RANT HERE thread

[Stroganoff]

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A neurologist/sleep specialist I saw a couple years ago mentioned that diphenhydramine (Benadryl) royally messes with sleep architecture (he didn't get into specifics on how it changes the phases or whatever), so it leads to terrible quality sleep. As someone with a multi-year Benny habit (hey, at least it's not heroin!) to use for insomnia, it's a double-edged sword. Sure, it can zonk you out, but you wake up hungover, and it lasts many hours or even all day. I suppose for common colds and such, it's pick your poison, and the body needs *some* rest just to get through the misery, even if it's poor quality sleep.

 

[vetmedhead]

A neurologist/sleep specialist I saw a couple years ago mentioned that diphenhydramine (Benadryl) royally messes with sleep architecture (he didn't get into specifics on how it changes the phases or whatever), so it leads to terrible quality sleep. As someone with a multi-year Benny habit (hey, at least it's not heroin!) to use for insomnia, it's a double-edged sword. Sure, it can zonk you out, but you wake up hungover, and it lasts many hours or even all day. I suppose for common colds and such, it's pick your poison, and the body needs *some* rest just to get through the misery, even if it's poor quality sleep.

This makes a lot of sense to me. I'm extremely sensitive to Benadryl for whatever reason and every time I have to take it, I pass out for like 13+ hours and spend the entire next day feeling so sleepy that I can barely sit upright

 

[vetmedhead]

Protip: NyQuil is usually just DayQuil with some Benadryl (or another 1st gen antihistamine) mixed in.

This also makes a ton of sense because DayQuil is fine, but NyQuil ****s me up every time I take it

 

[SkiOtter]

Lol am I the only one who is not affected by Benadryl

 

[vetmedhead]

Lol am I the only one who is not affected by Benadryl

I bet if we split my response to it, we could both be normally affected by Benadryl

 

[Stroganoff]

Lol am I the only one who is not affected by Benadryl

Wanna snort some Ambien with me?

 

[SkiOtter]

Wanna snort some Ambien with me?

That put me out for a 15 hour flight from LAX to Sydney a few years back. Conveniently though, I would wake up every time they were a few rows ahead passing out meals or snacks and never once missed food/an ice cream bar and then would pass tf back out after

 

[WeimMama]

A neurologist/sleep specialist I saw a couple years ago mentioned that diphenhydramine (Benadryl) royally messes with sleep architecture (he didn't get into specifics on how it changes the phases or whatever), so it leads to terrible quality sleep. As someone with a multi-year Benny habit (hey, at least it's not heroin!) to use for insomnia, it's a double-edged sword. Sure, it can zonk you out, but you wake up hungover, and it lasts many hours or even all day. I suppose for common colds and such, it's pick your poison, and the body needs *some* rest just to get through the misery, even if it's poor quality sleep.

Also studies have shown a link between chronically taking benadryl and early onset alzheimers. So yeah, not taking that stuff for the sleeps anymore!

 

[Stroganoff]

Also studies have shown a link between chronically taking benadryl and early onset alzheimers. So yeah, not taking that stuff for the sleeps anymore!

Oh crud, I'm hosed. And I just bought a 600-ct bottle from Costco. I'll stick with melatonin, even though it doesn't do squat. I'll have to find those studies!

 

[Stroganoff]

Where am I? Pre-vet? What's my name?

 

[WeimMama]

Oh crud, I'm hosed. And I just bought a 600-ct bottle from Costco. I'll stick with melatonin, even though it doesn't do squat. I'll have to find those studies!

I know! Apparently there is a major difference between people taking it regularly for 3 years or more and people taking it never or rarely. Guess how long I used that stuff to knock me out pretty regularly... the length of vet school... aka 3.5 years >_<

Luckily melatonin does work for me and I'm not drowsy when I get up but I do have a hard time GETTING up.

 

[pp9]

As I approach the end of my vet school years, I think the biggest lesson I've learned is that even when it's not your fault and was 1000000% not your responsibility to begin with, it is still your fault and your responsibility (especially when it comes to your peers dropping the ball, somehow that's my fault too).

 

[Squeaksmom]

Also studies have shown a link between chronically taking benadryl and early onset alzheimers. So yeah, not taking that stuff for the sleeps anymore!

One of the meds that keeps me alive has antihistaminic effects at H1. It's like taking a whopping dose of benadryl, every single day. I've actually been on it long enough to have stopped reacting to it, and don't get drowsy any more. It used to knock me flat within a couple of hours of the dose, and I'd sleep like a rock literally without moving for... a long time (generally at least 13 hours). I'm aware of the Alzheimer's link, and it scares me a lot especially after watching my Nana suffer from it for years, but also see the bit about it literally keeping me alive.... Pick your poison I guess?

