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Oregonian and Pharmacies

 Pet Talk: Oregon veterinarians concerned about prescription errors at retail, online pharmacies

By Monique Balas, Special to The Oregonian

….One of the most common errors veterinarians report is a change in dose for a drug called Levothyroxine, used to treat hypothyroidism, says Dr. Becky Marks of Timberland Animal Clinic.

Dogs metabolize the drug very differently and require a much higher dose than humans. A pharmacist might assume that the dose is incorrect and change it without checking.

“I’m always thrilled when I have one call me,” notes Marks, who has more concerns with online pharmacies renewing expired prescriptions… read  on.

http://www.oregonlive.com/pets/index.ssf/2013/01/pet_talk_oregon_veterinarians.html

vet prescriptions

Some veterinarians are concerned about mistakes made at retail and online pharmacies which they say are jeopardizing the health of their patients.
Courtesy of the Oregon Veterinary Medical Association

 

 

 


High Cost for Pet Care

Are you puzzled by the high cost of pet care? Do you think that your veterinary services are more expensive than they should be? Listen to what this veterinarian has to say.

siamese kitten

Dr. Marks and kitten

“I graduated 24 years ago from veterinary school. I had  school debts and poor excuse for a car and very little hopes of owning a house for quite awhile. My husband, also a veterinarian had graduated a couple of years before me. His school debts were even higher than mine and he lived with his parents until I graduated so that he could decrease the bills. He had a job when he graduated but it was 350  miles  away. His starting salary was 18K.  But we figured it would all be worth it some day.”

In the 90′s veterinarians could still make a decent living. Starting salaries were now about 28K. The goal was to gain experience working for other clinics and start your own clinic some day. We would have never been able to start a clinic if it had not been for a wonderful retiring DVM who was willing to sell us equipment at a bargain . In addition my parents generously gave us some money to get started and cover our expenses until the business could start paying for itself. I don’t mind telling you that first year was  a tough one. The second year  a little better and by the fifth year we could breath a little easier that our income was predicatable, that we had a loyal client base and that we could even start raising a family.  The latter was a sacrifice that many professionals face. Clients never realized all the sacrifices that we made.By the second millenium we were feeling rather secure. Happy and fulfilled. And I was saving lives!!!My gosh, I was living the dream of taking care of companion pets and making them better!

Then September 11th,  a day our country and our economy will never forget.  A tailspin of terror. Our world changed.  My world changed. Businesses began to change. Veterinary businesses began to change. All for the worse. A trust was lost as people began to lookout for themselves.’ Where can I get the cheapest medication or the cheapest surgery’ they asked.  Identifying with your DVM was now a second option, getting a bargain was first. I saw on-line pharmacies that boot-leg products become profit centers from animals that had been our every day customers. And price was the first comment that came out a clients mouth. We had worked so hard, had the best of surgery skills and now were expected to charge next to nothing if we wanted to keep our clients. If you adopted your pet from the Humane Society the spay/neuter reembursement to the DVM was laughable. We saw the first veterinary clinics close their doors due to the economy. We had never seen that before.

Ten years down the road the conditions have not improved. Many businesses have closed their doors.Specialists have closed their doors.  Veterinary care has shifted and been peeled from our hands. Pets are spayed (mostly by undergraduate veterinary students) at a pediatric age before even being released from the Humane Society. At 8 weeks of age the kitten/puppy is spayed, vaccinated and so overly stressed that  when we see them for the “complimentary”exam we have to explain why the pet  is seriously ill with a respiratory infection and needs hospital care.  So, routine surgeries are not that routine. Sick animals are really sick. People wait days to consider treatment because they had hoped the pet might get better on his own. And they may consider euthanasia rather than treatment. Franchises run by CEO ‘s  who don’t speak pet care are trying to dominate the field. I never expected our profession to faulter.

I am well trained and able to treat the full spectrum of diseases but people just don’t take care of their pets as they did 10-15 years ago. I still have to keep excellent equipment, a pharmacy and staff for all occassions. I have to run  a tight ship. For example:  Fewer items on the pharmacy shelf, fewer diets, fewer concurrent staff members and cut back where I can.Overhead costs go up, clientelle make fewer visits and pets get less care. Income is not on an incline. People just don’t have the discretionary income to take good care of their pets.

