I was a little disappointed recently to read a certain celebrity vet’s blog post about ‘overcharging vets.’ Despite a couple of sentences that attempted to act as somewhat of a balancer by ‘hoping that their view is coloured by bad personal experience’ and acknowledging that not all vets overcharge, I couldn’t help but feel that the comments were misguided, unhelpful and may simply act to further add to the list of grievances, both reasonable and unreasonable, that some may wish to level at the veterinary profession, whom the vast majority of the general public still imagine rake it in and live the lives of monied privilege, whilst the opposite is usually the case.
Although it is undoubtedly true that some vets may be tempted to propose additional tests and treatments that may ultimately, in hindsight, prove to be somewhat superfluous, I firmly believe that the motives for 99.9% of vets to make recommendations and suggest preventatives, procedures and other treatments are clinical, sound and ethical, with little or no concern for their own material gain. Granted that with the introduction by some veterinary employers of incentive schemes and bonuses linked to things like turnover, some individuals may feel the pressure to over-emphasise certain options in the pursuit of a boost to their salaries. However, if the vet in question is paid appropriately for their skills and expertise then I don’t see how the potential promise of a few extra quid in the monthly pay packet can really lead to their clinical morals becoming corrupted. If they’re the kind of person who is overly motivated by money then they probably wont spend a lengthy career in veterinary anyway and will probably work out that there are significantly easier, and possibly less stressful, ways of making themselves rich than trying to fleece the pet owning public. Personally I don’t view financial incentive schemes as being a particularly great idea in veterinary as I fear that they do introduce the risk of conflicts of interest developing, even if those conflicts never actually manifest themselves. Most organisations that employ turnover based bonus schemes use them as a means by which to justify keeping base salaries towards the lower end of the scale, especially as vets on lower salaries can “earn more of a bonus as a result if they exceed their monthly turnover targets,” due to the difference between the target monthly turnover figure, usually based on the current salary and the actual monthly turnover figure achieved, which can ultimately vary with the cases that walk in the door that month. I had a debate about exactly this when trying to negotiate a perfectly reasonable salary increase with my first employer a year after graduating and starting work as a vet. I ultimately left as a result of their refusal to appropriately value my training, skills and experience, preferring to espouse the apparent merits and “additional earning power” of the bonus scheme. Myself and my colleagues at that practice, and others that I have since worked at, did not make clinical recommendations because option A was going to make us an extra £15 compared to option B, but instead used our training and judgement as vets to discuss the various options with the owner and ultimately make recommendations, with the owner ultimately making the decision having felt satisfied that they were getting value for money.
The example given by the author of a friend whose dog was taken to the vets suffering from “mild intermittent digestive upsets for a while” and subsequently received a bill for £1700, which was then derided for being unjustifiable and clearly motivated by profit seemed to me to be one-sided, emotive and jumped to a number of conclusions, which was unfair to air publically without offering the vet in question the opportunity to justify the charges. There was no mention of the dog’s previous treatments or the nature of the digestive upsets that had been the problem. Nor did it make clear whether the owner had been involved in any discussion about the investigation options, including potential costs, and thus whether in spite of the final amount being quite a lot and the ultimate diagnosis – note that a diagnosis was reached – being fairly benign (hindsight is a wonderful thing), the owner knowingly consented to the range of investigations carried out and their cost. If not then yes, there is a problem, but that problem is one of proper client communication and customer care, not of profiteering. £1700 is not a lot of money for such an exhaustive, all encompassing investigation into a problem that by the sounds of it had been grumbling on for a good while. The alternative, of course, could have been to conduct the various tests over a longer period of time, but then that may have involved having to administer multiple anaesthetics (additional cost and risk to the patient), and may have simply served to prolong the period that the animal was suffering from the problem and the course of supportive therapy, such as prescription diets, that may have been used in the interim. The result? That the final bill would have potentially been significantly greater than £1700 and that the vet is accused of dragging the entire process out in order to maximise profit. Damned if you do and damned if you don’t.
