Wednesday, April 30, 2014

Musings of Dr Liz - Upsell Vs Good Medicine

The issue of upselling in the veterinary profession is possibly one of the biggest key issues that is
Otherwise known as Russell Vale Animal Clinic! 
affecting the important relationship between loving pet owners and veterinarians all over the world.

In my spare time, like most of you, I go onto various internet forums, and visit different pages. I am part of many groups, some are animal related, others are vet related, and some are about various hobbies, like gardening and investing.  In true testament to the community love of our pets, even in the animal- free pages, the issue of vets and our animals seems to crop up. We just love talking about our pets don't we.

Unfortunately, when the topic goes to vets, it doesn't always make me proud to be a veterinarian. When I read many of the comments, I sit in my bedroom and cringe.

Why would I feel like that? It isn't that the comments are directed at me personally, but at my chosen profession.  Most of the comments are downright nasty, some are childish, and most are just jealousy presented as truth.  There are some recent ones that have just tipped me over the edge, motivating me to write about them.  There have been many that have irked me, but I bit my tongue, and said nothing.... until now!

Our pets are super special, don't you agree?
And don't they deserve the very best in veterinary
One said that she would never go back to her vet  because he parked a Porsche in front of his vet hospital with personalised number plates.

Another said that her vet upsold her some blood and urine tests,  and is now upselling her specialised pet foods (her vet diagnosed chronic kidney disease in her sick cat).

Oh Wow!  So how do I get to own a Porsche.  I would love to know that vet's name!  That must be some awesome evil selling technique he must be using to be able to convince alot of people to spend alot of money with him.  (More likely, he is an amazing vet, with amazing skills and he deserves the Porsche and more - good on him - I feel happy, not jealous that a fellow human being achieved success in his chosen field!).

I don't drive a Porsche - I drive a 1999 Honda CRV which leaks when it rains through the sunroof, and the Mercedes van you see parked in our car park?  Well that was my Dad's van which he used for his scooter, which I inherited when he passed away.

I don't think people are flocking to me because I drive an old car, but it would be disconcerting to think that some people will stop coming to me when I go out to buy a new one, and God forbid, have it parked in public view.  Why should I be ashamed that I bought a new car? ( I haven't yet, but if you have any suggestions on a good cheap reliable car, let me know - I am never going to reach Porsche status).

Then there is the upselling comment from  another forum.  

The background to this one was that the elderly cat was apparently unwell.  The vet wanted to do blood and urine tests to find out why she was unwell.

How is that upselling?

It isn't!

 That is good, old fashioned, veterinary medicine.

The blood tests led to a diagnosis of chronic kidney disease.  That is a condition that has limited treatments, but we do know renal supportive diets can improve the cat's quality of life, as well as longevity.

 The veterinarian recommended appropriate nutritional support. But according to the owner, the sale of such food is also upselling.

It is not upselling.  That is good veterinary management of a chronic disease.  That vet is AWESOME! He/She deserves a medal, not accusations of upsellling via the obscurity of Facebook!

Admitting your pet into hospital for treatment is
not upselling, it is good veterinary care. 
 But client's perception is their reality, irrespective of whether it is true.

No one likes being "sold to" or being made to feel that they have been conned.  

Vets are not conmen (or conwomen).  We are caring individuals who care for your pets (most of us anyway).

I had never heard of the sales technique of "upselling" until I read the Choice article about vets a few years ago, and since then, it is like "all hell has broken loose,"  with the term used freely now, usually inappropriately.

So lets tackle what is and isn't upselling.

What is upselling?

sales strategy where the seller will provide opportunities to purchase related products or services, often for the sole purpose of making a larger sale.

Read more:

The sole purpose of upselling is purely for a larger "sale". There may or may not be benefits for the pet also, but at the end of the day, more dough has come out of your wallet for something that you may or may not have wanted.

When you are the victim of upselling
tactics, it can make you feel
very unhappy and used.
So, from a veterinary perspective, it would be.... well I don't know of a personal example, as I don't upsell.

 Ok, let me go through what I have seen from the actions of another veterinary hospital   -  a case of veterinary
upsell would be to do a Heartworm test on a 5 month old dog.  The (un) "diagnostic" test  would automatically give a negative result given the nature of the lifecycle of the Heartworm.

Another example would be wellness plans for our pets, which is  increasingly being offered in many veterinary hospitals. You pay a monthly subscription or an annual fee, which entitles you to alot of "free stuff", but then are encouraged a discount on food and flea stuff (so you actually spend more on your pet at that vets each year, hence upselling - it is a larger sale for the vet hospital).

