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Small animal vet rant

Around The Farm
#301

Internet pet meds

Pancakes… Thanks for posting the above links. I’ve followed this thread through 14 pages. I wondered what is the vet profession’s objection to internet sourcing of vet drugs besides the price competition.

I have a client/vet relationship for my large and small animals. I have no issues with paying a premium price for acute care drugs from the vet. When I need something Now, it is not price gouging. It is the cost of maintaining a stock “just in case” I need it. Any meds supplier or supplier of anything has a cost to carry “stuff” in stock. A vet has to buy and store a time sensitive item. If it’s not sold within its time, it’s a loss of $$$.

Preventive and maintenance drugs are something else. I have the time to price shop and ship the drugs. If my vet doesn’t facilitate these purchases for me. I’ll go to another vet. (And, I have)

After following the links, here’s my conclusion.

Counterfeit drugs are a risk to all channels. Even Vets can get them. The FDA’s statement is just so much blather to me. It speaks about certified on-line pharmacies, but “…Only pharmacies that sell human drugs are VIPPS-certified at this time”

The issue of drugs labeled for foreign countries… from the links…

“…Because the drugs are made for distribution in Europe and Australia, the formulations and labeling differ from those approved by the Food and Drug Administration for sale in the United States. Novartis, which distributes its products only where there is a veterinarian-client-patient relationship, says the different dosage amounts—kilograms rather than pounds—confuse customers and can lead to incorrect dosages…”

I can calculate the conversion and won’t be confused. As my 70 pound dog masses 31.8 Kg. I don’t need or want a nanny to hold my hand.:mad:

I will continue to price shop and purchase pet meds where ever possible. Just like I purchase EVERYTHING … vehicles, food, clothing, computers, vet services, plumbing services, fuel, cell phone service, etc.

PS… It is difficult to impossible to price shop human medical service since the cost is mainly paid by third parties. Few people ask for prices. I know because I tried with some elective surgeries.:yes:

#302

Wow. Page 15 - I couldn’t get through it all.

My two cents is that I’ve politely but firmly “passed” on much of the routine annual preventive care that is offered (or pushed, in some cases) by SA vets. I have three healthy Dobermans, and my two girls are from a breeder I trust and respect. Her dogs, over the decades, have been happy and healthy with only puppy shots and the required by law rabies vaccine. This past year I elected not to spend $41 x 3 dogs on “Annual Wellness Exam”, which involves them looking at my dogs, running hands over to check for lumps/bumps/growths, listening to their hearts, and looking at eyes/ears/mouths; Lepto at $21 x 3 dogs; Bordatella at $20 x 3 dogs; and DA2PP at $20 x 3 dogs; for a total of over $300.

Why? I LIVE with my dogs day in and day out. My hands are all over them, I feed them, I watch them eat, I watch them drink, I watch them potty. I see how they act, how they play, how they sleep EVERY DAY. And after my “bad feeling/something’s not right” diagnosing my mare three years ago as IR, after my LA vet told me I was nuts and didn’t catch it until the 3rd visit, and after this past winter KNOWING something was very wrong with Puppy and many of you know how that went, I’m confident that I will KNOW if anything funky is going on with any of my dogs.

No one can say I don’t do what my dogs need. They eat excellent food (Innova, at $50 for a 32lb bag), my oldest had both of her knees done (at about $2500 a pop, including PT afterwards), she also gets allergy shots (that I give, refills every 6 months at $160), they don’t get kenneled or sent anywhere where they are exposed to anything weird. When Ava crashed into Storm and acted like her back hurt (she basically whiplashed herself into her much bigger sister!), I took her for several chiropractic and acupuncture visits, and they worked. I am not opposed to spending money on things they need. I just don’t believe that the annual vaccines are needed, and I don’t believe that the “annual wellness exam” is anything special that I should pay $41 apiece for.

So this spring I paid for the required heartworm antigen test before they would prescribe the preventive, and politely turned the rest down, saving over $200. Then they refused to let me purchase the Interceptor from SmartPak…wouldn’t call the Rx in. For godsakes, I buy PERGOLIDE from there! Had to use the online pharmacy that THEY recommended, or not get it. If that’s not a racket, I don’t know what is.