People talk a lot more with each other than they ever used to and one result of this is that if there is something that people don’t like, whether it be poor service or excessive charging, then it is not long before everyone is made aware and if the issue is not addressed then the individual or organisation runs the risk of being adversely affected, especially if the messages are consistently poor. Vets that overcharge – and it is easy to ascertain whether this is the case by comparison with other vets, offering a similar service – will find that word gets out and they will either have to bring their prices and practices in line with their professional peers or risk not remaining in business for very long. As such, I simply don’t believe that overcharging is a real problem in veterinary medicine. In fact, I think that pet owners get a very good deal considering that they have access to exceptional standards of private medicine, often with the convenience, clinical and cost advantages of same-day diagnoses and treatments, especially when you compare that humans pay many times more for similar tests and procedures privately themselves.
I will be very interested to hear the kind of stories that are submitted to the author and predict that he will undoubtedly receive an electronic sackful of complaints and countless accounts of “profiteering” within the veterinary profession. However, what I suspect won’t be accompanying those stories are clear, detailed explanations for why various treatments, tests and procedures were advised, what the animals’ previous histories were, or whether the options were clearly discussed, explained and ultimately consented to, including knowledge of potential costs. Incidentally, you don’t see many vets driving Aston Martins, living in mansions or sending their kids to Eton, so I do wonder where all of these scurulous profiteers are hiding out?
It is rare that something crops up on Twitter that makes you sit up and say “Hey! That is truly awesome!” Today, however, was one of those days. I was casually flicking through my Twitter feed glossing over the usual fare of celeb announcements and product plugs when lo-and-behold this cracking story made itself known… True genius on an epic scale!
Nat Morris, an IT consultant and dog owner from Wales, put his technology skills to legendary use by rigging up a fun system that provides his Border Terrier, Toby, with a treat every time a message is tweeted to @FeedToby. The system, which incorporates a mini-computer, that receives the tweets and drives the funky device, sounds a buzzer to alert Toby of the imminent arrival of a tasty snack, and a camera that snaps a pic of Toby and tweets it back to Nat so that he can see that Toby has eaten the food. There are, however, self-imposed limits on the system to prevent Toby get overfed as a result of being the recipient of loads of well-meaning tweets!
I have just been listening to a section on BBC Radio 2 about dogs, breeding and the idea that many people are simply acquiring dogs that, to be honest, are wholly unsuitable to their lifestyle and, by extension, to the dog’s innate drives. This can, and often does, result in a doubly disappointing situation: a dog who is frustrated, and may end up displaying symptoms of that frustration, such as destructive behaviours (eg furniture chewing), and may end up being abandoned or rehomed; and owners who are equally frustrated, and end up with mixed emotions, including possible feelings of resentment towards their dog, or guilt that they can’t seem to satisfy their dog’s exercise or behavioural needs, and who may feel that they are left with few choices over what to do. The facts are that rescue and rehoming centres are seeing record numbers of dogs being admitted, reflecting a depressing state in which too many dogs are being given up by owners, for a multitude of reasons. However, on the flip side, as a vet I regularly see lots and lots of new puppies, purchased from breeders, often for hundreds of pounds, and in many cases perhaps questionable in terms of their suitability for that particular family or owner.
Why are dogs being given up?
There are many reasons why someone might feel they have to make the decision to rehome their dog, and it is important to point out that in the vast majority of cases such a decision will not have been reached lightly and will represent a heartbreaking and traumatic event for both the owner and the dog. The owners that I speak to in this position feel that there is simply no other choice and it is emotionally devastating to those clients, most of whom will have already explored all the other potential options for their dog (eg rehoming with a family member, seeking behavioural therapy, and more). The main reasons that I encounter for dogs being given up for rehoming are:
- Lifestyle factors – the breed of dog that was originally purchased as an adorable bundle of 8 week fluff has actually grown into a super-athletic, busy, intelligent animal who needs to be continuously stimulated and requires regular and long periods of exercise in order to stay both mentally and physically fit and stable. The classic example here is a Border Collie, which is traditionally a working dog used for herding. I have a friend who trains for and runs ultra-marathons. He takes his Collie out with him on runs and whereas he is ruined by the time he gets back in, his dog will have spent the entire run darting ahead and back, and generally not stopping, covering, in all likelihood, about five times the distance. And not even be tired! How can the average family, or even someone living in an urban environment or with a busy job, possibly be expected to cater to such a dog’s apparently insatiable exercise needs? We then act all shocked and upset when the same dog starts turning on our sofa to burn off some of their nervous energy. Who was on hand to advise that new owner about whether such a breed was actually a good lifestyle fit for them? Whose responsibility is it? Vets? Breeders? The Kennel Club? The Government? The owner’s themselves?
