, so they told me it was just at the end of its lifespan, replaced it, and that was that. I
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The one that kept randomly beeping was about that old. We put it in the tool shed for 2 days while it did the low battery/replace me beep and it was still going strong. It had no wires, just a bracket that hooked it to the ceiling. I looked it up, trying to figure out how to replace batteries. It was a kiddie combo alarm. There were a lot of reviews that said they often just go off for no reason, and funny stories about people trying to kill them when they did.

Glad you have the back ups!
 
LetItSnow said:
I am aware of the mechanism of action, but thank you. I'm also aware of people using it for add'l pain support. Really, my question was somewhat meant as snark - there's no evidence (that I'm aware of) to say it really helps with obstructed/post-obstructed cats. Bupe should be *plenty* to control their pain once they are unblocked. There's no reason to think they're nauseous. And the anti-inflammatory activity (with regard to cystitis) is speculative at best. I was asking her if, in her experience, it actually helps.

A lot of doctors now throw Cerenia at just about anything, without really bothering to stop and think "Is this actually necessary?" and "Is it going to help?"
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Wasn't sure, so I thought I'd throw info your way 🙂 I've actually met a lot of clinicians in the last year that aren't aware of Cerenia doing much more than working as an anti-emetic, and just as many that don't know the mechanism of action to start with (probably leading to the former). You're right though, people are using it for just about anything these days -- as some kind of panacea. I found out recently that people are using it for feline URIs that are proving difficult to treat otherwise. I spent some time trying to figure out why that would work, or why people would turn to Cerenia in that situation, and I wasn't able to turn up much.
 
Rwwilliams said:
Wasn't sure, so I thought I'd throw info your way 🙂 I've actually met a lot of clinicians in the last year that aren't aware of Cerenia doing much more than working as an anti-emetic, and just as many that don't know the mechanism of action to start with (probably leading to the former). You're right though, people are using it for just about anything these days -- as some kind of panacea. I found out recently that people are using it for feline URIs that are proving difficult to treat otherwise. I spent some time trying to figure out why that would work, or why people would turn to Cerenia in that situation, and I wasn't able to turn up much.
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Once upon a time, there was a cat that had a URI AND was puking on his owner's bed. The DVM gave cerenia and =gasp=, the URI got better too. So S/he told all their colleagues and so the legend started.

At least, that's how I'm guessing it happened.
 
LetItSnow said:
I am aware of the mechanism of action, but thank you. I'm also aware of people using it for add'l pain support. Really, my question was somewhat meant as snark - there's no evidence (that I'm aware of) to say it really helps with obstructed/post-obstructed cats. Bupe should be *plenty* to control their pain once they are unblocked. There's no reason to think they're nauseous. And the anti-inflammatory activity (with regard to cystitis) is speculative at best. I was asking her if, in her experience, it actually helps.

A lot of doctors now throw Cerenia at just about anything, without really bothering to stop and think "Is this actually necessary?" and "Is it going to help?"
Click to expand...

STOP JUDGING HOW I PRACTICE, LIS!






just kidding!
 
Even though Tuesdays already suck, today sucked extra bc I decided to treat myself with some starbucks on the way home from my internship, and then when I was trying to leave the brakes locked up in my car (AGAIN!!! THIS HAPPENED TWO WEEKS AGO! and I spent $800 at the shop!!!! ). Last time they released about 45 minutes, so i decided to try to wait it out. OH and my phone was dead! So I had to call my dad using some randos phone! The brakes didnt release, and that's how i ended up spending 3 hours freezing my ass off in a parking lot tonight waiting for a tow truck while fending off random men who kept trying to push my car into a parking spot (the BRAKES. ARE STUCK. YOU CAN'T.) Screw Tuesdays.

bonus rave: A guy who was actually nice and not clingy who goes to my university felt so bad for me he drove to kroger, and bought me a phone charger for my car. Didn't even catch his name- that helped me out a ton 🙂
 
Of course it has to be an RDVM's parent's FLUTD cat whose catheter (placed by RDVM) gets obstructed and won't flush, then won't come out, and then I take contrast rads and find that it's all tangled up in there.

Yup. Has to be that one.

Grumble.
 
Yesterday was an insane day at work and I had a very short lunch break which I used to go check on my cat that just had sx. Of course I was being stupid and running totally on autopilot and got pulled over for speeding (yeah I was...but I was going 75 in what I thought was a 70 but actually was a 65. Yeah, like I said, I know I'm dumb😳).

This has been a very stressful/expensive couple of days and I'm feeling hell of a burnt out. Sigh.🙁
 
mmmdreamerz said:
Yesterday was an insane day at work and I had a very short lunch break which I used to go check on my cat that just had sx. Of course I was being stupid and running totally on autopilot and got pulled over for speeding (yeah I was...but I was going 75 in what I thought was a 70 but actually was a 65. Yeah, like I said, I know I'm dumb😳).

This has been a very stressful/expensive couple of days and I'm feeling hell of a burnt out. Sigh.🙁
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Ugh, getting pulled over for going 75 in a 65 is lame
 
mmmdreamerz said:
Yesterday was an insane day at work and I had a very short lunch break which I used to go check on my cat that just had sx. Of course I was being stupid and running totally on autopilot and got pulled over for speeding (yeah I was...but I was going 75 in what I thought was a 70 but actually was a 65. Yeah, like I said, I know I'm dumb😳).

This has been a very stressful/expensive couple of days and I'm feeling hell of a burnt out. Sigh.🙁
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@mmmdreamerz, very sorry to hear you were cited.

Is your cat doing better?
 
