Pyometra Emergency. Saving your pets life when optimal options aren't possible.

Chloe is prepped for her big restoration and transformation.

There are many cases who find me. The power of social media and pet parent desperation often come to a head at my doorstep. It wasn't necessarily my intention to be the landing page for those who had no luck at other equally capable veterinarians hospitals, but I am finding myself to be the vet who offers options to those who are not receiving affordable treatment plans elsewhere. There is a great divide happening in medicine and consequently a huge number of pets falling into the growing chasm of divide simply because pet parents are being priced out of the care they need.

Chloe is a speck of a Yorkie. Demure, quiet, reserved and always trying to hide in the shadows of her moms arms who persistently protect her from having to face the world with a nose to the heavens.

Mom loves Chloe, but like so many others, life had gotten bumpy and difficult and Chloe's health care needs were being overlooked due to more immediate pressing matters until last weekend when Chloe wouldn't eat and was acting very sick and reluctant to move or play.

Chloe headed to the emergency clinic. Within a few hours her illness had a name; pyometra. Unfortunately that $750 work up cost her family all of the money they had. The price tag Chloe's mom was given for the treatment she needed was estimated at $2900. They walked out of the ER with antibiotics and a dog who still needed life threatening surgery.

I have this gripe that I cannot seem to convince the rest of the veterinary world to pay attention to.. the point of veterinary patient care, the reason people drive their pets into our door, is NOT JUST TO TELL THEM WHAT IS WRONG!!! OUR JOB IS TO DO THAT, AND (MOST VITALLY IMPORTANTLY), TO FIX THEM!! 

In fact, I am very certain that our clients are more interested in real help than real answers!

An invested vet will talk about the resources required to do both, diagnose and fix. Exhausting available resources and not getting to the finish line is not assisting our patients. It is short sighted, veterinary focused mismanagement of client and patient care. A good vet will talk about the most likely diagnosis, the available treatment options, the prognosis for each, and the costs associated with every step of this process. Spending all of Chloe's treatment resources before they get the help that will save their lives is simply cruel tragically failed patient care. 

Chloe has had a retained baby tooth, now mobile simply by touching it, for her whole life.
More information on this here.

Chloe had a laundry list of needs. By the grace of good luck her antibiotics were kicking her uterine infection to the curb and she was feeling better within two days. There was still much to address in her tiny 8 pounds.

People ask me all the time how they can affordably care for their pets? The answer is universal; Keep up with the day to day, month to month, and yearly stuff. Budget and plan for it. It is as important to your pets health as it is to yours.

Here is my short list of needed routine care to avoid the costly veterinary bumps in the road.

• Brush teeth daily.
• Eat a good nutritious wholesome food on a scheduled regimen.
• Get lots of sleep. Dogs have this concept mastered. We have some important lessons to learn from them. 
• Lots of interesting exercise. What do I mean by this? Let your dog be a dog. Sniff, tug, play, hide, walks that are adventurous. Let them explore the world.
• Play hard and sleep hard.
• Ideal body weight and muscle mass. Avoid lots of the diseases and disease processes that obesity predisposes your pet to. 
• Indoor cats need exercise and I warn about poor quality free feeding dry kibble. 
• Basic parasite prevention. For my part of the world this includes fleas, ticks, heartworm, and intestinal parasite preventatives.
• Spay and neuter by 1 year old.
• Obedience and socialization. What would happen to you if you were not able to care for your pet AND your pet refuses to allow anyone else near it?
• Microchips save lives every single day. Make a small investment for the best chance of a happily ever after that you hope you never need to rely on.
• Start a savings plan for the unforeseeable accidents ahead.
• Have a great vet who knows how much you love your pet and be there for each other. Here are my tips on how to get something for nothing from your vet.

Here is what Chloe needed;

• Dental cleaning with numerous extractions. Her mouth was so rotten that almost every tooth was mobile. Every client I show teeth like this to is always shocked that their pet gave them no clues there was such a significant problem. If you didn't brush your teeth daily yours would fall out too. Dogs get used to bad teeth and eat around them. Removing them resolves persistent oral infection and they will eat better afterward. The number of teeth to be removed is often also shocking to clients. In many cases dogs, like Chloe, will have a dozen, or more teeth extracted. If they are bad they are removed. No discussion here. Don't wake a dog up with bad teeth still on board UNLESS you have a dental professional who wants to stage the procedure. Ideal for the patient, more expensive for the client.
• Spay. Her uterine infection will return. Spay her as soon  as possible.
• Get an idea of her overall health before jumping into surgery.
• Caught up on vaccines and preventatives.
• Lay out a plan her mom understands and can afford so that she remains on healthy in the days, weeks, and months ahead.