- Change of circumstances – many people will purchase, or otherwise take on, a dog as a family, or perhaps with a partner and all is rosy and joyful at the time of acquiring said pooch. Life, however, has a way of serving up curveballs and some of those relationships may hit the ropes and, sadly, break up. What happens to the dog in those situations? Who is responsible for them? What was agreed at the time of getting them about what would happen in such an unthinkable scenario? Oh, nothing was discussed? This is a situation that unfortunately does seem to occur all too often and the dog ends up being in limbo between owners who either don’t want them or haven’t got the means or set-up to continue caring for them. The result is that said dog finds itself in a rehoming centre. Sad all round. Now, some may be baulking at the idea of a ‘puppy pre-nup’ but I think the idea has merit. We are used to thinking about our options and possible worst-case scenarios in many other aspects of our lives, including marriages, so why not take the time to really discuss and agree what would happen to Freckles the Labrador should he find himself in the middle of a messy break-up? It may be that the result of this discussion is that you both decide to get a different breed, which would be more suitable to a potentially different situation, or even, dare I say it, to opt for a cat instead, although that’s a whole other discussion. The point is that taking on a dog means to accept the responsibility for another life, much as you do when bringing a child into the world, and so you owe it to that dog to be sure about what will happen to it in the future. Unfortunately, too many people seem to just rush into the whole ‘get a puppy’ thing, caught up in the giddy excitement of the experience, without thinking long-term.
- Cost – it was interesting to note that the Radio 2 discussion did not, at any point, mention cost as a factor. This was surprising as I would argue that for many people who end up giving up their pets, not just dogs, the cost, or rather unexpected costs, of keeping that pet represents a major factor. Owning and caring properly for a dog over the course of it’s lifetime, which on average seems to be about 12 years, costs a lot of money. That’s a fact. The figures naturally vary but some estimates place the total cost at anything up to £15k! These costs include insurance cover, food, kenneling, and of course healthcare. This is the point that I am sure I should be getting ready to become all defensive about vets and what we cost, and answer the inevitable charges of us all being “ridiculously expensive.” I can, and probably will, write a separate lengthy post on this subject, but the facts remain that providing a dog with good, lifelong healthcare is expensive. Failing to provide such care, or attempting to do it “on a budget” is often a false economy. It does always amaze, sadden and usually anger me that many people will gladly fork out hundreds of pounds on a new puppy from a breeder yet baulk at the idea of spending the same amount, or usually less, on a trip to the vets and a course of treatment. I cannot get my head around the logic. The main point, however, is that for some the costs of owning a dog become too great and they feel there are no options other than to rehome that animal, which is desperately sad.
What’s the answer?
