Pet Insurance vs Vet Insurance.

Jekyll maximizing his couch real estate while I try to work.

One of the reasons I started Pawbly.com is because I know full well that most people will do whatever they can to avoid making an appointment to bring their pet in to see me. Whether it’s the inconvenience of taking the time out of their busy day, the stress of taking their pet out of the safety of the confines of their home, the idea of being told that “some medical condition might be serious,” the looming diagnostics, impending follow-ups, and the undeniable fact nothing is cheap anymore, people if given a choice would rather not visit me.

All of the previously listed possibilities scare people. But the simple truth is that in almost all cases if you are concerned about the health of your pet then I am going to tell you that you should have your pet seen by a veterinarian. That physical exam and the discussion that will ensue after, are essential. I know, not what you want to hear, and not what you want to do, but there are a few secrets that your vet has that benefit your pet far more than you might imagine.

Here are a few of the secrets that I tell clients that many of you might not know. (Why we don’t stencil over the front door I quite frankly don’t know? If everyone knew these secrets they would likely not be so hesitant to call us and book that appointment).

OUCH! one broken femur. Fixed a few days later.

Insurance policies

My honest opinion on them is this; if you have enough disposable income and want peace of mind then get your pet an insurance policy. But remember insurance companies are for profit businesses. They will never be able to pay out more than they bring in. You just have to hope that you get the benefits that you expect, when you need them. Human insurance companies are notorious for denying claims and I hope the same is never the case for you. If you think that insurance is right for you then look into the insurance carriers that cover you for accidents and illness only.

Here’s why: Your pet’s routine costs should be fairly close to fixed, thus making it easier to allot for them. The unforeseen disasters are the big wallops that will hit your wallet where it really hurts. If you don’t have the ability to put a thousand or two dollars down for a life threatening illness think about insurance. (If you want a specific company that I recommend just ask).

There are a few guarantees in life. Very few. If you decide to take on the responsibility of a living creature at some point that pet will get sick. It is inevitable. How can you get your pet the care they need and do it without walloping your wallet?

If you think the answer is insurance? I would reply, Maybe?

Little Hunter at his last puppy visit.

But do you know where the best insurance to be found is? At your vets office.

And here’s what should be plastered on every clinics walls. “You want a guarantee? See your Vet.”

Now there aren't many times in life that you are going to get a guarantee. And, in the world of medicine guarantees are elusive. Why? Well, because guarantees are binding. And no half-witted doctor wants to give you a binding obligation. I mean, shoot, we aren't perfect, we don’t have the ability to foretell the future. So, it would be crazy to say “guarantee” wouldn't it?

But, this is a word I will throw around. And I will guarantee a few things when it comes to your pet’s care if you are my client.

Heartworm disease can be fatal. It is a preventable disease and there are many options available to protect pets against it. Insurance? Well, if your pet is tested yearly and kept on a veterinary prescribed preventative purchased through your veterinarian AND if your pet contracts the disease the manufacturer of the heartworm preventive will cover your pet’s diagnosis and treatment. For most pets this is about a $2500 insurance policy. For my clients their heartworm preventative also covers for the intestinal worms it prevents or treats. If your pet’s yearly fecal examination yields a worm on the heartworm label the manufacturer will pay for the fecal test and the de-worming. In my clinic we use this guarantee at least twice a month. Last year we treated one heartworm positive dog on the heartworm manufacturers tab.

Charleston

Vaccines. Your pets vaccines should be individually tailored based on breed, age, location, and environment. Every vaccine your pet gets at your vet’s office is also guaranteed. If your pet gets the disease your veterinarian vaccinated for then the manufacturer will pay to test them AND to treat them. This includes kennel cough and Lyme disease. Which, unfortunately, dogs seem to get even with monthly flea and tick prevention and yearly vaccines. How many times have I called the manufacturer of these vaccines to stand by their guarantee? A lot! Almost weekly.

Any food or product you buy at the veterinary clinic or are prescribed by your vet is guaranteed. Ear cleaner, antibiotics, shampoos, flea and tick preventatives, the list goes on and on. If you spend $100 on a bag of prescription food, (not an uncommon price tag anymore), and your pet can’t tolerate it, or refuses to eat it, you can return it AND get your money back. All of the manufacturers will stand by their products and happily reimburse a client to keep the client and the veterinary clinic returning as customers.

