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Do vets charge too much for bitch spays?

As part of my work as a “media vet”, I’m a strong advocate for spaying and neutering pets as the best way to control the problem of pet overpopulation. Accidental pregnancies still account for a high number of unwanted puppies and kittens, and routine spaying/neutering of young adult pets is the best way to prevent these. This doesn’t meant that every pet needs to be spayed/neutered when young (there are some good reasons to delay or even not to do the operation for some individual animals), but it does mean that every pet owner should at least discuss the options with their vet around the time of puberty.

Why do people refuse to have their pets spayed?

People have a variety of reasons for not having the operations done on their pets, and the cost is a major factor. In a recent social media discussion, the following comment came in.

“Vets should reduce their fee to £120 for a female dog. A lot of people genuinely just can’t afford it.”

Why don’t vets reduce their fees?

This is a good point. Why don’t vets reduce the price of spaying?…

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Elizabethan Collars – a necessary evil?

One of my clients was talking about his recently neutered bitch today. “She needs one of those Victorian Buckets” he said. I knew what he was talking about, but his terminology was not quite correct. The problem was that his bitch had been licking her operation wound, and he wanted to stop her. The item he was describing is an important tool to assist the healing of animals’ wounds. It is more correctly called an ‘Elizabethan Collar’, because it resembles the white starched lace collars that Queen Elizabeth I and her subjects used to wear….

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Pet food: what does the label tell you, and how much does it matter to your pet?

Do you ever wonder what actually goes into pet food? Everyone with a pet has to provide food for them every day, but most of us are unaware of the background to what we are feeding. That’s not to say that we don’t care about it: pet food manufacturers know that we want to do the best for our pets, so labelling and packaging tends to give a sense of wholesome ingredients and tastiness. But what’s going on behind the scenes?

There’s an anti-corporate trend in the modern online world, with an underlying emotion of distrust in big companies. While this may sometimes be justified, the truth is that most companies are just bigger versions of small businesses, doing their best to provide products and services in an efficient, effective way. Pet food companies are no different: while some pet owners may dislike the idea of mass produced pet food, it’s still the method that most pet owners use to feed their pets, and for the most part, it works very well. Pet food production is regulated by law to ensure that it’s safe and nutritious. Recent research showed that 70% of owners and 85% of vets agreed that commercially prepared pet food provides optimum nutrition. Almost 60% of owners and 95% vets would go as far as to say pets are living longer as a result of advanced nutrition. Of course there are individual animals that have special nutritional needs, just as some humans do. But for most pets, commercial pet food does a good job.

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Vets are now doctors (in a strictly veterinary sense, that is….)

Did you know that your vet is now a doctor? The Royal College of Veterinary Surgeons  has just changed the rules. Vets are not obliged to call themselves “Doctor”, but we now have the option to do so, if we wish.

Traditionally, vets were called “Mr”: the logic was that as “veterinary surgeons”, we fell into the same (slightly superior) category of medical personnel as medical consultant surgeons, who were also “Mr”. Dentists (dental surgeons) were also called “Mr” for the same reason.

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Euthanasia – one vets opinion.

People often tell me that they think putting pets to sleep must be the worst part of my job but in many ways, it is one of the easiest. Yes it is sad, letting a beloved animal go, but in the majority of cases we are doing it for very good reasons; releasing them from a life that has become more about pain and suffering than the joy it should be.

A couple of years ago it was time to put our family labrador to sleep. Molly had reached the grand old age of 14 and had been struggling with arthritis for many years. Although her mind was still willing, her body had let her down and no amount of drugs would help her to be able to walk again.

What was interesting was my mother’s attitude. She is a GP and admitted that in her job death can be seen as a failure, rather than a release. She agreed with my decision but it was a totally different mind set to the one she was used to.

When patients come towards the end of their lives, in many ways the decisions that doctors and vets take are very similar, it is just that vets have an extra option; euthanasia….

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Ebola seems to be dwindling, but look out: Avian Flu is back!

Just as the news headlines about Ebola have dampened down from boiling to a quiet simmer, Avian Flu has leapt back into the news. The Telegraph headline today sums up the media reporting: “Bird flu strain which can be passed to humans detected in Holland”. Meanwhile, even closer to home, the BBC reports that a case of bird flu has been confirmed at a duck breeding farm in East Yorkshire. The ducks are being slaughtered and a 10km (6 mile) exclusion zone is in place. It all sounds as if an apocalypse along the lines of the “Contagious” movie has landed in Europe, but the truth is far less exciting. Avian Flu is a viral disease that is highly infectious between birds. This is the single fact that needs to be stressed more than anything else. It is a bird disease, and the risk to humans is minimal.

