RAVE HERE thread

[KCgophervet]

RAVE here... but I've been so blessed to have received so many interviews so far (lab animal residency programs). Pretty nervewracking bc I'm an introvert so doing all these have been stressful.. BUT I can say that I've been getting better an interviewing. Hoping I match ad excited/nervous for match day on March 1st! 8 more 2-week rotations left with 2 of those being off campus. WHOOOOOOOOOOOOOOOOOOOOO! I can see the end of the tunnel!

I have no doubt you will match somewhere great

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[cheathac]

I have no doubt you will match somewhere great

Thank you so much! As someone who has helped me get to this point, I thank you greatly.

 

[PippyPony]

I'm almost worried to post this because I don't want to jinx it, but so far I am batting a thousand on my cat blood draws (and struggling hard with almost every dog).

I think it's a sign.

Spoiler: All cats all the time

 

[genny]

My style of practice and client communication is very different from my boss's since she's an extrovert and I'm definitely not. And a lot of the time, I feel pretty inadequate by comparison because extroverts are just so much more popular. But today, my boss let me know that she appreciates me for who I am, and it gave me the warm fuzzies. There's a place for me in vet med with the weird, awkward, overly blunt communicators and that's a good thing.

 

[Amanasoul]

This might be a silly thing to rave about but...

I've been wanting an axolotl for over ten years now and things finally aligned so I've got one now (See; new pic). Like...it's probably weird for me to be this excited but it's been one of the biggest highlights of my year so far

 

[CoffeeQuestionMark]

This might be a silly thing to rave about but...

I've been wanting an axolotl for over ten years now and things finally aligned so I've got one now (See; new pic). Like...it's probably weird for me to be this excited but it's been one of the biggest highlights of my year so far

I used to work for a pathologist who kept an empty tank in the lab because she was promised some axolotls from someone she new. The tank sat there the entire time I worked there and 3 years later unfortunately still no axolotls. I did put a stuffed hippopotomus in there for fun, though.

 

[Lawpy]

This might be a silly thing to rave about but...

I've been wanting an axolotl for over ten years now and things finally aligned so I've got one now (See; new pic). Like...it's probably weird for me to be this excited but it's been one of the biggest highlights of my year so far

@Melchizedek proudly approves

 

[WildZoo]

Probably saved a patient's life today (or at least saved him a future hospital visit).

Long story short, I'm on rotation doing discharge counseling for patients in a hospital, and pt was about to be discharged on an anticoagulant with a dose that was wayyyy too high for him.

Spoiler: Long story long + clinical explanation

Patient was admitted to the hospital a few days ago with a new diagnosis of atrial fibrillation. He had previously been taking warfarin for a different indication that I can't remember right now, but they temporarily switched him to heparin while he was in the hospital. For treatment of his afib, they started him on amiodarone.

So INR monitoring. Basically your indicator of how good a patient's warfarin dose is. Too high and patient will bleed out. Too low and they'll have a blood clot. For healthy patients with no CV diseases, it should be around 1-ish. For most patients treated with warfarin, it should be between 2 and 3. This number also changes very slowly in response to warfarin. It takes about 5 days for the INR to stabilize when starting or changing warfarin doses, and you should consider holding or reducing the dose if it increases by more than 0.5 in a day.

A thing about warfarin, it's super touchy and interacts with just about everything. If you look at it funny you have to dose adjust it. But it's pretty easy to dose adjust in response if needed, and there's only a few interactions you really have to pay attention to.

Amiodarone is one of those. It increases the serum level of warfarin and requires the warfarin dose to be reduced by 30-50%.

Well this patient had his warfarin resumed yesterday afternoon with plans to discharge him on the amiodarone and his usual home dose of warfarin. Do you want to know what happened to his INR? It spiked a whopping 1.0 points in 24 hours (from 1.7 to 2.7). This was after ONE dose. Keeping him on his home dose would surely put him into the 5-ish range. And they were still going to send him home on his normal dose!