Almost anything your pet needs your vet can help you resolve. ANYTHING. Big disasters can befall your pet, but your vet can help you find options. There are ALWAYS options. Ask for them, and don’t be afraid to ask about what your options may be at other veterinary facilities. There are referral clinics of every specialty, and if by chance they are beyond your means there are also general practitioners who have areas of interest and treatment options that your vet may not have. Ask many questions and search for a treatment plan that works for you.

Now, here is where I am going to stick my foot in my mouth. Veterinarians are some of the hardest working, most generous, compassionate, and selfless people around. Most of us own our own practice or work for someone who has spent decades building theirs. We live and work in our small community and word of mouth will kill you. We are, like many other small businesses in your community, there for the long haul and dependent on maintaining this relationship. If your pet needs something and I can help, I will. It is not a matter of how much you can afford, it is merely a matter of whether or not you want to help the pet that you are responsible for and that needs you. I’ll press my boldness further. We will stand by our services, goods, and your pet through thick or thin as long as we are both on the same side, and with veterinary healthcare there is only one side, helping your pet.

Savannah

Be good to your vet, be better to your pet, and get the best deal anyone can ever give you by keeping your pets care under your vet’s roof.

I guarantee that there isn't anyone who can beat that deal.

If you have a pet related question you can ask it for free at Pawbly.com. Or find me at Twitter, @FreePetAdvice. 

Lovey, Franny, Jackson, and Henry. The saving of the lost cats.

There isn't a veterinary clinic in the world that doesn't have a few special clients who take it upon themselves to be the responsible party in a world of many irresponsible people. 

They are the clients who see a pet in need and do something about it.

The people who pull over to help a pet along the side of the road. Who find a cat near their home and put out food for it, provide it shelter, and even take them to the vet.

Today was a perfect example of the amazing acts of generosity and kindness these people provide.

Franny

Today Jackson, Franny, and Lovey came into the clinic.

Jackson and Franny were found in an abandoned dairy farm barn. They arrived separately and stayed because they were allowed to. They were provided shelter, food and kind words. They are not the first, and surely they will not be the last. Each cat that has arrived, or been left, has been cared for and provided for. Over the year a few have ended up at the clinic and been placed for adoption. The woman who watches the small colony at the farm does so out of the sheer goodness in her heart and the knowledge that if she doesn't these cats will be at the peril of the closest hungry predator. Their lifespan will be short and hard. Every day she checks on them, feeds them, and tries to tame them into trusting her enough to be vetted and placed in a suitable home. It is an act of compassion and dedication.

A  year ago one little affectionate orange kitten was found in the barn. She arrived to be examined, vaccinated, and micro-chipped a few weeks later. With her little inquisitive, charming face, and her unstoppable even in a strangers arms purr, she was so endearing that I couldn't get her out of my mind even days after she left. A week later I called my client, and now very good friend, and asked if she could come stay at our home. Oriole may have started as on orphan but she's one of our family now.

Jackson

Jackson was a kitten who was abandoned. Left to become someone else's worry. Left to be another pet expected to remember how to survive in the wild, but too little to have much luck on his own. He was found, loved, and adopted to a home. He was brought in today by his original mom 18 months later because his new mom needed help to complete his neuter and vaccines.

This is the text I received about him from his original mom.
"I need some advice..I got an email from the lady who adopted one of the black and white kittens I had 18 months ago. She tells me she lost her job and her house and is living in an apartment now and the litter box smell has become a problem. I asked if she has had him neutered and she responds "No."

Wow! Big surprise it smells!! She says she cannot afford it and has not been able to find him a home...Should I offer to pay to neuter him or just take him back? I guess I'm questioning her responsibility. She promised she wouldn't do anything until she heard from me. My thoughts are the litter box smell problem is because he is not neutered."

My reply,
"Offer to neuter the cat. I will do if for free. He is two now and it will be harder to find him a home, and there are still cats at the barn who need homes. At least he is safe and warm and cared for. If he has to go somewhere else we will deal with that later."

