Pain, pain go away: Pain meds, redux
By Gina Spadafori
January 12, 2008
Yesterday, my 11-year-old retriever had two lumps removed. We’d watched one of them, on the rear point of her hip, for more than two years, had drawn fat from it and were pretty sure it was of no concern, even in her notoriously cancer-prone breed.
But the lump had grown harder and larger recently, and so my darling veterinarian waved the staff surgeon in for a consult, which meant she was going under. I say this with all due respect and no small amount of bemusement, but I’ve rarely had a surgical consult that didn’t end with a recommendation for surgery.
Surgeons seem to be like that. When it doubt, cut it out.
All went perfectly (the second mass was never of any concern, more of a “while she’s under let’s do it” event). The worrisome lump was so obviously fatty it wasn’t even biopsied, and Heather was more or less ready to go home three hours post-op.
Except, as I was checking her out and paying the bill: No pain meds.
Come on, doc, the girl has eight staples in her butt.
“I’m sure if doctor wanted pain meds he would have prescribed them,” the check-out person said in moderately patronizing tone, reluctant to bother the surgeon. “He meant for her not to have them. And, um, I’m not even sure he’s still here.”
“In that case,” I said, with a non-smile smile that showed both my canines and the fact that this wasn’t up for discussion, “you’ll get him on the phone.”
“But …” she started, just as my regular veterinarian came into view. The surgeon had indeed gone home, but my main man took care of the problems, and Heather had her pain meds.
Why is this pain meds thing so difficult for the veterinary community to embrace? This is a top-notch specialty practice and a fantastic board-certified surgeon. I trust this surgeon so much I’d let him cut on me, but no post-op pain meds? C’mon.
To be fair, I know this surgeon prescribes pain meds — he has in the past for another dog of mine who had a more extensive procedure. But while the mass removal was not a big deal by a surgeon’s standards, it was no picnic for Heather, who even with the pain meds had a miserable night.
I’m not picking on the surgeon, but using him to make the point that when a top-notch specialist like this one doesn’t think to automatically review post-op pain protocol, pain management is still a hit-or-miss thing in veterinary medicine.
The evidence is clear that pain-management helps with post-op recovery (and certainly helps with the post-op misery). All veterinarians should at the very least be having a discussion of pain-management options with their clients as surgery is being discussed — and every pet-lover should bring up the subject if the veterinarian doesn’t.
The profession is in transition, and I offer as evidence the Minnesota vet charged by the state board for not prescribing pain meds — an event that would have been unimaginable even a decade ago.
But while the gospel of pain-management works its way in, you have a job as a pet-lover: If your vet doesn’t bring up the subject, you should. Because your pet can’t speak for herself. (Photographic evidence of Heather above to the contrary.)
***
And by the way (I write peevishly), I don’t ever want to be arguing about my pet’s medical care with a receptionist, no matter how valuable the doctor’s time is. My brother, in hearing this story last night, said, “Well, she didn’t realize who you were, and that you knew what you were talking about.”
She didn’t, but why should that matter? Get me the doctor.
Sheesh.
You’re well within your rights to demand pain meds when a simple request doesn’t do the trick. I’m sure the surgeon would have OK’ed them anyway. Perhaps he thought the one dose of Rimadyl or Metacam or the opiate used as a pre-op would be sufficient. Still, I’d have to agree that most surgeons tend to be more pain-conscious than most so your situation kind of surprises me. I’m lucky. Mine lectures on pain control so if he’s not using pain meds after my own dog’s surgeries I know it’s because he’s made a conscious decision against its need. If I asked for it, however, he’d never say no. That’s probably how your surgeon would have handled it had the receptionist managed to treat you with the respect, courtesy and willingness to call the surgeon any pet owner deserves in that situation. My profession bids you a warm mea culpa on her behalf.
Comment by Dr. Patty Khuly — January 12, 2008 @ 9:31 am
Oh, Dr. Patty, I’m glad you dropped in. And yes, I should have made clear that I KNOW the surgeon would have happily prescribed pain meds had I talked to him.
Comment by Gina Spadafori — January 12, 2008 @ 9:36 am
I don’t ever want to be arguing about my pet’s medical care with a receptionist>>>>
***********
Gina, I am with ya sister! Glad your pup is home, hope she is feeling better.
