Automatic Dog Eyedrops in the Works

When Gora, a bomb-sniffing German shepherd working for the Department of the Navy, began to have chronically red eyes and discharge, her Washington, D.C., caretakers took the professional pooch to her veterinarian. Gora was diagnosed with a common autoimmune condition called pannus. The veterinarian prescribed eyedrops, but Gora’s eye problem didn’t end there.

The hardworking canine loathed her new eyedrop routine. Her condition grew worse. Gora’s veterinarian sent her to Dr. Sinisa Grozdanic, DVM, at Iowa State University. The dog’s eyedrop-resistant condition made her the perfect candidate for Dr. Grozdanic’s experimental surgical treatment -- the implantation of a slow-release medicinal pellet inside the tissue surrounding the eye. In essence, Gora became one of the first dogs to be outfitted with automatic eyedrops.

Chances are that your dog, too, may very well end up with an eye problem. Below, Dr. Grozdanic shares crucial information about common canine eye problems, as well as his innovative solution.

Signs and Symptoms
Dog eye problems show up in the form of redness, squinting, tearing, cloudiness, sudden loss of vision, pupil dilation or swelling. These symptoms can signify a host of issues ranging from insignificant soreness to an advanced ulcer or even cancer. If you notice any of these symptoms for more than a day, or if your dog suffers any kind of injury in or around its eyes, prompt veterinary attention is crucial.

According to Dr. Grozdanic, three common conditions, other than injury, can cause eye discomfort in dogs. Each is thought to have a genetic component, so they can be treated, but not entirely prevented.

  • Pannus, also known as corneal disease, is the problem Gora faced. It causes cells in the cornea to multiply in response to UV light, such as sunlight. The cells become pigmented and scarred, making the tissue look red and meaty. “Owners notice the changes almost immediately, so it’s rare that it progresses enough to cause severe visual impairment,” says Dr. Grozdanic.
  • Pigmentary keratitis causes natural pigment to run over the eye, potentially causing blindness. This condition occurs most often in pugs, Boston terriers and other dogs with bulging eyes. It’s thought to be caused by dry eyes and exposure to the elements. “Owners will notice a brownish haze start to grow over the eye,” explains Dr. Grozdanic.
  • KCS, or dry eye disease, can result from either skin allergies or an autoimmune response that causes your dog’s immune system to attack its tear glands. In both cases, the lack of lubrication causes irritation -- which your dog may deal with by rubbing -- and scarring. Medicinal eyedrops can generally stimulate moisture production.


When Eyedrops Don’t Help
Treatment with eyedrops is impacted by the human factor. Pet owners may forget a dose or have trouble getting it into their furry friend’s eyes. But even with successful administration, not all dogs respond to the medicine. “The majority of the patients we’ve treated [with surgery] have been on eyedrops without success,” says Dr. Grozdanic. Drops fail to work in about 10 percent of the population. We’ve developed this treatment to try to close that gap.”

The outpatient procedure, currently available only with Dr. Grozdanic at Iowa State, involves numbing the eye with a topical anesthetic before injecting a biodegradable pellet into the tissue surrounding the eye. The medicine releases gradually, treating the eye for an entire year. “The polymer is so small, we make only a tiny slit and then one simple suture,” says Dr. Grozdanic. The sole risk of the procedure is associated with general anesthesia, which is only required if a lighter sedation does not keep the animal still.

Eight dogs have undergone the procedure to date. “Knock on wood, we haven’t had any problems,” reports Dr. Grozdanic. “The dogs are happy, and the owners are happy. It’s remarkable how much the animals improve.” Dr. Grozdanic predicts that the implant, currently making its way through the FDA’s regulatory process, will be widely available within the next two years.

As for Gora, the performance problems caused by her pannus have disappeared. Automatic eyedrops have allowed her to get back to work helping to protect people -- a result that can leave all of us just a little more confident and happy.

Insurance: Invest in Your Dog's Health

Like her fictional namesake, Tinkerbell the toy poodle seems to think she can fly. According to owner Toni Pasquariello, “One day I came home from work and Tink was so excited she jumped off of my husband’s lap and broke her leg.” Extensive surgery, including insertion of a plate, followed. “Then, a couple months later, I was holding Tink when something crashed in the house and startled her,” says the West Haven, Conn., resident. “She jumped out of my arms and broke her other leg!”