The strain of avian flu that is in the news is similar as the one which was first seen in Hong Kong in 1997, and has been appearing spasmodically ever since. That one was known as H5N1(H-five-N-one), a name that describes the type of proteins on the virus particles. The Netherlands strain is the H5N8. The strain in Yorkshire has been identified as an H5 strain but further details are not yet available. It is true that humans can be infected by such strains of the virus, but the risk of this is so small as to be almost negligible.
Hundreds of millions of birds have died because the disease spreads rapidly from bird to bird, and because authorities react to viral outbreaks by carrying out mass slaughtering of poultry flocks in an attempt to eliminate the virus. When humans have been infected, the virus has not spread from person to person. It has remained as a bird virus only, with humans only occasionally getting in the way, usually when they are working in close proximity to infected birds when they inhale viral particles. If Avian Flu reached the UK, everyone working with poultry would know to be ultra-careful about hygiene, so the risk of humans dying of bird flu would be minimal. There is no such thing as a human pandemic of bird flu.
Readers may then wonder why there seems to be a type of hysteria around Avian Flu. The reason for this is the potential for a change in the virus which could indeed lead to a human pandemic. The avian virus could mutate into a new strain of virus that is highly infectious to humans. If this happened, the new Human Flu virus would spread across the world rapidly. This is what happened in 1918, when 50 million people worldwide died in a flu pandemic and the authorities are justifiably concerned about the risk of a repeat of this.

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“Me and My Dog” – working together to eradicate rabies

Most dog owners adore their pets, and “pet selfies” are a popular way of expressing the joy of the bond between human and animal. A new campaign by a charity is using pet selfies to drive forwards an important goal: the global eradication of rabies.

The concept is simple. Take a selfie of yourself with your pet, then upload it to the charity website. When you reach the uploading page, you’ll be asked if you want to make a donation: even a couple of pounds will do. The idea is to make this a viral campaign: if enough people do this, the charity will raise a game-changing sum of money, and the goal of rabies eradication will be a step closer.
There’s an irony to the idea of “dog and owner” pictures being used to counter rabies: 99% of human cases of rabies are caused by dog bites. If it wasn’t for the close relationship between humans and dogs, rabies wouldn’t be an issue….

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The unnecessary death of the Ebola dog

Ebola virus hysteria is taking hold of the northern hemisphere. The latest victim was a cross-bred dog called Excalibur, who was euthanased by the Spanish authorities even though he showed no signs of being infected with the virus, and despite the fact that there is no evidence that dogs can transmit Ebola to humans.

The twelve year old rescued dog had the misfortune to belong to a Spanish nurse who became the first person to become infected with Ebola in Europe after nursing a Spanish missionary priest who had been repatriated from Sierra Leone to Madrid for intensive treatment. The priest died of the virus on September 25th,, and the nurse is thought to have picked up the virus after touching her face with a contaminated glove as she removed her protective suit after finishing her shift.

Excalibur was a much loved pet in perfect health, and after Madrid’s regional government obtained a court order to euthanase him, the nurse’s husband put out a call for his life to be saved. An online  petition rapidly gathered over 400000 signatures, and crowds of angry animal-loving protestors had to be restrained by police outside the apartment where the dog lived. Despite the protests, Excalibur was euthanased. The deed has been done. But was it really necessary? Did the animal present a risk, or was he just a scapegoat sacrificed to give the authorities a sense that they were doing something?

There is scanty evidence to support killing a dog in a situation like this. Bats are thought to be the natural reservoir for the Ebola virus in central Africa, carrying the virus without showing signs of illness. Monkeys and apes become infected and fall seriously ill, like humans. But despite extensive research, there’s been almost no evidence of other animals becoming infected or carrying the virus.

There is one study that casts a cloud over the innocence of dogs: researchers investigating the 2001-2002 outbreak of Ebola in Gabon found low levels of antibodies in blood samples from dogs in areas where there had been cases of Ebola in humans and apes. This confirmed that the dogs had been infected with the virus, but it was impossible to know the source of their contact: from bats, apes, or from humans? It was also not possible to determine whether the dogs could have been infectious to humans at some point. In theory, the fact that they had been infected with the virus implies that at some point they may have shed the virus in their secretions, in the same way as infected humans pass on the infection.

Some researchers believe that it would have been wiser to have kept Excalibur alive, not for sentimental reasons, but to learn more about the spread of the disease. If he had been kept in quarantine, serial blood samples could have been taken, monitoring his immune status. The question of whether or not dogs need to be included in Ebola virus control schemes could have been definitively answered in a safe environment. And if he had been clear of any sign of the virus after several months, he could have been released from quarantine to resume a normal happy doggy life.

Sorry, Excalibur: the precautionary principle and the political need for action seized the initiative: we still don’t know much about Ebola in dogs, and you’ll never enjoy another happy walk with your owners.…

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Are vets more interested in the health of their patients or the money in their pockets?

