Should You Always Sedate Pets For Radiographs?

Welcome to another episode of The Veterinary Roundtable! In this episode, the ladies answer what they'd replace the handshake with, Dr. King gives an update on her pleural effusion case, a question all the way from Scotland makes an appearance, and more!

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TIMESTAMPS
Intro 00:00
Icebreakers 07:50
Courtney's Case 12:05
Devyn's Case 18:00
Dr. King's Case 21:20
Dr. Duckwall's Case 25:14
Listener Question (@Michelle Cicalese) 29:34
Outro 38:30

Transcript

0:00

(upbeat music) Hello everyone and welcome back to another episode of the Veterinary Roundtable, the podcast where we answer your veterinary related questions while having some fun along the way. If you enjoyed today's episode, be sure to leave us a review on your podcast provider of choice and if you have any feedback to offer to improve the veterinary roundtable, let us know. We are really hammering home.- I think you can tell.- Wait for it. I have a magic bag baby.- Yeah.- I bet it is a magic bag.- That's how you're doing.- No one look. You can't look inside the magic bag.- It's an interesting thing.- I gotta find it.- Well the back's came, most I can't see it anyway.- I brought Thor's hammer.- Oh my gosh.- I thought it was thinking,"I didn't go here before you see it."- I thought it was gonna be like, if I don't look, is that like,- It's from one of those action figures.- Oh my gosh.- It looks like a pretzel.- Thor's hammer.- Isn't that what I said?- This is amazing.- It is from the wood.- I didn't know what I said.- Shoot over there.- Ticulous.- Ah!- I know, those reviews, let's hear more.- Is it a heavy?- Bring them, don't hammer it. Don't hammer the steam.- Okay, so duck ball.- It looks like a pretzel.- It's a little ball on a stone or a marshmallow.- Should I throw it and see if it comes back to me?- Oh, it's not a boomeray.- I wanna see how heavy it is.- I think he does not see the marble movies. Yes, he throws it in the morning.- Oh yeah, that's true.- It's true, I wanna see how heavy it is.- Oh God.- Is it a plastic?- Is it a lemur cream?- Wow.- Is he going?- No, he doesn't have any.- That would be great.- Sometimes there is no marble super-year-olds.- Oh, okay. All right, so here we're home, those reviews, duck ball, tell us where we're at in terms of number of reviews.- We didn't gain any on Apple from last time.- What the heck?- This is what I thought. I thought of after we had done the peanut butter commercial.- Yeah.- Devon needs to be layered, lathered, and peanut butter. She has to be laying on a ground with her scrubs, all, you know, not like naked or anything. I'm just saying like with her scrubs on, peanut butter on her arms and her face, she has to lay on the ground and then we release the dogs.- Oh, that's actually really neat too.- Yeah, it would be great.- It would be good, oh, she's not gonna get bit.- No, but before that, let's all just throw marshmallows out or so they stand and then put her on the ground.- Okay.- What if we just like cause a dog fight in front of her?- Okay, now listen.- We'll take dogs to our food aggressive.- Yeah, they're gonna be friendly dogs like Moose and Quill and-- Can I cover my face?- Miles and Whee.- Miles and Winnie and-- Just so we're gonna get along, right?- They have to face one.- Oh, no, look at you, a helmet.- We can get you a helmet.- That's so great.- Okay, so that's one of the ways to cover your peanut butter.- For what?- One of them can do, so we gotta get you a hard,- We gotta get you a hard,- I have the milk mile, oh,- 100, oh, then we have the milk mile. We have now devin covered in peanut butter.- And eating on the stupid food.- And yeah, eating the dog food.- I really like the dog food. Peanut butter and dog food.- No.- No, one of them.- It's a lot.- All on your body.(laughs)- But hey, we are at the 40's Spotify, where it 133,- 40 was two weeks ago, people, backwards 133 on Spotify, 40 on Apple.- Okay, yep.- I don't know what to go for.- 100, I think it's a 100 on Apple.- We don't, I don't think we really,- 'cause I mean, I'm not gonna spot a spot.- I know we have 60 followers, I know we can get 60 comments.- Yeah, we didn't get any.- And we didn't get any.- Zero out of it.- We gotta be better.- Well, devin had a good point. Maybe they love her too much and they don't wanna see her suffer.- Ooh, that's cool.- Because we clearly, these punishments are not nice.- Okay, you can point.- Devins, bam, bam, come into our rescue.- That's true, exactly, exactly.- It's like the Switties, but for Devin.- I don't know what to call it.- What do you call it?- The Devies.- The Devies.- Are the fortune cookies.- The fortune cookies.- The fortune cookies.- Oh, fortune cookies.- I like that, fortune cookies.- It's very nice.- Well, we'll see if people show up. Let's see if they do.- Yeah.- All right. Introduce yourself, ladies.- I'm Courtney.- I am a technician. And that's how I got.- We got an R-T-S-Boaring.- Warrr, wrarrr, wrarrr.- Hit the fail button.- I don't have it.- I don't have it.- You took away the fail button.- Why'd you take it away? I always use it.- He keeps us.- He's rough. Yeah.- Okay.- So sad.- Mark, Mark, Mark, Mark, Mark, Mark.- That's the fail.- There we go.