Comment by Judi — January 12, 2008 @ 10:14 am
When I took my little Georgie Girl in about this time last year for eating contaminated dog food, the vet thought poisoning, and then perhaps pancreatitis, both of which are very painful. In the written evaluation pain was right up there with refusal to eat or drink and shaking, and was, infact, the main symptom. We walked out with subcutaneous fluids, and several meds for her stomach. No pain killers. I started to drive back home with her and her suffering was obvious. I turned around, went back and asked for pain mediation, which I received. However, no one thought to send us home with it. This was at the University of Minnesota, you would think they would know better.
Comment by Kristi — January 12, 2008 @ 10:53 am
“I don’t ever want to be arguing about my pet’s medical care with a receptionist.”
*******
Gawd doncha hate that?
I use the veterinary practice that I do very largely based on the quality of their support staff. I’ve been using them for 12 years. They still have most of the same techs they did when I started, and have added some good ones and kept them, too. I’ve spent enough time tag-team wrestling uncooperative new foster dogs with these women to have developed some mutual respect.
Every other vet I’ve ever used has had a continuous turnover of ill-informed, snotty, surly, airheaded and/or incompetent techs and receptionists. I have to conclude that it is because those vets don’t pay well enough, treat the staff well enough, or take enough care in hiring to get top-notch people and keep them.
I’ve stopped using some really great vets because of this, and I’ve told them why when I left, but it didn’t seem to make an impression.
The large expensive specialty practice that I’ve sometimes been forced to use (for complex surgeries, PennHIP, and exotic critters that end up in my hands) has the worst staff ever, and constant turnover. I know that each time, there will be an argument with one or more support staff, and that they will refuse to bring a doctor out to settle the question. That bespeaks an institutional illness to me.
One receptionist refused to schedule my pup for hip radiographs and a knee exam, because he isn’t AKC registered, and according to her, isn’t a “real” breed. She was adamant that OFA required that the dog be AKC registered, and she was not to be gainsaid by the facts.
I’d love some feedback from the veterinary (and vet tech) community about why a few vets have such great staff, and so many others seem to have such problems in this area.
Comment by H. Houlahan — January 12, 2008 @ 12:32 pm
A few years ago my 10 year old cat had a spiral fracture of her front leg requiring surgery to insert a pin and bands, and as long as she was going to be out, the vet also did a dental. She was sent home only with Antirobe, no pain meds. When I asked about pain meds the response was “we want her to hurt enough not to move around”. We coped, but I think we both would have been happier if she’d had something to ease the pain for the first few days.
Comment by Moira — January 12, 2008 @ 12:46 pm
I was lucky when my wee fiend had his luxating patella surgery. The vet used a pain patch. The fiend is one of those ‘Don’t even come near me when I don’t feel good” kind of dogs so the patch got him what he needed and I didn’t have to lose any fingers trying to force pills down his throat.
Comment by cheryl — January 12, 2008 @ 12:51 pm
When I asked about pain meds the response was “we want her to hurt enough not to move around”. We coped, but I think we both would have been happier if she’d had something to ease the pain for the first few days.
And she’d have healed better and faster too. I think vets who use pain as a form of restraint are sadists.
Comment by Christie Keith — January 12, 2008 @ 12:52 pm
RE: Techs and receptionists: There’s this weird almost cultural thing that goes on with techs and receptionists where they almost seem to believe they’re a kind of “vet by proxy” - as if just working in the field somehow qualifies them to offer “stand-in vet advice” in situations such as a couple of those described in this thread. It’s bizarre, and I ran into it when I was in school for vet tech myself from some of my fellow students who’d spent many years working at vet’s offices (often as kennel help and the occasional “stand-in tech” when hands were needed).
I went on to work in industry rather than in a vet’s office, and I have to say that “the attitude” (which I still run into occasionally at the front desk of vet offices) is NOT something I missed having to work with on an ongoing basis.
Comment by The OTHER Pat — January 12, 2008 @ 1:25 pm
I bet that receptionist’s attitude would have been different had the staples been in *her* butt!
I think we do a pretty good job at the vet office where I work. I can’t imagine somebody treating a client- any client- like that. And especially about something like pain medication!! We’re a pretty small clinic, so stuff like that doesn’t slip through the cracks. The doctors wouldn’t stand for it, and the rest of the staff would not, either.
I see it happen more in big, busy practices. The place where my mom goes seems to have several receptionists with a lot of attitude and very little follow-through. The large clinic where I used to work had one receptionist who was notoriously rude to clients, and I was there two years before they finally fired her.
