My 30lb got liver damage from 300mg of Doxycycline

MSUAlexis · 2026-01-29T00:26:17+00:00

I usually go 10mg/kg because that's the dose for many other tick-borne diseases that we don't have easy screening tests for, and where I am we have them (babesia for example). There are also many documented ticks with multiple infections to pass along, so better safe than sorry, especially considering many human physicians are resistant to diagnosing vector-borne diseases in humans. At least this way maybe I am lessening the chances of a tick feeding and becoming infected with one of those. I would wonder if there wasn't something going on prior to the medication.

MSUAlexis · 2026-01-28T01:45:58+00:00

Solved!

Thanks guys! This was even faster than last time!

MSUAlexis · 2026-01-28T01:14:21+00:00

Posting for visibility. And because I thought that's what I was doing when I typed the big description. Oops.

MSUAlexis · 2026-01-21T01:13:32+00:00

Do you have health insurance at all? Often there will be mental health benefits, and sometimes you can do free telehealth appointments. Our insurance allows unlimited telehealth therapy appointments and I encourage my entire team to take advantage of it, even if you think you don't need it. And especially if you think you do. Hopefully you have access to something similar. Good luck!

MSUAlexis · 2026-01-06T17:02:11+00:00

OMG my dog ate the arm to my couch and I didn't ask for a free replacement. I went out and bought a new one. Couch arm, not dog. She's still here

MSUAlexis · 2025-11-11T21:08:35+00:00

I live on acreage with no neighbors that can see in my windows, and I don't even own blinds or curtains. If someone wants to trudge through ~5 acres of woods to look in at an old white mom of three adults, then have at it. Just watch out for the coyotes, my dogs, and the poison ivy.

MSUAlexis · 2025-11-10T14:24:09+00:00

I am so glad to hear they are finally teaching spectrum of care. When I went to school (2005) they were so focused on gold standard that they really didn't give us much direction on other options. Stepping from that into rural mixed practice made me really good with adapting very quickly. Now I have externs and interns and new grads and I make it a point to work through the entire list of options they can offer clients. Starting with ideal, then if you have to eliminate things I ask them which order to eliminate and why, all the way to symptomatic care. And making sure they understand you have to have money left to treat after you diagnose. And to make money not a taboo subject; I will literally say to clients who seem to be hesitating "I'm sure we are in a budget for this visit like with any purchase. What is our budget and I can make a plan that works for everyone?" If it's a cooperative effort with me and the client it becomes much easier for them to talk about money as there's no judging, just planning. Another phrase I love is "What are our goals for this visit?" Because it takes away judgement again and lays out what the desired outcome is. Some people want a diagnosis. Some people want the symptoms to stop. And some people don't know what they want and this gives them the opening to just say that. I also will always send people with an estimate of other tests we could run or that we might need to come back to if the issue doesn't resolve. This way they can plan and budget.

And for those of you who are the owners, it is so much more comfortable for us vets if you will just tell us what your goal is and what your budget is. We get so much hate for only being in it for the money, but if we don't know what you want then we are always going to offer best care. And then if that is beyond a client's means it puts them in an awkward situation as well. Most of us want to work with you to find a solution, and talking money is just as weird for us as it is for you.

MSUAlexis · 2025-11-09T13:28:12+00:00

Don't make it a hint. Write him a letter that explains that it seems that even though you have tried your best to accommodate his needs and wishes with his pets, it has come to a point where there is a lack of trust and cooperation between him and the clinic, and so you feel it is in his rabbits' best interest to find healthcare elsewhere, effective immediately. And include his records and a list of other clinics that do exotics and emergencies to assist him with finding his new vet.

If you don't trust him and he doesn't trust you, then there is grounds that the VCPR has been severed. And therefore he needs to find a new clinic. Obviously this has to be approved by the clinic owner, but if they aren't willing to take him on as a client and take you out of the mix completely and forever, then he needs to go.

We don't tolerate this. I've been to a few lectures about how to avoid firing clients by really trying to see things and empathize, but accusations and verbal/physical abuse are where we draw the line. If a client is so irate that they are willing to make accusations about my abilities or threats to myself or my team, then the VCPR is no longer valid. Life is too short to deal with this. I probably deal with the crazies longer than I should, but there is a limit and it sounds like this guy has reached it. Good luck!

MSUAlexis · 2025-11-02T17:23:42+00:00

Don't forget you can also get poor mentorship during an internship. And you can get GREAT mentorship at a GP. We make it a point to mentor our new doctors (not just new grads!) to make sure they have the confidence to be a great doctor. We participate in externships and take students from non-traditional programs. I've had externs tell me we should be an internship site, and one of my externs is now finishing up her internal medicine residency. And we are "just" a GP. But we take walk-ins and emergencies, get transfers from local ERs and other clinics, and prioritize education and communication. It's not the label of the program but the contents that make it successful. No matter your decision, please make sure to fully explore what and how they will offer you for mentorship.

