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Is Your Veterinarian Being Honest w/You--ABC News


Kris L. Christine
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There is not a one size fits all vaccine protocol. I worry about the people recommending stopping vaccines after the puppy/kitten series. At the very least do titers.

 

This - and this -

 

 

Titers are still not fully understood and should not been viewed as hard evidence of immunity. Dogs with low titers can be immune while those with high titers might get sick.

 

Thanks for your reply about the dogs you referred to earlier.

 

I would personally rather play safe and have my dogs vaccinated more often than they might need in case they fall outside the predicted immunity picture.

 

Vaccine damage isn't a big topic of conversation amongst my many dog owning friends, which it would be if it were as common as some people claim. Adverse reaction has never been an issue for my dogs.

 

It costs less than a titre test anyway and, as you say, they aren't conclusive.

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If I'm going to err, I'd rather give an unneeded vaccination than lose a dog to disease. I try to be reasonable for my dogs, myself, and our situation. Rabies as required, a multi-shot no more than every three years for adults and as my vet recommends for pups, and lepto 4-way annually. And I reserve the responsibility to change *my* protocol if I feel I should for the sake of the dogs.

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But one person's view of what is redundant/unnecessary may not be the same as another's. Those in your second category aren't a homogeneous group either.

That is true, but the point is those of us in this group are not anti-vaccine -- we vaccinate our own dogs, just not as often for distemper, hepatitis & parvo as most pet owners do; however we do vaccinate to prevent the core diseases.

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On 11/25/2013 at 9:30 PM, Liz P said:

A blog entry with the other perspective. Very timely after my day. Three cases of terminal cancer and a DOA (also cancer).

 

Hey, Liz. So sorry you had such a hard day yesterday.

 

I do hope that neither you nor anyone else feel that I am/was bashing vets. I have great respect for vets and I do understand how difficult a job it can be, especially dealing with clueless people who want to take their pain and frustration out on the vet. I may (or may not) have mentioned earlier in this thread that one of my dearest friends (of 30 years) is a vet whom I've worked for and helped in her clinic many times when she was in a pinch, so I've seen first hand many of the things that the vet in this blog speaks of.

 

So, yes, despite my enumerating several examples of some really awful encounters I've had with vets, I don't believe that they're indicative of the whole profession. Nor, as many of them as there have been (all in one geographical area, so maybe there's something in the water here), have they constituted all or even most of the encounters I've had with vets. Most have been honest, caring and understanding people.

 

But to bring it back to the original issue of honesty among veterinarians, I still think it's important for all of us to recognize that vets, like people in any other walk of life, are human beings and some can fall prey to various foibles such as greed, laziness, arrogance, etc. So it's up to us to be as informed as possible and not to take everything they tell us at face value with complete and utter, unquestioning faith. It's not an all or nothing proposition. Like anything else, there's the good and the bad and it's up to us to know the difference.

 

There are, sadly, many professions such as veterinary medicine (and teachers and child care providers among others) who are grossly underpaid in relation to others in often, imo, less "important" fields. And so it might be understandable that some vets might push vaccinations and tests that aren't really necessary to help push the balance sheets in their favor. And frankly, I think some of the practice management firms are a lot to blame. (I also used to work for a chiropractor whose practice management firm was pushing all sorts of crazy ideas at him.) But none of this makes it right.

 

So, yeah, I'm very, very grateful for the very excellent and compassionate vets I know. But that won't stop me from being leery of the others who don't fall into that category.

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That is true, but the point is those of us in this group are not anti-vaccine -- we vaccinate our own dogs, just not as often for distemper, hepatitis & parvo as most pet owners do; however we do vaccinate to prevent the core diseases.

 

And this is a very important distinction, especially since vaccination itself is not without risk.

 

I want my dogs to be protected from these diseases, so, yes, I vaccinate.

 

But I also don't want to put my dogs at risk from vaccine related adverse reactions or long term effects, so I do it judiciously.

