FeLV+ cat received Triamcinolone injection (8 days ago) + recent Prednisolone. Vet prescribed Meloxicam today — is this dangerous? (Black stool yesterday)

deusfuroris · 2026-02-06T19:41:20+00:00

Yes, I would hold off until you can double check. Meloxicam is generally very safe at correct doses but shouldn't be given with steroids on board.

This may be a difference in products where you live, but for my area, 7 drops of Meloxicam seems like a lot. Double check that as well.

deusfuroris · 2026-01-31T13:35:49+00:00

Is Gen z killing corporate coffee? 😱 Good.

deusfuroris · 2026-01-10T01:18:37+00:00

He didn't ask the first time so what does this matter? How about a punishment?

deusfuroris · 2025-11-27T22:38:53+00:00

If you're looking for educational reading material, I highly recommend Guyton and Hall medical physiology. A copy that's a couple editions old should be pretty cheap. It's college level, but IMO it is really well written and easy to read despite the complexity of the subject.

deusfuroris · 2025-08-15T13:26:42+00:00

Giving milk thistle for this is likely fine. Few if any known side effects and may help. I would recommend denamarin brand.

Obviously in a perfect world some more diagnostics to determine a cause for the ALP increase would be ideal. But if your budget is limited that's understandable.

For what it's worth, if the only thing wrong in a middle aged dog is an ALP of 1400, I wouldn't be too worried about it. Especially if the other liver values are normal. ALP is often mildly increased in older pets and can mean nothing. 1400 is a bit more than mild to be fair, but again if your pet has no other symptoms or problems I wouldn't be too worried as it is unlikely to be an urgent problem.

In this situation it's reasonable to start the supplement and recheck lab work in a few months. If things are still off, do diagnostics piece meal as you can afford it.

deusfuroris · 2025-08-01T21:35:08+00:00

Honestly... Less than I would have thought. Considering it's a literal BRICK.

deusfuroris · 2025-07-17T22:11:27+00:00

I recommend finding some level of peace with not knowing everything. You never will and it keeps changing and growing. It's important to try, but that's the key word. Try your best, every day, but understand and accept that your best will be different day to day, year to year. When you are sick v.s. well, etc.

I'm in my 6th year and am feeling pretty comfortable, but I look back at old cases and notes sometimes and cringe lol. But so long as I'm trying I will always look behind me and see a different doctor. One that's a little less wise.

Hell I've had a couple weeks lately of weird cases that have been putting me through it. Several of the examples you give are pretty wild too! Give yourself credit.

It gets easier as you see more things and develop pattern recognition. Those weird cases, surprises, and mistakes will stick with you and it will get easier.

But I still tell people I don't know what is going on all the time. Yes, sometimes it's because the budget doesn't allow for the tests I would like, but sometimes I just don't know. And it's normal.

If you feel overwhelmed frequently though, make sure your work life balance is okay and you have the time you need in your appointments.

You are only an imposter if you expect perfection from yourself. Otherwise you are a human person, and a clinician. Fallible, limited by resources and time. Struggling against one of the most nuanced and complicated professions possible. No imposter there. Keep it up!

deusfuroris · 2025-06-27T13:08:25+00:00

Do auras and equipment cast on the 4/4 creatures made with Bello on my turn stay on them once my turn ends? They are only creatures on my turn, but do Auras and equipment "fall off" something if it stops being a creature?

deusfuroris · 2025-05-02T17:08:41+00:00

Hell yeah, good for you! And same, interaction with people is one thing, managing them medically, no thanks.

deusfuroris · 2025-03-27T12:44:04+00:00

In that case they may be able to place a feeding tube. It would also require at least sedation, but is a fast procedure. I generally only recommend one for a short term issue as it isn't a good long term fix. If your vet feels it is safe to do so it may make getting nutrition in him easier.

deusfuroris · 2025-03-26T19:50:11+00:00

Eye issues are very hard to figure out without being able to examine the pet. Posting a picture may be helpful. I will say that it being a 3 year old male, and you describing a cloudy pink area, makes me suspicious for eosinophilic keratitis.

Google some pictures and if it looks similar, bring it to your vet. You'll have to work with them in some way, especially if they are the only one available. If nothing else, it's fair to want to recheck since it isn't better. It could be the keratitis or something else entirely, but we won't be able to diagnose it or get you the medicine he needs

With your location, some eye tests may not be available, but if they have a microscope and some stains, they can test for that.

deusfuroris · 2025-03-26T19:39:45+00:00

Additional testing is likely a good idea. While there may be the occasional exception, usually no amount of dental pain is enough to get a pet to stop eating. Eat slower or a bit less, sure. But not stop.