I recently wrote a blog here titled “Debunking myths about “rip off” veterinary fees”, and since then, the subject of money has continued to be one of the banes of my life as a vet in practice.

My aim in life is to do a job that I enjoy, and to be paid a reasonable salary: for most people, that just means that you go to work, do your stuff, and come home at the end of each day. For vets, it’s different: every day, as part of our job, we need to ask people to give us money. Most of us would be delighted if this discomfitting task was taken away from us, but unfortunately, it’s an unavoidable part of our job description.

One recent case provided a good example of the type of daily dilemma that faces vets. An elderly terrier, Sam, had a small benign tumour on his flank. He was fourteen years of age, and his owner had been hoping that we might be able to leave the tumour alone: it’d be better to avoid a general anaesthetic unless it was absolutely necessary. When the tumour began to ooze blood, and Sam began to lick it a lot, we couldn’t leave it any longer so he was booked in for surgery. When booking the operation, I mentioned to his owner that it would be wise to take the opportunity to clean up his teeth, which were caked in tartar. And I gave a detailed estimate of the expected costs.

We took all the usual precautions to ensure Sam’s safety. He had a detailed clinical examination and pre-anaesthetic blood tests to ensure that he had no underlying illnesses that could make an anaesthetic risky. An intravenous line was set up to give him continual fluids during the procedure and to give us instant access to a vein if any emergency treatment became necessary. And a vet nurse was designated to hold his paw and to monitor him for every second of his time under anaesthesia, from induction until he was sitting up at the end.

Everything went well: the tumour shelled out quickly and easily, and a line of sutures closed the wound. I carried out a thorough descale and polish of his teeth, as planned. But it was then that the dilemma arose: beneath the tartar covering his teeth, it turned out that two of his molar teeth had large diseased areas. The gum margins had recessed, exposing large parts of the tooth roots. One of the teeth had serious infection, causing the tooth to be loose: it was easily removed. The other molar tooth was more complicated: one root was seriously diseased, but the other two roots were healthy. The tooth needed to be extracted, but it would be a tedious, time consuming surgical extraction, taking over half an hour, and requiring follow up x-rays to ensure that it had been done properly. This would involve an extra cost to the owner of well over £100. I had already given an estimate, and I didn’t feel that I could go ahead with this without permission.

While Sam was still anaesthetised, I asked a nurse to phone his owner to explain the situation. There was no answer on the home line, and the mobile number wasn’t working. What should I do now?

If I went ahead, I’d be carrying out unauthorised work on someone’s pet. If there were any unexpected complications, the owner could hold me liable. And as for the extra cost? Could the owner justifiably refuse to pay?

The safest legal approach would be to make a note of what needed to be done, and then to inform Sam’s owner that he needed a follow up anaesthetic in a few weeks, during which we’d tackle his dental issues. But I knew that it would be far safer for Sam to have the entire procedure completed during this first anaesthetic, and I knew that his owner would be unlikely to agree to pay for a second anaesthetic on top of this first one. So Sam’s dental issues would probably not be treated, and he would suffer as a consequence.

I made an “on the hoof” decision to go ahead with the dental procedure. It took even longer than I had anticipated, and I had to take a series of x-rays rather than just one. By the end, I was happy that Sam had been given the best treatment, but I was nervous about the owner’s response. Would she think that I had done this just as a way of extracting more money from her? What if she genuinely couldn’t afford more than the estimate that I had given her?

I felt so uncomfortable about the situation that I gave a significant discount on the extra work that I had done. Effectively, I ended up working my lunch hour for nothing because I felt so awkward about it.

But what else could I have done? In the interest of the dog, I could not have left painful, diseased teeth untreated.

What would pet owners feel if the vet presented them with a situation like this? Should you pay the full amount of justifiable extra work if it is unauthorised?  Do you trust your vet? Or do you feel that we are working more for our own interests than for the benefit of your pet?


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Debunking myths about “rip off veterinary fees”

“Rip-off veterinary fees” were the subject of a recent poll on a vets-only website.
In answer to the question “How often does your practice receive complaints about the prices it charges?“, the results were:

  • All the time – 16%
  • Fairly often – 53%
  • Hardly ever – 30%
  • Never – 1%

So around 69% of vet clinics get regular complaints about their fees, and given that many people may feel irritated about fees without vocalising their concern to the vet, the true level of discontent is likely to be even higher. This is clearly an aspect of veterinary care that pet owners feel strongly about.

I always find this a difficult topic to discuss: as a vet, I can’t help feeling defensive, and it’s all too easy to write a self-justifying commentary. Sceptical readers may then brush off any of my explanations: “well, he would say that, wouldn’t he?”….

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