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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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Is your doggy going doddery? – Cognitive Dysfunction in dogs

Cognitive Dysfunction, a condition similar to Alzheimer’s, is very common in older dogs. 50% over the age of 10 year will show some sort of symptoms and this only increases with age. In the early stages these changes can be subtle and often the condition is only noticed when the pet’s behaviour becomes more severe. However, recognising and treating the condition early is vital to have the best chance of halting or even reversing the changes in the brain.

The symptoms of cognitive dysfunction will vary between individuals but can include;

Confusion or vacancy – these are often the first signs to manifest but are also the most difficult to pick up on. Affected dogs will have periods (which can initially last just a few seconds) of seeming confused or lost in familiar surroundings. In the early stages a call or command can bring them out of it but later on it can be more challenging.
Pacing or circling – again this can begin as quite a subtle problem but gradually becomes more apparent. Dogs will often move from room to room in the house, resisting all attempts to stop them or move in small circles. They can appear quite distressed during the activity, panting and wide eyed, but they won’t stop….

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Information overload? – Trusting online pet advice

From the minute you bring a new pet home, as well as the companionship, fun and general entertainment there will always be a lot of questions and there will always be plenty of people more than happy to give you their advice and opinions. From your mother (always!) to the lady down the road that’s owned dogs for years, to the man in the pet shop, to your vet (listen to them!) and, of course, the internet. However, sometimes views vary wildly and it can be difficult to know who to trust.

With any health related issue a vet should always be your first port of call; either by booking an appointment or ringing for advice. A good clinic will always be happy to chat on the phone but in many cases will want to see your pet before giving you a definitive answer. This can sometimes put people off but if you are concerned enough to ring, very often your suspicions are correct and there is a problem. However, there are many simple queries that can be handled over the phone, so do pick it up! Even at night and weekends, with a single call you should be able to speak to a vet or nurse, as in the UK all practices are required by law to provide a 24 hour service.

Sometimes though, you might have questions that are more mundane or trivial or want the answer right now and that is when you will fire up Google! However, this is when things can get tricky. There are loads of brilliant sites out there giving excellent quality advice but there is also an awful lot of old wives tails, self-important pontificators and downright bonkers information as well! How do you decide which is which and what to believe?…

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Are your cat’s kidneys crock? – The signs of kidney failure

Kidney failure is very common in cats, between 20% and 50% over the age of 15 will suffer to some degree. Unfortunately, it is often missed until it becomes advanced because the early symptoms are subtle and our feline friends are very good at hiding illness. However, the sooner it is caught the better

In most cases the cause for the kidney’s failing is unknown, it is just a gradual dying off of the tissue, particularly in elderly cats. If younger animals are diagnosed with the problem then can be a more obvious cause but it doesn’t often change the treatment plan.

The kidneys are the filtering organs for the blood. They remove all the waste products and toxins, sending them out in the urine. When they start to malfunction they become less efficient, these by-products stay in the body and, as they are effectively poisons, make the animal feel unwell and mildly nauseous. They are often mildly dehydrated, so it is not unlike a permanent hangover.

Feeling sick understandably means affected cats have poor appetites and to survive the body has to break down its own tissue. Unfortunately, this creates very high levels of toxic metabolites, which stay in the blood stream, make the cat feel worse, so they eat even less and so the vicious cycle continues. The toxins themselves also directly damage the kidneys, further exacerbating the problem….

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Ask a vet online- ‘My 10 year old dog has a lump not sure if I should take him to the vet?’

Question from:

Sheree Lu

My 10 year old dog has a lump around the size between a 10-cent/20-cent (Australian) coin. It’s round, soft to touch and when I touch it, it didn’t seem to cause him any discomfort or pain. It’s located on one of his hind flanks, on his thigh-ish area. Like if he sits down, the lump would be on the ground but it’s not near his anus. I’m not sure if I should take him to the vet..?

Answer by Shanika Winters Online vet

Hi Sheree and thanks for your question, with any lump you find on your pet I would advise that you take your dog to be seen by your vet. I will try and explain in my answer some of the possible causes for the lump and how it can be monitored, treated or removed.

Why has my dog got a small soft lump?

A small soft lump can be caused by an infection, reaction to a parasite/foreign body, swelling in response to an injury/allergy, a tumour or a combination of these.

Infection tends to lead to an area of reddened/hot (inflamed) skin, which may then swell up as it fills with fluid/puss. An infected lump would usually appear over a few days, may be painful to the touch and might burst followed by crusting over. An infected lump may be due to a skin infection, where a parasite has bitten, where a foreign body (e.g. a grass seed or thorn) has entered or is trying to exit or maybe on top of an existing lump…

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Ask a vet online-‘my cat has suddenly lost weight, she was fine a few weeks ago’

Question from Gemma Loopylou Moorey:

I has my cat suddenly lost weight I can even fill her ribs now she was fine a few weeks ago. Even her mood is changed she meows loudly when I talk to her in a bad mood way

Answer from Shanika Winters online vet:

Hi Gemma and thank you for your question regarding your cats sudden weight loss and change of temperament. I will discuss in my answer some possible cause for the changes you have noticed in your pet. I would advise that you take your cat to see your vet as soon as possible.