Jackson was neutered and I was told that his owner decided to keep him and was very grateful for the help.

Lovey

Lovey was brought in by another client. He wandered into her garage a few weeks ago. The weather has been at record lows, below freezing most nights, and there have been back to back snow storms leaving any available shelter a necessity. Assuming that he belonged to someone she fed him and made him a bed. Weeks later he made no effort to leave the bed nor his food bowl. His newly constructed home was a small area of the garage with a litter box, bed, and food. He was content. So much so that he simply lay on his blankets and purred at the approach of anyone. His charm and perseverance won him a permanent seat in their garage. He came in to be examined and receive the vets official blessing as being "healthy for home life."

Although he is a big stern-faced boy, he is gentle, calm and reserved. He is a perfect cat.

Henry

Henry is my own tale to tell.

On December 27, 2013 with a house full of guests for the holidays that included four boys between the ages of three and eleven, two additional dogs to add to our three, and our three very frightened indoor cats, I opened the front door to our home to try to coax our indoor-outdoor cat Jitterbug to seek refuge inside where it is warm and safe. 

I fret everyday when I let him outside. He is a demanding boy with clear opinions, and the lungs and vocal cords to put a cat cry to center stage at the Met. He is a cat that found us. He came to us years ago as a stray. I let him in and he has graced us with his intermittent presence since.

Whenever company is present he becomes elusive. I had spent all day calling for him. Begging him to come in, knowing that he was likely just a few hundred feet away cowering in the barn waiting for company to leave his house. When nightfall began to appoach I beckoned longer and more forcefully. At about 7 pm I opened the door called a few times and saw him dart in the door. As I closed out the winter cold I turned and looked down at him with my typical cursory, veterinary eye to make sure he looked OK, knowing full well that I won't see him for many more hours until he calls for his freedom at 4 am. When I glanced at him I noticed his chin looked dirty. A second quick glance a split second later and I realized he wasn't Jitterbug.

In that split second I looked at him I thought, "You aren't my cat!"

And, in that split second he looked at me and thought, "This isn't my house!" 

And there we were trapped. I wasn't letting him back out into the cold, I had a dozen creatures in the house that were about to come forward, likely causing him to hit his critical escape threshold and run to find the smallest least accessible hiding spot he could, and I had to decide in this split second what to do.

I bent down faster than a Ninja and scruffed him with my full intent to not let him escape.

Advice from the vet; "NEVER EVER DO THIS!" If a cat bites you, and has no vaccine history that cat will either have to go into a 6 month quarantine OR be put to sleep to check rabies status. Because rabies WILL KILL YOU.

But here I am now with a scruffed unknown cat in my hand and a house full of people. Thankfully he didn't go crazy on me so I placed a blanket around him and carried him to the garage where also thankfully I have a cat carrier. In he went and off I went to set up his temporary home and find Jitterbug.

Henry

I found Jitterbug hours later, with a large abscess on his neck and every sign that he had already met his impersonator and gotten his lunch handed to him.

Inside Jitterbug came. I shaved his wound and started antibiotics. Back to company I went with all my critters safe and sound and an extra guest also warm and safe in the garage

On January 2nd, 2014, after littering my neighborhood with inquiries Henry came to the clinic with me. He had no microchip, but had two tiny scabs indicating he had been recently neutered. I called all of the loal vets, sent his picture and got no leads.

Within two days of our Facebook post we found his dad. We then learned that his name was Henry. He had left his dads house about a month ago and traveled over 5 miles to get to me. He was an affectionate hearty sweet boy and must have met a few other kind people along the way.

His dad consented to microchipping him and keeping him inside the house to try to diminish his wanderlust. Henry's dad promised to bring him back for a visit and call me should he escape again so I can cage Jitterbug and save him another whooping from the kid down the road.

Jitterbug

If you have any pet questions you can ask them for free at Pawbly.com, or visit me on our Facebook page, or Twitter, or even at the clinic Jarrettsville Vet.

Thanks to all of my wonderful kind clients, and all of you, for helping to take care of the cats in need. You all inspire me everyday!

Could A Neurotoxin Be The New Treatment for Bone Cancer Pain?