They will push all sorts of medications onto you, usually as an injectable form to get it started, telling you that "it works faster", whereas in most cases, there is no difference between absorption rates of common oral or injectable medications (such as antibiotics or antiinflammatories).

The more appropriately designed wellness plans I have seen take into account the entire preventative plan for the individual pet, so you are actually paying what you reasonably would've been but in affordable monthly payments, but I have only seen these types of plans advertised in the UK These types of plans are not common in Australia.

From a non veterinary perspective, upselling would be "Do you want fries with that?"  The one that annoys me though, is when you buy a printer, and you have to buy the cable, or when you buy the camera, but need to buy the SD card that goes in it. That is pure upselling.

A common public perception of "veterinary upselling" is dentistry, but it doesn't deserve that tag at all. As a vet who does alot of dentistry on "normal looking mouths" only to find the dental disease underneath, I shudder to think of the pain the pet would've been in if I hadn't intervened.  Candy (pictured below) is a classic case in point, but I have many many others too - as have many of my colleagues who perform quality veterinary dentistry (with dental radiographs).

If I just flicked the tartar on the teeth in the consult, I would've
missed the severe endodontic disease in this three year old dog.
Some would have called a general anaesthetic and
dental work on a 3 year old "upselling"  but I call it good veterinary medicine!
Performing veterinary dentistry at the level that I do (with full dental charting, dental radio graphs etc),  has made me realise that our pets just do not complain and that they do hide their pain.  And as an animal lover, it is our role (yours as the pet owner, and mine as the vet)  to ensure our pets live a pain free humane life.

Vets who promote good dental practices are not upselling, but are actually providing you and your pet an opportunity towards identifying painful disease, and removing it. 

What is good veterinary medicine?

Veterinary medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in animals. (Source Wikipedia accessed 29th April 2014)

Blood tests are needed in high risk
breeds for disease. That isn't upselling,
that is awesome preventative veterinary
My first recollection of wanting to be a vet was in fourth class, and I stood firm, studied hard to do exactly what that definition says I am supposed to do.

That is what the majority of my colleagues out there are currently doing. We are preventing, diagnosing and treating disease in our pets - we are diagnosing and treating disorders and injuries.

And to do all of these things, requires tests and procedures to be done.  That is what we went to University for, to be able to do the best things for all creatures out there - whatever form they may take!

We are recommending screening tests in pets who are at high risk of certain diseases (for example, I would recommend thyroid panels in all Labradors and Golden Retrievers each year, as well as all cats older than 12 years of age).

  That is not upselling, that is good preventative veterinary medicine.  I want to know if the pet has hypothyroidism or hyperthyroidism before it causes irreversible damage. The history of science tells us that certain breeds and age groups are at higher risk.

We are recommending blood and urine tests in sick pets, as we need that extra information to find out what the problem truly is.  My example of Chronic kidney disease earlier is a case in point.  It cannot be diagnosed without blood and urine tests, irrespective of how good the vet is, but early diagnosis, and thus treatment,  can make a big difference to the quality of that  pet's life.

A big favour. 

Don't we deserve the best vet in the world?

Before you accuse a vet of upselling, please be clear about what it truly is, and what your accusation is.

Accusing  vets of upselling because your pet is ill and needs medical treatment, is, in my view, a cop out.

Accusing vets of upselling because your pet has been examined, and disease identified, but you choose to ignore the recommended treatment, that is also a cop out.

That is so not cool!

You have the right to say no (but not to the point of cruelty)  but you do not have the right to blame us for your pet's disease and the treatment involved.

Some of you are now using "upselling" as an excuse for denying the care that your pet needs and deserves.

I had that happen to me a few weeks ago with a very sick cat (blood tests confirm cholangiohepatitis). Treatment was declined.  Not cool!

The accusation only has to happen to me once, but it had me in tears and extreme sadness, due to the care and regard I have for our beautiful animals.  They deserve better from their human owners.

But, yes, there are vets out there who do "upsell", and sadly, do our entire profession and the animals they care for a disservice.  For these colleagues are giving some pet owners an excuse for not doing the right thing for their family pet.These colleagues are fueling the distrust that some people may  have for veterinary professionals.

As a vet, I only have your pet's best interest at heart, and an accusation of upselling is, well, unnecessary, and not likely to forge a bond between you and I.    You need to trust your vet that they will always act in your pet's best interest, with the knowledge that is available to them at the time.

Because simply, if you do not trust the vet you are with now, then find another one who you do trust. Your pet deserves that.

