Here's the abstract to the study. For the full text, follow the link, but you'll have to register and possibly pay.

Dr. Patty Khuly March 18th, 2009 09:01:01 AM

I don't think there's anything wrong with applying judgement to the severity of one's own wound and deciding whether or not to go to emergency. People do that all the time; it's hardly unique to vet practice. I also have nothing against using Clavamox to treat infection, even preventively. I'm a bit mystified as to the point of this study. An awful lot depends on the degree and context of the injury.

brebis noire March 18th, 2009 09:20:07 AM

I worked for a long time as a vet tech and had my share of dog and cat bites. I was always sent straight to the hospital. On the worst one I couldnt even drive as my hand was so messed up and swollen very quickly. Even with the ER visit and proper washing and care along with meds I still got blood poisoning. I was in alot of pain needless to say. I have seen a vet get bit in the face and he cleaned it up and used tissue bond and was perfectly fine all but the scar on his face. I do think they should be seen by a MD. Its not always OK to self treat.Then again I was seen at the ER and still had problems even after that. I guess to each his own.

Donna J March 18th, 2009 10:04:16 AM

As brebis noire says, people do this all the time - and they don't have to work with animals at all. If any and all wounds had to be seen by a human med doc (ER or other) to be treated "correctly", no one with an actual life threatening problem would be able to get in the door. Kid falls down and gets a small gash on the knee - clean it with soap and water and antiseptic and then bandage - check, clean, rebandage as necessary. Is this bad parenting? Not when your kid could pick up something much worse sitting in a waiting room, and your household budget gets hit when it's not necessary. I have been kicked, bitten, and scratched (and didn't even get to go to exotic animal training school, darn it!) by so many different animals from deer, cockatiels, and iguanas, as well as cats, dogs, horses, etc. and I almost never went to a human doc unless the site became infected (which it almost never did). The simple reasons were that most of the time I had no insurance and usually not enough spare cash, I didn't want to have an issue with my employers/volunteer supervisor, I didn't have the time to waste sitting in a waiting room, and I didn't want to hear a lecture from people who didn't have anything constructive to say about animal handling except "You shouldn't be doing that - you could get hurt." Duh, thanks, you're not my mother. And, most of the time I had a friend or two who worked in a huma doc's office who could get me antibiotics if I really needed them.

KateH March 18th, 2009 10:09:19 AM

brebis noire: Interesting comment. When I first read of it I assumed it was a lead-in to issues related to controlled drugs and veterinary self-medication in ways that play into addiction. I do believe it's important to use studies like this to understand the psyche of a group of professionals and I'm interested to see how our stats compare to dentists and physicians. 

And, sure, there's nothing wrong with assessing your own wounds (everyone does) but when they're borderline I've personally never gone to the ER. Instead, I call my own doc and she hooks me up with a script I can pick up. But she always tells me I need to come in--and I never do. We're both used to this dance--though I can tell she's not comfortable with it.

btw, the time I got bitten badly by a cat I didn't go to the ER until the next day--when it was clear that the infection was blowing up despite my choice of antibiotics (I didn't have a trusted GP at the time). I ended up with a hand surgeon and a two-day stay for IV timentin. Scary. I guess I can identify more with the need for these studies. But then, I should've known better. And I guess that's the point. We don't always.

Dr. Patty Khuly March 18th, 2009 10:09:22 AM

Ever told a friend "You should fight that ticket!"?  I know bar associations and lawyers who will call that "unauthorized practice of law" and I couldn't disagree more.  It is a fundamental right to represent oneself and, by extension, to seek the advice of whomever you wish.  (Often unwise to do either but nonetheless fundamentally your right to do so.)  I feel the same way about one's right to treat oneself medically and that includes unfettered access to the appropriate drugs.

In WWII, military first aid kits included morphine.  In many parts of the world, one can easily access antibiotics over the counter and for nominal cost even today.  For years, I maintained a first aid kit with pain meds, antibiotics, and a variety of other items for emergencies.  It's become nearly impossible to obtain many of the items and, during Hurricane Ike, I was reminded how abysmally unprepared even those of us who were prepared were without these supplies.  And, make no mistake, many were without access to any form of health care for more than a week after the hurricane.  Every year, many are caught in disasters or just plain snowed in and accidents are bound to happen.  One shouldn't suffer more for want of basic supplies or because they have to get to a gatekeeper to access those supplies.