- Okay, good job, Courtney.- He's gonna dig it out of the box.- Why are you gonna say?- I don't know anything, literally anything.- I braided my hair today.- Wow, it looks beautiful.- It looks like it's a treat to us.- There you go.- People don't know if they're not watching.- Oh, I did my own nails at home. I got a gel kit and I did my own nails.- Did it work?- Yeah.- Nice.- That's exciting. That will save you money.- Yeah.- That's cool.- The whole thing was like 30 bucks and a normal gel set is like 60.- And it's long.- No, it looked good. Okay, there's my fun thing.- It looked great.- Thanks.- For taking 30 minutes.- Tinks.- And they match your sweatshirt.- I'm Devon Fortune and I'm a assistant tech in training.- Nice.- Yes.- Oh, update everybody on your pharmacy.- Oh, yes.- It was my--- What?- It was what?- Wasn't it just form?- Yeah.- Not pharmacy, form.(laughs)- I don't know, is anybody here?- They can't hear that on here.- That must be the ghost.- There is something yelling.- Do it.- Oh! Get the tissues.(laughs)- No, you listeners. If you didn't watch the last one, watch it.- No, it's personal.- It's an update. Devon got really bothered by the fact that there have been cat ghosts.- There's a lot of tissues.- In this hospital. And so, you can say emotional.- Dr. King.- Dr. King.- Yeah, she got emotional. She cried. I'm just playing a cat meowing in the background and gave her tissues. That is actually fantastic.- It looked, is this supposed to be a cat?'Cause it looks like a wild animal.- It looks like an expensive cat.- You're just a protector ear. So you don't have--- Oh my gosh. Why do you have these?- These are for you.- Suns.- I know. I just had to, I had to buy those 'cause clearly I don't have--- That is fantastic.- There you go. Now you don't have to worry about hearing those scary sounds.- What?(laughs)- Oh, yes. My pharmacy final. I got my grade back, my proctored final, and I got a 99.- So you just missed the one that you told us?- I know, well I thought, I knew that I got one wrong and then I got one vitamin wrong, but they won't let me see what I, oh. Like got marked down on, so I don't really know when I got wrong. But I'm happy.- But I mean, I'm not that pretty cool.- But it's pretty good.- But it's pretty good.- It's always annoying when you're like when you're this one.- Yeah.- Good job, pharmacy.- Thanks.- I'm Ashland Duckwell, I'm a veterinarian. I'm just trying to make it through the day without coughing and it's not working.- I mean, you're doing pretty good.- You're doing great so far.- Okay, thanks.- I've got things for you too.- Just got a cold, residual cold.- Yes.- I'm really should take some.- I'm being one-up to all matchups.- I'm just a big fan.- Yes.- Maybe a fall.- Maybe a fall.- I'm not a magic-bide privileges refot.- Immune defense.- And by me.- And here's your other.- Hey, you know I love surprise gifts.- See, go, see.- Look at that.- Those are the best kind of gifts.- Okay, then you just got some cough drops, which is appropriate for why I said it was.- Yep. Excellent.- We're doing it. I'm here.- Okay, your cough matters.- It's worth the seat.- I get ear loss and a ghost. Duckwell gets cough drops. I can't wait to see.- It's not time for mine yet.- No, I just can't wait.- I just can't wait to see.- I'm Emily King, Dark Dragon Waking, and I was in charge of the magic bag today.- Yep.- And you're doing phenomenal so far.- She is.- Okay, awesome, sauce. She's doing amazing.- Is that supposed to be me now?- Yeah, I think so.- Again, for all those not watching and listening, Courtney is holding up a stuffed cat.- That does not look like a cat.- It looks like an alien and she's pushing the button.- Okay. Stop it.- I hope that I'm gonna have nightmares.- That is quite good.- That's quite good.- That helps for a reason.- That does look very scary.- Oh my god.- That sounds like a lot of other things.- All right, if you could replace the handshake, what quirky greeting would you invent?- Ooh, Courtney.- We'll get to our damage, whoever.- I don't have anything.- The hands nail.- Okay, what's the hands?- I love hand hug.- We started to face.- Hand hug.- I'll do the snow part.- Okay.- Wow.- Okay. Okay, now do mine. Handshake.- No.- No, I like that one.- Hand hug.- No, it has to be opposite hand.- Oh.- Oh my god.- Oh, you like how big?- Oh my gosh. Those are really dorky. Okay, nobody should do those.- Those watching.- Don't ever do those.- Am I talking loud?- Yes. Okay, wait, where did you come up with those?- Life.- Oh my god.- Those are actual real things.- Those are things people actually do.- Yeah, you've never done an hand hug? What would you do?- No.- Do you want to experience your first one with me?- No.- Why do I?- It'll change your life.- No, you have to hold it for 30 seconds to make yourself feel happier.- We can't sanitize our hands.- I'm not continuing to do any more.- Okay, listen, there is something about oxytocin being released when that's why people I can't really give high fives because of what we're going to say.- I was going to say you have to hold it for 45 seconds.- Yeah.- That's the feeling or the not drug.- And Dorphin?- Thank you or something that's released when you do that and so then that forms bonds and creates trust.- What's in fact of the week?