March 31, 2013

You gotta love your vet, part two

by winecountrydog Tilin Corgi, with Mum

After last month's piece "You gotta LOVE your veterinarian," mywoofself and Mum got comments and questions.

'Ere are three topics wot Mum (aka winecountrydogma) talks about:

1. SIT, STAY! BE YOUR PET'S ADVOCATE. -- People ask me if I would "just drop off a pet at the vet and come back later." My answer is "It depends on the circumstances. I rarely leave a pet. I stay. And I usually watch."

Of course it makes a difference to have an established relationship with a good vet -- "love your vet"! I know and trust my primary vet, and my dogs love her, plus she's an excellent cat doctor, and her staff are conscientious. When one of my pets has to stay there, it's usually fine with me.

In general, aside from times when an ill pet should not be moved, I would not leave a pet at a clinic unless
  • an IV drip is needed and I can't easily do it at home;
  • the animal is in surgery, or in pre- or post-op;
  • some type of mandatory quarantine is required;
  • the animal is recovering from anesthesia or resting after a procedure;
  • skilled nursing care or consistent prolonged observation in a hospital setting is required.
Regarding nursing care/overnight care services, caveat emptor. I will not (ever again!) leave a sick animal for so-called nursing care at a vet clinic I'm not completely familiar with.

You know it would be unusual, and unwise, for a parent just to drop off a human child at a medical clinic or hospital and then simply leave. Similarly, it's not the best practice to drop your pet off at the pet doc. The safest practice is to stay with the pet during the exam or minor procedure. In your absence, have a trustworthy stand-in advocate (with a signed permission form from you) stay there for your pet.

A pet owner/pet-patient advocate should always be there if the vet is new to the pet, or if the illness is serious, "challenging," or "mysterious." This includes possible pet poisoning cases. It's important to be there not only to answer the vet's questions and to get to know the vet, but also to observe the vet's approach and make sure you're comfortable with it. 

Should a pet owner/guardian stay to watch everything? It's a good idea to watch physical exams and minor procedures, including blood draws, shots, and ultrasound exams. Watching what our vets do teaches us things that make us better carers and medical advocates for our pets. And when we take our pets for yearly or semi-annual wellness exams, we get an opportunity to learn even more about their health needs.

Should you stay to watch surgery? Maybe. I'm the kind of person who likes to watch everything. Some vets don't mind if (calm) clients watch surgeries. I've watched a spay surgery and other procedures. However, I'd think twice about watching a major or traumatic surgery on any of my loved ones, animal or human, because it can take a big emotional toll, sapping energy better reserved for post-op patient care.

Whenever I stay in the exam room with my dog or cat, I'm there to be helpful, not to get in the way of the vet and staff. I'm there to answer questions the vet has about my pet as best as I can. I'm there to calm my pet, and to guide vet and staff past pet idiosyncracies -- for example, to distract my nervous pet; to let staff know that my pet can't stand on a metal exam table; or to muzzle my sweet but nippy dog when he's had enough. Moreover, I'm there as my pet's advocate -- to be a good observer, question asker, and decision-maker.

Sometimes I'll help hold my pet during an exam or minor procedure. At other times this offer is refused. (It can be a clinic liability if a client is injured on the premises.) One time I had to help hold one of my rescued cats on his first vet visit. Poor guy. He was such a sweet Maine Coon, but he surprised everyone by being exceptionally strong as well as "freaked out." It took myself and three vet staff members to get him into a restraint bag and keep him positioned for a blood draw.

I always leave the exam room when x-rays are being taken or when the room is too crowded for optimal execution of an urgent procedure.

I do not leave if I "get the feeling" that I need to be there. It's my client prerogative to stay with my pet during an exam or minor procedure, and a good vet recognizes why a good client feels this way. I usually sense when my trusted vets need me to step back, and they know that they can tell me when they need me to step back without worrying about hurting my feelings. 

Again, I'm not there to get in the vet's way. I'm there to be the best healthcare decision-maker I can be for my beloved dog or cat.

