Parenting-Furkids

Cats => Caring For Your Cat => Topic started by: FurMonster Mom on September 25, 2011, 12:38:22 AM

Title: Consultation: A Comedy of Errors
Post by: FurMonster Mom on September 25, 2011, 12:38:22 AM
Sssssoooooooo.....

Belle's teeth have not been improving, and she is in more pain than I can manage with the leftover 3 year old Torbutrol in the 'fridge.

So we took Miss High and Mighty Princess Belle in to the vet for a dental consultation.
I knew I'd be dealing with the weekend vet, so I was really only hoping for a little pain meds and maybe antibiotics to tide over until we could schedule a procedure with our regular vet.

So the weekend vet says, 'Oh yeah, it looks like she has neck lesions (http://en.wikipedia.org/wiki/Feline_odontoclastic_resorptive_lesion).  If that's the case, there is probably a pocket full of bacteria sitting underneath the teeth.... but the "good news" is that they are easier to take care of than a full tooth extraction'. 

She then goes on a lengthy explanation about the difference on how they handle a "crown zip" vs. a complete extraction.  Now, I generally catch on pretty quick, but I know that she is unfamiliar with us, so I let her prattle while my mind wanders...

Then this pops out of my mouth; "hmmm... if she loses most of her teeth, I'll have to do something with her food".  (daggum it!  inside voice!)
To which she instantly replies, "Oh it'll be no problem, they handle wet food just fine!"

Obviously, she did not read our file.

I smile and my husband chimes in with me, "No, we feed a raw diet." 
And I continue, "I was thinking about her boney meals".  (gah! I just can't seem to help myself.)

Suddenly she seems a little flustered, "oh.  errr... what kind of bones do you feed?"

"Chicken"

I will give her a little credit, she did try to contain her consternation... it was just a fleeting look of horror.

I smile again, "They're actually fairly soft when raw".

"Well," she says, desperately trying to regain her footing, "I guess you could chop them up, or put them through a blender" (wow, this girl is a real problem solver!).

Looking at her thoughtfully I say, "Oh, I do chop them up already, was just thinking if the boney bits will aggravate her gums with no teeth". 

"Or!" she exclaims with an air of sudden inspiration, "You could leave out the bone and substitute with some wet food.  You know, for the taurine."

Now it's my turn to look a little confused.  "I'm not worried about taurine, I feed them hearts every other day."

This time she is less successful in hiding her surprise.  "I'm... sure a blender would get it all fine enough."

I smile and nod, and Hubby chuckles. (bless him!)

So, to get back on track, I ask about antibiotics, and she says; 'Oh, I don't think we need to do that, unless you are unable to afford the procedure and we have to delay beyond a week'.

hmmmmm.... Didn't she explain at the start that there is probably a pocket of bacteria campin' out under the teeth?
I let it go.

So she rustles up an estimate for us... $1150
For a basic dental, with slight padding for the likelihood of surgery.

My instant reaction was, "Holey crap!  there's no way!"
And her instant reaction was, "If finances are tight, you could try Care Credit."
I shake my head stubbornly, "I don't like to use those guys".
She doesn't even bother to try to hide her surprise at this, "Oh?!  But they offer a 12 month, no interest --  why? ---".  (I think I stopped her with my "stubborn look"... I admit, it can be intimidating.  I inherited it from my dad.)
She tries one last rally, "If you're thinking of putting it on a credit card, it's a good option". 
I stare at her silently.

"Let me go see if that estimate has printed up, and we can go over it".  She flees.

I turn to my dear Hubby with my "O. M. G." face.  He looks back at me and shakes his head, "Let's see what the breakdown is."

The vet returns with the printout, which I take and peruse while she babbles on about how she included this and that, so the estimate is high, and if we want to cut costs she recommends doing it with the bloodwork, because they could conceivably do the procedure with a simple bloodworkup as long as everything else looks good.... 

And yes, I do believe she said all of that without taking a single breath.

So, I'm looking at the breakdown and something catches my eye.  "Rimadyl?", I blurt out.

"Yes," she assures me breezily, "it's an NSAID.  We give them an injection and it stays in their system for 3 days, then it clears out."
Alarms are going off in my head, but I can't remember exactly why this is unsettling me.  I just have this feeling....

I turn to Hubby with "that look".  He turns to the vet, "We need to take this home and discuss it."  (bless him, bless him!)
I chime in, "What can we take home to give her for the pain in the meantime?".

"Well," she hems, "I could send you home with a couple days worth of Buprenorphine (http://sunnysidevetclinic.com/Articles/buprenorphine.htm) drops."
"I've never heard of it, and believe it or not she does better with pills."
Now I guess it's her turn to be stubborn, "Well, it's really the only thing I can send you home with."
So I tell her that I've been giving Belle a small dose of the leftover Torb.
"Well," she hems again, "I could send you home with some Torb., but it only last for about 45 minutes, where the Buprenorphine will last for 8 hours".
I nod reluctantly, "Okay then, we'll give it a try".

We wrap up, and go out to pay our $42 consultation + $30 meds bill.

*sigh*

.
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on September 25, 2011, 01:38:21 AM
Oh we are so sorry that you are going through this with Belle.  That sure is expensive!! When Shadow had all her teeth out it was only just over 300$, she had all out but her fangs and a few inscissors.
If you can do it I would see if antibiotics work first, then you may just have to have her teeth removed, but not all of them. I remember reading a story about a cat on the internet who ate raw and did not have any teeth. So maybe at first it will be difficult, and you  will have to eliminate the bone until she heals, but she will be fine after that.
We hope you guys can figure out a plan, and Belle feels better.  Let us know how it goes ok. cat4
I remember someone posting about Rimadyl here, and that is is bad stuff, so its good that warning bells went off for you there.  phew!!!
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on September 25, 2011, 06:55:17 AM
First of all neck lesions is another word for resorptive lesions, which is another way of saying FORL, Feline Odonoclatstic Resorptive Lesions.  They are extremely painful (imagine razor blade in the mouth) and the only cure is to remove the entire tooth, including the root.