- What's your worky thing?- Mine would be more like a poop lung.- A handshake, like a full one.- Oh, yeah, like that. Wow, not someone else.- Yeah, sure.- That was a mess.- Yeah, it would be like that. It would be like one of those.- Hey, welcome to "Past Out."- Yeah.- Oh my...- We are on one, too.- Could you speak to stupid ear most?- Yeah, good.- Okay.- If animals could talk, which would be the rudest, the giraffe, because it's always looking down on you?- Okay.- Somebody wrote these questions over.- No, I literally thought that as soon as I read that, I was like the giraffe.- That's because it's always like a downer.- I love the logic when it's out.- She's crying.- Well, my first one is basic. It's my tissue.- Yes.- What was the first one?- It was just a cat, because they're always like, you're so judgmental.- But then I looked it up, because I was just curious what other people had to say, and they said"Seagulls," because they're already rude.- Like, I'm like, "Seagulls?"- They still eat them.- They have no respect for anything.- Yes, they are.- At all.- They are, it's all about them.- I'm still a cat.- But that's how cats are, too.- Let's try them.- They're just trying to survive.- They can't fly wherever they want to be.- A couple years ago.- They can't go.- They can't go.- There was one leg at Seagull, and we just kept feeding a french fries.- And he was fighting the other ones for the french fries. He did pretty good.- He did.- He said, but he only had one leg.- What's your opinion?- I mean, I'm not really thinking like a lot of animals, I think, cat, though.- Yeah.- I said, I said, "Sloth."- Okay.- I don't know who it is.- Well, because they don't even have like,- They don't even have like,- Passing them by the movies.- I don't, it would take them like 70 years to even say something else.- Somebody like, you,(laughs) throwing up the middle finger would take 10 years.(laughs)- Who is?- Or the thumbs down just very slowly.- They're mad because they're worse.- They're mad because they're worse.- They're even faster than them, so I thought they'd be the root is.- It would keep me on the edge of my seat if they're going like this. You're like, "Is it gonna be thumbs up?"- It's gonna be thumbs down.- Oh, it's going down. It's going down. Oh!(laughs)- Oh my god.- Oh, interesting.- That's good stuff.- Good stuff, good stuff, good stuff.- That's our whole episode where we just ask each other questions.- Okay.- I'm all down, or I don't know, I'm for it.- I didn't get a present.- It's coming. You're gonna catch it.- You played with your kitty, you're in there.- All right, case collections. Let's hear what you guys have.- It's a vibrates.- Okay, court, you go first.- Okay, it was a vibrates.- It's a vibrates.(laughs)- Don't cry, you're giving it back.- That's a bit over here.- Okay, anyway, case collections. So we had an 11-year-old new-dored Labrador. He presented for not acting like himself.- Oh boy. Someone's got to take the batteries out of that.- Give me that cat, I'm gonna get some gaffa.- It's a date it.- He presented for not acting like himself. He was constantly pacing at home, yet lethargic. He was drinking a lot of water more than he usually does. He refused his breakfast as well as any kind of treat which is very unlike him because he's never missed a meal in his life. He did vomit once, but otherwise his stool is normal, everything like that. So we started with some work-up diagnostics. So first we did blood work that showed mild neutrophilia, azotemia, azotemia, and mild hyperglobulinemia. I'm not gonna sing that word. His USG was 1008. His chest are as we're unremarkable. We did do an abdominal ultrasound because at this point we were kind of just looking for anything. And that was pretty unremarkable. We found an incidental splinic mass, but that was not causing his symptoms that he presented for. And then he did have a temperature of 104.104.2, which is extremely high, not normal. And so we were kind of going through the list of what could possibly be going on. And one of the first things that comes to mind is a tick-borne disease or virus. But the owners did not want to do that at that time. So we did not do that PCR. And then on exam he was very, very weak. Couldn't hold a self-up for very long. His eyes were also sunken in. So after discussing everything with the owner, and like I said, they didn't want to do the tick-borne panel. We decided to just treat for a fever of unknown origin. So what that included was hospitalization on IV fluids. We did a IV antibiotic, which is unison, and then we gave him serenia. We did multiple doses of each medication. And we kind of just continued to check his temp, make sure it was going down. The first day he was here, I don't think it really moved much. I think it went actually up a little bit and then started to drop, but it was never normal that day. And then the next day it did start to drop a little bit more and kind of go into the normal range. But he was still, I think he normally runs high, but I think when he left it was in like the 102.3 or 4 range, which is technically normal, but it's high and normal. So like I said, after he was here on fluids, he started to improve. He kind of perked up a little bit. He started