Finding an Honest Vet

[Ade]

My dog Guinness has been sick for the past few days. We weren't too crazy about the vet that we were going to, so I decided to go to another vet near our house. After an initial exam, she couldn't determine what was wrong with him, so said she wanted to do a full work up and would write up an estimate for it. The receptionist then presents me with a $750 estimate. My dog had no fever, no sign of eternal pain, but was dehydrated and had swollen lymph nodes. She proposed running an IV, doing full x-rays, running a full blood panel, an antibiotic shot and keeping him for 2 days. When I scoffed at the bill and asked if we could do things one step at a time, I got this major guilt trip laid on me, "we can't help your dog at all if you don't let us". I stated that it wasn't a matter of me not wanting to help my dog it was a matter of what we could and could not afford. Then I got "Fine, how much can you spend on your dog?" When I pushed her on what was really necessary she finally said we could do fluids under the skin, which is half the cost of an IV, run the blood panel and give him an antibiotic shot. Total cost $230, still pretty crazy, but better than $750. So, needless to say, I am completely frustrated and absolutely will not be not be going back there.

Anyway, the point of this long, drawn out vent/rant is that finding an honest vet just seems so hard. I understand that they have just as many school expenses as an MD, office expenses, staff expenses, etc. and probably have to deal with a lot of people not willing to pay. But, trying to play off pet owners emotions to get more money seems so wrong, but more an more common practice. Has anyone encountered this? If you do have a good vet, how did you find them, word of mouth, luck, trial and error?

[thelittlebabu]

I just went through a similar problem. After getting an itemized quote from my current vet, I called other vets to shop prices. Turns out that although some savings could be had with some procedures, other procedures would cost more. In essence, all the vets were similarly priced. I AM switching vets, however, due to philosophical differences on when it's appropriate to knock my dog out for various procedures.

[wendalah]

I hate to say it, but I think it's just trial and error...we go to an animal hospital that has several vets, and our dogs have seen them all at one time or another. One of the vets just seemed to stand out as the best, in my estimation. He consistently takes his time with our dogs' examinations, asks lots of questions, etc.

What really sold me on him, though, is when our small senior rescue dog died, he did a full post-mortem free of charge just because he wanted to pinpoint the cause of death to satisfy his own curiosity. He also was genuinely apologetic about leaving the hospital while our dog was under his care--our little guy was in an oxygen tent and being monitored by techs, but he died while our vet was on his lunch break. That just broke my heart when the vet apologized for leaving for his lunch. It was so not his fault, our dog was in stable condition when he left the hospital. However, you could tell he genuinely felt bad that he wasn't there when our dog died. This sealed him as a really caring, kind doctor in my mind.

[KK812]

It must be sick pet day! My cat was vomiting all night, and I was so worried aobut her. I took her to the vet, he felt around and said he couldnt feel anything abstucting her intestines, but they wanted to do an xray, give her fluids, something to settle her stomach, an antibiotic in case it was bacterial, and they want me to bring her back tomorrow for observation and blood work.

Cost today was $200. The xray shows nothing in her intestines, but he still wants her to come in tomorrow? DH is in the medical field and cats & humans have simiar anatomies, so he asked if he gave her such and such a medcine for her vomiting. He said oh, no, I gave her a shot of Pepcid. $25 for a shot of Pepcid?!:confused: Anyway, not sure if we will bring her back tomorrow or not...she seems to be acting pretty normal.

[SingleWhiteFemale]

wendalah, I remember your doggie. His name was Kenny, right?

My parents just chose a local vet when they moved here over 20 years ago. They got lucky--she is a great vet. Her prices were slightly on the high side, but pretty comparable with the area. Considering she will fit us in when needed--the day I brought home my rescue dog, within 2 hours he ripped apart his stitches and they said they will see him as soon as he walks in the door regardless that he was a brand new patient--the small amount more is worth it. She's been wrong only once in over 20 years (and it was a freak of a cat with an uber-rare condition that even the specialist was shocked to see), so with her track record I just really trust her.