I would encourage those with access to medical care to use it.  However, we have made it more and more difficult to access drugs and other supplies; creating a virtual monopoly for medical professionals.  With monopoly status comes an obligation to supply to those in need and THAT has not happened.  Even if it ever does, I believe we have certain rights and should be permitted to choose to use them so long as we're willing to accept the consequences as well.

This is one of those days when I'm glad you're a tolerant blogger! 

PJBoosinger March 18th, 2009 10:22:26 AM

The only time I got bitten seriously enough to warrant medical attention was a cow bite. Yes, it can happen - when you have your entire hand inside the mouth to pull out a tooth and the wedge slips. The grinding/crushing broke the skin, it was horribly, horribly painful - but I bandaged it up and finished my day's calls and went to the doc next day for a tetanus booster, just in case. My finger healed fine, but I was very spooked about tooth extractions after that. Could've been much worse. That said, I've used clinic antibiotics to treat my own sinusitis - because I know very well from experience that I will get a less effective antibiotic (if I get one at all) from the doctors. Worked like a charm the only two times I've done it. In my experience, the vets I know are rather hesitant to self-treat - considering the arsenal of drugs they have at their disposal.

brebis noire March 18th, 2009 10:23:09 AM

Do vets just accept that they are going to get bit and scratched a lot?  And do you guys/girls ever tell a client, "look, I won't see that animal unless it's restrained?  I only ask because my overly rambunctious border collie jumped up in excitement and scratched our vets one time and left 3 red (wolverine like (xmen)) scratches on his face.  He just shrugged it off and nothing more was said.  I trim her nails every few days, but it seems like they grow out of control.  Anyway I apologized to the vet but he wouldn't hear of it and kept playing with her and giving her treats.  Now maybe a little bit of it was his fault, like 2% or so as he did speak to her in a really excited tone, but I know I should have restrained her better.

Chuck March 18th, 2009 10:32:14 AM

Last year a nearby colleague was arrested for possession of hydrocodone and viagra without a valid prescription during a traffic stop in a shady part of town. He obviously self diagnosed and treated. I occaisionally go in to my M.D.for a cortisone injection for tendonitis and he always asks me why I come in when I can do this myself. No way. I do admit to using a little lidocaine to help push an imbedded treble hook out from under my thumbnail recently on a Sunday afternoon.

Hobson March 18th, 2009 10:36:45 AM

Chuck, I think anyone who works with animals expects to get kicked, bitten, and/or scratched, and tends not to be too bothered unless it's a serious wound. In fact, when I worked with wildlife, I, and the volunteers I worked with, sometimes had "Let me tell you about how I got this scar" conversations, each trying to top the other with interesting stories. I still point out, at opportune times, the small scar on my neck from an opossum claw that got pulled out of its nail bed when the opossum was trying to climb onto my head, and the scar on my eyebrow from the barred owl that went right for my facebecause it was tired of the medicated mice I was feeding it. I could go on, but that's normally sufficient to let people know I'm not afraid to handle their dog or cat. :-)

KateH March 18th, 2009 10:41:16 AM

I'd slap some betadine on it and only take an antibi if necessary...but seek help for pet bite?

No freakin way....

works for me....

LorriM March 18th, 2009 10:51:58 AM

Unfortunately, even the abstract of this study isn't available.  However, this study certainly has the smell of bootstrapping for the failing war on drugs rather than anything else.  Sorry, just don't think they're all that concerned about self bandaging or even a few self done stiches.

I saw quite a few expressions of not wanting vets to become the "spay/neuter police" in an earlier post.  So I gotta ask, how is one comfortable with being a part of the "drug police"/drug gatekeepers?  (I ask because, for example, I know I can get adequate pain meds for my 20 pound dog but will have to fight for them for my 100 pound dog simply because that's getting close to the adult human dosage which then makes vets nervous.)

PJBoosinger March 18th, 2009 11:25:37 AM

Arrrrrrgh! Did ya have to put that picture in there?

Evet March 18th, 2009 12:57:05 PM

LOL sorry like I said I'm squeamish.

Evet March 18th, 2009 01:21:27 PM

PJB: After one of our client's teenaged son overdosed on her dog's phenobarbital in a suicide attempt (a few years ago), we're painstakingly cautious about the quantities we Rx. One month is enough. No more than that for controlled prescriptions. And that's pretty reasonable, I think, given our exposure. 

LorriM: If the bite's bad enough I bet you, too, would hit the ER running (like the one in the pic). For most bites? Agreed. That's why I typically hide my bites. I'm an employee and I don't want to be forced to go to the ER like the rest of our staff is. Not a good thing for my bosses, but I assume they trust me after 11 years of practice in their place.