The two surgeries together cost several thousand dollars, but Pasquariello didn’t require a blood pressure pill when she saw the bills. That’s because she had previously insured her airborne poodle. The pet insurance covered a large percentage of the tab.

You needn’t live with an accident-prone pooch to consider health care insurance for your dog. Depending on the plan you choose, nearly every aspect of the canine medical spectrum is covered, from routine checkups and preventative wellness to treating diseases like cancer, which often force less well-prepared owners to put down their pets before they even attempt to address the problem. Insurance can therefore save lives, but before selecting a provider, keep in mind the following considerations.

Understand How Pet Insurance Companies Set Their Rates
At least six factors can come into play when pet insurance companies determine your monthly rates, according to Brian Iannessa, a spokesperson for Veterinary Pet Insurance (VPI), which is America’s oldest and largest provider.

  • Age “Rates do go up with age,” Iannessa says. VPI will not insure dogs 10 years and older. Other companies have similar age policies as well. The good news is that insurers will often cover such aged canines if continuous coverage is maintained prior to the decade mark. “So if you’ve insured your 9-year-old dog and he turns 10, we will continue to honor your pet’s plan,” he explains.
  • Species Be aware that dogs tend to cost more than cats, in terms of insurance rates. That could be because they’re often larger, with higher medical expenses. Due to their inquisitive natures, dogs “also seem to get into a lot of mischief,” Iannessa admits. Some providers will additionally consider your dog’s breed before coming up with your rate.
  • Plan Pet insurance plans are “kind of like human insurance,” says Jack Stephens, DVM, founder of Pets Best Insurance. He explains that costs depend upon the breadth of the plan. Plans can run between $8 and $50 per month, depending on what’s covered. Basic accident coverage tends to fall toward the lower end, while more complete health and wellness plans can go from around $25 and up.
  • State Since the cost of living can vary per state, your location may also come into play when companies set their rates.
  • Number of pets Does your house look like the pet version of The Brady Bunch? If so, you could be in luck. Many providers offer a multiple pet discount. At VPI, owners with two insured pets receive 5 percent off their base medical plan. If you have four or more pets, that discount doubles to 10 percent.
  • Where you work This one might surprise you, but your job could benefit your pet. Certain companies partner with pet insurance providers so that their employees can receive a more reasonable group rate. Three major employers that have done this are Chipotle Mexican Grill restaurants, Ford Motor Co. and Office Depot.

Learn How the Claim Process Works
One of the best types of insurance for dogs is termed “portable.” That means policyholders can visit any licensed veterinarian nationwide and receive coverage. At VPI, for example, you simply arrange for a veterinarian visit per usual. Once that’s through, you fill out a claim form. An itemized receipt is also required. The documents are mailed to the insurer, who then reimburses you for a portion of the amount within 30 days upon receipt of your paperwork. “Most reimbursements are mailed out well before the 30-day window,” Iannessa says.

Before selecting a provider, make sure that reimbursement amounts are fully disclosed to you in advance. Without such a setup, the insurer can send back percentage amounts at the company’s discretion. Look for this information under headings such as “benefit schedule” to see if such figures are disclosed from the start.

Does Your Dog Fall Into the Top 10s?
Based on a recent American Pet Products Manufacturers Association survey, Americans spent $10.1 billion on pet health care in 2007. Most of these owners were uninsured. According to Stephens, Americans only spend about $250 million on pet insurance each year. It’s no wonder he predicts that this figure will rise dramatically over the next five years. Given family budget considerations, pet health insurance may become an economic necessity for responsible dog owners.

