Wednesday, September 12, 2012

Pet 911: Prepare Now Before Needing Costly Emergency Veterinary Care

When Joan Michel's Saint Bernard Jazzi laid down and refused to come inside after a routine potty break in the yard, her husband, Jerry, knew something was seriously wrong. "He could not coax her up," says the Overland Park, Kansas member. "He started to lift her and when he put his hands on her belly, he noticed it was rigid."

Jazzi was suffering from gastic dilatation-volvulus, or bloat, a potentially fatal condition in which the stomach becomes twisted. Jerry rushed the 135 pound dog 6 miles to BluePearl Veterinary Partners, where she received lifesaving surgery and several days of follow up care at the facility, formerly known as Veterinary Specialty & Emergency Center. "When we wanted to visit her, we could just come right in and they'd let us sit there with our dog as long as we wanted," says Michel, who praised the A-rated company for calling with daily updates on Jazzi's condition. "We joke that she's still alive one year past her expiration date!"
      The Hollywood Animal Hospital in Hollywood, FL offers emergency care 24 hours a day, as well as general practice and specialty care during daytime hours. 

A Whopping 83 percent of Angie's List members who took an online poll have a pet, and 65 percent have experienced a pet emergency. For Jazzi's emergency and follow-up care, the Michels paid $5,000, which demonstrates how costly emergency care can be due to factors like the expense of specialized equipment and staffing, especially in cases where vets have specialty training beyond veterinary school.

Pet owners can find 911 care in a variety of settings, including general practices and emergency clinics, some of which maintain hours only on nights, weekends and holidays. Cases that come through their doors, emergency vets say, include injuries from car accidents, bites and lacerations, vomiting and urinary blockages. Some emergencies occur as a result of a chronic medical condition, sudden medical even or trauma. Veterinarians say pet owners should use their best judgment when deciding whether to take a pet to the emergency room, but obvious signs care is needed include an inability to go to the bathroom, immobility, frequent vomiting or diarrhea, seizures or bleeding. It was 10p.m. on a weeknight when Bob Kennedy's African Grey parrot Opus flew into a door, injuring his beak. "He scared the bejeezus out of us and was bleeding like a stuck pick," says the Berwyn, IL member. Kennedy's avian vet's office was closed, and the nearby emergency clinic didn't handle exotic pets. They recommend he rush Opus to the highly rated Animal 911 in the Chicago suburb of Skokie.

Animal 911 staff were able to stanch the bleeding and repair the bird's beak. "They did a beautiful job," says Kennedy, adding the parrot made a full recovery and soon returned to favored activities like singing "Old MacDonald" and eating peanut butter. Kennedy says Opus wouldn't have survived if he'd waited overnight for care.

Experts and members who've had emergencies recommend pet owners identify a high quality clinic that provides emergency care 24 hours a day before an incident occurs. "It's really hard to be ready for an emergency because by definition, it's something that's unexpected," says Dr. Chris Shacoski, owner of the Solano Napa Pet Emergency Clinic in Fairfield, CA, a clinic that operates outside regular business hours. "Knowing what your resources are ahead of time can make a difference in terms of outcome."

When searching on Angie's List, check whether a veterinary office's profile lists emergency services. Know the route to the clinic and keep the phone number on hand, along with the numbers for your regular vet and the Animal Poison Control Center for poison related emergencies. Once you choose an emergency vet, have your regular vet fax your pet's medical records to the clinic and keep a copy for yourself.

Dr. Thomas Sessa, who oversees emergency care at the Hollywood Animal Hospital in Hollywood, FL, recommends visiting a clinic you're considering using beforehand, with your pet, if possible. "When you're panicking, you'll go to the first place that will give you care," Sessa says. "Talk to your regular veterinarian and develop a plan for emergencies."

That's easy for clients of his A-rated hospital, which offers general veterinary practice, emergency services and specialty care in areas such as oncology and orthopedics. Their full-service facility houses a blood bank as well as equipment like defibrillators and a machine for digital radiography, and can deal with most health issues.

With different models of care, navigating the choices for where to seek emergency services for your furred, feathered or other animal friend can be difficult. Most general practices provide some emergency care, some dedicated clinics specialize in emergencies only, and other pet health care facilities provide a spectrum of services, including emergency care.