Burpenex (buprenophine)drops are not put down the throat.   The medicine is absorbed through the mucus membranes in the mouth.  You simply squirt the syringe into the mouth, and within 10 minutes, the cat is no longer feeling pain.  It is good for 10-12 hours, then they need another dose.

I would not discard the idea that she will not be able to eat a raw diet with no teeth, but if she can't, a life on a cannned diet is much preferable to a life of FORL pain.  My senior boy gets resorptive lesions, I know how terribly painful it is. And when you consider that cats HIDE pain, by the time they show they are in pain, they've been suffering a very long time.

I hope you don't have to see that vet again, with her misinformation.

Good luck to Belle, and get those FORL teeth taken out as soon as possible. I've heard FORL described both as razor blades in the mouth, and barbed wire in the mouth.
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on September 25, 2011, 07:02:22 AM
Your instincts on Rimadyl were right on, it should never be used in cats.

http://parenting-furkids.com/index.php?topic=686.0

Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on September 25, 2011, 03:05:05 PM
MC, thanks for the info on neck lesions... actually, I had included a link on that in my story, as well as a link on the buprenorphine.   ;)

I didn't mention how the drops are administered, because... well... the vet didn't tell us
Since it comes in a syringe, not a dropper, I went home and squirted the whole dose in the back of her mouth.  THEN I found several sites online that mentioned that you're supposed to drop the liquid bit by bit onto the gums and along the gum line.   Doh1
I am, however, satisfied that it is a viable pain management medication, even if it is a bit pricy ($3.50 per dose, 2 doses a day).

Also, I went to Rimady's own website, and at the bottom there is a link that says "Click here for full prescribing information".  It takes you to a PDF of the mandatory information paper (https://www.rimadyl.com/docs/pi.pdf) (you know, the ones printed in teensy font on tiny paper..).  Right up top it says "For subcutaneous use in dogs only".  Also, under the warnings section (5th section), it says in bold lettering "For use in dogs only", and the very next sentence is, "Do not use in cats."  There is no wiggle room with that statement.  If a vet is using this in cats, against the manufacturers own directions, they are opening themselves to liability.

Now, the reason I am calling this a "comedy of errors" is because, if I'm honest with myself, I have to admit I did not pick my battles very well.
That whole tangent about the food was completely unnecessary, even if it did produce that little gem about substituting bones with canned food for the taurine.

Nevertheless, when we got back to the car, Hubby and I started to share our thoughts on the "consultation".
My first comment was something along the lines of, "Why do I feel like she was just trying to make a sale?".
Hubby, "Well, she sure did talk a lot".
Me, "She... prattled... on and on and on."
Hubby, "Yeeeeaaaahhh..... I get the sense that she's one of those vets that does better with the animals than with the people."
Me, "Ya think?"
Hubby, "Yah.  I mean, she handled Belle without thinking twice, it was second nature to her.  But she seemed... nervous when talking to us."
Me, "So, maybe her blathering was just nerves?"  (I can relate to this a bit, happens to me when I audition).
Hubby, "Maybe."
Me, "Maybe."
Me, "But I still have questions about this... 'estimate'."
Hubby, "Yeah."

So, I will be digging up the records on Belle's last round of extractions, as well as Ol' Man Travis' round of extractions (he had 18 teeth pulled!), to compare.  I DO plan on having a conversation with our regular vet about all of this.

.
Title: Re: Consultation: A Comedy of Errors
Post by: CarnivorousCritter on September 25, 2011, 03:30:59 PM
FurMonsterMom, I'd have given anything to have had your foresight 5 years ago.   grouphug

We trusted blindly. Very blindly - too spoiled from out longtime vet; didn't know how to second guess the over-zealous salespeople because we'd never been exposed to the likes of them before.  
Title: Re: Consultation: A Comedy of Errors
Post by: Mo on September 25, 2011, 05:14:35 PM
It sounds a lot like what I just went through with Mikey, taking him to the vet.  He had a bite wound on his front leg, so he needed to go to get antibiotics.

This isn't the exact wording, but unfortunatly, it is close.

Vet:  He looks very healthy, and his teeth are so clean!  He must be around 9 months old?
Me:  He is actually 8.5 years old.  He looks that way because of what I feed him.
Vet: There is no way he is that old.   *looks at Mikey's leg*:  Well, it is a good thing it was caught before it abcessed.  I'll go get a shot of metacam to help with the pain, and he also will get some convenia, it is an antibiotic.
Me: I don't want him to get Metacam or Convenia.  They are both very unsafe for use in cats.
Vet:  They are both safe and meant to use in cats.
Me: Metacam is labelled for dogs, and says that it is not to be used for cats.  Convenia stays in the cats system for several months, Mikey already has issues with allergies, and I am not taking the chance of him being allergic to the Convenia.  I'd rather he had Clavamox, it has worked very well for him before.
Vet: Fine - your choice, your loss.  It is much more convenient to go the other route.  While he is here, it looks like he is 3 years overdue on all his vaccines, he should get them now, it would be more convenient for you. 
Me: I don't want him to be vaccinated right now.  His body is under enough stress. 
Vet: It isn't hard on the cat to get vaccinated.  *looks at Mikey again*  You said he looks healthy because of his diet.  You must be feeding Nutro then?

Me: I feed him a prey model raw diet.  You are not going to talk me out of feeding him that.  You yourself said he was healthy.  Can someone please go get the clavamox so that I can leave?
Vet: *walks out in a huff*
Vet Tech: *comes in and gives me Mikey's meds.*  He looks so healthy! 