#303

Hosspuller, I’m glad you took the time to read the links. Your decision is yours, and at the very least you are informed and aware of why the vets are concerned (and it’s not just about profit loss!). That’s really all I was getting at.

#304

Just last fall we had 2 dogs die from lepto and several others undergo hundreds of dollars of IV fluids/hospitalization etc for lepto(some of which will have permanent kidney issues), all because their owners did not believe in a $45 dollar wellness exam and $29 vaccine. One of these people was then irate , saying we never offered the vaccine to them, when clearly in the record it was declined three years in a row and the last year a note was made that these people “did not want a lepto vaccine and please stop asking if we do…” And why do you think we see less distemper, parvo etc ? Vaccination . Lepto is a perfect example, 15 years ago we never saw lepto and it became out of vogue to vaccinate due to a small number of animals having reactions to the vaccine. Now we see lepto very regularly and most practices have reimplemented a lepto vaccination protocol. It is not about who can we get an extra $29 from…

We also just euthanized an end stage lyme nephritis --same reasons

Doctors in our practice have diagnosed and started treatment for dilated cardiomyopathy before heart failure occured in more than one doberman due to an irregular heart rythm detected on a wellness exam.

If you do not want these things, it is your right to decline them, but in no way are they “useless” or inappropriate. I see my own doctor every year for wellness physical exams, it is no different.

Veterinarians are going to continue to offer what they feel is the best medicine despite what other people’s opinions are and honestly, I’d much rather someone be angry because something was offered than because something wasn’t…

the focus in veterinary medicine is about wellness and prevention, not just treating the dog when it is gravely ill by things that could possibly have been prevented. Why is this seen as so wrong in everyone’s eyes ? There are countless cases in our practice where wellness blood tests have diagnosed splenic tumors, lymphocytic leukemia, renal disease, cushings syndrome, thyroid disease, liver disease, etc in otherwise seemingly healthy animals thus giving their owners options BEFORE a crisis occured. I think the key is in communicating the benefits to what is being offered and to offer it in a nonjudgemental fashion.

I understand people’s needs to find less expensive medications and most vets I know will write a prescription for the owner to do with as they please. Most will not fax directly to the online pharmacies. On the flip side I’ve had people tell me they cannot afford to work up or treat diarrhea in a new puppy (they showed me the paperwork and over $1500 was the cost of that pup). The previous poster was willing to pay $50 for 30 lbs of food, it’s all about priortities and what is important to an individual and that’s fine. I do not believe $45 for an exam or $29 for a vaccine is highway robbery…

I really think we are all going to have to agree to disagree.

#305

And I can tell you that the single biggest increase in operating expenses for the practice I work for was the increase in our health insurance premiums.

And may all who have had rotten experiences with their veterinarians find someone they like who works with them.

#306

[QUOTE=idtogo;4212678]
Just last fall we had 2 dogs die from lepto and several others undergo hundreds of dollars of IV fluids/hospitalization etc for lepto(some of which will have permanent kidney issues), all because their owners did not believe in a $45 dollar wellness exam and $29 vaccine. One of these people was then irate , saying we never offered the vaccine to them, when clearly in the record it was declined three years in a row and the last year a note was made that these people “did not want a lepto vaccine and please stop asking if we do…” And why do you think we see less distemper, parvo etc ? Vaccination . Lepto is a perfect example, 15 years ago we never saw lepto and it became out of vogue to vaccinate due to a small number of animals having reactions to the vaccine. Now we see lepto very regularly and most practices have reimplemented a lepto vaccination protocol. It is not about who can we get an extra $29 from…

We also just euthanized an end stage lyme nephritis --same reasons

Doctors in our practice have diagnosed and started treatment for dilated cardiomyopathy before heart failure occured in more than one doberman due to an irregular heart rythm detected on a wellness exam.

If you do not want these things, it is your right to decline them, but in no way are they “useless” or inappropriate. I see my own doctor every year for wellness physical exams, it is no different.

