Saturday, November 29, 2014

Buffetting : Animal Handling 101- Panadol and animals

Disclaimer: This is an article written by a veterinary student. All information is based on non-professional interpretation of the student and is not subjected to any responsibilities of the readers' disposal.

I'm pretty sure I would have made a great pharmacist with my flair for pharmacology. Heck, we literally became dispensers of drugs over 1 semester of studies only compared to the professional pharmacy students. Yet, we only prescribe and dispense; we can't compound(aka make) drugs.

Paracetamol, also known as acetaminophen is the generic name of a non-steroidal anti-inflammatory drug(NSAID) named after its chemical name of N-acetyl-p-aminophenol is an easily retrieved over-the-counter drug commonly used in any household. Widely known as Panadol in Malaysia, the antipyretic drug is usually used to relief headache and fever in most cases.

With its miraculous use, it is normal for us to actually consider its use even for animals. If it works well in human, of course animals would be fine right?

This is when you are WRONG.

Drugs consumed in our body requires several organic mechanics for them to release the active ingredient and work on our body's biochemical pathways. In this case, acetaminophen serves the same as well.

However, species variation does prevail in every single drug used, zoonotically or interspecies.

While human can take up to 4000mg for an adult in a day without any adverse effect(recommended dose of 1000mg), cats only can withstand up to 100mg/kg while dogs 600mg/kg.

That means, one tablet of conventional acetaminophen of 500mg can already kill a cat weighing 2.5 to 3.0kg; while a 5 kg cat is already considered overweight.

In fact, acetaminophen is never prescribed for veterinary use; regardless of their species.

WHY? The mechanism

The metabolic pathway of acetaminophen in the liver includes 3 different pathways; the glucouronidase, the sulfonation as well as the cytochrome p450 pathway.

In cats, the first 2 mechanisms are extremely limited due the lack of required enzymes; hence a high dependence on the latter pathway. However, a high dose of acetaminophen renders the ability of the pathway to metabolize the incoming drug concentration; leading to a problem of Acetaminophen Toxicosis.

In the cytochrome P-450 pathway, acetaminophen is metabolized into NAPQI, a toxic substance; which requires the conjugation with gluthathione from the body reserve to be metabolized into cysteine and mercapturic acid which are non-toxic. The depletion of the gluthathione reserves in the cat's body due to a high acetaminophen dosage will lead to a high accumulation of toxic NAPQI in the body.

Gluthathione depletion leads to red blood cell oxidation injury while methemoglobin, an alternative form of red blood cell will be produced due to the oxidation of Fe2+ haem group to Fe3+ haem group. Red Blood Cell oxidation causes the death of the RBC leading to jaundice; while the failure of methemoglobin to bind to oxygen due to the inability of Fe3+ to be further oxidized causes a cyanosis effect(pale from hypoxia). NAPQI accumulation also damages the liver, contributing to the occurrence of jaundice.

The Signs
Once you have accidentally fed your cat or dog with panadol, there are signs that you can have a look out for:
1- Cyanosis- pale and blue appearance
2- Jaundice- yellow staining on the eyes and gums
3- Pallor- pale and blue and no energy
4- Facial edema- swelling of the face for which the bouncing back of skin after pressure is more than 2 secs.
5- Hypersalivation

courtesy of catvando

The Right Thing to do:
Send your cat or dog to the vet immediately. The vet will be able to diagnosis and assess what treatment to be given to the cat. In most cases. the vets will try their best to accomplish the goals below:

1- Prevent further absorption of the drug in the animal; usually emetics to induce vomiting or a gastric lavage if your animal is already comatose. An activated charcoal may also be prescribed. These procedures are only useful when the toxicosis is recent and the drug is consumed within few hours.

2- Antidote prescription; in this case a mucolytic named acetylcysteine. The drug works was a gluthathione precursor to supply the body with enough gluthathione for the conjugation of NAPQI into a non-toxic product. This drug is the first line drug to be considered in every acetaminophen toxicosis as it is the antidote to the problem source.

3- Reduce methemoglobin presence in the body to replenish the normal RBC . Vitamin C will be prescribed along with a single dose of methylene blue.

4- Supportive treatment if the cat or dog is extremely ill;  usually with blood transfusion, IV drip and oxygen provision. Cimetidine, a histamine-2 agonist may also be prescribed to inhibit the action of cytochrome P450 in generating more NAPQI toxic.