The uber-expensive referral practice where I took my dog to have her knee repaired, however, had fantastic customer service.
Comment by katie — January 12, 2008 @ 2:09 pm
We’re fortunate enough to have worked with a wonderful house call only vet for over 15 years, so we never have to deal with surly, patronizing reception staff at all. And boy, after reading these posts, do I appreciate it!
On the pain issue, don’t you think that part of it is that the whole idea that animal feel pain at all is still something that a lot of people have trouble getting their minds around? Maybe even especially vets because of their training? A lot of awful things have been done to animals because someone honestly believed or found it convenient and self-serving to assume that animals feel no pain and have no emotions.
Comment by Susan Fox — January 12, 2008 @ 2:38 pm
Wow. Sure sorry many have had problems with the staff in vet practices. I’ve had my vet for over
44 years and the people have always been wonderful and even sweet. Two vets that worked at the practice at one time or other were not people oriented but they didn’t stay long. The women have treated my pets gently and have been wonderful to me. On the other hand, I’ve had more nasty experiences with my own medical personnel but that’s another “event”.
Comment by VJ — January 12, 2008 @ 4:25 pm
So, Gina, are you gonna go after this guy’s license? Or does that only apply to old vets in Minnesota?
Comment by Bernard J. (Bernie) Starzewski — January 12, 2008 @ 6:59 pm
Bernie, I know this is a hot-button subject for you. But in fact, Heather had more than adequate pain control meds on board pre-op (as Dr. Patty surmised), and the post-op protocol was a matter for discussion between client and doctor.
The surgeon didn’t take an over- my-dead-body/nobody-tells-ME-what-to-do stand when the animal presented in pain, as the vet in MN did. Had he seen my animal in pain, or even if I had been able to talk to him about my concerns, pain meds would have been dispensed (as indeed they were without so much as a blink, by his colleague). Heather wasn’t hurting while in his care — in fact, she was pretty dope when I picked her up.
You do understand the distinction, I know, since you have shown time and time again that you’re highly intelligent and very kind-hearted. You’re just trying to jerk my chain, and it’s not working, sweetie.
Comment by Gina Spadafori — January 12, 2008 @ 7:17 pm
Comment by Christie Keith — January 12, 2008 @ 12:52 pm: “I think vets who use pain as a form of restraint are sadists.”
Couldn’t agree more.
~
Comment by The OTHER Pat — January 12, 2008 @ 1:25 pm: “…techs and receptionists where they almost seem to believe they’re a kind of ‘vet by proxy’….”
I REALLY hate that attitude in ANY business. And I never hesitate to tell them to knock it off AND then I tell the owner. The vets certainly care what happens “up front,” but tend to rely on the office manager to handle those problems so the vet can focus on real medicine. I’m guessing the clerk up front was told not to bother the vet unless it was a dire emergency and in her “infinite wisdom” tried to intimidate you, Gina. LOL. Picked on the wrong person, she did.
Comment by Lynn — January 12, 2008 @ 8:25 pm
I do not recall anything from the MN vet case where he said any such thing. I do recall that he made a statement to the effect he preferred to observe the animal before using meds.
It sounds like you managed to observe some pain but also note that your surgeon did not automatically dish out the goodies without such an observation, did he?
Did we not discuss the necessity of observing individual animals before? Is that not the exact thing we discussed with your bull calves?
So, where’s the consistency here? I think the further away we are from a situation and the less we know the people its much easier to get out the pitchforks and torches.
Comment by Bernard J. (Bernie) Starzewski — January 12, 2008 @ 8:34 pm
Bernie, I didn’t observe the dog. I observed at check-out that after being cut open in two places she was being sent home without pain medication. And I wanted to discuss that with the surgeon.
I don’t know if you’ve had surgery. I have, a couple of times. And I can tell you that chasing pain is a hell of a lot harder than preventing it.
Comment by Gina Spadafori — January 12, 2008 @ 9:34 pm
Let me tell you a little story - it happened within the past week, though it involves a human. A friend fractured a vertebrae and was in bad pain. She didn’t ask, but the ER doctor sent her home with pain meds. The next day I called to see how she was doing. She said it hurt like hell. I asked her when she last took the pain meds. She hasn’t taken any, she tells me. Why not? She doesn’t like pain meds.
So she suffers. Four days later she’s had it and takes a pill. It helps, but she says she’s scared of becoming addicted. Irrational. I tell her to stop it and take the d*** pill. She does.
