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What Wellness Reveals in Pets

I hear it time and again.  “Fluffy doesn’t need to go to the vet because she is so healthy, nothing is ever wrong with her.”  Or lately, I’ll also hear, “I only have to take her to that place for cheap shots.”  Such is the increasing mind set of many pet owners, and as a result, the value of the yearly wellness visit is diminishing from their point of view; and pets and their families are suffering the consequences.

Each year since 2008, well visits are decreasing steadily each year.  Part of the reason for this trend is the rise of the new discount shot facilities, and as I call them, shot wagons (vans that pull up to pharmacy, pet store, and now even gas station parking lots to give shots to pets).  I will not spend too much time on these type of places (for more on these places, please see my post: The Shot Wagon: The Bottom of the Veterinary Barrel).  I will mention that they have capitalized on the concerning economic climate of the past several years, and devoted their services to plugging pets with every vaccine under the sun (whether pets need them or not – more on this later on) and offer them at cheap prices.  The cheap prices come from the fact that they typically use cheap, poor quality vaccines; as well as not giving a physical examinations, not engaging in stool parasite screening, and often without even recommending a heartworm screening for dogs.  Their profit is based primarily on the the number of shots they can dole out in the shortest period of time.

But it is more than just these discount shot places that have led to the decrease in wellness visits.  The whole mid set of our Americans has changed since the great recession.  Rather than seek out the best quality for price they simply seek out the best price with less emphasis on quality.  Rather than than accept the veterinarian’s focus on the importance of wellness visits, they rationalize forgoing them because Fluffy looks great.  Why would they waste money on a well visit for a healthy pet?  The impact of this change in pet owner paradigm cannot be overstated…and is all too often devastating for the pet, and even a serious danger to the human family.

Pets Suffer Silently

The natural tendency of animals is to hide signs of pain or distress.  Showing weakness of that kind in the wild leaves them susceptible to predation, getting chased from territory, or getting their food taken.  Dogs and cats are no different.  Cat are especially good at hiding signs of pain or illness.

So when you are so convinced that Fluffy is so healthy, remember these facts:

– 1 in 3 dogs and cats carries a preventable parasite, some of which can infect people, while reducing the health and longevity of the pet.

–  1 in 4 dogs and cats over the age of 4 has painful and health diminishing periodontal and gum disease. 

– 30% of dogs and cats over the age of 7 have hypertension (high blood pressure).  Hypertension could be an early sign of preventable but serious disease if left unaddressed, but by itself can damage the eyes, heart, liver, and kidneys, while leaving the pet prone to dangerous blood clots.

– Heartworm disease in dogs in on the rise at a time in history that it has never been more preventable.

Here are perfect examples of serious disease I caught on routine wellness visits that the owners were certain their pets were in perfect health just this week:

– 1 case of early stage congestive heart failure in a dog

– 10 cases of advanced dental and gum disease.

– 3 cases of intestinal parasites found on routine stool analysis.

– 11 cases of flea infestation.

– 2 cases of hypothyroidism in dogs.

– 2 cases of Cushing’s disease in dogs.

– 1 case of feline diabetes.

– 1 case of feline hyperthyroidism.

– 1 case of heartworm disease in a dog.

– 10 cases of obesity.

– 3 cases of ear infections (2 dogs, 1 cat).

– 1 case of ear hematoma (blood and fluid swelling in the ear flap) in a dog.

– 5 cases of osteoarthritis (4 dog, 1 cat).

Folks, this is just this week and its only Thursday!  The last and most amazing example of a dog suffering silently was not this week, but a few weeks ago, and is a case I will never forget.  A sweet, vivacious little 9 pound min pin mix came in, not for a yearly well visit, but because of a little diarrhea, and because his stomach seemed to be making some odd noises.  On physical examination, I felt a firm swelling within his abdomen that prompted me to take an x-ray.  The x-ray revealed that the little dog’s diaphragm (the muscular wall that separates the abdominal and chest cavities and is responsible for breathing) had ruptured, and the dog’s liver and most of his intestines were in his chest wrapped around his heart and lungs.

This type of injury only happens in cases of significant trauma, so I asked the owners if the dog had any trauma to his body recently.  The owners noted that he was hit by a car 3 years ago, but they declined x-rays at the time because the dog looked so bright, alert, and responsive.  So this dog lived with a diaphragmatic hernia – an injury that causes pain upon breathing and pressure inside the chest cavity upon eating (because the intestines and stomach were in the chest, not the belly) – for 3 years with the owners not having had a single clue.  Not only was there likely pain and discomfort with this injury, but that hernia was a ticking time bomb that the owners of this dog did not know about, that could have at any time led to strangulation of intestines , dangerous clot formations, or asphyxiation.  Had this dog had well care in the past 3 years, the injury would have been discovered much sooner, the surgery done; and the patient alleviated from pain and out of danger.