I am Dr Liz, the mad vet from Russell Vale Animal Clinic.

Good veterinary medicine and appropriate care programs is what we practice here at our veterinary hospital, and fortunately, I am blessed to have some amazing pet owners and pets as part of my animalclinic family who trust me to do exactly that.  

As your vet is a part of your animal family, we encourage an open discussion about what you are actually looking for in your family's vet.  We cannot promise to be the right fit for everyone - but we do promise to be the right fit for the right ones.

Thank you (you know who you are)  for making each day of coming to 'work"  a joy.  I cannot continue to do what we do without your ongoing support of our  little veterinary hospital. Cheers!

Friday, April 25, 2014

Wollongong Dog Parks - Part One

Piper is almost six months old now, and geez it has been a ride.  As a vet, I know a lot about behaviour and care, but it is only when you have a dog join your family, that you look at things from a different slant.  I always knew off leash areas were out there, but didn't really look into what they truly were.  Our previous dog, unfortunately, never had the opportunity to go to these places, because simply, when he was a puppy, they didn't exist.
Piper, we do not mean this kind
of "off leash" activity!

But before I get started on our experiences with the local dog parks, it is important to define "dog park" and "off leash" area, as they are not the same thing.

 A dog park is an off leash area, but an off leash area is not a dog park.

To my surprise, there are no dog parks in Wollongong, and there is only one area that comes remotely close in Shellharbour. 

Wollongong dogs only have access to "off leash areas", which are restricted even further into what times the dog is able to be off leash.  The bureacrats are using the "traffic light system" - green, orange and red (and we are supposed to remember the fine print of each of these (methinks I am not going to remember that). Green means access all the time, orange means access is restricted to certain times of the day, which changes depending on the season, and red means that it is a no go zone at any time.

Piper running free at the park (well,
she is attached to a long lead as she
is still a puppy)
A "dog park" is a fully enclosed area, usually with a double gate entry (to stop accidental escapes), suitable seating and shade for pets and dogs alike, aswell as access to water and activities. There are separate areas for large and small dogs, and lots of areas where dogs can escape if being bullied or picked on.

An "off leash" area is any area that a dog can run free without a leash.  In NSW, the law states that out of these "off leash" areas, your dog needs to be on a physical leash (voice control is not good enough).
As a side issue,  I have seen dogs on a physical leash but not under effective control, and dogs who run loose next to their owners under absolute effective control, so I really disagree with governments position on this point, but, sadly, the law is what it is.

But do dogs really need off leash areas?

The answer is not an easy one - for some dogs, going to one of these areas is traumatic and stressful. For others, it is a chance to explore new things (such as the beach, rock pools and meet new mud puddles and the like). 

But, no, dogs do not really need these areas, if the owners are able to do generous walks and training twice a day.  Sadly, this doesn't happen in many households.  In many households, it is a once a week outing for an hour or two which then gives the owner the delusion that they are doing the right thing with their dog.

Piper is going to score each place out of ten, and
so will I.

So let's get started

Thanks to our Piper, my eyes have been opened to what animal services are available in Wollongong,  ranging from Puppy classes, dog training, and now off leash areas.  So far, it has been interesting (and in many aspects disappointing), but certainly explains why there are still so many pets that develop behavioural problems and problem behaviours.

Our off leash " criteria

Our criteria was a list of things that would be assessed, and each venue was given a score out of ten. A score was given by Piper, and by us (Tegan and I).

We looked at
  • Availability of drinking water
  • Materials to clean up and dispose of poop
  • Space available to romp
  • Fences and Entry/Exit gates
  • Visual barriers
  • separate small and large dog areas
  • Available activities - i.e fun stuff - either natural or man made
Did we miss any point we should've considered?  If so, let us know (via email or comments below).

Elebeena Reserve

The green thing behind the bin holds the "poop bags" 
definitely needed in every "dog friendly area"

(Wollongong City Council area)

This was the first one we went to, as it was the closest to where we live.  Even though it was a lovely Sunday, we were the only ones there.  The area was huge, but the boundary was either road or bushes (next to the creek). Lucky it is a narrow street, but during our time there, there were a few hoons (speeding idiots ignoring the 50 klm/hour speed limit).

Each area has a similar sign
it maps out the rules, so there
are no excuses if you "forget".
The only fun stuff there were the mud puddles, because it had rained a lot the week prior!  And Piper loves her mud puddles, like any kid!  There were no seats to sit at to just throw the ball.

