Wednesday, December 26, 2007

$50 Rule

Ti's the time of year for spending money one does not have. Little Suzy gets that laptop she wanted so badly, little Johnny gets the I-phone he insisted on having, and let's not forget the matching diamond earrings and necklace for the Mrs. With all this mass spending, some aspect of the family budget frequently has to suffer. Unfortunately, too often, the holiday gifts for little Suzy, little Johnny, and the Mrs. come at the expense of the family pet's health care.

It usually begins around early November. Patent's are brought in with various conditions that require diagnostic work-ups and treatments, and people implore me for the sake of increased holiday expenditures, to offer payment plans, treat on empirical evidence with no diagnostic work-up, give them temporary solutions to get them through the holidays to a time when they can better afford the veterinary care their pet needs, or offer less costly, even mediocre alternatives to treat a given ailment. When owners refuse to apply for or do not get accepted for Care Credit (a third party lender for medical services known to be even more lenient than credit card companies), I try to work with them the best I can, but in the end, these aforementioned approaches to medicine often lead to less than ideal results.

Since veterinary clinics are businesses that survive on the sale of services and products just like any other types of business, giving away our services and inventory is not a practical solution to people's holiday financial woes, nor is it remotely fair to burden our industry with such a demand. The solution to this problem is for pet owners to have a realistic approach to preparing for the veterinary costs that may be incurred when pets get sick or injured.

A member of the message boards of the parent site to this blog,, recently posted what sounds to me like a great solution to budget one's pet's health care needs, not just during the holidays, but for always: the $50 rule. Under the $50 rule, one should have a separate bank account where every month, $50 is deposited in the account for each pet in the home. According to said message board member, if one cannot afford $50 per month for a given animal, then one has no business adopting that animal. This member has 4 Labrador Retrievers, which means that 4 dogs X $50 per dog = $200, gets deposited in his dogs' health care account monthly. He stated that this covers all the yearly visits, preventive testing, and preventive medications, with plenty left over in the event of more financially demanding illness or injury.

Incredibly simple yet so effective, the $50 rule is a great way for a family to figure out if they can fit the financial demands of a pet into their budget. It just might be enough to ensure that families with pets do not have to choose between treatments or procedures that Fido needs, or gifts for the children.

Roger L. Welton, DVM
Founder, WebDVM

Wednesday, December 19, 2007

Holiday Tips For Your Pet's Safety

Holiday seasons statistically are the most dangerous time for pets, as is evidenced by my clinics typical inundation with all kinds of emergencies the day after Christmas. In order to help you to avoid your pet from becoming one of these statistical holiday mishaps, I have compiled a list of tips to help you avoid the most common health incidents that occur during the holidays.

1.) Do not leave your garbage cans unattended in the presence of your pet. Raw uncooked meats scraps, gizzards and other undesirable food items may be irresistible to your pet, but could lead to GI disturbance, food poisoning, and parasites. Poultry bones pose a serious danger, with their tendency to snap and splinter, making them a grave risk for gastrointestinal obstruction and perforation.

2.) Do not let one of your devious friends or relatives feed your dog alcohol. While cats typically will avoid booze, dogs seem to like it with the same enthusiasm they like milk. Their tolerance for alcohol is considerably lower than ours, making them very susceptible to intoxication, vomiting, and liver toxicity.

3.) Keep chocolates and chocolate deserts out of reach! Chocolate has a component called thiobromine, which is potentially toxic to the canine liver. Of the different kinds of chocolate, semi sweet and bakers chocolate, both essential component of brownies, chocolate chip cookies, and most other chocolate baked goods, have the highest concentration of thiobromine. If your dog eats a large quantity of chocolate or chocolate based desert or cookies (1 ounce per 10 pounds of body weight or more), then get the dog to a vet ASAP!

4.) If New Year's Eve marijuana brownies are your thing, BY ALL MEANS, keep out of reach from the dog for two reasons. As previously discussed, the chocolate component of brownies has potentially toxic thiobromine. Marijuana can lead to listlessness, loss of urinary and bowel control, excessively low heart rate, and loss of consciousness in severe cases. The combination of both thiobromine and marijuana toxicity can have devastating consequences.

5.) With the winter holiday season comes a spike in the number of household electrical cords from Christmas tree lights to window sill menorahs. Both dogs and cats have trouble resisting the temptation to gnaw on electrical cords, a behavior that can lead to severe burns in the mouth, oral tissue death, and even fatality. For this reason, keep all electrical cords out of reach, or confined to areas off limits to pets.