 

[DVMDream]

As I approach the end of my vet school years, I think the biggest lesson I've learned is that even when it's not your fault and was 1000000% not your responsibility to begin with, it is still your fault and your responsibility (especially when it comes to your peers dropping the ball, somehow that's my fault too).

Yup, good lesson. Everything is your fault when you're the Dr. Even the **** that isn't or that you didn't do/touch/see. Still your fault.

 

[DVMDream]

Meh, bring on the Alzheimers, benadryl is the only thing that allows me to sleep. I do have a rare day where I get that "benadryl fog" but it is very rare and better than how I was feeling with insomnia.

 

[Skimble]

This makes a lot of sense to me. I'm extremely sensitive to Benadryl for whatever reason and every time I have to take it, I pass out for like 13+ hours and spend the entire next day feeling so sleepy that I can barely sit upright

I’m also SUPER sensitive to Benadryl and I only take it if I absolutely have to. I once had an allergic reaction to an antibiotic and was given IV diphenhydramine. It was a bizarre experience. I slept so hard. They even moved me and my bed into the hallway and I didn’t wake up. The doctor tried to wake me several times and couldn’t. When I finally woke on my own, he told me he’s never seen anyone sleep like that.

Now if I have to take it, I only take 1/4-1/2 and it still knocks me on my butt.

 

[vetmedhead]

I’m also SUPER sensitive to Benadryl and I only take it if I absolutely have to. I once had an allergic reaction to an antibiotic and was given IV diphenhydramine. It was a bizarre experience. I slept so hard. They even moved me and my bed into the hallway and I didn’t wake up. The doctor tried to wake me several times and couldn’t. When I finally woke on my own, he told me he’s never seen anyone sleep like that.

Now if I have to take it, I only take 1/4-1/2 and it still knocks me on my butt.

I'm very similar. I took some for a wasp sting at the end of last summer and literally began to pass out in the shower. I thought I could time it to hit me once I finished my bedtime routine, but it hit me way faster than I had anticipated

 

[genny]

I used to take benadryl like candy when I was a kid, just because breathing was one of those things that I didn't seem to have an aptitude for. I used to be able to take a massive dose without getting sleepy. Now, I take a normal dose, and it knocks me out for about 4 hours but then I wake up wired and completely unable to fall asleep again.

 

[WeimMama]

One of the meds that keeps me alive has antihistaminic effects at H1. It's like taking a whopping dose of benadryl, every single day. I've actually been on it long enough to have stopped reacting to it, and don't get drowsy any more. It used to knock me flat within a couple of hours of the dose, and I'd sleep like a rock literally without moving for... a long time (generally at least 13 hours). I'm aware of the Alzheimer's link, and it scares me a lot especially after watching my Nana suffer from it for years, but also see the bit about it literally keeping me alive.... Pick your poison I guess?

yeah, living is a priority. hopefully for your, my, and many others' sake its just correlation and not causation?

 

[variegata]

Oh that’s good to know. Thanks.
Also yeah I’m just gonna day my DayQuil instead.
But the berry flavor doesnt make me want to vom quote as violently as the Orange flavor. And also I quite enjoy that sweet sweet antihistamine sleep.

They make both in capsules now! So much less awful tasting than the liquids.

 

[Squeaksmom]

yeah, living is a priority. hopefully for your, my, and many others' sake its just correlation and not causation?

When I was first on it and hadn't figured out what was going on yet, I very nearly collapsed into a sound sleep from standing up and talking... on a concrete floor... in a dairy barn... in front of 3 profs, the producers, and my whole class.... Fun times!

 

[pp9]

Yup, good lesson. Everything is your fault when you're the Dr. Even the **** that isn't or that you didn't do/touch/see. Still your fault.

Moreso referring to the stupid BS vet students go through on a daily basis just because people can **** on us when they've dropped the ball and need someone else to lash out on.

3 more months

 

[KCgophervet]

Lol am I the only one who is not affected by Benadryl

Meeeeee

 

[ajs513]

Lol am I the only one who is not affected by Benadryl

Meeeeee

I’ll take that a step further. I’m allergic to Benadryl. And I guess all other first generation antihistamines since I’m also allergic to famotidine...

 

[SkiOtter]

Meeeeee

Ah yes another way we are the exact same person.

 

[SkiOtter]

I’ll take that a step further. I’m allergic to Benadryl.

P sure my dog is too
Her body also does not like nasal bordetella anymore. To the point where we couldn’t touch her for 3 days. And adding Benadryl makes her worse 🙄

 

[ajs513]

P sure my dog is too
Her body also does not like nasal bordetella anymore. To the point where we couldn’t touch her for 3 days. And adding Benadryl makes her worse 🙄

That’s so weird! Everyone in much family thought I was making it up when I learned I was allergic around 12 or so. Then we went to an allergist who said it’s super uncommon but can happen. I feel like I should have a medical alert bracelet for that...
I’m just curious, but why do some vets use nasal vs oral bordetella? I’ve never worked somewhere that does so I’ve never thought to ask.