Cats Are Really Getting The Shaft

A recent study indicated that cats are really bearing the brunt of reduced wellness visits in the new paradigm of owners forsaking well care, with only 18% of household cats receiving routine wellness visits.  When it comes to suffering silently, cats are far more likely to hide signs of pain and distress than even dogs.  As a result, an unacceptable number of cats live with chronic parasitic infestations, fleas, periodontal disease, hypertension, thyroid disease, kidney failure, diabetes, periodontal disease…and a host of other ailments, with the owners not having any clue.  Parasites and fleas pose a serious danger to children, the elderly, and immune suppressed individuals.  A larval stage of a common canine and feline parasite called the roundworm, can cause irreversible blindness if children under 5 are infected with the parasite.  Still finding that yearly stool test a waste of money?

Shots Are Important, But Not All Pets Need All Shots

There are diseases that are edemic just about everywhere: rabies, canine distemper, canine parvo, canine parainfluenza virus, canine adenovirus, feline panleukopenia, feline rhinotracheitis, feline calicivirus.  We call vaccines for these diseases, “core vaccine.”  The others, feline leukemia, canine bordatella, canine leptospirosis, canine lyme disease, are regional and/or lifestyle specific, meaning that depending on the lifestyle of the pet or where in the country he/she may live, he/she may or may not necessarily need these vaccines.

By tailoring vaccine protocols to the individual needs of the patient, we are seeking to balance realistic disease risk, with making an effort to reduce vaccine frequency in pets.  While vaccines are necessary and important preventive measures for disease control, overdoing them can lead to health consequences.  In this regard, the American Veterinary Medical Association (AVMA) has established guidelines based on research that there are also several diseases whose vaccines offer 3 year protection, such as canine distemper, canine parvo, canine rabies, feline calicivirus, and feline panleukopenia virus.  Ethical, medicine minded veterinarians, therefore, tailor the vaccinal needs of each pet to its unique lifestyle, while using 3 year vaccine protocols where appropriate.

The shot wagons and discount shot facilities?  Not so much.  You see, their sole revenue structure does not come from general medical, surgical and dental services, it comes from the shots…and so they are going to plug your pet with very vaccine known to veterinary medicine and do it every year even if research proves 3 year protection.  For full service general practices, vaccines represent such a small percentage of overall gross yearly revenue, that there is little motivation to give your pet anything but what its lifestyle and current medical research indicates.  For my practice, vaccine revenue only represented 3% gross revenue for the entire 2012 calendar year.

Giving Shots to Sick Pets Can Make Them Sicker

In my practice, before giving vaccines, we give a full comprehensive examination, temperature reading, heartworm screening (dogs only), and blood pressure (on pets 7 years or older) reading prior to giving vaccines, for good reason.  Vaccines act by mimicking the disease they are meant to protect for, by stimulating the immune system to mount a protective immune response.  That process causes a temporary stress on the body, and we really need to know we have a healthy patient that can tolerate stated stress.  Plugging pets with multiple vaccines without any sort of examination is therefore a potentially dangerous gamble.

Pet Owners Think They Are Saving Money, But In Many Cases They Ultimately Are Not

By skipping well care and getting shots from a shot wagon or discount facility, once disease manifestation is so bad that the pet actually shows it and you end up in a practice like mine for treatment, not only could it be too late at that point, but if the disease is still treatable, it is often so advanced that to treat the disease, it is so much more costly than if it had been managed earlier after having been detected on routine wellness visits.

I will leave you with this last example.  Very nice lady and her husband brought one of her many shih tzu dogs into my office about 3 years ago with a swollen mandible (lower jaw).  I discovered that the dog had an oral abscess from a rotten tooth.  In addition to the abscessed tooth, the rest of the mouth was in barely better condition, with bleeding gums, severe tartar, and pus along the gum/tooth margins.  Worst of all, the infection in the mandible was so bad, that the bone had fractured – an incident we term pathological fracture.

To repair this dog’s problem, I ultimately had to perform a highly technical and invasive salvage procedure called a hemi-mandibulectomy.  I also had to pull 12 additional teeth because they were so far beyond repair, while hospitalizing the dog for 3 days to clear a secondary infection he had developed in his kidneys from the dental infection.  All said an done, the owners ended up spending $3600 dollars, whereas regular wellness and periodic dental cleanings would have cost less than half of that spread out through the course of this dog’s life to date (he was 10 years old); and spared the dog allot of unnecessary suffering.

His owners are wonderful people who meant no harm to their dog.  Like so many others, they just assumed their dog was fine…after all, he wasn’t showing any signs of pain.  Guess who now brings their dogs for wellness visits every year without fail?

Dr. Roger Welton is the President of Maybeck Animal Hospital in West Melbourne, FL and founder/CEO of Web-DVM.net.

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