I think there is a little bit on instinct involved on an owners part. If something doesn't feel right, usually it isn't. For your circumstance, I would have agreed to let the pup stay the day and get IV fluids and the shot, and run the bloodwork. If he hadn't improved by the end of the day, I would have let him stay overnight. I'm not the type to worry about money when it comes to my pets--and I know I'm really fortunate that finances aren't the determining factor for what can and cannot be treated or give up my pet--but still, I wouldn't want to subject my pet to the whole gammit of tests that may prove unneccessary. Especially in a non-emergency situation! I'm more of the school to take a couple steps, and see where it goes, because not everything is a major event. I love my cats and dog dearly and would do anything for them, but that includes not putting them through the ringer every time something minor has happened.

I would have been livid if they were "what can you afford?" That right there would have had me collecting my pup and making more phone calls to find another vet that could see him that afternoon. At my vet, if it was all necessary and I couldn't pay for it, the response would have been to pay what I could then, and deal with the rest later--but the pup's welfare is the most important thing. It seems that they're attempting to tug at your heartstrings and relying on your lack of knowledge to just say "do what you've gotta do regardless of cost." Seems like a shady mechanic, ya know?!

[greenbunny]

I am currently changing vets due to this very issue. I feel they overtreat and overmedicate. They want to see our 7-year-old every six months for full bloodwork, urine and stool tests, and booster shots. We've only had this cat a year, and they've had her on antibiotics at least six times. Based on what I've heard from friends with cats, all this is ridiculously excessive.

Rather than ask about the cost of item X or Y, I would talk to people about their vet's philosophy. The vet I plan to see was recommended to me as someone who thinks going to the vet too often is bad, because the stress can bring on a respiratory infection (which seems true, since after every vet visit Bella has had that problem). He recommends wellness check-ups every other year for younger cats and every year for older cats. He also believes in preventative maintenance and will spend a lot of time discussing nutrition, exercise methods, etc.

Also, the lack of knowledge at the old vet bothered me. When our other cat, Summer, was having constant runny stools, they did a ton of organ and blood tests and x rays. A couple thousand dollars later, they still had no idea what was going on. I finally diagnosed her myself with the help of a nonprofit hotline as having a grain allergy. Since going on grain-free food, she's been doing great. There is no reason I should have been able to figure that out before the vet did.

[Ade]

Thanks for all of the feedback. I'm glad to know that I wasn't just "being cheap". We can afford a $750 vet if it is necessary to save my pet's life. In this case, I just think the tactics were excessive and unnecessary. If you went into a doctor with achey body, swollen lymph nodes, fatigue and watery eyes, would your doctor suggest x-rays, full blood panels, anti-biotics, IV fluids, keep you for 2 days observation? No! They would say you probably have an infection, maybe give you fluids if you were severely dehydrated, maybe run a blood panel, if it they thought it were a bacterial infection, give you some anti-biotics and then send you on your way. If a doctor were to suggest it could possibly be lymphoma because you have swollen lymph lodes before even trying to treat you for a more likely infection, you'd be asking the medical board to revoke their license. So, why does a vet think that is okay?

My husband took our other dog to this same vet a little while back and when she suggested some unnecessary test, he jokingly said "forget it, I can buy a new dog for that". After that, she backed off and only stuck to what was necessary. I just feel like since I was calling my dog my baby and me his Mama, she felt like she could try to play off of my emotions and get me to agree to more that what was needed. It's just so unethical and it seems to happen more and more.

I had a good vet when I was growing up who was sure to explain everything involved from the beginning, tell us what was necessary and what would we could do if we really wanted, but was sure to specify if he thought it was excessive or unnecessary. I just can't seem to find a vet like that as an adult and it is so frustrating!

[Chimichanga]

When DH and I moved to our new house, we didn't know anyone in the area. One of the ladies I work with recommended her vet. She has cats and we have a dog, but I thought I'd take a chance.

the vet is great. She gives us free samples of stuff rather than writing a prescription and is very open about things. I'd definitely try talking to other pet owners in the area.

