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Companion care.

Byline: Lewis Taylor The Register-Guard

Every week, 40 to 50 pet patients pass through the doors of the Oregon Veterinary Referral Associates, a Springfield clinic offering everything from hip replacement for dogs to chemotherapy for cats.

Ten years ago, this facility didn't exist. The clinic moved to Springfield from Corvallis eight years ago to meet a growing need for specialized animal care.

"Americans are very bonded to their pets. Many people see them as members of the family," says Amy Valentine, an administrator at Oregon Veterinary Referral Associates. "There is a need for what we do."

Advances in veterinary medicine veterinary medicine, diagnosis and treatment of diseases of animals. An early interest in animal diseases is found in ancient Greek writings on medicine. Veterinary medicine began to achieve the stature of a science with the organization of the first school in the  aren't just happening in Lane County. Pet health care in this country is now a $19 billion a year industry and rising, according to according to
1. As stated or indicated by; on the authority of: according to historians.

2. In keeping with: according to instructions.

 the American Veterinary Medical Association American Veterinary Medical Association

a nonprofit, professional organization of veterinarians in the USA, whose stated objective is to advance the science and art of veterinary medicine, including its relationship to public health and agriculture.
. In 1996, that number was $11.1 billion.

Not everyone wants knee surgery for their dog or glaucoma glaucoma (glôkō`mə), ocular disorder characterized by pressure within the eyeball caused by an excessive amount of aqueous humor (the fluid substance filling the eyeball).  treatment for their cats, but clearly there is a market for specialized care, as evidenced by the mere existence of so many facilities. And it isn't just specialists who are providing advanced medicine. General practitioners general practitioner
n. Abbr. GP
A physician whose practice consists of providing ongoing care covering a variety of medical problems in patients of all ages, often including referral to appropriate specialists.
 are offering high-tech dentistry dentistry, treatment and care of the teeth and associated oral structures. Dentistry is mainly concerned with tooth decay, disease of the supporting structures, such as the gums, and faulty positioning of the teeth. , ophthalmology ophthalmology (ŏf'thălmŏl`əjē), branch of medicine specializing in the anatomy, function and diseases of the eye. Ophthalmologists specialize in the medical and surgical treatment of eye disorders, vision measurements for  and laser surgery.

But all that technology hasn't necessarily made it any easier on pet owners. In some ways it's made it harder. How do you decide to put a pet down when there are so many treatment options available? And how do you determine what's medically necessary medically necessary Managed care adjective Referring to a covered service or treatment that is absolutely necessary to protect and enhance the health status of a Pt, and could adversely affect the Pt's condition if omitted, in accordance with accepted  and what's merely available?

Vet is first step

Almost everyone agrees, the best place to start making decisions is with your general care veterinarian veterinarian /vet·er·i·nar·i·an/ (vet?er-i-nar´e-an) a person trained and authorized to practice veterinary medicine and surgery; a doctor of veterinary medicine.


"For veterinarians Veterinarians and veterinary surgeons (vets) are medical professionals who operate exclusively on animals. Well-known and notable veterinarians include:
  • Wayne Allard, a U.S.
 at any level, part of their responsibility is to make sure the client understands (the options)," Valentine says. "Most clients are able to come to a decision that's right for them in their situation, but that's going to be very different for each individual pet owner."

Valentine, whose clinic operates by referral, works closely with lots of other veterinarians. She says general care practitioners are often the best advisers for pet owners who are wondering whether a certain surgery or treatment is right for their pet.

Jerry Boggs, a veterinarian at Bush Animal Hospital, agrees.

"I try not to make any judgments," he says. "Between myself and the client, we come to a decision about what is the right (action) for the patient under those particular circumstances."

A 30-year veteran, Boggs has seen tremendous changes in the world of veterinary medicine. He says some of the biggest advances have been in anesthesiology anesthesiology (ăn'ĭsthē'zēŏl`əjē), branch of medicine concerned primarily with procedures for rendering patients insensitive to pain, and for supporting life systems under the strains of anesthesia and surgery.  and pain management. Veterinarians, he says, are going to great lengths to make sure their pet patients aren't undergoing any unnecessary ordeals.