In 2007, VPI reported that these were the top 10 dog medical claims the company processed:

1. Ear infections

2. Skin allergies

3. Hot spots/pyoderma (skin diseases)

4. Gastritis/vomiting

5. Enteritis/diarrhea

6. Urinary tract infections

7. Benign skin tumors

8. Eye inflammation

9. Osteoarthritis

10. Hypothyroidism

And these were the top insured dog breeds for that same year:

1. Labrador retriever

2. Golden retriever

3. Yorkshire terrier

4. Shih tzu

5. Boxer

6. German shepherd

7. Chihuahua

8. Maltese

9. Pug

10. Cocker Spaniel

Somewhere in this data is the flight-happy dog named Tinkerbell. “We do our best to keep Tink on the ground these days,” Pasquariello says. “Just one of her surgeries covers the cost I put into pet insurance each year for all four of my dogs.” She adds that it’s good to know that with pet insurance, “we will never be in a position where we can’t do everything possible to help our pets.”

Dog Blood Banks Save Canine Lives

Checkers and his owner, veterinary technician Bonnie Heitz, acted as heroes, even though their names never made the headlines. While this pair may not be familiar to you, Checkers, the Australian Shepherd from Concord, Calif. donated blood to save the lives of countless dogs that required blood transfusions to treat trauma, cancer, and other life-threatening conditions. These dogs were given a second chance because of Checkers, who passed away at a ripe old age in 1990. Both he and his owner helped inspire additional canine blood donations, which have since led to organized dog blood banks nationwide.

Why Dog Blood Banks Are on the Rise
Much progress has been made in the canine blood banking industry since Checkers’ lifetime. Most donor dogs in the early 1980s, like Checkers, belonged to veterinarians or their staff. “Checkers was before anyone thought of blood banks for dogs,” says Heitz. In fact, the practice of banking canine blood is a relatively new concept, with most facilities opening within the last 15 to 20 years. One reason is that advances in veterinary medical technology have fueled the need for blood. Animals are benefiting from many of the advanced tests and procedures developed initially for human medicine, and blood transfusions are no exception. Also, more owners are treating their dogs as part of the family and are willing to spend money on emergency and internal medicine, orthopedic and soft tissue surgery and oncology, all of which can require life-saving blood transfusions.

Donating Dog Blood: The Requirements
Qualifying as a donor is relatively simple. While purebreds and mixed breeds can be donors, dogs must meet certain age and weight requirements, which vary from program to program. For example, one program requires that dogs must be between one and six years of age and weigh at least 55 pounds. Another requires donors to be between one and eight years old, with a weight of at least 50 pounds. Yet another requires dogs to be aged between nine months and seven-and-a-half years old and weigh at least 35 pounds.

In addition, dogs must pass a physical examination and meet additional requirements. These may include that the dog is:

  • healthy, obedient and even tempered, which helps to ensure a positive experience, and that each animal is a willing participant. Stressed or untrained dogs are more difficult to handle and are less likely to cooperate.
  • up-to-date with its vaccinations to make sure only healthy dogs enter blood donor programs. You can obtain copies of your dog’s vaccination records from your veterinarian.
  • free of heartworm, which helps to secure the safety, health and well-being of donor dogs. Testing is performed by blood bank facilities. Heartworm positive dogs require medical treatment and are therefore not donor eligible.
  • free of blood- or tick-borne diseases that can be spread from one dog to another through blood transfusions. Tests are performed by blood bank facilities to help guard against future problems.
  • taking no medications other than a possible heartworm and flea or tick preventative. A dog that is on medication generally has an illness attached to it, which renders it unacceptable as a donor. Some medications can be transfused in the blood.
  • a dog that’s never received a blood transfusion. It is possible that a previous transfusion may not have been from a blood-matched donor dog. A recipient of unmatched donor blood could have been sensitized to some incompatible blood cell component that might result in an adverse reaction should this dog’s blood be transfused into a dog with unknown blood type history.

Screening and Typing Canine Blood
If dogs meet the pre-qualifications, their blood is typed and screened for pathogens, such as Lyme disease, ehrlichia and leptospirosis. The blood is typed since dogs, like humans, have different blood types. A complete blood count and a chemistry screen then check the red and white cells, platelets, electrolytes levels and general organ function. Screening potential donors is expensive --roughly $220 per dog, according to a 2006 study published in the Journal of Applied Animal Welfare Science. Donna Oakley, director of the Penn Animal Blood Bank at the University of Pennsylvania School of Veterinary Medicine, says, “You can’t put a price on the blood we collect. It helps us practice better medicine, and it helps save the lives of pets.”