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Disclaimer: I did not see the show.

 

But I hate the topic. I grew up in a culture where everything is left up to professionals. You best be certified out of the bum and one does not question the experts. Over the years I learned more than I care to recount. Unfortunately, most of my understanding about veterinary needs resulted out of one kind of chaos or another. Fortunately though, thanks to some wonderful vets (and there is a long list so I count myself very lucky), many of those experiences did end up in education with mostly wonderful outcomes.

 

But I am at an age now where I see vets coming out of school half of my age. Both of my best friends are vets.

 

One believes that you vaccinate to the hilt, use as many artificial and meds as available and eat and feeds her own dogs the dreaded SienceDiet. She is a wonderful, warm and caring owner and a person that came to those beliefs as someone that went to vet school at an advanced age and is driven by her own life experiences.

 

The other is a bit younger, took the traditional vet education route and is quite open to any and all alternative methods that work. Believes in titers and has dedicated her life to passing her knowledge on.

 

So as their friend and client it can get a bit confusing. But I do know one thing for sure...they both are heart broken and often angry when fatal conditions could have been avoided by a simple vaccine. And often some of these conditions are fatal because the owners can not afford (both practice in more or less rural communities where money is often an issue as is education) to save the pup that just came down with parvo or distemper.

 

And yes, I get that there are groups that believe and vaccinate as needed rather than at will. I fall under that group as well. Although, I had to learn and educate myself about that as well. And to me, this is where a lot of damage is done with accusing vets to not tell you the truth! People are so afraid of getting screwed by someone they perceive as being a big money maker, that it is too easy to not dig deeper. That is why I hate these headlines and discussions.

 

Now, I have seen a bunch of young vets that are either unable or unwilling to do anything without a barrage of tests! That is what they are taught at school now. Partially also because of liability issues. Heaven forbid a vet misses something a test could have revealed. Clients ability, understanding and personal responsibility are a huge issue as well. I ended up at Banfield a few weeks ago. Hated the techs and folks there. But it was an emergency. The vet working the case was super. He was clear, advised us what was going on, and offered alternatives. Even stayed for two hours after closing! But he also understood what our perspective was and advised us of the pro's and con's, knowing we got it and were willing to go on without ever holding him responsible.

 

On the flip side I remember walking into an emergency clinic years ago with a pup that showed definite signs of parvo. But I had a feeling it could not be. They never triaged, made it very clear that the dog with the minor bleeding gums was a priority and were absolutely unwilling to administer anything without a ton of tests. Only with my vets help via phone, I was able to coax them into giving me 3 estimates (it took 3 hours!!!!) and finally treating the symptoms (3 hours of vomiting and bloody discharge by the way in a nasty box in the back of the room) and letting me go home. I walked out of there with an anti nausea shot, two doses of meds, a tiny bag of fluids, an administration set and a $680 bill. Pup never did test positive for parvo (got to my own vet on Easter Sunday) and was fine after two days. Now, I don't totally blame them but I also can't help but wonder just how over diagnosed some things are.

 

Truth of the matter for me is...if I had unlimited resources I would never question all of the available tests, titers etc. But that is not the case. So often I have to be about prevention. About having viable options and would love to know without a doubt that the vet I chose will be of the caliber that I put my hope and faith in, they are.

 

My own dogs have been vaccinated without fail every year with the combo shots. This year will be different. I will split the shots. I will do lepto separate and will check with my vet what other I should maintain. One of the reasons is that I am not rescueing out of shelters anymore. Having had the exposure to parvo, distemper, kc and others on a regular basis, I am happy to say that none of my own dogs ever got anything else but a tiny bout of kc.And I do credit the vaccines.

 

And one final thing, I live right on a county line. 3 counties meet right here. So anytime I get into my car and go anywhere with my dogs, I will be in another county. One of them, which is Harris, accepts the 3 year rabies protocol best I could find out. Talking to our animal control officers, my county as well as one other, do not accept it. So what is my choice? Even the vets really don't have one. The vets, according to them and my friend that I consulted, can not recommend a 3 year protocol as it may put them at risk should a dog come down with rabies. And around here, it still runs rampant.