eating for us. And so therefore he was eating, so we felt comfortable sending him home on oral meds. And so the owner stick him home. Like I said, he got better at home progressively. He started eating, acting normal, playing with his toys, things like that. So I think he was here for almost a full two days. Sorry, yeah, he was here for two days. He went home on the second day towards the end of the day. So he went home on December 28th and he actually came back on January 1st for a splenectomy. Do that incidental splenic mass that we found. And now he's doing fantastic. Which came back as a negative, well, not negative, sorry, but nine hematoma on the splenectomy. So with those, it unfortunately is 50/50, but they still all have the risk of rupturing. So owners are very proactive, which I agree, because it was pretty big. Yeah. And we took it out when he felt better. But the biggest thing with him was fever of unknown origin. It could be really anything. And so I did discuss with the owners, like going down that rabbit hole diagnostics, which is not wrong, but for him, there was no history that would lead me, towards doing one test over the other. And so we just kind of agreed to focus the finance and just commitment of treatment or two treatment to get him feeling better as opposed to knowing the why. And because he was responding, that was also a good sign of what we were doing was working. So if it wasn't working, then yeah, we would go back to that discussion of diagnostics. But he's one of our frequent flyers. And when he came in that day, I actually went and picked him up, because his owner is right at town. And he wouldn't even get out of my car, which is very weird for him. And like Dr. Duffall walked back to treatment and didn't even recognize him. That's how dumpy he was. Yeah, he didn't look like himself. Yeah, he felt bad. But he's all better now. He's great. So treatment is also a way, what am I looking for? Like a diagnosing? Yes. Yeah, but yeah, that's kind of how we approached it. Yeah, I think he's all better. That's awesome. That's awesome. I think there are so many instances. I talked about it before too, where like you're working up something else and you find something else. And it's like kind of like a blessing in disguise. I agree. And you can actually the more pressing problem is the secondary thing that you find just because the dog or cat came in for something else incidental. I agree. And so it's pretty cool. Yeah. I feel like explained that happens a lot with spawning masks. Yeah. It's not a lot, but I mean, unless they're ruptured, you don't really, or unless they're about to rupture, you don't really find them. Yeah. Like there's no reason to just do an all-in-all for fun. Right. So, I think, yeah, so I'm really happy because it was, I think it was six centimeters or six millimeters, something like that. It would have been six centimeters. Yeah. Yeah. And I think that, yeah, I mean, it's just fascinating how often that happens. And, you know, to Duck Ball's point, you don't know when you're looking on ultrasound because hematomas and hemageostarcomas can be destructive in nature. So, you don't know which one it is, but they're what we call ticking time bombs. So, eventually, it's going to cause a problem. Yeah. So, it's much better to be proactive by the animals in a good place, physically, to be able to do surgery, remove the problem, and then they can move on about their, because they can live without their spleen. Yeah. Yeah. It's animal healthy enough to take it out. So, it's not a problem. And then you don't have to just sit there and wait for something bad. I mean, something bad might happen. Yeah. Yeah. Yeah. It's awesome. Okay. I can go. Yeah, go for it. Okay. So, this is my cat. He is a six-year-old domestic short hair, and he's kind of had chronic reverse sneezing for most of his life. So, it started in 2020, December of 2020. So, three years ago, he just started reverse sneezing out of nowhere. I brought him in, and then we did a round of doxycycline and started him on Lyceum Powder. And then he improved on the doxycycline, and he lasted like a few months with it out of his system, but then his reverse sneezing came back, summer of 2021. So, I brought him back in. We did another round of doxy, and then recommended a sedated oral exam to look for polyps. So, he, same thing with the doxy, he improved last a little while. He brought him back in. We did, we ended up doing a core, so a dental procedure, and then just looked for polyps there, and we did not find any. So, from there, I'm kind of a crazy cat mom, and I want to do everything. So, no polyps. So, we went forward with thoracic radiographs to look for asthma or any changes, no changes, no asthma. So, I did a upper respiratory PCR fan on him, and that all came back negative. Okay. So, after trying so many different things, because I just really, it wasn't affecting his quality of life at all, that it was bothering me. And he, like, sound congested, so I just wanted to make sure it was fine. But we started him on cyclovance. He's probably been on it for like a year now. He's doing wonderful. Like, I gave it to him consistently for probably a month, and then I slowly weaned him off of it, and