May you and your pets have a safe and peaceful holiday season!

Roger L. Welton, DVM
Founder, WebDVM

Friday, December 14, 2007

Michael Vick

23 months in prison camp (not maximum security) for having provided the financial means and real estate to enable absolutely vicious acts toward innocent living creatures, with atrocities that included death by electrocution, slamming, setting on fire; cruel fighting, starvation and rape boxes. Does this sentence even remotely approach the realm of justice? If these acts were perpetrated toward people, multiple life sentences in maximum security prison and/or death penalty would be in the legal discussion, not a matter of months or even years in prison camp, less with good behavior. Are the pain and suffering of dogs and other animals worth so much less than that of people, that punishment for inhumane crimes against people vs dogs should be a difference of life in max security prison or death penalty vs 23 months in prison camp??

Strictly from a veterinary standpoint, I can tell you from a physiological point of view, that dogs and people are virtually identical, complete with the same complement of nerves, sensory perception, and organs. They are also complex emotional social creatures. This means that they feel pain, hunger, neglect, and isolation no differently than we do. Despite this, however, vicious and sadistic crimes against them carry a mere fraction of the penalty when compared to crimes against people.

The saddest comment on this how this whole ordeal reflects us as a society, was evident from what I witnessed on prime time television during Monday Night Football, when the Atlanta Falcons were playing. The owner of the Atlanta Falcons and founder of Home Depot, Arthur Blank, expressed how sorry he felt for Michael Vick and where his poor choices had led him. When asked whether the Falcons would ever allow Vick to play for the Atlanta Falcons again if allowed back in the league, Blank even did not completely dismiss the possibility. The stands were full of fans that wore Michaels Vicks Jersey in support him, and teammates garnished t-shirts that said "Free Mike Vick." These athletes and thousands of fans actually felt that what he did does not deserve any jail time at all!

This tells me that people care more for their fallen hero than for the hundreds of innocent animals that were tortured, tormented, and killed in a venue that he provided, in a despicable sport that he helped finance. At a time when Arthur blank, Falcons fans, and Falcons team members should have set an example and rallied behind animal rights supporters to make the cruel, sadistic, and illegal sport of dog fighting the primary issue, they instead tried to turn the ring leader into a martyr. It is truly sickening and disheartening to know that there are so many that share my American nationality, that have such little compassion and care for the suffering of innocent lives and crimes committed against them.

Michael Vick and any other people that are capable of treating animals in the dreaded manner that those dogs were treated, are sociopaths of the worst kind. They are vicious and sadistic, posing a grave danger to society. They should be regarded and treated as such!

Roger L. Welton, DVM
Founder, WebDVM

Monday, December 10, 2007

Elevator Mishap

This is one of the those stories that seems too unbelievable to be true. My hospital's associate veterinarian admitted a small chihuahua for having a few broken teeth. The story of the events that led to the broken teeth just blew us all away!

The owner of this chihuahua lives in a multilevel retirement condominium that requires constant elevator use to get downstairs for any reason, including to walk her little dog. The chihuahua's owner uses one of those flex leashes, where the leash is coiled up in a plastic mechanism within a handle, where the owner controls the length of the leash with a button/lock mechanism. These leashes can be as long as 10-15 feet, unravelling without resistance as the dog moves foward until the owner either stops the extension by pressing the lock button, or the coil runs out of slack. For the record, I detest these kinds of leashes.

The chihuahua and her owner had entered the elevator to go up to their home and the elevator made a stop at one of the lower floors, where there was a man waiting to enter. Being the territorial ankle biter that many chihuahuas are, the chihuahua aggressively ran at the man that was still on the other side of the open elevator door. The owner did not press the lock button on the flex leash in time, so the dog was able to run out of the elevator and into the hallway. Unable to reel the dog back in, the elevator doors closed with the owner inside the elevator holding one end of the leash, and the dog on the other side of the closed elevator door still attached to the other end of the leash. From the owner's perspective, as the elevator started to go up, the leash slid to the bottom of the closed elevator door, became very taught with tension, then quickly snapped.