Me: Thanks, I feed him a prey model raw diet.  Cats are carnivores - raw feeding is really good for them.  *walk out leaving shocked vet tech in room*



Yeah, gotta love misinformed vets!
Title: Re: Consultation: A Comedy of Errors
Post by: Pookie on September 26, 2011, 11:40:15 AM
Vet:  He looks very healthy, and his teeth are so clean!  He must be around 9 months old?
Me:  He is actually 8.5 years old.  He looks that way because of what I feed him.
Vet: There is no way he is that old.   *looks at Mikey's leg*:  Well, it is a good thing it was caught before it abcessed.  I'll go get a shot of metacam to help with the pain, and he also will get some convenia, it is an antibiotic.
Me: I don't want him to get Metacam or Convenia.  They are both very unsafe for use in cats.
Vet:  They are both safe and meant to use in cats.
Me: Metacam is labelled for dogs, and says that it is not to be used for cats.  Convenia stays in the cats system for several months, Mikey already has issues with allergies, and I am not taking the chance of him being allergic to the Convenia.  I'd rather he had Clavamox, it has worked very well for him before.
Vet: Fine - your choice, your loss.  It is much more convenient to go the other route.  While he is here, it looks like he is 3 years overdue on all his vaccines, he should get them now, it would be more convenient for you. 
Me: I don't want him to be vaccinated right now.  His body is under enough stress. 
Vet: It isn't hard on the cat to get vaccinated.  *looks at Mikey again*  You said he looks healthy because of his diet.  You must be feeding Nutro then?
Me: I feed him a prey model raw diet.  You are not going to talk me out of feeding him that.  You yourself said he was healthy.  Can someone please go get the clavamox so that I can leave?
Vet: *walks out in a huff*

Sorry, Mo, but I have to say this:  what a jerk that vet is!  “There is no way he’s that old.”  Um, I would think the owner would know how old the cat is.  “Your choice, your loss.”  EXCUSE ME???  How rude!  “It is much more convenient to go the other route.”  More convenient for who?  It won’t be convenient for anybody if Mikey got sick on that stuff!  “You must be feeding Nutro then?”  AUGH!   bangshead

As for him/her not knowing those products were off-label for cats, I can’t stand it.  You know, I’m told I have really high expectations, and maybe I do, but is it really “high expectations” to expect a MEDICAL PROFESSIONAL to keep up on this stuff?

Sorry, I don’t mean to rant, but after 4 vets (and possibly soon to be 5, if I can find one that meets my “high expectations"), I’m so tired of the ignorance that seems to run rampant in this profession.  It seems like for every competent vet out there (and I’ve yet to actually meet one that I felt 100% confident in), there’s 100s more that aren’t.   pullingouthair

I wish I was like you, Mo, who knew exactly how to respond and hold your ground.  I’m always caught off-guard and end up thinking of what I should have said hours later.   bangshead Doh1
Title: Re: Consultation: A Comedy of Errors
Post by: CarnivorousCritter on September 26, 2011, 12:18:56 PM
Sorry, Mo, but I have to say this: 
As for him/her not knowing those products were off-label for cats, I can’t stand it.  You know, I’m told I have really high expectations, and maybe I do, but is it really “high expectations” to expect a MEDICAL PROFESSIONAL to keep up on this stuff?
bangshead Doh1

I spent over an hour on the phone with a Pfizer person (one of their vets) crying about what we went through because I didn't think to get on the Internet, and they told me I should have at least been given the print-out they provide with their meds. I was not warned of possible side effects and the "vets" refused to consider anything other than "neurological" a possibility when the sudden seizures began.

Quote
Sorry, I don’t mean to rant, but after 4 vets (and possibly soon to be 5, if I can find one that meets my “high expectations"), I’m so tired of the ignorance that seems to run rampant in this profession.  It seems like for every competent vet out there (and I’ve yet to actually meet one that I felt 100% confident in), there’s 100s more that aren’t.   pullingouthair

I wish I was like you, Mo, who knew exactly how to respond and hold your ground.  I’m always caught off-guard and end up thinking of what I should have said hours later.

IMO the problem is, unlike all the other professions save maybe the Politicians and even they get voted out (also lambasted publicly so that everybody knows their dirt), there is nobody to answer to. Not even the clients, because they won't raise a stink to attorneys and the like as they would with say an MD or Mechanic -- or any profession which has somebody other than the PFI & Pharma funding them to answer to.   

If you complain about a veterinarian committing malpractice, who do you complain to? The Association, which can NOT bad-mouth the PFI and Pharma which fundsthem?  This is the problem, IMO.   Consumers can sue the drug COs till they're blue in the face, but the vets will still keep on selling them to unknowing clients because, really, who is going to object?

Until "The Rules" for MDs apply to vets as well, and the "forgiving" double-standard ends, it will go on and on. How many clients DO find new vets even when they know the vets are "clueless" regarding food-drugs? Much different when it comes to everyone else, from MDs right down to hairdressers & restaurants.

They have no incentive to know the food they are telling people to feed and drugs prescribed are detrimental to health while the incentive IS there to promote and sell it -- along with NO regulation or unbiased authority to govern it.

It boils down to: Pet owners = biggest $ucker$ on earth because of the vulnerability of having beings in their care not being able to say what hurts...

Once the diamond in the rough is found, s/he is priceless. They are out there. Somewhere...










Title: Re: Consultation: A Comedy of Errors
Post by: CarnivorousCritter on September 26, 2011, 12:27:59 PM

As for him/her not knowing those products were off-label for cats, I can’t stand it.  You know, I’m told I have really high expectations, and maybe I do, but is it really “high expectations” to expect a MEDICAL PROFESSIONAL to keep up on this stuff?


Things are backwards now, different than yours and our longtime veterinarian's philosophy.

He would know everything about any drug he would consider prescribing, and admittedly nothing about what food to feed. He said it best when we asked about food:  "We're just Doctors."    Medicine surgery....they diagnose and treat.  

