Quick Tips for Pet Travel

Maybe you're headed on a big cross-country road trip. Maybe it's just a weekend with the in-laws a few hours away. Whatever the occasion, traveling with pets can be fun, exciting....and stressful. Poorly planned, it might even be dangerous. Today's article covers several easy tips to lower the stress level and keep things safe, so you can focus on relaxing and having a good time together.

Bear in mind this just refers to domestic travel by car; airlines and international travel are different beasts that will be covered in future articles.

1. Bring plenty of extra food / medications: This is an obvious one...so it should be no surprise it's the most common one folks forget. Imagine running out of food, having to substitute something else, and triggering a nice bout of diarrhea. While driving. In your car.


2. Seatbelts / carriers:  I'm not going to lie - my dog usually rides shotgun, unrestrained. He's also been dumped forcefully into the floor when I've had to slam the brakes. That wouldn't happen if I was smart enough to practice what I preach and get a pet seatbelt. Excited pets bouncing around the cabin isn't conducive to safe driving, either.


3. Windows up: I once witnessed a Yorkie jump out of the car window as it drove by the vet clinic I was working at. Good timing, I guess - but it nearly killed him.


4. LEASHES!: Never let your dog (or cat, or iguana) off leash in an unfamiliar place. I don't care how much you know/trust them - the unfamiliar sights, sounds, and smells could provide the unexpected surprise that leaves you spending the day searching for them, or worse.


5. Dealing with anxiety and car-sickness: Pheremone collars (DAP or Feliway) can help many pets with mild travel anxiety. For motion sickness or more significant anxiety, talk to your vet about Benadryl and other options.


6. Current flea & tick prevention: Make sure your pet's flea prevention will cover the duration of the trip; no one wants to finish off a vacation with a bunch of nasty new house guests. Do this even if you don't normally use a flea preventative - trust me. 


7. Microchips: Make sure your pet's microchip is registered to your current address. If they don't have a microchip consider getting one

Here are a few more things you may want to ring your veterinarian's office for:

1. Get a record or certificate of all vaccinations (and make sure they are up-to-date): Most hotels require up-to-date rabies vaccination at a minimum. Tell them where you are going, and ask if there are any other vaccines they'd recommend. These may include Bordetella, Leptospirosis, lyme disease, or others.


2. If your pet has any major medical history - chronic diseases under treatment or past major surgeries - ask for a copy of the medical record to take with you. Hopefully your pet won't need veterinary care during the trip, but if they do that record may be invaluable.


3. Ask your veterinarian about an official health certificate: may be required to enter certain states or to stay at some hotels, and all airlines require them. Your veterinarian can provide one after a thorough physical exam - which is itself valuable, since more than once I've picked up problems owners weren't aware of that might make travel a bad idea. Health certificates may only be good for a limited time (10 days for airlines), so set your appointment appropriately.

First Aid - How & When To Make Your Pet Puke

A bandage eaten by a dog. The ironic part?
It was from his tail amputation, which
resulted from his attempts to eat said tail.
He was not to be deterred.

Pets eat stuff. Sometimes things you, I, or even your average indiscriminate 3 year-old would never dream of eating. This first-aid article is about how to make your pet vomit that stuff back up again; but that's pretty simple (I know what you cat owners out there are thinking: all I need to make Muffy puke is a nice pair of shoes). The tough part is knowing when it's okay to do so - because in many situations inducing vomiting can make things WORSE. On the other hand, quickly getting certain toxins out of your pet could also save their life. So, this article is mostly about knowing the difference between those situations. Then we'll wrap up with quick instructions on inducing vomiting, without ruining your favorite shoes.

First thing's first - if your pet has eaten something you think may be harmful, call your vet or Animal Poison Control before attempting anything on your own. That's the guaranteed way to make sure you don't wind up doing more harm than good. It's also very possible your pet will need to go in for further treatment or monitoring. Oh, and one other thing - don't panic. That never helps, eh?