What about new DVM’s? How do they fair in all this? Well, over 40% of new DVM graduates will not get  a job, they owe 6 times in debt what I did (average 150k) and there are more graduates than ever. Why? Because the veterinary school numbers and class sized have increased. The universities are feeling the numbers crunch, too. So they are willing to take the tuition from students even though they know the field is supersaturated. If a graduate does get a position their starting salary is 40-45K and they will generally work for a franchise. I am so sad for our profession. Mc Donalds for Pets!

In 2013 their is a new excise tax on equipment. Any medical equipment not released specifically for Veterinary industry will have a tax added on. Much of our equipment is human compatible. However, this new rule affects the Veternary practice owner in a negative way. The number of veterinary- only companies can have a little monopoly. Prices won’t be going down at any rate.

So, is it all worth it? From the standpoint of saving lives? Surely. I wonder  though if the benefits have out weighed the declines I have seen. If petcare could be brought back to the veterinary professionals it would make all the difference. What can you do? As a pet owner give the best care you can to your pet (see  http://www.timbervet.com/economy-for-your-pet/ ) , show loyalty to the professionals who have devoted their lives to your pets and keep the spending local. Your Veterinarian will always be happy to give your pet the best of care.


Best Pet Foods

The best pet foods are difficult to identify . Here are  a few tips. The food should be identified for the stage of life. For example growth ( kitten, puppy) , adult,  less active ( overweight) and seniors. These are all non-prescription diets available in vet clinics, pet stores and supermarkets. There is no such diet that is “for all stages of life” . Go right now and check the bag of food for your pet. If you see this–don’t buy it again. Sorry Dick Van Patton… and numerous others. These diets may have inviting ingredients and may be “organic” ( more on this next post) but there is no food for a puppy and a senior . NO go. all stages of lifecat all stages of life

I prefer the first 2 ingredients to have meat and or poultry and the 3rd ingredient will likely be a grain. Many have corn as the second ingredient and that can still be a great food (unless your pet is allergic to corn). But more an more the price of corn increases so you will see soy or other protein grains. Barley is unique and wonderful.

The next will be ingredients to complete the balance of protein, fiber and carbohydrates. Often the fiber comes from beets, carrots, beans etc. These are vegetables that are healthful and in the wild many canines would eat them. Then follows, additive such as glucoseamines,  preservatives, vitamins and minerals. The preservatives have improved so much over the years because they more natural, eg , marigold extract, green tea extract, lycopene, rosemary extract, preserved with natural mixed tocopherols and citric acid. Not bad, right?

 

The food should always state that it meets the AAFCO guidelines–these are the minimum requirements for pet food standards. However, this doesn’t give complete comfort. I worked in the pet food industry in quality assurance and I didn’t feel very “assured”.  Sometimes the meat was brought in on a freezer truck that had no refrigeration, I checked the temperature of the raw product and turned the truckers away… the meat was nearly putrified. But they would leave, get the coolant back on board, return on the next shift and it would be accepted. It met the “requirements”. So,  minimum is not saying much.

You could produce pet food and market it. I could buy it and not really know if you had balanced it to meet my kittens requirements. It frankly is quite is easy. Not on a large scale. But you could do it. Science Diet, Royal Canin, Purina or ask your veterinarian or animal nutritionist for advice. Do not rely on a cashier in the pet store for help. They would rarely have any training.

Next post=organic and raw diets.


Economy for your Pet

The economic times are hard for you, we know that. Unfortunately, that means hard times for you pets, too. So what can you do to alleviate some of the pet care stress?

Start with an physical exam. Pet care is best approached by prevention.  While paying for an exam when your 5 year old dog may seem unnecessary  you may be thwarting off a problem in early stages that prevents worse problems down the road.  For example, simply having your DVM evaluate your pet’s weight may help you transition to that weight loss program that you have been ignoring. Obesity occurs in 20% of animals and leads to diabetes,  hip and heart issues. Or perhaps the habitual  cat halitosis may be as simple  as some home care steps. Maybe learning how to clean your dog’s ears will bring awareness of what healthy ears look like versus mild redness and swelling which can escalate to serious disease. Maybe your 14 year old cat lost a lot of weight. This can be a big indicator of other problems and the weight would not have been noticed at home.