The original source of Chloe's illness, her pyometra. 
Treatment; simple; uterus and ovaries are removed.

My clinic, my perception, and my obligation to my clients is deeply seeded in my ability to get them what their pet needs in an efficient and affordable fashion. 

Chloe's mom was deeply upset that her dog was in need of so much medical attention. She felt very guilty for both not knowing that her mouth was so diseased, but also that she had waited so long to provide the basic spay, vaccines and annual care she knew she needed. The luxury of going back in time when hindsight is present tense and everything is 20:20 is not something I waste much time on. We are here now, we cannot go back and undo, we can only learn, move forward and do the best we can in the present. 

Chloe's mom wanted to use her tax return to get her well. We had a budget. Budgets are a reality few vet businesses want to hear about. The reality is that most all of us live in the real world of budgets.

The conversation between Chloe's mom and I went something like this;

"Ideally we should put Chloe on antibiotics for two weeks and then give her a dental cleaning and remove all of her diseased teeth. The cost of this is about $800. She probably needs her spay soon too. The longer we wait the more likely it is that the uterine infection can resurface. This surgery is also about $800." Chloe's mom could barely scrape together the $800 for one, she couldn't do it twice. And, as every good family vet will point out, we still needed to get Chloe back on track AFTER the emergent disasters were addressed. Chloe needed about $200 of flea &  tick and heartworm preventatives. I feel very strongly that our mission is to help through the bumps and provide a path forward to help avoid bumps in the future. Every pet leaves Jarrettsville Vet with a short AND long term plan along with associated costs. 

"But how can I do both surgeries? I am so worried that she won't live through all of this if I don't do them? How do I choose between what is safe for her and what is possible for me to be able to afford?"

"We have to make a choice. We have to do what we can, accept what we cannot and tell ourselves that we did the best we could with the resources at hand." This is a concept that I think the veterinary profession is losing sight of. In some effort to promote our bottom lines, save our skin from the chance of liability we don't help people on the level they need us to. 

Chloe had her spay and dental surgeries a few days later. I asked our dental expert veterinarian to help. I wanted Chloe to get all that she needed and I wanted her little 8 pound body to be under general anesthesia for the shortest time possible. I was most worried about her getting too cold being under for the two hours it would take to do all she needed.

Chloe's bill...

Chloe's final bill for her spay and dental (which included almost a dozen teeth be removed) was about $760. It was by no means ideal. She had minimal additional blood work done. She had everything done at the emergency clinic the week before. It was all normal. We did not repeat it. We took a leap of faith, and a calculated risk. We also had the benefit of her being on antibiotics from the emergency visit. We scheduled her surgery on the last day of her emergency antibiotics and then resumed them the day after surgery. She was closely monitored and treated by experienced vets who wanted more than anything to get her back home with all of the needed care she came to us for. That's what your home town vet does.

Two weeks post-op and Chloe is doing great! She has a daily plan her mom understands. She is also on her needed monthly preventatives and will return every 6 months for examinations to make sure nothing else comes up to derail her health.

Chloe is an excellent lesson on finding a way to make a difference in a pets life while working within the real-life constraints of a family on a tight budget.

Update;
This is Chloe at her 2 week post-op visit. Her mouth and abdominal incision are all healing excellently! She received the last of her booster vaccines getting her all up to date on her medical needs. She is happy, active and on a path to maintain these. We are elated to see her back. Her mom knows we are here to help, and with a team in place to care for her, provide guidance, and be willing to face any bumps in the road together her chances of  trouble free future are the best they could possibly be.
Lots of love to Chloe and her family!

Life can be full of happy endings if you can bend, compromise and find help when it is needed. Keep looking if you can't it is out there, we promise!

If you would like to ask me a pet related question you can find me on Pawbly.com. Pawbly is free to use and open to anyone who needs a little  help in finding information or direction with their pets care. We also invite all of the pet lovers out there to join us and share your pet knowledge. 

Me and  the resident clinic governess, Loon.

