As a veterinarian I shudder when I think of clients purchasing medications such as thyroid supplementation or prescriptions to treat Addison’s Disease from a source that can not easily be traced. Such is the case when many medications are purchased over the internet. What does this mean? In the event of a drug being tainted or contaminated it may be impossible for the original manufacturer to issue a recall to the end user. In the best case scenario the drug in question is insufficiently effective for the disease for which i is targeted. However if the substance is contaminated as was the case in the following: http://en.wikipedia.org/wiki/New_England_Compounding_Center_meningitis_outbreak it could be virtually impossible to find all at risk patients. Several years ago many feline patients died from premature kidney disease from tainted food. The sole reason there were not many more deaths was the ability to track where the foods were distributed and what pets were at risk. We still see fallout from that event.

So what is the answer? There appears to be less risk with nutritional supplements, vitamins and insecticides such as Frontline and Advantage. But when it comes to prescription medications, special diets, and heartworm preventatives BUYER BEWARE!! Saving a few dollars may seriously be putting your pet at risk. Skipping one latte a week is a much safer way to conserve dollars without any inherent risk…..unless you consider owner crankiness on that day. My solution….skip the latte on a day when you sleep in. Get the critical medications from your local vet

Veterinarians provide pet and animal care as part of a business. Any negative statement made by a veterinarian regarding online pet pharmacies is seen as trying to prevent competition and to improve his or her own bottom line. But there is much more than that at stake. Is purchasing pet medication on line in the best interest of the patient? Is the medication the same in every way as what you bring home from your local animal hospital or could it be somewhat tainted? Are the online pharmacies adhering to all the legal and ethical requirements for the states in which they are doing business?

The internet pet pharmacies have been been around for a while now but the start was rocky to say the least. A quick review of this link http://en.wikipedia.org/wiki/PetMeds specifically the controversy section reveals lawsuits brought in Texas, Ohio, Florida and by company shareholders against Pet Meds. But the real concern comes from the actual sourcing of medications sold on line. While they (the pharmacies) will assert that these medications are acquired directly from the manufacturers such as Meriel (Heartguard and Frontline) and Merck (Triheart) contend that they do not sell directly to online pharmacies and therefore any medications sold on the internet arrive without their company guarantee.

So what is the reality of all of this and does it matter in the case of your own pet? If you are like most pet owners, an opportunity to save a few dollars here and there as long as it doesn’t compromise the well being of your companion is well appreciated. Does that translate to purchasing certain products on line? It certainly may. In the next post we’ll look at the instances in which it is of less risk to purchase from the internet sources and when to stick with your local vet.

A positive answer to all of the above should be prefaced by: “in a perfect world”. Reality is that most manufacturers do publish nutritional information on line but package recommendations often yield calories well in excess of what your pet needs. The equation is a simple one. Calorie requirement varies considerably depending upon the species, activity level, age and physical condition. A basic rule of thumb is that most adult cats require approximately 10-15 calories per pound per day for current maintenance and dogs need more closely to 15 calories per pound per day. Remember I said “for maintenance”. That means that a ten pound cat may need as few as 100 hundred calories daily in order to maintain their current weight. Similarly a fairly inactive 60 pound dog may only require 900 calories on a daily basis. If you think in terms of what we consume as humans these numbers are painfully low.

So what do we do if we are one of the two thirds of the pet owning population with overweight pets? Logically we can either reduce calories consumed or increase the number of calories burned. No secret here that long walks with your dog or for many owners with their cat as well as initiating periods of play indoors will help to burn calories. Ball or toy chasing, laser pointer games as well as active play with other pets either within your home or in a play group setting helps significantly. Take some time to calorie count using the manufacturer’s published data as well as phone calls to the company when necessary to figure out exactly what your pet is consuming, Keep a chart for one or two weeks of everything your pet is consuming including treats, snacks, morsels of your own food and reward treats to get a sense of exactly what he or she is eating. It will take a bit of effort to figure the calorie count for everything in the diet but it is doable. Once you have done a one or two week calorie count the real work begins. Consult with your local vet to evaluate your pet’s diet and to brainstorm how to go about increasing calorie burn while reducing calorie total. This is not rocket science. If we think in terms of counting points (Weight Watchers anyone?) your pet can only consume so many points (calories) daily. If he or she has more treats one day then something has to come off somewhere else.