Yesterday I stop by and she’s still complaining. I asked if she took her pain meds and she says she did and tells me she takes it once a day now. The script reads 1 pill every 4-6 hours. She’s aware of this but still has this stupid idea she’ll be addicted.
Meanwhile her three dogs are suffering as they miss her cuddling.
The home care nurse, a retired RN who works a few hours a week, stopped by. The woman must have been an Army Nurse - you know, the kind who tolerates no nonsense. So, in front of my friend I ask the nurse, “How are these pills supposed to be taken?”
Her response is immediate: “As directed.”
I play dumb and ask in a dumb blonde sort of way, “Oh, not just once a day?”
She glowers at me and tells me very clearly, “The orders are on the bottle and you [she’s practically shouting] TAKE THEM AS DIRECTED. If the doctor wanted you to take them once a day HE WOULD HAVE WRITTEN IT ON THE LABEL.”
My friend is humbled. I thank the nurse profusely as I walked her to the front door. Out of earshot she told me that my friend will have a slow recovery if doesn’t comply with the doctor’s orders.
Today I got an email from my friend. She’s feeling so much better now that she’s taking the pills as directed. I daresay the dogs are happy, too.
Comment by Lynn — January 12, 2008 @ 11:45 pm
Re comment by Bernard J. (Bernie) Starzewski — January 12, 2008 @ 8:34 pm: “I think the further away we are from a situation and the less we know the people its much easier to get out the pitchforks and torches.”
It’s very shortsighted of you to think that any of us would feel differently about the pain issue [vet from MN], Bernie, on the basis on geography. Do you actually think we’d change our tune if he was in the same room? LOL
An intelligent man questions his own beliefs when so many others believe differently.
Comment by Lynn — January 12, 2008 @ 11:57 pm
This is for Bernie:
http://os.hhs.gov/news/press/p.....920305.txt
Note that this was written over ten years ago. The consensus hasn’t changed since. I have a hundreds of medical and scientific papers from leading anesthesiologists that all concur with using pain medication.
Comment by Lynn — January 13, 2008 @ 12:04 am
“I think vets who use pain as a form of restraint are sadists.”
Too true. And yet it’s still out there as a commonly held belief in veterinary medicine—among some otherwise enlightened vets, too!
If a painful pet needs to be exercise restricted (as they almost always do), home crating, hospitalization and even sedatives(!) are far better options than failing to provide pain meds.
Any vet that feeds you that line needs to be told that you are responsible enough to keep your pet quiet through more humane means.
Comment by Dr. Patty Khuly — January 13, 2008 @ 7:53 am
Well Lynn the actual record says otherwise. If you care to page back to the previous arguements especially between myself and Gina you will see that the dicussion focussed on whether meds should be dispensed as a matter of course instead of based on demonstrated need - i.e. debilitating pain. I went into this in great detail.
In this story we see a dog undergoing a mild form of surgery and the vet clearly did not even leave instructions for the possibility of drugging the patient which just happens to be identical to the “protocol” I outlined in previous posts.
Because of the confrontation between the “receptionist” (if thats what she really was) and Gina I think its a little foggy as to whether the meds were dispensed because the dog was really in pain or because like most suburban vets he has learned the first rule of modern practice management which is…. “Animals do not write checks.”
But lets assume that Gina is not an unbiased observer for a second. What about the events does not describe perfectly the process I described in considerable detail of first determining that the animal is in distress? None. Yet Gina insists that the vet who performed a much more invasive procedure on her calves did not even glance at the behavior of the calves (now steers) post op while ignoring the fact that absolutely no meds were used AND in fact not even an anasthetic!
Now, the representation is made that this old vet took a drop dead approach to those who thought he should have done something different. Yet, nothing in the original story supports this. Instead he said something quite different. In fact he said something that perfectly parallels the events Gina has now described. He advocated observing the animal first.
Comment by Bernard J. (Bernie) Starzewski — January 13, 2008 @ 8:53 am
Bernie, here is a quote from a December article about this (http://www.startribune.com/loc.....2&c=y):
(beginning of quote)
“Marshak was one of several veterinarians interviewed for this story who said they suspect Seemann’s brusque manner has a lot to do with the trouble he’s in.
“That manner certainly showed when Jazz’s owners, Linda Lovegreen and Gerald Johnson, alarmed at the lack of post-operative pain medication, insisted on removing Jazz from Seemann’s care the day after surgery.