now I only have to give it maybe once a month. Like, if he starts flaring up and reversing, he's saying I'll give it a couple doses in a row, but... So, you think his allergy related to him? Yes. Yeah. So, rhinitis, like, just secondary to allergies. Yeah. Fascinating. So, my allergy kiddo, little kitty. Oh my gosh. So, I'm glad that we finally figured it out. Well, you know, and what you do is rule out all those other things. I know. I always make sure you're better though. Oh my gosh. I know that there's not something more serious going on. Yeah, for sure. That's cool. Yeah. Yeah, it's just like a cycle of ants. Probably once a month. Oh, okay. So, not very often. Yeah. Yeah. Mm-hm. Okay. And it doesn't seem to flare up, like, during certain seasons, because the first time I brought him in for it was December, and then, like, it was the same thing in the summer. So, it's not like only bad during spring or fall. Right. It's just, kind of... So, it's interesting. Yeah. Yeah. Maybe it's something in the house. I know. Maybe he has a allergic to your other cat. Maybe. Maybe he's allergic to me. Good-being. Too bad. I'm just thinking of what to do. Exactly. Got to go back together. That's too bad. Walter? Walter? Yes. Oh, my gosh. We should have a sneezing. Yeah, a whisper sneezing. I was doing great on cycle of ants. That's so good. Yes. It's good, because some cats don't do as good, so... Yeah. And I only have to... I was telling them, I only have to give it, like, once a month now. That's really good. Mm-hm. Oh. See, that's a happy story when you go to a disease. Yeah. Because I've had a couple of kiddos that just... It's the infection. It's the secondary infections I get, because it's just really annoying. Yeah. You do it in a wonderful... A lot third. Okay. I will go next. I was going to give everybody an update on the cat that I spoke about. I think last podcast where the cat had... It was a young cat that had a plural fusion. And by that, we mean free fluid in this chest. And so that cat, unfortunately, succumbed to the disease because he just... He can't keep tapping the cat's chest to provide relief. And so... And at that time, the owners didn't have the means to continue with the treatment or diagnostic process. Mm-hm. So we ended up euthanizing him. But as we were talking about that case, Courtney brought up the fact that we've had a handful of cats in the clinic, because we assumed that cat probably had FIP to the most common differential in a seven-month-old cat, with plural fusion. So then we were talking about treatment options for cats with FIP. And I think on the last podcast, we mentioned the Facebook group, the FIP warriors, the Facebook group. And then you start... You mentioned that you have a cat, right? Somebody has a cat... Or you saw on social media. I saw on social media. Social media. Yeah. There was a cat or a lady, so... Her cat, I think it's like between six and eight months old. And he was diagnosed with FIP. And they did all the conservative treatment, everything just to make him feel better. And the vet she was going to at the time was just like, "Hey, there's really nothing more we can do." Which is... I mean, that's usually the case with FIP. You do as much as you can and keep the animal comfortable and whatever. So they did that for a long time in the mom. Like, I mean, this cat was just like lateral. He wasn't doing anything. He wasn't eating. He looked horrible. And they were like, "Okay, you're eventually probably gonna euthanize, because the disease is just gonna get to him." And this lady was like, "Nope. I'm not doing that to my cat." So she went and she did her research. She did find the FIP warrior's Facebook page. And she got the... There's a drug I think that they talk about on there. She ended up getting a dose of it. I think she gave a few doses maybe. And her cat is completely healthy. And he no longer has FIP. I mean, hell, this blood works normal. He's eating again. He's playful. He's acting like a kitten. So I thought that was really cool. Yeah. I could... One of our doctors also, the clinic is used it for two kittens that have FIP. This drug doesn't have a name. It's like letters and numbers. Yeah. I don't know what it is off the top of my head. But it's like... I don't know. Like IG53. It's something like that, basically. It doesn't have a name. Yeah. But it also isn't sold in the United States, right? Well, I literally don't even know where people get it. So the Facebook page, the FIP warriors can get a hold of it. And so then that's why those are the people that are helping folks with cats on FIP. But we were in our doctor's meeting and we were talking about Rindisavir, which is used in people for coronavirus. And there are some consultants that are using that now for FIP. Because now that it's FDA-proved, now we could use it off-label and animals. So there are some clinicians that are pulling that because it now... Because the other product is not FDA-proved. And so it's hard to get a hold of. Whereas this one now that it's FDA-proved, if you can... If your distributor can get a hold of it then potentially that could be a product that could be used at FIP. Are we seeing improvement? Is there more success with the treatment? I don't