Veterinarians are going to continue to offer what they feel is the best medicine despite what other people’s opinions are and honestly, I’d much rather someone be angry because something was offered than because something wasn’t…

the focus in veterinary medicine is about wellness and prevention, not just treating the dog when it is gravely ill by things that could possibly have been prevented. Why is this seen as so wrong in everyone’s eyes ? There are countless cases in our practice where wellness blood tests have diagnosed splenic tumors, lymphocytic leukemia, renal disease, cushings syndrome, thyroid disease, liver disease, etc in otherwise seemingly healthy animals thus giving their owners options BEFORE a crisis occured. I think the key is in communicating the benefits to what is being offered and to offer it in a nonjudgemental fashion.

I understand people’s needs to find less expensive medications and most vets I know will write a prescription for the owner to do with as they please. Most will not fax directly to the online pharmacies. On the flip side I’ve had people tell me they cannot afford to work up or treat diarrhea in a new puppy (they showed me the paperwork and over $1500 was the cost of that pup). The previous poster was willing to pay $50 for 30 lbs of food, it’s all about priortities and what is important to an individual and that’s fine. I do not believe $45 for an exam or $29 for a vaccine is highway robbery…

I really think we are all going to have to agree to disagree.[/QUOTE]

Hear, hear. Excellent post! And despite the experiences many of the posters have had (unfortunately), most vets are NOT motivated by greed – just by good medicine with the pet’s best interest at stake. An ounce of prevention is worth a pound of cure. If you don’t believe in that, then find a vet with a philosophy that matches.

#307

[QUOTE=asb_own_me;4212293]
Wow. Page 15 - I couldn’t get through it all.

My two cents is that I’ve politely but firmly “passed” on much of the routine annual preventive care that is offered (or pushed, in some cases) by SA vets. I have three healthy Dobermans, and my two girls are from a breeder I trust and respect. Her dogs, over the decades, have been happy and healthy with only puppy shots and the required by law rabies vaccine. This past year I elected not to spend $41 x 3 dogs on “Annual Wellness Exam”, which involves them looking at my dogs, running hands over to check for lumps/bumps/growths, listening to their hearts, and looking at eyes/ears/mouths; Lepto at $21 x 3 dogs; Bordatella at $20 x 3 dogs; and DA2PP at $20 x 3 dogs; for a total of over $300.

Why? I LIVE with my dogs day in and day out. My hands are all over them, I feed them, I watch them eat, I watch them drink, I watch them potty. I see how they act, how they play, how they sleep EVERY DAY. And after my “bad feeling/something’s not right” diagnosing my mare three years ago as IR, after my LA vet told me I was nuts and didn’t catch it until the 3rd visit, and after this past winter KNOWING something was very wrong with Puppy and many of you know how that went, I’m confident that I will KNOW if anything funky is going on with any of my dogs.

No one can say I don’t do what my dogs need. They eat excellent food (Innova, at $50 for a 32lb bag), my oldest had both of her knees done (at about $2500 a pop, including PT afterwards), she also gets allergy shots (that I give, refills every 6 months at $160), they don’t get kenneled or sent anywhere where they are exposed to anything weird. When Ava crashed into Storm and acted like her back hurt (she basically whiplashed herself into her much bigger sister!), I took her for several chiropractic and acupuncture visits, and they worked. I am not opposed to spending money on things they need. I just don’t believe that the annual vaccines are needed, and I don’t believe that the “annual wellness exam” is anything special that I should pay $41 apiece for.

So this spring I paid for the required heartworm antigen test before they would prescribe the preventive, and politely turned the rest down, saving over $200. Then they refused to let me purchase the Interceptor from SmartPak…wouldn’t call the Rx in. For godsakes, I buy PERGOLIDE from there! Had to use the online pharmacy that THEY recommended, or not get it. If that’s not a racket, I don’t know what is.[/QUOTE]

My vet, a very nice and smart lady, has recommended no longer vaccinating my 10 yo dog except for rabies - it’s overkill, she doesn’t need it. I’ve agreed to titers if necessary, she said “not needed”, and I agree. I don’t think they need a yearly assault on their immune systems with no proof that the vaccines are not still effective.