 

So to finish this novel, I am still not sure what the best course of action is. I have to make a choice somehow and pray it is the right one. Oh, and the one time I (unbeknown to me actually) "followed" a less is better protocol, right when they took Lepto out of some vaccines about 15 years or so back) I lost a pup to it. It was avoidable. I have had to argue about the supposedly tiny occurance of lepto to the point of exhaustion. Well, I don't care how little it is out there....I lost a beautiful and healthy pup because my vet made a choice based on a "recommended" protocol. I would not have known back then what choice to make either. but the vet knew that I was around horses and on a farm all day and should have never made this mistake.

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One believes that you vaccinate to the hilt, use as many artificial and meds as available and eat and feeds her own dogs the dreaded SienceDiet. She is a wonderful, warm and caring owner and a person that came to those beliefs as someone that went to vet school at an advanced age and is driven by her own life experiences.

 

The other is a bit younger, took the traditional vet education route and is quite open to any and all alternative methods that work. Believes in titers and has dedicated her life to passing her knowledge on.

 

What my own vets do with their own dogs is an important factor for me.

 

The head vet/practice owner is a hard headed, no nonsense farm / horse vet with a sheep farm of her own. She is an excellent general vet and surgeon who does what she has found works in her long experience, whether it is currently fashionable or not. She will tell me honestly what her approach to her own dogs is on any issue and is always willing to discuss.

 

I can't recall any situation where she has tried to persuade me into spending money unnecessarily.

 

On the subject of vaccines I ask her what is around atm, whether cases are increasing etc. We don't have rabies or any legislation which dictates that our dogs must be immunised against certain diseases, but lepto and parvo are a potential issue locally. Not only that, my dogs travel throughout the country with me and will meet 1000s of unknown dogs, thankfully generally well cared for. Even that didn't prevent an OTT parvo panic in the agility community recently when a pup came down with it after a show.

 

But I will also ask one of the younger vets to get a balanced perspective before deciding on a course of action. You are right, younger vets do tend to go for test after test whether they are likely to throw up any interesting results or not. Maybe they don't trust their limited professional judgement.

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You are right, younger vets do tend to go for test after test whether they are likely to throw up any interesting results or not. Maybe they don't trust their limited professional judgement.

 

A point to not be forgotten for sure. (y)

 

I do wonder though how many of them also are raised to believe that it is all about science? How many forget to look at the animal along the way.

 

And just so I don't seem biased...I think human doctors are kind of in the same boat at times! :)

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And I'd argue that just because a vet recommends yearly vaccinations it doesn't mean that they're money hungry and unscrupulous. I think it's a bit more complex then that.

 

FWIW, I follow a 3 yr vaccination schedule and my regular vet still does yearly vaccinations. With the yearly vaccinations they do a through yearly check up. And I can't believe that they're making tons of money on the deal since the cost of vaccinations is the same as an office visit. $40 for a checkup and shots doesn't seem like a money grab. Since I don't do yearly vaccinations they'll give my dogs a check up when I take them in for HW checks or a rabies booster since those are in a different year than the 3 yr plan.

 

As far as yearly check ups for healthy dogs - I usually have them in at least once a year for something. But If I don't then I like the check up just for a precaution. Missy had a heart murmur that was detected in a yearly checkup. Since it was found early on, we keep tabs on it and started meds as soon as needed. And it never really progressed too much because of that.

 

 

I have the same experience cost wise. I don't know how my vets do it for the price taking into account their overheads.

 

They tell me income has dropped in recent years more because people are not having non emergency treatment like dentals carried out as anything else because they are short of money.

 

My dogs have never had a dental nor has it ever been suggested by my vets that they need one. They look at their teeth when they have a check up and tell me they're fine when even I think they need a bit of attention, which I can do myself. A dental scraper has been one of my best investments.

