Pets Best Insurance Blog

Blog posts Categorized under ‘Veterinary Medicine’

Aching joints may make kitty grumpy

Posted on: May 15th, 2012 by

A cat with pet insurance poses for a photo.

By: Dr. Jane Matheys
Associate Veterinarian
The Cat Doctor Veterinary Hospital
For Pets Best Insurance

Pets are living much longer lives these days due to the advances in veterinary medicine– this is one of the many reasons that dog and cat insurance have become so popular.

With increased life spans, however, come chronic illnesses like osteoarthritis (OA). Cats are graceful, agile and athletic creatures, but as they age, their joints, ligaments and bones are prone to wear and tear just like in people. OA is a commonly recognized disease in dogs, but it is only recently that veterinarians have begun to appreciate what the true incidence of OA might be in cats. It appears to be much more common than previously thought, and could be a major cause of discomfort, especially in cats over ten years of age.

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Osteoarthritis is a degenerative condition of the joints where normal cartilage that cushions the joint is worn away, exposing the bone and resulting in pain as adjacent bones rub against each other. It can cause decreased joint movement and even formation of bone spurs and other changes around the joint.

Clinical signs of OA in cats include weight loss, loss of appetite, depression, change in general attitude, poor grooming habits, defecation or urination outside the litter box, and inability to jump on and off objects. Lameness is relatively uncommon because joints on both sides of the body are frequently affected, allowing cats to compensate and appear to be walking normally.

The hips and elbows are the most frequently affected joints in cats. The most common complaint that I hear is that the cat is having a harder time jumping up onto the bed or sofa and takes the stairs more slowly or one step at a time. The cat may also seem a little stiff in the joints, especially after just getting up from sleeping.

Diagnosis of OA in cats is difficult even for the experienced veterinarian, and the disease remains largely underdiagnosed and undertreated. The problem is that cats are masters at hiding discomfort and do not readily demonstrate obvious signs of pain. Cats generally dislike being physically handled and manipulated during examinations, so it can be very difficult to determine if a cat is pulling its leg away because of pain or simply because it doesn’t want to be touched. Cats are also famous for hunkering down on the exam table and remaining immobile and reluctant to walk around the exam room for observation of gait.

Radiographs (x-rays) can be used to try to diagnose OA in cats, but they can be misleading. In many cases, cats with OA have no radiographic changes indicative of the disease. Studies have shown that if radiographic changes are present, they may not correspond to the degree of OA in the joints. Painful joints do not necessarily correspond to radiographic findings. Due to these obstacles in diagnosing OA in cats, veterinarians will often simply rely on the cat owner’s observation that their pet is not moving around like it used to. Veterinarians will often make the diagnosis of OA by treating the cat for the disease and seeing if the owners note any improvement in the cat’s quality of life.

Weight management is the first thing that must be addressed in cats with OA. Obesity does not cause OA, but it will exacerbate the condition. Consult with your veterinarian to design a safe cat weight loss program. It may be the most important thing you do for your cat with OA.

Steroids have been used to treat OA in the past, but they’ve fallen out of favor due to side effects. Non-steroidal anti-inflammatory drugs (NSAIDS) have been life savers for dogs with OA, but, unfortunately, repeated doses of NSAIDS can cause renal failure in some cats. However, for cats with severe OA, NSAIDS may be the best treatment choice. Be sure to discuss the risks and benefits with your veterinarian. Because diagnostic testing can be expensive, I always recommend my clients purchase the best pet insurance they can while their kitties are still young.

Lower dosages should be used, and labwork should be done prior to starting NSAIDS as well as during treatment. Remember to never give your cat any human medications like pain relievers without consulting your veterinarian first.

Nutraceuticals containing glucosamine and chondroitin may be helpful in early or mild cases, but it is important to choose high quality products. The brand product Cosequin* is generally my first line of defense for cats with OA. I’ve also had good results with an injectable form of a similar product called Adequan. Other drugs being used include buprenorphine, tramadol and gabapentin. Acupuncture can be extremely effective for OA and is becoming more widely accepted.