“According to court records, Seemann admits that he responded by adding $1,000 to his fee.”
(end of quote)
YOU may not think that qualifies as an “over- my-dead-body/nobody-tells-ME-what-to-do stand”, but it sure reads that way to me!
Comment by The OTHER Pat — January 13, 2008 @ 9:44 am
An octigenarian with a bruque manner.
Imagine that!
In other words, the only real difference between him and Gina’s vet is their respective willingness to treat the owner.
In still more words, it is a good deal more about the clash of personalities than actual differences in the treatment of the dogs.
Comment by Bernard J. (Bernie) Starzewski — January 13, 2008 @ 10:23 am
In reading the article in full Pat, I dont think it says what you claim.
Here’s the actual working link so folks can read it themselves.
http://www.startribune.com/loc.....=2&c=y
Marshak is in fact not responding to the pain issue as much as speaking to Seeman’s attitude. We also dont know what attitude was exhibited by the owners which was only described as “alarm”. Ive learned that it usually takes two to make an arguement.
I think its particularly ironic that Seeman’s history is in fact one of developing surgical procedures to aleve back pain in dogs.
Charging a fee for transferring a patient to another provider is not at all unusual because it it often involves consults with the other doctor to ensure continuity of care. There are also mal practice liability issues that can dictate this.
I was particularly interested in the comment about open mindedness. I’ve been calling for a little of that all along.
Comment by Bernard J. (Bernie) Starzewski — January 13, 2008 @ 10:41 am
Comment by Bernard J. (Bernie) Starzewski — January 13, 2008 @ 10:41 am
“I was particularly interested in the comment about open mindedness. I’ve been calling for a little of that all along.”
Was that before or after you were condemning the idea of Continuing Education for practicing veterinarians?
Comment by The OTHER Pat — January 13, 2008 @ 10:46 am
the process I described in considerable detail of first determining that the animal is in distress? None.
This is a scientifically invalid standard, and only in part due to the fact that animals hide pain.
It is invalid due to something called “dorsal horn windup.” This is a neurological response to painful stimuli by which the nerves become extra-sensitive to pain, and the harmful effects that pains causes on the systems of the body become magnified.
By basing pain treatment protocols on the completely subjective moving target of “observing to determine need,” you pretty much guarantee that this condition will take place, and that not only will those dogs who go on to experience pain experience MORE pain, but it will do MORE damage to them and be harder to control — often necessitating more drugs than would have been needed if dorsal horn windup had been prevented in the first place.
If, instead of “waiting and seeing,” you follow the clear evidential trail of modern science that tells us animals whose pain is pre-empted recover better and faster and with fewer after-effects, you can see that your attitude, while logical within its own framework, doesn’t match reality.
Pain does not just hurt, it harms. Pain is harder to eradicate than prevent. Animals given pain control recover faster and with fewer problems than animals not given.
Your presription of “wait and see” is wrong on the evidence.
Comment by Christie Keith — January 13, 2008 @ 10:50 am
I was particularly interested in the comment about open mindedness. I’ve been calling for a little of that all along.
That’s fine… until your brain falls out.
Comment by Christie Keith — January 13, 2008 @ 11:00 am
Bernie, this is not about “treating the owner.” If they were interested in that, there would have been pain meds (with mark-up) at the counter.
It’s about the documented scientific facts that pain hinders healing, and how those findings are slowly working into veterinary medicine.
As for waiting for signs of distress, why can you not take it as pretty darn obvious that having eight staples in your butt hurts? I don’t have to see the dog — and in fact didn’t before questioning the post-op pain-management protocol — to know she was going to be hurting that night.
Minor pain? Who knows, and who cares? Pain is pain.
I don’t understand your pain-med phobia, but I see pain meds as another weapon in the medical arsenal. Can you go without them? Sure. But you can go without antibiotics for an infection, too, and you may well heal on your own.
But why would you?
I suspect you have an idea like the woman mentioned above, that pain meds are somehow evil or immoral, a sign of weakness and something to be feared. You’ve said as much before, talking about how we “city folk” are such wimps.
That moral nonsense is widespread attitude; heck my own father has it. “Play with pain” has been his mantra since he was a professional athlete in the ’50s. (By the way, he’s as “city folk” as they come, born and raised in San Francisco.)
It may well be that my attitude towards “the goodies” as you so revealingly call them is based on my lack of interest in post-op pain for myself and so, by extension, for my pets.