There was a tap with no tap handle (i.e no water access), but there was a rubbish bin, and poop bags too.
Eleebana Reserve - the area is big, but that was it!

Piper's Score   6/10

-" I loved the mud puddles that were there"  Piper

Our Score   3/10

- "Disappointed in what the area had to offer for entertainment other than being an open green space" Dr Liz

Oak Flats (opposite Oak Flats Pool)

A narrow area between the park driveway and bushes.
This one is in Shellharbour City Council Area.  This one was a surprise in that it seemed that someone sat in their cubicle and came up with this narrow stretch of land without truly thinking it through. 

At least they could say they had an off leash area here!


Because it is a narrow strip of land next between the park driveway and bushes, with only a low fencing (so low we can step over it) as a boundary.  There was no drinking water access, limited seating, and no other fun stuff at all. 

Tegan and Piper in Oak Flats.
It would be great for dogs to play fetch, if they just went in a straight line only.

But there were great bushes for dogs to go into and explore, and lots of shade (great for those hot days).

There was no drinking water, nor where there poop bags.  But there was a lot of fun mud puddles, and really, dogs do love to roll in the mud, don't they!

Piper's Score   6/10

- " I loved the trees and the bushes - had a ball weaving around them.  And the mud puddles were to die for"


Our Score 4/10

- "At least there was some seating (if one could call the fence that) and shade".

Our overall take on the situation?

Well, if these two areas are an example of what is available out there for our dogs, then it is indeed disappointing.  Our Council needs a kick up the proverbial, and need to offer some services for the pets in our community (other than taking pet owners money in the form of fees and fines).

We are "rate payers" too!
My feeling was that  no thought had gone into creating dog friendly areas, but rather to satisfy government legislation about allowing "off leash" areas.   It felt like someone sat at a desk or perhaps around a table, and with a red marker, circled one park every so often.

At least, council can tick off the box that says "have you adequate off leash areas for dogs". 

 Councils can and should do better. Even so, we have to be grateful for what services they do offer. It could be worse. It could be the way it was 15 years ago, with virtually nothing.

As  a pet owner, and rate payer, it a disappointment. As a vet, it is downright wrong.

 But, the beauty of our pets, they are just happy spending time with us. 

That is one thing that I am grateful for - the time to be able to spend time with my family.
Hopefully, as we explore more areas available in both Wollongong and Shellharbour, my disappointment will be shortlived.

There is one thing that is true though - spending time with your pet is never time wasted,
and being in the park with them is always a joy. 

Looking forward to Part Two?  We will be visiting two other areas within the Shellharbour area, and after that, in Part Three, we heard north, to check out the ones closer to the vet hospital.

I am Dr Liz, the mad vet from Russell Vale Animal Clinic.  But, I need to also acknowledge Piper and Tegan, as without them, we wouldn't be having so much fun checking out these "off leash" dog areas.

Thursday, April 24, 2014

Piper and her friend, Giardia

It feels like rain is a constant in our area at the moment.  The other day, I heard that there was a yellow thing in the sky - I had to run out to see what it was. It looked very much like something I remembered from the past, which was called the sun!
Piper as a puppy.

Yes, it has been that wet - not bad for the driest continent in the world.  We seem to go from extreme wet to extreme dry, and all on the same day (it feels like). 

With the rain comes mosquitoes, malassezia infections and now giardia.  And our dog Piper was recently diagnosed with giardia. She has since made a full recovery, but it was the start of many other cases since then.  We are now up to 5 confirmed cases - and no, none of them met Piper before hand. She is not our "typhoid Mary" but the rain is!

Giardia is a protozoal parasite that causes chronic diarrhoea in us as well as our pets.  Infection occurs from drinking faecal contaminated water.  We suspect Piper got infected from drinking from the muddy water puddles at the dog parks she frequently visits.  She could just have easily got it from drinking tap water.  We will never know.

What I do know is that after she had diarrhoea for 4 days, and was not improving, we sought "vet advice".  We originally thought she had diarrhoea due to a slight change in her food, or perhaps she got into the rubbish (as puppies do). 

We wormed her and we fed her chicken/rice for a few days.  Does this type of treatment sound familiar to you?  My guess it does, as it is often what most of you would do aswell when your pet is unwell.  Us vets are also typical pet owners too - we try the simple stuff too.

Giardia Test - Two bands is a positive result 
A vet check is always in order. Often people ring up for "advice", but as there are so many causes of diarrhea, it is not something that advice can be given for.  I would hate to give advice to the effect of feeding small amounts of bland food often, if the diarrhoea is due to parvovirus.