How Canine Blood Helps Other Dogs
Dogs that pass with flying colors are eligible to become donors. While dogs can safely donate monthly, most programs collect every seven to 12 weeks, with dogs between 35 and 50 pounds donating one-half pint and dogs over 50 pounds donating one pint. Once collected, the blood is processed into components including packed red blood cells, which have a shelf life of about 30 days, and fresh frozen plasma, which can be stored for one year without losing its clotting factors. As a result, one unit of blood can theoretically treat three, four or more dogs depending on the recipient’s size and status, according to Oakley. “The therapeutic impact is much quicker when you use only the components -- that part of the blood that a dog needs.”

Laws Protect California Donors
California is the only state where commercial veterinary blood banks are required to be licensed and inspected yearly by the Department of Food and Agriculture. As a result, these facilities are required to house donor dogs on-site. Garden Grove’s Hemopet, a nonprofit facility that ships blood products nationwide as well as to Canada and Hong Kong, houses racing greyhounds rescued from Texas, Oklahoma and Arizona. Hemopet’s dogs, according to Founder and President W. Jean Dodds, DVM, receive 24-hour-a-day, on-site veterinary care and maintenance. Dogs remain in the program for approximately 12 to 18 months before being adopted by loving people within the region. “These dogs have given blood to save the lives of other animals,” says Dodds. “They have a special need to be adopted, and we have an ethical obligation to see that they are well cared for.” California facilities that collect and store blood for internal use, such as the University of California, Davis, School of Veterinary Medicine, are exempt from housing on-site donor dogs.

The Incentive Program
In addition to plenty of free cookies, kisses and tummy rubs, some programs offer dog contributors free physical examinations, comprehensive health care screening, and blood tests to guard against infectious diseases as long as a dog remains a donor. Others provide free vaccinations and canine goody bags filled with toys, treats and food. Some facilities, such as the Eastern Veterinary Blood Bank in Severna Park, Md., which ships 25,000 units a year, guarantee free blood for all donors. “For every unit of blood a dog donates,” says Theresa Connelly, Eastern Veterinary Blood Bank events coordinator, “that dog is guaranteed one unit of blood for free if it ever needs blood.” If the dog requires a transfusion any time throughout its life, EVBB will ship blood products, which normally cost upwards of $300, for free.

Canine Owners and Donors Are Indispensable
While closed colony or hospital-based donor programs were once the norm, many universities and blood bank organizations nationwide are turning to community-based volunteer donor programs using community blood drives that allow facilities to develop a large, reliable source of blood products without maintaining a colony of on-site dogs. “We are looking for people who care about people and animals. People who take good care of their pets and whose pets are in the best of health,” says Donna Oakley. The University of Pennsylvania School of Veterinary Medicine, where Oakley works, started the first volunteer donor program in 1985. The program currently has about 1500 active donors and the nation’s only canine blood mobile.  

Canine Donors Are True Volunteers
Commitment requirements may vary, with some programs requiring that dogs donate blood as little as three times a year. Others require a minimum of six times a year, while still others need a minimum three-year commitment, during which your dog would donate blood three or four times a year. Dogs must be calm enough to lie on their side for about 10 minutes, which is approximately how long a collection takes. “This is truly a volunteer program from the owner to the dog,” says Oakley. “The dog decides whether or not to donate blood. We use no chemical or physical restraints. If a dog struggles, we don’t draw blood.” Despite the possible discomfort, with a bit of coaxing from you, your dog can be a Checkers-inspired hero and help save many canine lives.

How to Save on Veterinarian Bills

When dog owner Melody Peterson’s bull terrier, Shasta, ate Peterson’s carpet, the veterinary bill set the Bend, Ore., resident back $1,800. That’s the good news. The bad news is that subsequent veterinary visits due to complications cost her an additional $2,500. A year later, Shasta ate a mini blind cord and the price tag for emergency surgery cost Peterson another $1,800. All told, Peterson has shelled out more than $6,000 on veterinary bills because of her dog’s propensity to eat anything and everything in sight, be it plastic water bottles, rocks, carpets, cell phones, or mini blind cords.