If you think your cat is chewing the food differently maybe it is a bad tooth. Guess what?; our clinic does free dental exams.  The hardest part is making the phone call.

You might consider pet insurance. While their is a monthly fee you are going to be way ahead if there is a medical or surgical issue that you would not be able to afford otherwise. Check out Trupanion for your first 30 days free.


Ear Problems?

Diagnosing Ear Problems

Ear problems

Ear problems are complicated

The appointment arrives. This is a Labrador that has a big problem. The right ear is blown up like a little balloon.  It happened overnight. “Is it a tumor” the owner queries?

I have the patient in the room . This is a dog that has had no history of ear problems before. She is 3 years old and has had some big changes since her exam a year ago. The ear indeed looks like a little pillow but in fact it is a pocket with the ear flap of blood, a hematoma. The ear canals are both dry, odorous and have excessive gray waxy debris. The ears look “old” so to speak .

The diagnosis begins by performing the exam. Since the ears are an extension of the skin , often there are other dermatologic (skin) issues. Facial rubbing, red lips, feet licking, scooting the itchy anus, chronic infections are all examples of allergies or food reactions.  A sample of the ear debris is examined under the microscope for evaluation of possible bacteria, yeast, mites , blood, and other cells.This dog had a mixture of 3 types of bacteria and some yeast. Skin samples may need to be exampled. In this case the lab had signs of feet licking but actual lesions.

The ear treatment in this case is 3 fold. 1. First the ear “pillow” will require a surgery to correct the blood pocket. Through the years many quick fixes have been tried but there is still only one treatment. Surgically open the ear, remove the clot and sew multiple sutures (stitches) in a series of somewhat random locations which appear like an old fashioned ticked mattress.  The animal has to be anesthetized for this procedure. 2.The ear canal is thoroughly examined and lavaged.  Aural antibiotics, oral antibiotics and some choice of medication for the underlying allergy component ( cortisone, antihistamines, cyclosporine) and 3. the hopeful identification of the allergan. Most often it is food which can be identified by the doctor’s experience.

The owner mentioned the dog has been on the same food for 2 years. That doesn’t make a difference. Allergies generally don’t reveal themselves until the dog is 3 years or older. I believe this is in-line with the end of their full growth and time for  the immune system to start deciding “what it likes and doesn’t like” on a repeated basis.

The surgery heals in about 3 weeks. The infection is resolved in about 3 weeks. The response to a new food can take up to 4 months. This dog has a great chance for managing the allergy as long as the owner is willing to stay with  the appropriate diet.


Giardia Infection

Monkey Faced Giardia
           By Becky E. Marks, D.V.M.monkey eyes

Recently, the Brown Family went for a hike in the Mountains. What a pleasure to get out of the city for awhile to enjoy nature:  fresh air, sunshine and pure stream water.  Within 48 hours they all had diarrhea including Dudley their pet dog.

The Browns and Dudley had been infected with Giardia.  In the early 70′s and 80′s Giardia had been “the most common infectious disease reported to the health departments”.  It is a protozoa that is found in streams and stagnant water and stools containing Giardia.  A common way to acquire Giardia is from a water supply where beavers have defecated upstream.  Any warm blooded mammal or bird can be infected.

When animals present to us (dogs more so than cats) they have usually had a profound diarrhea and a decrease in appetite.  Often the pet owner can identify when the problem began.  However some animals may have a more gradual disease with on and off diarrhea, vomiting, flatulence and weight loss.  In these cases the owner is not able to pinpoint when the problem started.  (Many people think these symptoms are from feeding cheap food.)  Either way the small bowel disease is serious because it can spread to other animal including pet owners.  This is by definition a zoonotic disease. 