Boggs' office offers lots of high-tech tools such as endoscopic en·do·scope  
An instrument for examining visually the interior of a bodily canal or a hollow organ such as the colon, bladder, or stomach.

 and ultrasound procedures that cut out the need for exploratory surgery Exploratory surgery is a diagnostic method used by doctors when trying to find a diagnosis for an ailment. It can be performed in both humans and animals, but it is far more common in animals. , and digital dental radiography Dental X-rays are pictures of the teeth, bones, and surrounding soft tissues to screen for and help identify problems with the teeth, mouth, and jaw. X-ray pictures can show cavities, hidden dental structures (such as wisdom teeth), and bone loss that cannot be seen during a visual  that allows xX-rays to go right into a computer.

"I'm sure you could find folks who think we've gone too far," Boggs says, "For many of the people that we deal with though, pets are truly a member of the family ... They want them to have the best medical care they can."

Roberta Boyden, a veterinarian who specializes in end of life care, says the goal is to provide treatment that takes the animal's best interests into account, along with the pet owner's interests, and factors in what the pet owner can realistically afford.

It may be easy to go overboard to go to an extreme; to overdo; as, he went overboard at the buffet and got an upset stomach s>.

See also: Overboard
 with medical care for your pet, but Boyden says it's just as easy to overlook the signs that something's wrong. She says it can be difficult to know exactly what a patient is going through when that patient doesn't talk.

"In dogs and cats, often the signs (of discomfort) are more subtle," Boyden says. "They're restless, they're not feeling well, not eating, panting panting

rapid, shallow breathing, a characteristic heat-losing reaction in dogs; represents an increase in dead-space ventilation resulting in heat loss without necessarily increasing oxygen uptake or carbon dioxide loss.
 a lot, limping, not using a leg. A lot of people think that if an animal is not crying out in pain they're (OK)."

New drugs, new forms of anesthesia and new methods of monitoring have taken much of the guesswork out of pain management. But when it comes to euthanizing a pet, medical technology often doesn't provide all the answers. The decision, Boyden says, is often a highly personal one, and it can be made more difficult by the array of medical options available.

"It's different for every person and every animal, and I try not to answer that question (of whether an animal should be euthanized) but try to help that person," she says. "I think most of the people I deal with make really good decisions."

Boyden can think of only one instance in which she felt as if a client may have sought to prolong her pet's life unnecessarily. The animal was suffering from kidney failure kidney failure
 or renal failure

Partial or complete loss of kidney function. Acute failure causes reduced urine output and blood chemical imbalance, including uremia. Most patients recover within six weeks.
 and ate very little for three months before it eventually succumbed to the condition.

Do your research

Education is one way a pet owner can help ensure they are making the right decisions, says Randi Golub, a certified veterinary care specialist who owns the business Catnurse on Call. She treats geriatric geriatric /ger·i·at·ric/ (jer?e-at´rik)
1. pertaining to elderly persons or to the aging process.

2. pertaining to geriatrics.

 pets and pets facing diabetes and other ailments.

"The more people know about their pets, the better able they are to take care of them and know exactly when they need to take them to the vet," she says.

Educating yourself, Golub says, can begin even before bringing home an animal. She recommends pet owners do as much research as possible to determine the basic needs of the animal they're about to adopt.

Still, there are some instances when no amount of education or consultation will help. If your dog or cat is hit by a car, you may find yourself facing some tough decisions. Golub suggests having a contingency plan A plan involving suitable backups, immediate actions and longer term measures for responding to computer emergencies such as attacks or accidental disasters. Contingency plans are part of business resumption planning.  for such situations. And if you can afford it, she says, a rainy day fund for unexpected veterinary bills is a good idea.

At the Emergency Veterinary Hospital in Springfield, Dr. Ingrid Kessler deals with just those kinds of cases.

She sees animals that have been accidentally poisoned, hit by cars, injured in·jure  
tr.v. in·jured, in·jur·ing, in·jures
1. To cause physical harm to; hurt.

2. To cause damage to; impair.

 in fights and some that have simply succumbed to the effects of aging. The clinic, which is staffed by 11 licenced veterinary technicians A veterinary technician (also called a vet tech), is a person trained and licensed to assist veterinarians. Their job is similar to that of a nurse. Job description  and seven veterinarians, saw about 8,000 patients last year.

That number is expected to climb this year, now that the hospital is open 24 hours a day.

