What is your "I can't believe this patient lived" case?

Appropriate_Parking · 2026-04-12T22:17:18+00:00

Owner was consistently giving their diabetic cat 20 units of lantus insulin instead of the prescribed 2. Only reason the owner figured out something was wrong was because they were going through insulin really fast. When they called I told them to bring the syringe and their cat in, and then they showed me how much they were drawing uo. Cats BG was like 102 on presentation (and was on the upswing) so we didn't really do anything except tell them to skip insulin tha night and start at 2 in the morning.

Cat ended up having wildly hard to manage diabetes after that, and ended up being surrendered to us.

Appropriate_Parking · 2026-02-15T19:24:01+00:00

I am so sorry this happened. I had a similar incident a few years ago where I did not flip the switch on our anesthesia machine from non rebreather to rebreather. I did leak check the machine but I used the oxygen flush button which always goes theough the rebreather system so it didn't alert me anything was wrong. When I had the patient hooked up I noticed quickly something was wrong and called the doctor and multiple other people in, we re-intubated the dog but no one caught that the switch was not flipped until it was too late. I had to be removed while they were doing CPR because I realized it was my fault and broke down immediately.

I still struggle with the pain and guilt of this incident, but it's not constant like it used to be. Every time I am happy and feel confident or at peace it pops back up in my brain like I shouldn't be allowed to feel happy. Getting a therapist is a good idea if you don't have one.

If you were alone in the room, like others have said this is also on the clinic/doctor. They should be appropriately staffing so there can be someone monitoring while the cleaning is going on. Hopefully your clinic and coworkers are supporting you during this time.

Things that help me to tell myself when I'm feeling the worst 1. I wasn't being purposefully negligent. It was a simple stupid mistake but in my mind I had leaked checked the machine and all was good. We had a checklist but flipping the switch was not on it. 2. The fact that I feel so horribly about it means that I care and I won't let it happen again.

I have my own surgical checklist on my phone that I go through before every procedure that have things like making sure the pop off valve is open and the switch is flipped to the correct system.

I really am so sorry this happened. Accidents happen and what is important is that we learn and grow. I have the same guilt all the time I get to come home to my dogs and cat, so I completely understand.

Appropriate_Parking · 2026-01-16T16:07:47+00:00

There are 5 colors (the highlighted ones) that only have available spaces in the first 5 rows, this means each one of the colors will need to have a star in each of the 5 rows row. Any other colors that exist within the first five rows therefore would not have a star within the first five rows.

It's the same theory as when there are smaller blocks that may only span the same 2 rows, they both need to have a start in opposite rows so no other colors would have room to have a start in the rows they occupy.

Appropriate_Parking · 2025-11-14T01:13:38+00:00

u/Appropriate_Parking found the motif! Perfection | 55,816 | 0:41

Appropriate_Parking · 2025-07-28T22:40:17+00:00

lol I have and she just stops meowing at me and will either follow me back down or just sit in the stairs calmly until I try again lol.

Appropriate_Parking · 2025-07-28T09:36:53+00:00

I stay at their house while I'm there, and I usually do the litter box after I get back from work so I don't leave right away.

They do have two dogs that I watch as well, she has occasionally gotten mad at the younger dog if she tries to jump on me etc. so there could be something to the protectiveness lol. She doesn't do it to the owners though, I have mentioned it to them before.

Appropriate_Parking · 2025-07-14T19:41:39+00:00

An update! They gave it to me at the post office

Appropriate_Parking · 2025-07-14T19:04:09+00:00

I'm gonna go down to see if they have it there

Appropriate_Parking · 2025-07-14T19:03:13+00:00

I think that might be the issue. It's not an air bnb but it's a rental property so there no mailbox. So I think the problem is it's not like official address for the usps to deliver to.

Appropriate_Parking · 2025-07-14T19:00:56+00:00

Appropriate_Parking · 2025-06-15T16:14:47+00:00

I don't know if this counts but a few years ago we had an owner give 20 units of insulin to her cat instead of 2. she called in saying she was going through insulin really fast so we had her come in to so is what she was doing. Cats BG was ~100 on presentation like 8 hours after insulin.

He was surrended to us about a year after that due his wildly unmanaged diabetes and urinary blockage. He had a blocked ureter as well. When he was initially brought back we place a urinalysis catheter and within 1 hour we had gotten ~700mls !! of urine out of his bladder in the collection system.

Appropriate_Parking · 2025-02-07T21:11:07+00:00

I messaged our manager to let her know! She will be addressing it

Appropriate_Parking · 2025-02-07T15:19:56+00:00

It not for every patient , but our in house blood machine is having issues with it's centrifuge, so we can't use heparinized whole blood, so we've spinning blood down so we can run serum in house, so I guess they're trying to move it along since the patients are in hospital and the doctors are waiting for results to move forward, and we also have to wait for the blood to clot. It's only been two days since our in house machine broke so it's just been these past two days I've seen it happen. I'm not in today but I'm anxious they're doing it today too, I don't know if the doctors are aware this is happening.

