Survey: please help

We're trying to develop a better picture of the unmet needs for veterinary treatment in the area served by our animal clinic and beyond.
Please encourage anyone you know who has pets to complete it: all information is anonymous, but will help us to find what we need to do to reduce the numbers of animals who go without the treatment they need.

Hello 2009!

Hopefully not starting as it means to go on, with a 6.30 am call from the 24 hour vet to say they'd been phoned by one of the clients registered with our clinic, whose 16 year old dog was suddenly showing alarming symptoms of some kind of generalised allergic reaction.

The owners were evidently in such a panic that they'd forgotten how to make contact with us outside normal hours, by phoning the number given on their registration card. Instead they'd phoned the National Control Centre, who'd naturally said that our clinic is closed on Bank holidays. They'd then phoned the 24 hour vet and been horrified to find that the consultation charge alone for 6.30 on a holiday morning is £130.

Fortunately the receptionist at Vet24 was on the ball (one of the advantages of running on a shift system is that that staff are awake and in their right minds at peculiar times of day) and thought to contact me, so I was able to get them into our own out of hours cover via the University vet school, which is still reasonably expensive at that time of day, but nothing like £130.

I can't reiterate enough. If you are very strapped for cash it is more vital than ever that you make sure you understand how your own vet's out of hours cover works. If an animal is off-colour just before a holiday, don't hope for the best; get it checked out while the surgery is still running on normal charging rates. If you can't afford a private vet because you are on benefits, get your animal registered with the PDSA, Blue Cross or RSPCA before something happens.

Pet Insurance woes again

It does make me cross. An owner who did the responsible thing and got her dog insured found that her policy was almost worthless because the insurers refused to pay out until they'd received a copy of the paid invoice from the vet, and the company employing her usual vet were insisting on payment up front. 

For many people this wouldn't be a big deal: they'd simply pay with their credit card and pay off the card when the insurer reimbursed them. This owner was on benefits (and kudos to her for putting aside the money to pay her insurance each month in the circumstances). Hopefully she will get at least something back on the policy, as she's eligible to use our clinic and will be able to claim reimbursement of the cost of having the dog's operation done there. That doesn't make it fair that she's had nearly a week of misery thinking the dog might die if she couldn't find a way to get the operation done.

Moral: read the small print before taking out pet insurance, and ask your vet to check their practice's policy on settling bills via insurance claims. 

Update on cat with dislocated hip

At least some good news for a change! Dislocated hip cat turns out to have an owner and is fully insured, so no further cause for concern about his treatment. It looks as though he's going to make a full recovery. Excellent. 

Falling Through the Cracks

The RSPCA and the RCVS (Royal College of Veterinary Surgeons) have an agreement which governs the way we decide the financial criteria for allowing owners to attend RSPCA clinics and hospital. Basically this is designed to avoid creating a situation where charity clinics could undercut local private vets for routine operations and eventually drive them out of business. 

The agreement is that our clinics and hospitals only treat animals taken into RSPCA care for rehoming or owned by people on  state benefits (including pensions, working tax credit and students in full time education living away from home). Anyone who is not on state benefits is deemed to be capable of arranging treatment by a private vet — because they would normally be able to insure their animals or else pay using a credit card or bank overdraft if they do not have cash available. Diverting people who are on benefits to charity clinics is not likely to undercut private vets because these are people who probably would be unable to pay anyway.

Virtually all other welfare charities who run animal clinics operate similar criteria, although some have more restricted lists of benefits that they will accept as proof of low income. 

Most of the time this is clearly in the best interest of everyone, including the animals, because there is no way we could afford to run a complete "NHS for animals" providing veterinary care for all domestic pets — even if the RSPCA's entire resources were diverted to running clinics. If the private vets closed because we were taking away their clients through unfair competition everyone would be worse off. 

It can be very hard, though, if an owner's application for benefit is delayed through no fault of their own. This seems to be happening more frequently — usually because the owner has lost their job, or because a partner who was earning moves out. We can legitimately give a small amount of help via private vets as that doesn't contravene the agreement against unfair competition, but there are limits on what's possible. 