Sorry this is long, but here are excerpts from Dr. Michael W Fox:

 http://www.twobitdog.com/drfox/specialreport_Article.aspx?ID=f78aec92-0b02-47f3-9575-cb1778647ad5
http://advocacy.britannica.com/blog/advocacy/2009/07/conflicts-of-interest-in-the-veterinary-profession/.

Quote
...Unnecessary vaccinations. Far too many veterinarians administer unnecessary annual vaccinations to animals. . In dogs---who are harmed more frequently than cats by this practice---this can result in much suffering from chronic health problems such as allergies, neurological and joint problems, autoimmune and endocrine diseases. Cats are prone to develop often fatal skin cancer at the site of vaccine injection.

Inappropriate nutrition. Cats suffer more than dogs from poor nutrition because they are obligate carnivores requiring a meat-based diet. Too many veterinarians are profiting from selling dry cat foods high in cereals and soy; these only too often lead to obesity, diabetes mellitus, urinary tract and inflammatory bowel disease, and other chronic degenerative diseases. The veterinarians then profit from treating these diseases and from prescribing expensive special diets that would not be needed if the cats had been fed properly from the start.

But dogs are not without diet-related problems, such as chronic skin and digestive problems, ear and anal gland infections, and a host of other maladies including depression and epilepsy. These clear up once the dogs are taken off highly processed manufactured foods.

Rather than addressing what their patients are eating, far too many veterinarians put them on cortisone/prednisone to stop self-mutilation from scratching and chewing. Then new health problems develop, such as Cushing’s disease in dogs and cystitis and diabetes in cats.

Veterinary dentistry has become a highly profitable field. An estimated 75 percent of dogs in the United States suffer from periodontal disease, which is also a common affliction of cats.... Highly processed food ingredients that are micro-particulate---especially the high cereal and gluten content of popular pet foods---play a major role in this virtual epidemic in the canine and feline population. ...


 I consider myself fortunate to have a wide-angle view on these matters, since I have received many thousands of letters from pet owners over the past 30-plus years through my internationally syndicated newspaper column, Animal Doctor. I have learned about such serious animal health and welfare issues as over-vaccination and diet-related adverse consequences of manufactured pet foods. (For details visit www.twobitdog.com/DrFox.)  



Letter to the Editor,
Journal of the American Veterinary Medical Association,
Sent via e-mail May 26, 2009

Dear Sir,
Quote


EXAMINING CONFLICTS OF INTEREST IN THE VETERINARY PROFESSION

The relationships between the corporate sector, and in particular with drug companies, and private medical practitioners, hospitals, and medical schools, are being called to question by the Institute of Medicine in the US (1).

Is a similar examination called for in the veterinary sector where comparable corporate interests may be at play and affect the quality of care and services animal patients receive? ...

Corporate sector partnering in academia even includes chairs and professorships named after the donating company at many veterinary colleges. What role such partnering may play in contributing to the grave consequences of poor diets, over-medication, and hyperimmunization in companion animals by deferring to vested interests and by claiming lack of scientific proof of harm from such practices, is an open question. Academia should not be exploited to garner public credibility, nor should the market place become the final arbiter of what is acceptable.

Examining possible conflicts of interest may be difficult, considering the partnership of the American Veterinary Medical Association with Fort Dodge and Merial pharmaceutical companies, and Hill™s Pet Nutrition, who together have pledged $4.5 million in support of AVMA programs and services over the next four years (4). But this difficulty could become a confluence of interests once the health and well-being of companion animals are first and foremost on the agenda. The content of both the JAVMA, and its equivalent with the British Veterinary Association’s (BVA) Veterinary Record, increasingly addresses issues concerning animal health and welfare, including nutrition and vaccinations....
[/size]

Quote
I did not even receive an acknowledgement from the British Veterinary Association, while the Interim Editor-in-Chief of the American Veterinary Medical Association’s Journal of the American Veterinary Medical Association, which usually publishes my letters, sent me the following letter via regular mail, dated May 28, 2009:...[/size]

 http://www.twobitdog.com/drfox/specialreport_Article.aspx?ID=f78aec92-0b02-47f3-9575-cb1778647ad5



Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on September 26, 2011, 12:47:21 PM
Oh but wait guys here is an honest Vet bonkhead sarcasmalert

http://www.youtube.com/watch?feature=player_embedded&v=YugT3uDpinA (http://www.youtube.com/watch?feature=player_embedded&v=YugT3uDpinA)
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on September 26, 2011, 03:40:00 PM
lol Shadow....
It's sad how much truth there is to that.

The thing that is still annoying the hell out of me, is that the vet sent us home without any antibiotics.

I mean, come on!  It's obvious that there is an infection, and you can't tell me that it's not a contributing factor to the pain.  Yes, it's obvious that we need to pull the teeth, but why not get a jump on the infection before the procedure to 1) alleviate the pain, and 2) reduce the bacterial load for the inevitable surgery?

I have dug up previous dental paperwork, and that is exactly how we handled Ol' Man Travis' teeth.  Also, his bill was about $650 - for pulling 18 teeth.  Belle's last dental extractions cost about $750.  You should see the estimate with all my scribbled notes on it... lol. 

I suppose the one good thing to come out of all this is that I finally got off my tukus and put in a call to the one holistic vet in town that looks good.  We'll see if she meets my expectations.
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on September 26, 2011, 03:40:53 PM
I.... don't know what I did here...   :-[
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on September 27, 2011, 10:41:19 AM
It is pathetic that the stories Mo and FurMonster Mom told...are more the norm than not. 

FMM...had any luck with getting an appointment with the new vet?
How is Belle doing? 
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on September 27, 2011, 08:24:14 PM
FMM...had any luck with getting an appointment with the new vet?
How is Belle doing? 

I was able to consult with the homeopathic vet over the phone yesterday.  When I mentioned that the weekend vet hadn't sent me home with antibiotics, I heard her give one of those ugh/groans.  And when I mentioned the bones/taurine bit, she was just as confused as I was... her response was, "But taurine is already in the meat..."