So anyway, contacted the doc and said "maybe don't pls?" and he halved the dose. And then when I went to counsel the patient I made sure to tell him to ask his care team when he should take his next dose (since I technically can't tell him to hold his dose for a day).

Semi-related rave, yesterday I got to do discharge counseling for a patient who had been in the hospital for over a month. She was almost crying from happiness while I was talking to her.

Nice job!
Just out of curiosity, why do people still do warfarin instead of the newer anticoagulants that don't have all these interactions or need intense monitoring? Just a cost thing?

(note that I'm on Xarelto and my mom is on Eliquis so it's of interest to me)

 

[capri1722]

Nice job!
Just out of curiosity, why do people still do warfarin instead of the newer anticoagulants that don't have all these interactions or need intense monitoring? Just a cost thing?

(note that I'm on Xarelto and my mom is on Eliquis so it's of interest to me)

98% of the time, yes, cost. Warfarin is dirt cheap, and the DOACs (Pradaxa, Eliquis, Xarelto, etc) are still under patent for a few more years.

But there are a couple disease states where you'd prefer warfarin over a DOAC. Main one is end stage renal disease (CrCl < 15), but also for people with mechanical prosthetic heart valves and/or rheumatic mitral stenosis. I'm not entirely sure why those specifically, but my guess is that they just weren't studied in those populations, or if they were, there was a higher risk of mortality or something with the DOACs.

 

[WildZoo]

98% of the time, yes, cost. Warfarin is dirt cheap, and the DOACs (Pradaxa, Eliquis, Xarelto, etc) are still under patent for a few more years.

But there are a couple disease states where you'd prefer warfarin over a DOAC. Main one is end stage renal disease (CrCl < 15), but also for people with mechanical prosthetic heart valves and/or rheumatic mitral stenosis. I'm not entirely sure why those specifically, but my guess is that they just weren't studied in those populations, or if they were, there was a higher risk of mortality or something with the DOACs.

Yeah the cost is no joke, I still have nightmares about the time my husband made the mistake of putting us on a high deductible insurance plan...

But that's cool that there are actually diseases that it's better for! Do people use Plavix a lot? That's the only longterm anticoagulant (though I guess technically anti...platelet or something) I've ever seen used in animals.

 

[PippyPony]

@capri1722 how do you pronounce amiodarone? I've always said it amiOdarone, but some people here pronounce it amioDArone. I need to know!

 

[vetmedhead]

@capri1722 how do you pronounce amiodarone? I've always said it amiOdarone, but some people here pronounce it amioDArone. I need to know!

My PharmD professor here pronounced it the first way

the second kind of makes my skin crawl haha

 

[capri1722]

Yeah the cost is no joke, I still have nightmares about the time my husband made the mistake of putting us on a high deductible insurance plan...

But that's cool that there are actually diseases that it's better for! Do people use Plavix a lot? That's the only longterm anticoagulant (though I guess technically anti...platelet or something) I've ever seen used in animals.

Plavix is used for different stuff entirely! Whereas DOACs are used for prevention of VTE (and stroke in afib), antiplatelets are used for prevention of heart attack and stroke. Generally a patient will be on dual antiplatelet therapy (aspirin + P2Y12 inhibitor like Plavix) for several months or lifetime following a heart attack or stroke.

But yes, Plavix is super common because it's probably the second cheapest antiplatelet agent, after aspirin.

@capri1722 how do you pronounce amiodarone? I've always said it amiOdarone, but some people here pronounce it amioDArone. I need to know!

I'm with VMH, the second one makes me cringe.

am-ee-OH-da-rone

 

[JaynaAli]

But let’s discuss levetiracetam pronunciation. People often have strong opinions as to whether it’s leve-tier-A$$-uh-tam or leve-tier-uh-CEE-tum. And cefazolin...See-fa-ZOH-lin or suh-FAZ-oh-lin.