If you would like me to meet your pet and assist in their care I am happy to try to help. Call me at the clinic, Jarrettsville Veterinary Center in Jarrettsville Maryland. We publish our Price List every year. You can find it here.

I am also occasionally visiting on Twitter @FreePetAdvice,

How Much Does The Average Cat Tooth Extraction Cost?

The questions that I receive on Pawbly remind me that I loose track of what you all out there are thinking about. It is a wonderful reminder to listen to my clients and help educate them so they can make the right decisions for their pets.

Here is today's question;

What is an average cost of a tooth extraction for a cat?

Here's my answer;

Hello Rebecca,

Thanks for your question.

Did you know that dental disease is the most common pet ailment? And, that many many pets suffer from chronic long standing dental disease without showing any clinical signs, or at least any signs that their guardians ever notice?

In every single physical exam that I do I take great care and time to examine the mouth of every one of my patients. I also show my clients any problems or concerns that I see. I would estimate that almost every cat that I see over 6 years old is in need of a dental. And, almost every cat over 10 years old is in need of a dental cleaning and at least one tooth extraction.

Every patient and every dental is different. At the clinic I work at we try very hard to give an estimate for any and every service that we provide. But, by far the hardest estimate that I give is the one for a dental. You see until I get my patient under anesthesia, take a full set of digital dental x-rays, clean all of the calculi (that yellow hard stuff that sticks to the teeth, especially the molars), and probe the teeth (we look for pockets along the teeth roots) I cannot usually tell any client exactly what the final dental will require.

I did a dental just yesterday on a very healthy middle aged dog that I thought had just a little calculi and needed a cleaning and polishing, but when I examined the entire mouth when he was under anesthesia I found three very bad teeth with a terrible amount of bone loss around them. One of them was so bad (the last molar, which is found waaay in the back of the mouth) was mobile. It was so loose that I could almost remove it with my fingers. It also caused the tooth next to it to need to be extracted. That presumed 20 minute dental took my an hour and a half. Thankfully the dog did very well under anesthesia, and his dad has promised to start brushing daily so that hopefully he will never need another dental cleaning, or any additional extractions.

His bill at my clinic was almost $400. I would say this is about average for our clinic. But I have seen some dental's take over three hours and cost almost $1,000.

The average cat dental is about $200-$300, but it is always a rough estimate until we start cleaning. But, please understand that as dentals go cats are some of the hardest and scariest to do. Did you know that it is possible to fracture the mandible of a cat when trying to remove a lower tooth? We have to be very careful and patient..or we can make a simple dental a much more difficult procedure.

To add further confusion, in most cases we suggest pre-op blood work, sometimes pre-op antibiotics and always an examination. So even before the dental you might spend a few hundred dollars.

Whenever someone calls me to ask for an estimate I encourage them to not try to price shop this service. It is almost impossible to compare apples to apples. Not every clinic does a dental the same way. For instance, at our clinic almost every patient receives i.v. fluids, pain medications, nerve blocks in the mouth to reduce pain, and i.v. antibiotics. We also routinely check digital dental x-rays for any hidden tooth problems that we cannot see on our oral cavity examination.

So my advice is; It is impossible to give a "good estimate" for this service. I would urge you to not "price shop it" but rather to use a veterinarian with an interest and strength in dental care and most importantly someone that you trust. Your pets dental is one of the very few opportunities we have to do a thorough oral exam, resolve any current or near future problems, and also keep your pet safe, and healthy. If you are uncomfortable with the estimate your veterinarian has given you ask them to explain it to you.

It is my opinion that every pet should have a very thorough pre-op exam, blood work, etc, and a safe, professional dental procedure. For me this includes, i.v. fluids, pain medications, antibiotics (most cases), appropriate orthodontic care, pre-peri- and post-op monitoring, dental x-rays, and a trained skilled veterinarian to perform the procedure using a dental machine that can clean, polish, and has a high speed drill to remove any teeth that need orthodontic extraction.

I am sorry that I couldn't give you a quick dollar reference number, but I hope this helps.

If you need any other assistance or if your cat needs a dental and would like to talk to us about this service, you can find me at the clinic, the address and information is listed below.

Sincerely,
Krista

Simba's severe dental disease.

If you have any pet related questions you can find me, or any of our other pet experts, at Pawbly. We are here to help you and your pet and we are always free! 

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