Kessler says it's important for pet owners to be realistic, both about the care they can provide and about the quality of life the animal will experience after treatment.

"A lot of end-of-life issues are medical, but they are also very personal," she says.

And, Kessler and other veterinarians say, animal patients have very different needs than humans.

Chemotherapy is one area where those differences become apparent. Radiation treatments are generally more aggressive for humans. That's because the goal in treating humans is to eradicate the cancer completely, no matter what the effect on the patient. Veterinarians, on the other hand, are more concerned with maintaining a minimal quality of life. Without that, a cat or dog becomes something other than a house pet. As Valentine puts it, it's simply not feasible to put a dog in the intensive care unit for two weeks.

The advantage of all this advanced veterinary care is that pets can live longer and enjoy a higher quality of life. The disadvantage is that the technology is not available to all pet owners.

"Not everyone can afford going to a specialized facility, not everybody can afford advanced care," Kessler says. "That's hard (to deal with) sometimes."

Rising costs

The range of what pet owners pay for a visit to the emergency room is huge. Kessler says many of her clients leave with an $86 examination fee and $12 in antibiotics, but some face vet bills in the thousands of dollars.

The high cost of animal health care is compounded by the fact that pet health insurance has not really caught on. Kessler says fewer than 5 percent of her clients have insurance.

Other veterinarians report similar numbers. For many, the high monthly premiums simply do not add up.

Veterinarians say the industry is moving in the direction of more affordable health insurance, but until then, credit cards or cash are the most popular forms of payment.

Boyden points to several local nonprofit A corporation or an association that conducts business for the benefit of the general public without shareholders and without a profit motive.

Nonprofits are also called not-for-profit corporations. Nonprofit corporations are created according to state law.
 groups striving to make veterinary care more affordable, including a group hoping to establish a low-cost clinic modeled after the Whitebird Medical Clinic, and an organization called Pro Bone-O providing veterinary care for the pets of homeless people.

A for-profit service called CareCredit also offers credit lines for pet owners facing bills they can't afford to pay. The company offers plans for human dental care, chiropractic chiropractic (kīrəprăk`tĭk) [Gr.,=doing by hand], medical practice based on the theory that all disease results from a disruption of the functions of the nerves.  treatment and other treatments not covered not covered Health care adjective Referring to a procedure, test or other health service to which a policy holder or insurance beneficiary is not entitled under the terms of the policy or payment system–eg, Medicare. Cf Covered.  by insurance, which goes to show how close animal health care has come to human health care.

The fact that pet health care in this country exceeds human health care in many developing nations does not go unnoticed by veterinarians.

"You think about that all the time," Boyden says. "(There are) children that have lost arms and legs and there is nobody that's (helping them) and there are people who will spend a fortune to put braces on their dog."

Boyden says you could probably argue that having pets is a luxury in itself, but she and other animal caregivers aren't about to suggest that we cut animals out of our lives.

Not only have they become de facto [Latin, In fact.] In fact, in deed, actually.

This phrase is used to characterize an officer, a government, a past action, or a state of affairs that must be accepted for all practical purposes, but is illegal or illegitimate.
 family members, but, animal experts say, they also provide comfort, happiness and relief from stress.

"I think here in Eugene, people really love their pets," Golub says. "We're really fortunate we have a lot of services (to offer them).

"And when I think how much joy I'm getting from my animals, I know my money is well spent."

PICKING THE RIGHT VET Animal health care is much more involved than it used to be. Given the array of medical options available, choosing the right veterinarian is more important than ever. Here are some suggestions for what to look for in your pet's primary care provider: Attitude: Think of your veterinarian as a trusted adviser. Choose someone who has a similar philosophy toward animal health, and with a similar definition of ``reasonable'' care. Chemistry: Choose someone you like and get along with. Ask your friends for recommendations. Talk to the vet: Before making that first appointment, don't be afraid to call and ask to speak to the veterinarian, or better yet, drop by the office. Price: Don't use cost as your only factor. Paying more doesn't ensure the best care, just as paying less doesn't mean the worst.
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Title Annotation:Animals; Tremendous advances in animal health care have given pet owners more options, difficult decisions
Publication:The Register-Guard (Eugene, OR)
Date:Nov 20, 2006
Previous Article:Is it done yet?
Next Article:Reasoning, well seasoned.

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