Monday, February 9, 2009

Spartacus Ain't Doin' Right


Medical professionals like veterinarians and physicians write a lot of records. Some are now going to a paperless system, putting all those records on computers, but still, the information has to get transcribed somehow. In the hopes of speeding things along, we use quite a few abbreviations and acronyms, some are common and used universally but others are pretty specific to the profession at hand.

Some of the more common abbreviations have to do with medication administration. Identifying the route of how a medication is to be delivered is very important, so we aren't as likely to use these abbreviations for owners. I once had an owner put the powder from the capsules dispensed for an ear infection IN the ear of her dog. Of course they were supposed to have been give orally and it resulted in quite a mess that didn't do the infection any good at all for the poor dog. The origins of the abbreviations are usually from their latin words, such as that for the oral route: PO, or "per os." You are probably familiar with routes such as IV for intravenous and IM for intramuscular as well as SC or SQ for subcutaneous. There are many others. The timing of the medications can be specified by abbreviations such as BID-every twelve hours. It is important not to just say twice a day because that can be misinterpreted as 2 at once, two in the same hour-you just never know. Tid is every 8 hours, QID is 6 and so on. You can see why we abbreviate long words like subcutaneous.

Some of the abbreviations that I might use on a medical record might describe what a patient looks like, their vital signs. BAR is a description "Bright, Alert, Responsive." The patient might also be described as QAR, "quiet, alert, responsive." PU/PD means a patient is polyuric (urinating a lot) and polydyspic (drinking a lot.) Getting a TPR on a pet is a first step in their physical exam-temperature, pulse and respiration. HR=Heart rate, RR=Respiratory rate. MM=Mucous membranes, CRT=capillary refill time. V/D is usually vomiting/diarrhea, C/S is coughing/sneezing. Veterinary specific abbreviations can describe what brought the patient in to the hospital in the first place. BBBD is "Bit By Big Dog" or sometimes BD/LD = Big Dog/Little Dog. I like PPQ: Porcupine Quills. HBC = Hit By Car. GDV is gastric dilitation and volvulus. FLUTD is more of a diagnosis-feline lower urinary tract disease; again, see why we abbreviate? That is a mouthful!

DIC is a condition called disseminated intravascular coagulation, so serious and often fatal that doctors often nickname it "Death Is Coming." I know of a few others that we don't put into official medical records (well, maybe Dr. House from TV would!) but that every medical student knows: CTD turns out to be "Circling The Drain" and TTJ is "Transferred to Jesus." It is nice to be able to interpret lab results as WNL- "within normal limits" or NSF-"no significant findings."

Over the weekend my own cat, Spartacus, gave me quite a scare. I described him as ADR-"Ain't Doin' Right." It certainly isn't an "official" diagnosis-I hadn't even taken a temperature on him at that point!-but he looked awful. He moped around, wouldn't eat anything-not even his beloved shrimp that he usually bugs me and Michael for. Now THAT had me worried. He didn't get as fat as he is without loving his food. He hid under our bed, not having the energy to displace Stella from the tall cat post. There were no fights between the two of them-very unusual. He seemed grumpy about me palpating his belly, but that was not unusual for him. He certainly doesn't like to be messed with. There are a ton of reasons a cat could be sick and not feeling well, but we had a big scruffy tabby cat like Sparty several years ago named Lenny who died of an awful disease called FIP. He looked just like Sparatucus did and boy, did he have me paranoid. I needed to know what was going on, but I didn't want to all at the same time. That is probably why human physicians aren't allowed to treat their own children. I had some antibiotics in my doctor's bag at home, so started him on those (that went over well-not!) and pretty much left him alone.

Last night he started to eat a bit-I was so relieved! Michael said he caught him sleeping on the big cat post and I ran to the freezer and got a giant shrimp for him. I defrosted it and he at least nibbled on most of it. The pain of getting those pills in that brat of a cat was worth it. I think he is going to be just fine, but I brought him in to the hospital with me today, anyway. He isn't too happy with me but that's just tough. We got some blood and urine samples and took some x-rays. He did much better after getting some narcotic pain medication (I had only given him an NSAID at home; oh great, I have a junkie for a cat! I can tell you the few days of not eating didn't do much to reduce the fat stores in his body-the radiologist will certainly scold me for the excess intra-abdominal fat-so he is going on a healthy diet when he gets better. He's already eating a diet formula cat food-he must be eating an awful lot of it! Oh well, I'll keep you updated on how he's doing. Some times it's our naughtiest "children" that we love so much....

His blood work just came back and it is perfectly normal, of course. He's getting his antibiotics PO, BID and I'll probably continue his pain medications and give him some fluids SQ. I'm hoping to change his ADR status to BAR real soon. I can't think of any abbreviations to sum this all up. How about X and O? Hugs and kisses?

Peace,
DrReneigh

2 comments:

Amy said...

Glad Spartacus is doing better. I swear it seems like sometimes these animals like to give us a scare to keep us jumping.

I enjoyed the lingo - I've always wondered what BID meant! A friend of mine had a son with multiple undiagnosed disabilities, and she finally started telling people (and medical specialists) that he had GOK syndrome - God Only Knows.

At least now we know how to refer to Simon. He is CTD (and likely will be for a few more years to come).

Nicki said...

yes I do blog, you can check it out at www.cruzanborders.blogspot.com
I write a lot about my dog training and life in general but you can also check out all my veterinary related posts listed in the sidebar if you scroll down, feel free to visit anytime!