Piper had her "vet check" with me - she came into the vets, and had a full examination (which we also found that her first lower first premolars weren't erupted either - but that is another story)..

There are a lot of tests that we can perform on site  which gives us very quick results.   We performed a faecal floatation and a giardia antigen test.  The Giardia antigen test gives us a result within 5 minutes.

Sadly, Piper's result was positive, but the good thing was - we had a diagnosis, and a treatment started.  She was normal within two days, but we treated for 5 days.

Just a quick note about this giardia antigen test - One band is a negative (or below detectable limits) result, and two bands is a positive result.

There are two options of medications - either metronidazole (which we chose for Piper) or fenbendazole - both need to be given for 5 days.

As you will recall, there are many causes of diarrhoea in a pet, and there is no law that says that the diarrhoea will be due to one thing only.  We have had cases where the pets had multiple infections, all of which needed different treatments.. 

The take home message:

Any time your pet has diarrhoea, then a vet visit is in order.  Take along a poop sample for testing, just in case, especially if it has been for more than 4 days. Don't muck around as pets can dehydrate very quickly.  Allow your vet to do the tests to identify the cause of the infection.

What if all the tests are negative?

There are a whole range of tests and treatments that will need to be done.  Sometimes the ones we start off with don't give us any information. We then have to dig further... it is like any other mystery - you keep on digging until you get the solution.

All of us here are for happy healthy pets, always. Let us help your pet by bringing them in to us when they are unwell, so we can help them get better.

I am Dr Liz, the mad vet from Russell Vale Animal Clinic in Bellambi.  Any questions?  Call me on 02 42 845988 or email.

Tuesday, April 22, 2014

Dr Liz's Gratitude Project - Animals

Dr Liz's Gratitude Project continues, although admittedly, it has hit a big hurdle in March and April - I was struggling to find things to be grateful for.

The work one does with animals is always full of emotion - sadness, happiness, joy, gratitude, love, companionship, compassion and kindness.

And then one has to work with their owners - sometimes it is a mutual understanding, care and respect, and sometimes it is dysfunctional (aka not very nice).

A cat, a human and a dog - in the same bed - notice the hierarchy?  (there is Pusski up the top, Dirk, then Piper though I think is keeping the peace between Pusski and Piper).

I am so grateful for my animals who teach me about 

compassion, kindness and tolerance. 

Piper co-existing in our bed with Dirk

Saturday, April 19, 2014

Musings of Dr Liz - the In-between years of a pet's life

Welcome to another Dr Liz's musings, and this one is about many pet owner's attitudes to veterinary care for their  pets in the middles years of their pet's lives.
Our dog Teddy as a puppy - in 2000.

From a vet's perspective, a pet's life is broadly classified into three age ranges
- the young ones (up to about 12 months)
- the middle years (usually from 1 to 7 years)
- the senior years (usually from 7 years of age to older).

Now of course, this will vary between dogs and cats, and particularly breeds too. Use the following chart as a rough guide! (The old rule of 1 human year = 7 dog years is just a "guideline" suitable for the 20 kg dog only).

And from our perspective, a pet needs regular check ups - very regularly when they are young, at least once or twice a year when they are in the middle years, and definitely twice a year when they are in the senior years.

But from a pet owner's perspective?  What do you do?

Our dog Teddy - when he was 7 years old - a happy boy then!
All of us who have young animals, know the large number of  visits - the vaccinations, worming, heartworming, flea control, then comes desexing and council registration (with microchipping in there somewhere).  Then you have the obedience training, house training, walking - geez, I am tired just writing about it. It is quite an intense first year!

And then, when the pet hits a year old, many owners then seem to do very little. 

The vet visits drop off, to maybe just be the annual vaccinations, but more often than not, many years may go past before the pet gets a vet check.  What is often said to me by pet owners is  " they have been fine" or " I would know if something was wrong".

This is such a common mistake, that it breaks my heart when I see a pet that is 9, who hasn't been to the vet in the past 7 years, but has developed a minor problem

 - and suddenly, as a vet, I find so many abnormalities that the pet owner's head swim with too much information.  Every so often, an elderly pet comes in, to be euthenased, and during the discussion it appears the pet's last visit at the vets was when it was desexed - at six months of age. I am not disputing the love the owners feel for their pets, but it is a shame that there was not a vet somewhere who could've treated the dental disease, or helped with the arthritis pain so at least the last few months or years of that pet's life could've been pain free.