Dr. Patty Khuly March 18th, 2009 01:42:18 PM

well, I think most of us who work with dogs on a daily basis treat ourselves ...or at least I thought so LOL

Even if I do go to the ER which has been like twice or the regular MD I always say it was a horse that bit me ;) 

Being self employed now(doggie daycare & grooming shop), I simply can't afford to go running to the MD unless it needs more than 3 stitches or skin glue won't hold it shut ;)  I wouldn't fault a vet who self treated, especially a self employed one - those of us trying to run a business in this economy can't afford (or don't want to) ER visits, plus the loss of time from work or sleep !  LOL

I'd also have to add that in almost every case I have been bitten (which isn't many considering 25 years) it was my fault,  as it is in most cases ;)  So, maybe we don't go to the MD out of shame too.....

LC March 18th, 2009 01:54:41 PM

LorriM, that was my philosophy too, until I woke up two mornings after a bite by my foster dog (totally my own fault!) with an arm so swollen and painful from infection that I couldn't even shift the gears on my car without debilitating pain. Fortunately my brand new Honda Fit is sensitive enough that I could drive the entire way to doggie daycare in second gear before heading home and walking to the emergency room. I ended up spending two separate days in the ER (had to go back after the first visit because the infection spread), and missing 3 and a half days of work. But at least I got some lovely percacet out of the deal. And a trio of tiny scars.

Mary March 18th, 2009 02:00:05 PM

I went to the urgent care after a feral cat used my leg for his anger management issues.  That was the only time I've sought medical care for work-related injuries - mostly, I knew I needed a tetanus booster...otherwise, I would have just grabbed Clavamox off the shelf as usual.  The doctor prescribed me Augmentin (aka, human Clavamox), and at the pharmacy I found out it was generic and cost me $4.00, which is a miniscule fraction of the amount we would pay for the equivalent amount of Clavamox 375mg.  Even after the urgent care co-pay, I still saved money!

Also, did you know that Baytril causes way-trippy hallucinations in humans?

beth March 18th, 2009 03:16:49 PM

LC: Shame...a biggie, IMO. It's what keeps us from letting others know how stupid we were. And we often are. After all, we're only human. 

And Beth: No, I didn't know...but don't let word get around. It'll be the new Ketamine if it does. And we don't want to have to schedule Baytril, right? ;-)

Dr. Patty Khuly March 18th, 2009 07:24:20 PM

I don't go to the dr. for a scratch unless it won't heal. Almost had that happen once when a cat claw got right along my cuticule and pulled it out from under the nail. Made a dr. appt a week later and it suddenly started healing, cancelled appt. Been bit by a cat, waited till next day and had to go to the ER with a nasty infection. Tetanus shot and antibiotics and all was well. Dog bite wouldn't stop bleeding, went to ER, several stitches later, and a round of antibiotics and it still got infected and drained pus. Self treated with Clavamox and it healed up with barely a scar. Now it's bad enough when you watch the vet sew herself up after a bite (sans Lidocane). What gets me is not wanting your employees to go to the dr. after a small bite because of the ins. claim and she just gives them antibiotics, even when the rabies was expired! Now that was just not cool. Fortunately no complications on that incident.

rollseyes March 18th, 2009 07:38:54 PM

I used to keep a fair number of herps, and getting bitten/scratched was just part of that, especially if you are having to medicate a large snake or lizard that would rather you didn't touch. I did go to my GP a few days after helping someone with a 10-11 foot green anaconda that was dumped on her doorstep in a box. Three nasty machine gun quick bites to the wrist. I had bruising up to my elbow (blood seepage, not crush) and her 200 plus teeth went through a bunch of tendons and irritated a few nerves. Getting bit and going to the doctor, 20 dollar co-pay. Look on doctor's face as I told him the story, priceless!

Never try to handle a large snake without competent assistance, lesson learned!

Now I have dogs and do feral kitties and rescue dogs. I honestly won't go to the doc or an ER unless it's just really awful. 

My hubby, btw, is a physician so people assume he can patch things up. His general reply is "Yep, that's a bite. I'm an oncologist but that sure looks like a bite." So it's off to the medicine cabinet for self-treatment.

JenniferJ March 18th, 2009 07:56:13 PM

"PJB: After one of our client's teenaged son overdosed on her dog's phenobarbital in a suicide attempt (a few years ago), we're painstakingly cautious about the quantities we Rx. One month is enough. No more than that for controlled prescriptions. And that's pretty reasonable, I think, given our exposure. 

