Rappie

The practice I work in does 'standard' vaccinations for the puppy series (one <12weeks and one >12 weeks), then starts the triannual vaccination schedule at the first adult vaccination (approx 15-16 months). Unless people specifically request annual C3, we use the 3 year vaccine for all adult dogs, alternative years are BB / PI and C2i (we have seen a few cases of leptospirosis in our region). The alternate years are cheaper and we will modify vaccination schedules on request. We haven't had anyone request a titre test specifically but we have run several on dogs with immune mediated conditions that are still undergoing treatment. Haven't found prices as cheap as mentioned on here but we are investigating. Vaccinations are important but we prefer to focus on the "wellness" check ups with vaccinations as incidental and have plenty of other things to keep us busy. It's easy to become resistant to change and I think the veterinary profession are facing some new challenges - some practices will step up, some will continue to play it safe until more information is available. I think it's time for pet owners to inform themselves and go in search of quality care

Only a quick reply as I have to be at work in...er...8 hours I have treated pancreatitis both ways for various reasons. Over the last few years it's generally accepted to maintain fluid support and begin feeding small low fat meals once there has been no vomiting for 24 hours (so long as the feeding does not make the dog worse). I have found that with a more aggressive approach to pain relief and supportive care that dog recover better when they are fed early. The previous thinking was to keep them on fluids and wait until the amylase and lipase levels were normal before feeding, but recent research has shown that not all lipase is pancreatic in origin (so the CPLi test was very exciting) thus treating the 'numbers' was not always for the benefit of the patient.

Glad things are going well for you Westiemum

Dealing with the animals is the easy bit, as long as you get someone else to hold the bitey end.

A 'normal' consultation consists of obtaining a history, doing a physical examination of the pet, relaying findings of that examination to the owner then developing a plan. Mostly the plan consists of options A, B or C which are discussed with owner and then they make a decision about how they wish to proceed. Then there is a time where most people ask questions to clarify anything they are not sure about, including cost. Any treatments that require the dog so stay in hospital should also require the owner to sign a consent form - which bears a written estimate of the expected cost. There are sometimes additional unexpected costs - if you're not willing for these to be incurred then you need to make your finite $$ limit known before hand. This is all information that is frequently relayed to vets through their relevant states registration board. If your vets don't do this, then don't complain about the entire profession - find someone who offers services in a way you are happy with.

I gather from reading this forum that most good vets are equipped with crystal balls and x-ray fingers.

Or treating to cover most of the differential diagnoses. It's better to cover bases for treating a burn if that is a possibility. I don't think we can draw any conclusions.

The only animal that would require 40ml of Clavulox injection in one sitting is a cow. Seeing as how it's not registered in large animals (except for the 500mg tablets being approved for use in calves) I doubt that Danois' dog received more than 6mls and that would have been at the "high" dose rate. It comes in multidose vials.

Or a short course for a very large dog! What you decided to do is what I will often offer to owners where there is some reason that the first 24 hours of treatment might be difficult - particularly cats with large abscesses on their head or gastrointestinal problems. I see it as offering options for lower stress and effective treatment, but I know many people fee its just money sucking. Nevertheless, it's only an option.

The dog didn't receive 10ml of Clavulox. Also the tablets come in 50mg, 250mg and 500mg. The number of tablets suggests it was either a short course for a dog 20-30kg using 250mg tablets or a longer course for a similarly sized dog using 500mg tabs. The bigger tabs are comparatively more expensive, but some vets with hearts will dispense the larger tablets to be given as fractions of tablets (1/2 or 3/4) because it's more economical. (Edit: Some clients also complain about having to break tablets) The price of the injection will be made up of an injection fee and the cost of the drug. In my local area the injection fee run between $13 and $17. Clavulox (as in product manufactured by Pfizer) is not a generic and is more expensive than other products. The injection also covers the first 24 hours of treatment.

I would be suspicious of either licking due to anxiety (changes in social situation or dynamics etc) or something causing an inflammatory reaction (environmental allergens, contact reactions to plants / chemical / plastic food bowls etc). The other common cause of licking is nausea but generally I would expect to see some other systemic signs that this was the case. As others have mentioned, continued licking may be secondary to inflammation and possibly pain If there is severe inflammation it may require antibiotics and anti-inflammatory medications as well.

I didn't realise I needed to justify myself by the number of times I squeeze anal sacs per day. I'll take your tissues and raise you a free squirt of dog cologne. I referred to the royal 'we', the profession. Not me, I'm guilty as anyone for letting little things slide.

Please note that this is not a comment specific to this case: The few incidents that I am (personally) aware of burns sustained during a surgery are usually not during recovery, but in smaller animals who have advertently got a wet back (from surgical prep solutions) while in a cradle and then spent a period of time lying on top of a heated mat, rather than the use of a hot water bottle. The wet patch in contact with reasonably direct heat over a period of time can cause a fair bit of heat. As I said, I am NOT commenting specifically on this situation, only the cases that I have seen (thankfully few).

