Thursday, February 19, 2009

The Vet -- A Rant

Dear Reader:

It is a long time since I've posted. Please accept my apologies. I have been caught up in matters canine and matters economical, and to be perfectly frank, I've been suffering from the kind of melancholy that is hard to pinpoint, the type that keeps you up at night, has you feeling bleak during the day, and doesn't really lend itself to creative outpourings. I don't embrace it; I don't love myself at all when I'm like this and so I don't want to infect anyone else's lives with it. Perhaps, if this were a blog that people came to for medical help, if we were called MissMelancholia for example, it would be fine, but usually, I believe our readers are looking for a little bit of sunshine in an otherwise dull world, a funny story maybe, a painting to ogle, a poem to uplift the spirits, a piece of prose about my daily mishaps, a new recipe for lentil curry, a tip for dealing with a bearded husband. I avoid writing when I feel suffocated like this. I avoid telling my friends about it, while wishing feverishly they'd come to my rescue, and then not wanting them to at the same time because it looks pathetic and self-indulgent. So I make myself endless cups of tea and try to focus myself on all things jolly, on what a beautiful day it is today, how the sky is a perfect shade of pale blue, how the birds are singing their spring songs, and how many new tricks I can teach the dogs. Dotsie can jump onto a kitchen stool, lie down and play dead and now knows how to brush her teeth with a toothbrush (bolognese is used instead of toothpaste). Bean is learning how to grin, revealing her perfect little puppy teeth and pink gums.

However, all is not well in the Whistling canine community. My little Bean, who loves to rough house (such a brilliant American word, one that is missing from English English), managed to dislocate her knee cap while playing with a chocolate brown labradoodle about six weeks ago and now limps on three legs. The initial visit to the vet scored us some rimadyl and muscle relaxant (which seemed a little silly to me, because surely if she's on a painkiller and her knee feels fine she's more likely to use it). He didn't x-ray her, but just gave her a manual exam and decided that she had not torn her ACL, which would be a far worse problem. So bad, in fact, that the sugery could cost $2900. I told him that I would be fine with amputation. He looked at me for a moment, not sure if I was joking or not. I was. But I didn't want to be treated like a wuss, or one of those pet owners that just throws money at the merest, most trivial problem. Which is exactly what my mother thinks Los Angeles dog owners are. She's not far wrong. But gone are the days when my father would do "surgery" in the egg kitchen sink to his old gun dog, Vagabond, who was suffering from severe constipation. Anyway, the dalmatian was duly administered her medication over the course of about a week but now, more than a month later, she is still lame, and still hopping (very happily, it has to be said) on three legs.

This morning after the school run I swung by the vet's office with Miss Bean and they kindly let me right in. Dr R asked me again the dog's age, whether she had been spayed (we've been there a year) and then told me that she needed x-rays and surgery. The x-rays, he told me, would extend to the hips and the back to make sure that there were no problems other than the knee (medial luxating patella) and that we would need to do surgery because as she ages the knee and leg joints would become arthritic. I asked whether they could do the surgery immediately after the x-rays as they were sedating her anyway and he said, yes, and that could save you some money. Easy, right? At the counter, I was shocked when I was presented with an estimated bill for $3900, of which I would have to leave half as a deposit. "Oh dear, I am sorry" I say in my ridiculously English way to the nurse "but this seems a little high, doesn't it?" She looks a little irritated and I begin to feel the bilious indignation rise in my throat. "That is more than the deposit on my daughter's school fees for next year which I can't afford to pay and I can't really justify paying more for my dog than my kid." Other customers laugh appreciatively. Oh, I love this, playing to a crowd. I can feel my inner Joyce Grenfell itching to get out.

So the vet, Dr R, floats in and magnaminously alters my bill by a thousand bucks. However, it's still $3000. A Hell. Of a Lot. Of Money. For a puppy who is not obviously in pain.

I come home fuming, having left the poor pup in their able hands. Get read the riot act on the way by Jumby who's in Mexico, and not sleeping at night worrying about the economy. Fret a bit more and then call. "Hello, this is MissW. Please do not do surgery on Bean. I only want the x-rays." Affirmative.