"LorriM: If the bite's bad enough I bet you, too, would hit the ER running (like the one in the pic). For most bites? Agreed. That's why I typically hide my bites. I'm an employee and I don't want to be forced to go to the ER like the rest of our staff is. Not a good thing for my bosses, but I assume they trust me after 11 years of practice in their place."

Nice evasion Dr. K but please reconcile your willingness to play gatekeeper for others while you break the rules yourself which most assuredly exposes your company to liability.  I'm not asking about your exposure but whether or not you should be subject to exposure at all; should there really be a law that allows (actually requires) you to restrict other peoples' choices?  You don't want to be forced but being party to forcing/restricting others is OK?  And, if so, what makes being the spay/neuter police special or an exception?

PJBoosinger March 18th, 2009 08:05:29 PM

Well...I guess we could do a lead in to abuse of narcotics, Hobson jumped in!

Actually the post makes me remember 1993, having a rescue Scottie in our home that did a tremendous bite to one of ours and boyfriend got caught in the middle.

No insurance at that time, we took care of our dog first for a couple of hundred $, then Bill at the emergency room. It was $450 total, in 1993! Came out with a large bandaid & probably "clavamox".

That wasn't the "kicker", it was the followup animal control interview (yes, valid rabies), and the subsequent worry of my "house insurance premiums". Did it ever happen again? Yes, but we quickly learned to treat both us & our dogs/cat, with the warm soaks, keep the wound open, and nary a problem (fortunately)!

Ahhh, those days are behind us. Oh yes, I know how it feels too, a week out of work with a non-functioning hand.

If it makes anyone feel better, I know a dentist, that has a small stash of antibiotics for 'personal' use....

Barbara A. Albright/NH

Pocket's Story from NH March 18th, 2009 08:11:30 PM

Sorry to dissolusion Dr. K, but I didn't hit an ER until I bled out 4 pints of blood (true story) and even then I drove and walked myself in....my hematocrit was 20, and I did wind up with a transfusion.

I've had bites worse than that picture....guess I am just made of tough stuff (german and scottish)

or crazy....crazy works for me too....  :)_

spent too much time in an ER in my EMT days.

LorriM March 18th, 2009 08:15:53 PM

LorriM: So sorry. Scar? Pics? You're a mad woman!

Dr. Patty Khuly March 18th, 2009 08:16:46 PM

I will conceed however that cat bites DO hurt like a <B> ich, and I've never been bitten by dog that did more then barely break the skin.

Cats move faster....seems like...

I would however go to the ER if a stray/feral/wild animal were to bite me. That would be foolish not to.

LorriM March 18th, 2009 08:20:34 PM

PJB: Hmmm...good questions. In the case of mandatory spay/neuter there is no potential harm to a human. In the case of my clients and drug abuse there is not only a moral imperative to protect but a duty to the higher authority of the DEA (beats local government every time).

Dr. Patty Khuly March 18th, 2009 08:22:22 PM

the 4 pint loss wasn't from a bite wound...it was ..lets see..how to describe it for the delicates....it was from a uterine hemorrhage...

I guess I can do bite mark pics if you really want.....give me a minute to take pics....

LorriM March 18th, 2009 08:27:01 PM

Hobson: Can't resist a side comment to your post. Did you know a potent form of Viagra is used to treat pulmonary hypotension? Well, we sure had our share of yukks, but it was $800 for one months supply ...geesh, I guess that has to have a "street" value!! (oh, and it was some BIG DEAL to get the insurance to agree on coverage ---for a 73 yr. old lady)

Pocket's Story from NH March 18th, 2009 08:29:16 PM

I have an interesting and tragic story relating to a dog biting a vet. It is not related to the self-medicating aspect, though I'm sure that may have occurred as well. As many of you probably know, I am a serious advocate for veterinary board reform here in Texas and nationwide. As such, I receive copies of all board orders issued by the Texas board after their 3 meetings a year. I recently received this board order from the February board meeting. It is a disturbing story. I do not believe for one second that the dog "fell off the table." At least the board did take action, though I do not believe enough was done to serve as a future deterrent. Better than nothing, I guess.

Greg - Stempy's Story March 18th, 2009 08:34:01 PM

I am a practicing small animal vet although my dad and sister are human doctors. Also we have a lot of clients who are doctors, surgeons and dentists. Because of my fortunate interaction with so many from the human field, we often compare notes, diagnostics and treatments. For example, a human anaesthestist informed me that 25% of patients vomit with tramadol and so it often used with an anti-emetic. 

