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.

Urgent Care for Canines

In an emergency situation, time is of the essence. But are you able to recognize a canine health crisis? Here are some common emergency scenarios. Choose the answers you think are most correct. For each question, more than one answer can be selected.

1. Your dog ate the pill you dropped. Which drugs could cause problems?

A. Birth-control pills
B. Tranquilizers
C. Ibuprofen (Advil/Motrin)
D. Acetaminophen (Tylenol)

Correct answer: None or all. A single dose of any of these drugs is unlikely to cause problems for most dogs, but for safety's sake, contact your veterinarian for his or her advice.

2. Your dog was hit by a car. The dog should be examined by a veterinarian if:

A. It can walk, but with a limp
B. You see no injuries
C. It seemed fine, but now is lethargic
D. It is panting

Correct answer: All. Internal injuries aren't immediately obvious, and even a dog that seems unhurt should be examined by a veterinarian. Breathing difficulties are especially critical.

3. Your dog is bleeding. Seek emergency help if:

A. The cut is deep, and still bleeding after 30 minutes
B. You over-clipped a toenail; your dog is yelping
C. Its gums are pale
D. You applied pressure and the bleeding stopped

Correct answer: A and C. Pale gums can indicate excessive blood loss. Any injury that bleeds for more than five minutes requires immediate medical attention. If a dog loses too much blood, the results can be fatal.
 
4. Your dog was playing in the backyard and injured itself trying to jump a fence. It is serious if:

A. Your dog avoids walking on one leg
B. Your canine walks with a limp
C. Your dog limped briefly, then the limp disappeared
D. One leg is now at a funny angle

Correct answers: A and D. A non-weight-bearing or abnormally positioned limb could be fractured or dislocated, and needs immediate medical care. A weight-bearing, but painful limb, may be able to wait until morning as long as your dog is not whining or showing other obvious signs of pain, such as not wanting to go outside to eliminate.

5. A friend gave your 10-pound dog some chocolate. It may be dangerous if it was:

A. Milk chocolate
B. Dark chocolate
C. Chocolate-covered almonds
D. Unsweetened baking chocolate

Correct answer: All or none. The rule: Darker chocolate is more dangerous. Some veterinarians recommend inducing vomiting immediately if your dog ingests chocolate. Ask your veterinarian ahead of time what to give your dog in this situation, and how much. Furthermore, many table foods, not just chocolate, can be dangerous to your pet. Teach your dog not to beg for table scraps.

6. You were playing catch with your dog. You should be concerned if:

A. The baseball hit your dog's head; your pooch yelped but continued playing
B. The rubber ball is stuck in the back of your dog's mouth
C. Your dog can catch better than you

Correct answer: B. Soft rubber balls are the perfect size to lodge in the upper airway of medium to large dogs. An obstructed airway is a true critical emergency; fortunately, it's highly uncommon. Dogs normally expel foreign bodies without help.

To be safe, post the telephone numbers for your regular veterinarian and your local after-hours emergency veterinary hospital on the fridge or in a place where you can find them quickly in case of a canine emergency.

Better Health for Your Hound

It's easy to spot a healthy-looking dog: a gleam in the eye, a bounce in the step, and a glossy, healthy coat. That glow is a reflection of a dog's overall health, and a good gauge of what's going on inside and outside. Several factors play roles in your dog's skin and coat health. They are:

  • Heredity
  • Nutrition
  • Internal or external parasites
  • Health
  • Grooming

Although heredity determines the thickness, length, color and texture of a dog's coat, your care can make a big difference in your pet's skin and coat health.

Regular veterinary checkups will help ensure that your dog is disease and parasite free. Flea-bite allergy and external parasites, such as mange, are primary causes of hair loss and skin problems.

Balanced Nutrition for a Better Coat
What's the best thing you can do for your dog's skin and coat health? Feed a high-quality food packed with protein. Dogs are carnivores -- they need protein and thrive on diets rich in animal-based protein sources.

Hair is actually 95% protein! Although coat growth varies from dog to dog, the combined growth of all the hair can add up to 100 feet per day in some dogs. This means that nearly 30% of the animal's daily protein requirement is used just for coat growth during some seasons.

If your dog's skin seems thick or scaly, lacks elasticity, and you see hair loss, these may be signs of a nutritional deficiency. Check with your veterinarian.

Quality pet foods are carefully formulated to be complete and balanced, which means the food includes all the nutrients your pet needs. Ingredients are highly digestible so your dog's body uses the nutrients efficiently.

Dietary Fats Give That Glow
Studies have found that certain fatty acids play a critical role in canine skin and coat health. For some time, veterinarians and scientists have known omega-6 and omega-3 fatty acids, are important for achieving and maintaining a full, glossy coat.