There are few diagnoses feared more than cancer. And, few conversations more difficult to discuss with clients than bone cancer. Clients walk in the clinic with what they believe is a simple limping dog and leave with a death sentence and a few months left to enjoy their pet.

By the time we diagnose these tumors they have usually spread. We may not see evidence of those satellite tumors in the chest, but odds are they are there, small, quiet, unorganized, lurking and waiting.

These cases require a patient, calm, repetitive approach. Clients need time to accept, understand, and process the diagnosis. They also need time to come to terms with the treatment options available to them.

I have written about osteosarcoma's and my personal opinions and belief that the one thing we must do for these patients is provide them with some way to manage their pain. Bone tumors are excruciatingly painful. So much so, that pets will refuse to move, eat, or interact on any level just to avoid moving because the pain is so intense. My advice, based on years of practicing and dozens of patients, has always been the same; Get rid of the pain by getting rid of the source. Amputate that useless limb that is killing your pet and killing their ability to live a pain free life for whatever amount of time they have left. They don't use that leg anyway, so get rid of it. I promise they won't miss it and they won't feel bad about looking "disfigured."

But, alas, I am not always able to convince my clients that this is the right decision. And at some point there are no opioids, steroids, NSAID's, or options left to manage their pain. These pets are put down because we cannot keep them comfortable.

It was with great delight and interest that I found the following article on a new treatment option for these patients.

Researchers at the University of Pennsylvania School of Veterinary Medicine injected a single dose of a SP-PAP, a neurotoxin, into the spinal cord, under general anesthesia, and found that the patients receiving the neurotoxin in the study were considerably less painful than those without it. The results were so promising that the drug and study is expected to be used for humans. 

Maybe someday very soon I can offer this instead of euthanasia as a way to keep my patients comfortable?

Please read more about bone tumors and treatment options at Heidi's Story.

Article abstract follows:

Intrathecal substance P-saporin in the dog: efficacy in bone cancer pain.

Anesthesiology. November 2013;119(5):1178-85.

Dorothy Cimino Brown¹; Kimberly Agnello

¹* Professor of Surgery, † Assistant Professor of Surgery, Department of Clinical Studies - Philadelphia, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, Pennsylvania.

Article Abstract

BACKGROUND: Substance P-saporin (SP-SAP), a chemical conjugate of substance P and a recombinant version of the ribosome-inactivating protein, saporin, when administered intrathecally, acts as a targeted neurotoxin producing selective destruction of superficial neurokinin-1 receptor-bearing cells in the spinal dorsal horn. The goal of this study was to provide proof-of-concept data that a single intrathecal injection of SP-SAP could safely provide effective pain relief in spontaneous bone cancer pain in companion (pet) dogs. METHODS: In a single-blind, controlled study, 70 companion dogs with bone cancer pain were randomized to standard-of-care analgesic therapy alone (control, n=35) or intrathecal SP-SAP (20-60 µg) in addition to standard-of-care analgesic therapy (n=35). Activity, pain scores, and videography data were collected at baseline, 2 weeks postrandomization, and then monthly until death. RESULTS: Although the efficacy results at the 2-week postrandomization point were equivocal, the outcomes evaluated beyond 2 weeks revealed a positive effect of SP-SAP on chronic pain management. Significantly, more dogs in the control group (74%) required unblinding and adjustment in analgesic protocol or euthanasia within 6 weeks of randomization than dogs that were treated with SP-SAP (24%; P<0.001); and overall, dogs in the control group required unblinding significantly sooner than dogs that had been treated with SP-SAP (P<0.01). CONCLUSION: Intrathecal administration of SP-SAP in dogs with bone cancer produces a time-dependent antinociceptive effect with no evidence of development of deafferentation pain syndrome which can be seen with neurolytic therapies.

If you have a pet related question you can ask it for free at Pawbly.com, or find me on Twitter @FreePetAdvice.

Jekyll and Charlie, patiently waiting for me to get ready for work.

Thanksgiving 2012

It is hard to say “No,” to my mom who is 4 hours away and I only see a few times a year. I know she wants all of her kids to be together with her on the holidays, but I just couldn't muster the energy to drive the day after Tyler’s funeral.