The Summary: 
Responsible pet ownership does not stop at providing food and shelter and love to the animal. It includes understanding the general physiology of the animal as well as dos and don'ts in making sure the veterinary health of the animal is up to par. Never anthromorphize animals.

So, get educated!

Another series will be updated on the nutrition segment of the companion animals in the near future!

Friday, November 28, 2014

Buffetting : Doing more

During the clinical conference this evening, I somehow ended up sitting beside Miss N.

We are usually professionally associated, talking about academics most of the time because we have differences; but I guess my simple gesture of handing her a packet of pills for cold broke the ice barrier.

So we were talking about various issues; until Miss N startled me a little on her comment.

"I feel like people like you who have the brains should go further more and contribute to the veterinary profession more than just being in sales; or just a small animal practitioner."

I wasn't expecting that from her, because well she is pretty well-known for the good grades; 4.0 for every semester if I weren't wrong.

And silly little me who hardly get any 4.0 in my life before*cross fingers for this semester* being acknowledged by the comment simply was, dumbfounded.

Maybe a little over the top for that comment; but I guess she feels like I can do more for the veterinary community than just pharmaceutical sales.

I'm still in the midst of deciding.

I definitely wish to complete a PhD to end my academic pathway with a great full stop; as my life accomplishment as well as a pride for my family(though I'm sure the Dr title does well for that)

But there are so much more to offer out there; and I sometimes do feel like being a materialistic person.

Yet, some voice in there screams *be yourself, because you will shine better that way*

So I guess Miss N did a great job for a pep talk session.

Tuesday, November 25, 2014

Buffetting : Wrong vibes

The faculty these days require an extra spice.(not that the recurrent theft cases have not done a fabulous job on that)

By spice I meant, like lovey dovey spices.

Lady Boss finally made it official with Sea, which is really about time.

However, when a new couple buds, the people around; especially the ones who used to hang out with them will probably feel the effect most.

Even if the couples weren't really doing much of PDA or what not, us being reserved as Asians probably would just back off to give them some space.

Before Lady Boss made it official, it was always the dynamic trio of me, Lady Boss and Ice Queen around; for we would go for lunch and all together.

Now, its just me and Ice Queen. Not to say that we don't have other Vet souls around to mingle with because we do; its just that most of the time before, we were the ones to hang out because of our long time of contact in the practicals.

Well, being just me and Ice Queen; and our interaction over the social media and meet ups, people begin to pull red strings for the both of us. Polar Bear probably thought the both of us really had something going on.

We probably have chemistry, but in the really close friend kind of way. We know our romantic preferences and heck we are definitely not for each other in any romantic ways. Plus, Ice Queen's one of the first ones to know about T, she'd probably be turned off by me.

But its comfortable to have Ice Queen around and just talk, about almost anything and everything. At least for me. It's not easy to get someone to talk like that. As of the conditions these days, its even worse.

The guys are probably no longer available for there's only 4 single blokes left; the others are taken.
Same goes to the girls.
What's making the whole picture even more complex is the rotation in year 4, everyone seemed to be just not together anymore; simply because the time for rotation takes up so much of their lives.

I don't blame them or anything. But I can slowly feel a certain degree of letting go by my side for now. They are probably too sedated by tests and academics to notice; while I'm still available to post here every fortnight or so. On the other hand, I'm slowly assimilating into my current academic batch in their outings and fun stuffs; apart from just academics.

Life is complex. Relationships are even more.

I'm just grateful that we can still talk about stuffs even after a long time. Just like Best bud, I think.

Side note: T is now back in my newsfeed; but I'm pretty sure I'm not in T's. I would say I'm slowing getting over T, but there are still shades of our memories. And there are still questions on why did T suggest the break up back then.

Yet, in split seconds I would say its meaningless. Because romance right now, is meaningless to me.

Monday, November 24, 2014

Buffetting : Be Vigilant

About everything you do pretty much.

Today I had my probably worst paper of the semester.

Not because I coudn't answer it, more like the after effects from the studying.

Usually I'm pretty much well prepared for the tests; or so I believe.

But today's was absolutely different to the point that on the previous night I'm still stressing over the facts that I may not yet gotten right.

The other fact which makes the whole paper lot harder is because it's a Pharmacology paper, for which there are 7 systems of drugs I need to know from Gastrous, Cardiac, Urinary, Respiratory, Cerntral Nervous System, Peripheral Nervous System, as well as the Ocular system.

