Need Opinions (Long)

"Howard Berkowitz" wrote in message
...
In article .net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand before I put a
cat through a battery of stressful tests. That doesn't take a degree in
biology, just common sense, experience and compassion for the cat -- none of
which you seem to have.

You questioned my suggestion to retest the cat - I gave my reasons - that's
it. Now stop whining like a spoiled little brat because I don't agree you.

In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article .net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand before I put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't understand. You
rerun them to see if there is anything different. Why should your
understanding of the repeated test be any different than the first?

If you are questioning possible lab error, standard practice for many
out-of-range conditions is for the lab to rerun it, as well as controls.
The blood sample volumes requested are intended to be enough that the
lab can rerun the test if necessary.

Now, as to "stressful tests". To repeat the test, you will have to draw
blood at least once from the cat. To do, say, a dynamic creatinine
clearance rate test, you need to make one puncture, draw blood, and then
inject creatinine through the same needle. At a timed interval
afterwards, you take a second blood sample.

Personally, I don't like having blood drawn. I'm sure a cat likes it
even less. Nevertheless, the only difference I see in your approach and
mine is that I propose one more stick, and getting back results that are
considerably more sensitive (i.e., high rate of detecting positives) and
selective (i.e., low rate of false positives) than two sequential
Chem-7's (Basic Metabolic Profile) giving you an additional BUN and
creatinine. Unless you also do osmolality, Hct or PCV, and other
measures of hydration, the sequential BUN and creatinine are not
necessarily well correlated.

An actual measurement of the proportion of a known amount of creatinine
metabolized in a unit time gives a far more accurate estimation of GFR
than the semi-random repeats you propose. BUN and creatinine, in and of
themselves, are not informative -- they are clues to renal function, and
the most important part of renal function is GFR.

That doesn't take a degree in
biology, just common sense, experience and compassion for the cat -- none
of which you seem to have.

Lot of assumptions there, boy. Any data supporting it?


You questioned my suggestion to retest the cat - I gave my reasons -
that's
it. Now stop whining like a spoiled little brat because I don't agree
you.



Laughing hysterically...whining like a spoiled brat? Who started the
sarcasm, asking if I was a high school student, an apparent slap at
credentials. Now you're saying it's irrelevant to have a degree in
biology.

Let me get this comedy straight...it's not quite worthy of Monty Python
logic, but perhaps we can elevate you to that point. First, you put me
down as not having knowledge and experience. Second, when I come back
with credentials, you quickly change your tune to not needing education
but using "common sense".

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article .net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand before I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't understand. You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!

In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article .net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your
curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand before I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't understand.
You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!




Do the ideas of "statistical significance" and "predictive power" have
any meaning to you? So now you have two results. If they differ, which
is the correct one? To be able to confirm a trend, you need at least
three samples, assuming that the curve is smooth, or you accept the most
consistent 2 out of 3.

Now, to take that third sample, the cat has to be stuck again. You were
complaining because my proposal to use measured creatinine clearance was
more stressful. The only additional stress was an additional stick.
But to get anything with clinical validity with two conflicting samples,
you have to do a third stick anyway.

Where have I referred to a "battery of stressful tests"? I referred to
one specific procedure involving two sticks. I mentioned that to avoid
the stress of confining tha cat in a metabolic cage.

Yes, you can get a much better calculation of creatinine clearance given
even an isolated urine sample and a single blood sample. But getting the
urine, if you don't cage the cat, requires cystocentesis -- not major,
but another stick.

In every scenario, to have what is a statistically meaningful
measurement that is in accordance with every principle of good clinical
pathology, as opposed to your "common sense", the cat has to be stuck
three times.

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article
.net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your
curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand before
I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't understand.
You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!




Do the ideas of "statistical significance" and "predictive power" have
any meaning to you? So now you have two results. If they differ,

It looks like you didn't get it after all... I give up on you Howie. You
just don't know enough about cats.

"Phil P." wrote in message
...

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article
.net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your
curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand before
I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't understand.
You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!




Do the ideas of "statistical significance" and "predictive power" have
any meaning to you? So now you have two results. If they differ,

It looks like you didn't get it after all... I give up on you Howie. You
just don't know enough about cats.

I need to understand this argument a bit better. Are you a qualified
veterinary surgeon who specialises in cats, Phil?

Tweed

"Christina Websell" wrote in message
...

"Phil P." wrote in message
...

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article
.net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your
curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand
before
I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't
understand.
You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!




Do the ideas of "statistical significance" and "predictive power" have
any meaning to you? So now you have two results. If they differ,

It looks like you didn't get it after all... I give up on you Howie.
You
just don't know enough about cats.

I need to understand this argument a bit better. Are you a qualified
veterinary surgeon who specialises in cats, Phil?

Nope. I just work with a lot of cats and a lot of vets for many years.
Whenever we get back questionable results, every vet I've ever worked with
simply retests the cats. Howie seems to have a problem with that because
its too simple and also because he doesn't know much about cats.

You see, its not unusual for and older cat to become azotemic or
hyperglycemic or have a high WBC count from a trip to the vet - its called
the "white coat effect". Retesting the cat after allowing her to calm down
and adjust to all the other animal scents in the office, more often than
not, will produce a more accurate result. I've seen this happen many, many
times.

Howie doesn't understand that because he's too wrapped up in his credentials
and not enough in cats.

Phil

"Phil P." wrote in message
...

"Christina Websell" wrote in message
...