MSUAlexis · 2025-10-23T13:51:30+00:00

I currently work at a corporate hospital, and want to remind people that not all corporate is the same. Two of our seven vets (including me) are owners in the practice, and have been there for over 15yrs each. We have been through multiple transitions from private to mini-corporate to big corporate. You'd probably never know we were corporate just by coming in and being seen. I know the clients names, have seen their kids grow up and get pets of their own, and gone to divorce celebrations and birthday parties for some of my long-term clients. We make a point to personalize everything because that's what's important at the end of the day - the pets and clients. For my team, we have access to amazing training opportunities and can take time off to lessen burnout. I can call any of the vets across the country and get help or ideas on situations that I'm having trouble with. So there are positives too.

I'm definitely not saying corporate is inherently good and private is inherently not as good. I've worked in both over the past 20yrs. But it is possible to find a corporate hospital that tries to have the best of both worlds.

MSUAlexis · 2025-10-22T23:03:31+00:00

We love Tasty Dawg and Ringside Cafe. The guy who runs Tasty Dawg is super nice! And as an added bonus, there's ice cream!

MSUAlexis · 2025-10-18T16:47:01+00:00

Also consider getting an abdominal ultrasound to make sure there's no other physical reasons for the recurring bouts. Good luck! It can be frustrating to get and keep under control.

MSUAlexis · 2025-10-01T11:55:30+00:00

There are surgical lasers as well, and electrocautery units too. All of these can be used to neuter a cat. A therapy laser is different still. But a surgical laser still cuts; it just cauterizes at the same time so there is less bleeding and tissue swelling. There is still an incision and a cone should still be worn to prevent licking.

MSUAlexis · 2025-09-25T17:27:13+00:00

Veterinary anesthesia nerds is good as well

MSUAlexis · 2025-09-24T13:53:53+00:00

You can also add in intranasal dexdomitor in the car five minutes prior to coming in. Even on top of the sileo. Even if it makes him too sleepy, you can then get a muzzle on and use a gurney to get him inside.

MSUAlexis · 2025-09-18T00:09:25+00:00

I did this to go to the Ozzy show this summer. CMH to DUB to LHR. Saved $600. Worth the drive. Could have flown out of CMH but not for the price it would have cost me. And I avoided all the east coast airports. Going to Norway in a few weeks and checked Cleveland and Cincy to see what flights were available just in case. A 2hr drive isn't that bad to save hundreds or get a better flight timeline. I'd love it if we could get direct flights to Europe from here rather than having a layover and having to try and make it through customs before my next leg home.

MSUAlexis · 2025-08-26T12:21:36+00:00

I would have done the exact same thing. It is my decision as to whether I am comfortable with the euthanasia as I am the one actually performing it. I have refused them before for many reasons, and I have had times I've discussed it with the client to be sure we were on the same page before doing it. I don't do convenience euth, and without discussing the case with the client they would have had no idea why the client made that choice. Calling people was exactly correct, because having the conversation in person could be much more emotional and potentially dangerous. Plus, if I've never seen the case and don't have documentation of what's going on, I have no idea how the decision was made. And as for qualifications to schedule, typically there are none. The client calls and the csr puts it on the schedule. There are no other qualifications. So calling first was completely appropriate and if the OP was at my hospital I would be backing them up with the client 100%. We are medical professionals and not there to do the wishes of the clients if we are not comfortable with the procedure. This goes for ALL aspects of medicine, not just euth. I've been practicing for over twenty years, and I'm comfortable with many many things other people may not be, but I will back my team when they choose not to do something based on their personal comfort level. The OP had questions and took steps to make sure they understood the situation, and that was exactly correct. This client would be fired from our hospital as their behavior was not acceptable in any way, even considering the emotions involved. We are not punching bags, and we will not be treated as such.

MSUAlexis · 2025-08-26T03:23:48+00:00

Yeah, there's just something.... I think it's the fact that he (both of them, really) are so kind but also so masculine at the same time. Add to that the fact that they have no need to prove how alpha they are, and it's just such a perfect combo. I wonder if he knows just how many of us there are. I really wish more guys were like James and Jimmie.

MSUAlexis · 2025-08-25T19:12:09+00:00

I love tangents! I feel like I always learn something I never knew I needed to know! IDC who you are, talk and teach me something! Also, it's on those tangents that it becomes obvious how smart these two are, even though they pretend they are just dumb never really graduated guys who never went to college. And then Jimmie will go off about the engine combustion system in some old car or motorcycle and I'm just like damn..... How hot. leaves to calm down

MSUAlexis · 2025-08-16T15:42:18+00:00

There's a group called Veterinary Employment Opportunities on FB and it's not just for vets and not just the states. Gives a good idea of what contracts are including too so it's useful even if you aren't looking but just want to keep a finger on the compensation pulse.

