Wednesday, September 21, 2005

10 Things Your Veterinarian Won't Tell You

1. "Good thing you love Schatzi like a son. His care could cost as much."
After a New York City taxi struck Jessica Malionek's dog, Mojo, flinging him 30 feet in the air, she spent $4,000 for veterinarians to perform emergency treatment and then life-saving surgeries on her beloved dog. "It was like they were treating a person," Malionek says.

These days veterinary medicine can be every bit as sophisticated as human health care — and the costs reflect it. Animal lovers spent $19 billion on veterinary care in 2001, the most recent figure available, up from $7.2 billion a decade earlier, according to the American Veterinary Medical Association. And per-visit costs are skyrocketing: Between 1991 and 2001, the average cost of a veterinary visit for a dog nearly doubled, from $50 to $99. For cats, costs rose even more precipitously, jumping by 107%.

Why the steep price hikes? Chris Green, an attorney and member of the American Veterinary Medical Law Association, says vets are happily obliging owners who want to keep their pets alive at all costs. That means paying up for the latest high-tech procedures, such as feline kidney transplants and CAT scans. There are also more aged pets today, which require more care.

2. "Vaccinating your pet may do more harm than good."
For years the primary reason for seeing a vet was to get your pet vaccinated against a host of diseases ranging from distemper to rabies — either with individual vaccinations or "combo wombo" shots that could cover seven separate conditions.
Indeed, annual vaccinations have been an economic bulwark for many vet practices, but some veterinarians say they're not only unnecessary, but they can actually be harmful in some cases. Marty Goldstein, a veterinarian in South Salem, N.Y., says he sees a range of vaccination-related reactions in animals, everything from cancerous sarcomas to epilepsy. Another reason to think twice about certain vaccines: The immunity provided by some of them can last well beyond a year, even as long as the pet's lifetime, Goldstein says, negating the need for some annual shots.
Both the AVMA and the American Animal Hospital Association now say vaccinations should be assessed yearly and tailored to an animal's age, health and lifestyle. For example, an indoor cat with limited exposure to some diseases may not ever need certain common vaccinations, says W. Jean Dodds, an immunologist and veterinarian with Hemopet in Garden Grove, Calif.

3. "I have more complaints filed against me than a used-car lot — not that you'll ever know about it."
When she picked up her kitten, Pumpkin, from the veterinarian after a routine spaying, Mount Pleasant, S.C., resident Marcia Rosenberg was stunned to find the cat nearly comatose. Soon Pumpkin's body was wracked with seizures, and her stomach swelled. Rosenberg rushed Pumpkin to another vet, who saved the cat, but the distraught owner called her state's veterinary board to complain. Told that the board had no procedure for alerting consumers about disciplinary actions taken against incompetent vets, Rosenberg mounted a successful campaign to have such actions posted on the South Carolina veterinary board's web site.Continue ->


Tracking complaints against vets often requires a bit of detective work. Some state veterinary boards list disciplinary actions against vets, while others do not. And complaints typically aren't disclosed until a board investigation and judicial ruling have determined a case of wrongdoing. On her own, Rosenberg says she was able to find that the vet had previously had his license suspended in Ohio and since then had more than a dozen complaints against him in South Carolina.

4. "Sure, I can do root canal on your pup — real dentists are for people."
When John James, an academic adviser in Los Angeles, took his geriatric cockapoo, Amber, to his veterinarian for a chipped tooth, the vet told him his dog needed a root canal and that he could take care of it. Amber died during the procedure. James's lawyer later learned the vet's canine dentistry training came from a weekend course. What's more, elderly Amber should never have been a candidate for the intensive procedure.

How do you know whether your pet is in the hands of a skilled specialist? The AVMA lists 20 specialties for veterinarians, ranging from anaesthesiology to dermatology. Legitimate specialists have done graduate work in their specialty and been certified by an industry medical board. Some vets may claim a "special interest" in an area, meaning they've taken some continuing education, but they aren't necessarily certified specialists, says Peter Weinstein, former medical director of Veterinary Pet Insurance in Brea, Calif.

If your pet needs a specialist, check the vet's educational background and certification. Also, ask how many specialized procedures he performs annually. Having a "special interest" may be fine if the vet has enough experience.

5. "Surgery's a cinch. It's the overnight stay you should be worried about."
If you think your pet will be tenderly nurtured through the night after surgery at a veterinary office or hospital, think again. Many vets don't staff their offices overnight, so it's important to ask about what happens in the wee hours.

Laura Ireland Moore, an animal law attorney in Portland, Ore., says she represented a client who took her dog to the vet after stitches from a routine spaying came undone. The veterinarian repaired the stitches with metal sutures but neglected to put a cone over the dog's head to protect the wound during an overnight stay. The office was unattended through the night, and by morning the animal had chewed through the sutures — as well as 15 feet of its own intestines. The agonized dog had to be put down. The moral of this unpleasant story: "You should definitely check if anyone will be on the premises overnight," Moore says.

