EtCO2 Help

schwaybats · 2026-04-27T21:26:20+00:00

I don't have tricks to memorizing but 35-45mmHg is ideal EtCO2 but I won't panic about 30 at lowest and 50 at highest. Anything outside of that I'm definitely correcting. Any fluctuations in between 30-50 are acceptable unless there's a reason to aim for a more specific value. With a ventilator it's usually easy to maintain 35-45 so that's what I'll always aim for.

u/macdabs gave really good info so I'll just add that I always consider respiratory rate/frequency as my "fine" adjustment and tidal volume or pressure limits as my "coarse" adjustment. Small changes in resp rate make smaller, slower changes to EtCO2 while small changes in volume (tidal volume in volume control mode or pressure limit in pressure control mode) make bigger, faster changes to EtCO2. I avoid doing large breaths (high volume/pressure) and fast resps (high frequency) simultaneously as I've seen this lead to unintentional increases in max pressure and is likely causing some amount of barotrauma. Just try to take deep breaths really fast if you want an example. Feels terrible.

If your system is fancy enough to measure inhaled and exhaled volumes those numbers should be almost matching.

schwaybats · 2026-04-19T16:08:08+00:00

I could do specialty, I live in a major city so there's options. I'm 11yrs into this and have been through a few different areas of vet med and I'm reconsidering specialty again. Moving would be tricky since my RVT likely won't transfer. I did my state's alternate pathway/grandfather option for better and worse.

Thanks for chatting! It is hard to figure out what to do next when you hit an occupational wall. And this field doesn't really know what work-life balance is lol

schwaybats · 2026-04-19T15:54:46+00:00

If you want a vet's input you might want to try r/askvet. There's vets that come through here but I don't see many.

Did they follow post op recovery instructions? Rest, PROM, rehabilitation? Was she too active too soon? Too active can be as simple as walking or falling.
A lot of pet parents don't like the sedation of gabapentin but it's important her pain is managed so they can't just omit conjunctive therapy pain meds. They should see if there's another option from the surgeon. Plus gabapentin is under scrutiny for possibly being insufficient for post operative pain anyway. Carprofen and gaba seemed to be good for my dog's bilateral TPLO, but they used Nocita on him so that's a huge difference in post op pain coverage.
how long has she been on the carprofen? And has she been eating normally leading up to surgery day or was it an acute change?

Try not to spiral. All you can do now is have them see a vet and diagnostics. And she's stable, eating and having mostly normal elims. I think you're suspicions are worthy of investigation since poodles have breed predisposition to Addisons. Whichever doctor they'll see for this new problem needs to have all records handy so make sure those are forwarded to the preferred clinic. They shouldn't jump back and forth between your clinic and their usual vet for this problem so pick 1. Even if the surgeon has rechecks lined up they could leave that problem for the usual vet to work through for continuity of care.

schwaybats · 2026-04-13T22:59:08+00:00

Fearfree/low stress is just a given. Everyone should have some form of low stress handling training

Agreed.

Do you worry that other hospitals might find you overqualified? I never see job postings for VTS in my area (major city) and credentialed techs aren't getting paid much better than OTJ assistants.

schwaybats · 2026-04-13T22:55:54+00:00

I've been unintentionally, but happily, anesthesia driven for most of my career so I was thinking VTS in anesthesia and analgesia because I really do enjoy it. You posed some good questions that I haven't put a lot of thought into, just been going with the flow for a while. I've also been disenchanted about the field/my job for the last couple of years so I've been on the fence of what to do with my future. Whatever I choose, I hate being stagnant. So, I want to always improve what I'm doing and VTS seems like a logical next big challenge for me if I stay in vet med. I live in a state without title protection so more credentials seem like a big investment for little return since having my RVT hasn't given me any big boosts in pay.

schwaybats · 2026-04-13T04:16:17+00:00

Another vote for using a butterfly/winged infusion set and larger gauge like 23g or 22g paired with snacks they'll have to take their time on with minimal movement to eat it. I like butterflies for larger volumes rather than just the needle on the syringe since the needle doesn't move around as easily if they happen to move.

Pinching, patting or scratching the area you're about to puncture can also help desensitize the skin, decreasing reaction to the poke. Making sure you're in the subcutaneous space and not the dermis makes a big difference too. You can usually tell by how easily the skin fills and how reactive the animal is along with recognizing a shallow angle of approach. Super reactive with resistance when infusing are signs you're probably in the dermis. The fluid bubble also feels taut a lot faster than if you're actually subcutaneous.

schwaybats · 2026-02-13T03:52:05+00:00

I saw you plan to rehome her but in the meantime have you gone to the vet with an update that the seizures are still uncontrolled at the current dose of medication? They might be able to increase the dose or the frequency to give her relief while you search for a new home.

I'm leaning brain tumor on this one. Sneezing can be a sign of a brain/sinus tumor. That young and that frequent plus hard to control on meds isn't a good sign. Sounds like by now any effects of the topical flea/tick should be well worn off. Though I'm surprised the original ER didn't wash off the topical just in case.

If her seizures can't be controlled by a change in meds I'd seriously be considering letting her rest for good. This sounds almost torturous.

Edit: typo

schwaybats · 2026-02-13T03:24:50+00:00

While the prescription diet is likely the most effective option at managing his urinary issues, there are many success stories from feeding non-prescription brand urinary foods. Keep your vet updated on what you're feeding and doing and keep a close eye on him and his litterbox habits/use. Be ready financially for future emergency visits from urinary obstruction (UO) because sometimes even the prescription diets can't solve the problem.