think it's... I think it's not much brand new, like from the standpoint of... Just, you know, it's just because it was on emergency use only for people. Yeah, okay. So we couldn't get a hold of it. Right. And so then once it's FDA-proved, now I think if you can get it through your distributor, then you could use it off-label. I'd be interested to see how it works. Yeah, so VIN I think had information on the dosing and they were talking about it on VIN. So that's why we were talking about it on VIN. Still a risk to doing either one, but honestly it's better than the alternative that... Unfortunately, these kiddies don't really... It doesn't end well. Well, you have no other... I mean, there's... Right, that's what I'm talking about. Yeah, you can do anything. Do what you can. Yeah. So... I do have a case. I was going to talk about a dog named Charlie. She's a two-year-old lab mix. And I saw her a couple weeks ago for hair loss. Just essentially just diffuse alopecia on her limbs, her belly, all four limbs. And she had had an episode of this back in the summer. And saw a different doctor here and was worked out for allergies and ended up responding. They tried apical. She didn't tolerate it. G-I-Y's. And so then they switched to cytopoint. And it had been sometimes through that process. And so then she got the cytopoint, her hair was coming back. She wasn't like overtly puritic or even licking a lot or anything though. And so she had responded to the cytopoint and then kind of went on her way. So then it started happening again just two weeks ago. And again, nothing in our history that's like allergies is screaming allergies. She's on prevention. She's on some paracetriote each month. So that helps minimize my concern, prepare sites and things like that. So the pattern of it is very interesting because truly her hair is flaking off. But there's no redness. There's not scaling. There's not like pimple type bumps anywhere. Again, she's not overly itchy or anything. So it looked a lot like maybe a follicular dysplasia, which is like an umbrella term for these different types of diseases or dysplasia. The hair follicle or the skin of the hair or the gosh, the life cycle of the hair, if you will, things like that. So that I have that on my list and then hormonal. So we checked her labs for thyroid or maybe cushings type changes on her blood work and everything was normal. I still can't rule out thyroid, I guess, because we didn't do the full detailed thyroid panel. But anyway, that's still on my list too. So we ended up just jumping straight to biopsies because moms in the medical field and honestly that's our best quickest way to start to get a diagnosis. So we just performed those on Monday. I got samples and kept the hair so that the pathologist could look at it. So to be determined on what's going on. Yeah, it's, I usually think a lot of times when it's just like a cosmetic thing mostly and the dog's not super uncomfortable, we may kind of jump along to different therapeutics or supplements or supportive care first. But I think I'm excited because we're jumping right to the biopsies. The owner said she did try melatonin but it was like for like a week and she was like, "You know what, it's great. Let's just..." Yeah, well she, she did come in being on melatonin since the last episode. Oh, that's a good idea. And she was also on Benadro for reverse sneezing but that was it. So she's been on melatonin for a hot minute. Yeah, I'm doing something your hair is still falling out. Interesting. That'll be fun to hear what the dramatic histopathologist said. I hope we get like a direct answer when we have to go. We stand at a dentist. So the texas. Yeah, if you're out there and you're sending in samples, send them to Texas. Yes, they're great. Yeah, they're awesome. Yes, I sent pictures too. We'll see. Okay, those are great cases. Good case it. Speaking of great cases. You gotta get out, my. Oh my. Oh my. Oh my. Oh my. Your bag is giving birth. Oh, that's Courtney's home. Put it on. You're all cat. Courtney, you're. You want to give a mother hand. There's a bottle. Courtney, your case is King case. Really? Oh, there you go. You're. You're. You're. You're. You're. You're. Is this what you're going to have? What is happening? She's not even. We have a fake. That is just what the. You can definitely use it as a. A white helmet. Sure. Why not? We can go into wall. Oh, Jay. Oh, when. That has what be presented. Catcher the rudist. Oh, yeah, but I'm. I'm. I'm. Gave two little rolls like some. Toys to play with. And they're just like. Gosh. He wants your. Where are them with your helmet? That would keep your helmet on. And then you're. And your. Your ghost cat. Okay. Here we go. Let's move on. This is the girls in school. Okay. Go ahead, duck wall. All right. Hi, yeah. I'm a third year vet student at the University of Glasgow, which is amazing in Scotland. Oh, my gosh. I'm so jealous. I am from New Jersey back in the States and am here for a school. Why not travel? Why get my dream degree? It's genius. So amazing. coming to your podcast and following you on TikTok since I started vet school. I love your podcast so much and I can relate them to my classes which has been helping me understand the content