The lecturer mentioned that we need not know the drug names, for which he will be providing the group names and only require us to explain the function.

Heck no, the test turn out otherwise.

Everyone else was wondering why did I spend so much effort memorizing the names of the drugs.

Well now they do.

Deceived by the lecturer, yes. But we should be vigilant at all times. Some lecturers are meant to be guarded of, especially this one.

Well, I would say I did well for the test, being the first one to leave and all. And I deserve my break tonight because of the migraine the whole study process gave me.

This Friday, virology. Pathogenesis, clinical signs and morphological here we go.

Saturday, November 22, 2014

Buffeting : Naughty boy

Did I mention I'm like this pet for a particular lecturer in my pharmacology course?

It happened on the first day of lecture because I was able to answer most of her questions on basic pharmacology, thanks to my Form 6 days. Thanks to that phenomenon, she makes it a point to ask me all the first questions she have in the lecture ; every single lecture.

Thanks to that, I too make a point to read up her notes before her lecture begins; and I managed to practice that for other courses too.

So yesterday we had lecture on prescription writing. She wanted us to present our definitions on prescription. Here's mine:

The details of a drug including its active ingredient, dosage, administration route, frequency and duration which is given to the patient specifically to alleviate an indication by a veterinarian.

What the lecturer had in mind was:

The instruction given to the pharmacist by a veterinarian to prepare a drug for use in the patient for the client.

I forgot.

Our patients can't comprehend prescriptions. Our clients can.

For that, the lecturer gave a comment of "Patient? Naughty boy... how can your patient read this?" while the whole class burst into laughter; including me.

Naughty boy? Well, it has been a long time. Pun both intended and not.

Friday, November 21, 2014

Buffetting : Foreplan

Sorry, the last alphabet probably caught you off guard.

Being in the vet program of my university speaks of planning ahead; way ahead compared to other courses; that I'm pretty sure.

Placements for practical training ain't as abundant as they used to, because of the increasing number of students; not to mention dates, deadlines and cheap air tickets to be bought before they all come haunting you last minute.

In my academic year 4, we need to complete 2 courses of extra mural placements, namely:

Extra mural clinical rotation
Extra mural laboratory placement

In the clinical rotation, we are required to complete rotations of ruminant medicine, equine medicine, small animal medicine and an elective medicine; all which require supervision of a certified veterinarian.

For ruminant and electives; I've decided to go for Mahidol University in June-July 2015 for a 4 week exchange program; since their agriculture is still far ahead from ours, while their climate differ much less compared to the European countries as well.

For equine and small animal medicine; I've decided to still retain in local veterinarian vicinity since I'm afraid that I might not be able to appreciate the beauty of the medicine before I enter surgery class. Plus, I'd figure the local scene will be much suffice to sustain our industry right now; maybe I'll consider European countries later on.

In laboratory placement, we are required to complete 3 weeks of any lab placements. I've chosen Yamaguchi University in August-September 2015 for the public health lab placement; simply because I've been dying to go to Japan, while their laboratory facilities are probably worth the money to explore. Plus, my vet student counterpart from IVSA in Japan managed to lodge me a volunteer accommodation for I need not pay for 3 weeks, why not nab that opportunity?

Planning ahead is really important for these placements; or you will really get a migraine as the dates come closer. Even if you are only thinking of going local, places are still limited.

Thanks to the vet school, I've managed to slash off Japan and Thailand off my travel list! Maybe a 10 weeks placement in an European country in my 5th year since I've no more placements by then.

Now, to focus on more drugs effect of pharmacology!!!!

Monday, November 17, 2014

Buffetting : Pessimist

I was having an educational health discussion with the sister only to be pointed out that me being negative all the time.

I am experience some issues with my blood pressure some way or another; weird part being I have no problem with cardiopulmonary exercises.

In fact, I usually get tired because of muscle sores over lack of stamina.

The point is, the sister pointed that I am being too negative all the time leading to the blood pressure issues.

I have to be honest I'm very easily irritated and infuriated; and very hot-tempered. Anyone who knows me personally knows that I'm the typical Leo;

I hate you entirely, or I love you entirely. Best be on the same side as I am, or you are going to experience the worst of me on  my opposing end.

So yes, I am easily annoyed if things go from my way.

Something I developed over the years in Form 6.

But I still do think that I became less cynical and more positive in the university.

Though I still think I'm towards the pessimist end for now.