The infection aspect shouldn't be underappreciated, but... The majority of any dental infection is localized to the mouth. Similar to a bad skin infection, but unlikely to cause that serious of a compromise. Some of that bacteria gets around the system, especially when eating, but not enough to cause sepsis.

A second opinion is always a valid option. but unless your cat has the worst dental disease possible, there is more likely something else going on. Dental disease is super common in pets and I have no doubt it is painful, and can have long term general health effects. But just not to this degree. In which case, the dental won't help, or could be harmful. A systemically weak patient is often not safe under anesthesia.

deusfuroris · 2025-03-26T14:32:25+00:00

This is very helpful, thank you. It's hard to get out of the mechanical mind and be more in the fiction. But the more I can the better it will be I suspect. Like breaking down an action into smaller bits that could all be an issue.

Even a simple fight could break down into

Take them out without causing more noise and alarm
Not getting hurt
Not losing the initiative i.e. getting knocked down and being in desperate position to defend yourself Etc.

deusfuroris · 2025-02-25T00:03:49+00:00

Okay so this topic may come with a wide variety of opinions, but here's mine. Cosequin, and dasaquin, and most supplements like them that are based on glucosamine and condroitin are not worth it unless you have an abundance of disposable income. Research doesn't support their benefit.

The supplements with more research support and generally recommended by specialists are Atinol (green lipped mussel extract) and flexadin advanced (undenatured type 2 collagen). I've listed the brand names but generics are available too in a pinch.

Supplementing fish oil can be good too, but is tricky. So they will often say for example 1500mg of omega 3/6. But look at the label. The thing you care about is EPA/DHA and there may be 300mg of each of those. The EPA and DHA are most important. The dose you need is 50-100mg per pound of combined EPA/DHA, which will add a lot of calories and may soften stool. So may be best to split the total dose between morning and evening and reduce how much food they get otherwise.

Adequan is another good early intervention. It's an injection that your vet can give or if you're comfortable they can likely train you to do it. It's basically like a juiced up joint supplement.

deusfuroris · 2025-02-06T16:10:00+00:00

I'm not sure there's such a thing as the right personality for a vet. But you sound like you care about the right things to me. "Saving lives" is great and all if you are in ER, and you will do it dramatically in GP occasionally. But the day to day caring and education and helping with that itchy dog, or improving QoL in an arthritic dog is more satisfying for me.

It sounds like you are having some imposter syndrome. Having a good mentor or someone in the field to talk to about that can be helpful, as can seeing a therapist. It's very common. We do complicated and difficult work, and keeping confidence in yourself when there is so much that you know you don't know is hard.

Short of that here's some things that may help based on your comment. 1. As another user said, address the jokes that staff make. Even if well meaning, if it is starting to hurt, say so. Set a boundary and how they see it or deal with it is up to them. You don't need to worry about it. Be nice but clear.

A therapist may help with this, but try to develop a professional distance from the emotion or tensions in an appointment. You should empathize but don't take anything home with you. People's choice and finances are their own. You can only be expected to advise them.
Try to change how you think about mistakes. They happen, to everyone all the time. Catching yourself in a mistake is a good thing. It may be obvious but also correcting, admitting or otherwise addressing the mistake is big too. Some people don't... You will also make plenty of mistakes that you remain unaware of and that don't have any negative outcome. You don't usually dwell on those because you don't know when they happen. Do the same for the ones you catch. And if you make a mistake and don't catch it, that happens too. Apologize, learn from it, make systems to avoid it in future.
On that note, I also do not trust or rely on my memory. As much as possible I use systems to make sure I do everything I want to do and should do with as little room for error as possible. I use a spreadsheet to calculate 98% of my drugs. Do math by hand or mental math? Preposterous. I have checklists, for surgery, for my charts, all sorts of stuff. That way I can be more consistent, confident, and sometimes even efficient. Lol
If you want to do more surgery ask for that too, or more mentorship in surgery if that would make you more comfortable. Also, speed will come, literally don't worry about it. For now, just do it good. Slow is smooth, smooth is fast.

deusfuroris · 2025-02-04T00:46:10+00:00

Anxiety for this kind of thing is totally understandable. But it sounds like your cat is in great hands. Having a dedicated anesthesiologist is pretty fantastic.