Adjustments to the home environment are vital to improving the cat’s quality of life and can be just as important as medications. Provide soft beds in easily accessible, warm, sunny spots. Place litter boxes and food and water dishes where your cat can reach them easily. You may need to find litter boxes with lower sides. Provide steps or ramps up to higher sites like beds or sofas. Many cats with OA have difficulty grooming, so gently brushing the fur and cleaning the rectal area may be necessary. Work with your veterinarian to design a specific management program to meet your cat’s needs.

*Pets Best Insurance policies do not cover Cosequin.

Spring is in the air— and so is pollen and pet dander

Posted on: May 14th, 2012 by

A cat with pet insurance licks her coat.

Many people suffer from mild-to-moderate allergies throughout the year, and spring can be a whopper, especially for animal lovers. Because giving up our pets just isn’t an option, we often become experts at self-treatment, visit the doctor and submit claims for both human and pet health insurance.

As our immune system tries to deal with budding trees, blooming flowers, and growing grass, our pets also start shedding more. For some of us, this gives our immune system an even bigger workout.

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Some may seek out “hypoallergenic” dog or cat breeds, amp up dusting and vacuuming efforts, or even start clipping coupons for Kleenex. Luckily, unless symptoms become so severe that they cause asthma and breathing problems, pet allergies don’t have to cause that big of a problem.

Here are some tips:

• Your doctor can prescribe antihistamines, nasal sprays, and asthma inhalers.

• Over-the-counter antihistamines may also prove beneficial.

• Regular grooming and bathing of your pet will help reduce shedding and dander.

• Pet stores sell pre-packaged wet wipes made especially to quickly bathe your dog or cat and reduce dander.

• Air purifiers and air conditioners help clean the air in the home.

• Take vitamins and treat colds early to help give your immune system a head-start.

• Scoop litter boxes daily, as allergy-inducing proteins can also be shed there.

• Resist the urge to let your pets sleep with you in bed. If they must, then look into allergy-reducing mattress and pillow covers.

If your allergies make you miserable, imagine how they can make your pet feel! Watch for allergies in your own pets. Excessive licking, paw biting, ear scratching, head shaking, and hair loss are all signs that your pet is suffering from allergies, too.

These symptoms are common reasons why pet owners seek veterinary attention. Additionally, dog and cat insurance may help make vet bills more affordable.

Breakdown of a vet bill: Pet insurance can help

Posted on: May 8th, 2012 by

A vet cares for an animal.

By: Dr. Fiona Caldwell
Idaho Veterinary Hospital
For Pets Best Insurance

Almost every veterinarian goes into this profession because of passion and love for animals. But unfortunately, there’s a misconception that because veterinary care is expensive, it’s somehow funding vacation homes and fancy cars.

If you ask any veterinarian, one of the hardest parts of our jobs is not being able to provide for every animal equally due to financial restraints of the client– this is why I have always been a huge proponent of pet insurance as it helps pet owners afford the highest level of care available.

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As a profession, the veterinary medical community absolutely recognizes that our medicine is expensive, and this has more to do with advances in vet medicine than anything else. Here’s a breakdown of why a trip to the veterinarians is so dang expensive (and why you should definitely look into dog or cat insurance ASAP!)

Regardless of how big your veterinarian’s heart is, your neighborhood veterinary clinic is a business, and a business needs to make money to survive. It provides a service and like any other business, the clinic has bills to pay, including rent and utilities. In addition, keeping up with current medical advancements is expensive.

Many clinics have equipment like you’d find in a human hospital or doctor office, including, digital radiology, ultrasound machines, laser surgery devices, endoscopy and other high tech instruments that are very expensive, but necessary to practice the level of professional veterinary healthcare needed. Purchasing up to date and current equipment can cost tens of thousands of dollars.