About 15% of small animal practices in the U.S. are accredited by the American Animal Hospital Association, a voluntary program that has stringent requirements for care, service and medical protocol.

Training among veterinarians also varies. Although specialty training is not required to administer emergency and critical care, some vets pursue to obtain additional experience. Some also become Diplomates of the American College of Veterinary Emergency and Critical Care, which requires an additional three years of intense training in treating life threatening conditions after receiving a Doctorate of Veterinary Medicine. "This can be confusing to the pet owner, because if they go to an emergency clinic, it's not guaranteed they're seeing an emergency and critical care specialist," says Dr. Armelle de Laforcade, the executive secretary of the American College of Veterinary Emergency and Critical Care and a teacher of veterinary medicine at Tufts University in Boston. She says there are about 340 Diplomates nationwide, which is a small percentage of the 85,000 veterinarians estimated by the American Veterinary Medical Association.

De Laforcade acknowledges pet owners can find excellent emergency care at various settings by vets with differing backgrounds, but the most critical cases may require a specialist. "The critical care specialist is really there to ensure the best emergency care is being administered," she says.

If follow-up care is needed, your provider should be able to recommend other certified specialists, such as those trained in ophthalmology, neurology or other fields of veterinary medicine. After you receive a diagnosis and a referral, shop your options for continuing vet treatment if time allows. Whatever type of provider you choose for your pet, be warned that emergency services might take a chunk out of your wallet. Veterinarians and members interviewed for this story acknowledged that emergency care for pets can be quite costly due to factors like round-the-clock staffing; technology that may include ultrasound machines, oxygen cages or fluid pumps: and medicine or supplies. The costs for care vary depending on the case, but most require a fee for the initial exam.

At the Solano-Napa Pet Emergency Clinic, the base fee is $79, but Shacoski says $110 is not uncommon in California. The American Veterinary Medical Association says there is no standard model for the industry but some emergency vets require payment before treatment. 34% of Angie's List poll respondents reported paying between $251 and $500 for an emergency visit. Sixteen percent spent as much as $1000 or more.

While some members say they're willing to pay higher costs for emergency or after-hours care, others are turned off by prices. Member Jann Howell says she was treated with indifference at Animal Emergency Clinic in Greenville, SC, where she took her dog Ashleigh after she began throwing up on a Saturday night.

"They just want your credit card or check," says Howell, who complained about wait times and a lack of compassion from employees of the D-Rated company. "They don't care about your dog or you." After exploratory surgery revealed the pieces of bone marrow lodged in her intestines, Ashleigh continued to deteriorate and had to be euthanized the following day. Howell paid $4000 for emergency care.

Rana Sargent, hospital manager at Animal Emergency Clinic, says she couldn't comment on Howell's case, but the fact that clients usually come to the clinic in a state of panic can lead to misunderstandings.

"Like a human emergency, we have to triage, based on the how serious the case is," Sargent says to explain wait times. She also says because her hospital typically deals with clients on a one-time basis, it can be difficult to balance the medical needs of the pet with the expectations of its owner.

Members who rate their experiences with emergency pet care providers cite good communication about treatment options and kindness towards themselves and their pets as qualities that helped them get through tough ordeals. Megan Lamon, the veterinarian who manages emergency care at the highly rated Pilchuck Veterinary Hospital in Snohomish, WA, says keeping a calm, reassuring demeanor, and sharing as much information as soon as possible with the pet parent is key. "We're treating the owner and the patient similarly because they're both in a state of agitation," says Lamon, adding that she learned most of her communication skills on the job. "I have to work very quickly with people who don't know me to gain their trust."

Member Danita Applebaum of Sterling, VA, was mortified when her families pet guinea pic, Mo, lost his ability to walk after a fall. She brought him to the highly rated Towne Animal Clinic in Leesburg, VA where they diagnosed and treated a spinal cord injury for $150. "I was blown away with how caring and gentle everyone was," Applebaum says. "They had to flip this little guy on his back and x-ray him, and showed the finesse you need to deal with a small animal."

Applebaum found the clinic on Angie's List, and has since adopted it as her full-time vet for Mo, who was returning to hopping around begging for his favorite fruits and veggies. "Mo and the Towne Animal Clinic have reminded me how intelligent and responsive to care and kindness all creatures can be."

Angie's List - August 2011
By Emily Udell


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