better. Y'all make me so excited for this career and I'm so grateful for your podcast. So I have a question for the group. In the UK you have to in all caps, today any animal for radio graphs. Does not matter if it's an emergency or the age, you have to do it as humans are not allowed to be within two meters of the primary x-ray beam. Meaning patients are held into position with tape and sandbags. My question is, what is your opinion on this? How would you feel about sedating or putting under GA any and all patients that need a radio graph at Michelle? So I was thinking about this question. I was like, oh, back in the day. So digital x-rays are new, right? And new in terms of newer years. So when I was in school, they definitely sedated every single patient for x-rays. And that was the protocol. Everything had to be sedated. Actually they did it for me too and I was in school and I think about it. And I don't know if part of it was, I think there's lots of reasons why people do it or why that's the recommendation which would include things like better positioning, fewer x-rays. And so then fewer people exposed to x-rays are probably the biggest things. Yeah. Oh, I think that's hand-staff. That's a good question. That's stressful for the time. And then when you're taking, and the fewer the number of x-rays you have to take to get it correct, was very advantageous when we had to use film. So back in the day, we had to use film and you had to send the film through a processor. And if you had to do that 15 times. Yeah, that had a lot. It was a lot of freaking film. So they're like, get your animal positioned correctly and so the only way to do that is to have the patients. So I think when I was in school, I think the biggest thing is, well, one is also good for learning. I should say that with when you're in school for the students just on where to call me, where to how to position them, things like that is not having a moving animal. Yeah. I think that you need something like me. Sure, just waiting for you to call. A little bit of mineral water with a twist of lime that's carbonated that might tickle your throat. So a twist of lime. Does anybody else need anything? Pop-o-chico. Do you need a bottle? It's a little bit of coffee. No, I have no idea. I've never bought them, but they just caught my eye. I was like, I wonder if this would help. This is twist. Do you have a bottle of butter? Someone got some sharp teeth. No, we'll know. Someone help her. She's coughing. Okay. I don't think it's twist off. I think coming to the real world, it was like, it's this twist of lime. Oh my gosh. Some of these animals are crazy. And of course, our lovely technicians are the ones who are positioning them and doing the x-rays. So it's like, I think, I mean, I'm thankful that they're great to know like the level of stress, right? Right. The dog, it's too much or it's not safe for anyone. They'll call it and call us and say, we need drugs. Like, we need something to calm them. So like, luckily in here in the United States, we don't have like, so we don't have that role. So independent animal. And I don't think it's practical in the everyday sense because of the added cost. Added cost was going to be the thing that I said to you. Yeah, that you can't do that to every owner. No, especially if the animal, like, we have some great patients that will not care at all. Taking extras by myself on an animal. Yeah. Yeah. So it's doable without it. And so then it's like, why are you taking x-rays? What's the health concern? Restoring? What is their age? PPE. You know, we're still wearing personal protective equipment? Yes. But that is correct, yeah. Yes, yeah, no, you absolutely do. But I still think the safest thing is to not be. Right. Not be there. Not be there. Yeah. When we have sedated patients, we don't even leave the room. We're still in the room. Yeah. Taking the extras. Oh, to show that I think. To be away from them. Yeah. I see. Which I guess, I mean, for two seconds, it's fine. But I mean, you walk around the door, push the button. Yeah. I mean, you know, so you tape the patient in and then you walk around the door, push the button, walk back in, and then, you know, get the next film. Yeah. But it used to take so much longer. I mean, there have to be patients that, like, it's not safe for them to go under sedation or GA. I think at that point, doesn't the extras probably earn as important maybe? Yeah. I think it's just, yeah, it's a case dependent. I don't think it's a bad role to have. I just don't think when you, especially when you come back to New Jersey and into the States, you're going to, I mean, depending on your client, tell, probably realize it's you won't have to do that. That's not necessary. But then also it's going to add to your day in the time too, like, you be as efficient still by doing that. And, yeah, so do you. Is the patient fasted? There's another risk there. Right. I mean, I think, at least for my team are, like, if we have an orthopedic X-ray, we have to do, we always sedate them. Right. Because the patient's usually painful and you need specific positioning. And so you just can't practically do that awake. Yeah. That's just not any head stuff. Yeah. I mean, I think that it's, yeah, it's