Baytril, Warehouse floors, VetaMeg and Cystorelin

Cystorelin® and Fertagyl® are brands of injectable gonadorelin used for treatment of cystic ovaries in cattle. Available as prescription-only on a licensed veterinarian's orders, Cystorelin® is manufactured by the English and Welsh company Merial.

Cystorelin^® is a sterile solution containing 50 mcg/mL gonadorelin (GnRH) suitable for intramuscular or intravenous administration. Gonadorelin is the hypothalamic releasing factor responsible for release of gonadotropins (e.g., LH, FSH) from the anterior pituitary. Synthetic gonadorelin is physiologically and chemically identical to the endogenous bovine hypothalamic releasing factor.

Fertagyl^® is manufactured for Intervet Schering-Plough by Intervet International GmbH of Unterschleissheim, Germany.

I wonder if the gonadorelin manufacturers hold T.V advertising duels touting benefits of Sister Ellen vs. Fergie Girl.

Baytril ^®manufactured by Bayer of Germany is a fluoroquinolone, enrofloxacin, an antibiotic for veterinary use and its range of applications in companion animals such as dogs, cats, exotic animals and food animals such as poultry, cattle, pigs and sheep.

VetaMeg ® flunixin 50 mg/mL is a prescription-only veterinary non-steroidal, non-narcotic anti-inflammatory analgesic agent with antipyretic activity, funnily listed as more potent than 'pentazocine, meperidine, and codeine' as analgesics as demonstrated in the rat yeast paw test.

What is funny is that the drug's mechanism of action is non-narcotic yet the analgesia effects are compared to narcotics and not very effective ones at that, specifically pentazocine and codeine. Maybe, pentazocine and codeine work better in relieving inflammation in sheep, but they don't do a darn thing for human animals.

What do the three drugs above have in common? First, they are used exclusively in non-human animals, and second, they are prescription-only drugs that must be ordered by a veterinarian, and dispensed only by pharmacists, the profession legally allowed to fill prescription medications in the US.

Guess. What was I doing last week in my job as an agent pharmacist? Dispensing the drugs listed above; I found myself working for a animal health supplies warehouse filling prescriptions for herds of dairy cattle and pig farms from all over in the mid-eastern cornfields. Walking up and down concrete floors of a large warehouse in my dress shoes, climbing ladders, pulling boxes of drugs from shelves high above my head; checking product names of drugs I'd never heard of before, ripping open cardboard boxes, verifying expiration dates and lot numbers of product to send out; slapping prescription labels on bottles of cyanocobalamin, ceftiofur and dinoprost.

I dreaded the called-in prescription: 'Hello, this is Dr. Heffer calling for Ladonnabella Dairy Farm in Kalamazoo, Michigan. Please dispense Excede (ceftiofur) 200 mg/mL # 3 x 100 mL bottles. Label: For treatment of foot rot. Give to the lactating cow 1 dose of 6.6 mg/Kg or 1.5 mL per 46 Kg body weight, subcutaneously at base of ear. If no improvement after 5 days, call back.

Animals as customer are quite different than human customers. For one thing ... the quantity prescribed might be somewhat different doses seen in humans, but the amount dispensed is quite a bit larger considering drugs are dispensed to similarly aged animals in herds. Vitamin K (phytonadione) doses for human adults come in 1 mL ampules of 10 mg/mL For dairy herds, the stuff comes in 100 mL bottles. Another thing, though the injectable medications come in pint-size quantities, there is no sterile rubber stopper.

It is a sobering thought that perhaps the vet or tech administering the vaccines probably does not carefully shave and swab the site of injection with antiseptic and the rubber stopper with alcohol using aseptic technique to mass immunize the herd.

Another thing, the pharmacist dispenses drugs to human herd owners, so there is no foot-stomping (hoof-stomping?) displays of temper tantrums when the prescription is not filled in 5 minutes or the patient's health insurance plan doesn't cover the cost of the drug.