I don't often take medication, preferring to allow the body to heal naturally. However, if necessary, I either use the drugs we have or order it in. Also, it is far cheaper to use our own drugs than to pay for them elsewhere, as we can get the wholesale price. Over the years, I have treated myself for:

Fungal nail infection with lamisil, bites/scratches with anitbiotics, ear infections needing pain killers, bandages for small wounds, severe gastroenteritis with ciprofloxacin and metronidazole, administered vaccinations like hepatitis B and taken blood for sampling (although sent to human lab).

I have never had any complications although I could always seek doctor's advice if necessary. I have been fortunate though that I have never been very ill and if so, I would definitely go to a doctor.

(NB. One time I did go to a GP when I had bad gastroenteritis, I was given a buscopan injection and all sorts of tablets including paracetamol despite vomiting. This put me off from seeing a doctor for some time!)

Andy (aka http://twitter.com/TheDolittleVet)

Andy March 18th, 2009 10:01:43 PM

Guilty as charged (in regards to being a self treater), but it was in my younger days....when I was invincible you know. But I would say that unless it is a severe bite, my tendency is to just clean it, soak in some Betadine and monitor. I don't really want to be on antibiotic's if I don't have to. I think I know myself and am capable of assessing when I need to be seen. Now a days the biggest thing that keeps me from self treating is the emerging drug resistance. I don't want to add to the problem. I won't go to the doctor for every bite I get.....it would not be practical!!

J.C. March 18th, 2009 10:43:04 PM

Dr. Khuly - I should clarify about the Baytril (and not from personal experience, lol) - when asked about it, the Bayer reps tend to respond along the lines of, "ya, we know about that...it'd be a problem if the trips were any good, but they're not".  Apparently it can involve the sudden and irresistible compulsion to lick one's bloody scalpel blade during surgery, amongst creepy voices.  I believe VIN has several accounts of self-medicating vets who forgot to Google "Baytril + human use" prior to ingestion :)

beth March 19th, 2009 12:10:38 AM

Just out of curiosity: What is your reaction when your patient bites your arm of head? Asproolee’s Story

Fotini March 19th, 2009 01:22:07 AM

Fotini: If it's serious I back off, of course, letting others secure the animal any way they can.

In the case in which I was bitten in the head it was my fault (there are few "accidents," it's usually some form of human stupidity that gets us in trouble). I was getting a post-op blood sample from a dog I thought was still out cold. Though normally a nice dog, he awoke with a start at my poke and ravaged my head, pinning me (in close quarters since he was recovering in a cage) against the stainless steel for a few more bites. I was able to get away and slam the door before he got more of me.

Too bad all my war wounds are all under my hairline, otherwise I could show 'em all off. ;-)

If it's not serious, I play it as if nothing happened and go on my merry way, stopping only to get some gauze on the wound. 

Dr. Patty Khuly March 19th, 2009 08:37:19 AM

Andy: Nice to see some of my new Twitter friends here. As to regulations for your self medication: You're in the UK, right?

Dr. Patty Khuly March 19th, 2009 08:39:08 AM

Dr. K. - "If it's not serious, I play it as if nothing happened and go on my merry way, stopping only to get some gauze on the wound." and "Shame...a biggie, IMO. It's what keeps us from letting others know how stupid we were." Near the beginning of my wildlife work I was giving a talk in front of a large group of people and got bit (3x) on my left foremarm by a big black rat snake. I was going to let the audience comee up to see it closer and ask questions, but had to put the snake away (didn't want it to bite anyone else, and I was bleeding) and take out the only other creature I had with me - a red-tail hawk. Only problem, you hold birds of prey on the left arm, and the glove didn't cover the bleeding anyway. So I tried to balance the glove as a cover on top of my right arm and have the bird stand on it (while I held the left arm behind my back). It was not a good way for the bird to balance, and he had to grip my arm harder than normal. A baby started crying right next to us, startling the bird, who stepped around, the glove fell on the floor, and several talons went into my right arm. Try to take care of 'boo-boos' on one arm, when the other one is hurting (and vice-cersa) - that was not a tale I told anyone for a long time, because, yes, the shame and embarassment was too much (and didn't get human doc attention, for that reason). When I finally did tell about it, it was as a major cautionary tale for new volunteers, a "Don't be this dang stupid, 'cause you'll be sorry!"