I wish I knew as it would be a dream come true to be able to fix the problem and instantly empty the rehoming centres, with all dogs happy and secure in a suitable and loving home. I do, however, have some thoughts…
- Breeders – I agree with the gentleman interviewed on the segment about dog breeding best being done by responsible hobbyists, who are in a better position in many cases, to properly socialise their puppies and who are able to advise and cater to potential new dog owners on a local level. Socialisation is one of the key factors in any dog’s long-term health and mental stability, and of course it’s going to be difficult to do a great job at an early age in a large commercial breeding set-up. There may be exceptions, and there often are to both sides, but I think generally small scale, local breeders represent a better opportunity to get it right. In any case, the aim should be for the breeder to really discuss and educate the potential new owner on the actual suitability of their breed for that owner, as I believe they have a responsibility to both the dog they have bred and the new owner to maximise the chances of that relationship being a long and successful one. On the point of ‘local’ there is one word of warning I would offer, and that is to really question how local your breeder actually is. I personally have seen puppies who have been presented by their excited new owners for second vaccinations, and enquired as to where said cute puppy has been bred. The answer in both cases was that they were bred by a local breeder. I then looked at the accompanying vaccination card and saw that the first jabs had been given in, in these cases, Wales. Now, I do not imagine for a second that the ‘breeder’ in question was taking all of their new puppies on a four hour journey for their vaccinations, which suggests that the same puppy that the owner had assumed was bred locally has in actual fact simply been supplied by a middle-man, a dealer if you will. Is it the responsibility of the supplier to make it clear the origin of the puppy, or is up to the owner to ask the question and feel confident about exactly where their new puppy has come from? That’s difficult to know the answer to.
- Vets – we are, at the end of the day, charged with a duty of care for our patients and to ensure the safeguarding of their welfare. Should we, therefore, as a profession be doing more to educate and advise potential dog owners on choosing a dog? How do we do this, especially given that most of us only get to meet new dog owners after the event of them having actually acquired the dog? Will we be accused of meddling and sticking our noses in where and when it isn’t wanted? All valid questions and ones worth considering answers to.
- Professional bodies – there are lots of groups catering to the doggy sector, from individual breed associations to the one we probably all know, The Kennel Club. What duties do these groups have to advise and educate new dog owners over what type of breed they should consider, or even whether they should be considering a dog at all? They are in a great position to influence owner choices but the main problem at present is that many are failing to sing from the same hymn sheet, resulting in fragmented and confusing advice and information for potential new owners, who may then decide to just buy their new puppy based on cuteness after all.
Dogs are so different and it is vital to really spend time and effort in really researching options when it comes to choosing a new dog. Maybe if we all thought longer and harder before diving into the exciting and, ultimately for most, richly rewarding experience of owning a dog then there would be fewer sad cases of abandonment and more empty rehoming centres. We can and do dream.
The latest episode of Safari Vet School saw a new group of vet students arrive at the reserve, with most being more experienced than their predecessors yet just as keen to get stuck in to the fun. This week’s episode seemed to have much more of an edge to it, with the word ‘danger’ very much being the one that kept cropping up. Whether it was the ‘danger’ posed by getting too close to a protective female elephant and her calves, or the ‘danger’ posed to the Hartebeest that was very close to succumbing to the effects of hyperthermia, the new students had a lot to really keep their adrenaline levels at maximum.
The elephant experience reminded me of a story my late grandfather used to tell us, in which he came face to face with a rogue bull elephant whilst living in Kenya right out in the bush. The elephant in question had apparently been terrorising local people and it was suspected that it had something very wrong with it. My grandad was charged by it and had the terrifying and upsetting decision to make of having to kill it, in order to safeguard his own life and those of his family. As a result, we had it drilled into us from a very early age of the unpredictabilty and ‘danger’ posed by animals, even those we consider to be cute and generally harmless.