I have a stray dog in hospital right now with a tooth root abscess that has been there a while, but his last vet visit was in 2006 - and the owner was told back then that the tooth needed treatment.  This pet has been in pain all this time, but I have no doubt I will hear the same thing " he has been eating fine".

 Our animals hide their pain - simple.

 It is our role as pet owners to know this, and allow the experts (the vets) to check them over thoroughly, including blood tests if that is what is needed every year - even twice a year if this is what is the best thing for that pet.

Regular visits keeps you up to date on the latest treatments. There are many owners are not aware that there is an injection that can prevent Heartworm disease for 12 months in dogs!  Or that there is a topical all wormer for cats that can be applied each 3 months (saves the skin on your arms).

The inbetweenie years in a pets life is a very very important time.  Any excess weight, activity or injury that they incur then  will haunt them in their senior years.  

Don't forget to make your vet part of your pet's life at each and every stage.
Our dog Teddy in 2010 - at the end of his days.  RIP sweet Teddy

For me, as I see my role in your family as a vet -  I am a part of each and every one of my animalclinic pets lives - for better, for worse. I am there for you all in the fun times, and in the sad times too.

Our pets are never with us for long enough, and it is soooo important - I mean really really important that we do not take them for granted.  As a vet, I have been there at the beginning and end of too many of my animal's (my and your pet's) lives, and whilst losing a loved one is sad, I never regret being part of that pet's lives - I wouldn't trade in that time  for anything.

I know that I, personally, have made a positive difference in many animals' lives.  It is this gift that all veterinarians bring into lives of all animals all over the world. 

As it is written on the bottom of the front page of my website

"Not to hurt our humble brethren is our first duty to them, but to stop there is not enough.
 We have a higher mission--to be of service to them wherever they require it."
Saint Francis of Assisi (1182 - 1226)

I am Dr Liz, the mad vet in Bellambi Lane - if it has been a few years between vet visits, then ring up your vet now, and get your pet checked over.

The more your pet comes in to see us (or your vet), the more they will grow to love us (or them) too.  And don't forget, we have our yummy home made liver treats too - certainly worth the visit IMHO!

Friday, April 18, 2014

Choosing the right desexing package for your pet

at Russell Vale Animal Clinic


We hope this information will help you,

the pet owner make an informed decision,

on choosing the right desexing package

for your family pet.

Desexing is a Sterile Surgery,
it is the first major surgery your
pet is likely to have.
At Russell Vale Animal Clinic, we have been offering two levels of  desexing care for all pets since 2000, but even so,  it still raises eyebrows, and “really” comments from many new pet owners when they are doing the “shop around” phone call for a desexing price.

I can only think this is so because most pet owners still do not understand what the surgery procedure actually involves, and as such, do not realise that things can and do go wrong. Fortunately, complication rates are rare at Russell Vale Animal Clinic, but they can happen to the best of us.

All about desexing.

Desexing for a female pet is a full ovario – hysterectomy – we surgically remove both ovaries and both uterine horns. It is not a “tying of the tubes” as occurs in women.

For a male pet, it is an  orchidectomy – we surgically remove both testicles. It is not a “vasectomy” as occurs in men.

It is a procedure that is performed once, and is usually the first surgical procedure under anaesthetic that your pet will ever under go.

Just because it is an everyday, routine, common procedure does not mean it is any less serious than any other procedure which involves an anaesthetic.

What are your desexing packages? And why do you offer both?

We have a “Standard” and “Deluxe” (otherwise known as my pamper pack), which gives you, the pet owner, a choice in the level of comfort.

The Standard package is similar to what many other veterinary hospitals offer, except we also include post operative pain relief (first 24 hours) and we also do intradermal (dissolving) skin sutures for your pet’s comfort.  There is no need for 10 day revisits for suture removals.  

 Quality pain relief is not an “extra” option at Russell Vale Animal Clinic.  However, take home pain relief is an extra option, if you need that extra piece of mind.

Our Standard desexing is suited to those pet owners on a limited budget, but still demand quality.

The Deluxe package is unique to Russell Vale Animal Clinic as it provides so many extra features -  it really is a “pamper pack”.  It is more suited to those pet owners who want the very best for their family member.

What do both packages offer in common ?

They both include a full physical examination, as well as the hospital stay, individual anaesthetic plan including a pain management plan.  All desexing procedures are performed in our state of the art operating theatre, using modern anaesthetic medications.

The pain management plan includes sedation before the procedure, as well as pain control during and in the immediate recovery time.  It also includes medications which offer 24 hours of post operative pain relief too.

Detailed home care notes as well as a Certificate of Desexing will be given to you also.