too hard at the animals moving and all. Yeah. Your X-rays are blown. Yeah. I was also going to add, and when I was in college, which was like four years ago, we sedated every patient taped on the table and had to process every film too. Oh, yeah. You did have to process every... We had a dark room. Oh my god. We started getting the digital. Even these days. Even these days. We started back in the day. We started here. We just started getting the digital. Well, yeah, but we didn't have to process them. We had, like, we just put the film into the machines. We didn't have like a dark room. We didn't have to. Like, I had to put it to the thing, dip it in the thing, hang it up. Yeah. Like, we had a dark room. Yeah, like, it goes through and we, and we, and we, and we, and we, and we, and we, and we, and it goes through, like, it's film, you, and take, so you go in a room, it's dark. Yeah. You open the cassette, you take the film out, you have to feed it into the thing. And make sure it's the right way. Make sure it's the right way. And it goes in. Well, did you look at me? I don't know. I was like, the processor goes in the developer, comes out into the dryer and then comes out on the back of the machine. And then you could put it up and like, you have to, you have to, but there's like a very faint, small red light. There wasn't ours. So you could see, you couldn't see. So you had to stand there for like a while. I just got adjusted. So you knew where everything was. And like, if you missed or messed up one step, you, oh my God. Yeah, you gotta go back and do that. Yeah, I had to do that. And that was only four years ago. That's a nice, I'd be see still has a dark room. Right. No, it's not. It's like knowing the capitals now. Well, yeah, what am I going to do with that matter? Well, that's what I'm saying. It does not matter. It does not matter. I don't know your computer. There's like one or two seconds. Like, who cares if you know the capital of Massachusetts, you know the States? No, I don't know. Probably no. Alabama. Alaska, Arizona. Arkansas. I'm not. Arkansas. I'm trying to think. What is the capital of North Dakota? I think I don't know, but you know what I can do. I think I start to realize the capital of North Dakota. Siri, what are the capital of North Dakota? I'm not really answering. Siri, I don't know about it. Siri doesn't care. What's the capital of North Dakota? Bismarck. Bismarck. Bussy, but like the dark room. There's probably like one in a million clinics right now that have a dark room and you have to process or it. Oh, I think so. I do absolutely. Absolutely. I do absolutely. Yes, cheap and just, you know, then I wouldn't work with this clinic. Yeah, I would not work in those clinics. Yeah. So, okay, that's our other advice, Michelle. You get out and come back to Jersey. Don't know the clinic that has a dark room. No, get a clinic with digital. We got that digital, actually, machine here. I was like, whoa. Yeah. Because I don't know how we used to do it because there would be like 10 to 15 minutes in between each film because we'd have to put it in the thing. I'm like, what do we do with the dogs? I said, I don't remember. I think somebody's, you act man. Maybe we had an extra person. Yeah. So, is why we held that might have been a lot of me and I did a lot of weird things that we got. So, the customers, very good question. Did everyone share their opinion on the question? I think so. Okay, great question. Courtney, would you like to have every animal was sedated? You're the technician. You're the technician. Um, an anti-corporate. It's case of Pennay, okay? An orangey. Because, like, sedation is so time-consuming and like I would not want to have to sedate every single animal that walked through the building and then needed extra space. Yeah. That would not, that's not feasible. Yeah. So, our opinion is we would sedate animals that are painful. Yes. Too wiggly. You can't get accurate phones. Too aggressive. Too aggressive. Mm-hmm. And orthopedics. That's for me. That's for me. Yeah. But no, I would not want to sedate every animal. It sounds nice. It sounds like amazing. That I could just lay an animal there, but that's a lot. You should recover then. Well, that's the big thing is that we have a whole lot of the post-war. A whole hour. A whole sedation. Yeah. Like, hour or longer depending on how fast the patient wakes up. So, no. Okay. There we have it. At least you can decide in the United States. Exactly. You have the power. The power. All right, Michelle. Keep after it. Great question. Yes. You're almost there. And thanks for listening. Instead of a picture of scum. I was just going to say, that was pictures. That was pictures. That's my dream. It's my dream places to go. It's a big thing. Very cool. Very cool. Thank you for, thank you so much for tuning into another episode of the veterinary roundtable. Remember, send in those questions and be sure to follow us on all social media platforms at AllStar veterinary clinic. If you enjoyed this episode or a previous episode, leave us a review on your podcast provider of choice. We'll see you in a few weeks for the next episode of the veterinary roundtable. That was perfect. That was perfect.[laughs][music][music]