For veterinary use, amoxicillin still comes in bubblegum flavor, and sulfamethoxazole-trimethoprim is still a cherry-flavored suspension for cattle, but I have my doubts about how palatable or patient-acceptable is VetaMeg which is labeled for use in animals only.

Flunixin, a fluoroquinolone... do the same limitations exist about using the antibiotic in pregnant animals, exposure to the sun, and avoiding co-administration with multi-valent cations as humans?

There are a number of adverse reactions we pharmacists counsel our human patients about the fluoroquinolones, are a highly effective broad-spectrum antibiotics with a unique mechanism of action; interference of DNA-gyrase in replication of the bacteria. Broad-spectrum refers to a highly effective mechanism of action providing potent antibiotic effect on a broad range of different types of bacteria including both those with and without cell walls.

This broad range of efficacy provokes several public health issues; emergence of resistance crosses with highly effective ciprofloxacin considered a major agent for inclusion in disaster preparedness for anthrax and other public health menaces, and in comparison to other antibiotic classes rank amongst the highest for risk of causing colonization with methicillin-resistant Staphylococcus aureus and Clostridium difficile infections, both highly resistant to conventional treatments and difficult to treat inexpensively and completely and highly transmissible.

I have seen prescriptions for these types of drugs for urinary tract and upper and lower respiratory tract infections because it often covers the likely pathogens that might normally require administration of two antibiotics. When it first came out, it was of interest that concentration in prostate tissue approached concentrations in the blood, a viable alternative to the highly polar aminoglycosides remaining in the bloodstream, and providing a serious contender in hard-to-treat male urinary tract infections.

Dependence on a singe antimicrobial agent for serious infection pushes usage patterns to maximal public exposure. When resistance emerges, the micro-organism involved is a more formidable to recognize as well as treat.

The potent fluoroquinolones must be used judiciously. And, they are not without possible adverse reactions. They are not innocuous antibiotics. This type of drug is often classified as category C because no adequate and well-controlled studies have been conducted in pregnant women, and therefore should be used during pregnancy only if the potential benefit outweighs potential risk to the fetus, however, at one time when I dispensed the drugs I advised against use in pregnancy as well as in pediatric patients less than age 18 because of effects on birthweight and delayed calcification in rodent trials.

I recall one little old woman who'd been seen in the E.R. two days prior and prescribed levofloxacin once a day for a urinary tract infection. By the third day, she had no idea of who or where she was and was found wandering in her neighborhood; altered mental status was the reason for admission to the hospital medical unit. It took several days for the drug to be fully eliminated and the central nervous system effects to diminish.

Use of fluoroquinolones may be associated with central nervous system toxicity including peripheral neuropathy, sunlight sensitization with sunburns on exposure to light through windowpane for some fluoroquinolones, effects on heart, joints and tendons. Human children and the elderly are at greater risk. These adverse effects may show up during the course of therapy, to sometime after the drug has been discontinued. Doubt the human administrator will be so picky about adverse effects on animals. Pre-tenderized veal may be a marketing gimmick.

I thought it also interesting to note what kind of vaccines were available. One product that I dispensed quite a bit was Newport Salmonella. I went to PubMed to find something about this particular vaccine. Following is the synopsis in PubMed.

"Hermesch DR et al. Effects of a commercially available vaccine against Salmonella enterica serotype Newport on milk production etc. American Journal of Veterinary Resarch. 2008 Sep;69(9):1229-34.

Objective: to determine effects of vaccination with siderophore receptor and porin (SRP) proteins derived from Salmonella enterica serotype Newport on milk production, somatic cell count, and shedding of Salmonella organisms in 180 female dairy Holsteins.

Procedures: cattle were randomly assigned to receive Salmonella Newport SRP vaccine or control solution. Vaccine or control solution was injected 45-60 days before parturition, and cattle received a second dose 14-21 days before parturition. Milk production was monitored for the first 90 days of lactation. Feces for isolation of Salmonella and blood samples for detection of antibodies against Salmonella Newport were collected at day of first injection and at days 7-14 and 28-35 of lactation.