She did say that once the body starts in on the resorption process, there was no stopping it.  Also, the generally accepted theory on the cause is that it's another one of those genetic autoimmune things. It will likely continue with the rest of the teeth eventually.  She mentioned that an alternative to extractions would be to cauterize the nerve, and just let the body continue the resorption process.  It's kinda the same idea as the "crown zip", except just leaving the tooth until it falls out on it's own.

Meanwhile, Belle did not want to eat her breakfast this morning, no matter how much I choppity-chopped or how soupy I made it. (and it was only an hour after I'd given her the Buprenox drops)

So, then we had our appointment with our regular vet this afternoon.
After she spent several minutes looking at all of Belle's teeth (which the other vet barely glanced at), we had a discussion.
I pretty much laid everything out for her.  It's her practice, she's "the boss", so she needed to know how I felt.

It went kinda like this:

Me: Sssssoooo, this is where I had some problems...
She:  (gives me an apprehensive-brace-myself smile)  err... okay?
Me:  I just felt like Dr. P--- wasn't really listening.  She was too busy talking at us, y'know.
She:  (closes her eyes in that 'have heard this before' acknowledgement)
Me:  I never feel like that with you or Dr. B---.  You guys don't talk at me, (joking) at least I don't feel like you are...(raise eyebrow)?
She:  (laughs reassuringly)  no no
Me:  (smile) I always feel like you are listening, and we have back & forth discussions. 
She:  Yes, I cannot argue with you here.  Dr. P--- is actually a good vet, but she... could... work on her communication skills.
Hubby:  I kinda wondered if she was just nervous... (I just love him!)
Me:  (laughing) Yes, you did bring up that possibility.  But I still felt like I had just walked off a car lot... like she was trying too hard to make a sale.
She:  (looking a little offended and doubtful)
Me:  She probably didn't intend for that to come across, but it was just my initial reaction to her "presentation".
She:  I'm sure she didn't intend that at all!  I can pretty much guarantee that she was thinking about Belle's welfare and her own preference on how to manage her issues.  She is a good vet, but you are right... she does need to work on her communication with the clients.
Me:  .... well, that does bring me to my next issue.... the Rimadyl...
She:  (nods knowingly)  It is not licensed for cats, but is very commonly used in special circumstances...
Me:  (cutting her off with my "concerned" voice)  Now, you know me, I go home and google stuff to death... It says in the manufacturer's own literature, "Do not use in cats".  Anyone who uses it in cats is opening themselves to liability.
She:  You're right.  It's absolutely a legitimate concern.  The fact is, there are no NSAIDS that are actually licensed for cats.  Metacam used to be, but isn't any longer.  It's still common practice to give them to cats in special circumstances, though we don't dose the same way we would for a dog (over time).  (she explains the reasoning and I listen until my patience runs out)
Me:  I really just don't want to chance it.
She:  Fair enough.  It's a reasonable concern.  I just wanted you to understand it from our perspective as well.
Me:  (smile) I understand... but I can't say I agree.
She: (laughs)  Fair enough.  You wouldn't be the only one.  There's plenty of debate in the vet community as well.  (THIS is why I like her!  Even if we don't see eye to eye on something, she is willing to work around it.  Plus, she doesn't "talk down" to me.)

Anyway... We continued on in that back and forth discussion for about 45 minutes.  We talked about the different pain meds available (she prefers Torbutrol over Buprenorphine), and different antibiotics (Convenia came up, and she admitted that it would be a very last resort in her book).  We talked about her pricing and how it could be translated or adjusted.  We talked about the alternative of cauterizing the nerve, and her concern was that it would still leave the cavity open to bacteria.  It could take quite a long while for the teeth to be completely reabsorbed, and during that time Belle would need to be constantly on antibiotics (an interesting point, I thought).

Unfortunately, She is leaving on vacation on Thursday, and the other vet we like won't be back until Sunday.  We are also in a little financial limbo for a few more days (waiting on checks).  So she sent us home with some Torbutrol and Clavamox for Belle.  We are hoping to schedule for next Monday or Tuesday, I hope Belle can hold out until then.

In the meantime, I'm still thinking I'd like to schedule some time with the holistic vet.  She is somewhat of a "nomad" vet, if you will.  She runs on housecalls for her own personal practice, but also schedules time with a local holistic hospital, AND works with a conventional vet hospital in the San Francisco area.  I'm hoping I can pin her down for some time next month.
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on September 27, 2011, 08:50:43 PM
Actually clindamycin (antirobe) is a better choice of antibiotic for dental/mouth issues. I hope the torb can keep her comfortable, but I am sorry to hear she is not eating.  My boy lost a considerable amount of weight in the time between being diagnosed and his surgery, the first time. (there was a wait because of other health issues, then my vet was out of town)   Once I knew what to watch for, he never had to go longer that the first chatter before he was in getting the painful teeth and roots extracted.  He doesn't have many teeth left but he doesn't care.

All paws crossed for Belle.
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on September 30, 2011, 12:10:11 PM
FMM,
I'm thinking weekend vet needs to work on a LOT more than just her communication skills. 
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 02, 2011, 03:05:44 AM
Lola, I'd agree. 
But I chewed that bone pretty well throughout my conversation with our regular vet, so I'm sure the message was heard loud and clear.

MC, clindamycin was one of the antibiotics mentioned, but we tend to lean toward clavamox for a first round. 

The redness of the infection has gone down noticeably and the torb seems to be working as well.
Belle has been doing better, been eating and not hiding in her bed (crate) as much. 

Dental is on monday, bright and early (at least for me, it is).  It was mentioned that they would skip the penicillin injection as long as I gave her some clavamox before coming in.