If you've never thought about staying and watching, or about getting more involved in understanding your pet's healthcare needs, I hope you'll give this some thought. Every pet needs his/her guardian to be a good medical advocate. 

As veterinarian Nancy Kay explains in Speaking for Spot, her book about helping your dog live a "happy, healthy, longer life" . . .
"Gone are the days when you simply followed your vet's orders and asked few, if any, questions. The vet is now a member of your dog's health-care team, and you get to be the team captain! Your job description has evolved from receiving and following doctor's orders to processing and making decisions. . . . What are the chances that you'll never be called upon to act for your dog in a medical situation? Probably the same as winning the lottery."

As you can see by Tilin Corgi's expression (in above pic), it's important for us pet carers to acknowledge that "sooner or later," as Dr Kay says, almost every one of us will have to make difficult medical decisions. We might as well sit-stay, watch, and learn whenever we can.

2. AVOID VETS WHO UNDERCHARGE. -- It's great to find a vet whose fees are reasonable, meaning that the fees are within the range of the area's "going rate." But what about when a vet's fees are below the going rate? One of my veterinarians pointed out to me that "vets who undercharge are just as suspect as those that overcharge (maybe more so). Think about it -- would you trust your life to the cheapest surgeon in town? I wouldn't!"

Well, I wouldn't either! So it's good advice to avoid vets who undercharge.

I made the mistake a few years back of going to a "cheap" vet clinic for x-rays. What a nightmare. Blurry x-rays and misdiagnosis. I've recently learned that this "affordable" clinic, located in Santa Rosa, CA, is still in existence and has become notorious for its bad care.

What's a good way, then, to judge reasonable vet fees? Call around and ask different clinics what they charge for various services to get an idea of the going rate. Some clinics won't quote fees over the phone, so it's worthwhile to go around and talk with them in person.

If you live in NYC or other major urban area where the cost of doing business is high, you'll find that vet fees are typically high too. Maybe it's worth a drive to a suburban clinic for routine exams? Just a thought.

3. KEEP LOOKING TILL YOU FIND DR. WONDERFUL. -- "Where can I find a good vet?" As we said in the previous post, "everyone deserves a Doctor Wonderful."

If only it were possible to tell whether vets are good vets from finding out what they charge. If you're looking at fees for major surgery or extensive treatment, consider not only the fees for services but also the experience, educational credentials, and successful track record of the vet. This applies regardless of whether the vet uses allopathic (conventional) or non-conventional ("natural" or "traditional") modalities.

To find the vets in your area who are said to be the best at what they do, go beyond Yelp and other online ratings. Call area animal rescue organizations, breeders, groomers, and "upscale" pet supply stores to see which vets are their favorites.

If you're looking for a veterinary specialist, you'll find that searching online turns up board-certified vets (for example, in the U.S., internists listed on ACVIM, and ophthalmologists on ACVO) and vets with other types of practices, such as "holistic" vets listed on AHVMA. But also ask your regional veterinary teaching hospital and local vets for specialist recommendations and referrals.

Be sure to ask vets in your area whom they refer out to for special cases -- for example, for orthopedic surgery, oncology, Class IV laser therapy, herbal medicine, or acupuncture. Also ask local vets whom they'd recommend for allied healthcare services -- such as ortho rehab, swim therapy, or behavioral modification. In any case, try to get more than one name, even if some of the practitioners are a distance away.

Finally, as someone who researches health topics and makes my pets' food, I add this thought: When seeking good vet care, consider that many health conditions are prevented or helped by dietary change, either as the primary or adjunct treatment. In other words, there are few health conditions that are not improved with the right diet. "Food is medicine." . . . Sometimes, of course, it can be useful temporarily to use medical foods, and in cases such as prolonged anorexia, necessary to use parenteral nutrition; otherwise, the best diet is a fresh (organic) whole food diet. Unfortunately, not many vets are recommending foods other than commercial canned and kibble brands. So I'm always looking to add to my list of "Doctors Wonderful" those vets whose practice includes a focus on fresh whole food pet diets.

Let's all keep growing our lists of "Doctors Wonderful" and spreading the word about good vet care!

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