Recent research has shown a precise balance, of omega-6 and omega-3 fatty acids are important. Supplying a dietary fatty acid balance (or ratio) of between five and 10 omega-6 fatty acids to every one omega-3 fatty acid can be key to a healthy skin and coat.

Fatty Acids and Skin Health
Fatty acid supplements of omega-3s or adding fat, such as corn oil or bacon grease, to the pet's diet rarely makes for a healthy skin and coat. The best way to provide the precise balance necessary is through a complete diet.

A diet with a properly adjusted fatty acid balance may also be helpful for skin health. The ratio of omega-6 fatty acids to omega-3 fatty acids should be between 5:1 and 10:1. Ingredients that are rich in omega-6 include:  safflower oil, corn oil, poultry fat.

Ingredients that are rich in omega-3 include:  fish oil or meal, flax and canola oil.  It will usually take between 6 and 8 weeks after a diet change to see results in skin and coat health.

Working on the "Outer Dog"
The overall health of your "inner dog" helps create a beautiful, healthy coat, but the care of the "outer dog" is important, too.

Regular grooming removes loose hair, dirt and mats, and distributes skin oils. Grooming lets you check your pet closely, catching any skin problems early. Plus, your dog will love the attention!

Here are some essential tools for grooming:  brush, flea comb, nail clippers, and mild canine shampoo.

As dogs age, their skin may become more sensitive. Select a mild canine shampoo for an older dog. Shampoos made from coconut or palm oils are the mildest. Unusual or "doggy" odors can signal disease, so if odors persist, contact your veterinarian. Do not use human shampoos since they can actually be too harsh for a dog's skin.

When bathing your dog, be sure to rinse thoroughly. Residue left on the skin can be irritating. You may want to follow the shampoo with a hair conditioner to control static electricity and add extra body or sheen.

During the summer, pay close attention to your dog's skin and coat. Many dogs shed a winter coat and others face flea problems, so it's a good time to evaluate your dog's skin and coat condition to nip any problems in the bud.

Attention to your dog's coat and skin from the inside out will produce a healthy, lively dog that is a joy to look at and a pleasure to live with every day!

Health Problems Can Cause Behavior Problems

Behavior problems in dogs are very common; it would be unusual to find even one dog that doesn't do something that annoys its owner. However, dog owners learn to live with minor annoyances -- it's just part of living with a dog. But some behavior problems can be more than dog owners are willing to live with, and in these instances, stopping the behavior could mean the difference between keeping the dog as a member of the family, or not.

Identifying why a dog does what it does is a vital part of stopping or controlling a behavior problem. For example, most canine behavior experts understand that dogs jump up on people to greet them face-to-face. If you watch a puppy or young dog greet an older dog, the puppy will come up under the older dog's face and lick the older dog's muzzle. Puppies and young dogs, when given the chance, will do the same thing to people. When dogs are taught to sit and hold that position before they are petted, they can no longer jump up. When they learn they get petted while sitting, they no longer have the need to jump up and that behavior problem is eliminated.

It can be difficult to identify the cause of all behavior problems, however, because not all are associated with normal canine behaviors. Many behavioral experts feel that about 20 percent of problem behaviors may be caused by a physical problem. For example, most people know that epilepsy can cause seizures, but not all seizures are convulsions. A seizure may show up as twitching, or a blank look in the eyes or a frozen appearance. These signs may look like the dog is ignoring you or taking an aggressive posture. Epilepsy can also cause changes in the dog's emotions, showing up as fearfulness or aggression, sometimes even uncontrollable rage.

There are some other physical problems that can cause behavior problems:
  • A loss of vision (especially a sudden loss) can cause either fearful or aggressive behavior.
  • A hearing loss can cause startle reflexes, sometimes aggressively.
  • Arthritis can cause pain, leading to frustration and aggression.
  • A brain tumor or other problems in the brain can lead to severe behavioral changes.
  • A bladder or urinary tract infection can lead to a loss of housetraining skills.
When behavioral changes occur, especially when they happen without any obvious cause, dog owners should consult with their veterinarian first, before talking to their dog trainer or behaviorist. When talking to the vet, be very specific about the dog's behavior. Mention anything you see, no matter how tiny it seems. Sometimes all those little things you noticed, when put together, make a much clearer picture of what is going on with the dog.

Once the health problem is identified, the veterinarian can provide guidance as to what happens next. Depending upon the problem, your vet may recommend medical treatment only; or may recommend medical treatment first, followed by assistance from your trainer or behaviorist. You may want to put your veterinarian and trainer or behaviorist in touch with one another to discuss the dog, so that they can both agree on what should be done.