Overheating & Death as an unhappy fact of the job
The incident with the Hartebeest was a close one and it was clear that the group very nearly lost the animal to over-heating. This really drove home the fact that in spite of our best efforts, animals are ultimately complex biological systems with all of the inherent unpredictability that you’d perhaps expect but which can serve up real curve-balls on occasion. This is an important lesson to learn early on in a veterinary career as there are guaranteed to be a number of such situations throughout any vet’s working life. I had one such case on the weekend. We had a middle-aged Rottweiler transferred to us from it’s vet for ongoing fluid therapy and treatment for vomiting, weight loss and bloody diarrhoea (not the nicest of combinations). The dog was also very yellow and clearly had significant liver issues. Owners have a great way of really piling on the pressure and the owner’s parting words were that her dog “could not die.” As I say, no pressure. Further blood tests and an ultrasound scan later made it clear that the dog had serious liver problems and as such the prognosis was guarded to poor. She did, however, start to look better and more responsive after a few hours of fluid therapy, and as such we felt that we may have made a difference. Now this is where as a vet you have to be very careful as animals like this have a particularly nasty habit of perking up just before a major crisis, and that’s exactly what happened. The dog suddenly went downhill, turned pale and basically started dying in front of our eyes. Unfortunately, in spite of our very best efforts, the damage was too great and she was put to sleep. This really drove home the fact that cases can take an unexpected turn, sometimes for the better, sometimes for the worse, and that as vets one of our most important tasks is to sensibly manage owner expectations. It would have been easy at admit to reassure the owner by telling her that her dog was “going to be OK,” but that would have been misleading and caused even greater anguish to her compared to being realistic and cautious by advising a guarded prognosis. Although the dog’s owner was understandably very upset, she had been given a chance to come to terms with the fact that her pet was very ill and may well die rather than languising under false, or misguided, thoughts that everything was going to be OK. So, the thing I would say to the Safari Vet School students is that in spite of their best efforts, that particular Hartebeest on that particular day had obviously ‘decided’ that it was going to test the boundaries between life and death. Sometimes stuff just happens and you have to be prepared to accept the fallout, learn any lessons and then move on.
Watching Safari Vet School this week reminded me of those days in practice when you find yourself, for no apparent reason, completely behind with consults and as a result feeling the stress levels rise and the panic start to simmer beneath the cool, controlled exterior that one must always be seen to command whilst consulting. The students, led by mentor Steve Leonard, although by his own admission, in somewhat of a haphazard and seat-of-your-pants manner, had the task of administering first opinion veterinary healthcare to the area’s pet dogs, with apparently hundreds of animals being presented patiently by their owners, who could not really afford to provide the sort of basic veterinary care that we often take very much for granted in this country. The team conducted clinical exams, vaccinated the dogs against rabies and administered both preventative measures, such as worming, to treatments for specific problems, mostly skin issues such as mange. Many of the dogs were unused to veterinary attention and so the work was clearly hazardous, not only from the risk of being bitten, but also the risks of potentially contracting one of the plethora of conditions that the dogs were likely to have been carrying. Anyone who has ever had the misfortune of picking up mange – something I thankfully have not – will attest to how uncomfortable it is and how repeating the experience is not high on the wish list. Still, despite the challenges and eventually running low on supplies, the students all seemed to get on brilliantly and no one got bitten, which is always a bonus!
The work conducted by the team with the local community really helped drive home the importance of animals to communities, especially in impoverished parts of the world. Animals play many vital roles within society, from providing food, to powering agriculture, and, on a more social level, to providing companionship for people, and the importance to such communities of ensuring their animals remain fit and healthy is clear to see. I had the good fortune to become involved with the charity WVS (Worldwide Veterinary Service) a couple of years ago after competing in three triathlons over three months to raise money to help fund their amazing work. Their belief is in educating and thus empowering the local people to care for and safeguard their own animals’ health, rather than simply flying in, firefighting the problems and then flying out again, as is the case with a lot of charitable endeavours. They offer vets the chance to go out to various parts of the world and volunteer their expertise and time to help in much the same way that the Safari Vet School students do. Steve mentioned in the show that he was going to repeat the experience and I would suggest that he gets in touch with the WVS, who I am sure would be thrilled to benefit from his profile in supporting the work they do.
Give that man a medal
Can I say right now that vet Will should be on the South African shooting team at the Olympics because someone who is able to hit two Cheetahs running at full pelt with a dart, from a helicopter, first shot, deserves a gold medal!