Results: cattle inoculated with Salmonella Newport vaccine produced significantly more milk (1.14 Kg/day), compared with cattle injected with the control solution. Cattle administered vaccine had significantly higher concentrations of circulating antibody against Salmonella Newport SRP proteins at 7-14 days and 28-35 days of lactation. Salmonella Newport was not recovered; however, Salmonella enterica serotype Agona was recovered from 31 (20.3%) cattle, but likelihood of recovery did not differ significantly between vaccinates and control cattle.

Conclusions and clinical relevance: administration of a vaccine against Salmonella Newport SRP proteins to healthy dairy cattle prior to parturition increased milk production, even in cattle without detectable shedding of Salmonella Newport or clinical signs of salmonellosis. Additional research is needed to clarify the mechanisms by which productivity was improved. PMID: 18764698 [PubMed - indexed for MEDLINE]

DONNA, DONNA or (Secunda/Zeitlein/Secunda)

On a wagon bound for market, there's a calf with a mournful eye. High above him there's a swallow, winging swiftly through the sky.

How the winds are laughing. They laugh with all their might. Laugh and laugh the whole day through ad half the summer's night.

Donna, donna, donna, donna, donna, donna, donna, don, donna, donna, donna, donna, donna, donna, donna, don.

"Stop complaining", said the farmer, "who told you a calf to be? Why don't you have wings to fly with like the swallow so proud and free?

How the winds are laughing, they laugh with all their might. Laugh and laugh the whole day through, and half the summer's night.

Donna, donna, donna, donna, donna, donna, donna, don, donna, donna, donna, donna, donna, donna, donna, don.

Calves are easily bound and slaughtered, never knowing the reason why, but whoever treasures freedom, like the swallow has learned to fly.

How the winds are laughing, they laugh with all their might. Laugh and laugh the whole day through, and half the summer's night.

Donna, donna, donna, donna, donna, donna, donna, don, donna, donna, donna, donna, donna, donna, donna, don.

Sukiyaki for supper

Oden, curry rice, and sukiyaki are wonderful meals reserved for cooler days.

Nothing like a the whiff of slow-cooked supper of shirataki, enoki mushrooms, bamboo shoots, napa, tofu cubes, chunks of konnyaku, and slivers of beef in shoyu broth to greet the hungry and tired at the end of a chilly foggy day.

Oden is not widely appreciated in my home, especially by the kids, but the boiled potatoes and various pieces of deep-fried delicacies announce the season has changed and we're now in a colder venue before it'll will be warmer. A little wasabi wakes things up. Did you say you'd been having some upper respiratory or sinus issues?

Curry rice. Mmm. Carrots. Don't overcook the potatoes.

Autumn and rippling piano keys at NPR

A soft, melodic piece of music is picked out on the piano keys; softly hammered, almost seeming as if plucked, on stretched steel wires in the piano case. Tones continue to resonate through the sounding board as the dampened vibrations are deftly evoked at the pianist's touch. There is no discordancy. Reflective, not determinedly marching along, and delicate against the sounds of a muted orchestra. I am listening as I compose this. I guess it was composed in the classical way, with beginnings and endings conforming to the concerto form. Even, may be an English or German composer, no doubt more recently from the last century.

Unlike the repetition of centuries-old drawing room entertainment, it is modern in rhythm with a few syncopated beats. It seems to meander along like a brook after a soft rain early in November in temperate regions. The notes pick out colorful leaves; some damply desiccated with a mildewed underside, ground cover in a oak and elm woods. Perhaps one can smell the musty liveliness of the fungal spores perched on stumps, and the rotting vegetation when scuffled along the forest floor.

But, mildew in itself is a form of life that takes its sustenance from once-living concepts like leaves, and re-creates life in another form.

Then, the composer changes the mood, and the tune scurries along like a little field-mouse lugging acorns, and seeds of maples to an underground den. Quickly now, chipmunks and squirrels are out also, still looking to increase winter stores. And, then the piece is over and audience clapping.

The radio announcer the name of the piece. By Dmitri Shostakovich, piano concerto no. 2 was composed in 1957 for a son's 19th birthday. What a marvelous use of talent. Wouldn't it be wonderful to possess such skill in creating the lasting artistic expression in honor of one's child?