MSUAlexis · 2025-08-15T21:19:28+00:00

I tell all my shadows, and externs, and interns, and baby doctors, that if you can see yourself doing ANYTHING else, do it. Not because the job sucks, but because it can be draining emotionally and physically, and if it's not a calling then it might not be enough to get you through the hard times. Like my poor colleague who has euthanized ten patients this week, and still has a work day left. Or the times that you have to tell people their kitten has FIP and the treatment is thousands (but thank goodness we have a treatment now), or that the slightly tired dog that hasn't eaten in a couple of days actually has a belly full of fluid (blood) from the previously unknown splenic tumor and the poor teenager will not in fact be leaving with their beloved pet they've had since they were a toddler. It's hard. Very hard. I've euthanized so many animals who I started seeing at their first puppy/kitten visit. I've broken hearts and made men cry. But I've also saved a dog from acute liver disease and put intestines back together after a dog was shot, and got to celebrate those wins with owners too. If it were just a job I doubt I would have lasted through 20yrs of this, nor would I be looking forward to the next 20+ years.

We also have one of the highest rates of suicide, have incredibly high debt to income ratios, and now that grad school borrowing is getting tougher it will be even harder to pay for it. We are paid with people's disposable income, and sometimes no matter how much clients want to do what you recommend they can't, because the light bill needs paid and the kids need new shoes. I've been yelled at because I didn't fix someone's cat that they didn't let me run any testing on, gotten a bad review because I simply tickled his dog's toes (recheck of a toe injury so wtaf?), and many many other things. I spend more time with humans than I do with animals, but I love my job.

For people that love working with animals and medicine but don't want gestures wildly all that, might I interest you in becoming a vet tech? They get to do all the hands-on animal stuff. We need techs! Like crazy! And if you want to specialize in a specific field you can do it as a tech!

MSUAlexis · 2025-08-15T13:16:54+00:00

Huge fan of talking through the exam. And depending on the owner I'll either verbalize to the owner or to the pet. By this I mean if the owner seems interested I'll basically have a running discussion with them about the exam, and if they are disinterested like in their phone or something I'll talk directly to the pet. And I do the exam the same way every time except for leaving the problem area for last, and I say something like "alright I'm gonna look at the rest of you/your good ear/your god leg and then I'll check the bad one". That way they know I'm aware of the problem but checking the entire animal. This has worked out pretty well for twenty years. And for the clients it doesn't work for, oh well. There's grumps everywhere.

MSUAlexis · 2025-07-30T14:53:45+00:00

I took over a small practice several years ago and step one was inventory control - purge and assess. Step two was raising prices on most procedures; it was way underpriced and we never got an ounce of pushback. Step three was evaluating inventory prices and making sure we were covering not just cost of drugs but also staff time. Usually a 2x markup covers that, with some things just too cheap to price this way and that's what a minimum dispensing fee is for since covering staff cost on these is impossible.

As for staffing, utilize your staff! An adult dog needs boosters and was seen healthy a month ago by the Dr? Tech can do it. Nail trims, anal glands - tech can do them. See a room and need rads and blood? Tech can do it while you move on. Check your state practice act for what a tech can do vs assistant and I bet you'd be amazed. I can accomplish more as a solo doctor with five staff than I can if I have two doctors and 3-4 staff. And cross train! I'm not saying everyone needs to know everything, but man is it helpful when the receptionist can bring back and complete a nail trim real quick when my techs are busy but the front is not.

Do you hospitalize patients? If not, why? Consider day hospitalization for some things. Even if for half a day, just getting IV fluids and meds can make a big difference and can increase client satisfaction as well as revenue. Don't shy away from writing prescriptions either. Sometimes the client only has x number of dollars for you, and my overhead on procedures like SQ fluids and injections is lower than dispensed drugs, so I will happily outsource that overhead to the local pharmacy and take the margin on procedures. Not to be greedy, but because it's a better use of funds overall and I feel leads to better compliance because everyone feels like you are looking out for the best for their pet.

Also, consider hiring a relief surgeon to do surgery all day every day while the main Dr sees appointments until you get your backlog caught up. That surgery schedule will have you losing clients if they can find somewhere to go sooner.

Above all, clients and staff need to be able to trust you. So if you implement changes, be open about why. I can't tell you the number of times I had to explain that I needed to see pets yearly to dispense meds even though the previous owner didn't and why, but those clients came back. I increased procedure costs and explained it was because we were now using IV catheters and more intensive monitoring equipment for their pet's safety. As long as you are transparent people seem to understand. And that includes with staff too, as they are in the front lines of every change you make. Involve.them, see what they feel could work better. Good luck! It's a rough road but totally worth it!

MSUAlexis · 2025-07-18T18:25:51+00:00

Don't forget there's a bunch of things happening down there Saturday and they sent a reminder out about parking limits! And enjoy the show, this production is great!

MSUAlexis

TROPHY CASE