 

[cowgirla]

I have awful reactions to benadryl (and to a lesser extent, most other common antihistamines).
First time I had benadryl I hallucinated (first it was lions dancing), then pretty much had delusional parasitosis (spiders. spiders everywhere)- complete with itching. I get twitchy and hyperalert despite also feeling exhausted. Weird feeling.

 

[ajs513]

I have awful reactions to benadryl (and to a lesser extent, most other common antihistamines).
First time I had benadryl I hallucinated (first it was lions dancing), then pretty much had delusional parasitosis (spiders. spiders everywhere)- complete with itching. I get twitchy and hyperalert despite also feeling exhausted. Weird feeling.

Wow... that’s way worse than anything I’ve ever heard of with Benadryl. I’ve heard of that with Robitussin though. One vet I work with had a cold years ago and took it and started hallucinating during a cat spay.

 

[cowgirla]

Wow... that’s way worse than anything I’ve ever heard of with Benadryl. I’ve heard of that with Robitussin though. One vet I work with had a cold years ago and took it and started hallucinating during a cat spay.

My immune system is super special. I'm allergic to everything but antihistamines make me more miserable. Luckily most OTC cold meds I'm fine with, but I definitely don't take new things if I have to be anywhere other than my bed.

 

[SkiOtter]

I’m just curious, but why do some vets use nasal vs oral bordetella? I’ve never worked somewhere that does so I’ve never thought to ask.

My vet just doesn’t do oral and never has. Idk how true it is, but I heard someone somewhere say that the oral ones aren’t as effective or something as nasal. I’m sure someone else on here can verify or deny that

 

[cdo96]

I’m just curious, but why do some vets use nasal vs oral bordetella? I’ve never worked somewhere that does so I’ve never thought to ask.

I’ve never heard of oral bordetella, but I’m pretty sure the number of IgM receptors in the nasal passageways are greater than in the mouth.

Have you worked with the oral vaccine before?

 

[mypetmoose]

Lol am I the only one who is not affected by Benadryl

Ooh me too.

 

[Stroganoff]

delusional parasitosis (spiders. spiders everywhere)

Ooo I had this delusion too at my last apartment. Except it was real. 🙁

 

[SkiOtter]

Ooo I had this delusion too at my last apartment. Except it was real. 🙁

I hope you burnt the place down and that’s why it was your previous apartment

 

[ajs513]

I’ve never heard of oral bordetella, but I’m pretty sure the number of IgM receptors in the nasal passageways are greater than in the mouth.

Have you worked with the oral vaccine before?

I’ve only ever used the oral or the injectable. Elanco makes an oral one called Bronchishield. I forget which other company we use that makes one. The other one looks like a little dropper that you break the tip off of and mix with the cake. My practice now really just uses the oral bordetella.

 

[cdo96]

My vet just doesn’t do oral and never has. Idk how true it is, but I heard someone somewhere say that the oral ones aren’t as effective or something as nasal. I’m sure someone else on here can verify or deny that

I just googled it- it’s really new. Looks like the main benefit behind it is that it’s available to be administered syringe free to prevent accidentally injecting the intranasal Bordetella (which is bad if you like your skin and/ or liver)

 

[SkiOtter]

I’ve only ever used the oral or the injectable. Elanco makes an oral one called Bronchishield. I forget which other company we use that makes one. The other one looks like a little dropper that you break the tip off of and mix with the cake. My practice now really just uses the oral bordetella.

I just googled it- it’s really new. Looks like the main benefit behind it is that it’s available to be administered syringe free to prevent accidentally injecting the intranasal Bordetella (which is bad if you like your skin and/ or liver)

this is how my nasal bordetella is too. prevents any sort of possibility of injecting it.

 

[cdo96]

this is how my nasal bordetella is too. prevents any sort of possibility of injecting it.
View attachment 250308

Interesting! Yeah my clinics have just used the old kind and the doctor double checks before squirting it in

 

[SkiOtter]

Interesting! Yeah my clinics have just used the old kind and the doctor double checks before squirting it in

most places do

 

[ajs513]

this is how my nasal bordetella is too. prevents any sort of possibility of injecting it.
View attachment 250308

Interesting. The one from elanco is drawn in a syringe but the proprietary syringes have super large bore needles that I guess make it difficult to inject with. So the second you see it you know you should take the needle off.

 

[Keri]

Our clinic swapped from nasal to oral simply because it was a little cheaper for them to buy

 

[ajs513]

Comparative onset of immunity of oral and intranasal vaccines against challenge with Bordetella bronchiseptica
This is the most recent study I found. Not a large sample size but definitely seems promising. It seems like oral bordetella is comparable to intranasal but doesn’t have the risk of causing nasal irritation.