If the above seems simplistic it is. But taking the time and putting in the effort can significantly increase your pet’s life expectancy as well improving the quality of that life. Make sure the entire household becomes involved in this project for in the end everyone wins……especially our four legged friends.

Let’s start by looking in the mirror. Ultimately we are our pet’s primary caretaker and are responsible for what they consume. Many pet owners have chosen a free choice method of feeding. That is ensuring that there is always food in the bowl. Many dogs and cats can handle this method of feeding without engorging. However for some, the drive to always feed when available (a holdover from when they were not domesticated) overwhelms and they will eat themselves well beyond what they need to subsist. The most common cause of obesity in pets is calorie overload from their normal maintenance food. Often in multiple pet households the competitive drive or alpha aspect of a personality may emerge and encourage additional feeding as a statement of social order. Regardless of cause pets that can not readily free feed without becoming severely overweight need to be fed in a different manner.

Often I hear this explanation: “When the kids, or my husband comes home the cat greets them and then goes to his feeding place looking for food. I thought that maybe he hadn’t been fed yet”. So of course in order to please the pet more food goes down. I have a simple solution for this problem. One person becomes in charge of feeding the pet. That person measures up the appropriate amount of food in the morning and stores it in a container in the cabinet. It can be doled out in any way the family desires but if someone returns to the house and the container is empty this is a sign that the pet has consumed his or her ration for the day and no more should be given. Then the comment “He really looks for something when I come in”. That is the time when a small treat can be given from the previously determined (and measured out) daily treat container.

How do we know what comprises the appropriate amount of food, treats or even the occasional human enticement? That should be discussed and carefully calculated by your veterinarian. A considerable emphasis is now being placed on the profession to become more informed regarding diets and nutrition. If there is not a vet at your animal hospital that is capable and willing to discuss feeding then it may be time to look further to a practice that takes more of an interest in the total picture of your pet’s health. The world of veterinary nutrition is changing dramatically. We know that the health and well being of our dogs and cats is in large part dependent on what goes into their bodies. Many diseases are treated partly or occasionally even completely with nutritional alterations. When it comes to the pet population the adage “You are what you eat” couldn’t possibly be more accurate. In the next post we will examine the roll the pet food manufacturers play in contributing to this problem and how to look past the labels.

If, however, it appears that there were cancerous cells at the margin of the surgery then the situation is more complicated. Sometimes a repeat surgery will be recommended in an attempt to remove remaining cancerous cells. If the growth is considerably invasive additional therapy may be needed in order to treat the illness. Surgery alone often is not enough to effect a cure or even a remission. In this case it is a good idea to seek out the opinion of a veterinary oncologist. There are many options available ranging from radiation therapy, chemotherapy as well as alternative and nutritional treatments. In some instances therapy is directed toward cure but in others the intent is to allow your pet to maintain a comfortable and meaningful life for as long as possible. This is referred to as palliative care. In this circumstance, there may be difficult decisions to be made and it is imperative that the family considers many factors.
While some pet owners desire to do “whatever it takes” to maximize the time left with a pet, others will take a more pragmatic approach and weigh in more heavily on the specific aspect of what they define as quality of life. These decisions are personal ones and it is incumbent to consider the emotions of all the family members. In addition to recommendations of the oncologist take some time to have an honest discussion with your local vet. If the relationship with your vet is a close one he or she may be able to add perspective with the additional knowledge of your family and/or your pet’s history. These decisions can be the most difficult ones to make in the life of a beloved pet. Try to approach these issues early in the course of the disease to prevent making irrational or emotional decisions under extreme duress.

