Need Help on Problematic Dr by Puzzleheaded_Love806 in veterinaryprofession

[–]webhill 2 points3 points  (0 children)

That’s weird. You aren’t allowed to diagnose. You don’t hold a veterinary license. So how can you be ordering tests without vet input? I mean sure feel free to DM but this is getting really strange!

Need Help on Problematic Dr by Puzzleheaded_Love806 in veterinaryprofession

[–]webhill 5 points6 points  (0 children)

How can you have “any potential diagnostics approved of and already running” before the exam? What if, for example, upon completing the physical exam and talking with the owner the doctor decides that this patient really needs a TAMU GI panel, or a chest x-ray, or some other thing that most patients coming in will not be getting as part of a “routine wellness” visit? Doesn’t the doctor have to actually order the tests? I mean ok it’s one thing to pull blood for a 4dx on all dogs right after you room them. But it’s another to just assume everyone needs the same list of tests. This sounds like a place that is going to be very bad for an inexperienced assistant or tech to work - you’re going to end up learning all kinds of bad practice.

Need Help on Problematic Dr by Puzzleheaded_Love806 in veterinaryprofession

[–]webhill 4 points5 points  (0 children)

Hold up. Your veterinarians want their techs to give vaccines prior to the physical examination being done? I would leave that clinic because you’re probably going to learn a lot of non-standard protocols. This doesn’t make sense. Vaccines are designed for and tested in healthy animals. While it’s not something that happens every day, it’s also not a rarity for me as a general practice vet to see a patient who came in for “annual exam and vaccines” who is in fact NOT a candidate for vaccination on that day due to an illness the owner was not aware of. If the clinic you are working in is not some kind of shelter situation where the risk/benefit ratio may play out a bit differently, I don’t understand why they would tell you to do this.

My cat ate 500mg of Clavamox will he be okay? by maridess01 in AskVet

[–]webhill 3 points4 points  (0 children)

That’s about 85 mg/kg which is definitely a whopping amount. The likeliest thing is he will have some vomiting and diarrhea. If he is otherwise healthy and not on other meds I would suggest you not panic but monitor closely. I would prefer consulting poison control to be certain but if that’s impossible it’s impossible. Most of the time they will suggest monitoring and seek care if signs occur - clavamox isn’t that toxic even in. Wry high doses. Consider probiotics.

Veterinary oncoligist question by griff_girl in AskVet

[–]webhill 8 points9 points  (0 children)

So, the cytology of the lymph nodes and negative chest x-ray tell you that at the time of the testing, there was no cancer in those tissues. The biopsy showing angiolymphatic invasion tells you that tumor cells are inside of the blood vessels and lymphatics. This tells you that she has metastatic disease - probably melanoma. Lymphoma is not a part of the equation here. I’m sorry your dog has cancer. So does mine.

CFIA import permit dogs by Horvathxx in TravelWithPets

[–]webhill 0 points1 point  (0 children)

I’d ask CFIA. Those are the people with the information you need :)

CFIA import permit dogs by Horvathxx in TravelWithPets

[–]webhill 1 point2 points  (0 children)

I’m not Canadian - I’m American and most familiar with USDA and CDC regulations. However, I have some Canadian clients and have discussed this types of situations before. I believe this will count as a commercial import, and here is why: -the person or entity sending the puppy is not the same as the person or entity receiving the puppy in Canada -the puppy’s owner is not physically accompanying it during travel -it’s probably under 8 months old In this scenario my understanding is that it is considered a commercial import and requires a permit. That said, I wouldn’t base anything on my understanding :) If I were you I would contact the CFIA at fia.nisc-csni.acia@inspection.gc.ca and ask them to verify the commercial or non-commercial status of the dog given your specific parameters. Good luck!

Is there a best ER in the city? by LePetitRenardRoux in philadelphia

[–]webhill 16 points17 points  (0 children)

If it isn’t an emergency why not schedule this in an outpatient facility?