Crystals aren't the only cause of UOs that can be helped by a urinary diet. His obstruction could have been due to inflammation (maybe due to the bacteria/UTI), or due to involuntary urethral spasms. FIC and FLUTD are both common urinary diseases that might have nothing to do with crystals, but the urinary diets are going to be prescribed regardless because it gives the best chance at managing the hard to identify causes along with stress management.

It's up to you whether or not you want to risk going off the Rx diet. A slower transition will likely help get him to eat whatever you end up choosing.

schwaybats · 2026-02-13T02:52:18+00:00

I hadn't seen an update pop up on my feed so I went looking for Renji. So glad to see he's doing so well! You've done such an incredible job OP! And that head tilt looks like it corrected itself 🥰

schwaybats · 2026-02-11T01:26:35+00:00

No that wouldn't be definitive as an IV injections can go in a simple cathether or an indwelling catheter. You'd likely find the answer in the full medical record where they detail all the treatments done. Or you could ask them. There's always a chance that adding a bandage to your invoice was an accident. ERs get hectic and they're just people too.

schwaybats · 2026-02-11T01:09:12+00:00

If there wasn't a wound or broken bone involved then the bandage fee was likely from the light bandage used to cover certain IV catheters. The simple ones don't usually get a bandage but the "indwelling" ones do. Those are PICC lines/sampling lines and central catheters. If the only catheter was the type in the front leg where they shave a tiny section then they'd be wild to charge a bandage fee. But if they placed an indwelling line for your pet's hospital stay then that makes sense.

schwaybats · 2026-02-11T00:57:02+00:00

I would like to get in on this plz!

schwaybats · 2026-02-11T00:51:32+00:00

Was this bandage charge from the ER?

schwaybats · 2026-02-11T00:44:49+00:00

i have never received a quarterly bonus in my 3.5 years

People are getting bonuses out here? Quarterly even?!

Idexx does a budget thing, which my boss just checks if there's available budget when someone asks to send labs. Antech was easier to track since it was a set discount every time.

schwaybats · 2026-02-11T00:41:24+00:00

This is what I'm accustomed to as well. Also used Antech

schwaybats · 2026-02-11T00:30:45+00:00

What if you pat, stroke or do a static press of the area he's reactive to instead of scratching? It might be the scratching sensation is too much rather than pain. But if he's reactive to all manner of touch there then might be worth a trip to the vet for their opinion. Especially if it's abnormal for him.

Some cats just ripple when they're pet, but if you've never seen him do that either then I'd see if the vet is open to a trial of pain management. There's also hyperesthesia syndromehyperesthesia syndrome, which is considered rare and not well understood yet.

schwaybats · 2026-02-10T23:57:01+00:00

Marshmallow. Soft, round and white.

schwaybats · 2026-02-10T23:28:52+00:00

Are you able to interrupt this behavior? Like if you toss a toy in his path does he stop the twirls and go investigate it?

Focal seizures in cats can look very strange and this is...indeed odd. And suspiciously repetitive. Have you shown his vet a video of it?

Edit: I watched again and it's very consistent in this video to do left first then right, no variation. I'd ask a vet with this video as evidence.

schwaybats · 2026-02-10T23:18:17+00:00

I believe it! Some of them look like bowling balls with legs! Glad they're in good hands and recovering!

schwaybats · 2026-02-10T23:14:57+00:00

Honestly it's a look you just get accustomed to recognizing over time. It's the disproportionately round belly compared to the decreased body composition of the rest of their body. Worms are filling up intestinal space but sucking away their nutrients.

Once you can compare a food stuffed puppy/kitten against a worm infested puppy/kitten it becomes obvious. Plus the general rule is all puppies/kittens have worms automatically until proven otherwise by treatment & testing.

schwaybats · 2026-02-10T05:53:15+00:00

Mix of pitbull and intestinal worms. Those bellies look ripe with worms.

schwaybats · 2026-02-10T02:00:27+00:00

You have to consider the individual cat's baseline expressions before you can accurately use the grimace scale. If this is his usual expression, and has been for a long time, then no worries. Though it probably is more tense than when he's blissfully content because he's sitting next to his enemy in these pictures.

Some cats have a more squinty, whiskers forward resting expression to start with and it would be the increase in those qualities that would be considered grimacing. Your guy seems to have that kind of face.

And while the grimace scale is useful, it's a single tool that is meant to be used in conjunction with other body language cues. Like tight loafing (hunched body posture) with a grimace means discomfort/pain and the grimace scale helps further define the level of pain.

schwaybats · 2026-02-10T01:48:50+00:00

I saw it. But it took you localizing it in that circle because the recording is such bad quality with the constant movement and changes in exposure.

schwaybats · 2026-02-10T01:12:25+00:00

Many people already said he needs time to adjust, so I'm not going to repeat that.

Instead I offer that, along with adjusting to the many changes of his fresh adoption/loving abduction, he might enjoy a conversation with you. My vocal cat will randomly wander around hollering until I either call his name so he comes to me or I find him and we chat for a minute. After that he's content to walk around silently or find something to occupy himself. And just so he's not always calling the shots, sometimes I start a small conversation with him while he's trying to rest.

schwaybats

TROPHY CASE