KateH March 19th, 2009 11:06:17 AM

Gosh, NOBODY has anything to say on the story I posted? Board Orders ARE public record, so it's not like it's a confidential story or anything. Here is the link again - click here.

Greg - March 19th, 2009 11:06:29 AM

Pocket's Story from NH

Barbara A./NH advocate for ethical veterinary care

Pocket's Story from NH March 19th, 2009 05:24:26 PM

LorriM, PLEASE, if ever you lose that amount of blood again, DON'T drive yourself...I'm all in favor of your being as tough as you please in every other way, but as someone who may be out driving on the roads when you are on your way to the hospital sans four pints of blood--that's not being tough, it's taking chances with OTHER people's lives. The staff at the blood drives I frequent tell me that EVERYone who ever faints (after donating ONE pint) says, right before dropping, "No, I'm not going to faint, I'm FINE..."

Judy March 19th, 2009 06:40:54 PM

Barbara, hydrocodone (tussigon, hycodan) is commonly prescribed by veterinarians for cough suppression. The Vet I spoke of got in trouble when he was stopped with it in his car while cruising in an area known for prostitution. (He was arrested and went into a rehab/diversion program, only to be recently arrested for domestic violence against his wife, also a vet and business partner, that's another story). This is just one way the regulatory agencies get involved. Recently the FDA punished some of their employees for abtaining antibiotics and making it available for non-vet employees' personal/human use. No one will pay much attention to small quantities of hydrocodone, but when you order large amounts, DEA will investigate. They will also investigate if you order a controlled substance that does not have a customary veterinary use (Oxycontin, methadone). For non narcotic drugs such as viagra, they only care if there is evidence of human use.

Hobson March 19th, 2009 07:30:11 PM

We "civilians" self-treat most small wounds or burns.  A couple weeks ago I saw another one, deepish gash to the finger from the outer metal cover of a small appliance.   This one bled a lot, the victim's tetanus booster is up to date, and after a couple butterfly closures and bandaging the bleeding slowed down.  The finger was kept dry for a few days, rebandaged and re-treated with "Neosporin" daily.  No physician was involved.  As of now it's healed quite well except for some bits of dead skin around the edges.  It looks like the scar won't be any more than a very narrow line on the side of the finger. 

I stock Neosporin, butterfly closures, assorted bandages, and peroxide.

Fortunately, the divine Miss K. has been gentled.  She occasionally mouths in play, but does not apply pressure.   I have never had a cat bite, but I'm aware that they are likely to be infected.  I do have a narrow line on my right wrist, from a scratch from an elkhound's single canine tooth, more like a superficial scrap, not a real bite.  It was a long time ago, so I suppose it  was simply washed with soap and water.  That one was from my own dog, she was somewhat provoked, had a current rabies vaccination, and the wound was tiny, so no physician was consulted.

There's a saying that you only get fast service in an ER in a large metropolitan area if you come in with a knife in your back or a gunshot wound, and I think it's about right, from the (fortunately) limited experience I've had.  The experience with urgent care hasn't been so great, either, and it doesn't hurt to avoid the latest respiratory virus epidemic you might get from the small children in the waiting room.

Miss Kitty's Mom March 19th, 2009 08:29:05 PM

Hobson: Shows how much I know about drugs, I thought hydrocodone was a component of Oxycontin or some similar type narcotic ?? vicodin?? I don't know, I don't even like taking aspirins.

Actually, it was the more "potent" form of Viagra and had a different name from all the TV commercials that raised eyebrows with health insurance, or medicare?? for my Mom. We just couldn't get over the $800 sticker shock.

I had my elderly now deceased dog on Benezapril for a while, seems that wasn't a cheap one, but it made her very unsteady with balance, so I weaned her off. She did just as well without it, it was the lymphoma that got her.

Prescription drug abuse is such a growing problem, along with obtaining on the street. Very scary stuff. The violence connection: the mix of drugs, violence, animal abuse, spousal,people---- awful, awful.

And what is this about Baytril? How is it known for sure not to cause "hallucinations" in pets? Is this really true??

Barb A./NH

Pocket's Story from NH March 19th, 2009 08:42:49 PM

Well, today at work a coworker got bitten by a cat - her first bite in 8 years in vet med.  She came to me (I'm the OSHA safety officer) to confess and fill out her OSHA paperwork.  I told her in no uncertain terms to go to the walk-in clinic.  She hedged around and finally said she just didn't want to, and it wasn't a bad bite.   I told her it broke the skin - GO!  She finally promised to go after work tomorrow - no one to watch her kids tonight.  Then I heard the vet telling her that if it was him, he would use such and such a dose of such and such an antibiotic, and she went home with a bottle of ABs!  Not actually treating her, but almost!  I'm still going to check that she goes to see a human doctor .  Cat bites should not be messed around with!