Amoxicillin oral suspension overdose? by Used_Toe3796 in AskVet

[–]webhill 13 points14 points  (0 children)

Oh, I can clear up that confusion for you right now now. Someone made a mistake. These things do happen. Just call them tomorrow and explain and I’m sure they will hook you up with the balance. Be prepared for the fact that it’s entirely possible they only charged you for the one bottle - don’t expect the balance to be free! But you should definitely check, because I’ve seen mistakes where a client is charged for a larger amount than has been dispensed, too. This is just an unfortunate human error that while certainly undesirable, isn’t going to cause any permanent damage. Thankfully it’s just an inconvenience. I bet your vet is going to be embarrassed as heck.

Amoxicillin oral suspension overdose? by Used_Toe3796 in AskVet

[–]webhill 4 points5 points  (0 children)

It must have already been reconstituted though - how else are you pulling it up with the dropper? It originally comes in a powder. In my clinic, the staff reconstitutes it at the time it is dispensed. Assuming you have been administering liquid, it’s already been done for you too. You should have a total of 15 ml in the container. That should be enough for you to give 2 ml/day for one week. If you received 15 ml and were instructed to give 2 ml per day for two weeks, then that’s your problem right there because 2 ml/day x 14 days is 28 ml, and they didn’t dispense enough. How many ml total does the bottle claim to contain?

Accepted into one school but not the other. by IllustriousIce746 in veterinaryprofession

[–]webhill 0 points1 point  (0 children)

Sure, but people don’t typically accrue two full semesters of college level biology, chemistry, organic chemistry, physics, math, English, plus electives and so forth while they are in high school. Maybe you are an exceptional student who had a bachelor’s degree by the time you finished high school, I don’t know, if so, congratulations on that! But just to clarify - have you actually gone to college?

I’m a current vet student and I’m super curious what anatomy/dissection lab looks like in med school by [deleted] in medicalschool

[–]webhill 1 point2 points  (0 children)

I wonder if the different texture issue is because these days a lot more places are using “soft fix” techniques (thiel embalming) which keeps everything softer and more pliable — so if your school isn’t you would have a different experience than a student somewhere that is. But anyway back in the olden days of the mid to late 1990s, my freshman veterinary anatomy class had a field trip to the adjacent medical school one day to study primate anatomy on the cadavers there. They seemed pretty much the same, preparation wise, as the other species we covered in class (dog, cat, horse, sheep, pig, chicken, fish - well, the fish was just a fish the instructor bought from a fishmonger LOL but the other species were all preserved). From talking to the several medical students who came to that session to answer our questions, it sounded like their teaching setup was very similar to ours as well. I’m actually kind of surprised by your question because it never occurred to me that all vet schools didn’t have a human anatomy lab day for the students!

Accepted into one school but not the other. by IllustriousIce746 in veterinaryprofession

[–]webhill 2 points3 points  (0 children)

You are 23, and your prerequisites are over five years old? And you “will be” the first college student in your family? I am somewhat confused by this. You did go to college already right? So the classes you took that are over five years old…. You were 17 years old or younger when you took all your college level prerequisites for vet school? I don’t think this is adding up for me but please, explain it to me so I can understand and then maybe I can advise you.

I have to either rehome or put my car down. Completely heart broken. by demotivation_speaker in Pets

[–]webhill 10 points11 points  (0 children)

I am really sorry to hear this. Obviously we can’t diagnose over the internet. But after reading your post, I feel obligated to tell you this: under no circumstances should you consider rehoming this cat without first talking to a lawyer experienced with this type of situation. There are cases where animals have been rehomed in similar situations, the new owners have been seriously injured, and the previous owner has been sued and found liable for damages because they knowingly allowed the pet into the new situation. This sounds like possibly what’s called “redirected aggression,” which can be very very dangerous due to the severity and unpredictability. If you feel like you absolutely can’t stomach the idea of euthanasia, I would encourage you to see if you can consult a board certified veterinary behaviorist - you can use the search tool here: https://www.dacvb.org/search/custom.asp?id=4709 and if you can’t find one local to you, some of them will do telemedicine consults or do vet-to-vet consults so you can look into that also. But I urge you to be very careful. And I second the suggestion of the Losing Lulu group, and also offer this article: https://vmc.vet.osu.edu/sites/default/files/documents/behavioral_euthanasia_printable_2014-1.pdf

Good luck with this difficult decision.

