Good People: they do exist!

As in most other professions, in veterinary medicine, we are often exposed to some of the worst examples of the human race. It is not uncommon to hear statements like, “if this [treatment of the pet] is going to cost me more than 50 bucks, I’ll just take her home and shoot her.” Meanwhile, people of this ilk may drive a huge $60,000 diesel pick up truck, and/or wreak of alcohol. Obviously there is money available for the truck and the booze, but none to get treatment for the loyal companion who never asked to be owned by such scum.

Then we get home to see political scandals, violent religious fanatics, con artists, and gang violence on the news to further contribute to our overall disillusionment with humanity. Sometimes it is enough to make one feel as if it is pointless to try to infuse good into society by making the world better and safer for animals, by not only treating their illnesses and preventing disease, but also by changing the hearts of those who are ignorant to the fact that animals feel pain, cold, and hunger, no differently than we do. Why bother? Doesn’t life prove time and again that people are inherently bad, perhaps that it is actually the minority, not the majority of people that have a conscience, that have the ability to act selflessly, and that want to make meaningful positive contributions to society?

While some of my colleagues may have occasion to despair when having the unfortunate circumstance of crossing paths with less than honorable people, I do not. To be sure, it saddens and frustrates me to have interactions with people who possess little compassion or exhibit lack of moral values, but it is experiences like the one I had today that sustain me through these times, reminding me that there are great people in the world.

A new client came in today with a feral cat that she had been feeding for a few days since she recently moved here. She and her husband moved here because her mother and mother in law are both quite elderly and stricken with dementia, and she refused to put them in homes. Here, she was able to find a large enough parcel of land where she could have a house for she and her husband, and also have room to have a separate cottage built for the mother and in law to live in – all this while having access to an Alzheimer’s resource center and support group in the area. She had retired early to care for these ladies full time.

She had planned to take in the feral once she had her house settled, but she found the kitty flat out in her garden this morning, unable to move or walk. When the kitty was brought in, she was poorly responsive, and after a thorough examination it was evident that the kitty had experienced a significant trauma, perhaps a fall, hit by car, or kicked by person. After we determined that there were no serious internal or external injuries, we administered symptomatic care which perked the kitty up, and were able to discharged her.

This person who had just met this cat, did not refuse one diagnostic or treatment, and happily paid her bill without even blinking an eye. She also intends to keep the kitty as her pet and assume all responsibility for her. The owner was especially grateful that the visit did not take as long as anticipated, so she could get back to check on “the girls.” She could not have been more sweet and personable.

I so enjoyed my interaction with this new client that I felt compelled to blog about it this week, as a reminder those that may have occasion to lack faith in the human race. While you have every right and reason to feel the way you do, just remember that this lady and others like her exist.

Halloween is not just for kids!

One of my favorite aspects of Halloween is seeing the dogs (and sometimes cats), dressed in costumes. The best one I saw this year was a golden retriever dressed up as Shrek! Unfortunately, as fun as the doggy and kitty costumes are for us, I have yet to see a dog or cat actually enjoy its costume, but instead observe tolerance at best. It is almost comical as we humans laugh and so enjoy the pet costumes, while in costume, our pets look at us as if we were either insane, sadists, or both for making them where the get-ups we put them in.

That being said, as long as the costumes are not painful or overly restrictive in any way, I see nothing wrong with our furry little friends sacrificing a few hours sporting unwanted garments in exchange for the great photos and memories it will provide their owners indefinitely. It sure makes Halloween that much more enjoyable for my family!

Thanks for the sacrifice Bernie, Lulu, and Bear! Seeing you in your costumes was priceless!

Good Medicine Is Not Negotiable

Veterinary medicine is a business to be sure. Just like any other businesses, veterinary hospitals need a healthy bottom line in order to afford payroll, inventory, mortgages, and all the other expenses that maintaining a hospital incurs. Unlike other businesses, however, veterinary medicine is held to a higher ethical standard that is predicated upon establishing the best quality diagnostics and treatments to help patients.

Despite this standard, some pet owners try to treat veterinary hospitals as other businesses, calling clinic to clinic to find the cheapest rate for a surgery for their pets. Sometimes when we offer our price, they will tell us that a clinic down the road offers it for less as if we are going to be so desperate for their business that we will agree to match the price. Other times, they will take the itemized estimate we give them for a given procedure, and ask about moving forward with the procedure, but omitting certain services – sometimes even pain management injections, intra-operative cardiac monitors – in order to save on cost. Still others will even low ball our estimate, as if we were haggling over a car.

In order to appease these types of clients, some vet hospitals play into this and offer their services at a lower cost by cutting corners. One less pain injection here, a cheaper lower quality anesthetic there, omit a little of this, then a little of that, and there you have it, a procedure that costs less. The patient may have a stormier, more painful, perhaps even more dangerous recovery, but that procedure will be cheaper. My hospital is not one of these types..

I will not compromise my level of medicine by cutting what I deem essential top of the line anesthetics, pain management medications, and vital sign monitoring equipment. At the same time, I do not have any obligation to give away valuable services and medications to clients that do not want to pay for them. I would rather not perform a given procedure rather than perform it with one hand tied behind my back under these circumstances.