A Puppy Health Primer

The day you bring home a little puppy for the first time is a memorable one. It's exciting to add a new four-legged member to the family. And in these first days, it is critical to begin laying the groundwork for how you will care for your precious puppy's health and medial needs.  Here are a few of the basic essentials to get you started.

Finding a Veterinarian
Just like you, your new puppy needs high-quality health care. Ask a friend or your local humane society to recommend a veterinarian. Be sure to give consideration to the location of the clinic. A drive across town during a medical emergency could delay urgently needed treatment.

Once you've narrowed your choices, take time to visit the veterinarian's office, inquire on services offered, and talk to the doctor and staff about your new puppy. If you like what you see and hear, arrange a time to bring your puppy in for an initial examination. It's a good idea to visit the veterinarian within the first three days after you bring your puppy home to make sure it's in good health. The veterinarian will probably check:

  • Stool. A fecal exam will reveal the presence of internal parasites.
  • Body. A head-to-tail physical exam includes inspecting your dog's coat and feeling the body for abnormalities. The doctor will check the eyes, ears, mouth and heart as well as examining the anus for signs of intestinal parasites.

Once an exam is completed, your veterinarian can advise you on immunizations, the importance of spaying and neutering and future health care visits.

Spaying and Neutering
For most pet parents, the expense, time and expertise involved in breeding dogs responsibly is beyond their reach. Here are some advantages to having your puppy spayed or neutered:

  • For females, there will no longer be a mess to deal with during their 21-day heat cycles, which occur approximately every six months. The heat cycle begins in females sometime after six months of age.
  • Spaying a female before her first heat cycle will reduce the chance of mammary tumors or uterine diseases.
  • Neutered males tend to be less aggressive than un-neutered males.
  • With a neutered male, the urge to mark territory may lessen.
  • A neutered male is less likely to want to roam in search of potential mates.

Most veterinarians say dogs should be spayed or neutered by the time they are six months old. Both operations are performed under anesthesia and may require an overnight stay at the veterinarian's office. Recovery time is quick, with most dogs resuming normal activity in a few days.

Spaying (for females) consists of an ovario-hysterectomy. Neutering (for males) involves the removal of the testicles. When you bring your puppy to the veterinarian's office for the first thorough examination, this is a good time to ask the doctor to explain the details of these procedures.

Giving Your Puppy a Pill
Most puppies don't like taking medicine.  And who could blame them.  But the good news is that when you use the right technique, that bitter pill can be much easier to swallow.  Here's how.

Step 1: Begin with a play session and praise your puppy to relax it. Then get on the same physical level as your puppy. With a large puppy, kneel next to it while the dog is in the sitting position; with a small puppy, place the pup on a grooming table or a countertop.

Step 2: Place one hand over the top of the puppy's muzzle. Hold the pill in your free hand and then gently open its mouth with that hand.

Step 3: Place the pill in the center of the tongue as far back as you're able to reach. Then close your puppy's mouth and hold it shut while you blow gently but quickly at its nose. This will cause your dog to swallow before it has a chance to spit the pill out. Give your dog a treat immediately afterward to ensure that the pill has really been swallowed. End each session with play and praise.

Fighting Fleas
The common flea not only causes your dog discomfort, it can also transmit disease, pass on tapeworms and cause anemia, especially in vulnerable puppies and older dogs. Regularly inspect your dog for any signs of fleas. Intermittent scratching, biting and gnawing, plus evidence of flea dirt between your dog's back legs or on top of its rump, are telltale signs of fleas. If your dog is constantly biting and gnawing itself or you can actually see fleas, you've got a full-blown infestation. To check out your dog for fleas, stand it in a bathtub and vigorously rub your hands through its fur. If little dark dots fall on the tub floor, they're likely either fleas or flea "dirt" (which is the flea's excrement). You'll know it's a flea problem if the "dirt" turns red when you add a drop of water.

Prevention is the key to winning the battle against fleas. There are prescription products that prevent fleas from biting or reproducing. They are given to your dog in either oral or topical treatments, once a month, to break the flea's reproductive cycle.  Ask your veterinarian for more information.

Meanwhile, there are many misconceptions about keeping these pesky critters away.  Here's the truth about the two most common myths:

Myth: Garlic and onion repels fleas.
Reality: Feeding your dog garlic or onion will only result in bad breath. It will have absolutely no effect on fleas and, in fact, feeding large amounts of onion to dogs can be toxic.

Myth: Brewer's Yeast repels fleas.
Reality: There is no evidence that feeding your dog Brewer's Yeast repels fleas.

Paying careful attention to your puppy's health will get your new family member off to a great start.