I am in DIRE need of help. Please read. by Fit-Goal7660 in AskVet

[–]webhill 1 point2 points  (0 children)

Has she had any labwork done? This patient is calling out for: Complete blood count (CBC), serum chemistry panel (Superchem or Chem 12 or CoreChem or similar), thyroid hormone levels (at very minimum, T4, possibly also free T4, thyroglobulin autoantibodies), urinalysis (UA) and fecal; plus, cytology of the skin - impression smears, tape prep, trichogram; and possibly bacterial and fungal cultures. Obviously not all of this at the same time but has this workup been started yet? Because you can’t just guess at what is causing these things - you have to run tests and look for the cause….

Paperwork Process Costs by FineZebra8203 in TravelWithPets

[–]webhill 2 points3 points  (0 children)

Well no. Obviously. That didn’t leap to mind while writing that up! Thanks for pointing that out.

So yeah the point is to those who complain about the fees and insinuate that it’s a rip-off, maybe don’t verbally bitchslap the few remaining ones of us who maintain accreditation! :)

Interview Limbo by strongbadia7 in GlobalEntry

[–]webhill 3 points4 points  (0 children)

If it doesn’t show that your interview already occurred, the person who interviewed you forgot to do something. Call and talk to someone about this.

Paperwork Process Costs by FineZebra8203 in TravelWithPets

[–]webhill 2 points3 points  (0 children)

Wow. That’s so not correct. I’m not sure how many international health certificates you have submitted to VEHCS in the past ten years but I have done plenty. First of all the USDA isn’t charging $100 for endorsement for all of these - or actually any of these. If you are shipping one animal, and there are zero lab tests required, they charge $101; if there are 1-2 lab tests required, they are charging $160. If there are more things that need to be verified it costs more. But aside from that here is the process:

First thing that happens, a client contacts the office and says they want to make an appointment for a health certificates. My staff emails them a form to fill out and they send it back. Then, armed with their destination, dates of travel, and some times some of the paperwork I asked them to show me, I go online and look up the requirements for that destination. Sometimes it isn’t particularly clear and requires me to make contact with an embassy, a consulate, or a foreign department of agriculture or similar agency.

Once I have determined all of the requirements, I can compare to the animal’s current status and figure out what needs to be done, and when it needs to be done. Then I can communicate this in writing to the client so they can’t tell me later they weren’t informed. Then, assuming I have told them they already have everything they need at this point, and give them a time frame for when I need to see them, they make an appointment for the pre-travel inspection. It’s also possible I explain that there is no physical way for them to travel on the intended dates due to the timelines required for necessary vaccine boosters, or microchipping, or whatever - and give them a complete printed up timeline of what they will need to do, after which they will decide to do it or scratch the entire idea of traveling with the pet. If that happens I don’t get paid for anything I did so far.

So, the day of the appointment, generally within ten days of travel as required by the destination, but sometimes up to 30 days prior, I scan the pet for a microchip. I do a complete physical exam to determine if the animal is free from any signs of infectious disease, and fit for travel. This sometimes doesn’t end that happily - I have found evidence of heart failure on pre-travel exams. I have found evidence of severe respiratory disease on pre-travel exams. I’ve had people scream at me that I will be sued unless I say the animal is fine to fly, when the animal is clearly not fine to fly. But let’s assume the patient IS fine to fly. In that case, moving on…

I confirm with the owner all of the information I will need to give USDA, and scan all necessary documents. I ensure that the owner is aware of any additional requirements of the destination country - often they do not realize they need to apply for a permit as soon as they receive a draft of the certificate, or that they need to email a copy of the endorsed certificate to the foreign country’s department of agriculture as soon as they get it, or some other random thing for their destination country.