Sunday, November 16, 2014

Buffetting : Luck out

The week has been hectically lucked out for me.

Especially in financial terms.
it took me really long to decide to use this birthday gift. really long.

Gonna have to tighten up my wallet next week, and make sure nothing loses itself again.

However, booked another ticket to Japan; this time for Yamaguchi and Tokyo for my lab rotation.

30days in Japan, are you ready?

Friday, November 14, 2014

Buffetting : 不幸








Wednesday, November 12, 2014

Buffetting : Japalore, again

Well, I guess getting into vet school has really opened up my options so much more than I thought it would; and definitely more than medicine school could have if I were to continue my studies in Monash.

This time round, the Japanse Vet Students Association has managed to come up with a regional summit for veterinary students, namely Vet Youth Summit Japan 2015.

The main topics which will be covered in the summit are:
1- Infectious Diseases
2- Animal Welfare
3- Wildlife Conservation

3 topics which are extremely important even in Malaysia's context, for they are all developing and require attention for the betterment of the country.
probably be using this line a lot!

I've booked my plane tickets, spending about 9 days, in Osaka and Kyoto intermittently.

The bookings for accommodations, however is a little tricky as I will be travelling between areas and places a lot between the 9 days due to the location of the conference, as well as the period which I will be spending there.

I'm in the verge of getting nuts, both because of the ecstasy as well as my workload for test 2 in the faculty.

Yet, this should be a good trip!

Hello Japan!

Thursday, November 6, 2014

Buffeting : Listener

I was being told at multiple occasions that I'm an extremely good listener, when I choose to listen.

The fact is I am, and I'm proud of that trait of mine.

Yet, I'm also human. If you are going to just come and get things out of me, but really lack the interest in making the conversation two way, take what you need and just go.

Don't ask questions and then leave the whole conversation hanging.

I guess that's a Leo's pride.

Back to infectious diseases causing neuropathy.

Aiming for a successful future.

Monday, November 3, 2014

Buffetting : Ties

I'm just going to spend about 5 minutes on this before I head for Pathology on the neurological system.

It occurred to me that late, my ties and relationships are going all backwards and differently from what I began in first year.

Originally, when I headed to university I wanted loosen up my ties with my family, for all the distress they have caused in that time; I wanted to tighten up my ties with my course mates , for all the good times they have given; I wanted to tighten up my tie with someone special.

Today, at the midway of my university journey, I began to tighten up my ties with my family; for the things that they will need me to be at home for such as my niece, and my new home; I began to loosen up my ties with my course mates, for they no longer are going to be available around me with their different schedule, or different plans; I no longer has any ties for anyone special.

It's so ironic and cynical, for me to actually boil back to my family, after all these while I have been trying so hard to sever. Where as for friendship and romance which I tried so hard to preserve before now I'm beginning to let go.

The cycle, is pretty insulting at times.

Something I've noticed, but it actually means I'm now closer to my family? Or they became my focus since I might have subconsciously trying to pull away from my course mates.

It's something that I would do. But somehow, I don't really feel that empty inside though.

Saturday, November 1, 2014

Buffetting : Terminal 5

Today was e day which most UPM graduates of 2014 rejoice because of their official end of term in the university.

I somehow volunteered to help out a lecturer in being one of the usherers of our faculty for the sponsors for the faculty prizes, in return the lecturer promised us internship opportunities as well as future subject bonus marks.

In the midst of all that, I too managed to see few of our seniors name on the faculty prizes' boards, wondering if I could one day have my name there.

The thing is, I don't think I can go study like a crazy maniac to score top score for all the subjects in the course.

I find that, extremely tiring.

And the fact that I'm stretching the course over 6 years, mask me wonder if I would be eligible for any prizes at all.

Should I be bothered to aim for the prizes, or should I probably just study on my own pace, and get what's the best that come?

I should do the latter, for my life would suck less.

Plus, prizes ain't probably everything we need to look at right?

On the side note, if you readers managed to read about the death of a UMS graduate killer by her own brother, she was someone I knew. She was also my successor for the Buddhist fellowship president in my pre university high school.

Monkey and Chimp(another monkey) managed to organize a smile lunch Dhana over SJBA for her to share some merits with her, hoping she would be in a better state from the death in the next life cycle.

I am glad I took the morning off for this, because submerging myself in the dharma allows me to be in control and mindful over my thoughts and speech.

I am too wasted today to study, but tomorrow for sure.