If the facility doesn't have a night attendant, or if you don't trust his or her credentials — a late-shift babysitter may or may not be a vet or even a vet technician — you should ideally find a facility where a licensed vet stays over, Moore advises.
6. "Personally, I think declawing is inhumane. But, hey, it's your dime."
Animal activists have long held that cosmetic and so-called convenience surgeries, such as declawing a cat or clipping the ears of a Doberman, are unnecessary and cruel. That argument is gaining broader support, as declawing, in particular, has come under fire. While the surgery — which many vets say is the equivalent of toe amputation — will usually keep a cat from scratching the furniture, it may cause other physical and behavioral problems, according to veterinarian Jean Hofve, ranging from lameness and joint stiffness to behavioral issues such as reclusiveness and biting.
In keeping with these concerns, the American Animal Hospital Association now recommends that its members inform clients about the risks of nonvital surgeries and the alternatives. "A lot of vets still feel they should do what the client wants," says Teri Barnato, national director of the Association of Veterinarians for Animal Rights. Many vets fear losing clients or having animals abandoned.

If you're considering a cosmetic or convenience procedure, ask your vet if he'd perform the surgery on his own pet. And weigh the alternatives — instead of declawing, you could get a scratching post and keep your cat's claws trimmed.

7. "Go ahead and sue — it'll hurt you more than it hurts me."
When Marc Bluestone's dog Shane died after being treated for seizures at All-Care Animal Referral Center in Fountain Valley, Calif., Bluestone decided to sue. In a precedent-setting ruling, a jury awarded him $39,000 for malpractice, claiming he and his dog had a "special and close relationship." (All-Care is appealing the ruling.)

But that's an exception — suing a veterinarian is at best a dodgy financial undertaking. The reason is that under the law pets are considered property, says Ireland Moore, the animal lawyer in Portland, Ore. More often than not, that means court awards are for the straight market value of the pet, which could be as little as $10 for your beloved mutt. Meanwhile, suing a vet is likely to be an expensive undertaking.

If your pet becomes the victim of a medical mishap, know that your legal recourse is anything but guaranteed. "It's not always the most economically smart thing to do," Moore concedes.
8. "The key to my thriving practice? Location, location, location."
While a referral is probably the best way to select a veterinarian, many people pick one simply because the office is around the corner. Indeed, according to the AVMA, only 10% of cat and dog owners choose their veterinarians through referral. That could be a mistake. If you have an aging kitty and the neighborhood vet doesn't have geriatric expertise, it won't be a good fit, says Nancy Peterson, a registered veterinary technician and a spokesperson for the Humane Society of the United States. Peterson adds that in her experience few pet emergencies happened during office hours anyway, nullifying some of the benefits of geographic convenience.

So how best to assess a vet? First, check out the facility. Is the staff friendly? Is the place clean? Look into the veterinarian's educational background, board certification and record both with the state's medical board and the local humane society. Beyond that, veterinarian Elliot Katz, president and founder of In Defense of Animals in Mill Valley, Calif., recommends studying the veterinarian's body language with animals. Make sure she greets animals in a friendly way, approaching them slowly and touching them gently. And if you have a special request, such as wanting to hold your pet when it's vaccinated, make sure you and your vet are on the same page.
9. "I haven't the foggiest idea why your dog's acting crazy."
The study of animal behavior is a relatively new specialty in veterinary medicine. In fact, the AVMA lists only 36 board-certified animal behavior specialists on its web site, compared with 1,500 internal medicine specialists. Yet many pet owners get rid of their cats and dogs, or even put them to sleep, for annoying behavior ranging from barking to eating drywall. Daniel Aja, a veterinarian in Traverse City, Mich., and president of the American Animal Hospital Association, recalls one client who brought in a St. Bernard to be euthanized because of severe separation anxiety. Once when the owner left the house, the dog jumped through a plate-glass window to chase after him. Aja convinced the owner to treat the pup with antidepressants and had behaviorists on his staff counsel the client on how to work with his dog.

Not all vets will make the extra effort to diagnose a behavioral problem, which entails taking a complete medical and behavioral history and spending hours with a pet. What do you do if Champ continues to chase his tail? Ask your vet if he has experience with behavioral issues. If not, request a referral. The International Association of Animal Behavior Consultants' web site lists professionals with varying experience in behavior training, from vets to dog trainers.

10. "Our technology may be state of the art, but our industry regulations are still in the Dark Ages."
While veterinarians and animal hospitals are increasingly working with the same level of sophistication as human doctors and hospitals, the regulatory oversight within the field is far less stringent. Under federal law, human hospitals must be inspected, but it's possible for a veterinary hospital to operate for years and never undergo an independent inspection, Aja says. The American Animal Hospital Association does accredit animal hospitals, assessing them on more than 900 different standards ranging from organization of medical records to diagnostic capabilities. But only roughly one in seven pet hospitals in the U.S. and Canada have been accredited by the oranization. Some states, such as California, perform inspections on vet hospitals, checking them for everything from outdated drugs to unsanitary conditions. Even seemingly petty requirements can have lifesaving results: After a California mandate required vets to have emergency lighting, one veterinarian used a flashlight to finish surgery when a blackout hit.
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