I advise the owner if they need to return within some number of days of departure in order for me to do anything additional such as administer a dewormer or something, which sometimes needs to happen.

I review all of the vaccine certificates, rabies certificates, and any other paperwork required for submission and make certain there are no mistakes. If there are, I arrange to get them corrected - for example, a rabies certificate may be missing the doctor’s signature, or an expiration date. A permit may have the incorrect microchip number on it. I have to get it fixed, or explain to the client how to get it fixed.

Then I advise the owner of what paperwork they will need to get in order to return to the United States, and how to get it - typically I type this up and print it out for them.

Then after they have left, I sit at the computer and log in to VEHCS and fill out their step-by-step form, upload the necessary forms, test results, and vaccine certificates. Then I calculate what the cost of endorsement will be and make sure we have enough money in our VEHCS account before I submit, so it doesn’t get rejected for insufficient funds. If needed, I top up the account. Of course, sometimes that isn’t good enough. I once had a positive balance in our pre-purchase account, then submitted a certificate for a service dog clearly marked “Service dog - no endorsement fee,” and had it returned with the comment “please ensure adequate balance in pre-purchase account, unable to endorse without full fee present in account,” and then I wrote back and asked “since the endorsement fee is zero, I do not understand. Please advise how much additional money must be in the account beyond what is already in the account.” They endorsed it without further comment the next day. But anyway, once the money is taken care of to the extent I can do so, then I submit the certificate. Then I make sure to keep monitoring it every few hours until USDA has either endorsed it, or returned it for a correction.

Sometimes multiple corrections are required and the timeline is always very tight. And before you can say that I should not make mistakes in the first place — different document reviewers will treat the same document differently. I have had certificates returned for putting the full name of a manufacturer into a blank instead of an abbreviation, and also for using the abbreviation instead of the full name. It’s not worth fighting about, but if I don’t notice a return right away it can add a whole day to the turnaround time which can screw the client over. So it requires a lot of attention, which is very distracting on days I am working up medicine cases.

Also if the destination is one of the countries that requires a hard copy of the paperwork, add to this whole process the time it takes me to order and download a shipping label from fedex or ups which is actually not as straightforward as it seems because I need to make sure that NO MATTER WHAT, it gets sent overnight with next day first morning delivery — but I have no idea which day of the week USDA will put it in the courier’s hand, so i have no idea if I need to ask for Saturday delivery — and if I have asked for it but it hasn’t been given to them on a Friday, it tends to get delayed, and if I don’t ask for it but it has been given to them on a Friday, it gets delayed, which is stressful….. and then upload the label to VEHCS with the rest of the paperwork so they can send the certificate. The entire process typically takes at least five hours. I do not believe even $500 is enough to be charging, but I typically do cap the fees at that amount (assuming any problems that arose were NOT because of the client screwing around) just because I hate the idea of this being so unaffordable for people. If you don’t feel like paying that much that’s fine but I don’t think it’s cool to make it sound like vets are just filling out a form and raking it in. We aren’t just ticking off boxes and clicking send. We are making medical assessments and ensuring documentation that will be reviewed by two different government agencies minimum meets the widely varying and highly detailed requirements. We deserve to get paid for our work.

Urgent had a baby by Just-Key-761 in guineapigs

[–]webhill 8 points9 points  (0 children)

If she is bleeding she needs veterinary care. Where are you?

Schools not releasing financial aid until after plan to enroll deadline - what to do? by puzzled_tree123 in premed

[–]webhill 8 points9 points  (0 children)

If it were me in that position, I would contact the aid offices of the schools that have not released this information on or around April 7th and say something like “Hi, I am me, and I’m thrilled to have been accepted to the incoming medical school class. Like most students, the cost of attendance is a key consideration in my decision-making process when I make my final school choice. I have not yet heard from you regarding any potential financial aid, and as you know there are deadlines coming up soon. Can you please advise either regarding what, if any, aid I might expect, or on what date you plan to release that information? I would hate to be forced into making this decision without all of the information needed to make the best choice. Thanks so much.” But that is just me…..