 

As LizP said though, some dogs are genetically programmed to have bad teeth so I wouldn't say never if I had such a dog.

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I lost a beautiful and healthy pup because my vet made a choice based on a "recommended" protocol. I would not have known back then what choice to make either. but the vet knew that I was around horses and on a farm all day and should have never made this mistake.

 

I am very sorry about your puppy. That is beyond sad.

 

Lepto is a disease that scares the stuffing out of me and yet I don’t feel like I can win with that vaccine. I have heard vets say that they will not give the shot to puppies because they had such bad reactions, including death. My Lhasa’s breeder commented that the only puppy she lost after shots was with Lepto. When my Lhasa had a bad reaction to his Lepto shot at about 15 months old, his vet said he should never get another one. I’ve seen and heard of enough bad reactions to the lepto shot in dogs, especially puppies, that I now personally choose not to get that shot for them. But I live in a subdivision and not out in the country.

 

My point is not that I’m right in this choice because I remain uncomfortable in that choice. Lepto is such a swift and severe illness, that even when my Lhasa had nearly died and my vet told me he did not have lepto, the very thought of even the possibility made my blood run cold. And that was when I knew my dog would survive and he did not have that disease. The Lepto vaccine is just one of the choices I face with my dogs that I make the best decision I can, then really hope and pray for the best.

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We have to recommend testing and treatments that are considered the current standard of care* for liability reasons. You, as the owner, can decline it. It's your pet and your money. If we don't recommend it, we could face legal action or even lose our license.

 

* The current standard of care changes with the times. As we make more medical progress, you are going to see more tests and more advanced treatments recommended.

 

Check out this response to the show.

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I wonder how much of this comes from the vet wanting the owner to be the one to make the choice.

 

I can see someone more zealous trying to explain all the options, look for all the tests, so the owner can make the informed choice. And I can see the owner feeling that if they go for the 'ordinary', 'low-intervention' or 'cheap' option that they're not doing all they can for their dog, or that they're being irresponsible.

 

Similarly, a vet might estimate risks differently to an owner- someone who's seen more serious disease (as a vet would) might be more likely to overestimate the risk of it happening. Hence the 'c word' for growths.

 

Most of the time, too, the vet doesn't see you that often and doesn't get to grips with your philosophy on dogs, their health etc. So everyone who goes in gets the hard sell on not buying puppy-mill dogs, vaccinating, spaying and neutering the dog etc. Because even though I don't need it, the next person might, or the previous person might have. Same as how newbies here get the straight dope on only breeding for ability, not looks.

 

I'm not saying it's the best way, or that vets are all or even generally good, or that selling for the sake of selling doesn't happen. Certainly not advocating yearly vaccinations.

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To be honest, the vets I have liked/worked with the best and trusted the most have all been vets who care for both large and small animals. I have sometimes wondered if they tend to be a little more practical minded simply because it's not as easy to throw a bunch of tests and treatments at livestock (not saying it doesn't happen, but I think it happens less often). I am one of those people who wants to hear the options, including conservative approaches and alternative medicine options. I also want an honest discussion of the usefulness of tests and procedures for the problem at hand.

 

An example is when I took Willow to an oncologist for treatment of her mast cell cancer (after all treatments with my regular vet up to that point had failed). They immediately wanted to do an ultrasound (and I had just lost my job so money was tight) and so I asked if the information gained from doing so would change the course of her treatment and the answer was no, so I opted not to have the US done. Later, when she became quite ill while on chemo, I did opt for the US, because at that point it made sense to see if there was any evidence of spread of the cancer before going forward with a decision on further treatment. Even then, though, the oncologist came to me at one point saying they had seen fluid in her pericardium and would need to tap that and then send me to the local vet school to see a cardiologist. I said to him, quite frankly, that she didn't act like a dog who had fluid around her heart but that if they really felt they needed to tap her pericardium then I would have them do that, but I was not going to consider the cardiologist at that point because my *(and her) immediate concern was the CANCER. Honestly, the hard sell for the cardiologist was a bit offensive to me at a time when I was battling what I considered a more important health issue. (In other words, it didn't make sense to me to start pursuing a possible heart problem--and we, that is, my regular vet and I, were aware of her heart murmur and the likelihood of mitral valve prolapse and were treating her for that--when she was having an immediate crisis related to her cancer/cancer treatment.) It turns out that when they went back to look for the fluid in her pericardium, they couldn't find it again, so no procedure was done.