Sassy March 19th, 2009 09:34:15 PM

I'm a rescuer and keep antibiotics on hand at all times. First time I ever had my hand blow up big as a balloon from a cat scratch (actually it was more a puncture wound - small tiny blip of a hole with zero blood) I called my doctor and asked if I needed to be worried about it. His reply was ANY bite or scratch to our hands with all the small bones could be serious and to come see him. So I did and he prescribed cephalexin. My hand looked like an overblown blimp and ached but nothing adverse other than that occured. So ... anytime I get bitten or scratched with any degree of severity I take the same drugs (cephalexin which is for animals AND humans) I keep on hand for the dogs and cats as a precaution. No way I have time for emergency rooms and if I wait 'til the next day for my doctor's office infection could already be setting in. The good Lord (if you believe in "IT") blessed us (hopefully) with something called "common sense." One reason medical care in this country is so damned expensive is because everybody runs to ER with minor ailments. I think I'm adult enough to know when I may/may not need a professional doctor for a bite or scratch. Now, after Natasha Richardson's death yesterday from a mere small bang to her head I'll think twice next time I slip and fall and smack it which has happened FAR more often than dog or cat bites and scratches! I have had my feet slip out from under me on wet tile, ski slopes and mere misslips while walking and I've landed smack dab banging the HELL out of the back of my head on the ground. That is far more scarey to me than a small scratch or bite Betadine and cephalexin can handle nicely. The aching never lasts more than 7-days and as painful as it can be migraines and stomach gas are FAR more bothersome and by far hinder my daily activities more than a swollen, aching hand or arm. I once had several foster dogs break out in a fight and as I dragged Howie away by his collar he turned and I watched as his once canine sank into my lower arm ... he didn't MEAN to bite me it was a dog fight and they were biting at the air and anything they could get. Weirdest thing to watch a tooth sink into your arm ... the dogs weren't too worse the wear but my arm hung by my side within the hour like I was the Hunchbank of Notre Dame. AND we had a hurricane coming. AND I'm a single woman with a ton of animals on 1/3rd an acre which is HUGE in Miami. So I singlehandedly (literally) cleaned up my yard and secured things with my arm aching as I had ZERO time for an emergency room. It's the one time I probably could have used a few stitches yet other things were definitely MORE important AND with antibiotics I knew I wouldn't die. So Howie now lives in a mansion on FL's west coast and I have the neatest scar about 5" up from my wrist on my left arm to remind me of that wonderful Catahoula hound for life! Who needs jewelry? xoxox

Lee M. in Miami March 19th, 2009 10:33:20 PM

In over 27 years as an ER nurse, I can remember treating exactly two veterinarians for bite wounds, so I would surmise that you are right, Patty, and that most vets treat themselves. I might add here that one of the two vets was the one I work with at the shelter where I volunteer. He had been bitten the day before, and when I showed up at the shelter to assist with surgeries the next day, his hand was red, swollen to nearly twice its normal size, and had lymphangitis. One look and I told him he needed treatment. We postponed the day's surgeries, and off to the ER he went for IV antibiotics. It took a couple days before he was able to use the hand well enough to do surgery.

I must also confess that vets and human docs are not the only ones who self-treat. After doing shelter work for over three years, both in the OR and the clinic, I have been administering meds to animals both peri-operatively and as treatment for sick shelter dogs and cats. One of the meds I routinely give is injectable penicillin; most commonly to animals immediately post-op, but on occasion as treatment for illness. I have a severe penicillin allergy (anaphylaxis), and never thought twice about it. When the shelter director (and my vet friend) discovered this, they got really wigged out about the possible consequences if I should accidentally get stuck. So one of my (human ER) doc friends made up what is laughingly called my "Oh, s#*t!" kit, consisting of an subq. epinephrine, IV catheter and flush, 50 mg. of IV benadryl, 125 mg. of Solu-Medrol, and 300 mg. of IV Tagamet. The kit is kept in the surgery area where someone could treat me, if need be, and keep me alive and breathing until medics arrive (can sometimes take awhile here).