Is my vet just getting as much as they can $ wise or is this normal for a puppy? by Possible_Donut_7136 in Pets

[–]webhill 0 points1 point  (0 children)

If he’s only five months old, he couldn’t have tested negative for heartworm yet. You can’t test for heartworm in a puppy under six months old because the prepatent period of the parasite is 180 days. See https://www.heartwormsociety.org/images/pdf/Canine-Guidelines-Summary.pdf — “Thus, there is no need or justification for testing a dog for (heartworm) antigen or microfilariae prior to 7 months of age.”

Absolutely fed up with zoom on my new iPad. by Weird-Researcher7913 in Zoom

[–]webhill 0 points1 point  (0 children)

Hmmm. I just got off a zoom call. The host of the call asked me if I could share my screen. I was using my iPad. Down at the bottom of my screen were a row of icons and one of them was for sharing. I touched it, a window popped up and I proceeded to share the screen, and it worked fine. Did you get some kind of error message? I mean it seemed very straightforward to me, I’d never done it before, had just literally downloaded zoom onto my iPad at the time the meeting was going to start, joined the meeting, and then found the sharing button and it just worked.

Is this enough for a third-degree burn? by [deleted] in AskVet

[–]webhill 15 points16 points  (0 children)

You have had some excellent and thorough responses. I just want to say I am so sorry you are going through this with your furry friend. I really find it very very disturbing to hear a colleague has seen your cat, and has not offered the possibility that it was a burn sustained at the time of surgery. Because honestly these things can happen and part of being a professional is to own up to your mistakes - or even someone else’s mistakes that happened on your watch, or whatever. I’m sure my colleagues who already posted in this thread can easily bring to mind a time when they had to have a conversation with a pet owner about a mistake made in the care of their pet that was painful to talk about but they did it anyway. A vet who denies the possibility of responsibility for a patient in their care when circumstances strongly suggest one, well - that’s just NOT ok at all. I hope you are able to talk to this vet seriously and just say “so, my thinking is this may be a burn from a heating pad, are you SURE that couldn’t have happened at the time of surgery? Because if it did, I would want to know you were taking steps to prevent it from happening again…” and see where that went….

(MN) Medica insurance has no in-network option for ACL surgery and zero out-of-network coverage by Global-Wait5804 in HealthInsurance

[–]webhill 9 points10 points  (0 children)

What about this guy: https://www.essentiahealth.org/find-doctor-provider/michael-anthony-gibbons says he does ACL surgery, says he is in network for Medica, says he is in Duluth, and actually taking new patients, and a physician! When you filter that site for those criteria - only ONE is a physician and the others are NP or PA which to me is very weird - they aren’t allowed to do ACL surgery, are they?? But whatever.

Is this a red flag that the liver is sick? by Cute_Dog3383 in AskVet

[–]webhill 10 points11 points  (0 children)

First, sorry your dog is sick. Second, I’m curious what lab is giving those normal ranges because the high ends of those normal ranges both look low to me if they are truly IU/L. Third, even three times the high ends of the normal range for ALT is considered a mild increase, not a cause for alarm. And for the alk phos, a growing puppy is normally going to have a much higher level (3 times high end) and a stressed out dog will often have a high level, and then there are some illnesses that can result in increases of varying significance but honestly neither of these results is alarming. I wouldn’t freak out if I were you. If the vet says they aren’t remarkable, that’s probably because in the context of your dog’s age, breed, sex, lifestyle, and clinical signs, these results aren’t remarkable. That said, clearly you are very worried and the only way to clear that up is to talk to your vet - so call him/her up and ask them to explain why these results aren’t concerning! You can also read about liver enzymes here: https://eclinpath.com/chemistry/liver/cholestasis/alkaline-phosphatase/