How do you choose the right vet?

Some of my criteria:

1. Gilly (or other animals over the years) likes not only the vet(s), but the techs. That’s a tricky one sometimes, since he doesn’t like going to the vet at all, and generally holds the vet responsible for anything bad that has ever happened to him. Even so, he does his best to be polite and submissive with most vets, so if he’s really showing a lot of fear or dislike I figure something’s off: he has the right to be more comfortable than that , so if there’s an option I should find it.

2. The techs are professional and reasonably kind – ie: not hostile, rude, or generally behaving as though their primary duty is to block access to the vet from all these distasteful clients (I don’t know why this is ever tolerated by a business owner, since it’s a lousy model, but I’ve run into it in several places). Also, if they’re that rude to me, I don’t trust them behind closed doors with my animals. Finally, these are the people I’m going to be dealing with every time I call for any reason (including to assess whether or not I need to bring someone in), and they’ll be the ones I have deal with when I have to make end-of-life decisions which are excruciating enough without the involvement of mean people.

3. Definite no-no: the vet is so over-committed I can’t get an appointment (or, more commonly, I run into #2 any time I call). I’m perfectly happy to schedule check-ups/yearly visits well in advance. In an emergency or sudden illness, I want to know that they’ll be there for the animal without question.

4. The office smells clean, I can see the surgery and it’s clean, etc.. If the place reeks of old urine, something isn’t going right in that office. If it’s visibly unsanitary, forget it.

5. The vet is clear with me about what to do in an emergency, and has a decent answering service (or a willingness to address the problem if their answering service sucks). Gilly could have died because the bonehead who answered the after-hours emergency line could not, apparently, process what “emergency” meant (or how to use her own phone equipment): his vet, however, figured out that there was a problem and addressed it with the service so it wouldn’t happen to anyone else.

6. The vet takes the time to explain things to me: not only what is happening and why, but what the options for treatment are, including what s/he thinks is best for the animal in any given situation, what is absolutely necessary and what isn’t, and what the various costs are.

Some newer vet grads seem hugely enamored of nifty new gadgets and tests. While I’m enormously grateful veterinary medicine is advancing and treatment options are increasing, and I want to be careful about how I say this, I also know there’s sometimes an increasing disconnect between what is possible and what is necessary – and that can create unnecessary experiences and suffering for the animal. For most of us, it also causes financial hardship that will hurt both the animal and the person in the long run.

Gilly’s had honest, clear, and realist vets, and he’s still a $10,000 dog at this point (it’s his extreme-sports habit: it’s like being responsible for Jackie Chan, only without health insurance).

I will move mountains with my bare hands to get Gilly what he needs: I’ll not buy myself groceries, I’ll cancel holidays, I’ll beg and grovel and pick up extra jobs and do whatever I have to do. Because this is true, because I’ll put anything on the line for his well-being and I am not wealthy, I have to be able to trust my vet to tell me what really is necessary (and what isn’t) – without inhumane profit-motive.

If they want to chew people up and spit them out, paving the road to personal wealth by creating unnecessary and invasive suffering, I hear there are some openings on Wall Street.

7. The vet and staff are committed to the animals’ well-being over and above  strict adherence to some policy/billing procedure/convenience for them. That is increasingly hard to find, and tells me a lot.

Couple of stories about why:

When Gilly was waiting for emergency surgery in 2007 the Burlington Emergency Veterinary Clinic doc gave him his painkiller then put both me and him in a huge cage right in the treatment area. They told me he was going to be loopy, and maybe pukey, and that I should hold him to keep him comforted until they could start his surgery. As high as Gilly was on the drugs, this probably meant more to me than it did to him; but every time they stepped over my feet to continue saving another dog’s life while I held the bleeding and barfing Gilly, I loved them a little more for not making him bleed and barf alone  (and I know his anxiety was lower than it would have been otherwise, because loopy or not, he could smell me right there).

On the other side of things, a different animal hospital insisted they were the only place that could do his eye surgery when he scratched his cornea and it ulcerated: they wanted a thousand dollars, and up front. ‘Our business is expensive to run,’ they informed me. I didn’t have it. They told me he’d go blind in horrible pain, that only a specialist could fix it, and tough luck or pay up. I called around to his old vets in a panic: my all time favorite vet (a State away in New Hampshire, but worth the drive) made an appointment for him the next day, told me he’d done several of these and he was not only confident he could fix it but glad to do the surgery since it was an interesting one, and that there was no reason it should cost more than $250 or so for his time and the meds.  The bill came in at $230. Gilly healed beautifully.

Emergency situations with individual animals don’t adhere to policies. A little flexibility goes a long way toward taking some of the horror out of it for everyone.

The vet I love best is in a clean, large, bright animal hospital. He’s an older gent who started out as a country doc working with large animals as well as small: he did mornings in barns and fields and afternoons in the surgery. He still does some large animal work, though he says he likes to tromp about in the ice less than he used to.

