Comments on: Hour 8: All nighters versus school of hard knocks http://www.pawcurious.com/2009/11/all-nighters-versus-school-of-hard-knocks/ eat. play. love. Fri, 12 Mar 2010 03:39:54 +0000 http://wordpress.org/?v=2.9.1 hourly 1 By: megan http://www.pawcurious.com/2009/11/all-nighters-versus-school-of-hard-knocks/#comment-2234 megan Sat, 07 Nov 2009 10:16:00 +0000 http://www.pawcurious.com/?p=1635#comment-2234 I'm still awake! I run into the catheter issue at work a lot, actually. If I'm doing a short procedure with reversible anesthesia, I might be ok with it, depending on the patient's age and health status. If an owner declines an IV catheter, I make darn sure they understand what they are declining and that their pet has a higher risk of complications, including death. I refuse to use propofol without some form of IV access and intubation supplies at the ready. My anesthesiology prof drilled that one intio my brain on that rotation. Unfortunately in my area, my ER clinic does service some lower income areas, and not everyone can do the 'ideal' thing for their pet, like the HBC chihuahua with a fractured pelvis and tail that I had to send home the other night with a single shot of hydromorphone, a few days of oral buprenorphine and a script for tramadol. She had $300 total to fix her dog. She spent over $200 of it with me. She said her regular vet takes payment plans (which we don't). I would have loved to monitor her for contusions, internal bleeding, and shock on an IV, but the owner couldn't afford it. I am liberal with AMA (against medical advice) forms when I need them. ER medicine can be frustrating sometimes (which is why I wrote the guest blog for everyone!) I’m still awake! I run into the catheter issue at work a lot, actually. If I’m doing a short procedure with reversible anesthesia, I might be ok with it, depending on the patient’s age and health status. If an owner declines an IV catheter, I make darn sure they understand what they are declining and that their pet has a higher risk of complications, including death. I refuse to use propofol without some form of IV access and intubation supplies at the ready. My anesthesiology prof drilled that one intio my brain on that rotation. Unfortunately in my area, my ER clinic does service some lower income areas, and not everyone can do the ‘ideal’ thing for their pet, like the HBC chihuahua with a fractured pelvis and tail that I had to send home the other night with a single shot of hydromorphone, a few days of oral buprenorphine and a script for tramadol. She had $300 total to fix her dog. She spent over $200 of it with me. She said her regular vet takes payment plans (which we don’t). I would have loved to monitor her for contusions, internal bleeding, and shock on an IV, but the owner couldn’t afford it. I am liberal with AMA (against medical advice) forms when I need them. ER medicine can be frustrating sometimes (which is why I wrote the guest blog for everyone!)

]]> By: Elizabeth http://www.pawcurious.com/2009/11/all-nighters-versus-school-of-hard-knocks/#comment-2233 Elizabeth Sat, 07 Nov 2009 09:56:34 +0000 http://www.pawcurious.com/?p=1635#comment-2233 no opting out, I like that.. The clinic I go to they now use a form and you opt out of what you don't want... there was even one to opt of of pain meds.. WTF .. sorry but what's with that.. My boy was having a small tumor removed from his leg last Aug and the tech actually asked me if I wanted him to have pain meds.. I asked if she was kidding me, she then went on to tell me that clients get upset about paying for them without being asked.. She also asked if I wanted it sent for diagnostics becaue I didn't have to she said... hmmm yes that's why its coming off.. we don't know what it is. There was no IV listed on the opt out so I asked and she said well it's not major surgery he proably doesn't need it.. YES he does. The tumor was a haemangiopericytoma.. We didn't get clear margins ( not possible ) but it's one of the better cancers to have so we wait and see. There are just some things worth the money. no opting out, I like that.. The clinic I go to they now use a form and you opt out of what you don’t want… there was even one to opt of of pain meds.. WTF .. sorry but what’s with that.. My boy was having a small tumor removed from his leg last Aug and the tech actually asked me if I wanted him to have pain meds.. I asked if she was kidding me, she then went on to tell me that clients get upset about paying for them without being asked..
She also asked if I wanted it sent for diagnostics becaue I didn’t have to she said… hmmm yes that’s why its coming off.. we don’t know what it is.
There was no IV listed on the opt out so I asked and she said well it’s not major surgery he proably doesn’t need it.. YES he does.
The tumor was a haemangiopericytoma.. We didn’t get clear margins ( not possible ) but it’s one of the better cancers to have so we wait and see.

There are just some things worth the money.

]]> By: Dr. V http://www.pawcurious.com/2009/11/all-nighters-versus-school-of-hard-knocks/#comment-2232 Dr. V Sat, 07 Nov 2009 09:38:22 +0000 http://www.pawcurious.com/?p=1635#comment-2232 Me too. We're not the cheapest place in town, but I'm very proud of our protocol. Safest one we can come up with and aggressive pain management from cruciates to cat neuters, no opting out. I believe we might be the only ones up. Me too. We’re not the cheapest place in town, but I’m very proud of our protocol. Safest one we can come up with and aggressive pain management from cruciates to cat neuters, no opting out.

I believe we might be the only ones up.

]]> By: Elizabeth http://www.pawcurious.com/2009/11/all-nighters-versus-school-of-hard-knocks/#comment-2231 Elizabeth Sat, 07 Nov 2009 09:35:58 +0000 http://www.pawcurious.com/?p=1635#comment-2231 No IV, no anesthetic is my rule for my animals. Same as pre op blood work. These should be basic. Most clinics when I live don't use IV's on a regular basis, telling you it really is not necessary for routine procedures. It's all routine until it isn't. Or you hear it is only a dental.. right.... Not using an IV is a deal breaker for me. Are we the only ones up?? No IV, no anesthetic is my rule for my animals. Same as pre op blood work. These should be basic. Most clinics when I live don’t use IV’s on a regular basis, telling you it really is not necessary for routine procedures. It’s all routine until it isn’t. Or you hear it is only a dental.. right…. Not using an IV is a deal breaker for me.

Are we the only ones up??

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