Shellie March 20th, 2009 12:13:49 AM

Both Viagra and hydrocodone are used in veterinary medicine. 

hydrocodone is GREAT for cough suppression, as noted.  It is however hard to find.  I spent about 45 minutes on the phone with different pharmacies looking for it one day, finally found tablets, no liquid preparation to be found.  Those pharmacies must have thought I was a freak.

Our local cardiologist uses viagra (on his patients) once in a while.  I know of at least two that we have referred to him that have come back with that suggestion. 

Is viagra even a schedule IV?  If not, why would the DEA care?

And I'll admit to popping an amoxitab on occasion...usually just to get me started whilst I wait for an MD appt.  Clavamox 375's are too expensive and my dose too high, and I've got good insurance...so I just see the doctor so I can get the prescription.  And no, Augmentin is NOT a generic $4.  If it was, I can assure you my dogs would each have a prescription waiting in their medicine cabinet.  (which is considerably larger than mine)

Jackson March 20th, 2009 09:29:05 PM

"American Indian?....Apache?"

Could be (my ancestor, "English", kidnapped his 13 year old bride from a Res in SW OK) but I suspect Scottish/Celtic berserk type genes are more likely.

PJBoosinger March 21st, 2009 04:03:05 PM

Interesting - in the past I have been eager not to go the ER for a scratch/bite  or even take antibiotics, often I have simply washed well in iodine and monitored.  When I have needed antibiotics I have seen a Dr to get them. Honestly clavamox makes me feel naseous and the tablets are big.

But after recent surgery that involved a splenectomy and a CE lecture from Mike Lappin - re: bartonella and capnocytophaga, I will be forced to be a lot more concerned about bites/scratches.  To be honest as veterinarians we have been too complacent about infections in our every day work - we should consider gloves with ears and skin - esp as many pet owners are health care providers and exposed to MRSA.

Strange how thoughts changed based on your own health constraints!!! 

Kathryn  (aka  http://twitter.com/kathrynvet)

Kathryn March 21st, 2009 07:20:51 PM

Jackson: Why would the DEA care? Maybe because it is illegal? And a DEA licensed professional would be abusing the privilege if prescribing ANY drugs for self, friends, or family----and if done often enough and long enough, just may be discovered?

Pocket's Story from NH: a pet and owner that cruelly suffered because of no license for narcotics

Barb A.

Barbara A. Albright March 21st, 2009 08:53:32 PM

Dr. Patty: I've had two bad cat bites, one to my right thumb, one to my left. The first time I was seen in the ER by a hand surgeon (I had been seeing him for another problem). He put in a radial (nerve) block then went to work flushing and flushing and then flushing some more with huge amounts of betadine and saline. He put my hand in a rigid bandage and prescribed two antibiotics (this was in the days before Clavamox/Augmentin, so a broad-spectrum beta-lactamase-resistant antibiotic plus penicillin were neessary). He saw me a few days later to check on the wounds which looked great and would have seen me again if not for the fact that I was moving away.

The second time, I went to the ER where the doc on call lackaidaisically spent 30 seconds looking at the wounds, which didn't look that bad (like cat bites ever do!), ordered a tetanus shot, gave me a prescription for Augmentin and sent me on my way. When I saw the hand surgeon the following day (about 16 hours after the bite), my hand was already hugely swollen. I ended up in the OR for exploration of my MP joint, since one of the bites was right over it (luckily the capsule was intact) and in the hospital for four days for IV antibiotics. I've always wondered if the difference was in the thorough flushing my wounds got the first time.

silkenpaw March 22nd, 2009 03:53:21 AM

"Strange how thoughts changed based on your own health constraints"  It does indeed change one's perspective a wee bit :)

PJBoosinger March 22nd, 2009 06:43:05 AM

silkenpaw: Dilution is the solution to pollution. Wish everyone did it that way. I've also had the same treatment differential. Once at University of Pennsylvania's ER where my head underwent a thorough 15 minute drenching with syringe-pressure dilute chlorhexidine. The other time at Baptist Hospital in Miami where I had little wound flushing. I informed the latter crew that I hadn't yet thoroughly flushed the wounds myself--to no avail. When the hand surgeon finally arrived, he chastised the ER crew for failing to flush. 'Nuff said. 

Dr. Patty Khuly March 23rd, 2009 07:37:28 PM

Dr Patty: "Dilution is the solution to pollution." LOL. You got that right. Shoulda called the hand surgeon when I went to the ER for my second cat bite. I would have ended up in the OR, anyway, because of the location of the bite, but maybe not in the hospital for IV antibiotics. Live and learn, I guess...

silkenpaw March 31st, 2009 08:33:28 PM

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