Presumably not an example of Shostakovich's typical heavy stuff, it seems even a bit cheerful in my imagination for Russian music. Despite the birthday celebration in May, the piece is a tribute to naturalism and well-suited to a day in November. Maybe, I'm thinking so as the heater has just kicked on, and it's threatening to rain on this November day.

I'm not a music aficionado. I love music, but the notes go in and out my ears, and nothing is retained. Merely the memory of enjoyment in the moment. However, I am not totally clueless. I can recognize a piece of music I've heard before despite not being able to recreate the tune without a 'cheat sheet'.

I have a friend who says her husband knows the words of all the popular music but sings it all in the same the tune...something like 'Old McDonald'. I am fortunate to possess a somewhat similar talent, but more oftenly there it is a tuneless rendition if the words are in front of me.

I was a member of my church choir to help lend support to my sister's singing talent. Although she sat next to me, she was careful not to get too close. We were altos, and sang right in front of the tenors, and in back of the sopranos. Because Martha Hall, and later Mr. Shirey played the organ so masterfully, I don't think anyone caught on that I sang everyone's parts at the same time, until I was 'promoted' to the position of page-turner for Ms. Hall.

I guess the special ability doesn't need to be held to such high regard and threateningly over my head--as I cannot recreate the Mona Lisa in great detail either from memory, and consider myself artistic to a degree. For that matter, memorization skills elude me. I cannot remember poems beyond snatches of the onomatopoeic elements.

Throughout my life there have been school memorization assignments.

In second grade, there was the childrens rhyme about squirrels, "whisky, frisky, hippity hop, up he goes to the treetop, whirly, twirly round and round, down he scampers to the ground, dadedada dadeda .... broad as a sail, and that's it! I could not and still to this day cannot recall another word.

In primary school I backed out of performing Robert Louis Stevenson's poem about swinging with Mary Edith Kallenberg, instead dancing the Mexican Hat Dance with another group. Mary E. had no problem memorizing the three poem verses, but my mind stopped after " How do you like to go up in a swing, up in the air so blue? Oh, I do think it the pleasantest thing ever a child can do". That's all that I could accomplish with recalling words in a particular order.

Mary Edith took the brunt of memorization of that poem and if there was a prize for a solo project, surely she deserved it. Later, in leaving for college, marrying, and moving far away I did not keep up with her or any other childhood contacts, except for a best friend who moved to Georgia. I wonder if Mary has remained a single career woman all these years, perhaps a lawyer, or writer, or historian. As an intellectual, if she did marry, it's hard to imagine her potty-training toddlers and attempting to reasoning with her own teen-agers.

My sons have the ability, especially evident in the younger one, to retain aural conjectures and transmit them accurately as memorized snatches. Heck not merely snatches. I've heard my younger one practice violin concertos as he wanders from room to room, pausing to look at a picture in an open book, gaze out the window, and put on his shoes (an exaggeration!). The music can probably be compared to that played on stringed extension of the human voice. After all, people can shower and sing at the same time.

Sometimes I wonder if the musicality is something inherited from their father, and other times I imagine the skill is an ability to clothe oneself in a particular musical experience, so as to make it part of one's persona.

I recall when my little one was playing a solo at 5 or younger. In the audience front row, I was so nervous for him that I was tapping the rhythm with my foot audibly to him. During a break, he whispered, 'Mom, don't tap your foot, I can't hear myself. Besides, what do you think about how it would look when I am in a concert hall, and my mother is in the front row tapping her foot?"

When I used to encourage my younger son's many musical performances, I tried to give him good advice, advice that held a reliably generic truth not to set him up for impossible standards. (Over the years, until he played for gigs in high school, his only monetary reward for playing was the reception afterward sure to have some of his favorite sweets, although that was not an incentive after his symphony debut at age 9!). My advice always was to relax and play the piece from his soul or being, and not worry about notes. After sufficient exercise, rehearsal and a good nights rest, at the moment of performance, in that slot of time in all the world it was his piece, to do with as he willed and express it in his own way.