He’s basically something out of James Herriot. He is kind to Gilly and my cat Peep, and approaches them in a way that leaves them feeling entirely un-pressured. He’s intellectually curious in a way that means every health issue is an interesting puzzle. He’s communicative, and neither presumes I know what he’s talking about or that I don’t. When I ask a question, he explains in greater detail and with greater gusto than I even wanted sometimes.

My cat Peep has a common chronic viral respiratory disease he’s had since birth that causes him bouts of nasty congestion: these can turn into bacterial infections that are pretty difficult to treat. I asked him to explain it to me, since no vet ever really had gotten me clear on what I should be doing: he went off and got a cat skull and a magnifying glass and gave me a full lesson on feline nasal anatomy and why it’s so easy for bacteria to entrench in a cat’s nose. I worried aloud again about how long it was taking for the antibiotics and nose-drops to work, he pointed out that snotty or not my cat was very happy so I probably shouldn’t worry too much. Skilled information and calm common sense: what any animal lover needs in a vet.

Gilly was once stung by some nasty arachnid and had a violent and terrifying allergic reaction which lasted several days: it required antihistamine shots, sub-cutaneous hydration, 24-hour monitoring since the hives were all over him (including in his throat). Since Gilly was miserable but not at risk of death once the initial swellings came down some and he had nothing left to come out at either end, the doc suggested I keep Gilly home with me where he’d be happier. I brought him in for daily treatment, brought him home for rest.

The first night, the doc called me at 2 a.m. to see how Gilly and I were doing. He knew I’d be awake, and he was on call, so he checked in: I updated him on Gilly’s condition, he told me what to do, confirmed our appointment for the next afternoon, and had my adoration and loyalty from there forward. That level of calm, committed care is so rare.

The other thing I love about him is that in addition to his own obvious curiosity and constant learning, he has hired a bunch of hotshots fresh out of school to fill out his practice: between them, they have the best of new and old worlds. Knowledge of new technology and techniques, folk wisdom, decades of experience, energy to spare. It’s a great place. The techs are friendly and very evidently competent and enjoying their jobs. The reception lady is kind of scary, but nothing is perfect – and she almost adds a necessary spice to the place. Surrounded by excellence and warmth, she becomes comic relief.

That vet is an hour and a half away from where I am now.

The place is so great and I trust the vet so much that for anything that doesn’t require emergency treatment, that’s still where we’ll go.

* * *

I’d like to build the ‘adoption’ category of this blog to something including as much helpful information for new dog owners as possible, and the more perspectives the better: please add your two cents on how to choose the right vet in the comments!
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7 responses to “How do you choose the right vet?

  1. Jess, if you do worry about health costs for Gilly, have you considered pet insurance? We were with Embrace while we were in the US for Siena, and I loved them. Fantastic people and the rates were very reasonable.
    As for vets, I concur with everything you’ve said. We adopted Siena when she was 4, and she knew much more about what to expect from a vet than we did. So to me, a good vet will also be able to know how to deal with silly/paranoid/anxious parents as well as with the animals themselves! Having a wide range of experience with out of the ordinary situations is a big plus in a vet. Two examples: We were going on vacation and leaving Siena in the care of someone else was very stressful. The vet allowed us to fill out a form which detailed information about the carer, who in the event of emergency would bring Siena in for treatment. It just facilitated things from their POV which also reassured us that our baby would be cared for. The other example was preparing for our move to the UK. There was SO much paperwork and tests that we had to do to apply for Siena’s pet passport, and the vet never blinked an eye. They had done a few international moves before so were happy to comply with our requests and get us everything we needed on time.
    Our vet here has been great so far, and it is always amusing to get in line behind the sheep! They have an open clinic time if you don’t make an appointment and the techs are all very helpful. Sounds like you have a great one to go to, even if it is a schlep away!

  2. hahaha..nice post….with cute cat…!

  3. Good to know you had a good experience with Embrace!

    The credit card companies finally figured out how to exploit animal people in emergencies – emergency hospitals are hawking them like mad. It sounds like pet insurance is probably a much better option for a lot of people.

    Your American vet sounds great, and so does a sheep clinic! : )

  4. FYI, all:

    I did some research to see if pet insurance has become any more affordable and widely useful than it was when I first checked it out.

    As I-Chant said, it’s reasonable for some – but it’s prohibitively expensive for too many people.

    Animals cost a lot of money, and caring for them properly requires a significant financial commitment – and, it is also true that there are a lot of people financially exploiting our love for our animals and making it much harder than it used to be to care for them well.

    Some vets will still do payment plans, but very few.

    A savings account is still the least exploitable way to build up a stockpile of money in case of veterinary emergency.

    Vet charges vary HUGELY.