As for the scripts, in this state I believe it is illegal for a vet to refuse to write a prescription and let the patient fill it where they want.

#308

Honest question… was there no rabies clincis avail? No pet smart or Petco or Pet People vaccines clincis? Certainly the animal shelter offered low cost Rabies Vaccines? No other clincis offered low cost vaccines? You HAD to get them vaccinated that very day, you couldn’t go home and call around to find something better suited to your dogs?

Edited for this link:

http://www.sonomahumane.org/vaccinations_microchipping.php

in the future, you can utilize this service for your pets( if your listed location is correct).
Rabies 10 dollars

#309

Re: lepto - I can have titers drawn.

Re: DCM. Catching it does not cure the dog…there is supportive care and past that, nada.

As I’ve said before, I am confident that I will notice if something is amiss with ANY of my animals.

#310

[QUOTE=asb_own_me;4214412]
Re: lepto - I can have titers drawn.

Re: DCM. Catching it does not cure the dog…there is supportive care and past that, nada.

As I’ve said before, I am confident that I will notice if something is amiss with ANY of my animals.[/QUOTE]

Yes you can have titers drawn. I do believe that most SA vets who are practicing quality medicine have dramatically changed their vaccination protocols over the the last 5 years. Not “one size fits all” as it used to be ( once again back to the good medicine). Part of that is offering titers- but I don’t think if you are already a proponent of basic, economical pet care titers are going to be your “thing” - you think vaccines are expensive??? Get a price on having your dog’s titers run!

As far DCM - not curable, but certainly easier to deal with in an asymptomatic patient vs the syncopal, dyspneic dog in CHF. And since the meds are relatively inexpensive vs treating a case of failure etc I think it even fits with the more economy minded vet consumers.

OK. I am done with this thread. I am ready to move on to giving my opinion on how other professions manage their affairs. It’s only fair - I mean I eat at restaurants, hire plumbers, use doctors, buy groceries etc so I am fully qualified to critique all their business and professional decisions so WHO IS NEXT??? :lol:

#311

[QUOTE=dr j;4214764]
It’s only fair - I mean I eat at restaurants, hire plumbers, use doctors, buy groceries etc so I am fully qualified to critique all their business and professional decisions so WHO IS NEXT??? :lol:[/QUOTE]

Well yes, let’s hear it. Last time I checked no profession was entitled to be completely free of criticism. No occupation, profession or sector is without its critics - and plenty of that criticism is justified.

What is ironic is that until you came along and started spouting off - I really had no strong opinion or real beef with vet bills - just some little concerns here and there about some silly things some vets do sometimes. And personally I thought the discussion was pretty darn balanced and civil - as well as educational.

Sorry lady - I have enormous respect for any professional or business owner but none of us are entitled to do anything we want and answer to no one.

While I know nothing about the restaurant business, if the kitchen is infested with rats I’m going to complain about the turds in my soup - and I don’t need to be the Orkin Man for the complaint to be legitimate.

I’m happy to pay a tremendous amount of money to keep my pets and livestock healthy - and I do so and have for years.

But lady - I’d sure as hell not use you as a vet. Not with your attitude.

#312

That is exactly the point, though- why can’t routine vaccination be done for a reasonable cost, without the mark-up, at our vet’s office?

And the truth is, several vets around here do offer it. Those that inflate routine care, push “extras” that many of us don’t find necessary, and run their business like a chiropractor’s office are driving away part of their customer base. It appears that we’re among the percent they didn’t want anyway :frowning:

#313

I think I only saw one other person on this thread who also has their horse vet look over their small animals and do routine shots during his farm visits. This was a large vet practice, and 7 years ago, havn’t owned any small animals since, but it saved tons. Also, he was quite frank as to what my animals REALLY needed and what they didn’t, and explained why. The exams or time was included in the farm visit, and I paid for the meds or shots. I’m sorry folks have had other experiences, and I too have had my share of usery small animal vet experiences. I was grateful for the honesty and cost savings the equine vet practice provided in this way. Made me stick with them, that’s for sure.