Another reason vet care can be expensive is because a veterinary clinic is often the primary care, dentist, oral surgeon, orthopedic surgeon, dermatologist and behaviorist all in one!

In addition to medical instruments, invoices also help pay staff salaries. In my opinion, animal technicians and assistants are probably one of the most sorely unpaid professionals. Many will have gone to two to three years of school, have considerable student debt and make an average of $12.88 per hour, according to the Bureau of Labor Statistics. They are able to place catheters, take detailed radiographs, calculate drug dosages and have a whole slew of other advanced technical skills. The reason they don’t they get paid more is because that cost would be passed onto you, the client.

Believe it or not, being a veterinarian is not a “cushy” job. Most live modestly and have considerable school debt. Every time a client says, “I probably just paid for your next vacation” after seeing their invoice, I want to take them out to the parking lot and show them my thirteen year old car with the missing hubcap and 175,000 miles on it!

The average veterinary starting salary in 2011 was $46,971 according to the American Veterinary Medical Association. That’s by no means a terrible wage, but you have to consider the average school loan debt accrued is $142,613. Veterinarians have enormous monthly school loan repayments.

In comparison, the average starting salaries of an MD or a dentist who has similar school loan debt, are considerably higher. Starting salary in 2008 for physicians was between $174,000 and $209,000, four times higher than that for veterinarians. Average school debt for physicians, according to the American Medical Association was $130,000, actually less than that of veterinarians.

So, how does that vet bill add up anyway? Let’s take the case of Tulah, a five year old female Pomeranian. She has been asking to go outside to potty frequently, and then straining to urinate, with only small amounts of urine coming out. She’s done this before and you’re certain it’s a urinary tract infection. You make an appointment to get her the antibiotics you know she needs and the bill is $205.

Here is how Tulah’s invoice is broken down:
-Exam - $50, this pays for the doctor’s expertise. He or she will likely examine all of her, even though it is her bladder that is a problem. We are looking to make sure nothing has changed recently, such as gain loss or gain or other problems, like ear infections or periodontal disease. If she has lost weight she could actually have a bigger problem, such as diabetes that is causing her to develop urinary tract infections.

-Urinalysis – $40. Examining the urine under the microscope to confirm the presence of bacteria and determine the type of bacteria is crucial prior to picking the type of antibiotic she needs. If the urine also has protein in it, or sugar, or some other abnormality, this can alert the doctor that something else might be going on.

-Ultrasound of bladder -$60. This test is important to rule out the presence of urinary stones or even masses of tumors that could be causing Tulah’s urinary tract infection. Neglecting to rule this out could prevent her from being treated appropriately.

-Antibiotics – $30. It is true that the antibiotics are marked up from their original cost from the warehouse. The mark up covers the technician’s time to count them out, possibly split them for you, make a label and discuss how to administer them and any possible side effects.

-Pain medication – $15. Urinary tract infections are uncomfortable. Tulah is going to heal more quickly if her discomfort is treated as well.

Put together, the bill comes to $205. If Tulah had only gotten antibiotics without those other tests, something serious could have been missed, or she could have been inappropriately treated.

The economic downturn has hit the veterinary community hard. Many clients are unable to afford treatment their pets need and are cutting back on regular care as well. The decline in veterinary visits has made it hard for many clinics to make ends meet. So when someone comes in with a sick animal and only $50 in their pocket, it isn’t because we’re heartless that the animal may be refused care, it’s because this happens every day, and clinics often don’t have the resources to extend free care. Someone has to pay for it, where do you draw the line? If you ask any veterinarian, I bet most would agree that having an animal that goes untreated, or receives subpar care is the worst part of our jobs.

So what can be done? The number one best solution to this problem is cat and dog insurance. I often have clients tell me, “my own knee surgery cost less than this!” But that client probably had human health insurance which paid the bulk of that cost, leaving the out of pocket expenses much lower. According to Medscape.com the average cost for ACL repair in humans is about $11,500; the average cost for a similar surgery in your pet is likely somewhere between $2,000 and $5,000, depending on how it is repaired and where you live. Pet insurance is comparable to human insurance and can substantially defray the costs of unexpected veterinary bills.