I sent a note to the holistic vet, letting her know I appreciated her input, and that I would love to set up a home consultation sometime in the next month.  She responded graciously, saying to keep her posted.
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 02, 2011, 11:40:35 AM
I'll be thinking of Belle on Monday.  I'm so glad she is feeling better.  Once those bad FORL teeth are gone she will be a new cat.
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on October 02, 2011, 12:55:57 PM
So glad Belle is doing a bit better, let us know how she does after monday. I know she will feel a lot better :) grouphug
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 04, 2011, 05:19:56 PM
So, if yesterday could have a title of it's own, it would be "Timing"

Got up, fell asleep, got up, fell asleep...
Finally crawled outta bed 45 mins before "go time".
For a non-morning night owl... that's pretty good timing.

Zombie-walked around the house....
Gave Belle her antibiotic...
Pulled myself together, loaded Belle into the travel bag (http://www.sherpapet.com/page.asp?id=38&name=Original%20Deluxe%20Bags) and into the car.

Car won't start.
So much for timing.

Luckily, we have a charger, so I call the Vet and tell them I'm running late.
Plug in the charging machine, flip the switch, and.... there seems to be no charge.
So I text hubby, and he insists that the thing should be working, tells me to check the gfi, the strip switch.. blah blah blah...
I tell him the gfi was the first thing I checked, and I'm not using the stupid strip on his workbench because it's buried under a bunch of his crap.

So, as a last ditch effort, I hook up the charger to my battery anyway, and voila!
I'm only 30 minutes late.

I get to the vet, apologize for being late, throwing her day off, and she says in all seriousness, "Oh no!  Actually it works out perfectly.  I had some other things to deal with, so the timing works out just fine."
Huh.

After dropping Belle off, I go get myself a new battery.
Now, usually, someone at the parts store will help with a simple battery swap, but this guy didn't offer.
That's okay.  I'm a self-sufficient woman.  Google is my friend, and I know how to use tools.
When I have tools.

I get home and look up a few articles on changing a car battery.  It's about as simple as I thought.
So, I clean the corrosion off the old battery with baking soda solution, and notice that the nut holding the negative clasp/connection to the terminal head is... shall we say, very beat up.  With a sigh, I look for my tools.
Hubby has them.

The vet calls to say that Belle has come through the surgery just fine.  The roots were well on their way in the resorption process, so they just did the crown amputations as discussed.  She basically "lost" 6 teeth.  Also mentioned that one of her kidney levels was a little "high normal", and her urine was a little concentrated; probably due to dehydration.  I wasn't too surprised, since she hadn't eaten much on Sunday.  The vet asked me to pick her up at 4:00.

Sure, no prob.
Hopefully, I'll have a new battery in my car by then.

So I call the parts store, and they say, "Okay, come on back 'round 3". 
Fine.  Perfect timing.
Three o'clock rolls around. 
I charge up my dead battery, head to the parts store, swap out for the new one, and go pick Belle up.

Did I mention the weather?
It was... teasing... all day long; sprinkles, sun, sprinkles, sun, clouds, sun, sprinkles...
Once I picked Belle up, it started to look more serious.
A ten minute drive home, put Belle in the bedroom, and then it started storming in earnest.

Timing.





Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 04, 2011, 08:17:32 PM
Goodness, that is a day of Timing!

So how is Belle doing?  I don't understand leaving the roots to be resorpted. Won't they still cause pain until they are done, especially now that they are totally exposed, with the crown of the tooth removed?

I am not criticizing, but I don't understand the reasoning.

Keep us posted on Belle's recovery.  Does she have pain meds?
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 04, 2011, 10:07:29 PM
So how is Belle doing?  I don't understand leaving the roots to be resorpted. Won't they still cause pain until they are done, especially now that they are totally exposed, with the crown of the tooth removed?

Oh!  No.  Sorry I wasn't clear on that.
The crown is removed, the nerve is killed, and the gum is sewn over it (definitely not left exposed).
Killing the nerve is the key for stopping the pain. 
Though there is of course, some pain due to the gum incision/stitches.  So, yes, we are still on Torb and Clavamox for another week.

She's not eating much, but is making a good attempt with a little coaxing.
And the others have dialed down the hissing.
So, hopefully tomorrow will be better.

.
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on October 04, 2011, 11:47:56 PM
So glad you got Belle home safe and sound now.  Hope she gets her appettite back soon.
Sending butterfly kisses your way  kittybutterfly
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 05, 2011, 08:14:05 AM
Oh!  No.  Sorry I wasn't clear on that.
The crown is removed, the nerve is killed, and the gum is sewn over it (definitely not left exposed).
Killing the nerve is the key for stopping the pain. 
Though there is of course, some pain due to the gum incision/stitches.  So, yes, we are still on Torb and Clavamox for another week.

She's not eating much, but is making a good attempt with a little coaxing.
And the others have dialed down the hissing.
So, hopefully tomorrow will be better.

.

OH!  That does make some sense to me, rather than going digging for the roots.  Thanks for explaining.

All paws crossed that Belle's appetite picks up.  The meds of course will affect her appetite too.  Be sure to give her a little probiotic every day to counteract the clavamox. :)
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 06, 2011, 09:46:25 AM
I'm waaaaaaaaaaaaaaaaaaaaay behind! 
What a Monday you and Belle had!   :o
How is she doing?
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 06, 2011, 10:05:03 PM
How's Belle now? 
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 08, 2011, 11:48:39 AM
Well..... the saga continues.

As you know, Belle had her surgery on Monday. 
On Tuesday, I pretty much let her be.  She hid in her crate most of the day.
On Wednesday, I noticed something going on with her eyes.  One was very dilated and didn't want to contract, the other was contracted and didn't want to dilate.  :o
So.... another trip to the vet.