Oops – I almost forgot – of course it includes the actual surgery itself.  All equipment is either single use or autoclavable, and all sutures materials are individually packed for maximum sterility.  Dissolving skin sutures mean no need for uncomfortable external sutures, and nothing for the pet to lick or tug at, and definitely no need for suture removal in 10-14 days as occurs in other veterinary hospitals. 

If the Standard package is so comprehensive, why should I choose the Deluxe package?  In other words, is it really necessary?

As a vet, I believe every pet deserves the “deluxe” package, as I can see the difference in how they cope with the anaesthetic, and I know the difference in the way they recover and feel over all.  And whenever my pets needed to be desexed, I also chose the deluxe package for them. 

Will you notice the difference when you come to pick them up?  Probably not.  But you pet will experience the difference.

In short, the Deluxe “Pamper Pack”  is a comprehensive, inclusive package which is unique to Russell Vale Animal Clinic.

What are the “extras” in the Deluxe Package?

·         It starts with pre-anaesthetic blood tests,

o    where we check your pet’s liver, kidneys and blood sugar.  We check the blood count, and make sure that there are not any hidden surprises.  Perfectly healthy looking pets can have congenital liver or kidney problems, which can mean death under anaesthetic. 

o   With our cats, the pre-anaesthetic blood tests also includes the Feline Triple – which is Feline Immunodeficiency Virus, Feline Heartworm Disease and Feline Leukemia Virus.

o   With our dogs, it also includes Heartworm Testing if indicated (i.e pet older than six months)

·         Intravenous fluids – or “going onto the drip”.

o   An intravenous catheter (known as cannula in the human side), is placed, and sterile intravenous fluids are administered.  This helps support  your pet before, during and after the anaesthetic.

o   The fluids flush the medications through the kidneys, as well as maintains blood pressure throughout.

·         Local Anaesthetic

o   As part of our pain management program, local anaesthetic is applied to the areas which are ligated or cut, to give extra pain relief during the recovery phase.

·         Post Operative Pain Relief is dispensed

o   Injectable pain relief is given before and after, which offers up to 24 hours of pain relief, but we also dispense extra medication to give that night (for a comfy night’s sleep), and for the next few days also.

o   We do know that pain slows healing, and we also know our pets hide their pain.

o   We do know that all surgery is painful and that our pets feel pain as we do –they just don’t complain as loudly as we do.

·         Radiographs – either “Hip Dysplasia” or “Full Mouth Dental Radiographs” depending on the pet

o   A full dental examination is performed in all pets.  But we do know that toy breeds commonly have dental issues, such as unerupted teeth, missing teeth, retained baby teeth (just to name a few).  In these breeds, full mouth dental radiographs are required to check the oral health. 

§  This is perfect for all brachycephalic dogs (such as pugs, Boxers, Shih Tzu’s) where we know that unerupted teeth, missing teeth or extra teeth are common.

§  This is perfect for all toy breeds where unerupted or missing teeth are very common.

§  The most common dental procedure performed is the surgical extraction of retained baby teeth, and extraction of unerupted first premolars.

§  We were the first in the Illawarra to offer dental radiographs, and we remain the most experienced.

o   In those pets where dental charting shows no obvious problems, but who may be at higher risk of hip dysplasia, then we do hip xrays instead

§  Hip Dysplasia radiographs are the “Extended Frog Leg View”, and can be diagnostic even in young pets.  Identifying this problem early, increases the options available to make your pet more comfortable long term.

 Detailed home care notes as well as a Certificate of Desexing will be given to you also.
You need to allow 20 minutes at "go home" time, to allow Dirk (our vet nurse) to go through our discharge information, and to address any questions or concerns that you may have.  We care enough about your pet to give you the time and the information you need to care for them in the crucial post operative time.

Do you have any other questions which the information here did not answer?  Feel free to email me or call us directly on 0242845988.
Do you want to know more about how much this procedure costs with us?  It's all on my
I am Dr Liz, the mad vet of Russell Vale Animal Clinic.  We love looking after all animals, and try to do the best we can for each and every one, even for something as "routine" as a pet's desexing. 

Are you ready to book your pet in?  Then you can book online or call us on 0242845988.

Wednesday, April 16, 2014

A Stray Cat Story - A cat named George. Part One.

In mid April 2014, I shared the following story with my animalclinic family members on the Russell Vale Animal Clinic Facebook page.

It was just to share that we had a new cat with us at our vet hospital, and to share the story of how he came to be with us.  It was also hoped to remind cat owners to check their cat's nails, and that good appetite does not mean good health.