[kithara]

If you are worried about overmedicated, look into holistic or homeopathic vets. Overmedicating is something that they, as a rule, work to avoid.

[petdoc08]

I'm sorry you had such a bad experience with your veterinarian.

I'm pretty sure it's not a case of dishonesty though vs. a case of wanting to be as thorough as possible. Animals cannot tell us what they are feeling so sometimes it makes a veterinarian’s job much harder than a physician. This is why they want to do a complete workup. It is also recommended to do a full work up (bloodwork, urine analysis, xrays, etc) every six months because pets age MUCH faster than humans do. A recent baseline normal is needed to compare to values a pet may have when sick. Animals also tend to hide illness much longer so while you may have noticed that your pet has been acting ill for 3 days, he could have been sick for much longer and has only been showing signs of illness for the last three days. This is why the treatment plan is more aggressive than if you walk into the doctors with the same symptoms.
As for the reference to lymphoma, it is VERY common in middle age dogs. It is one of the top one or two differentials when dealing with swollen lymphnodes in a dog over 4 or 5. The vet was very correct for mentioning this and should not have his license revoked! He does have 8 years or more of schooling to do his job. While animals and people are somewhat similar, they are not the same. As a veterinarian, I cannot expect to be able to treat humans, so human medical workers cannot expect to treat animals. For example, aspirin which is relatively harmless in humans can kill your cat.
When you were growing up vet medicine was a completely different “beast” if you will. We have moved away from the farming/agriculture mentality that an animal is dispensable and moved towards the notion that an animal is member of the family. There are still old school vets out there that will do the minimum, but the minimum is not good medicine and we are now being taught great medicine. We have dedicated our lives to the service of animals, in the meantime racking up hundreds of thousands of dollars in school loans. Combine the desire to practice quality medicine, not just use “band aids”, and our increasing student loan burden and the price of animal care will continue to rise, as it should. It has nothing to do with the veterinarian playing off of your emotions. It is his/her desire to properly treat your animal while paying his bills and maintaining some decent quality of life for himself. The average vet in America makes around $50,000 a year, compared to your average physician that makes a whooping ton more. Yet they have comparable student loan debt, are using the same equipment/medicines, work the same grueling hours etc? How unethical does your $750 bill sound now? I apologize for jumping on a soapbox, but I have dedicated my life to helping pets and feel the need to educate people about changing veterinary profession.

I will not respond to your husbands response that he could get another dog for that amount of money, I am sure you already realize how inappropriate that comment is.

[Ade]

petdoc08 sorry that you have taken offense to my post, but I believe my concerns are legitimate. My dog is 3 and has no other signs of lymphoma except for swollen lymph nodes. His blood work came back showing slight anemia, but no other problems. The vet's response was that this could be due to either an infection or disease, so rather than ruling out an infection first, she wants to start doing a more thorough check for lymphoma involving bone marrow scans, needle biopsies, x-rays, more blood work, etc, and cost much more than the original $750 quote. She was discussing chemotherapy and blood transfusion options with me before even suggesting that maybe we try some simple anti-biotics in the short term, see if he responds, if not, then we can consider that it may be something more serious. By the way, my dog is doing much better today, not 100%, but definitely a lot better than yesterday. Which in my uneducated opinion would indicate that this is probably an infection responding to the anti-biotic shot from yesterday. I told the vet this and yet she still wanted to proceed with the lymphoma testing. I finally told her that I do not agree with her methods and approaches, I think they are overly aggressive and unnecessary and that I would be seeking a second opinion. She asked if I would like a referral to a specialist because at this point that's where she thinks I should go. I said no, I would rather get the opinion of another vet I find on my own. She said "Fine" and hung up.

I'm sorry if vets feel overworked and undercompensated, but suggesting an incredibly invasive, involved and expensive procedure before ruling out the simplest cause first is irresponsible and unethical anyway you look at it. I've had cancer twice and my doctors exhausted every other possibilty before jumping to that diagnoisis. They wouldn't even mention the word cancer until they were absolutely sure I had it both times, they didn't want to scare me unnecessarily. Again, I know humans and animals are different, but I think it is such bad practice to jump to such an extreme diagnoisis without further evidence first.