 

[allygator13]

But let’s discuss levetiracetam pronunciation. People often have strong opinions as to whether it’s leve-tier-A$$-uh-tam or leve-tier-uh-CEE-tum. And cefazolin...See-fa-ZOH-lin or suh-FAZ-oh-lin.

The latter in both for me

 

[genny]

But let’s discuss levetiracetam pronunciation. People often have strong opinions as to whether it’s leve-tier-A$$-uh-tam or leve-tier-uh-CEE-tum. And cefazolin...See-fa-ZOH-lin or suh-FAZ-oh-lin.

Keppra

 

[genny]

How do you pronounce the A in Apoquel? Long A like Ape, or short A like Apple?

 

[MOOSEygoosey]

How do you pronounce the A in Apoquel? Long A like Ape, or short A like Apple?

App-oquel

 

[WildZoo]

How do you pronounce the A in Apoquel? Long A like Ape, or short A like Apple?

Definitely the latter

But let’s discuss levetiracetam pronunciation. People often have strong opinions as to whether it’s leve-tier-A$$-uh-tam or leve-tier-uh-CEE-tum. And cefazolin...See-fa-ZOH-lin or suh-FAZ-oh-lin.

Former for the first (but I just say keppra lol) and latter for the second

 

[WildZoo]

Plavix is used for different stuff entirely! Whereas DOACs are used for prevention of VTE (and stroke in afib), antiplatelets are used for prevention of heart attack and stroke. Generally a patient will be on dual antiplatelet therapy (aspirin + P2Y12 inhibitor like Plavix) for several months or lifetime following a heart attack or stroke.

But yes, Plavix is super common because it's probably the second cheapest antiplatelet agent, after aspirin.

Interesting!
Not sure if there are studies but I've mostly seen plavix used in cats with HCM to prevent saddle thrombus

 

[Barkley13]

How do you pronounce the A in Apoquel? Long A like Ape, or short A like Apple?

Or the A in apomorphine. I’ve heard both almost equally

 

[WildZoo]

Or the A in apomorphine. I’ve heard both almost equally

That one I say like ape

 

[Lawpy]

So far nothing as complex as bamlanivimab yet!

 

[SARdoghandler]

Ok but like

Oclacitinib

Which I know we were already talking about Apoquel but it's drug name is my absolute favourite to mispronounce. Pretty sure they just named it by rolling around on the keyboard for a bit

 

[WildZoo]

Ok but like

Oclacitinib

Which I know we were already talking about Apoquel but it's drug name is my absolute favourite to mispronounce. Pretty sure they just named it by rolling around on the keyboard for a bit

Yeah I don't even actually try to say that one in my head

 

[WildZoo]

Though Plumb's says it is OK-la-SIT-ti-nib

 

[WildZoo]

Of course it also says keppra is lee-ve-tye-RA-see-tam and that just seems wrong

 

[PippyPony]

Of course it also says keppra is lee-ve-tye-RA-see-tam and that just seems wrong

that's how I pronounce it

 

[WildZoo]

that's how I pronounce it

It's the -tye- part that trips me up

 

[vetmedhead]

I'm realizing now that I pronounce apoquel both ways.

Ok but like

Oclacitinib

Which I know we were already talking about Apoquel but it's drug name is my absolute favourite to mispronounce. Pretty sure they just named it by rolling around on the keyboard for a bit

okay but my favorite is lokivetmab. Why does nobody talk about how hilarious the name for cytopoint is???

 

[PippyPony]

okay but my favorite is lokivetmab. Why does nobody talk about how hilarious the name for cytopoint is???

It sounds like they took two magic fairy names and stuck "vet" in the middle of it

 

[JustPaws]

Ok but like

Oclacitinib

Which I know we were already talking about Apoquel but it's drug name is my absolute favourite to mispronounce. Pretty sure they just named it by rolling around on the keyboard for a bit

Maybe a cat walked on the keyboard and the drug designer shrugged and said hey why not.