When You Should NEVER Induce Vomiting

• Your pet is in any way sedated, confused, weakened, or mentally altered: If their consciousness is altered, they may not be able to keep the vomit from getting into their windpipe - making a bad situation far worse.
• Household chemicals (detergents, cleaners, pesticides, etc): many of these are inherently caustic and can do much more damage coming back up again. Pesticides usually aren't harmful coming back up, but many can cause neurological effects (see #1) that predispose to aspirating stuff back into the lungs.
• Petroleum products: if they get into the airways on the way back up, they'll wreak all kinds of havoc.
• Anything sharp, or potentially sharp: It could puncture the esophagus or stomach in the process. Vomiting can be a good way to deal with ingestion of small foreign bodies, but it's best to leave that call to your vet - I generally recommend x-rays first (who knows what else is in there) and in-hospital monitoring (in case of choking) if we're going to try this.
• Your pet recently had surgery. 

Looking around the web for other's thoughts on the subject, I noticed many warnings against inducing vomiting if...they're already vomiting. Kinda seems that would go without saying - I guess my readers are smarter than theirs. Many also recommend against inducing vomiting if it's been over two hours; that's a textbook number for how long it should take to digest something. I haven't caught a dog reading a textbook yet, but I have seen more than a few toss stuff up long after it "should" have been digested. Often folks don't know when it happened, for that matter, and I wouldn't obsess over that 2 hour mark - though it's a good rule of thumb.

When TO Induce Vomiting

If you've ruled out all the above contraindications, and talked to your vet or APC, it's likely a good idea to induce vomiting if your pet has recently eaten the following:

• Potentially harmful foods.
• Prescription medications (yours, or overdoses of theirs)
• Antifreeze (caveat - this needs to happen fast, as it is absorbed very fast)
• Rodent poisons

What To Do AFTER Inducing Vomiting

Yes, we'll get to inducing vomiting in a minute. What you do next is extremely important, and I don't want you to stop reading after the punchline (like I would). 

• Obtain some of the vomit for potential ID by your vet.
• Gather the packages or product inserts for whatever you think they got into. We need to see the ingredient lists - I've got no idea what's in "Super Cleaner X."
• Closely monitor your pet.
• Unless you've talked to them and they told you not to, head to your vet's office or the nearest pet ER. Your pet's life could depend on further treatment; this isn't the time to "wait and see."

How To Induce Vomiting

Okay, here's the moment you've all been waiting for! 

• If your pet is a cat, stop reading: Don't try this unless specifically instructed by your vet. Peroxide makes kitty guts very unhappy.
• If your pet hasn't eaten much recently, offer a small meal: Bread is good, since it sponges stuff up. It's tough to vomit thoroughly when there isn't much in the stomach.
• Grab some 3% hydrogen peroxide - DO NOT use anything other than 3%: Stronger peroxide formulas like the stuff beauticians use can kill your pet.
• Get 1 milliliter per 2 lb into your pet: There's about 5ml in a teaspoon, so that's 1/2tsp for a 5lb chihuahuah or 4tsp for a 40lb border collie. Don't exceed 45ml per dose. You can use a syringe or turkey baster, but often if you just mix it in some ice cream or milk they'll do the work for you. You can repeat that dose once if it hasn't worked in 15 minutes.
• Get a towel: Put it in the back seat of your car. It's probably going to take 5-15 minutes to work, and you should be on your way to the vet. Yet another reason you should only do this if your vet tells you it's necessary, eh?
• Do all those things listed above in "AFTER Inducing Vomiting": Seriously.

Lastly, NEVER, NEVER, NEVER (!) induce vomiting on your own if your pet ingests large denominations of money. Leave that to the professionals - call me at home, I'll take care of it. I'll need to keep the evidence, of course - you don't want a bunch of nasty vomit-covered hundred dollar bills anyway, right?

Is Pet Insurance For Me?