Shasta, who appears to have as many lives as a cat, is currently living the well-deserved life of a pampered pooch. Although Peterson’s pocketbook took a big hit, she doesn’t regret the money spent. She considers herself, and Shasta, quite fortunate.

While Peterson’s situation may be excessive, Americans spent an estimated $24.5 billion for veterinary expenditures in 2006, according to the American Veterinary Medical Association’s 2007 U.S. Pet Ownership & Demographics Sourcebook, with $16.1 billion of the pie chart going to canine veterinary care. While the AVMA estimates that dog owners spend on average $356 per year for veterinary care, the American Pet Products Manufacturers Association Inc., (APPMA) estimates the 2006 figure higher, at $672 per year for the average dog owner.

Whether your own veterinary bills have fallen lower or higher than these averages, chances are you could have saved money. Preventative care, according to Wendy Wallace, DVM, certified veterinary acupuncturist and owner of the Four Seasons Animal Hospital in Lafayette, Calif., is key to reducing veterinary costs. She recommends a proactive approach with the following 10 strategies:

  • Feed well-balanced, good-quality dog food This allows your dog to maximize nutrients while eating less, so your wallet benefits, too. “Correcting problems at this level may prevent the development of more serious problems,” says Dr. Wallace. Also, many human foods, including chocolate, mushrooms and grapes, can cause serious health problems, so never offer these to your dog.
  • Keep your canine fit and trim Keeping your dog at its right size can increase its life span by nearly two years. Dr. Wallace says overweight dogs are subject to diabetes; heart and respiratory problems; arthritis; increased surgical risks; decreased immune function and increased damage to joints, bones and ligaments. To reduce your dog’s weight, look for foods formulated for calorie restriction and exercise your dog daily, with walks, scheduled playtimes or other activities.
  • Brush your dog’s teeth daily This will not only prevent tartar buildup, but also periodontal disease -- a progressive disease that can, in advanced cases, lead to decayed gums, infection and liver, kidney and heart damage.
  • Groom your pet weekly This will help prevent hot spots, rashes, mats and painful broken nails, which can require anesthesia to treat. “Hair and skin are reflective of nutritional health,” says Dr. Wallace. Daily inspections of the ears, nose, mouth, teeth and feet can help you spot minor issues before they escalate into potentially life-threatening and expensive problems.
  • Keep parasite prevention and vaccines current Internal and external parasites, such as ticks and heartworms, and diseases like parvo, distemper and hepatitis can require intensive hospitalized treatment for your canine, which is a great deal more expensive than the cost of vaccinating.
  • Spay or neuter your dog This way, you decrease the incidence of pyometra (a potentially life-threatening uterine infection), mammary cancer, unwanted pregnancies in females and prostate infections in male dogs. Spaying or neutering also decreases the tendency to roam, which, in turn, decreases the odds your dog will fight with other animals or will be hit by a car.
  • Dog-proof your home and yard Store medications and all toxic products in a safe place. Keep poisonous plants, cell phones, slippers, marbles, dolls and other hazards out of reach. Secure all fences and gates.
  • Schedule (and keep!) regular checkups It is especially important to keep those that include laboratory testing, such as blood chemistries, complete blood cell counts and urinalysis. “This allows detection of disease early when it is likely to be more treatable and prevent or extend the quality of life before more expensive procedures are necessary,” says Dr. Wallace.
  • Train your dog “If your dog is comfortable being handled, having his ears, feet and mouth looked at, it allows the veterinarian to do many procedures safely, such as examining and treating ears, removing foreign bodies and caring for wounds, less expensively and without general anesthesia,” says Dr. Wallace.
  • Consider purchasing pet insurance Pet insurance can act as a safeguard against unexpected illnesses and accidents. But be sure to shop around. Prices, plans and coverage vary from company to company.

Following these simple and very doable guidelines will help you keep a leash on veterinary bills. Equally important, they will assure that your dog has the best chance to live a long, happy and healthy life, thereby increasing the enjoyment you share with your best canine friend.