Meanwhile, with the help of the far-reaching power of Twitter and Google, I find out the following information about a medial luxating patella:
  • It is not an emergency surgery
  • That many dogs manage it with glucosamine and no surgery
  • Toy breeds are more susceptible but because of their size are less likely to be bothered by it
  • There are different gradations of it, 1-4, 4 being worst.
  • Some dogs need surgery on the femur if it is bowing, to make sure the kneecap adheres to it properly
  • Dr Cambridge in Tustin will do the whole thing including consultation, x-rays, re-check for about $2,800*
  • Dr Mueller at the VCA will do the whole thing for about $2,500
  • My friend Bill's dad who is a big old vet in Boston is going to ring me tonight for a consultation
* obviously the quotes will vary with each dog and each situation, these are ballpark figures

Dr R calls this afternoon to tell me that the x-rays show that it is the knee and only the knee that is affected but that the groove in the bone is in good shape and that which "could significantly impact the economy of the surgery" meaning, I suppose, that because she's groovy it will be cheaper.

But here's the kicker. (And thank you for sitting patiently through my long, rambling story. It does me good just to write it down). Here's the kicker: My bill for the x-rays was $639.00.
This includes an "injection", two "additional injections," anesthesia and gas anesthesia, radiology, office visit/exm and medical waste fee. It took everything I had not to burst into tears when they handed me the invoice. Anesthesia - since when has anesthesia been a part of radiology?

Tell me this, o wise reader, is it because I live in Los Angeles? Do they assume that everyone is an airhead? Or am I crazy? Is this, in fact, the going rate for x-rays? I'm happy to be corrected.

I am pretty sure that we will be changing vets at this point. I am not a crazy person and I do not consider myself a difficult customer, but I do expect my vet to respect me enough to explain exactly what he intends to do to my dog, and why he's suggesting the things he's suggesting, and what they cost up front. I expect my vet to know the age of my dog and whether or not she is spayed. I expect my vet to take the time to answer my questions, all of which were relevant to the situation.

And one more thing, I have been of mixed feelings about the Governor of California's proposed tax on veterinary services. After all, how do you make up a $40bn deficit without slapping on some new taxes? Now, there is no doubt in my mind, not a smidgen. If that tax passes, there will be many, many more abandoned pets on the streets of Los Angeles.

As for Bean, she's happy to be home. Her surgery will wait until we can gather a few more expert opinions.

Be nice to your doggles, dear reader.


MissWhistle x


John Hayes said...

A trustworthy vet is a wonderful thing-- our vet up here in Idaho is also the mayor; in fact, he perfomed the marriage ceremony for my wife & me. Obviously bills such as this would differ between a small rural town & a metro area, but that does strike me as really high. I had cats & a dog when I lived in San Francisco (admittedly, over 10 years ago) & this is way different than what I recall.

Hope the dog is ok, & hope you cheer up.

Miss Whistle said...

Dear John Hayes,
Thank you for your comment and thanks for the kind words.
I love that your vet is also your Mayor. I think it's time to move to Idaho!
I'll let you know what happens!

thelma said...

;) O that tale about the horrendous cost of vets bill in America, can't advise, though my beautiful Moss at the age of two jumped through some glass and severed a tendon and a piece of bone off and I went through a terrible few months with 'this is a possible amputee' on the vets computer. Leg was wired, I walked him on the lead for months and he is fine, the glutosamine sounds alright. Exuberant young dogs do calm down eventually, I see Moss gets plenty of oil/fat in his meals (for lubrication, he runs it off).. have'nt you got pet insurance in the US?
Can't recommend anything for yourself had a similar experience this week myself.. could be a wave of suicidal depression is hitting us from outer space or the news is so bad that our brain cells are closing down in despair ;)

Miss Whistle said...

"..could be a wave of suicidal depression is hitting us from outer space or the news is so bad that our brain cells are closing down in despair.."

Ha ha! I agree with you Thelma! This too shall pass.

Moss's accident sounds awful, so glad he's feeling better now.

MissW x

Anonymous said...

B, There is one doc on your list who took me for a $10,000 ride with back surgeries on Rocky years ago, only to have him put down a week later....

Anonymous said...

Do yourself & your dog a huge favor & go to good chiropractor. My very old dog was diagnosed with degenerative disc disease & referred for surgery. Instead I went straight to the chiropractor. He fixed her in one visit.

One more thing. Please google rimadyl before you use it & get all the facts. I wish I had ...