For many of us our pets are a huge part of our lives. Having lost a canine friend to cancer almost two years ago I marvel at how much I enjoyed his last three months. I often refer to them as some of the sweetest days of his life. The approach after diagnosis was to gather as much information as possible, consult with oncologists, surgeons and veterinary friends and to engage in open and frank discussions with all family members. We chose palliative chemotherapy, Low Level Laser Therapy and nutritional support. I still smile when I think of him and especially when I consider that from the day of his surgery until the very last day of his life he never missed a meal or a walk that we all so cherished.

So what is the best way to approach the issue should your pet develop one or more tumors?  We begin the assessment with a physical exam and palpation (gentle manipulation) of the growth.  Although it is impossible to determine if a growth is malignant or benign based on feel alone certain lumps have distinctive characteristics.  This palpation also helps to provide valuable information regarding the tentative removal of the mass as to degree of difficulty and depth of involvement.  In addition to palpation, fine needle aspirate (FNA) which allows us to take a somewhat representative sample of the growth can also aid in identification of the neoplasm and to help assess the urgency of removal.  It should be stressed that FNA is not as accurate as biopsy,  a surgical procedure which requires cutting into the lump. Summarizing the steps in dealing with a growth is as follows:

1. Upon first identifying a growth have your vet examine and palpate the mass to get a general idea as far as size, invasiveness, and location.

2. Next your doctor should aspirate the growth to gain additional information as far as the likelihood of malignancy.

3. Based on the above information surgical removal should be scheduled appropriately.  What is meant by appropriately? A small growth that is in a favorable location may still warrant immediate removal if it has characteristics suggestive of cancer.  Similarly a large yet likely benign tumor (one can never be sure until biopsy) may require urgent surgical attention if it is growing in an area that is likely to interfere with walking or laying down such as in an armpit.  Some growths although large can safely be delayed if they appear to be benign and are not immediately causing problems.  If your pet has several growths and you are not able to remove all at once, a similar priority should be assigned in an effort to avoid cancerous growths spreading as well as to avoid benign growths from becoming problematic.

In the next post we’ll cover some other supportive procedures that should be considered in dealing with tumors.

What we have discovered in the insurance arena exceeded our wildest suppositions.  Medical insurance has moved light years from where it had been when we last explored the benefits.  Plans are now available to cover up to 90% of costs associated with illness as well as wellness plans to help those concerned about being able to provide their pets with some of the basic care.  Perhaps the most encouraging aspect of this search has been the response of representatives we have talked to in an attempt to read ‘ between the lines’ of some of the policies.  It should be noted here that our calls were not prefaced with the fact we were reviewing health care companies with the intent to post online with recommendations. We merely cold called to clarify some aspects of certain policies.  It seems as, at least for now, the pet medical insurance companies are actually concerned with the well being of their clients and their pets.  Several companies actually offer a free trial with no charge coverage for the first 15- 30 days.  But to ensure that the “uh oh” phrase  pre-existing condition doesn’t crop up when you are looking to your company to cover an episode, have a thorough physical and history performed by your vet AS SOON AS you initiate coverage.

So who is the winner in the end?  We are.  The pet owners.  We now have, within our grasps, the ability to prevent finances from ever forcing us into a decision about whether our pet receives the recommended care. Petplan USA, Trupanion, and Purina Care all appear to pass our muster.  It behooves the pet owner to check out each one and evaluate which best suits your needs..  From our perspective you can’t go wrong with any one of them. It might take a little time for you to research but hopefully we have made it a bit easier.  You owe that much to your special companion (s).

A few of the more interesting aspects of Petplan’s Gold Policy are coverage for boarding kennel fees if you are hospitalized, a “life insurance” policy which pays up to $1000 in the event of your pet’s death of accident or illness, and trip cancellation insurance which pays up to $1000 in fees lost by you if you need to return from your vacation prematurely due to a serious illness to your dog or cat.