The vet checked her for corneal scratches, but they were all clear.  So that left the possibility of a drug reaction.
Now, recall that we initially had her on Buprenex drops, which are a synthetic opiate.  Besides hating the drops themselves, Belle seemed kinda hyper on them.  So we switched to Torbutol in pill form.  Torb and Bup are in the same "class" of medication, as in they are both synthetic opiates that block pain by targeting the central nervous system.   

So, prior to her surgery, Belle was taking Torbutrol.  We skipped the dose on the morning of, since they were planning on giving her a Buprenorphine injection for the surgery.  Then, late that night, we went back on the Torb and continued.

On Wednesday, after clearing her of any physical issues, the vet says... "Well, since both the Bup and the Torb are meds that affect the central nervous system, lemme look up the side effects".  Now, this is one of the vets that I love, but in the back of my mind I'm thinking, "What?  You don't KNOW?".   Doh1 *sigh*

So we wait, and she comes back confirming my/her suspicions.  So she says, "Let's put her on Tramadol.  It's a different class of drug, works a little differently." 
And I say, "Yeah.  I think that's what we used for her last round of extractions."
"Oh!" she says, "You might be right.  Lemme look that up."  She hops over to the in-room terminal and confirms, "Yup, there it is."   ::)

So... now we are on Tramadol... which is what we used last time and which, in my opinion, we should have used from the get-go.   bangshead

Belle's eyes are back to normal.
But she is still not eating on her own. 
I think part of that is because she now has lost both top canines along with all her main scissor teeth.  Even when I put a small piece of meat in the back of her mouth to swallow, she mouths it around and ends up spitting it out.  Feeding time has become a bit of an ordeal, as I literally stuff food in her mouth and make her swallow it.   :(

*sigh*

Gotta go.
Gotta figure out how I'm going to get her to eat her chicken today.   :-\
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on October 08, 2011, 02:43:21 PM
Oh dear, well glad you got her on better meds, maybe once those other meds are totally out of her system she may get her appetite back?  What about an appetite stimulant?  Or could you take the food she eats and put it in a blender and syringe feed her that and some baby food?
We are so worried for Belle....come on Belle please eat!!!:(
purring for Belle cat1
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 08, 2011, 05:38:19 PM
I tried blending last night.... it didn't go over very well. 
But the baby food idea might be worth a shot.
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 08, 2011, 11:44:35 PM
*sigh*

She hates me.

.
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 09, 2011, 07:36:15 AM
I'm sure all the medications may be affecting her appetite.  You may have to assist feed for a few more days, until she no longer needs the pain meds.  Tramadol is heavy stuff.

Cats don't care if they have teeth or not for eating, my senior boy has very few teeth left.  He's not on a raw diet though, he eats canned food, but he doesn't 'chew' anything, regardless of texture.  In fact when he does get a resorptive lesion he prefers kibble, because he can eat it without any contact to his teeth at all, just scoop the pieces and swallow, where as with canned, bits would get caught on the affected roots and cause him great pain.

Anyway, I'm glad her pupils are normal again and hope she doesn't need the tramadol for much longer.
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 09, 2011, 12:35:49 PM
*sigh*

She hates me.


What makes you think that?  Have you tried the baby food or wet food to get her to eat?
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 09, 2011, 01:40:04 PM
Cats don't care if they have teeth or not for eating,...can eat it without any contact to his teeth at all, just scoop the pieces and swallow,
I know that's how it's supposed to work... but she does still have her lower canines, and I've noticed that when she is mouthing the food, she will sometimes catch her upper lip with them.... basically biting her lip quite frequently, since there is nothing above to keep it clear.

What makes you think that?  Have you tried the baby food or wet food to get her to eat?

Yep.  Did that last night, and she wouldn't touch it.  She'd lick it off her lip when we put it there, but wouldn't eat it on her own.
I ended up trying to syringe feed it to her, and that was a complete disaster.
Now I'm afraid feeding time has become such a trauma, that she just doesn't want any part of it....
Plus, now she runs from me.   :(

I'm frustrated to tears, and she's mad and scared...
Maybe we'll just take a break today.  If she eats, she eats; if not, then maybe tomorrow. 

.
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 09, 2011, 07:33:23 PM
Aw, that's rough.  How much longer will she be on the medication?  If she skips a day of eating, perhaps you can bring her in to the vet for some sub q fluids to keep her hydrated anyway.  Have you let the vet know she's not eating?
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 09, 2011, 10:06:43 PM
Any stinky smelly nasty toppers/additives you can put on her food to interest her in eating? 
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 11, 2011, 02:34:25 PM
Went to the vet yesterday for the followup.  She says there is only one suture that hasn't finished dissolving, and all the wounds are healing very nicely.

Belle finally ate on her own last night.... though it took her 3 hours to get through her meal.  ::)
She is making a good effort at it this morning as well.
I've been cutting the meat into tiny 1/4 inch bites... no bone or eggshell yet.
Hopefully, I'll be able to get a little bone into her soon.
I'm trying not to be too anxious over it, but we need her to be eating on her own by next week, as we will be taking a trip to visit Hubby's ailing father.
Title: Re: Consultation: A Comedy of Errors
Post by: CarnivorousCritter on October 11, 2011, 10:59:35 PM
 grouphug FurmonsterMom  grouphug

She does not hate you. (Don't think they are capable of that anyway)  :)
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 12, 2011, 01:55:43 PM
I'm glad to hear that Belle is mending AND eating.  I'm really sorry for all that BOTH of you are going through.  Don't know if this will help or not, but here's a smoochie to maybe help you feel better.  kissyou
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on October 12, 2011, 03:16:08 PM
Glad to hear that Belle is doing a little better :-* hope your father in- law is ok too, so sorry to hear of this. grouphug
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 12, 2011, 06:55:42 PM
I'm glad she's doing better.  Is she off the pain meds now?  I think, once she's done with all the meds, and begins to really realize that her mouth doesn't hurt any more, she will start to bounce back all at once.  All paws crossed here that happens this week.
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 13, 2011, 02:54:27 PM
You guys are awesome... thanks for the hugs & smoochies.   grouphug :-*

Belle is definitely on the upswing. 
She's even been up on the bed, snuggled up to Dad, and trying really hard to ignore the other monsters.