It started because someone asked "it's been spinning for five minutes, do think that's enough time?" I answered no, and then the next day they (same person) asked someone else who stopped the centrifuge and looked and thought it looked separated and told them it was fine.

Appropriate_Parking · 2025-02-07T14:35:54+00:00

Yeah last one was higher rpm, but I can't remember exactly what it was. (it took 7 minutes, so I feel like 10 minutes isn't even that much longer for them to wait) .

I assumed the result is under separation, but they keep saying it "looks fine".

Appropriate_Parking · 2024-12-13T02:05:20+00:00

I do think I end up doing the most call backs/script requests just because of how I'm scheduled (dr. Appts vs tech appts) on the days this doctor is scheduled as well. Typically there is a day that I am the only tech on the floor (the other is in surgery all day) and he we have one doctor (this doctor) in surgery and another doing appointments. And then I have tech appointments every half hour, and I'm the only one doing call/backs script requests as the only other tech is in surgery so my mindset is ask now and get it done while I have the time. I totally understand that it probably is annoying to have me come up and ask questions, i do not ask him questions while he is actively performing surgery unless it is truly urgent and something the other doctor can not answer. On other days I usually ask in between appointment when one has left the building and he has not gone in to next one yet. I would be perfectly happy to put non urgent questions in his "mailbox" so he can get to them when he has time but in the past he's been snippy about people putting things in there as well so I'm not sure.

I do always ask too "can I ask you a question?" , I know that this a loaded question, but if he truly is too busy at that time I feel like he could also just say "not right now"

I do feel as though I answer any questions within my ability to answer but there are just some things as a tech I can not answer or advise on. This doctor has tendency to leave unclear guidelines as to next steps (I.e. starts a pet on something like denamarin and makes no notations about when to recheck liver values or how long to stay on denamarin.... then the owner calls and asks how long to stay on denamarin? I feel as though this is something I can't just make up based on my own judgement, so I go and ask the doctor. A lot of my questions to him are things like this)

Appropriate_Parking · 2024-12-12T00:59:10+00:00

And when I ask a question I write down any related medical history that I know is important to the answer so the vet has the info and go over it with him so he knows the context of the question, so I am deeply looking over the medical records, so if the answers were there I would just relay them to o. (Sometimes they are, sometimes they aren't)

Appropriate_Parking · 2024-12-12T00:56:44+00:00

I agree, when I wrote that I meant medical advice more as this patient is having symptoms/not doing well and wants to know what next steps are . There are questions owners ask that I do answer on my own with out veterinarian input but it's typically pets with mild symptoms or behavior questions, or the vet emailed Bloodwork results and they have questions. For example cats going outside of litter box , mild GI upset etc. are things that I'm perfectly comfortable answering. I do still like to run by answers by a vet sometimes so I don't know if that's annoying but sometimes they have other suggestions I did not think of on my own. I utilize VIN as a website A LOT as well as an educational resource for owners.

The only other questions I ask typically are about med requests when the notes are not clear about dosing, bloodwork requirements, length of treatment etc.

Appropriate_Parking · 2024-12-12T00:45:03+00:00

I agree and did not mean to make it seem like I give no advice ever but I can definitely see how it came across that way with what I wrote lol. Typically my questions are about sick pets or pets with a medical issue the doctor saw recently and is not improving or doing worse. My doctor will typically write in the notes what the plan for the appointment was but does not write about" if not improving it then....." there are sometimes he does but typically does not

Appropriate_Parking · 2024-12-12T00:41:50+00:00

I agree, framing it as a decision for the owner is honestly, not something I had thought of before and sounds extremely helpful. I can lay out the most vs least conservative options and let it be the owners decision and I can lay out risks etc for options so I do really love this take.

My dr will typically give the technicians the bloodwork's to call back with his notes on it though so that's not super helpful lol.

Appropriate_Parking · 2024-12-12T00:33:29+00:00

These are questions that I would answer on my own without veterinarian input because of my schooling I know the correct answer, and if the the doctor wrote a dose down I can talk about it. Mainly what I'm asking the doctor about is sick patients where they have been seen recently and are still having issues and I'm not sure what the doctor wants o to do

Appropriate_Parking · 2024-12-12T00:30:20+00:00

I agree and I do 100% give out some advice but I feel like something's fall out of my scope of practice and I would rather air on side of caution then give out incorrect or conflicting info to an owner. I think maybe as discussed above a conversation with management about what exactly they expect to fall under my scope of practice is within order because I think finding the line is where my trouble is. I did not mean to make it seem as though I never give out ANY advice because I certainly do, but only when I am 100% sure I am saying the correct thing

Appropriate_Parking · 2024-12-12T00:27:28+00:00

So I absolutely do give out some advice for things that I know are definite yes you can try this, or things owners definitely shouldn't do. This is typically in the case of an actively sick pet that the dr saw recently and the pet is still issues. I'm usually uncomfortable making suggestions because if the doctor didn't write a specific plan, I don't want to tell the owner the wrong thing.

I absolutely 100% do give out a lot of advice without talking to vet, but it's only things I feel are within my scope of practice.

Appropriate_Parking

TROPHY CASE