But wherever our attitudes comes from, science is on my side. And this won’t even be debatable in another decade.
Comment by Gina Spadafori — January 13, 2008 @ 11:24 am
Colorado State University this year is giving a course in PAIN to student veterinarians. The website is csuvets.colostate.edu/pain
The course is given by Dr. Narda Robinson who is a license veterinarian and believes is humane treatment for animals.
Comment by Colorado Transplant — January 13, 2008 @ 5:30 pm
By the way, I happen to be the proud mother of Dr. Narda Robinson who loves animals just as much as I do.
Comment by Colorado Transplant — January 13, 2008 @ 5:41 pm
Dr. Narda’s mom, she is a well-known name in vet med! I hope to learn acupuncture from her after I graduate vet school :)
Comment by Megan — January 13, 2008 @ 7:59 pm
Re comment by Bernie at January 13, 2008 @ 8:53 am: “Well Lynn the actual record says otherwise. If you care to page back to the previous arguements especially between myself and Gina you will see that the dicussion focussed on whether meds should be dispensed as a matter of course instead of based on demonstrated need – i.e. debilitating pain. I went into this in great detail.”
Yes, indeed you did. We ALL went into it in great detail. We essentially told you that your empirical views were short-sighted. You’re tenaciously holding to the believe that an animal must demonstrate that he’s in pain before relief in the form of a pain pill is given. Poor, poor animal.
What does “the actual record says otherwise” refer to? Bernie, you need to be more specific.
You will remember, of course, that I’m the one that brought up the issue of CEU’s as a requirement for vets, especially old vets. Everytime I turn around my vet is off to a conference.
Even mild forms of surgery often end with pain. Perhaps you’ve never experienced this. I’ve had staples in my abdomen and it hurt. And if I hurt, you’d better believe it REALLY hurts the next guy. But here’s the bottom line: WOULD YOU WANT YOUR PET TO SUFFER EVEN ONE SECOND IN PAIN IF IT COULD BE AVOIDED?
Pain causes stress. Period. You don’t get to debate that. Read the beginning of this article to understand the connection and negative effects of pain.
http://www.long-beach.med.va.g.....pmp-6.html
There’s one key sentence in article above: “…the physical and mental/emotional tension created by pain tends to worsen the pain.”
Taking the pain pill prevents the vicious cycle and downward spiral from happening. That makes a lot of sense to me.
Don’t keep your mind in a cavern, Bernie. There’s far, far too much current scientific literature out there that supports pain management.
Comment by Lynn — January 13, 2008 @ 8:00 pm
Thank you, Megan—she is also the chief examiner for acupuncture in humans, for she is a licensed D.O.
Maybe the younger graduates from vet. schools will address pain in animals more completely.
Some animals will hide their pain, but they hurt, nonetheless.
Comment by Colorado Transplant — January 13, 2008 @ 10:32 pm
Gina, what a timely post. One of my pack went to the E.R. last Wednesday for a laceration repair. The tear was jagged so they had to cut skin away. Resulting repair was about 1 1/2 inches long. As I looked over the bill after hubby came home with said dog: you guessed it, no pain meds.
I asked hubby if the vet even offered him the choice. (Which we would have turned down since we have some Deramaxx on hand for all our dogs.) He said nope. The dog was clearly in some pain, so we medicated him.
I’m not alarmed. Not even surprised. Go to one vet, you get pain killers post-procedure. Go to another vet across town (or in a different city) and you won’t. There’s no consistency.
Comment by Deanna — January 14, 2008 @ 8:34 am
Dr. Narda’s mom: You SHOULD be proud! Dr. Becker and I were just talking about her yesterday, and I’m going to call her to interview her for part of our new book series.
:)
Comment by Gina Spadafori — January 14, 2008 @ 9:19 am
Deanna, if you’re keeping “extra” Deramaxx around to medicate when it’s not under direct doctor’s orders, how are you addressing the issue of the (strongly) recommended blood tests to monitor organ function?
Comment by The OTHER Pat — January 14, 2008 @ 9:48 am
Never ever save such drugs for a future event.
You have no idea which drugs they gave the pet in the hospital; Deramaxx may, when used with one of the hospital-dispensed drugs [for this event], cause a reaction.
And just because the pet had been tested before for any sensitivity to Deramaxx it is no assurance that the same conditions apply now.
Comment by Lynn — January 14, 2008 @ 5:18 pm