    So for those of us who struggle financially from month to month, some thoughts:

    Here’s an estimated quote for pet insurance for an 8 year old, neutered, mixed breed dog (I used Gilly for a model – I’m sure mileage would vary, though I don’t know by how much).:

    29$/mo for accident and illness coverage, with a 500$ deductible, a 5,000$/year maximum benefit, and a 20% co-pay
    (@ 350$/yr to the insurance company regardless of usage, plus 20% per visit)

    46$/mo for the same coverage with a 200$ deductible and a $10,000/year maximum benefit
    (@ 550$/yr to the insurance company regardless of usage, plus 20% per visit)

    85$/mo for accident, illness, dental, prescription, and wellness coverage with a 200$ deductible, a $10,000/yr max. benefit, and a 10% co-pay
    (@ 1,020$/yr to the insurance company regardless of usage, plus 10% per visit)

    To put it in context: if nothing out of the ordinary happens to Gilly, at my great and inexpensive vet in New Hampshire I will pay about 50-75$ a year for his check up and vaccinations (I know, that is amazingly inexpensive: the office visit is about 30$ and the vaccines themselves run very cheap – he is committed to affordable care).

    In the Five College area of Massachusetts, I can expect to double – or even triple, depending on where I go – that cost.

    Dental care adds a lot to that figure, and different vets have widely varying recommendations about what to do and how often (including widely varying perspectives on anesthesia risks vs. benefits of professional cleanings).

    In a year when Gilly requires a couple of emergency procedures (like the eye surgery for a scratched cornea, and the follow-up treatment) I might pass the deductible of 500$ and be able to start getting something out of the insurance.

    If I took him to one of the more local vets who charge at least double what my New Hampshire guy does (and who pressure every client to do every conceivable test and procedure and supplement and grooming and and and – ie: boutique-style vet care vs. only what is generally agreed upon as being what is truly necessary for the animal’s health), I’d probably pass the deductibles in one visit and this kind of pet insurance might actually save me money.

    So for someone who can afford the monthly payments and doesn’t have access to truly affordable vet care, and/or for someone who is of the more-is-more school in terms of how many visits & procedures they want their animal to have, it might be great.

    One catastrophic accident would make the insurance worthwhile for that year.

    My impression is that you have to pre-pay all of this then get reimbursed, though, so you still have to have the cash on hand or put it on credit. A word about credit: if you’re a conscientious credit objector like me, or if – like millions of other Americans at this point, so there’s truly no shame in it – you have no or poor credit because of foreclosure, student loans, or whatever other circumstance, you’re out of luck and have to have the cash.

    Emergency hospitals will turn you and your dying animal away if you can’t prove ability to pay prior to treatment. At this point I don’t know of a single one that doesn’t do this: there is no financial assistance or qualifying for free care or other equivalents to human hospital care (not that hospitals truly make this available to many people anyway).

    If I needed to do chemotherapy for a dog or cat, or some other regular and extremely expensive treatment by a veterinary specialist, the insurance would be a huge and instant help – and in fact would probably be the only way I could do it. Keep in mind, they don’t cover pre-existing conditions so I would have to have been paying for the insurance already when the animal got diagnosed with whatever ongoing health problem.

    If anyone knows of vet care assistance resources other than credit or insurance of this kind, I’m sure readers would be glad to know of it!

    The one thing I can say is that there are almost always discount (or free) spay/neuter clinics to be found (call your local shelter or rescue org), and sometimes counties and towns will also do discount or free rabies vaccinations.

    It can’t hurt, too, to speak with your vet (in advance of needing it!) about a payment plan, pre-paying an in-case-of-emergency-fund into your account, or other creative solutions to serve as back up in a worst case scenario.

    * * *

    Particularly when there are so many millions of animals in need of loving homes, I would like to see anyone who can afford to feed and shelter an animal be able to access some kind of help in medical bills for that animal.

    I don’t feel we have the luxury of simply shrugging and saying ‘well if you can’t afford several thousand dollars a year, you shouldn’t have an animal.’

    In my perfect world, I imagine a couple of things (and I’m sure there are many other possible solutions) –

    Vets donating (rotating) single days per month of free care for low-income owners at some central (or rotating) vet office/animal hospital location. Many human doctors do it: vets could too.

    People who can afford it paying their vet extra at each visit (even doing a round-up to the nearest dollar!), and the vets putting this money into an emergency assistance fund for clients of lesser means. Same thing at emergency hospitals.

    Other ideas?

  5. I like the idea of the emergency fund. I am going to start one here.

  6. It’s a small thing that could have a huge beneficial impact, right?

    If Bank of America can do a round up to the nearest dollar into a savings account thing, vets could certainly put up a little sign at the desk asking people to do that if they can (or give more) toward a low-income emergency fund.

    I’m thinking through making an organized proposal in my local tri-county area for this and/or for vet clinic participation in a monthly sliding–scale or free clinic open to anyone who needs help paying for the care of animals which will otherwise end up in shelter, sick, or dead. There are some tricky aspects to figure out, but it shouldn’t be insurmountable to find a sustainable way to pull it off.

  7. (Whoops: Ryan, the spam queue got you and a few others: just fished out the not-spam. Sorry for the delay, and thanks! He is cute, isn’t he? Applehead.)

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