From the other side of the elevator door, the gentleman who had remained in the hallway for fear of the little dog that was attacking him, did not enter the elevator. After the elevator door closed and continued to go up, from his perspective, the dog still attached to its leash, began to slide up the closed elevator doors. Acting quickly and heroically despite the dog's bad intentions for him, the man ran to the dog's rescue and unsnapped the dog's collar, just nanoseconds before the end of the leash with collar, got sucked up into the elevator shaft through the tiny slit of the closed elevator doors. Had the man not acted so quickly, the dog truly would have likely been decapitated.

Thinking that her dog had indeed been decapitated, upon the owner's return, she was elated to see that the dog was not only alive, but alert and responsive, only moderately bleeding from the mouth and terrified. Ultimately, aside from a few damaged teeth that had to be removed, the chihuahua escaped the incident unharmed.

That is one lucky dog to have been saved by a man for whom the dog showed blatant aggression. I hope she learned a lesson!

Roger L. Welton, DVM
founder, WebDVM

Saturday, December 1, 2007

Bubbles, My Inspiration.

Upon assuming ownership of my current practice 3 years ago, I would have loved to immediately hire Dr. Mengering, (the doctor I purchased from), but with the financial uncertainty of a change of ownership, I feared that it would not end up financially feasible. As such, I ran the practice without the services of Dr. Mengering my first year (thankfully, this has changed and she is now a part time associate), which did not sit well with some of her regular clients, none less than a senior aged owner of a chubby little chihuahua named Bubbles.

I first met Bubbles one week after after I had taken over in December of 2004. Bubbles owner was rather blunt about her displeasure that she could no longer have her beloved Bubbles seen by her trusted veterinarian of many years, instead having to trust her dog's life with the likes of me, a 30 year old vet who was only 3 years out of vet school. I did not take it personally not only because I could understand her point of view, but also because of Bubbles medical history.

Upon thumbing through her record, I saw that Bubbles has battled and survived repeated bouts of life threatening pancreatitis, that were later finally determined to have been precipitated by and endocrine disease known as Cushings Disease. Once the treatment for Cushings was in place, her pancreatitis had stopped returning and her health was in a delicate, but effectively managed state. Having had such an extensive medical history, I could completely see why Bubbles owner had some apprehension about starting with a new vet, a young one at that.

Within a fairly short time, however, Bubbles owner began to trust me, and we gradually developed a very nice professional relationship. In fact, she was quickly becoming one of my most beloved clients, and I just adored little Bubbles. Even after Dr. Mengering's return, she comfortable to see whichever one of us was available, not hold out to be seen only on Dr. Mengering's days, as some of her regulars chose (and still choose) to do.

In year 2 of managing Bubbles health, she suddenly became very ill one day. Blood work revealed that the medication that was managing her Cushings Disease was causing her kidneys to shut down, creating the need to both hospitalize her and stop the Cushings medication. Aggressive treatment was successful and Bubbles was discharged in a few days, but I could no longer treat her Cushings disease for risk of harming her kidneys.

Over time her Cushings Disease began to take its toll on her body, and she had yet another bout of pancreatitis. We were once again able to stabilize Bubbles, and thankfully a new cutting edge Cushings Disease treatment with virtually no adverse side effects had come available, so we now once again manage her Cushings Disease.

In the next 2 years, while Bubbles' Cushings Disease has remained under control, I have had to treat Bubbles for upper GI ulcer, herniated disc in her neck, anal sacs abscesses, tooth root abscess, chronic obstructive pulmonary disease (COPD), and in every instance, she has recovered. During this heights of her illnesses, she remained sweet, affectionate, and never once resented any blood draws, catheters, or any other procedures we had to implement in her diagnostics and treatments. Her daily medication regimen was a long as a grocery list.

In my most recent visit with Bubbles, her COPD has led to secondary enlargement of her heart and the subsequent development of congestive heart disease, and once again, she had bounce back from the abyss and is doing well on yet more treatment. This little dog's courage and will to live, as well as her mother's dedication, has touched my heart in an unforgettable way. Now 12 years old and juggling so many health issues, I know that the day will come that we will lose the battle. While that will be one of the most difficult days of my career, I will always be grateful for having had the honor of taking care of Bubbles and her wonderful Mommy.

Roger L. Welton, DVM
Founder, WebDVM

Tuesday, November 20, 2007

Dog With Narcolepsy!