She's still a little shy with me, but is letting me pick her up for short periods.

I choppity-chopped part of a wing bone superfine with some extra meat, and even though it took her 2 meal times to get through it, she did eat it all.
I will probably have to do that for all her "bone meals" from now on, but I'm okay with that.   thumbsup1 
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on October 13, 2011, 03:29:01 PM
Yippee!!! sounds alot better, but she is Daddy's girl anyhow right?  ;)
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 14, 2011, 09:15:27 AM
Glad Belle is doing better! purplekat
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on October 14, 2011, 11:50:05 PM
Thanks for the happy update!
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 15, 2011, 09:56:44 AM
If you are now on the road to visit your FIL....wishing all of you THE BEST!!!! 
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 15, 2011, 02:54:00 PM
If you are now on the road to visit your FIL....wishing all of you THE BEST!!!!  

We will be leaving at "OMG it's F'in early" on Tuesday morning.

I'm currently on a packaging project... vac-packing meals for the sitter (my friend that I've mentioned before).
8 days, 4 cats, 2 meals each = ... 64 meals.... with special attention to Belle's meals.
And even though we are taking Babee with us, I'm pre-packing her meals as well... so add another 16 meals for a grand total of ... 80 meals.

Does this officially make me a "crazy" cat lady?   sillytongue
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on October 15, 2011, 03:34:26 PM
We will be leaving at "OMG it's F'in early" on Tuesday morning.

I'm currently on a packaging project... vac-packing meals for the sitter (my friend that I've mentioned before).
8 days, 4 cats, 2 meals each = ... 64 meals.... with special attention to Belle's meals.
And even though we are taking Babee with us, I'm pre-packing her meals as well... so add another 16 meals for a grand total of ... 80 meals.

Does this officially make me a "crazy" cat lady?   sillytongue

LOL to leaving early.
LOTS of work to leave furkids for days.  We have only both left for 3 1/2.  It was MUCH easier to drop the skin kids off at Grandma's house.   ;D
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on November 05, 2011, 01:03:52 AM
Quick Update:

Belle is doing great.  Slowly giving her larger chunks to work on.

Teaka had to go in for emergency dental today to the tune of $760.  Her top left canine had resorbed to the point that the tooth BROKE OFF.  She also had another tooth in the beginning stages of resorbtion that was removed.
She gave absolutely NO INDICATIONS that she had anything wrong with her teeth.  I like to think I look at their teeth all the time, I can't believe I missed this.
I feel dumb...
and poor.
 Doh1 bangshead
Title: Re: Consultation: A Comedy of Errors
Post by: Middle Child on November 05, 2011, 07:20:09 AM
Thanks for the update on Belle.  Please try not to blame yourself.  Cats are just so incredibly good at hiding pain.  I felt the same way when my boy first had the resorptive lesions.  I had had no idea he was in pain, and I was absolutely mortified when my vet told me about the resorptive lesions.

Teaka will be feeling good as new very soon.  All paws crossed for a quick recovery.   grouphug
Title: Re: Consultation: A Comedy of Errors
Post by: Shadow on November 05, 2011, 12:39:41 PM
Oh no Teaka!!! so sorry about your tooth, I hope you are feeling better soon. what does reabsorption mean? did she get a bone stuck in there?
So glad that Belle is doing better.

Purrs, hugs and butterfly kisses love1
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on November 05, 2011, 02:39:37 PM
Welcome BACK!
Glad to hear Belle is doing better.  Sooooooo sorry about Teaka...and the vet bills.  YIKES.   :o
I agree with the others...don't feel badly.  Cats DO hide/tolerate pain very well.  You are a wonderful cat mom...things get missed.  You are human.
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on October 31, 2013, 03:35:35 AM
Well, it's Halloween, so I suppose it's appropriate to resurrect this thread from the ashes....

*raises arms grandiosely*

Arrriiiiise old thread, a-RIIIIISE!!!

(https://parenting-furkids.com/proxy.php?request=http%3A%2F%2Fimageshack.us%2Fa%2Fimg718%2F8049%2Fheavenpeep3x5.jpg&hash=088a28c18fca67c2cf703dc30550dc7e2dc102ad)



Belle went in for another tooth extraction yesterday....  she now has 3 teeth left... total.  lol

I guess my message about the Rimadyl was heard loud and clear.  When I mentioned it, the vet said, "Just so you know, I have that note in ALL of your cat's files.  So in case anyone other than me is looking, they will know."  lol

On the other hand, it was good that I insisted on a "refresher", as I had to reiterate that I did not want the antibiotic injection.  I'd rather take pills home.

It's actually a good thing I re-read this whole thing, I'd forgotten that Belle had a reaction to the Buprenol... which is what we were sent home with.    oops!  Guess I'll be making a call about that later.

So now I'm off to the store down the street to pick up candy for the trick or treaters... nothing like contributing to someone else's eventual dental bills... muahahahahaha!
Title: Re: Consultation: A Comedy of Errors
Post by: Lola on November 03, 2013, 01:54:36 AM
3 teeth… how does she eat raw?  You feed raw chunks right… not the raw mush.  (Non-technical terms.) 
Title: Re: Consultation: A Comedy of Errors
Post by: FurMonster Mom on November 03, 2013, 10:58:50 PM
On meat days, I cut the pieces into small bites that she can just swallow after gumming them a bit.
On bone days, it depends. 
     If it's ribs, I cut them into long slices across the ribs, they are fairly easy for her to swallow.
     If it's wings, I get out the 5 lb cleaver and choppity-chop it all into mush.  yah, I do it by hand.

She is again having a tough recovery, poor thing.  She is so grumpy.  Don't blame her.  :(