My mom and sister's kids at the grandparents house for Turkey Day.
They are spying on the deer in the yard.

I decided last weekend when the accident was reported to us and the deaths were confirmed that I needed to cancel everything for the Thanksgiving holiday week.

I knew that getting the staff and clinic through the week, (thank goodness it was a short week to begin with), would be difficult enough. I didn't feel right about traveling and I wanted to be home.

Wednesday was Tyler's funeral. There was not a dry eye in the packed chapel. Tyler’s mom stood to tell us all what we already knew, that "she loved him more than life," and that when he would say “I love you mom,” she would always reply “I love you more.” If anyone thought they could keep it together through that service they were proved wrong when she spoke. The grief in her heart and the pain in that chapel was palpable, inescapable, and ominous.

Every member of Jarrettsville Veterinary Center, past and present, was at Tyler’s funeral. We all remembered his funny, quirky, demeanor. His masculine obsession with keeping the lawn and landscaping perfect (which none of us women understand to begin with. After all, the dogs just pee and poop on it anyway). His love of long hair, his inability to eat anything “until every last task he had to do was done to his perception of perfection.” He was compulsive about cleaning and keeping the kennel in perfect order. It was “his kennel" and we all had to remember to put "his" stuff back just where "he had left it." Which was "just where it was supposed to be.” He knew every pet in the kennel by name, personality, preference to bedding, bathroom, eating, drinking, and play. He also knew every boarding client by name. Where they were going, and when their pet was going to be groomed, or picked up.

Every year I would ask him if he had made any decisions about working his way up the vet clinic ladder? I even tried at one point to cross-train him so that he would be able to perform the duties of the rest of the veterinary technicians and staff. I had him spend a few days as a technician and a receptionist. Oh, my goodness, did he hate those days. After 2 days of answering phones he begged me to never make him do it again. 

“Don’t you want to move on, move forward, do something else as you grow up?” I would quizzically ask?

“Nope, I’m good.” He would smile contently back at me.

It took me three years to figure out that that boy was doing exactly what he wanted to do. And that he didn't want to move out of his parents home. He wanted to stay just as he was. Doing a job he knew he was very good at, with the animals he loved, and spending his free time working on his car, playing disc golf, or going to Cape Hatteras.

It took me 35 years to figure that out. To just be happy and not feel like I had to accomplish something. Especially when that ‘something’ was for someone else. (Lord, what a waste of time).

Saying goodbye to Tyler, knowing that work won’t be half as much fun without his smile, his obsessing, and his laughter is hard. Wondering how to replace even a piece of him? Impossible. And trying to provide my staff with any kind of support while they adjust to life without him is about all the strength that I have left.

After the funeral we went out for dinner to toast a life cut tragically short, and to spend a last few moments remembering Tyler’s impact on all of us.

Thanksgiving morning was met by the alarm clock so Joe, Amy, and I could be in Bel Air at 8 am for the annual YMCA 5K Turkey Trot. I made a shirt so I could run in Tyler’s honor. I know that many of the other runners know of this accident and it was my last good-bye to him publicly. I ran feeling lucky to be alive, healthy, and to have had such an amazing journey. I ran to let him know that we still carry his memory with us, and that I am grateful for all of my life’s stumbles, friends, and family. It was a beautiful chilly morning and I got to share it with 2,000 other early risers.

My husband and I went to the crash site to say our goodbye, and try to reconcile our grief. It is a horror to witness. There are pieces of his prized Mazda scattered over a 200 plus foot area in the ravine. At the bottom is a fence decorated with memorial flowers, cards, discs, one of his shoes, a pile of random car pieces, and notes from dozens of friends. It is a surreal site to witness.

I said my last goodbye to this place too. I have to move on, keep living, and love him for the free happy spirit he always was. I won’t go back. There is no place for life in that place of three people’s death.

I spent the rest of the day with my family; my four cats, my three dogs, my pig, and my husband. I hugged each of them and told them all how much I love them.

Wren.

Magpie.

Oh, those pesky kittens. There is no reprieve.

Little Oriole. The newest member of the clan.

A perfect day at home.

In love already.

And very comfortable in her new home.

May you all have someone to snuggle with and love this holiday season.