I have never seen anything like this in my career, nor have I even learned that this disease can affect dogs. UNTIL NOW!! Click the link below:


Saturday, November 17, 2007

Another Reason To Be Wary Of Breeders

Two days ago, a dear client of mine came in a with a 4 month old pug puppy they had just purchased. The purpose of the visit was to administer the final round of vaccines, but also to check a "protrusion" coming out of the vagina that was giving the puppy discomfort every time she sat. Under the breeder's care, the puppy had only had one puppy vaccine at the age of 11 weeks (puppy vaccines should be started at 6 weeks, then boostered again at 9 and 12 weeks), and came with no state health certificate for sale signed by a veterinarian, a legal requirement to sell any animal in Florida. Both of these facts concerned me from the beginning of this visit.

Upon examination, I was fairly certain that the "protrusion" from the vaginal cavity was actually a small penis, meaning that the puppy was born with mixed male and female reproductive organs, a condition known as hermaphroditism. I explained to the owner that the puppy would need to have an imaging contrast study to ascertain the exact location and path of the urethra and lower urinary tract, before it can be decided whether I could perform the surgical correction, or whether this needed to be in the hands of a specialist. I also informed the owners that altering the patient could be tricky, as the puppy could have ovaries, testes, or both, and only abdominal exploratory surgery would reveal this.

The owners were already attached to this puppy, but they were concerned about making the financial commitment necessary to repair the puppy's deformity; a puppy that had been in their lives for less than 24 hours. I attempted to quell their concerns by telling them about the Florida State puppy lemon law, which states that if within 14 days of purchase, a veterinarian deems that a puppy if sick or has one or congenital deformities, the owners are entitled to return the puppy for a full refund, or be compensated for medical fees up to and including the price of the animal. Many breeders will try to worm their way out of this responsibility, but I thought that this breeder would likely capitulate knowing that he had already broken the law once by not having a health certificate for the puppy he sold.

The next day, the owners of the puppy called me very upset that the breeder had informed them that he was not going to provide them with a refund, that they were misinformed about both the lemon law and health certificate requirement. He told them that the puppy was theirs for better or for worse. What's more, when they called the vet where the puppy had received her one and only vaccine, they informed the owners that they had denied dispensing a health certificate on the grounds of her deformity! This fact confirmed that this breeder knowingly and purposefully sold this puppy with a deformity.

I decided that I would call the breeder myself on behalf of the owners. Often, once a breeder knows that an owner has the full backing and support of a licensed veterinarian to pursue legal satisfaction, they change their tune. I reached the breeder's voice mail and left him a message stating that he had already broken the law once by selling a puppy without a state health certificate, and he is breaking yet a second time by not observing the lemon law. As such, I informed him that I will offer the owners my full support and testimony for any legal action they take against him in this matter, if he does not concede and do the right thing.

The breeder called me back in a short period of time and started yelling a string of profanities, meanwhile threatening that he was going to use my message to have my license taken away. To this I laughed and told him how funny the state board will find it when an unethical and unlawful business man approaches them demanding that a they revoke the license of a veterinarian with a flawless record in 7 years of practice - all on the grounds of my attempt to help my clients uphold the law and preserve their rights. To this he became hostile and said,"Yeah? How about I just come down to your place and smack you like a little female dog [he used a different word for this]?" At that, I told him the conversation was over and hung up.

I called the owners back shortly thereafter and informed them that they were unfortunately dealing with, not only an unethical and unlawful breeder, but a sociopath as well. Interestingly enough, the owners told me that the breeder had already called them back with a completely different demeanor, offering his apologies and a full refund that they can put toward having the puppy's deformity fixed. I guess despite all of his hostility, I must have made an impression.

These owners and their puppy have potentially a tough road ahead of them in getting this puppy right, but at least they have the financial relief that was rightfully theirs, to offset the financial burden that the puppy's treatment could end up costing them. I offer this story so that the public is aware of the caliber of people they could end up dealing with, even when partaking in an activity as innocent as buying a puppy. Always beware of people like the breeder in this story.

Tuesday, November 13, 2007

Who's Smarter, Dogs or Cats??

On 11/9/07, I introduced a Web Poll on our parent website, WebDVM 's home page, polling visitors about which species they feel is smarter, dogs or cats, a debate that has been going on for as long as these two species have been domesticated.

The dogs are smarter camp argue that dogs must be smarter because they answer to their names, come when they are called, and learn obedience and tricks so much more readily than cats. In addition, many fetch, hunt with their owners, and catch Frisbees.

The cats are smarter camp argue that cats are smarter because they generally do not follow, come when they are good and ready to and not on their owner's whim, since they are independently minded and more capable of making their own decisions; not having the need to "follow the leader." In addition, they are incredibly efficient self groomers, and use their front paws almost like hands at times.