 

[cowgirla]

Comparative onset of immunity of oral and intranasal vaccines against challenge with Bordetella bronchiseptica
This is the most recent study I found. Not a large sample size but definitely seems promising. It seems like oral bordetella is comparable to intranasal but doesn’t have the risk of causing nasal irritation.

Also less risk of pissing off your patient. It is so much easier to give than the intranasal. We used to be about 70% intranasal, 30% injectable because couldn't get the IN in. Now we are about 95% oral. We get far fewer complaints about low grade URI/sneezing for a few days after the vaccine as well.

 

[ajs513]

Also less risk of pissing off your patient. It is so much easier to give than the intranasal. We used to be about 70% intranasal, 30% injectable because couldn't get the IN in. Now we are about 95% oral. We get far fewer complaints about low grade URI/sneezing for a few days after the vaccine as well.

Correct me if I’m wrong as well, but even if the oral vaccines was a little less effective than the IN, is the difference in effectiveness a bigger deal than the lower risk of URI symptoms? I’ve only been working at a vet for 3 years, but I’ve never seen a very severe case of kennel cough. In the vast majority of patients who are healthy, wouldn’t a lower effectiveness be worth the lower risk of side effects? Again, looking at older studies that said oral vaccines were less effectiveness.

 

[cdo96]

Correct me if I’m wrong as well, but even if the oral vaccines was a little less effective than the IN, is the difference in effectiveness a bigger deal than the lower risk of URI symptoms? I’ve only been working at a vet for 3 years, but I’ve never seen a very severe case of kennel cough. In the vast majority of patients who are healthy, wouldn’t a lower effectiveness be worth the lower risk of side effects? Again, looking at older studies that said oral vaccines were less effectiveness.

be grateful for this, I’ve seen numberous cases/ suspected cases, but one of them was the very severe cases and it was roughhhhh. Owner elected to euthanize instead of dealing with it, and everything was contaminated.

 

[DVMDream]

I regularly use IN bordetella, have absolutely very little trouble giving it except in stupid severely aggressive patients in which case they are getting injectable then anyway and I have never seen it cause URI signs or have an owner complain about URI signs post vaccine. Most I have seen it do is cause some sneezing immediately after that resolves before the owner even leaves the clinic.

 

[vetmedhead]

Correct me if I’m wrong as well, but even if the oral vaccines was a little less effective than the IN, is the difference in effectiveness a bigger deal than the lower risk of URI symptoms? I’ve only been working at a vet for 3 years, but I’ve never seen a very severe case of kennel cough. In the vast majority of patients who are healthy, wouldn’t a lower effectiveness be worth the lower risk of side effects? Again, looking at older studies that said oral vaccines were less effectiveness.

I think this turns into a complex discussion because what gets referred to as "kennel cough" often includes the broader overarching list of things that are all part of the canine upper respiratory syndrome disease complex. It can be difficult to say if a severe case of "kennel cough" is related to lower efficacy of the bordetella vaccine without culturing the underlying agent causing the problem to confirm that it is bordetella.

That being said, your willingness to play give-and-take with the efficacy really depends on your goals. In a shelter setting (my predominant background), we're pretty concerned about getting the highest efficacy vaccine possible because we're more concerned about managing an outbreak even if the affected dogs themselves didn't get terribly sick when they did contract bordetella. It's also important to remember that while kennel cough is overall mild, it can progress to severe (and fatal) bronchopneumonia or more chronic bronchitis in young/old/immunocompromised dogs.

There are a lot of situations where you may have to do that sort of cost/benefit analysis for a variety of products, treatments, and approaches. The best thing for one patient isn't necessarily the best for the other.

 

[ajs513]

@cdoconn @DVMDream @vetmedhead
I really appreciate the input. Like I said, I haven’t had experience with severe cases since I’ve only worked in GP offices. I know along the way I’ll encounter some scary things, but I’m lucky that I haven’t yet (for this specifically). I definitely think that it should be tailored for the patient, and that’s what my office recommends anyway. We don’t give bordetella super often though due to the clientele and what they do with their pets. Most are pretty coddled, not boarded, and have personal groomers. The ones who do get boarded or go for grooming get it. We also get a lot of crazy anti-vaxxers, but don’t even get me started on that.

 

[cowgirla]

I regularly use IN bordetella, have absolutely very little trouble giving it except in stupid severely aggressive patients in which case they are getting injectable then anyway and I have never seen it cause URI signs or have an owner complain about URI signs post vaccine. Most I have seen it do is cause some sneezing immediately after that resolves before the owner even leaves the clinic.

If we switch back, I'll have to pick your brain on technique.
I don't generally have a tech in the room with me, or when out on the farm, and it was a battle in the vast majority of patients. I can do a very good exam in most patients with minimal restraint, but that stupid vaccine never went well.