In order to diagnose the problem samples of stool must be examined microscopically or via an enzyme test.  The bacterial flora should be examined microscopically, too.  Humorously, one form of the tiny protozoa looks like a monkey face under the microscope.  There they sit with “big eyes” looking back at you. The treatment may range from antibiotics and a temporary bland diet change to hospitalization and fluids.  It depends on the severity of the symptoms. The treatment for the protozoa is conventionally a specific antibiotic. However, no treatment is 100% effective.  Retreatment or alternative  treatments are needed and negative stools to confirm elimination.  If an animal carries the Giardia but does not appear sick then he will be a silent carrier and continue to spread the disease.  The yard and any areas where stools have been left should be thoroughly cleaned.  This may include shutting down the Koi pond or cleaning the bird bath because they are stagnant water sources primed for growth of Giardia.  Avoid letting your dog drink from puddles. 

Currently, the vaccine  for Giardia is no longer available because the demand was low.  The vaccine was safe and    effective.  The goal is to decrease the spread of what is now the most common waterborne infection.  If the Browns go hiking again they will carry their own water. Dudley is protected by the vaccine.


Report a Problem > How to Report a Pet Food Complaint

Report a Problem > How to Report a Pet Food Complaint.


Heartworm Testing your Pet

Heartworm Disease
Heartworm transmission

 

Heartworm Disease is alive and well in Oregon. After the Hurricane Katrina event (2005) many dogs were transferred into the State of Oregon . Those that were screened through public channels (Oregon Humane Society, veterinary clinic)were treated. However, many were just brought into a friend or family’s home as goodwill until the New Orleans residents could get back on their feet.  So, we do not really know the current statistics. Our clinic had 2 dogs that tested positive at that time. All it takes is 1 positive dog and 1 mosquito and the disease can be passed on. Have your dog tested today.You need to know. It is a simple blood test and simple preventative.

If you dog becomes infected the microscopic larvae called microfilaria begin to molt from one stage to the next. Within several months they become a mature worm ranging from 8-11 inches long . While the tiny microfilaria begin in the capillaries of the bloodstream they ultimately need the spacious rooms of the heart chambers.  Here they begin the severe  damage to the heart valves which interferes with normal heart function.  The dog will begin to show signs of deterioration such as exercise intolerance, coughing, lethargy, poor hair coat, decreased appetite, belly distension and failing effects on the other organs ( kidney , liver and lung).  It may be a year after infection before these signs are noticeable to pet owners. Diagnosis is a simple screening test .  In Oregon this may not be the first test your veterinarian would choose to run because the disease is not commonly seen here. In the majority of the United States this test would more routinely be run. The good news is the disease can be treated.  The medication contains arsenic injections and and follow-up insecticide. The bad news is the treatment is difficult on the body and the dog requires rest and gentle home care. After treatment the dog would be put on common once monthly  oral preventative.

Clients often ask about Heartworm infection in cats. Testing is important and if most often included in the basic screening test for kittens. however, prevention is no commonly recommended. The infection is rare and infection generally causes minimal damage compared to the canine counterparts.


Whole Food Vitamins vs Synthetic Vitamins

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Dog and Cat ID Microchipping | HomeAgain Pet Microchip

Why Microchip?– It’s the StandardHow an Chip is Implanted

Microchipping your pet has become the standard. You can always have the assurance that your pet is identified.  What if you home caught on fire or you had a break in? Your pet would try to escape. You need help relocating your pet. Remember a ID tag on the collar is still important.  A Home Again Chip is permanent.  And for international travel it is a requirement.

Dog and cat microchipping is a simple procedure. A veterinarian simply injects a microchip for pets, about the size of a grain of rice (12mm), beneath the surface of your pets skin between the shoulder blades. The process is similar to a routine shot, takes only a few seconds, and your pet will not react any more than he would to a vaccination. No anesthetic is required.

A HomeAgain microchip is permanent pet ID. The microchip itself has no internal energy source, so it will last the life of your pet. It is read by passing a microchip scanner over the pets shoulder blades. The scanner emits a low radio frequency that provides the power necessary to transmit the microchips unique cat or dog ID code and positively identify the pet.

HomeAgain is the only dog & cat microchipping product on the market today that has the Bio-Bond patented anti-migration feature to help ensure that the microchip will stay in place so that it may be easily located and scanned. If your pet gets lost and is taken to an animal shelter or veterinarian, they will scan the microchip to read its unique dog or cat ID code. This is the number used by HomeAgain to identify the pet and retrieve your contact information, which is used to contact you and reunite you with your pet.

via Dog and Cat ID Microchipping | HomeAgain Pet Microchip.