At the time of the writing of this blog, there were 60 voters. 70% voted in favor of dogs being the smarter species, with 30% favoring cats as the more intelligent species. So who is right?

The answer to which species is smarter is unequivocally dogs. Dogs are descended from pack animals (wolves) that exhibit complex social behavior. Their existence is not one of equality, but one of hierarchy, starting with the alpha leader, and going all the way down to the lowly omega. This pecking order is essential to survival, enabling packs to formulate sophisticated hunting strategies, and feeding and mating order. Human society in a more highly evolved sense similarly oriented, with social order maintained by hierarchy in government, military, business, clubs and sports.

Dogs readily obey and do their master's bidding because in most cases, dogs view the owner as the alpha leader, being the one that provides food, obedience, and usually are of a physically larger stature. It is inherent in their pack nature to follow and obey their "superiors." Coming when they are called and responding to training are not signs of an animal that lacks the ability to think for itself, but reflect an intelligent intention to respond and react acutely to the signs and signals of its leader.

Cats, on the other hand are by their nature solitary animals, that do not depend on one another for survival, a sign of lower intelligence when compared to pack animals. They do not have the mental capacity to coordinate hunting strategy with others of their kind, nor are they able to create complex social interaction. Feline hunting is performed alone, with the cat operating more on instinct than premeditated planning.

Cats are very stress driven animals, constantly responding in a "fight or flight" manner to even non-threatening environmental stimulus. That is why they are often regarded as cautious and and sneaky. Stress driven existence is not only observable but is also seen quantitatively. On routine blood work, cats commonly have increased blood sugar and increased white blood cell counts though they are not sick. These are considered normal phenomena brought on by the stress of the visit, known respectively as stress induced hyperglycemia, and stress induced neutrophilia. This fight or flight first mentality is another sign of lower intelligence.

So there you have it, the debate answered from an objective, evolutionary, and scientifically based point of view. However, although they may not be generally as intelligent and subsequently social as dogs, cats often transcend their intrinsic nature. Many cats live harmoniously in multiple cat households, are very affectionate to owners and to one another, learn their names, and even come when they are called. Some, can even be taught to do tricks. It does not take pack evolved intelligence to make a loving, fun, and interesting pet!

Roger L. Welton, DVM
Founder, WebDVM

Friday, November 9, 2007

Good People: they do exist!

As in most other professions, in veterinary medicine, we are often exposed to some of the worst examples of the human race. It is not uncommon to hear statements like, "if this [treatment of the pet] is going to cost me more than 50 bucks, I'll just take her home and shoot her." Meanwhile, people of this ilk may drive a huge $60,000 diesel pick up truck, and/or wreak of alcohol. Obviously there is money available for the truck and the booze, but none to get treatment for the loyal companion who never asked to be owned by such scum.

Then we get home to see political scandals, violent religious fanatics, con artists, and gang violence on the news to further contribute to our overall disillusionment with humanity. Sometimes it is enough to make one feel as if it is pointless to try to infuse good into society by making the world better and safer for animals, by not only treating their illnesses and preventing disease, but also by changing the hearts of those who are ignorant to the fact that animals feel pain, cold, and hunger, no differently than we do. Why bother? Doesn't life prove time and again that people are inherently bad, perhaps that it is actually the minority, not the majority of people that have a conscience, that have the ability to act selflessly, and that want to make meaningful positive contributions to society?

While some of my colleagues may have occasion to despair when having the unfortunate circumstance of crossing paths with less than honorable people, I do not. To be sure, it saddens and frustrates me to have interactions with people who possess little compassion or exhibit lack of moral values, but it is experiences like the one I had today that sustain me through these times, reminding me that there are great people in the world.

A new client came in today with a feral cat that she had been feeding for a few days since she recently moved here. She and her husband moved here because her mother and mother in law are both quite elderly and stricken with dementia, and she refused to put them in homes. Here, she was able to find a large enough parcel of land where she could have a house for she and her husband, and also have room to have a separate cottage built for the mother and in law to live in - all this while having access to an Alzheimer's resource center and support group in the area. She had retired early to care for these ladies full time.

She had planned to take in the feral once she had her house settled, but she found the kitty flat out in her garden this morning, unable to move or walk. When the kitty was brought in, she was poorly responsive, and after a thorough examination it was evident that the kitty had experienced a significant trauma, perhaps a fall, hit by car, or kicked by person. After we determined that there were no serious internal or external injuries, we administered symptomatic care which perked the kitty up, and were able to discharged her.