Some of my peers think that my stance is too rigid, and that I sacrifice revenue by refusing to compromise the gold standard. My answer to that is that I would rather not have those that value a bargain in higher regard than good medicine and what is best for their pet. I prefer a smaller client base comprised of people that not only accept my standard, but enjoy that I offer only the best for their pets and nothing less.

A few weeks ago, a client brought a pitbull in that had a tumor on the bottom jaw that I deemed should be surgically removed ASAP. My technician gave her the estimate for the procedure, and after that, we did not hear from her for a while. This week, the client finally made the appointment to have the procedure performed. She told me that the delay was that she had gone to another vet hospital to see if it would be cheaper to have it done there. When she received her estimate, she had found that it was 30% cheaper than our estimate. A human anesthesia nurse herself, my client told me that her decision as to where to have the procedure performed was an easy one. Where the other hospital’s estimate would have indeed saved money, it did not include what she deemed essential items that were present on our estimate: an anti-inflammatory pain injection to complement a narcotic pain injection, a fentanyl patch (a morphine derivative pain patch) to go home, and 7 days of oral anti-inflammatory medication to go home.

Now, one may think, “Well, this client was an anesthesia nurse that understood what everything on the estimate means. Maybe the people that go with the lower cost procedures just don’t understand that lower cost often sacrifices quality.” My rebuttal to this would be that the client is never just handed an estimate for a procedure. As the client receives the estimate, a technician fully explains each item line by line. We even advise the client that if considering other estimates, that lower cost may mean that some of the important services and medications may not be included.

I would take one client of the mind of the anesthesia nurse over any number of those who value bargain over good medicine.

To pet owners: always keep in mind that, just as in all other industries, in medicine, you get what you pay for.

Roger L. Welton, DVM
Founder, WebDVM

The Dirty Truth About Online Pet Med Companies

Several months ago, our drug rep for Merial, a very prominent animal health care pharmaceutical, was in my hospital giving the staff a learning seminar about their flea and tick product, Frontline. What prompted Rob to come in educate the staff about Frontline, was the fact that I had mentioned to him on one of his visits that I was seeing an increased number of patients that were having flea and tick troubles despite having Frontline applied as directed.

The first premise that he discussed is that the first question that we should ask the client when Frontline fails, is where he or she is purchasing the product. The reason Rob brought this up is that Merial does not sell to online pharmacies, but deal only directly with veterinarians. Since they refuse to stock these pharmacies, the pet medications they sell must come from overseas.

These overseas products do not undergo the scrutiny of the USDA as a result lack quality control. This leads to products that are not what they claim to be, and are even found to be outright counterfeits. Merial is legally powerless to stop this, since apparently our government does not care about the health of its citizens’ pets (overseas prescription medication is expressly forbidden in human medicine). As a result, Merial, as well as many other animal health pharmaceuticals, refuse to guarantee the safety and effectiveness of their medications and preventives that are purchased online.

Frontline is an excellent product with a great reputation, and for it to fail is unusual and usually because the pets’ environment is heavily saturated with fleas and/or ticks. As my staff and I began to examine cases of failure of Frontline effectiveness, we found the a large percentage of Frontline failures were from Frontline that was purchased from online pharmacies.

Once we came to this realization, we became concerned about how potentially dangerous it would be for for a patient to be on an ineffective or counterfeit heartoworm preventive, especially here in Florida where the disease is so prevalent. In the three years that I have practiced in Florida, there have been a handful of cases where dogs have gotten heartworm disease despite being on a reputable brand name preventive. I can only wonder if any of these cases were the result of patients being treated with preventive purchased from online pharmacies. I certainly plan to keep track of this in such future cases.

As a result of all this, I found a company called vetcentric that has set up an online pharmacy for my hospital (Maybeck Animal Hospital VetStore). Pet medication pharmaceuticals readily sell to Vetcentric, since they represent animal clinics directly. Not having to pay inventory costs to offer the items, I can offer the pet meds at a discounted price, often competitive with online pharmacies. Also, the clients still get the benefit of home delivery, but the product they recieve comes from the USA based manufacturers, complete with the manufacturer guarantee of safety and effectiveness.

Roger L. Welton, DVM
Founder, Web-DVM.net

“Her Daddy Done Got To Her”

Recently, on a day that I was bogged down with appointments, a client came in and asked the receptionist how much it would cost to pregnancy check her one year old American Bull Dog. As the receptionist was giving her the price for a pregnancy ultrasound, I was coming up to reception to get a file and over heard her say, “We really want to know because her daddy done got to her.” despite my time constraints with rooms full of clients and pets, I paused immediately and told her that the preg check needs to be performed ASAP since, if the dog was indeed pregnant, the pregnancy would need to be terminated, a process that is performed by hormonal injection, and most effective and safe for the female the earlier it is done.