Coverage for previously mentioned orthopedic conditions, namely anterior cruciate ligament injury and patellar luxation are well covered providing they are not preexisting conditions.  In conversing with claims representatives at Petplan it seems that the intent is to be fair with the client and to be willing to discuss the occasional “gray” area of coverage…such as dental cleanings.  Although prophylactic dental cleanings are not normally covered, if there is any evidence of even mild periodontal disease as diagnosed by your veterinarian, the cleaning is considered therapeutic for an existing disease condition.

Petplan, an active pet health insurer in other countries intends to be a major player here in the US.  In reviewing the various levels of coverage, I was impressed with their offerings and some of the minor, yet appreciated perks.  Though previously unfamiliar with this company it appears that Petplan should be on your short list when contemplating health insurance for your pet.  In the next and final post on pet health insurance we will summarize our findings and make a few key recommendations in attaining medical insurance for the feline and canine members of your family,

Comparing closely with Trupanion, Purinacare offers an 80% unscheduled coverage with optional deductions ranging from $100-$1000.  While Trupanion offers a 90% coverage policy with optional deductibles Purinacare does offer wellness care which Trupanion does not.  By purchasing the wellness plan as well as the the medical plan, dental cleanings are a covered item.  Since Trupanion does not offer this same option, extractions and dental care resulting from disease conditions are covered but not routine cleaning.  Since an integral part of wellness care in pets is exemplary dental prophylaxis this option by Purinacare is of considerable importance.

Both Purina and Trupanion reimburse for laser therapy (Trupanion as long as you have the complementary care option) as long as it is performed in a clinical setting.  In our practice Low Level Laser Therapy and dentistry have become of hugely important so either of these plans would satisfy most of the needs of our clients.

Another area that we reviewed critically is orthopedics, particularly Cranial or Anterior Cruciate Ligament injuries (ACL or CrCL). This condition as well as Luxating Patellae occur with some regularity in veterinary practice both in dogs and cats.  Both plans appear to cover these conditions as long as they are not preexisting.  The wait time for knee surgery with Puricare is two weeks a very reasonable length of time to allow coverage.

As with all the pet health insurance plans we surveyed, preexisting conditions are not covered. Both Purina and Trupanion appear reasonable in determining what is covered in most instances.  Obviously it is difficult to note all scenarios that could happen and it pays to be an informed and vigilant consumer.  Given the nature of veterinary care Purinacare with the Preventative Care plan would be an excellent choice for those looking for wellness and major medical as would Trupanion with Complementary Care option with the 90% coverage for those for whom wellness care is not a coverage priority.

The last pet health insurance we will look at is Petplan Pet Insurance, an provider in the UK for thirty five years who have now entered the US market.

Trupanion’s core plan is a 90 % coverage plan with a choice of deductibles.  This means that they will pay 90% of incurred expenses of most care after you pay the exam fee and the deductible that you choose.  By always requiring the client to be responsible for the initial exam or consultation fee, Trupanion calculates that they can avoid having to pay “frivolous” visits thereby preserving resources for more serious veterinary care.  Trupanion also boasts no maximum dollar amount for covered conditions.  Given the rapid progress in the sophistication of veterinary care this can be useful in the unfortunate event that your pet suffers a bout with cancer which can demand costly care.

One aspect of this coverage that is unusual is the coverage for dental extractions but not dental cleaning.  When contacted  a representative from Trupanion explained that dental cleaning is more akin to routine or wellness care.  Extractions, however, are more indicative of disease.  They will cover the cost of x rays to evaluate whether teeth need to be extracted even in the event that no extractions are performed.  Trupanion will also pay a pro rated part of the anesthesia expense since sedation is required in order to take acceptable x rays.

Trupanion appears to be a good value in the veterinary medical care insurance business.  Although the premiums are a bit higher than the VPI plan, coverage seems to be more than worth the difference in price.  The clarity of how the plan works should also be appreciated by pet owners who like to stay well informed.