In the cases where a client really just cannot afford anything and has no pet insurance, we usually refer them to the local humane society, where donations and grants allow the organization to provide for needy animals. Often the client has to give their pet up in order to have it treated, and usually don’t get him or her back.

Veterinarians love animals and they want to be able to heal everyone that walks through the door, but unfortunately, often their hands are tied by lack of finances. It will be a great day when most pets are covered by pet insurance and they are able to get the care they need.

ACL Injuries: What they mean for your pet

Posted on: April 28th, 2011 by

A dog with dog insurance heals from an ACL injury.

By: Dr. Fional Caldwell
For Pets Best Insurance

It’s all too common, a big athletic dog suddenly comes back from the park limping, or even holding up the hind leg completely. You end up at the veterinarian’s office, where you are told your dog has just injured its ACL.

ACL stands for Anterior Cruciate Ligament; in proper veterinary terminology this ligament is the Cranial Cruciate Ligament, or CCL. We think of ACL injuries occurring in athletes, such as football players and skiers, but this happens in dogs and cats too. In fact, cruciate ruptures are the most common orthopedic injury seen in veterinary medicine; having dog insurance can often make this injury more financially feasible to treat.*

The cruciate ligaments are located in the knee (or stifle in animals). These ligaments are vital for proper movement of the knee. The term “cruciate” implies there are two ligaments that form an ‘X.’ The cranial and caudal ligaments do just this and normally function to stabilize the knee so the shinbone (tibia) doesn’t slide back front to back in relation to the thigh bone (femur).

One big difference between veterinary and human cruciate injuries is that human cruciate ruptures tend to be due to traumatic injuries, such as, playing sports. In animals this isn’t always the case, which is another good reason it’s often a good idea to look into insurance for dogs.

While some may occur as the result of some injury, such as after chasing a Frisbee, 75% of cases are thought to be due to congenital predisposition (genetics) or degeneration in the stifle. Obesity is a huge predisposing factor! Breeds prone to this condition include the Labrador Retriever, Golden Retriever, Rottweiler, and St. Bernard among others.

Due to the degenerative nature of cruciate disease, between 30-40% of dogs will go on to eventually injure the other knee. This is due to increased weight bearing on the ‘good’ knee while the dog is lame, combined by the fact that the knees are generally symmetrical. Thus, an underlying predisposing problem in one knee will undoubtedly be present in the other.

There are basically four ways of treating a torn or ruptured cruciate ligament, three of these are surgical and can be quite costly; dog health insurance can often help to reduce these costs. Non-surgical treatment is only ever considered in pets weighing less than 15 pounds. Even in these smaller pets this is generally unrewarding and typically fails. About 50% of cats and 20-to 25% of dogs may respond to strict cage rest, weight control and pain relievers.

There are several companies that are making orthopedic knee braces for dogs. Although some dog insurance companies might cover the cost of these types of braces, most people agree that they are cumbersome to put on and difficult to keep on the patient. They also are not a long term solution, as the amount of stability provided isn’t sufficient for healing.

A permanent surgical correction is a better option, although braces may be suitable for post-operative rehabilitation. The majority of pets need to have surgical correction to provide return to normal function of the leg. Surgery is generally expensive and dog health insurance can often come in handy.

There are three main types of surgical repair. Your veterinarian should help you decide which is appropriate for your pet.

A Lateral Stabilizing procedure, also called a ‘Tight Rope’ or ‘Fishing Line’ procedure is generally less costly and can be a good choice for dogs weighing up to 40 or 50 pounds. This implant approximates the position and plane of the torn cruciate, providing stability. In people a graft can be used to replace the ligament, but this doesn’t provide long term stability in dogs and has fallen out of favor. Success rate is about 85% with surgical correction.