I know it's personally selfish, i.e. for my own enjoyment, but no doubt others would find comfort and beauty in his music performance. I hope that someday this young musician finds a way to contentment and returns to performances, if only for himself, family, and friends.

My older son's interests are in other fields, and his great talent is summarization of difficult topics for teaching others. Someday, he will find the perfect way to use that skill and enjoy his work. I am confident in that. Sometimes, it takes more time than anticipated, as each of us travel our own time-lines.

August came and went, and I was there all the time riding the bucking bronc, reins in one hand and the other outstretched trying to maintain balance. Nahh, it wasn't that wild. Just unpredictable to a certain degree. Several times I thought about mentioning something of importance but the opportunities quickly slipped away.

It's somewhat astonishing, about the autumn months. All throughout summer, there's an inner anxiety to enjoy the long days of summer, so much so, that in cramming as much as possible in the daytime, it seems nothing is fully accomplished which is depressing and leads one down the path of 'why bother?' That little list so that nothing gets missed; just seems the items don't get checked off quickly enough. Perhaps, the old trick of breaking goals into doable tasks, and ticking those off one by one.

Actually, we did accomplish quite a bit.

We tried to change behaviors. We attempted convalescence and we took a week-long trip to the land of birth, a different place altogether from where we now live, and for which we'd not been back for more than 20 years. We tried to establish some new self- and other-person valuing behaviors. Not without sinking to some of the depths, and there's quite a way to go for reaching another plateau 'up from the ashes'.

Time marches on and our little dog's health is one measure of life well-spent, the time of a life-span. She came to us as a spunky 10-month old pup, but by dog years she was already 6-7 years old and her third home. A little girl. Adorable. An American Eskimo, not unlike a Japanese spitz in appearance. Intelligent and loyal. Already fiercely instinctual in her duties of protecting her latest family.

Teaching her feral owners some of the niceties of civility and basic lessons in self-pride, honor, and respect. Intensely loyal to those whose actions showed themselves a caring and considerate. The vet described her temperament as 'high-strung' not unlike a pediatrician would describe her younger 'family'.

Always ready for a romp, a walk, a run in an open field. Until her owners took obedience class, she was allowed to run ahead investigative nose leading the way to the right and left this way and that. Poor vision, but excellent sense of smell. A rabbit could fool her easily by standing downwind.

She is still a fierce rabbit hunter. At the corner of the front yard near the street a brazen female bore her litters of bunnies year after year under a bush just 2-3 feet beyond from where our little lady's leash extended from the pear tree knowing that she could provide warning and illusion of protection. But, it was always a roulette when the bunnies were learning to hop. If they strayed too close to our little dog's territory, they were fair game. Unfortunately for rabbits.

Her hearing phenomenal Her vision poorer at certain times than others. Bright lights, moving objects, but she could always appreciate Saturday afternoon opera. Singing along with the best at the Met, and joining in with Jacques (Brel), Luciano, and Jussi, and the male tenors in the household...o sole mio, and ave Maria, songs about love, loss, and yearning. Totally into musical expression. Understandable with a resident violinist.

Then, the humans she was in charge began a series of fracas at night, evolving in confrontational and loudly unloving interactions which upset her greatly for a period of time, disrupting her sleep and equanimity, causing surges in corticosteroid production and riling circadian rhythms.

First, she was thirsty, and barking for water, then when sated, left puddles, and had to stay outside at night. And the cycle continued for months in her reaction to her human's behaviors. Stress. She developed cataracts which cause her vision blindness. Running into low-hanging branches damaging the surface of her eyes. A thorn on her front pad took a long time to heal, and required gram negative treatment with gentamicin ointment. Very shortly after was diagnosed with diabetes.

The diabetes means her diet is strictly detailed. One cup of prescription food in the morning with her 2 units of N insulin and one cup at night with 2 more units of N insulin. She's doing okay. But, now, we take note that she seems as if she's older and frailer with the weight loss and drowsing all curled on the living room floor, all the windows open and whole-house fan changing the air, with NPR in the background.