Missed yet Proud
There was one part of the show this week that particularly struck me on a personal level, and that was when vet student Vicky was talking very honestly about the sadness felt due to her grandmother passing away before she was able to see her attend the course. I fully empathise with Vicky here as I longed for my grandfather, who had always been an encouraging and positive influence in my life and efforts to gain a place at vet school, to see me graduate as a vet. Unfortunately he passed away even before I had started university and was not even able to see me commence my training, something I find very sad, especially as I know how happy and proud he would have been. I am certain, Vicky, that your grandmother would have been as proud of your achievements with the Safari Vet School as I know my grandfather was of me 🙂
I had the pleasure on Sunday of being involved in an official capacity with the Pet Blood Bank, a fantastic UK charity that collects blood from volunteer dogs, with the blood then being processed into packed red cells and plasma, which is then made available to vets around the country for use in emergency situations and for major surgeries.
The organisation was fantastic with the session overseen and administered by a fantastic team from the Pet Blood Bank HQ based in Loughborough. The whole day was relaxed – for donor dogs, owners, and even vets! My role, as an official vet, was to health check the donors, including taking pre-screening blood samples, and to decide whether, in my professional opinion, the dogs could indeed go through to donate. Every dog I saw was an absolute picture of health, and so well behaved, that the entire day just seemed to whiz by in a happy, healthy blur of activity. The criteria for dogs to donate is quite strict, and rightly so, with dogs having to meet the following criteria:
- be aged between one and eight years old
- weigh more than 25kg
- have a good temperament
- never have travelled abroad
- be up to date on all vaccinations, and not have been vaccinated within the last two weeks
- be fit and healthy
- not be on any medication, other than routine flea and worm control
Before the dogs can donate they have a blood sample taken, and their packed cell volume (PCV), which is the percentage of the blood that is made up of red blood cells, and total protein (TP) are measured. If they are both within certain healthy limits then they can be cleared for donation. Every dog I saw passed with flying colours! Each dog then donates 1 unit of blood, which is equivalent to about 450ml of blood, and the actual donation stage only takes about 5-10 minutes. The great thing is that every dog then gets to tuck into some tasty food – the equivalent, I guess, of our ‘tea and biscuit’ – after their session and gets a goody bag, complete with toy, to say a huge thank you for their donation.
The great thing is that the blood that is donated goes to help vets save lives in real practice – something that as an emergency vet myself, I have been involved in first hand. Donor blood truly does save lives! The wonderful thing was that the day saw experienced, repeat donors turn up as well as dogs and owners for whom this was their very first experience, and everyone had a good time doing something worthwhile.
If you would like to find out more about the work of the Pet Blood Bank, including how to get involve yourself, then click here to visit the Pet Blood Bank website.
Its the time of year again when we see lots of coughing dogs and, as a result, lots of anxious owners. The signs of Kennel Cough, which is simply a blanket term used to describe an upper respiratory infection, are typically a dry, hacking cough, which can sound like they have something stuck in their throat and can cause such frenzied coughing as to make your dog actually vomit. Gently pinching the dog’s windpipe (trachea) can often elicit a cough and this is what vets call the ‘tracheal pinch test.’ If the infection, which is usually a mixed infection caused by a cocktail of viruses and bacteria, is mild then a low grade cough may be the only feature and they will usually recover within about 1-2 weeks. Some cases can be more severe, however, and may require antibiotics and/ or antiinflammatories. The key signs that antibiotics are required are if your dog is hacking up phlegm, or has a nasal discharge, or has a really rattling cough – the kind that you would have with a nasty chest infection.
The best way of thinking of Kennel Cough is more like the ‘Doggy Common Cold,’ and the name is really an historical reference to the fact that we tended to see more cases in kenneled dogs as a result of lots of different dogs coming together and sharing the same airspace. This is very much like the situation when students all return to university and we see outbreaks of ‘Freshers Flu.’
There are Kennel Cough vaccines, which are given up the nose by your vet, and your dog’s annual vaccination actually already provides immunity to one common respiratory virus. The nasal vaccine is not, however, 100% protective and your dog can still pick up an infection, again, due in large part to the fact that the signs are caused by lots of different infectious agents and not simply by the few that are included as part of the vaccine.
So, if your dog has recently developed a cough then maybe, just maybe, they have picked up a spot of ‘Doggy Common Cold.’