 

I had a discussion recently with the wife of the vet I worked for all through college and she commented that as with human medicine vets seem to have become more specialized and do rely more on testing than just old-fashioned hands-on diagnosis. I am not against testing by any means, but as with some human doctors I know, the actual *practice* of medicine sometimes gets lost in the throes of testing, testing, testing.

 

Anyway, as far as vaccines are concerned, I have educated myself and have chosen a protocol I am comfortable with and vaccines that I feel are useful. Sometimes it's difficult to find a vet who will agree, but ulitmately I do get to make the decisions about my animals, so I just don't allow anyone to push me into something I disagree with.

 

J.

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I do worry about people not coming in annually because their pets are on a 3 year schedule (which happens a LOT). Unfortunately, many veterinarians placed the value of the annual visit on vaccines in the past. We created the problem ourselves, not valuing the actual exam more than the vaccines. The profession is trying to fix that perception, but it's going to take a very long time. Our practice works hard to focus on the exam, but we still see a lot of pets coming from other clinics that haven't shifted their priorities. Some of those owners are shocked when we actually do a physical exam (their pet has never had one before, the vet just popped in the vaccines and called it a day).

My animals go in for annual exams - not for vaccines, but because I want my vet to put his hands on my dog and cat to get a sense of what is normal for those animals.

 

How can a vet get a good overall picture of the individuals' baselines if they never see them until they are ill? My guys are on a 3-year vaccination schedule and my vet has no problem with that.

 

I have worked in good clinics and bad ones. It's up to the consumer to be informed, ask questions and make informed decisions. So many people don't want to know about their animals bodies and needs. They just want a pill. It's the same at the doctor's offices.

 

I've chosen to go with a 3-year vaccination schedule. I feel it's the best choice for me. Everyone has to choose for themselves.

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My animals go in for annual exams - not for vaccines, but because I want my vet to put his hands on my dog and cat to get a sense of what is normal for those animals.

 

How can a vet get a good overall picture of the individuals' baselines if they never see them until they are ill? My guys are on a 3-year vaccination schedule and my vet has no problem with that.

 

I agree about the annual exams. I, too, take all of my dogs at least once a year for a wellness check. My old gal -- 15-16 y.o. -- goes twice a year if there hasn't been another reason to take her in, which, since she has intestinal disease (I joke that she's my million dollar dog), there often is.

 

Where I differ from you is that I choose not to vaccinate (except for the state mandated rabies) as often as every 3 years. It's been about 6 years since Bodhi had his last core vaccines when he came into rescue at about 2 y.o., so I'll probably have a titer done at his next exam in the spring. My vet has respected my decision -- based on my own research and also the recommendation of my friend who's a vet, though no longer my primary vet because of distance -- and has never offered any arguments against it, and in fact has said she supports less frequent vaccinations.

 

Interestingly, unlike someone else who mentioned that vaccinations are included in the cost of the visit, my experience has been that you pay a flat rate for the office visit, which includes a basic exam. Other things then like vaccines, fecal flotation, HW, tick borne disease testing, blood work, etc are all additional charges. So, conceivably I could walk out with a $40 OV bill, though that's never happened, since there are always things I want tested in order to catch and treat things earlier rather than later.

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If you board or do doggy day care with your dog, kennels require bordatella every six months, and something else I can't remember every year. So, since I rely on boarding kennels and doggy day care, that's what I do.