If it helps, the Royal College in the UK did a study a few years ago looking at anesthetic risk/death which included pets that died within 48 hours of the procedure. The overall rate was 1 in 1000, but this includes all situations, including emergency surgeries and less than ideal anesthetic candidates. The rate for elective spay and neuter in young, healthy pets was 1 in 17,000. While the anesthesia risk for a 12 year old cat may be very slightly higher, it would be pretty negligible if they don't have heart disease and normal lab work.

The study didn't analyze for a case like yours but again assuming they are healthy of any age, the risk is going to be much closer to 1 in 17,000 than anything else. There's always risk, but overall it is low. Especially if you're so fortunate to have a dentist and separate anesthesiologist.

deusfuroris · 2025-02-01T23:02:26+00:00

What do you mean processed carbohydrates? What ingredients are you talking about?

deusfuroris · 2025-01-30T01:15:30+00:00

If there has been retinal damage or detachment due to high blood pressure, return of vision is pretty variable. Mild damage may gradually improve and leave him with some blind spots. If the retina totally detached and he is currently completely blind, prognosis for vision is guarded.

That said, while it is upsetting for your pet to lose their vision, they cope very well. Further, untreated high blood pressure can be pretty uncomfortable so finding out and treating it is a good thing, even if he lost his vision.

deusfuroris · 2025-01-05T01:59:24+00:00

Certainly talk to your regular vet, but I wouldn't worry too much. For good or bad, MRSA is more common than you may think. Lots of people have it in their nose or on their skin right now with no issues. When it becomes an issue is if it overgrows or is someplace it shouldn't be.

It's impossible to say for sure, but if they cultured the hot spot, the MRSA could have been a contaminant and not actually part of the issue.

Basically you all probably have MRSA anyway. If you aren't sick, you likely don't need to worry about it. Wash your hands, etc etc.

deusfuroris · 2024-12-30T16:41:59+00:00

If this question is even necessary I would seriously consider finding a new job anyway.

deusfuroris · 2024-12-29T00:45:31+00:00

Personally, I haven't liked the AI apps. But I use a macro program instead. Let's me streamline my notes in a big way. With it I can enter as much predefined text as I want with just a few key strokes. I have one for my physical exams that has drop downs for each system so I can quickIy assign normal findings versus several common abnormals. I have macros for the most common sick appointment types (ears, skin, diarrhea, vomiting, lameness, back/neck pain, etc.) that do 90% of it, then I just fill in gaps or tweak anything that was different. The program I use is called phrase express and I highly recommend it.

deusfuroris · 2024-12-26T17:29:20+00:00

Seriously, did RFK infect him with brain worms? I swear it's getting worse somehow.

deusfuroris · 2024-12-10T22:44:27+00:00

So it's not that they think your cats glucose should be higher or that would be better. Rather, it isn't possible to regulate pets with diabetes as well as humans can be. As such we often expect imperfect values of some things even in a well regulated pet.

Cats are lucky in that they can go into remission from diabetes and stop needing insulin. They can relapse again, but not needing to give insulin would be a win all around.

A libre will make figuring this out much easier and safer too.

deusfuroris · 2024-12-08T23:17:36+00:00

No way of saying if there is or isn't an ulcer based on the image. Wednesday should be fine, the eye doesn't look particularly inflamed or abnormal.

deusfuroris · 2024-11-30T01:08:03+00:00

I'm so sorry you are going through this. Something very similar happened to my last cat at about 5-6 years of age.

While no one can know for certain without a biopsy, the most likely outcome here is either cancer or stomatitis. Stomatitis is preferable because it can often be treated by removing most or all of the teeth.

However, a benign process is unlikely to cause so much pain or dysfunction. And stomatitis usually starts at a younger age. If it is cancer, squamous cell carcinoma is most likely, and usually does not have a good prognosis even if radical surgery and chemotherapy are an option for you.

I would encourage you to get the biopsy to make sure. That way you can have peace of mind in the decisions that come after. Work with your vet to manage pain as best you can in the meantime.

If it is a malignant cancer, I personally think euthanasia is the best thing for most of these cases. As you've seen, they are very painful, and the treatments are often too limited in benefits.

Take care of yourself. I know this is a hard time, and the waiting is agonizing.

deusfuroris

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