Is Your Dog's Health Care Better Than Yours?

New York City-based writer Sharon Glassman was unhappy with her own health care experiences for some time when her three and a half-year-old Bichon Frisé, bb, began having urinary problems. “When I have a health issue, it’s only made worse by the hurdles I have to jump to see a doctor,” Glassman says. “With bb, we just called the vet and went in and her insurance didn’t question the veterinarian’s opinion that she needed an ultra-sound.”

Glassman wrote a humor piece for her blog comparing bb’s health care to her own, which hit a nerve for readers, many of whom responded with an “I’ve thought that, too.”

Trisha Joyce, DVM at New York City Veterinary Specialists, isn’t surprised. “In studies of public perceptions of certain professions, veterinarians rank pretty high in terms of being liked and trusted,” she says. “I’d say my personal experience backs that up.”

Here’s what doctors who treat people could learn from doctors who treat animals:

Explain Their Recommendations Doctors who treat humans are famously crunched for time. So while they will tell you what you to do, they won’t necessarily slow down to explain the rationale for procedures, let alone the pros and cons of their prescribed treatment. Veterinarians, whose clients are often reluctant to pay the out-of-pocket fees that pet healthcare requires, can’t simply assume that the pet owners will do as they say. “Vets are more in the position of having to ‘sell’ their therapy to the owner,” explains Dr. Joyce. “As a result, this probably makes us take a little more time to explain treatments, make sure the client gets it and is on board with what needs to happen. This may engender more of a team feeling in the owner.”

What to do if your veterinarian doesn’t: Politely slow him or her down and explain that you’re very interested in understanding your pet’s issue and treatment plan. Make eye contact to help illustrate your concern and to keep the conversation focused.

Familiarize Themselves with the Costs of Care Veterinarians know how much each procedure costs. Expenditure on veterinary care is discretionary, which means that veterinarians tend to do a much better job of explaining costs. Dr. Joyce realized this after her own physician failed to mention that while her fee for an outpatient surgery was only $2,000, additional costs, including anesthesia, hospital charges and pathology, hike the procedure cost to $7,000. “Insurance paid for it, but my high deductible meant that my out-of-pocket expense was much more than I’d anticipated. My clients would scream bloody murder if they got a bill that much higher than they’d been told. It’s just something veterinary medicine knows to be careful about.”

What to do if your veterinarian doesn’t: Tell your veterinarian that you’ll need an itemized list of all projected costs before proceeding, including those related to drugs, office visits, overnight hospital stays and aftercare.

Schedule Longer Appointments It’s probably not your doctor’s fault that he or she has to keep your appointment to 10 or 15 minutes (you can blame that one on managed care). However, you may notice that you feel less rushed when you visit your veterinarian, where the appointments generally run 20 minutes, sometimes even 30. “Plus,” adds Dr. Joyce, “we tend to have a more accommodating schedule with evening and Saturday hours. And we’re generally available for phone conversations.” Good luck getting your over-scheduled physician on the phone.

What to do if your veterinarian doesn’t: If you have some extra concerns about your pet’s well-being, schedule an appointment far enough in advance that you can ask the receptionist for five or ten minutes longer than is standard. If it’s in the schedule, you’re likely to get it.

Provide a Patient-Care Advocate When you take your pet to the vet, you are never the patient. This makes it intrinsically easier to keep your wits about you and get the information you need to ensure that you pet is receiving the best care. There is currently a lot of talk in the human health care industry about “patient advocates” -- people who work for patients in much the way that you work for your furry friend, listening effectively and making sure that the veterinarian is clear. Glassman thinks this is a fantastic idea. “Having functioned as a patient advocate for bb, and watching how smoothly things go, has confirmed for me that there’s something really positive about that method.”

What to do if you can’t advocate: If you’re too anxious about your pet’s health to be an effective collector of information, bring a coolheaded friend along to do the work.

While your own doctor may be reluctant to take tips from the world of veterinary medicine, you can always hold out hope for what human medicine may eventually come to realize -- in some ways, pet health care is a model for how even the tail-less among us would like to be treated.