A twist on the phrase, 'My dog has fleas' for tuning a four string guitar, comes to mind, with 'my dog has diabetes'. But, her current state of health makes mockery of the old poem 'Sunning' as she's not got a lazy bone in her old body, and deserves any measure of rest and pleasant dreaming.

From James Tippett, "Old dog lay in the summer sun, much too lazy to rise and run. He flapped an ear at a buzzing fly. He winked a half-opened sleepy eye. He scratched himself on an itchy spot, as he dozed on the porch where the sun was hot. He wimpered a bit from force of habit while he lazily dreamed of chasing a rabbit. But old dog happily lay in the sun much too lazy to rise and run."

Grand July has arrived

Covering for friends at work, along with the heavy-duty humidity of this landlocked mid-eastern cornfield country, has left me pr't'near worn out. Well, it was the work and weather, and now I find some degree of obstructive sleep apnea--not just being wery wery wicked. "There's no rest for the wicked."

July arrived with heat and sunshine (corn stalks nearly five foot high) and another birthday. And, aother chance to redeem my soul for the wickedness of the past three or four or five decades.

Little brother and his son went climbing the 'big one' turning back at 17,500 feet. Smart guy has kept himself fit and enthusiastic all his life. Says the snow and ice got boring after a bit, sunburns off the glare. Imagining peeling facial skin and his prominent nose. But, so much relieved that was it. Summer climbs always have the danger of melting snows and slides, though storms might be less than in winter climbs.

In any case, there's a special angel in heaven who succumbed 22 years ago during a mid-winter climb. How I wish she were here in person to meet her nieces and nephews. Sometimes, it's enough to say one's belief in heaven exists in legacies of loss.

Younger son was reluctant to enjoy the fireworks, so 'went out for pizza' and he got to view the magnificence in the skies, something of beauty, beyond his control, and a wonder to behold, taking him beyond 'himself' if for only a few minutes. Older son took videos, and it was wonderful, as it took him out of 'himself' as well, in an effort to think of others and their enjoyment.

Fireworks, invented by the Chinese, and such an ephemerally short occasion of beauty and grandness, a nanosecond of the blossoming of the stargazer lily, evoking summertime, often considered a state of mind; a time to be looking forward all the cold times of the year when an icy wind blows, but a time to curse the lack of sleep it engenders. Summertime is a time of grand enjoyment of everlasting green lit by fireflies, cold watermelon and symphony fermatas echoing in the trees of air-conditioned evenings, far far from mosquitoes.

June, wonderful June--ne'er a rare day in June

June arrived within the last week, and already the first firefly sighted in the heavy evening air. We record the first firefly of the season as well as last sighting when the evening air is less heavy with warm humidity---

At this time I do not like to recollect cold-tinged autumn air fraught with molds and decaying deciduous leaves set against the brilliant clear azure blue. For many years, the chill of an autumn afternoon evoked the ancient rhythms of life playing out in the havoc of blood flow through slightly constricted vessels and bringing on an increased heart rate of anticipatory school assignments. This feeling of thinning air could also come about even on an evening stroll in light twilight at 11:30 PM up the local mountain at a time close to the longest day of the year, to view Fourth of July fireworks on Point Woronzof.

Here, the fireflies flitting in the grass of the backyard, drone of cicadas, and waning light of evening dusk bring to mind a time of 'lazy' summer. No agenda. Just a bowlful of ripe cherries or cold wedges of watermelon to enjoy and engage in seed-spitting competition off the back stoop. (I wonder why we never see emergence of baby cherry trees or a watermelon patch.)

end of May

another end to another month...hard to say whether am on the way to or from...summer's on the way in
getting ready to grill beef like shish kebabs for supper...corn on the cob's been great so far...maybe baked potatoes and grilled beef...maybe just the baked potatoes and beef with onions and mushrooms...Kikkoman shoyu seems to dress up meat whenever it's used...a little brown sugar and bonito flakes
gotta get motivated