This person who had just met this cat, did not refuse one diagnostic or treatment, and happily paid her bill without even blinking an eye. She also intends to keep the kitty as her pet and assume all responsibility for her. The owner was especially grateful that the visit did not take as long as anticipated, so she could get back to check on "the girls." She could not have been more sweet and personable.

I so enjoyed my interaction with this new client that I felt compelled to blog about it this week, as a reminder those that may have occasion to lack faith in the human race. While you have every right and reason to feel the way you do, just remember that this lady and others like her exist.

Thursday, November 1, 2007

Halloween is not just for kids!

One of my favorite aspects of Halloween is seeing the dogs (and sometimes cats), dressed in costumes. The best one I saw this year was a golden retriever dressed up as Shrek! Unfortunately, as fun as the doggy and kitty costumes are for us, I have yet to see a dog or cat actually enjoy its costume, but instead observe tolerance at best. It is almost comical as we humans laugh and so enjoy the pet costumes, while in costume, our pets look at us as if we were either insane, sadists, or both for making them where the get-ups we put them in.

That being said, as long as the costumes are not painful or overly restrictive in any way, I see nothing wrong with our furry little friends sacrificing a few hours sporting unwanted garments in exchange for the great photos and memories it will provide their owners indefinitely. It sure makes Halloween that much more enjoyable for my family!

Thanks for the sacrifice Bernie, Lulu, and Bear! Seeing you in your costumes was priceless!

Thursday, October 25, 2007

Good Medicine Is Not Negotiable

Veterinary medicine is a business to be sure. Just like any other businesses, veterinary hospitals need a healthy bottom line in order to afford payroll, inventory, mortgages, and all the other expenses that maintaining a hospital incurs. Unlike other businesses, however, veterinary medicine is held to a higher ethical standard that is predicated upon establishing the best quality diagnostics and treatments to help patients.

Despite this standard, some pet owners try to treat veterinary hospitals as other businesses, calling clinic to clinic to find the cheapest rate for a surgery for their pets. Sometimes when we offer our price, they will tell us that a clinic down the road offers it for less as if we are going to be so desperate for their business that we will agree to match the price. Other times, they will take the itemized estimate we give them for a given procedure, and ask about moving forward with the procedure, but omitting certain services - sometimes even pain management injections, intra-operative cardiac monitors - in order to save on cost. Still others will even low ball our estimate, as if we were haggling over a car.

In order to appease these types of clients, some vet hospitals play into this and offer their services at a lower cost by cutting corners. One less pain injection here, a cheaper lower quality anesthetic there, omit a little of this, then a little of that, and there you have it, a procedure that costs less. The patient may have a stormier, more painful, perhaps even more dangerous recovery, but that procedure will be cheaper. My hospital is not one of these types..

I will not compromise my level of medicine by cutting what I deem essential top of the line anesthetics, pain management medications, and vital sign monitoring equipment. At the same time, I do not have any obligation to give away valuable services and medications to clients that do not want to pay for them. I would rather not perform a given procedure rather than perform it with one hand tied behind my back under these circumstances.

Some of my peers think that my stance is too rigid, and that I sacrifice revenue by refusing to compromise the gold standard. My answer to that is that I would rather not have those that value a bargain in higher regard than good medicine and what is best for their pet. I prefer a smaller client base comprised of people that not only accept my standard, but enjoy that I offer only the best for their pets and nothing less.

A few weeks ago, a client brought a pitbull in that had a tumor on the bottom jaw that I deemed should be surgically removed ASAP. My technician gave her the estimate for the procedure, and after that, we did not hear from her for a while. This week, the client finally made the appointment to have the procedure performed. She told me that the delay was that she had gone to another vet hospital to see if it would be cheaper to have it done there. When she received her estimate, she had found that it was 30% cheaper than our estimate. A human anesthesia nurse herself, my client told me that her decision as to where to have the procedure performed was an easy one. Where the other hospital's estimate would have indeed saved money, it did not include what she deemed essential items that were present on our estimate: an anti-inflammatory pain injection to complement a narcotic pain injection, a fentanyl patch (a morphine derivative pain patch) to go home, and 7 days of oral anti-inflammatory medication to go home.