My message wasn't that ALL vets are unethical or dishonest. It was that in this case, it definitely seems that way. I guess I just need to keep trying out different vets until I find one that seems good.

[Hello Kitty]

Ade, I'm glad your baby is feeling better. That's a good sign! :)

Is there anyone you know who likes their vet? If you live in a major area - maybe some CCers would have a recommendation for you?

Awhile back, we had a terrible vet - we called him the 'guilt trip' vet b/c he made us feel like we were never providing sufficient care for our dog. We finally had enough and started taking her to my parents' vet 2 hrs away, and couldn't be more impressed with their care.
suggesting an incredibly invasive, involved and expensive procedure before ruling out the simplest cause first is irresponsible and unethical anyway you look at it.
I agree - I don't want to get into our dog's story, but this is exactly why we have the vet we do now.

[maxandmolly]

I came home one day to my cat (well, one of them) having thrown up about 10 times. This less than a year after nearly dying from an illness that began the very same way. Which I put off treatment for due to finances. The vet who treated her that time was rude, inconsiderate and just plain icky.
So I immediately called a friend that lived in my apartment complex and asked where she took her dog. I called her vet, who said they were not taking new patients, but recommended another vet to me. They got Molly in right away, and finally, *finally* correctly diagnosed her as having allergies-a simple cortisone shot prevented SO much misery for my girl! I lucked out, in that he is a wonderful, wonderful, fabulous, wonderful, amazing vet. When I took Max in with missing fur and weight loss, we couldn't figure out what was wrong. He ruled out A, B, & C, but couldn't put his finger on the problem. He suggested some blood work to rule out a few things and some high quality canned food for his weight loss. He wanted to see him again after the results came back. They found nothing wrong. His exact words to me were, "I trust your mother's instinct, if you think something is wrong with him, something's wrong, but I don't know what it is, and the next level of testing to find out would be QUITE expensive-but he doesn't seem to be getting any worse. What do you want to do from here?" He's WONDERFUL. If anybody in central FL needs a vet rec, I'd be happy to share!

[keska]

Asking around has always produced the best results for us too. I live right in San Francisco where there are plenty of vets but one place was consisently recommended to us. We took our cats there and we love it.

Awhile back, we had a terrible vet - we called him the 'guilt trip' vet b/c he made us feel like we were never providing sufficient care for our dog.

We had a vet like this once too. It made me feel terrible. I'm glad I finally left that vet because I recently took my cat to an animal dentist and found out that vet had given me bad advice when my cat broke his tooth.

[Ade]

Thanks for all of the great advice. My pup isn't recovering like we want him to, so we'll be taking him to another vet today. I have asked around and haven't gotten anyone clear recommendation, so I guess we'll just have to do a bit of trial and error. But, one clear consensus I have gotten is that the vet that I went to is terrible and unethical. I got three different stories of her tacking on hidden fees and pulling the guilt card when people questioned the necessity of the add ons, and her suggesting very involved and unecessary treatments. So, that makes me feel more reassured in my decision.

[kemorr]

Ade, I'm sorry that your pup isn't feeling better. I do, however, agree with Petdoc that lymphoma is the most common cause of swollen lymph nodes (so long as more than one lymph node is swollen) in dogs, even as young as 3. The youngest dog that I have ever treated for lymphoma was 7 months old. So, your vet was not wrong in mentioning lymphoma. There are relatively few infections that can cause enlargement of several lymph nodes, these include tick borne diseases (such as Ehrlichia, Lyme disease etc) and fungal infections. HOWEVER, the diagnosis of what is causing a swollen lymph node is simple and inexpensive. A vet simply needs to take a fine needle (the same as they would use to give your dog a shot), place it into the swollen lymph node, extract a few cells and send it out for pathology. At our clinic we charge $100 for this test, no sedation or anesthesia needed. It is fast and non-painful. The pathologist can look at the lymph node cells and determine if the lymph node is reactive (ie responding to an infection) versus neoplastic (ie cancer). The chance of getting a diagnosis does somewhat depend on your vet's skill, but should be around 80% with this simple test. I don't agree with the philosphohy of "treat with antibiotics first, just in case it is an infection" for several reasons. (1) This leads to overuse of antibiotics and possible resistance, (2) How do you know which antibiotic to use if you have no clue what's causing the infection - different infections need different antibiotics and (3) if it isn't an infection you've wasted not only time but also money on a useless treatment.