Why does the 'validity' of the actual % markup have anything to do with you as a consumer? The markup will vary between practices just as the overheads will, and just as the quality of care and service will. Some people are prepared to pay a higher price for excellent service and best practice veterinary medicine and some are not. If you want the cheapest prices, then go to the practice that offers that. I see this a lot on the forums when people compare the cost of desexing - a spey is not just a spey, and it's worthwhile asking exactly what is included. A lot of the time an 'appropriate fee' is just code for the smallest number that one finds acceptable, and has no actual reflection on what service is actually provided. There is no point comparing the cost of human medicines from pharmacies and the same drug sold through veterinary practices as often the cost price to the clinic is higher than the retail cost from the pharmacy. It comes down to whether you want the treatment NOW with professional advice and ongoing care or whether you would really rather wait and traipse around the countryside to save a few $$. I find that most of our good clients choose the former. As for inflating bills for difficult clients, I think you've misinterpreted. As a profession, we tend to get ourselves in trouble by being very generous with our time and by trying to be 'nice' we frequently don't charge for all the services provided. It's not adding unnecessary things to the bills, that is unethical. It's more that we might let occasional charge slide for excellent clients as a matter of goodwill, like the umpteenth recheck for a chronic medical problem, or the free anal gland squeeze because you asked nicely.

Nothing has changed there Prescriptions for human drugs should only be made where there is no veterinary equivalent and where their use is well accepted in veterinary medicine. A lot of those drugs I will dispense to patients in small quantities, but I wont write a prescription for them to be bought from the chemist. Prime example of this is drugs such as tramadol and diazepam. You also wont find me writing a prescription for Mobic (meloxicam) any time soon. It's not worth my registration.

Most of the premium brands have a satisfaction guarantee which means that you can return the unused portion to the place of purchase for a refund. This applies to brands like Hills, Royal Canin and Eukanuba, not sure about the others but it might be worth an enquiry if it's really not helping. It usually applies even to dogs that don't like the taste of the food.

You would just need to start an oral heartworm preventative when the heartworm injection would be due to be repeated (so 12 months after the initial injection was given).

Different dogs will respond to different drugs. Propalin works well in most cases, but I have had dogs respond better to Incurin and Stilboestrol. Stilboestrol is an older treatment and certainly has the potential to cause problems but they are very unlikely at the commonly use dose rates of 1mg per dog once or twice a week. The oestrogen-based treatments can cause bone marrow suppression but this is a problem reported in humans and would require a much higher dose than is normally encountered in veterinary medicine - this specific problem was discussed at the WSAVA conference in 2007. Incurin is the mid-point - similar mode of action to Stilboestrol with a better safety profile. As a note - pseudoephidrine works on the same receptor type as Propalin so it unlikely to have any success over it. I have heard of a few cases where the Suprelorin implant has been used with some success also.

Good stuff ;)

I would suggest that you have a read of this website: http://www.heartwormsociety.org/ Stormie has just posted standard information regarding the duration of action of ivermectin and the reasons for the dosing interval. The is a lot of misinformation and misinterpreted scientific information to be found on the net - I would really strongly suggest that people discuss health care issues with their vet.

I'm sorry to hear that Colliewood In terms of drug reactions, it is possible for an individual to have any kind of idiosyncratic reaction that can't be predicted. Any type of organ failure or dysfunction may alter the way a particular drug is metabolised but cephalexin is usually quite well tolerated. In an older dog with an acute onset of neurological signs and change in mentation I would consider the possibility of a 'stroke' or another underlying disease process. It's very hard to make comment without any other knowledge of the case.

The daily tablets contain a completely different active ingredient to the monthly treatments. The risk lies in the daily administration, even a lapse of 2-3 days is sufficient to allow infection of a dog with heartworm. Additionally any dog that hasn't been on heartworm prevention MUST be tested prior to starting daily DEC treatment.

I would be hesitant to recommend that. Some product have a '3 month reachback' but this is more a reflection of the fact that they kill larval stages of the worms and not adults. Given that the time for development of microfilariae into adult worms is 2-3 months, it seems odd to recommend a treatment interval longer than the life cycle. This leaves you at risk of developing adult worms in the heart... I would recommend following the standard treatment intervals - however which product you choose is entirely up to you and what suits you best. Daily DEC is effective but it MUST be given EVERY day - if you can't do this each and every day then it is not the treatment for you. Missing one day of treatment potentially leaves your dog at risk.

The most common sides effects to cephalexin are gastrointestinal - so inappetance, lethargy, vomiting and diarrhoea. If any of these occur and you feel they are related to the medication let your vet know so they can substitute another antibiotic. Cephalexin brings me out in hives - not pretty :rolleyes:

We have been starting our 'new' arthritis patients on Zydex and any patients that were midway through Cartrophen courses continue to get that. Anecdotally, I've found that more dogs are responding very well to Zydex than responded very well to Cartrophen / Pentosan. Usually I found that about 70-80% of dog responded well to the others, and it was often a positive response seen towards the end of the course. Our pricing is very similar between the products, so it's not a marketing issue. It IS the same ingredient but I feel there may be a difference in response to this particular formulation. Then again, maybe not :rolleyes: