feemandvm

We lost Sky to osteosarcoma on 4/1/07. He lived for 1 year and 3 days after amputation and chemotherapy. I bought a silver dogtag at Things Remembered and had the front side engraved with his name and dates and 2 paw prints. I wanted to have something engraved on the back but haven't been able to come up with anything that seems appropriate. I was thinking of something along the lines of "Gone but not forgotten" or "Forever in my heart" or "Fly free" or words to that effect but all the little phrases I come up with on my own just don't seem right. Just thought I'd see if anyone had any thoughts suggestions and I'm hoping one will seem just right so I can finish the engraving. Thanks in advance for any suggestions anyone has!!

No advice unfortunately other tehn I would pursue the referral and try to get some concrete answers. : ( I've seen clots (saddle thrombus) in cats but not in dogs.

Be sure to stick with a big company. I've heard of several smaller companies going out of business and owners having paid all their premiums on their younger pets being left out to dry once they were older. VPI is "owned" by Iams/Eukanuba so there is a lot of financial stability there. Other companies may also be fine... just do your research!

Obviously with any insurance policy... the company is betting you'll pay them more then they will pay you at the end of the day. If that wasn't the case more often than not, then they'd be out of business. Having said that... pet insurance is just that... it is insurance. I know that I NEVER come anywhere close to using what I pay for insurance. HOWEVER, if I was in major accident... I would never be able to handle it w/o insurance. One thing I can tell you from a vet's point of view is this. Owners with pet insurance to me seem less stressed at the hospital as they rarely have to worry about $$$ on top of health!

Quite timely but just read an article in a vet journal today that said average student debt (counting undergraduate) for veterinarians graduating in 2005 was over $100,000. This doesn't mean that vets should make millions of dollars... but that although a salary may be $50,000/year, a big chunk of that is going to have to go toward paying off that student debt!

Extra question... what is the average student debt for a PhD in chemistry? The average student debt for veterinary school alone (not counting undergraduate) is in excess of $60,000! Most students that pursue a masters degree and PhD will have their school paid for by a stipend. Not an option in veterinary school. Ok, I have a question for you: do you think that salary should be a function of how expensive or cheap a particular school is? A Lehigh University engineer owes $150,000 at the end of 4 years, a Penn State engineer owes $40,000, Do you think the Lehigh grad should get 3X the salary? The cost of vet school is an irrelevent arguement. I think most, if not all, vets know what their potential salaries will be before they decide to go to vet school. I doupt anyone goes into veterinary medicine expecting to make a lot of money. If you knew going into school what the salary is and how much school would cost... Bill, perhaps you should have gone to get your doctorate in chemistry. You could teach college chemistry like I do...and get paid $3500/class/semester. Talk about underpaid! You won't get an argument from me on you being underpaid! Teachers as a profession IMHO are the most woefully underpaid of all. Teachers are critical to every profession and shape our youth. . How they can be paid so poorly is beyond my comprehension. Also now they seem to be trying to eliminate benefits which is the one thing teachers had going for them. Also... I don't think you will ever find a vet that joined the profession for money. If they did they will quickly leave it. You could work fewer hours and make a much larger salary in human medicine. However, I believe that some people think vets are paid on a comparable level to human doctors and that is not true.

Extra question... what is the average student debt for a PhD in chemistry? The average student debt for veterinary school alone (not counting undergraduate) is in excess of $60,000! Most students that pursue a masters degree and PhD will have their school paid for by a stipend. Not an option in veterinary school.

No official website... I think that isn't likely to happen soon. Here is the closest thing so far: http://www.vet.ohio-state.edu/2095.htm

The corona vaccine is not one that I personally recommend. When they tried to research the efficacy of the vaccine they couldn't tell b/c they had a hard time making the unvaccinated dogs sick with the virus! : ) We use a 3 year protocol for Distemper. If Leptospirosis is endemic in your area, that vaccine needs to be given annually. Bordatella is another vaccine that if your pets are at risk needs to be given every 6-12 months. I don't titer my own pups due to the inaccuracy of hte test. Many false negative test results and some false positives. In theory the titers are the best thing... in practice it just doesn't work out. In 10 years maybe we will discover that dogs don't need a booster after 18 months... but right now we don't know that so a protocol like that is risky. Maybe they will be fine... maybe they won't. We just don't know. If your vet vaccinates annually... you can still have your pups vaccinated on a q 3 year schedule if you request it. You are hte owner and ultimately you dicatate how your pet is treated. Having said that... this is a decision that you should reach after having discussed it with your vet. We don't live in a Lyme endemic area so I would leave vaccine comments to those vets that do. I can probably count on 1 hand the number of dogs I've given Lyme vaccine to but we haven't had any problems.

“Until one has loved an animal, a part of one’s soul remains unawakened” -Anabele France The loss of a pet can often be as devastating as the loss of a human family member. Our pets find ways of working their way into our families and becoming more than just pets, but actual members of the family. Pets teach us a great many things about unconditional love, forgiveness, compassion, living each day moment to moment, not holding grudges and to take joy in the simple things in life. Their love and companionship brightens everyday that we spend with them which makes their loss all the more troubling. Having lost pets ourselves, these are some ideas that we have come up with over the years to help ease the feeling of loss: 1. Baked clay pawprints with your dog’s name can be obtained at Animal Medical Centre of Medina. Please ask a technician if you are interested in this. 2. Share fond memories, funny stories, favorite pictures, etc. with other family members or friends who also shared in your dog’s life. Talking about your loved one is often one of the best ways to deal with the loss. 3. Support staff is available and can be reached by calling “The Pet Loss Hotline” at (614) 292-1823. Their hours of operation are Monday, Wednesday, and Friday from 6:30 p.m. to 9:30 p.m. They may be able to put you in touch with a local support group if requested. 4. Have a personalized picture frame created (Things Remembered and many other stores make them) with your pet’s name or a favorite phrase and place it somewhere special in your home. 5. Consider writing a letter to your dog, telling them how special they were and how much you miss them. If you make a picture frame as well… consider placing the letter behind the picture in the frame. 6. Numerous websites are available where you can post pictures and text as memorials to your pets. Most of these sites charge a small fee, part of which is often given to charity. www.rainbowbridge.com 7. Numerous websites are available dealing with grief: http://www.avma.org/careforanimals/animate...end/goodbye.asp http://www.deltasociety.org/dsn000.htm http://www.pet-loss.net/resources/Int.html http://www.aplb.org/ http://www.aplb.org/ http://www.vetmed.ucdavis.edu/ccab/petloss.html 8. Consider making a scrapbook or photo album with all of your favorite pictures of your dog and/or other memorabilia you have. 9. Consider making or purchasing some type of memorial to keep around the house. Stepping stones, statues etc. can be purchased (Michael’s and many other stores sell them) which can be personalized with your dog’s name and dates of life. 10. There are several children’s books that are available and are good for both adults and children alike. “For Every Dog an Angel” by Christine Davis, “Dog Heaven” by Cynthia Rylant, and “Bailey Bymyside” by Patricia Burlin Kennedy are a few that we recommend. 11. Consider donating money to a charitable cause in your dog’s name. 12. If you choose to have your dog cremated, you can choose to have the ashes returned in an urn. Some owners display the urn in their house while others have buried the urn as a memorial. 13. You can purchase a crystal to hang in a window. Whenever the light hits the crystal and casts a rainbow of colors into the room… you can be reminded of your faithful friend waiting for you at the Rainbow Bridge. These are all tips that we have learned over the years to help cope with the loss of a pet. We hope that some of these are able to help you during your time of loss. We are always available should you have any questions. If you feel that you are suffering from major depression following the loss of your pet, we recommend consulting with a counselor. A Lifetime Of Love I remember bringing you home. You were so small and cuddly. You bounced around the room with eyes flashing and ears flopping. Making a mess of the house and chewing on everything in sight became a passion, and when I scolded you, you just put your head down and looked up at me with those innocent eyes. As you got older, you protected me by looking out the window and barking at everyone who walked by. When I had a tough day at work, you would be waiting for me with your tail wagging. I could always count on you to be there for me. You never asked for anything more than to have me pat your head. As you got older, you moved around more slowly. Then, one day, old age finally took its toll, and you couldn’t stand on those wobbly legs anymore. With tears in my eyes, I drove you one last time to the vet. One last time, you were lying next to me. As the vet led you away, you stopped for an instant, turned your head and looked at me as if to say, “Thank you for taking care of me.” I thought, “No, thank you for taking care of me.” Chuck Wells- Palmyra, New York The Rainbow Bridge Just this side of heaven is a place called the Rainbow Bridge. When an animal dies that has been especially close to someone here, that pet goes to the Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable. All the animals who had been ill and old are restored to health and vigor. Those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by. The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind. They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent. His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster. You have been spotted, and when you and your special friend finally meet, you cling together in a joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart. Then you cross the rainbow bridge together… Author Unknown… I went back and sat down by the bed. Miss Stubbs looked out the window for a few minutes, then turned to me. “You know, Mr. Herriot,” she said casually. “It will be my turn next. I have only one fear.” Her expression changed with startling suddenness as if a mask had dropped. A kind of terror flickered in her eyes and she quickly grasped my hand. “It’s my dogs and cats, Mr. Herriot. I’m afraid I might never see them when I’m gone and it worries me so. You see, I know I’ll be reunited with my parents and my brothers but…” ”Well why not with your animals?” “That’s just it.” She rocked her head on the pillow and for the first time I saw tears on her cheeks. “They say animals have no souls.” “Miss Stubbs, I’m afraid I’m a bit foggy on all this,” I said. “But I’m absolutely certain of one thing. Wherever you are going, they are going too.” She stared at me but her face was calm again. “Thank you, Mr. Herriot, I know you are being honest with me. That’s what you really believe, isn’t it?” “I do believe it, “ I said. “With all my heart I believe it.” -James Herriot This is my comfort in my affliction that your word has revived me. -Proverbs 119:50 All things bright and beautiful All creatures great and small All things wise and wonderful The lord God made them all. -Gail Frances Alexander “The best friend a man has in this world may turn against him and become his enemy. The money that a man has he may lose. The one absolutely unselfish friend that man can have in this selfish world, the one that never deserts him, the one that never moves ungrateful or treacherous, is his dog. He will kiss the hand that has no food to offer. When all other friends desert, he remains. If fortune drives the master forth an outcast in the world, friendless and homeless, the faithful dog asks no higher privilege than that of accompanying him to guard against danger, to fight his enemies, and when the last scene of all comes, and death takes the master in its embrace and his body is laid away in the cold ground, no matter if all other friends pursue their way, there by his graveside will the noble dog be found, his head between his paws, his eyes sad but open on alert watchfulness, faithful and true even to death”. –George G. Vest "As long as we give them the love they deserve and as much love as we can, we've done what we were supposed to do, and that is Love them for the rest of their lives, however long that may be." -Jeanette Ambrose A righteous man cares for the needs of his animals… -Proverbs 12:10 One day… The wolf will live with the lamb, the leopard will lie down with the goat, the calf and the lion and the yearling together and a little child will lead them. -Isaiah 11:6 “The great pleasure of a dog is that you may make a fool of yourself with him and not only will he not scold you, but he will make a fool of himself too”. -Samuel Butler There is a time for everything, and a season for very activity under heaven: a time to be born and a time to die. -Ecclesiastes 3:1,2 “I realize something I did not realize then—how lucky I was compared to so many others who have to face the loss of their animal without other people around them. I, at least, was surrounded by animal people. And I think they’ve got to let the person know that it’s O.K., that grief for a pet is acceptable, it is normal. Unlike some people who have experienced the loss of an animal, I did not believe, even for a moment, that I would never get another. I did know full well that there were just too many animals out there in need of homes for me to take what I have always regarded as the self-indulgent road of saying the heartbreak of the loss of an animal was too much ever to want to go through with it again. To me, such an admission brought up the far more powerful admission that all the wonderful times you had with your animal were not worth the unhappiness at the end”. -Cleveland Amory In His hand is the life of every creature and the breath of all mankind… -Job 12:10 Blessed be the God and Father of our Lord Jesus Christ the Father of mercies and God of all comfort, who comforts us in all our afflictions. -2 Corintheans 1:3,4 The Price I Pay The nuzzles that you give to me you give so often and for free you never ask a price I pay to hold you close and let you stay I stroke your ears and hear your purr and run my hands on silken fur you gaze on me with eyes of green the sweetest sight I've ever seen You sleep all still, rolled in a ball I think this is the thrill of all and something's happened here within I feel my head begin to spin And now I know the price I pay the one I'll pay to let you stay you hold my heart with furry glove the price I pay is all my love. -Mark A. Dye “A dog can express more with his tail in minutes than his owner can express with his tongue in hours”. -Anonymous “Everybody’s born so they can learn to live a good life and love others. Animals already know how to do that, so they don’t need to stay as long.” -Anonymous four year old child A Dog's Plea Treat me kindly, my beloved friend, for no heart in all the world is more grateful for kindness than the loving heart of me. Do not break my spirit with a stick, for though I should lick your hand between blows, your patience and understanding will more quickly teach me the things you would have me learn. Speak to me often, for your voice is the world's sweetest music, as you must know by the fierce wagging of my tail when the sound of your footstep falls upon my waiting ear. Please take me inside when it is cold and wet, for I am a domesticated animal, no longer accustomed to bitter elements. I ask no greater glory than the privilege of sitting beneath your feet beside the hearth. Keep my pan filled with fresh water for I cannot tell you when I suffer thirst. Feed me clean food that I may stay well, to romp and play and do your bidding, to walk by your side and stand ready, willing and able to protect you with my life should your life be in danger. And my friend, when I am very old, and I no longer enjoy good health, hearing and sight, do not make heroic efforts to keep me going. I'm not having any fun. Please see that my trusting life is taken gently. I shall leave this earth knowing with the last breath I draw that my fate was always safest in your hands. – Author unknown. Member of the Family What would I do without you, My precious, furry friend? Part mischief, but all blessing, And faithful to the end! You look at me with eyes of love; You never hold a grudge . . . You think I'm far too wonderful To criticize or judge. It seems your greatest joy in life Is being close to me . . . I think God knew how comforting Your warm, soft fur would be. I know you think you're human, But I'm glad it isn't true . . . The world would be a nicer place If folks were more like you! A few short years are all we have; One day we'll have to part . . . But you, my pet, will always have A place within my heart. - Hope Harrington Kolb May I Go? May I Go? May I go now? Do you think the time is right? May I say good-bye to pain-filled days and endless lonely nights? I’ve lived my life and done my best, an example tried to be. So can I take that step beyond and set my spirit free? I didn’t want to go at first, I fought with all my might. But something seems to draw me now to a warm and loving light. I want to go. I really do. It’s difficult to stay. But I will try as best I can to live just one more day, To give you time to care for me and share your love and fears. I know you’re sad and so afraid, because I see your tears. I’ll not be far, I promise that, and hope you’ll always know that my spirit will be close to you, wherever you may go. Thank you so for loving me. You know I love you too. That’s why it’s hard to say good-bye and end this life with you. So hold me now, just one more time and let me hear you say, because you care so much for me, you’ll let me go today. -Susan A. Jackson Take Time to Heal Now Dying is the easier role Returning Home to God, the angels The spirit world of peace and love. Our animal loved ones are there now safe, whole, loved and ever loving. It is in staying behind on earth feeling alone without the animals we love so dearly that is the harder role. The anguish of it comes unbidden, when least expected, seemingly unending, inescapable, dark hours of pain. Yet relief from pain and healing and growth are possible too Nourishment and support are all around in people, the animals, the sun, the rivers in forests, in flowers, in books, in tapes, in pictures, in song, from angels, from God and the strength and wisdom of our own souls. We must only open our hearts to the love waiting to help us heal. Pouring our love and care and nurturing onto our animals must shift now, to loving and caring and nurturing ourselves. It is time for us now. As one who has loved so completely so fully You are just as important as the one who has died. You do not dishonor your loved one or their memory by taking care of yourself. Take time to heal now. Make choices to grow now. Love yourself as you love your animal. Love yourself as your animal loves you. -Teresa Wagner A Doggie Prayer So do not grieve for me, my friend, As I am with my kind. My collar is a rainbow’s hue My leash a shooting star My boundaries are the milky way Where I sparkle from afar There are no pens or kennels here For I am not confined But free to roam God’s heavens Among my special kind I nap the day on a snowy cloud With gentle breezes rocking me I dream the dreams of earthlings And how it used to be The trees are full of liver treats And tennis balls abound And milk bones line the walking ways Just waiting to be found. There even is a ring set up The grass all lush and green And everyone who gaits around Becomes the “Best Of Breed.” For we’re all winners in this place We have no faults you see And God passes out the ribbons To each one—even me. At night I sleep in angels’ arms Their wings protecting me And moonbeams dance about us As stardust falls on thee. So when your life on earth is spent And you reach heaven’s gate Have no fear of loneliness For her, you know I wait. -Author Unknown Never Left Your Side I stood by your bed last night, I came to have a peep. I could see that you were crying, You found it hard to sleep. I whined to you softly as you brushed away a tear, "It's me, I haven't left you, I'm well, I'm fine, I'm here." I was close to you at breakfast, I watched you pour the tea, You were thinking of the many times, your hands reached down to me. I was with you at the shops today, Your arms were getting sore. I longed to take your parcels, I wish I could do more. I was with you at my grave today, You tend it with such care. I want to reassure you, that I'm not lying there. I walked with you towards the house, as you fumbled for your key. I gently put my paw on you, I smiled and said "it's me." You looked so very tired, and sank into a chair. I tried so hard to let you know, that I was standing there. It's possible for me, to be so near you everyday. To say to you with certainty, "I never went away." You sat there very quietly, then smiled, I think you knew ... in the stillness of that evening, I was very close to you. The day is over... I smile and watch you yawning and say "goodnight, God bless, I'll see you in the morning." And when the time is right for you to cross the brief divide, I'll rush across to greet you and we'll stand, side by side. I have so many things to show you, there is so much for you to see. Be patient, live your journey out ... then come home to be with me. -Author unknown

Right now that site is mostly regarding active racing problems (quarantines, etc.)... but it's origin actually stemmed from the veterinarians for retired racing greyhounds meeting in Jan. at the North American Veterinary Conference. As the site gets up and running it will include a public library on Greyhound health issues and a veterinary message board. Those are the improvements I am looking forward to. I've registered already and an email was sent to everyone in the vets for retired racing greyhounds group the first day that it opened. It's already a good site but give it time and it will be greyt! : )

OH I guess I should add the group is currently communicating via email and meets annually (at least so far) at the North American Veterinary Conference.

The group is made up of vets who see a lot of Greyhounds so we can stay up to date on the latest research and treatment modalities. We've had discussions on bleeding problems in Greyhounds, TBD titers, corns, anesthesia, whatever topics people have questions on at the time. I found one suggestion on corns VERY helpful where one vet actually "hulled" them out using a dental tool. The procedure was painless and only took about 5 minutes with no anesthesia and the dog seemed to show some pretty quick improvement. That technique isn't found in ANY textbook or any article... although I'm trying to talk the vet into publishing it!!! : ) Anyway... that is what it is about. Eventually there will be a website available for vets with a message board on which to post on www.ghrin.org but it isn't up and running yet. That may come later this year or early 2006.

Sounds like it was a difficult diagnosis to come to. : ( My deepest sympathies on your loss.

Sorry to read about your loss. If the diagnosis of histiocytic sarcoma was correct then that was a bad disease that is ultimately fatal. : ( The biopsy was unusual in that the person who read it even mentioned it and stated "warrants consideration" and not "is diagnostic for". In cases like these I would typically have lab send the sample somewhere else for a 2nd opinion. If it were in Ohio, I'd probably send it to OSU and have them read it and then consult with Dr. Couto their oncologist on how to proceed as this is a rare diagnosis. I don't have very much info. to share on this condition as it is rare... but this is what I could track down: Malignant histiocytosis is often characterized by the systemic proliferation of large, pleomorphic, single and multinucleated histiocytes with marked cellular atypia and phagocytosis of erythrocytes and leukocytes. These histiocytes are pleomorphic, large, discrete, markedly atypical mononuclear cells; nuclei are round to oval or reniform. Features of malignancy that are usually present include marked anisocytosis and anisokaryosis, prominent nucleoli, bizarre mitotic figures, marked phagocytosis of erythrocytes, leukocytes, and other tumor cells, and moderate amounts of lightly basophilic, vacuolated cytoplasm. The presence of multinucleated giant cells also supports the diagnosis. Malignant histiocytosis is a rapidly progressive, ultimately fatal, disorder that has been described in adult dogs, including Bernese mountain dogs and other breeds; an increased incidence of the disorder has been suggested in the golden retriever and flat coated retriever breeds.

Now to be fair... I don't think a vet is overcharging if they recommend veterinary products. There are some vets out there that still recommend that owners use aspirin instead of the newer and safer veterinary NSAIDs. There are some vets who won't do various tests b/c they feel that owners cannot afford them. I actually talked to an emergency technician who stated that sometimes they tailor recommendations to what an owner can afford. To me that is the worst possible thing anyone can do. It is not a vet's place or a technician's place to decide what an owner can or cannot afford. It is certainly an owner's place to decide what they can and cannot afford but that decision should be their own to make. When I see a sick pet I always tell the owner what the best way to handle it would be. If an owner cannot afford that, then we compromise and try to help the pet as best we can within the budget of the owner. There are some cheap ways of handling some conditions like boiling chicken and rice as a bland diet and I've used those as well but recommending a bland balanced diet like I/D isn't wrong either... and I certainly wouldn't think that vet was price gouging. Nor would recommending a veterinary shampoo... most human shampoos are too drying to dog's skin and have the potential to cause as many problems as they may help to treat. I think there is inherent danger in shopping for price... not that less is less or less is more or more is less or more is more... but that prices do no correlate with quality. Sometimes a $50 dental cleaning is $50 b/c cornors may be cut... sometimes it might be because overhead is lower. As long as you are happy where you are with teh quality of medicine being practiced that is the most important thing.

I think Greyhounds are more prone to secondary forms of immune mediated disease b/c we see the incidence of infectious causes such as Babesia (RBCs) and Ehrlichia (platelets) more in Greys than other breeds. I'm not aware of any study though that states that primary immune mediated hemolytic anemia or thrombocytopenia is higher in Greys though. If you come across something that does... please let me know. My deepest sympathies on your loss and here are a few links that might be helpful to you: http://www.VeterinaryPartner.com/Content.plx?P=A&A=1390 http://www.VeterinaryPartner.com/Content.plx?P=A&A=1412

That is a very good point actually. Our clinic does discuss with owners to be aware of various reactions from lethargy to vomiting to diarrhea, etc. and to call if noted. It is very rare that we receive a phone call. You are right though in that there probably are a lot of unreported minor reactions!

World Wide Web-Based Survey of Vaccination Practices, Postvaccinal Reactions, and Vaccine Site-Associated Sarcomas in Cats J Am Vet Med Assoc 220[10]:1477-1482 May 15'02 Survey 8 Refs Glenna M. Gobar, DVM, MPVM, MS, and Philip H. Kass, DVM, PhD, DACVPM * Section of Biometrics and Preventive Medicine, Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616 [* address correspondence] OBJECTIVE: To quantify incidence of vaccination practices, postvaccinal reactions, and vaccine site-associated sarcomas in cats. DESIGN: Epidemiologic survey. ANIMALS: 31,671 cats vaccinated in the United States and Canada by veterinarians with World Wide Web access. PROCEDURE: Veterinarians used secure Web-based survey forms to report data regarding administered vaccines, postvaccinal inflammatory reactions, vaccine site-associated sarcomas, and detailed information and history on each sarcoma. Data were collected from Jan 1, 1998 to Dec 31, 2000, allowing a 1-to 3-year follow-up of vaccinated cats. RESULTS: Participants reported administering 61,747 doses of vaccine to 31,671 cats; postvaccinal inflammatory reactions developed in 73 cats (11.8 reactions/10,000 vaccine doses), and qualifying vaccine site-associated sarcomas developed in 2 cats (0.63 sarcomas/10,000 cats; 0.32 sarcomas/10,000 doses of all vaccines). CONCLUSIONS & CLINICAL RELEVANCE: These findings indicate that the incidence of vaccine site-associated sarcomas is low and is not increasing. Thoughtful consideration of the relative risks and benefits of specific vaccines remains the best means of reducing the incidence of sarcomas. It is not necessary to remove postvaccinal granulomas unless malignant behavior is apparent or they persist > 4 months.