Now, one may think, "Well, this client was an anesthesia nurse that understood what everything on the estimate means. Maybe the people that go with the lower cost procedures just don't understand that lower cost often sacrifices quality." My rebuttal to this would be that the client is never just handed an estimate for a procedure. As the client receives the estimate, a technician fully explains each item line by line. We even advise the client that if considering other estimates, that lower cost may mean that some of the important services and medications may not be included.

I would take one client of the mind of the anesthesia nurse over any number of those who value bargain over good medicine.

To pet owners: always keep in mind that, just as in all other industries, in medicine, you get what you pay for.

Roger L. Welton, DVM
Founder, WebDVM

Friday, October 5, 2007

The Dirty Truth About Online Pet Med Companies

Several months ago, our drug rep for Merial, a very prominent animal health care pharmaceutical, was in my hospital giving the staff a learning seminar about their flea and tick product, Frontline. What prompted Rob to come in educate the staff about Frontline, was the fact that I had mentioned to him on one of his visits that I was seeing an increased number of patients that were having flea and tick troubles despite having Frontline applied as directed.

The first premise that he discussed is that the first question that we should ask the client when Frontline fails, is where he or she is purchasing the product. The reason Rob brought this up is that Merial does not sell to online pharmacies, but deal only directly with veterinarians. Since they refuse to stock these pharmacies, the pet medications they sell must come from overseas.

These overseas products do not undergo the scrutiny of the USDA as a result lack quality control. This leads to products that are not what they claim to be, and are even found to be outright counterfeits. Merial is legally powerless to stop this, since apparently our government does not care about the health of its citizens' pets (overseas prescription medication is expressly forbidden in human medicine). As a result, Merial, as well as many other animal health pharmaceuticals, refuse to guarantee the safety and effectiveness of their medications and preventives that are purchased online.

Frontline is an excellent product with a great reputation, and for it to fail is unusual and usually because the pets' environment is heavily saturated with fleas and/or ticks. As my staff and I began to examine cases of failure of Frontline effectiveness, we found the a large percentage of Frontline failures were from Frontline that was purchased from online pharmacies.

Once we came to this realization, we became concerned about how potentially dangerous it would be for for a patient to be on an ineffective or counterfeit heartoworm preventive, especially here in Florida where the disease is so prevalent. In the three years that I have practiced in Florida, there have been a handful of cases where dogs have gotten heartworm disease despite being on a reputable brand name preventive. I can only wonder if any of these cases were the result of patients being treated with preventive purchased from online pharmacies. I certainly plan to keep track of this in such future cases.

As a result of all this, I found a company called vetcentric that has set up an online pharmacy for my hospital (Maybeck Animal Hospital VetStore). Pet medication pharmaceuticals readily sell to Vetcentric, since they represent animal clinics directly. Not having to pay inventory costs to offer the items, I can offer the pet meds at a discounted price, often competitive with online pharmacies. Also, the clients still get the benefit of home delivery, but the product they recieve comes from the USA based manufacturers, complete with the manufacturer guarantee of safety and effectiveness.

Roger L. Welton, DVM

Thursday, September 27, 2007

"Her Daddy Done Got To Her"

Recently, on a day that I was bogged down with appointments, a client came in and asked the receptionist how much it would cost to pregnancy check her one year old American Bull Dog. As the receptionist was giving her the price for a pregnancy ultrasound, I was coming up to reception to get a file and over heard her say, "We really want to know because her daddy done got to her." despite my time constraints with rooms full of clients and pets, I paused immediately and told her that the preg check needs to be performed ASAP since, if the dog was indeed pregnant, the pregnancy would need to be terminated, a process that is performed by hormonal injection, and most effective and safe for the female the earlier it is done.

The woman proceeded to give me a bewildered look, and then it hit me quickly that she had PLANNED THE BREEDING AND ACTUALLY WANTED THE PUPPIES! I then asked her, "Mam, did you actually want for this to happen?" "Yes," she answered. I replied,"Mam, are you not aware of the dangers of inbreeding related dogs? Even cousins have a high potential to have genetic diseases. With father and daughter, the likelihood is exceptionally high that the puppies will be not be health overall, have behvarioravl problems, and not live healthy lives. "

She answered, "well, I was told that it was okay in dogs." I replied, "you need to be careful who you take your advice from, because whoever told you this either has a complete lack of ethics, is grossly misinformed, or both. It is no more safe for dogs to inbreed like this than it is for people. In addition, your dog is way too young to have been bred. Many genetically inherited diseases do not appear until 2 years of age, so breeding a dog before this age even to a dog that is of no familial relation, means that you could be unknowingly be passing these diseases to future generations." I then recommended she visit the Breeder Page of WebDVM so she can get an idea of what responsible and ethical breeding entails. I also told her that she needs to make an appointment for a preg check and pregnancy termination in the event that the dog is pregnant, ASAP. She said would do both, walked out the door, and we never heard from her again.