Vomiting dogs again

Yet another owner with two young, recently-acquired puppies with vomiting and diarrhoea with blood in it. It is enormously expensive to treat puppies like this effectively, because the vets have to set up barrier nursing if they admit them as inpatients. She's been quoted £300 per day, which in fact isn't unreasonable of the vet when you consider the cost of a veterinary nurse's salary; vet's salary and of completely disinfecting their isolation facilities (plus the initial costs of building an isolation unit at the practice).

These two puppies aren't insured or vaccinated and they're not registered either with the PDSA (for help with treatment at a local private vet) or with our own clinic in Cambridge — and in fact we wouldn't be able to have them admitted to the University Vet School who provide our hospital facilities because of the risk to their private patients.

I've agreed that we could help with the cost of giving the puppies intravenous fluids at the private vet, followed by home nursing by the owner, which will at least give them a chance.

Sadly, this is the situation we see over and over again. If you buy a puppy, ask for proof that the mother's vaccinations were up to date, and ensure that the puppy is vaccinated at 8 weeks (preferably by the breeder before leaving the mother) with a follow-up booster according to your vet's advice. Never, ever buy from an establishment where puppies are brought in from multiple sources — mixing different groups of puppies means spreading any infection. Make sure any adult dogs who will be in contact with the new puppy are up to date with their vaccinations. Take out pet insurance to cover vet bills, (or register the puppy with the PDSA, RSPCA or Blue Cross if you are on benefits and can't afford insurance).

Pet Food Politics - just out

Just finished reading Pet Food Politics: the Chihuahua in the Coal Mine - rather horribly topical in view of the current tragedy in China over babies dying of kidney failure due to adulteration of milk formula with the chemical melamine.

Pet Food Politics is a serious documentary which really does read like a thriller and explains how a combination of greed, dishonesty, incompetence and sheer inability to trace the complexity of global markets in food products led to the death of pets in Canada and the US. The villains of the piece used the same adulterating chemicals that caused the deaths of babies in 2008.

Fortunately pet food companies in the UK were either more careful, or just luckier.

Evidently it was "luckier" (update 5th Oct. 2008).

One very interesting observation which Marion Nestle makes is the potential value of the animal health data which pet insurance companies collect as a side effect of their business. One of the first pieces of real evidence that there was a problem with US pet food was the observation of one insurance company that claims for treatment of kidney disease in cats had soared in March 2007. Clearly there are all kinds of other posible ways similar information collecting could benefit pets - for example we could get unbiased evidence of the real extent of the problem with pedigree dogs.

Marion Nestle has her own blog at whattoeatbook.com.

Pet Insurance woes

Pet insurance is a life-saver, but owners can be lulled into a false sense of security if they don't make sure their policy is the right one for their financial circumstances. Many policies have an excess - a fixed amount of money which the animal's owner is expected to cover themselves - and will only pay out if the cost of treatment is more than the excess amount. It can be as much as eighty pounds - a sum which an owner on a really low income may not be able to lay their hands on in an emergency. Some policies only pay out once the owner has settled the vet's bill in full - again potentially something that an owner who doesn't have a credit card will find completely impossible.

Aggravatingly, this is just what's happened to a caller who's adopted a dog from a local rescue centre (not RSPCA) recently. The centre rehomes all its dogs with 30 day health insurance cover, and she'd delayed registering her dog at our clinic until after the bank holiday as a result.

Getting stung by jellyfish on an August bank holiday, will set you back £100+ at a private vet if you are a labrador. Unfortunately her policy has an excess of £80 which she doesn't have - and she doesn't have access to her savings because they are in a Post Office account.

Moral - always read the small print and never put off until tomorrow what you need to do today.

Running round in circles

Most of the people we deal with mean well, but they can create complicated situations. Phoned last night by an elderly lady who takes her dogs to our clinic. Her grandson's looking after his parent's home while they're away and taken in an unwanted kitten. This would have been fine, until kitty managed to get caught in a door - now has a leg swelling to twice its natural size, and, of course, being a bank holiday weekend, only the 24 hour emergency vet is open. At 7 weeks, the kitten's not old enough to have been registered at our clinic for their emergency cover.

