@Minnerbelle I am so incredibly sorry about your experiences with your cats.
No one should have to feel neglected like that. I was actually saying "no!!" out loud when I read some sections of your post
It was especially brutal to read how you were trying to be understanding of the demands on the system, but that kindness got abused instead of appreciated.
Like you, I can also see how those situations could happen from the other side and I do empathize with that...but it's not an excuse and my heart breaks for you and your pets.
Honestly I am glad to have this discussion prior to clinics+internship because I hope I can remember it when I am exhausted and use it to drag up some energy reserves. Thank you for sharing.
Though I will say, the last few chronic rhinitis/snuffler kitties I sent for referral were all talked out of advanced imaging as well, so it may not be just you.
Sigh. It makes me want to do some kind of a study tbh.
Granted I may be jumpier than your average bear about sniffly cats because I have had
three very personal experiences with nasal tumors in cats (despite their purported rarity), and
four experiences with being told that dyspnea is just a cold or asthma...and then oops nope it is cancer and they can't breathe and are dying an awful death.
So yeah, I know this cat is just a kitten and thankfully neoplasia is at the bottom of the ddx list this time... but a non-infectious etiology is not
impossible either.
And unless you are working with derm, many clinicians in other services don’t really know how to read/interpret ear cytologies.... interns/residents/attendings in most services have limited experience managing chronic skin/ears. I’ve had clinicians ask me as a student what to do with ear cytologies after I went through my derm rotation...
Man, this year I am beginning to realize how lucky I am for the job I had before school. I worked for a dermatologist who also had GP associates at her clinic, and so I think we all got spoiled on derm stuff.
Ear cytologies are SO easy, cheap, and fast ...and they are high reward in terms of treating painful pets. It felt like we ran them for almost every other exam, especially because if you're quickly swabbing an ear
anyway as part of a comprehensive PE, why not just roll that qtip around on a slide first instead of chucking it in the trash (or even just save the qtips if you don't want to use up a slide). Then if it turns out the history indicates some head shaking, itchiness, what have you...then bam, you have your sample that you can stain & get a tech to review, and haven't done anything more invasive than what you would have already done in the first place.
From talking to my classmates recently, they didn't see much of it in GP either, though. So I guess I am turning into a derm evangelist; my old boss would be thrilled haha
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