The woman proceeded to give me a bewildered look, and then it hit me quickly that she had PLANNED THE BREEDING AND ACTUALLY WANTED THE PUPPIES! I then asked her, “Mam, did you actually want for this to happen?” “Yes,” she answered. I replied,”Mam, are you not aware of the dangers of inbreeding related dogs? Even cousins have a high potential to have genetic diseases. With father and daughter, the likelihood is exceptionally high that the puppies will be not be health overall, have behvarioravl problems, and not live healthy lives. “

She answered, “well, I was told that it was okay in dogs.” I replied, “you need to be careful who you take your advice from, because whoever told you this either has a complete lack of ethics, is grossly misinformed, or both. It is no more safe for dogs to inbreed like this than it is for people. In addition, your dog is way too young to have been bred. Many genetically inherited diseases do not appear until 2 years of age, so breeding a dog before this age even to a dog that is of no familial relation, means that you could be unknowingly be passing these diseases to future generations.” I then recommended she visit the Breeder Page of WebDVM so she can get an idea of what responsible and ethical breeding entails. I also told her that she needs to make an appointment for a preg check and pregnancy termination in the event that the dog is pregnant, ASAP. She said would do both, walked out the door, and we never heard from her again.

By now those puppies likely have been born, and many poor unsuspecting people just wanting to adopt a pure bred American Bull dog, have likely paid a lot of money for dogs that have a high likelihood of having many different possible genetic diseases, aggressive temperaments, and have a low likelihood of living long, healthy lives. The people that buy these puppies think that they must be getting good quality puppies because they are not from a pet store, and they are AKC registered. They have no idea that ignorant and/or unscrupulous breeders can be every bit as bad as pet stores. They also do not realize that AKC registration is meaningless. All one has to do to get puppies registered with the AKC is to simply state that the puppies are a certain breed and send their check, period.

Now, this is an extreme case of breeder ignorance for certain. However, while many breeders are not this misinformed or unscrupulous, the vast majority of breeders are not doing what is necessary to give the highest probability that puppies will be free of genetic disease and strengthen, rather than weaken, a given breed as a whole. Later in life, when dogs are afflicted with genetic diseases such as skin allergies, skeletal disorders, cardiac disorders, and cancer, among many more, they often aim their blame at the vets who charge for their services to manage these problems, rather than the breeders that created them. Always remember that a large percentage of sickness that is seen in veterinary practice is the result of genetic aberrations created by bad breeding.

To be fair, it is usually not the fault of the pet owners whose only mistake was trusting that these breeders were breeding ethically and responsibly. Therefore, until there is government implemented regulation of animal breeding, be certain to educate yourselves and others in the market for a new puppy. Never forget that it requires no degree, training, or licensing whatsoever to call oneself a breeder. As such, never assume that a breeder has even a remote clue of what they are talking about, and use the WebDVM Breeder Page as a guide to help you weed out backyard breeders from good, ethically based, responsible breeders.

Roger L. Welton, DVM
Founder, Web-DVM.net

WebDVM’s Maiden Blog

Hello Pet Lovers Around the world! Although not quite yet complete, the WebDVM already has a substantial web presence that we could not hide from the major search engines. Believe me, I am not complaining. It is very encouraging that pet lovers around the world are already making use of our site with it still yet to be finished, as well as with our organization having yet to promote the WebDVM at all. However, since we are already experiencing a lot of hits on the site, I decided to write my inaugural blog a bit sooner than expected, as a courtesy to the good people that are already frequenting the site with regularity.

While the core pages are all completed at this point, the one daunting task that remains is to complete the drafting of all of the disease article pages that represent all the pertinent disease links that make up both the “Diseases A-Z” and “Symptom Checker” pages. However, it is easy to tell which disease articles are complete on either page, as the ones that are complete are clearly linked to their respective articles, whereas the ones that are incomplete are clearly not linked. If you find our database lacking at this point, I invite you check back regularly, as we are working very hard to complete the disease articles, linking between 2-10 disease article pages per day, making our estimated finish time between 2 – 4 weeks from the date of this blog.

So one may ask, why my colleagues and I have decided to launch the WebDVM. The answer for me started in 2002 when I created AskDVM.com as a veterinary question and answer pay site both for fun, as well as to generate some extra income. While the income was certainly helpful, what I found the most exciting about my new Internet venture was the global correspondence my site achieved, with consultations coming from all over the US, as well as the entire world, from places as far away a Singapore.

Later in 2004, when I incorporated my veterinary advice service into my new veterinary hospital’s website, at the same time I also spun off a free pet health chat forum, which quickly swelled to over 1000 worldwide members in less than a year’s time. I just found it so overwhelmingly gratifying that from this modest little venue, animal enthusiasts all over the world could correspond with one another, meanwhile utilizing my hospital web site’s modestly sized health article database to learn from.

Well, early in 2007, it occurred to me that if my modest little hospital website and pet chat forum could bring so many people from different countries and from all walks of life together with the common purpose of bettering the lives of animals, imagine what a mega portal like WebDVM could achieve. The WebDVM’s mission is to provide more news and information for more pet loving people for an ever growing global online community on a scale never before seen in the animal care industry.

We hope your enjoyment and benefit for WebDVM matches our passion for it!