Advising Owners on Vaccine Side Effects Western Veterinary Conference 2002 Michael J. Day, BSc BVMS(Hons) PhD FASM DiplECVP MRCPath FRCVS University of Bristol Langford, Bristol, United Kingdom Objectives To review the problem of adverse reactions to vaccines. To review the proposals to minimize the occurrence of such reactions. To discuss how best to communicate these points to pet owners. Key Points A range of adverse reactions to vaccines are documented in companion animals. A firm scientific basis for most of these has not been established. The incidence of adverse reactions in terms of doses of vaccine sold is minimal. Vaccines have had a major impact on the control of infectious disease in companion animals. Strategies for minimising adverse reactions to vaccines have been proposed. Veterinary vaccines are distinct from human vaccines. Overview The controversy surrounding adverse reactions to canine and feline vaccines has been one of the major issues facing the veterinary profession over the past decade. It is important that veterinary practitioners understand the facts underlying this debate, and be able to communicate them effectively to owners and breeders. The USA has led in the formulation of specific recommendations to address this problem, which is only now becoming a significant issue in Europe. Key to this area are the concepts of “risk assessment,” “risk communication” and ”risk management.” Risk Assessment That such reactions exist is now clear, but the scientific evidence that links vaccination to the causation of specific clinical abnormalities is limited. The best-documented association is with feline sarcoma1, but there is no accepted mechanistic explanation for the initiation of this neoplasm by specific vaccines. The scientific research that defines a mechanistic association between the onset of various immune-mediated diseases and vaccination is considerably less extensive. There is continued need for definition of the extent of this problem by well-funded epidemiological research. Existing evidence, based on the collection of suspect adverse reactions (SAR) by drug companies and government agencies suggests that the incidence of such reactions is extremely low2. Risk Communication and Risk Management What practical advice and recommendations should be given to owners or breeders who are concerned about adverse reactions to vaccination? The process of presenting this information in a clear and open manner is referred to as “risk communication” 3, and the application of these concepts lies in the area of 'risk management'. The key points for discussion are listed below. Vaccination is of benefit to the individual and to the population in prevention and control of infectious disease, and being unvaccinated does place an animal at risk. This risk increases as the unvaccinated population of animals increases. This is best illustrated by the recent recrudescence of canine distemper in geographical areas where reduced vaccine usage, or use of a product of inadequate efficacy, was practiced. The modification of vaccine protocols to avoid future adverse reactions must therefore be assessed in light of the risk to the individual and to the population of being exposed to infectious disease. The risk to an individual animal of not receiving a booster vaccine can be assessed by measurement of specific antibody status4,5,6. Animals with “protective” titres may not necessarily require revaccination at that time. However, the value of measurement of antibody versus cell-mediated immunity in assessing protection from disease should be considered. Related to this, the “maximum duration of immunity” and the “maximum duration of protection” has not been defined for most veterinary vaccines by experimental challenge studies. Vaccine regimes can be modified to reduce the perceived risk from “over-vaccination” 7,8,9. In this regard, the USA has been more proactive than Europe in publishing such revised protocols. For example, the recommendations for 3 yearly feline boosters, protocols for specific sites of administration of different vaccines, decreasing the use of polyvalent and alum-adjuvanted vaccines, and the concept of “core” (e.g., distemper, adenovirus, parvovirus, rabies) and “optional” vaccines (e.g., leptospirosis, borreliosis, kennel cough) have received much publicity. Vaccine schedules might be tailored to the needs of individual animals, or be appropriately modified for breeds in which there may be a greater prevalence of adverse reactions. Although perhaps obvious, it is wise to stress to lay owners that veterinary vaccines are distinct from human products and that concern over adverse reactions to animal vaccines should not flow into the human public health arena. This is a particularly significant concept in the UK where recent public controversy over the use of combined measles, mumps and rubella (MMR) vaccine in infants has led to a 25% failure rate in infant vaccination nationwide, and the re-emergence of childhood measles. Summary Adverse reactions to veterinary vaccines clearly exist, but their prevalence is very low and the scientific basis for their causation remains unknown. A range of approaches may be adopted for animals that are considered at risk for developing such a reaction, including monitoring of protective immune status and the administration of alternative vaccine regimes. The adoption of these approaches must be based on risk assessment of the individual and population with respect to exposure to infectious disease. Vaccines have made a major impact on infectious disease control in companion animals, and altered vaccine usage can change the prevalence of disease within a population. References 1. McEntee MC, Page RL. Feline vaccine-associated sarcomas. J Vet Intern Med. 2001; 15: 176-182. 2. Gray AK. Cat and dog vaccination: results from the Suspected Adverse Reaction Surveillance Scheme. Vet Rec. 1998; 143: 455. 3. Glickman LT. Weighing the risks and benefits of vaccination. Adv Vet Med. 1999; 41: 701-713. 4. McCaw DL, Thompson M, Tate D, et al. Serum distemper virus and parvovirus antibody titres among dogs brought to a veterinary hospital for revaccination. J Am Vet Med Assoc. 1998; 213: 72-75. 5. Tizard I, Yawei N. Use of serologic testing to assess immune status of companion animals. J Am Vet Med Assoc. 1998; 213: 54-60. 6. Twark L, Dodds WJ. Clinical use of serum parvovirus and distemper virus antibody titers for determining revaccination strategies in healthy dogs. J Am Vet Med Assoc. 2000; 217: 1021-1024. 7. Scott FW, Geissinger CM. Long-term immunity in cats vaccinated with an inactivated trivalent vaccine. Am J Vet Res. 1999; 60: 652-658. 8. Dodds WJ. Vaccination protocols for dogs predisposed to vaccine reactions. J Am Anim Hosp Assoc. 2001; 37: 211-214. 9. Schultz RD. Current and future canine and feline vaccination programs. Vet Med. 1998; 93: 233-254.