By now those puppies likely have been born, and many poor unsuspecting people just wanting to adopt a pure bred American Bull dog, have likely paid a lot of money for dogs that have a high likelihood of having many different possible genetic diseases, aggressive temperaments, and have a low likelihood of living long, healthy lives. The people that buy these puppies think that they must be getting good quality puppies because they are not from a pet store, and they are AKC registered. They have no idea that ignorant and/or unscrupulous breeders can be every bit as bad as pet stores. They also do not realize that AKC registration is meaningless. All one has to do to get puppies registered with the AKC is to simply state that the puppies are a certain breed and send their check, period.

Now, this is an extreme case of breeder ignorance for certain. However, while many breeders are not this misinformed or unscrupulous, the vast majority of breeders are not doing what is necessary to give the highest probability that puppies will be free of genetic disease and strengthen, rather than weaken, a given breed as a whole. Later in life, when dogs are afflicted with genetic diseases such as skin allergies, skeletal disorders, cardiac disorders, and cancer, among many more, they often aim their blame at the vets who charge for their services to manage these problems, rather than the breeders that created them. Always remember that a large percentage of sickness that is seen in veterinary practice is the result of genetic aberrations created by bad breeding.

To be fair, it is usually not the fault of the pet owners whose only mistake was trusting that these breeders were breeding ethically and responsibly. Therefore, until there is government implemented regulation of animal breeding, be certain to educate yourselves and others in the market for a new puppy. Never forget that it requires no degree, training, or licensing whatsoever to call oneself a breeder. As such, never assume that a breeder has even a remote clue of what they are talking about, and use the WebDVM Breeder Page as a guide to help you weed out backyard breeders from good, ethically based, responsible breeders.

Roger L. Welton, DVM

Tuesday, September 11, 2007

WebDVM's Maiden Blog

Hello Pet Lovers Around the world! Although not quite yet complete, the WebDVM already has a substantial web presence that we could not hide from the major search engines. Believe me, I am not complaining. It is very encouraging that pet lovers around the world are already making use of our site with it still yet to be finished, as well as with our organization having yet to promote the WebDVM at all. However, since we are already experiencing a lot of hits on the site, I decided to write my inaugural blog a bit sooner than expected, as a courtesy to the good people that are already frequenting the site with regularity.

While the core pages are all completed at this point, the one daunting task that remains is to complete the drafting of all of the disease article pages that represent all the pertinent disease links that make up both the "Diseases A-Z" and "Symptom Checker" pages. However, it is easy to tell which disease articles are complete on either page, as the ones that are complete are clearly linked to their respective articles, whereas the ones that are incomplete are clearly not linked. If you find our database lacking at this point, I invite you check back regularly, as we are working very hard to complete the disease articles, linking between 2-10 disease article pages per day, making our estimated finish time between 2 - 4 weeks from the date of this blog.

So one may ask, why my colleagues and I have decided to launch the WebDVM. The answer for me started in 2002 when I created as a veterinary question and answer pay site both for fun, as well as to generate some extra income. While the income was certainly helpful, what I found the most exciting about my new Internet venture was the global correspondence my site achieved, with consultations coming from all over the US, as well as the entire world, from places as far away a Singapore.

Later in 2004, when I incorporated my veterinary advice service into my new veterinary hospital's website, at the same time I also spun off a free pet health chat forum, which quickly swelled to over 1000 worldwide members in less than a year's time. I just found it so overwhelmingly gratifying that from this modest little venue, animal enthusiasts all over the world could correspond with one another, meanwhile utilizing my hospital web site's modestly sized health article database to learn from.

Well, early in 2007, it occurred to me that if my modest little hospital website and pet chat forum could bring so many people from different countries and from all walks of life together with the common purpose of bettering the lives of animals, imagine what a mega portal like WebDVM could achieve. The WebDVM's mission is to provide more news and information for more pet loving people for an ever growing global online community on a scale never before seen in the animal care industry.

We hope your enjoyment and benefit for WebDVM matches our passion for it!