#314

[QUOTE=JSwan;4214817]

But lady - I’d sure as hell not use you as a vet. Not with your attitude.[/QUOTE]

My attitude? ( I know, I know, I said I was done!) None of the things I have posted reflect much of my personal attitude, they are basic practice management facts. I didn’t make them up and I think all the other vets on this thread have pretty much agreed.

If I offend you because I tried to educate you with factual information, then I guess we both have to live with that.

I don’t think you know squat about my “attitude”. I disagree with some of the tenets of practice management but that doesn’t make them false.

#315

[QUOTE=AnotherRound;4214841]
I think I only saw one other person on this thread who also has their horse vet look over their small animals and do routine shots during his farm visits. This was a large vet practice, and 7 years ago, havn’t owned any small animals since, but it saved tons. Also, he was quite frank as to what my animals REALLY needed and what they didn’t, and explained why. The exams or time was included in the farm visit, and I paid for the meds or shots. I’m sorry folks have had other experiences, and I too have had my share of usery small animal vet experiences. I was grateful for the honesty and cost savings the equine vet practice provided in this way. Made me stick with them, that’s for sure.[/QUOTE]

I have practiced mixed animal practice most of my career and routinely do vaccines at farm visits. But the large percentage of our SA clients do not have large animals so SA practice policies are more tailored to the SA exclusive clientele of course. But still we had folks who want everything possibly available for their horse and/or dogs/cats. And since we were truly a mixed practice we have plenty of people who want nothing ( dairy farmers and farm cats come to mind) and OF COURSE we accomodate them all. If ( as many of you insinuate) there are practices out there that attempt to bully you into things you don’t want to do, I am sorry but my guess it’s not common or customary. And as mentioned previously, no one can make you feel guilty about your choices but you.

In our area of the country our horse clients are much less likely to follow our recommendations than other groups. But once again those that follow our reccs for their horses usually do the same for their SA. The client who opted for colic surgery on her 20 year old QH gelding, also had a TPLO done on her lab. She also has her horses teeth done ( complete oral exam and floating etc if required) every 6 months like clockwork. Her dogs get their vacc as needed and HWT as needed. She treats use with respect and vice versa. Including a night years ago when she decided it was “time” for her elderly schnauzer. Yet when she arrived at the clinic she couldn’t do it… and decided the same thing the second trip. By the 3rd time ( in the same night) I met her at the clinic, she had decided. And just for you vet cynics- I didn’t charge her at all. I never charge to euthanize a pet I have taken care for it’s entire life. ( I am probably still a biotch to some of you though:winkgrin:). For me not to offer the best and be at my best for a client like this would be beyond comprehension. She is not alone and she is the type of client that drives veterinary medical management decisions.

#316

One other comment I would make.

There is a different level of connection between SA vets and clients and LA vets and clients in my experience. I see most of my horse clients often - since I work for a lot of trainers -often daily. They know me well and vice versa. I go to their barns/homes etc. SA clients you have a very small window and it makes a difference. You might see them for 15 minutes twice a year. In that small amount of time you must determine what their needs for their pets are… it would be remiss to do anything but offer your best recommendations without more in-depth knowledge of your client.

I guess that’s my attitude coming out!!

Thank you all, honestly I have a great deal of fun with this!!

#317

The attitude I refer to is that which I quoted. The “screw you the public has no right to question our charges or business practices.” No other profession has that luxury and vets are no exception.

That isn’t practice management - it’s treating clients (or potential clients) like sh** so they’ll shut up and pay you, and if they question your billing they’re not worth your time. That’s the attitude I’ve gotten from you - but not the other vets that have chimed in.

I disagree with some things SA veterinarians do that I feel is inappropriate, manipulative, or unethical. If you are not bullying or bilking clients then you are not among the vets to whom I refer. If you treat your clients dismissively and arrogantly as you have done so here - then yes - you are one of the vets I am describing.