A sudden loss of a significant amount of weight can be very dangerous for your cat, regardless of the cause of the weight loss in the first place such changes can lead to organs failing and your cat being in need of emergency veterinary care.

An average cat weighs between 4 and 6 kg so even a change of a few 100g of weight is significant on such a small animal. Ideally your vet will weigh your cat each time they are seen; it is easy to keep track of your cat’s weight at home too, weigh your cat carrier empty and then with your cat inside and the difference is your cat’s weight…

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June bugs – stopping parasites from bugging your pets!

Hurrah, it’s June! Which means the weather is (hopefully) warming up and summer is just around the corner! However, just as we enjoy the sunny conditions, so do the bugs and beasties that live on our pets. A little forethought and treatment now, can save a whole lot of trouble (and maybe some vets bills!) in the future.


These irritating little creatures are the ones everyone thinks about as the weather warms but here’s an interesting fact; actually the worst time of year for fleas is the Autumn. Then the few fleas our pets have picked up over the summer move into our centrally heated houses and have a party. However, what that means is by protecting our pets over the summer, we not only keep them from getting itchy bites now, we can stop a house infestation later!

It can be surprisingly difficult to know if an animal has fleas….

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Ask a vet online – ‘ have taken our cat to the vet at least 4 times regarding the fact that she has lost the hair on inside of back legs’

Question from Margaret Duke:

Have taken our cat to the vet at least 4 times regarding the fact that she has lost the hair on inside of back legs. Vet thought it maybe an allergy and we stopped allowing her milk. Vet gave her tablets which made her eat [she is a very fuzzy eater] This has gone on for months and she is just the same.

Answer from Shanika Winters:

Hi Margaret, sorry to hear that your cat has been suffering with ongoing hair loss on the inside of her back legs. I will discuss possible causes for the hair loss and some treatment options.

Why has my cat lost hair on the inside of her back legs?

It is really important to have a full clinical examination of any pet suffering from hair loss by your vet to make sure that your pet is in good health, hair loss can be associated with conditions such as hormone imbalances, parasites and allergies . It is also worth being aware that hair loss can be self- inflicted as a result of stress this is often referred to as ‘over grooming’.

Could my cat have an allergy?

Yes it is possible that the hair loss could be due to an allergy causing your cat’s skin to feel uncomfortable and then it licking and chewing away the hair on the inside of its legs. Allergies can be to substances that your cat eats/drinks, breathes in or is in contact with. Most cats are fed a commercially prepared diet with few treats, but if trying to rule out a food allergy a low allergy or specific protein diet (a protein your cat has not eaten before) can be tried….

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Ask a vet online – ‘Can you suggest a home remedy for mites in dogs please?’

Question from Sharon Barett:

Hi can you suggest a home remedy for mites in dogs please? I used the spot on treatment off the vet for 3 months but it did not make any difference she still scratches it a King Charles Spaniel 5months old thank you .x

Answer from Shanika Winters MRCVS, online vet

Hi Sharon and thank you for your question regarding your itchy Cavalier King Charles Spaniel. In order to answer your question I will discuss the possible causes of the itch, how we work out a diagnosis and then some treatment options.

Why is my pet scratching/itchy?

If your pet is scratching itself then something will be causing an irritation, most commonly this is due to the presence of external parasites such as fleas ( Ctenocephalides canis or felis) or mites ( e.g. cheyletiella, sarcoptes scabeii). Itchiness can also be due to the presence of an allergy to things you pets eats (food allergy), contacts (contact allergy) or inhales (atopic allergy).

How to diagnose the itch

It is really important to work with your vet to find out the cause of your pet’s itch. The first thing your vet will do is ask for a detailed history of your pets condition including how long it has been going on, any changes to your pets routine, any changes to your household, what treatments have already been tried and if they have had any effect.

The next step is for your vet to perform a full physical examination of your pet paying extra attention to the skin and coat, underlying diseases can have symptoms that affect the skin which include Hypothyroidism( under active thyroid gland), Cushing’s disease ( over production of steroid) and diseases of the immune system….

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Ask a vet online ‘vet found a soft lump underneath one of my puppies’ – what next?

Question from Eileen Murphy

Hi I have a set of pups.all at 7wks old.took them for there vet check an she found a soft lump underneath one of the girls were her tummy is the vets said it is nothing to worry about! It is a hernia an won’t see to it unless.she gets.spayed but I am still worrying these pups.are bitchions

Answer from Shanika Winters (Online Vet)

Hi Eileen and thank you for your question regarding your puppy’s hernia, I will start by explaining what a hernia is and then discuss the treatment options.

When your puppy had her routine health check with your vet the soft lump that was felt underneath her tummy (abdomen) is what we call an umbilical hernia. A hernia is a gap or opening that should not be there. You have most likely heard of people with a hernia, this will be describing a diseased disc in their back or an area of muscle separation leading to weakness….

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