I think your vet did get a little "over-excited" telling you about x-rays, bone marrow aspirates etc. These are all recommended staging tests done AFTER a diagnosis of lymphoma is made based on an aspirate or biopsy of the lymph node. However, I do think that the majority of vets are honest (all though not necessarily at the top of their game) and only want to do what is best for a client's animal. Cases where clients are dissatisfied are often more to do with poor communication than poor medicine.

Goodluck at your second vet. I hope your pet doesn't have lymphoma (but I also hope he doesn't have Ehrlichia, Lymes or a fungal infection either, as these are all potentially bad diseases). Just remember that sometimes it takes more than 1 test to diagnose a disease and that this is certainly true in the human world as well. But, there is nothing wrong with a step by step approach.

[jesvet]

7 months old? wow!

[Ade]

kemorr thanks for all of the great information. I will definitely mention this to the new vet. I didn't realize that there was an easy, relatively inexpensive test for lymphoma, as that option was never presented to me, just the very involved, invasive and expensive procedures as a next step. I am aware that lymphoma is a possibility, but I am not comfortable with a doctor that is going to assume that that is the only possibility and start moving forward with that diagnosis before ruling out other things first. I know there are good vets out there who are very conscientious, up to date on their training and new methods and can find a balance between doing what is best for both the animal and the owner. I'm just having a tough time finding one.

[kemorr]

jes - yep, 7 months. Sad, huh? He was a puppy mill Weimeraner and had an awfully bad case of it. He made it to 2 though.... (just)

[jesvet]

Ade- like others have said it sounds like more of a problem with her communication skills than her medicine. Not that that makes things any better for you, because both are equally important. You need to find someone you can trust and is willing to approach things the way you are comfortable with. One of the biggest challenges as a vet is seeing all the things that need to be done, and effectively letting the client know the many options for approaching a problem. Some people like to do everything, some nothing, some like the stepwise approach. Most people do have financial constraints, and it is too bad that you were made to feel guilty for making your limits known.

It's a trial and error thing. Vets vary widely in the quality of medicine they practice, as well as their personalities and approaches. And while I don't doubt there are flat out greedy and unprofessional ones, I would venture that as others have said the good ones outweigh the annoying ones. Most are in it for the right reasons, and I wish you the best in finding the right one for you.

[Ade]

Just wanted to post a quick update on this. We're still looking for a good regular vet, but I consulted with a vet friend of mine (she's too far away to have her be our regular vet). She said it sounded like it could just be a simple infection. She prescibed a course of anti-biotics and suggested we give him a mutivitamin and B vitamin each day. One week later, he is a completely different dog. His energy is back, his eyes are clear, he's eating and drinking normally, his lymph nodes are no longer swollen and all in all looks so much better. Not at all what you'd expect from a dog dying of lymphoma. ;)

Granted, we could be completely wrong, instead of a simple infection, it could end up being lymphoma. But, at this point I'd rather be blissfully ignorant and have my dog feeling and acting better than be going through thousands of dollars of tests looking for a disease that there is no cure for, only treatement which we couldnl't afford that would compromise his quality of life.

[keska]

That's great. I hope your pup continues to get better.

[Kanga]

We found ours by trail and error. She is great. Our cat had a UTI about a month ago. At the time, we had no idea what it was. The vet said it was either bladder stones or a UTI. When she presented us with info, she did it in a way that you could tell what was absolutely critical to do right.now, and what stuff you could do a wait and see approach.