The  response that followed was overwhelming, and unexpected.  The response oozed love and compassion for George.

(Please note, there are some graphic photos near the end)

Here is what I wrote...
Here is George

"Introducing George. If you have been in to see us in the past few weeks, you might have seen this old gentleman walking around the place. Well, he has a sad story.
 He came in a few weeks ago on a Saturday afternoon found on the side of the road all skin and bone. Some Good Samaritans found him on the side of the road in the gutter, not moving. He looked so bad that they thought he should be euthenased.
 Well, I had to examine him first. I looked at his eyes, and he wasn't ready to go yet - he had severely overgrown nails (they were digging into his feet), and he was skin and bone. We trimmed his nails and started him on antibiotics. The beautiful boy was so happy afterwards he rubbed his head against us - it made us cry. We know we made the right decision then.
 We scanned him for a microchip - he doesn't have one. We fed him, wormed and gave him flea treatments. He ate so well, we thought he was sure to put on weight.
 He looks a lot better than he did, but he still isn't putting on much weight. So we did blood tests on the weekend, and sadly, confirmed that he had hyperthyroidism.
 Hyperthyroidism is a common hormonal condition of cats older than 12 years of age, and means that he is producing too much thyroid hormone, so he can never fill himself up. It is the reason why we recommend blood testing of all cats who are older than 12 years of age.
 Now comes our dilemma - should we euthenase him or treat him. The ideal treatment is radioactive iodine therapy (only 4 centres offer this in NSW) and this costs around $1100, the next best option is tablets twice a day which will cost around $40/month. And the third option is to euthenase him - and we can't bring ourselves to do that quite yet.
 Well, the tablets have been ordered from the compounding pharmacist, and hopefully we will be able to start him on medication before Easter.
 Please send good wishes to George, and when you are next in, come and give him a pat." 

I shared the story with everyone because I wanted everyone to know share George's beauty, and to also make them aware that as cats get older, they are unable to care for their nails as they used to.  George's nails had grown so long, that they had dug into his feet so he was unable to walk. (graphic picture below)

Nails do not belong in footpads!  These were infected and very very painful for him.
I also wanted to share that older cats will eat extraordinarily well - but this does not mean that they are healthy.  In fact, it can mean the opposite.  George weighed 2.8 kg when he came in, and he ate so well, that he went up to 3.1 kg - and there he stayed.  At that point, we then ordered blood tests for him, and found that he had some liver enzyme increases, but that he also had hyperthyroidism.  This meant that he would never be able to fill himself up - his body is running on overdrive.
As I said earlier, the response on Facebook was overwhelming  - to answer some of the questions asked.
How old is he?  
Well, his age is hard to determine because the hyperthyroidism makes him look alot older than he probably is.  He would have to be at least 12 years of age, as we know that hyperthyroidism is an old cat disease.  His joints are too mobile too, as a result of his overgrown nails - he had to try to move somehow, which again makes him look older than he probably is.  But at a rough guess, we think he is around 15 years old. 
Where was he found? 
He was found in Woonona.  We have gone through our Lost/Found book and also online, and there are no cats that matches his description.  This means that either he is a true "community cat" which everyone feeds but no one takes responsibility for, or some other horrible thought (his owners did not care). 
What are your plans for him? 
His care falls under the Prevention of Cruelty to Animals Act, where we are only required to give him emergency first aid and also the authority to euthenase if required.  Obviously we didn't euthenase him, and we have done more than basic first aid too. 
Our immediate plan is to keep him happy, and safe.  Give warmth, food and shelter (and lots of love too). We have ordered medication to treat his hyperthyroidism, and will assess his response to that in a months time with blood work. In other words, we will do whatever is necessary to keep George happy, healthy and pain free.
We know that we will have to make a decision to euthenase him at some point, but we hope it will be later, not sooner.  It all depends on how he responds to the medication, and how he is in himself.  
If you are in our neck of the woods, why not drop in to meet George (although he does sleep alot, like any cat).  He is a friendly, gentle cat despite his thyroid condition.  We hope that we can give him some happy memories in the twilight of his life.  He certainly is bemused by the interest in his little life - what a true gentleman.
I am Dr Liz, the mad vet in Bellambi Lane.  I promise to keep you updated on George's progress here, on Facebook and Instagram. 
Can I ask you all a big favour?  If you have a cat that is older than 12, eating well - then ask your vet for a thyroid test for them.  Cats should be tested for this each 12 months.  Dogs should be tested annually no matter how old they are.