Managed to get kitty into Vet24. They think his leg's probably broken, so they'll keep him on pain relief until Tuesday when we can transfer him to our clinic. If the leg is broken, we're looking at around £200 to get it pinned, even with our RSPCA discount, so I think the owner may have to sign the kitten over for rehoming. Sad, as he's a nice lad and very concerned about it.

On Payment Plans and Responsibility

Hardly any vets will allow arrangements where pet owners pay back the cost of treatment over a period of time, for the simple reason that too many people never pay back the full amount.

Our animal clinic is run in association with Cambridge University Vet School, and they charge pet owners for most operations direct, at prices which reflect the learning value to students of the opportunity to watch the process. This usually works out at roughly a third of what a private vet would charge (and is subsidised by us and by the University). Unfortunately, a third of £600 is still a lot of money for someone who is on benefit, and the Vet School used to offer payment plans so that owners could pay back a small amount each week. Like the private vets, they found that there were too many bad debts for the scheme to continue - money is tight and Universities are being pressed to pay their way like everyone else.

We're now left with the conundrum of what to do about the existing debtors. The School have a list and theoretically can refuse their animals any further treatment until the debt is paid. If we don't make some attempt to get everyone to pay it isn't fair on those who do make an effort and live on bread and jam until their animals' treatment is paid for. The non-payers have already cost the rest the payment plan option. It's also pretty unfair on the volunteer helpers and clinic staff when one of the people on the list turns up and makes a scene because they're not allowed to register more animals until they've paid. Further knock-on effects are less money for the School to employ enough nurses, so fewer in-patients can be admitted, and so on.

I've asked for a breakdown of the total amount owed by RSPCA clients and left unpaid. In the interest of maintaining a high standard of service, we may have to offer to make a one-off payment to reduce the debt. We'll also be looking to write to all the outstanding debtors to explain that their actions have caused the withdrawal of the payment plan option for operations.

£200 is a lot of money. Probably the single most effective thing the individual owner of a female dog can do to reduce her risk of needing such an operation is to have her spayed during the first few years of life. Spaying costs £35 at our clinic and up to £150 at a private vet. It eliminates the risk that she will need an emergency pyometria operation (£200-£700) later in life and greatly reduces the risk of breast tumours.

Insurance musings

Guardian Money has an article on breed-specific insurance premiums:

Axa, the insurance company that provides the policy (and which underwrites well over half a million pet policies sold by a wide range of partners, including the RSPCA, the Post Office and John Lewis's Greenbee) has this month introduced a "selected breeds" category: they are bulldogs, estrela mountain dogs, German shepherds (alsatian), great danes, greyhounds, Irish wolfhounds, leonbergers, Newfoundlands, old English sheepdogs, rottweilers, Pyrenean mountain dogs and St Bernards.

Thinking about it, I'm not surprised that most of these breeds are bad insurance risks, but a bit surprised by the inclusion of greyhounds; I can only think they've got a higher than normal risk of expensive, but survivable, "athletes" injuries, such as damaged cruciate ligaments (which can set you back £1k for a repair operation). Breeds like the cavaliers' heart problems or setters' retinal atrophy are a problem for the dog and owner, but not so much for the insurer, because there isn't a ruinously-expensive treatment option.

I'd second their advice to shop around - not only for better deals if you own one of the high-risk breeds, but, crucially, to make sure you get a policy which suits your financial circumstances. If you don't have savings or a credit card, it is absolutely essential to check that your insurer will either pay the vet direct or be prepared to pay you on the basis of an invoice from the vet which you have not yet paid. If you don't have a credit card, some policies are virtually useless if you are on a very low income, because they assume you will pay the vet and then claim the money back.

Pet insurance isn't the answer to all veterinary cost problems, but without it a lot more animals would have to be put to sleep, or have amputations rather than effective treatment.

Our own webshop offers some links to insurers who pay us commission, as does the national site. We are encouraging insurance in general, and no individual insurer will be right for everyone.