"Phil P." wrote in message
...

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article
.net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your
curriculum
vitae.
LOL!

No, but since you've decided to act superior and all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get back
questionable or unusual test results that I don't understand
before
I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't
understand.
You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!




Do the ideas of "statistical significance" and "predictive power" have
any meaning to you? So now you have two results. If they differ,

It looks like you didn't get it after all... I give up on you Howie.
You
just don't know enough about cats.

I need to understand this argument a bit better. Are you a qualified
veterinary surgeon who specialises in cats, Phil?

Nope. I just work with a lot of cats and a lot of vets for many years.
Whenever we get back questionable results, every vet I've ever worked with
simply retests the cats. Howie seems to have a problem with that because
its too simple and also because he doesn't know much about cats.

You see, its not unusual for and older cat to become azotemic or
hyperglycemic or have a high WBC count from a trip to the vet - its called
the "white coat effect". Retesting the cat after allowing her to calm
down
and adjust to all the other animal scents in the office, more often than
not, will produce a more accurate result. I've seen this happen many,
many
times.

Howie doesn't understand that because he's too wrapped up in his
credentials
and not enough in cats.

Phil


Thanks for clearing that up, Phil. Are you a vet tech? We have someone on
this group studying to be one at the moment.

I've been told I too have what is apparently called "white coat syndrome."
As soon as I am admitted to hospital my blood pressure goes through the roof
and sets the monitor off. Pure fright, I'm sure, as I'm usually there for
an eye operation.

Tweed

"Christina Websell" wrote

I need to understand this argument a bit better. Are you a qualified
veterinary surgeon who specialises in cats, Phil?

Nope. I just work with a lot of cats and a lot of vets for many years.
Whenever we get back questionable results, every vet I've ever worked
with
simply retests the cats. Howie seems to have a problem with that
because
its too simple and also because he doesn't know much about cats.

You see, its not unusual for and older cat to become azotemic or
hyperglycemic or have a high WBC count from a trip to the vet - its
called
the "white coat effect". Retesting the cat after allowing her to calm
down
and adjust to all the other animal scents in the office, more often than
not, will produce a more accurate result. I've seen this happen many,
many
times.

Thanks for clearing that up, Phil. Are you a vet tech? We have someone
on
this group studying to be one at the moment.

I've been told I too have what is apparently called "white coat syndrome."
As soon as I am admitted to hospital my blood pressure goes through the
roof
and sets the monitor off. Pure fright, I'm sure, as I'm usually there for
an eye operation.


I have this too. My bp is generally 120/60, but my doctor has to take
it twice. Once when I first get there, when it is as high as 150/100, then
later after he has talked with me and distracted me and calmed me down,
when it is much lower. Before he understood this he almost put me on
bp meds.

"Christina Websell" wrote in message
...

"Phil P." wrote in message
...

"Christina Websell" wrote in
message
...

"Phil P." wrote in message
...

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article , "Phil P."
wrote:

"Howard Berkowitz" wrote in message
...
In article
.net,
"Phil P." wrote:

Are you applying for job here?! I didn't ask you for your
curriculum
vitae.
LOL!

No, but since you've decided to act superior and
all-knowing,

You see, that's the point you can't see through your academic
credentials,
I'm not all-knowing that's why I rerun the tests when I get
back
questionable or unusual test results that I don't understand
before
I
put
a cat through a battery of stressful tests.

Let me get this straight. You get back results you don't
understand.
You
rerun them to see if there is anything different.

Yes! I'm glad you finally got it! Took you long enough. LOL!




Do the ideas of "statistical significance" and "predictive power"
have
any meaning to you? So now you have two results. If they differ,

It looks like you didn't get it after all... I give up on you Howie.
You
just don't know enough about cats.

I need to understand this argument a bit better. Are you a qualified
veterinary surgeon who specialises in cats, Phil?

Nope. I just work with a lot of cats and a lot of vets for many years.
Whenever we get back questionable results, every vet I've ever worked
with
simply retests the cats. Howie seems to have a problem with that
because
its too simple and also because he doesn't know much about cats.

You see, its not unusual for and older cat to become azotemic or
hyperglycemic or have a high WBC count from a trip to the vet - its
called
the "white coat effect". Retesting the cat after allowing her to calm
down
and adjust to all the other animal scents in the office, more often than
not, will produce a more accurate result. I've seen this happen many,
many
times.

Howie doesn't understand that because he's too wrapped up in his
credentials
and not enough in cats.

Phil


Thanks for clearing that up, Phil. Are you a vet tech?

I have no formal training in veterinary medicine whatsoever. I've been
working in animal rescue and welfare for about 45 years and picked up a few
things here and there.


We have someone on
this group studying to be one at the moment.


Now's an exciting time to get into veterinary technology - it seemed to have
stalled up until a few years ago. I think we'll be seeing some major
breakthroughs and even cures for some of the major scourges of cats within
the next decade.



I've been told I too have what is apparently called "white coat syndrome."
As soon as I am admitted to hospital my blood pressure goes through the
roof
and sets the monitor off. Pure fright, I'm sure, as I'm usually there for
an eye operation.

I had an eye operation myself - so I understand your panic.

The white coat effect can wreak havoc on a cat's test results - especially
the glucose levels. Many cats have been erroneously diagnosed as diabetic
by incompetent vets.

There's nothing wrong with questioning a test result and even the vet. Your
loyalty should be to your cat, not to your vet.

Cheers,

Phil