By Dr. Courtney Smock

I have recently been asked my opinion about pet insurance several times by friends and family, and it seems to be a question on the rise among clients as well. While a quick comparison between the costs of identical services at human vs. veterinary hospitals makes clear that vet care is one heck of a value, that still doesn't mean it is cheap. Particularly when the bill is coming out of your pocket, not Humana's or Blue Cross'. We want the best care for out pets, and it's no surprise an increasing number of people are looking toward insurance plans to afford that care. But are they a good deal for everyone?

As with any free-market product, there are almost as many choices for pet health insurance as there are pets.  However, with little exception, they all share an operational feature: YOU pay the bill at the veterinary clinic, submit your claim, and get reimbursed (or not!) at a later date.  This is an extremely important point to consider before anything else - even though pet insurance may help offset your costs in the future, you are still responsible for the entire bill in the present.  So, if you cannot temporarily access a few thousand dollars for an emergency situation (think tapping into savings, a high interest rate credit card you wouldn't normally use, or borrowing from friends and family), then pet insurance is not going to do squat for you, because there will probably be very little veterinary care happening.

Well then, what is pet insurance for?  Like any insurance, it is a tool to mitigate your expenses should something unfortunate happen.  But pet insurance is unique in the respect that it may help you make a difficult medical care decision should something unfortunate happen to your pet.  Let me give you two examples:

• At your dog’s yearly wellness visit, the veterinarian tells you that she feels a mass in Muffy’s belly.  X-rays suggest that it is a tumor in the spleen.  Your vet explains that there is a decent chance the tumor is benign, meaning that surgical removal of the spleen could be 100% curative.  If you do nothing, Muffy’s spleen could rupture, leading to fatal blood loss.  The estimate for surgery is $1500.  You have a credit card you could use, but every dollar is already spoken for in your budget and you don’t know how you will be able to make payments.  Pet insurance might allow you to authorize the surgery, knowing that most of the cost will be reimbursed in your insurance payout.  
• Your happy-go-lucky lab puppy gets loose at the dog park and is hit by a car (Dog forbid).  Fortunately there are no mortal wounds, but one of her legs is broken in the incident.  The vet says the fracture is too complicated and will need to go to a specialist for repair - but all those plates, screws, rechecks and the expertise of the surgical specialist are going to run $3000-$4000.  Otherwise, the fracture won't heal and the only humane thing to do is to remove the leg.  Pet insurance could save the leg without amputating your savings in turn.  

I used to tell clients that I didn’t think pet insurance was a good value; that they should take the money they would pay in premiums each month and put it in a dedicated pet savings account.  The problem with this recommendation is that if aforementioned puppy goes on the lam and you’ve only had time to save $60, that’s not really much help.  Now I amend that statement to say that if you have $2-5,000 to put in a dedicated savings account for your pet, or some other way to access that kind of money in an emergency, you definitely don’t NEED pet insurance.  However, if the idea of dropping five grand on Muffy’s prolonged hospital stay when she breaks her elbow jumping out of your handbag makes your stomach turn, you may still WANT pet insurance.

In the interest of full disclosure, I will freely admit that my pets are not insured, nor do I have $5,000 socked away in a pet savings account.  If, dear reader, you are still with me, and still thinking about getting pet insurance, then consider these KEY POINTS:

1. Remember that insurance providers are businesses, and they wouldn’t offer this service if they didn’t make a profit – you may break even or come out ahead financially, but the odds are not in your favor, so that should not be the main factor in your decision.
2. Wellness care (annual exam, vaccines, spay/neuter surgery, heartworm testing and preventative) is an expense that can be anticipated and for which you can save – I do not recommend insuring for wellness care.
3.  For the love of Dog, READ and be sure you understand any policy in full before committing (See point #1 above)!  Particularly be on the lookout for pre-existing condition exclusions and waiting periods, breed-related exclusions, and maximum payout details. If you have questions, talk to your veterinarian.
4. Go to Dr. Frances Wilkerson's site, Pet Insurance University.  Aside from an excellent article series on how pet insurance works and why you would consider it, she provides detailed reviews on all the major plans for easy comparison.