A TPLO, or Tibial Plateau Leveling Osteotomy is another common type of surgical repair. Smaller dogs may not be good candidates for this type of surgery due to the size of the surgical implant. This surgery is different from the lateral stabilizing surgery because it changes the biomechanics of the knee, negating the need for the cranial cruciate. It alters the slope of the top of the shinbone (tibia) to neutralize the forward motion of the shinbone in the absence of an intact cruciate ligament.

A TTA, or Tibial Tuberosity Advancement, has a similar goal to alter the biomechanics of the knee, and can be another excellent choice for surgical repair. Studies show that regardless of the surgery type, the TPLO or TTA surgeries appear to be associated with better results and less degenerative joint disease in very large dogs than the Lateral Stabilizing procedure.

There are some things you can do to prevent this type of injury. If you have a larger dog, or any pet for that matter, consider having dog insurance prior to any problems occurring. Don’t let your pets become obese, monitoring treats and people food is essential. Regular check ups with your veterinarian can help you to determine if your pet is getting too heavy.

If you are concerned your pet may have a torn cruciate ligament, schedule an appointment with your veterinarian.

*Pets Best Insurance does not cover cruciate injuries within in the first 12 months of coverage. After 12 months, regular benefits will apply to cruciate injures that develop after the first year of coverage.

Pet health: Heartworm Disease

Posted on: April 14th, 2011 by

A veterinarian gives heartworm medication to a dog with pet insurance.

By: Dr. Fiona Caldwell
For Pets Best Insurance

Heartworm disease is a pet health condition that is becoming increasingly more prevalent in the United States. It has currently been documented in all 50 states and is most common in the Mississippi valley and southern US. Even if you and your dog don’t live in the south, heartworm prevention is very important anywhere to avert this serious pet health disease. Many pet insurance companies even offer limited coverage for testing and prevention with their wellness coverage.

Heartworm disease is a potentially fatal disease characterized by parasitic worms that live in the heart and arteries in the lungs. The worms are a type of roundworm or nematode called filarids, and any age or breed of dog can be susceptible.

Filarids require an intermediate host to spread the worm from animal to animal. This intermediate host is the mosquito. This means that dogs can’t catch heartworm from causal contact with an infected dog, rather, they have to be bitten by an infected mosquito. Regions with the most mosquitoes tend to have the most incidences of heartworm disease.

Heartworms have a very interesting lifecycle. Like most parasites, they have a larval phase and an adult worm phase, but they also have a phase called microfilaria. The complete life cycle cannot take place in the dog’s body, but has to occur in the mosquito. This means dogs can’t ‘re-infect’ themselves, once the microfilaria turn into adults, the adults can’t replicate without using a mosquito as an intermediate host.

The larva is the infective phase of heartworm disease and is carried by the mosquitoes. The larva matures into adult worms, which in turn, produce millions of microfilaria that travel through the blood stream. Microfilaria cannot turn into the infective larval phase unless a mosquito takes a blood meal that has microfilaria in it. The microfilaria requires 10 to 30 days to turn into the infective larval phase. When the mosquito bites another dog, it can transmit the infective larval phase that once again turns into mature adult heartworms.

Treatment for this disease is costly and difficult. There are medications available that will kill the worms, but the heartworms have nowhere to safely go in the body after dying. Dead worms in the arteries of the lungs and in the heart pose a serious risk for the patient. The best method to keep your dog healthy is focus on preventing this disease. Most veterinarians agree that monthly heartworm preventatives are important for any pet that spends time outside and could be bitten by a mosquito.

Heartworm preventative generally takes the form of a monthly product that either is poured on the skin, or a tablet taken orally. Heartworm preventatives should be in prescription form, and therefore must be purchased at or through a veterinarian’s office, or certified veterinary pharmacy. If you are considering keeping your pet on a heartworm preventative, contact your veterinarian with any additional questions.

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