LetItSnow said:
See, yer a better doc than me. I don't send out culture. I should. But my $2000 ER estimate is already more than most people want to swallow.
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Way late to this convo, but I swear our micro fellow at school said Penn would do out of house cultures for people. Believe it's only like $95 vs the $130+ through Antech/Idexx. I can try to confirm with him if that's still a thing/if I made it up/figure out costs if anyone is interested.
 
orca2011 said:
Way late to this convo, but I swear our micro fellow at school said Penn would do out of house cultures for people. Believe it's only like $95 vs the $130+ through Antech/Idexx. I can try to confirm with him if that's still a thing/if I made it up/figure out costs if anyone is interested.
Click to expand...

Yeah. Part of it is .... well, laziness and convenience. For starters, for typical young male FLUTD cases, infectious etiologies are so rare it's dumb. Way overdiagnosed. So spending the $100 (or whatever) to culture is hard to really argue, even though we're all taught "for every urinary tract problem, do rads, bloodwork, and UA". That's great in the "money don't matter" world, but....

And there's an element of me being ER. I'll see the case, send it out, but I may not be back at work for 2 days...4 days... a week... or I'm at another hospital for the next month... and then we get the results... and hopefully they don't get lost in follow-up... and then someone has to remember to get it to the RDVM... it's just got all sorts of opportunity for getting lost in the system.

I typically keep a urine sample and give it to the owners with a "put in your fridge, call your RDVM in the AM, and ask if they want to submit it." All sorts of pluses to that: 1) I don't have to deal with it, 2) Forces the owner to contact their RDVM, which is always my goal, 3) Gives some of the revenue to the RDVM, which is good politics, 4) The RDVM will be doing the long-term care anyway, so they get the results.

And, I'm in the camp that starts a round of Clavamox or whatever after I pull the u-cath. Unless there is an obvious <raging> UTI on my initial UA, I don't do abx while the u-cath is in because of the potential for resistant bacterial development AND because they're cranking out urine like crazy - they're flushing bacteria out anyway.

All in all ... I don't see a lot of reason to culture for the classic young boy FLUTD/UO.
 
If my body would let me go to sleep right now I would be so grateful
tenor.gif
 
Trilt said:
I slept for long enough last night that I actually dreamt. Feels good man, would recommend.
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I'm running off a solid hour of sleep. I almost fell asleep a few hours before I actually did but my tossing and turning woke my cat up and he had to terrorize me as payback.
 
LetItSnow said:
Yeah. Part of it is .... well, laziness and convenience. For starters, for typical young male FLUTD cases, infectious etiologies are so rare it's dumb. Way overdiagnosed. So spending the $100 (or whatever) to culture is hard to really argue, even though we're all taught "for every urinary tract problem, do rads, bloodwork, and UA". That's great in the "money don't matter" world, but....

And there's an element of me being ER. I'll see the case, send it out, but I may not be back at work for 2 days...4 days... a week... or I'm at another hospital for the next month... and then we get the results... and hopefully they don't get lost in follow-up... and then someone has to remember to get it to the RDVM... it's just got all sorts of opportunity for getting lost in the system.

I typically keep a urine sample and give it to the owners with a "put in your fridge, call your RDVM in the AM, and ask if they want to submit it." All sorts of pluses to that: 1) I don't have to deal with it, 2) Forces the owner to contact their RDVM, which is always my goal, 3) Gives some of the revenue to the RDVM, which is good politics, 4) The RDVM will be doing the long-term care anyway, so they get the results.

And, I'm in the camp that starts a round of Clavamox or whatever after I pull the u-cath. Unless there is an obvious <raging> UTI on my initial UA, I don't do abx while the u-cath is in because of the potential for resistant bacterial development AND because they're cranking out urine like crazy - they're flushing bacteria out anyway.

All in all ... I don't see a lot of reason to culture for the classic young boy FLUTD/UO.
Click to expand...


I've done both here, mainly dependent on client finances (plus if I don't offer it, I get backlash) but agree that an underlying UTI isn't typically the cause. I like the idea of saving the urine thougb. I'll keep that in mind for my next job since I dunno if I'm going into GP, ER or both yet
 
Trilt said:
I slept for long enough last night that I actually dreamt. Feels good man, would recommend.
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I got about 2 hours and I responded to my alarm clock/ Biochemistry/ life/ school with a string of profanities guaranteed to impress even the toughest of sailors.
 
Some days I kinda miss having class. I mean, not *really* - but one of those show up, sit there and pretend to pay attention for 4-5 hours, maybe even take some notes... then go home at 3pm and take a nap.

Or, alternately, plan to go to class and then sleep though an alarm and then say "F it" to the rest of the day and go back to sleep.

Actually, I was watching MTV U the other day because trashy music videos make good background when I'm doing other stuff (e.g. putting together a cat tree in this case). It has little animated bits about being an undergrad student and I got this sudden pang of nostalgia. What the heck. I guess I want a dorm room (with the good roomie and not any of the bad ones, or no roomie at all) and my TV on - glorious cable TV, and my glorious T1 internet connection after growing up with rabbit ears and dial-up. Eating junk food all the time... random ass sleep schedule... just living for the weekends so I could go home and see the boyfriend. Studying like, two hours the day before an exam. Maybe.

It makes sense to miss some of that, but not the shared bathrooms, the idiots down the hall playing Halo at 2am, having to take history and government and philosophy classes... writing papers... lol that brings us back to the little animated short. I can only find it on FB...



Sorry, that all comes from "woke up with massive headache so took 5 Advil and drank 2 cups of coffee" TT...
 
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