 

[SARdoghandler]

Though Plumb's says it is OK-la-SIT-ti-nib

I say oh-klack-it-in-ib and no one will ever convince me otherwise.

Maybe a cat walked on the keyboard and the drug designer shrugged and said hey why not.

#truth

 

[capri1722]

But let’s discuss levetiracetam pronunciation. People often have strong opinions as to whether it’s leve-tier-A$$-uh-tam or leve-tier-uh-CEE-tum. And cefazolin...See-fa-ZOH-lin or suh-FAZ-oh-lin.

Def say it with the booty. Or I tell patients to pronounce it as "generic Keppra."
And seh-FAZ-oh-lin.

Ok but like

Oclacitinib

Which I know we were already talking about Apoquel but it's drug name is my absolute favourite to mispronounce. Pretty sure they just named it by rolling around on the keyboard for a bit

I feel like oncology last semester made me really confident in pronouncing a lot of these newer biologics because I got that one immediately.

Spoiler: Also, relevant

I really appreciate that the person who made this video used real drug names.

Of course it also says keppra is lee-ve-tye-RA-see-tam and that just seems wrong

Ok, whether you say it as levetirASSetam or levetiraSEEtam, I think we can all agree that lee-ve-tye-RA-see-tam is wrong. I even tried to say it out loud to myself and I couldn't do it.

 

[Viscernable]

had to read this about 20 times and am still 50% convinced it was a mistake and I’ll have a very embarrassed follow up email to send after my acceptance

 

[supershorty]

I get to start a new, hopefully long-term therapy aimed at getting me in remission today! Yay!

But holy moly, these pills are HUGE and I'm terrified.

Spoiler: I have tiny hands, but STILL

Edited to update that the panic attack that preceded taking the first pill (I have to take 4) was worse than the actual pills lol I'm a baby

 

[b3gintw1ntig]

I've struggled with imposter syndrome super hard all year, and throughout vet school. I'm currently applying to lab animal residencies and have actually gotten quite a few interviews, and second interviews, that seem to be going well. I have a long way to go but like...these programs actually want me to go be a resident there. That feeling is indescribable. I've felt so undeserving the past 4 years and to feel validated now is everything. I don't post here much at all but it felt nice to write this out.

 

[genny]

I might be going to ExoticsCon this year, covid permitting!

 

[WildZoo]

I might be going to ExoticsCon this year, covid permitting!

OMG ME TOO

 

[JaynaAli]

ME THREE (but only if I don’t get my first choice of acvim...exoticscon was my #2 choice)

 

[battie]

We have a phenomenal surgical resident. I was called in Tuesday night at 7:30 and didn't leave till 1:45. During surgery, I struggle bussed with instruments, keep sterility (straight up ripped my gown -_-). Just a lot of struggle. The resident was cool.

I then wrote the surgery report on 4 hours of sleep. Just looked it up. And it was almost perfect. So close. <3 The resident said i did well.

Made me feel good after how much I struggled.

 

[ajs513]

Back at the end of last semester I was invited to give an oral presentation at the AASV symposium (swine things) which I was super excited about. It comes with a stipend and the potential to win a scholarship. Then the symposium got moved online. Then they pushed the due date up by an entire month, which took off a lot of time for me to work on my presentation. But I got it done.

I read the directions for my presentation and I thought that I was supposed to record it and upload it to the speaker portal. So I did that last weekend. Then I get an email Wednesday saying I actually am supposed to present live over Zoom for a panel of judges... on Saturday. Which is today. So I freaked out. A lot. Not to mention I had gotten my second covid vaccine yesterday and was fully expecting to wake up feeling like absolutely death and just sleep all day.