Some information on vaccine reaction incidence. I wanted to try to find a canine journal article to quote for incidence of vaccine reactions, but I don't have one... only a cat article so I'll post that and some information from one of the big 3 veterinary CE meetings that goes on every year.

WOW!!! That is a crazy difference in price! I would wonder what teh procedure cost and what was contained within those estimates! Certainly there is some regional difference... but not to that degree! Most vets do not charge for phone or in person consultations... we don't. However, most human doctors do... I honestly can't even get my doctor on the phone... even if I did pay him!!! I really don't mind staying after hours to call and talk to clients... I just think of it as part of my job. I think some clients may expect too much though. We had one client who came in and wanted to talk to 2 of the doctors regarding a case and tied up 2 doctors for 45 minutes during office hours. We didn't charge that owner anything... but we really probably should have.

I personally do not believe that pet health insurance will drive up prices... at least not VPI (the one through Eukanuba). Most of the paperwork is handled between the owner and the insurance company. The vet only has to provide a diagnosis. The owner pays the bill and the company reimburses the owner. No paperwork for the vet means no increase in cost of service! A couple things that can or will drive up the cost of health care though are on the horizon. The more money vets lose in pharmacy products will mean X% net profit loss for the practice. Now granted pharmaceuticals make up less than 20% of the profit, but imagine what would happen if the buisness you worked at suddenly "lost" 15% of its profits!!! The loss of income should it become significant will result in a rise in the costs of services to make up for the loss. I really don't see this becoming that big of an issue though. One issue that could really KILL veterinary medicine though is one that I am really torn up over. Right now pets are seen as property by the law. Therefore, if your pet is killed by your neighbor you can only sue them for the value of the pet (i.e. a mixed breed may only be like $15 which is RIDICULOUS). However, if that law changes and allows for pain and suffering and larger lawsuits... that will drive malpractice insurance up which will force veterinary service fees to skyrocket!!! I'm disgusted that our law sees our pets as property and nothing more... however, a change in the law could really put costs through the roof!!!! Office visit costs are largely regional. Some areas charge as little as $15 for an office call whereas other places charge as much as $80 (NYC). It is based on a LOT fo factors... real estate costs, services provided (24 hour care, ultrasound, etc.), staffing, etc.

Just curious to hear peoples opinions. I often read about high prices and overpriced pharmacy items on various posts and I am curious as to how people feel that translates into salary. Because if you feel a dental is too expensive at $130 and Heartgard is too much at $50 but you dont feel your vet is overpaid... then those 2 thoughts cannot add up. Anyway just curious to see what peoples thoughts are.

I put together a packet dealing with pet loss over the Summer to help those dealing with this difficult time. It contains things that I have done and others that I know have done to help them with the grieving process. It also has a short collection of quotations and short stories. If anyone is interested in it... please e-mail and I would be happy to email you a copy back!