Others have tried to share factual information with you - their own experiences with vets who shame, manipulate, or insist that clients purchase services and items that they don’t need. If you don’t do that - again - that’s great.

That doesn’t mean it doesn’t happen, and it doesn’t mean people don’t have the right to be upset about it.

[QUOTE=dr j;4215182]
My attitude? ( I know, I know, I said I was done!) None of the things I have posted reflect much of my personal attitude, they are basic practice management facts. I didn’t make them up and I think all the other vets on this thread have pretty much agreed.

I don’t think you know squat about my “attitude”. I disagree with some of the tenets of practice management but that doesn’t make them false.[/QUOTE]

#318

[QUOTE=Horsegal984;4211350]
Don’t believe me, or the links posted? Google 1-800-PETMEDS. Check out the LOOOOOOOONG list of lawsuits against them, from owners, vets, and product manufacturers. Accodring to Merial themselves, they don’t have a F’n clue where Petmeds is getting their products, because they will not do buisness with them. ACCORDING TO MERIAL- warrenties on their products are null and void if purchased through petmeds or a similar site. The best that anyone can figure out? There’s a group of very unscruplous money hungry vets that are buying up large quanties of Heartgard and then reselling it to PetMeds. Those vets could be in Mexico, Germany, Australia, heck Antartica for all anyone knows. If those vets don’t care enough about the laws to keep them from doing it then who’s to say they didn’t let the product sit out in 100+ degree heat, or freeze for days on end. Which can very easially alter the effectiveness of almost any medication. Honestly, do I personally know that it ruins Heartgard? Nope, just know that Merial believes it will, and that’s enough for me.

Believe it’s fear tactics if you will, but I call it letting intelligent consumers make informed decisions.

BTW- 12 pack Heartgard Green on 1-800-PETMEDS $53.99
Same Heartgard purchased through our clinic’s online pharmacy? $49.00
Yes, you’re reading that right, and buying off the clinic’s online pharmacy keeps the product warrenty intact too.

Katherine
Vet Tech[/QUOTE]

And yet, there are others, like KV VET who say up front they buy their drugs at the same place as the vet does, only they offer them at a lower price - probably by buying volume. Unless they’re out and out lying on their website, then I don’t buy the “ooh, they could be bad” argument. Drug companies make the same drugs sold in Canada for less money, yet try to insinuate that unless we buy them here for 6 times the price, they’re “dangerous”. Not too dangerous for the nation full of Canadians to take them, mind you, but too dangerous for AMERICANS to buy them cheaper in Canada. What’s dangerous is that the drug companies will do and say ANYTHING to keep gouging the consumer, they have very strong and well paid lobbyists to make sure their profits are protected. Doesn’t mean it’s right, it means they get away with it until the political climate changes.

#319

[QUOTE=Pancakes;4192830]
Large animal vets have much less overhead than small animal vets. They typically don’t have a fully staffed facility stocked with expensive equipment. It’s not just arbitrary marking up of prices for the sake of it. Yes, small animal vets are typically more expensive, but there is a reason for it. Those that are cheaper probably have less overhead, maybe got used machines/equipment vs. new ones and thus have less to pay back, maybe have inherited the facility from a previous owner and don’t have to pay rent or pay back construction costs…there are a lot of factors.
FWIW, $140 for an ultrasound is really not a bad price.[/QUOTE]

UMMM- yes large animal vets DO have fully staffed offices, equipment, etc to maintain and run-plus the mobile vet vehicles they tend to have as well- Do you think they keep all their equipment in their garage at home and just haul it out when it is needed? They need to have larger exam areas, stocks,stalls, holding corrals, etc… I think there is alot more overhead in developing a large animal facility than a small one- the difference is that alot of people who have pets treat them like a family member and will spare no expense to keep poor fluffy in the family another day, whereas livestock people tend to be more likley to opt for lesser procedures…

#320

Maybe Dr. J is right. Maybe its not her personality which is so offensive to these readers and small animal owners. Maybe its just her practices which we find so offensive.

Nah. Its her personality, too.

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