This morning I woke up and feel perfectly fine. A sore arm, but no worse than the first dose. I got dressed in my suit and prepared a little for the presentation. I gave it a little bit ago and I think it went great! I was a bit nervous for the first minute but quickly caught my breath and calmed down. I don’t think I spoke overly fast as I usually do, and they only asked three questions. I had prepared for questions beforehand, and I was able to answer all of them to a degree that I think was satisfactory. So now I wait until March 1st to see how I did. I’m just so glad it’s done and that I didn’t screw it up.

 

[Doggo Labs]

Back at the end of last semester I was invited to give an oral presentation at the AASV symposium (swine things) which I was super excited about. It comes with a stipend and the potential to win a scholarship. Then the symposium got moved online. Then they pushed the due date up by an entire month, which took off a lot of time for me to work on my presentation. But I got it done.

I read the directions for my presentation and I thought that I was supposed to record it and upload it to the speaker portal. So I did that last weekend. Then I get an email Wednesday saying I actually am supposed to present live over Zoom for a panel of judges... on Saturday. Which is today. So I freaked out. A lot. Not to mention I had gotten my second covid vaccine yesterday and was fully expecting to wake up feeling like absolutely death and just sleep all day.

This morning I woke up and feel perfectly fine. A sore arm, but no worse than the first dose. I got dressed in my suit and prepared a little for the presentation. I gave it a little bit ago and I think it went great! I was a bit nervous for the first minute but quickly caught my breath and calmed down. I don’t think I spoke overly fast as I usually do, and they only asked three questions. I had prepared for questions beforehand, and I was able to answer all of them to a degree that I think was satisfactory. So now I wait until March 1st to see how I did. I’m just so glad it’s done and that I didn’t screw it up.

Hey I’m giving mine in about two hours!! I was defs not happy with the whole online thing, but hopefully it goes well. Glad it went well for you!

What was your presentation on?

 

[ajs513]

Hey I’m giving mine in about two hours!! I was defs not happy with the whole online thing, but hopefully it goes well. Glad it went well for you!

What was your presentation on?

Congrats! Mine was on a method for measuring lameness in sows.

To put you at ease a bit, it’s super well run. You go into a main room five minutes before your presentation, make sure all your stuff works, then you go into a breakout room and set up. Then the judges join the room, you get introduced, and you start. Super simple.

 

[Doggo Labs]

Congrats! Mine was on a method for measuring lameness in sows.

To put you at ease a bit, it’s super well run. You go into a main room five minutes before your presentation, make sure all your stuff works, then you go into a breakout room and set up. Then the judges join the room, you get introduced, and you start. Super simple.

Thanks! Mine is on different anesthetic combinations.

That sounds easy enough. I’m glad I reread the times cause I thought they were in CST not EST...

 

[PippyPony]

Thanks! Mine is on different anesthetic combinations.

That sounds easy enough. I’m glad I reread the times cause I thought they were in CST not EST...

Is there a way for me to see this? I'm very interested in the topic!

 

[Doggo Labs]

Is there a way for me to see this? I'm very interested in the topic!

I might be able to send you a link to the video, or send you my presentation. The AASV judges are the ones recording it, but I can ask for the recording. I’ll let you know more when I know.

 

[ajs513]

I might be able to send you a link to the video, or send you my presentation. The AASV judges are the ones recording it, but I can ask for the recording. I’ll let you know more when I know.

Looks like you’re up! Break a leg (and then I’ll assess you for lameness using my new method)

 

[Doggo Labs]

Looks like you’re up! Break a leg (and then I’ll assess you for lameness using my new method)

Thanks!

It did not go well... but that’s okay, I was not expecting it to go well either.

I can’t wait to hear about this new lameness method!

 

[ajs513]

Thanks!

It did not go well... but that’s okay, I was not expecting it to go well either.

I can’t wait to hear about this new lameness method!

It’s not easy doing research, writing it up, and presenting it virtually in these times. The fact that you took this past year and did something with it in and of itself is awesome. I’m glad you got the chance to present today.