 

I get those vaccinations at clinic that just does vaccinations. They also sell flea/tick stuff. It's cheaper than my vet, who doesn't try to push anything on me.

 

Ruth and Agent Gibbs

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Great post, simba, you made a number of good points. And I was especially struck by this:

 

Most of the time, too, the vet doesn't see you that often and doesn't get to grips with your philosophy on dogs, their health etc. So everyone who goes in gets the hard sell on not buying puppy-mill dogs, vaccinating, spaying and neutering the dog etc. Because even though I don't need it, the next person might, or the previous person might have. Same as how newbies here get the straight dope on only breeding for ability, not looks. [Emphasis added.]

 

And how often our motives too are questioned when we present that position. We're elitist, we want to be considered better than others, we want to keep all the breeding for ourselves and don't want competition, etc. And we know these are not our motives, so we take offense.

 

I think it would really be nice if discussions about things like vaccination considerations/frequency could focus on the facts without getting sidetracked into motives. There is no way to know how many vets are motivated by money rather than by the creditable motives/concerns that simba and others have stated, and when all is said and done, the point is the facts, not whether somebody's motives are bad or good.

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I think the problem with the ABC piece was really no different from 90% of the stuff on American TV it's over dramatized, when there is a story burried in their that the average pet owner should think about. I hate watching tv news as they give no details just the drama, even animal and history documentaries don't give a clean narrative, they emphasis the drama and that is what that piece did, they said most vets are honest.. BUT.. And I have experienced the but.

 

Most of us on this board have given way more thought to our pets/animals than most but we all started with limited knowledge. When I got my first dog as an adult 18 years ago I knew that establishing a relationship with a vet was going to be important. I went to the vet in my town, most of my friends went there. On our third visit, after 2 years of dog ownership, for my dogs annual she was diagnosed with heartworm, but in the same visit they recommended a dentistry. I had no idea what was involved, but as I am stood booking her an appointment, a lady with a cat walks up to schedule a dentistry, immediately I had this strange feeling, and asked what was involved, the thought of putting my heartworm positive dog under general for her teeth just seemed wrong. I left and never went back... She had her teeth done 10 years later and then only because one was cracked. Over those 18 years I have had numerous friends and acquaintances moan about their bills from this practise (I would estimate 1/3 more than other practices), while I have watched it grow and the building get smarter. I would never fault the standard of care, it just looks like they do more tests, charge more procedures and certainly clean teeth more frequently. And as the practise has got flashier there is no shortage of clients.

 

I left and went to my current vet, I respect the fact that she has a business to run, but in the last 15 years I have never felt I have been in anyway ripped off... Fair prices, and a great vet, who over the years has gone above and beyond and when we move I will really miss her.

 

Bottom line, one vet I always talk up, and try and persuade people to go to, even if they have to drive a little further, and the other I have nothing good to say about.

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I also want an honest discussion of the usefulness of tests and procedures for the problem at hand.

 

Definitely to this, and everything else in your post.

 

Discuss tests with the head vet at my practice and she will often say "We could try X but..........."

 

Younger vets tend to say "We could try X" and I have to ask them about the "but". I'm sure they don't do it deliberately, just as I'm sure that they don't mean to prescribe more drugs than the head vet; it's just the culture they have been trained in and the fact that they don't have as much hands on experience. They're OK though - I can handle them.

 

Being a farm vet the boss is used to dealing with people who are very resistant to spending money without a good reason.

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I'm sure they don't do it deliberately, just as I'm sure that they don't mean to prescribe more drugs than the head vet; it's just the culture they have been trained in and the fact that they don't have as much hands on experience. They're OK though - I can handle them.

 

:P;);)

 

Yeah, I often (not always) feel I can handle them too. I appreciate hearing about the latest advancements and treatments, etc., but I believe that I disappoint my youngish vet when I don't immediately agree with his treatment recommendations - but he doesn't get pushy about it.

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