Quick Tips For Low-Stress Vet Visits

Imagine your mother dropped by this morning with a very large box; without words or explanation she unceremoniously forced you into it, then tossed you in the car and took off. Eventually the car stops and she lugs you into the doctor's office (she's stronger than she looks, that mother of yours). She doesn't seem to understand your repeated questions, so you still have no idea what's going on or why you're here. However, several others seem to be in similar situations. Some are in boxes like you, others are tied to ropes - there's one person who won't stop shouting nonsense, another urinating on a chair leg, and one guy who won't stop trying to lick everyone in the face. Eventually you're taken into another room, dumped out of the box and onto your keister, then poked and prodded for no apparent reason by some strange woman in a white coat. They finish off with a couple of unexpected shots in the rump, then good ol' mom shoves you back in the box and drives you home.

Yeah, I guess that might be a little stressful. 

A little food cajoles most cats...

For some pets there may be no such thing as a "stress-free" vet visit, but we can reduce that stress to manageable levels. It's also important to note that animals deal with stress differently, just like people - some may growl or cower, but acting overly submissive or affectionate can be less-obvious signs too. Today's article covers several simple things you can do to make veterinary visits easier on your furry housemate's nerves (and in turn, your own).

Setting Expectations
Animals are bright, fast learners. If that cat carrier, leash, or car ride always culminates in getting poked in the butt by a stranger, it won't take them long to start freaking out at the first sign trouble is on it's way. I have one diabetic patient whose owner tells me Tiny's fine in the car if they turn left out of the driveway - but turning right always means the vet, and blood draws, and one instantly ticked-off Tiny. Fortunately, pets make positive associations just as easily, so you can undo most of this stress with a little effort.

....and the odd dog. This one
is more odd than most.

• Get in the habit of setting the cat carrier out once or twice a week with a treat or toy in it. They'll be eager to get in the next time you need to use it for travel.
• Likewise, take your dog on fun leash walks around the neighborhood regularly if you don't already.
• Once they are good with the paraphernalia, start taking your dog or cat on short car trips. Bring a food reward or two to make it fun - some fast food places like Sonic keep dog treats at the drive-thru so you can both get a little positive reinforcement.
• Placing a familiar-smelling item like a blanket in the car or carrier also helps pets relax.
• Drop by the vet clinic occasionally with Muffy, just to say hello or check their weight. Bring a favorite reward and ask a staff member to offer it.

On a related note, I highly recommend the pet carriers with snap-on tops. It's so much less stressful on everyone to just pop the top off, instead of prying Muffy out only to force her back in afterwards.

There's Stress In Numbers
Stress is additive and contagious. It's tempting to try getting all the pets in at once, and make it a family-fun event, but....Take two hyperactive kids, one mother shouting for them to calm down, then add in your incessantly barking Beagle-buddy to boot, and even the calmest Shih Tzu in the world is going to be on edge.

• Making veterinary visits an adults-only, single pet endeavor can really go a long way toward lowering the stress levels for everyone - you included. Plus, you get a lot more for your money when you can focus on asking questions and listening to the staff's recommendations without extra kids, furry or otherwise, vying for your attention. 
• If your significant other likes to argue or won't let you get a word in edgewise, get them a sitter too (my wife says her spouse is like that...). 
• On the other hand, if you are stressed out - which is okay, and often understandable - your pet will sense that and follow suit. It's always okay to ask to wait outside during the exam, and sometimes it really is less stressful for everyone.

The same strategies can be applied when choosing a vet or setting an appointment:

• Some clinics have started providing separate waiting areas for cats and exotics, since a room full of barking dogs is pretty much guaranteed to stress them out. 
• If you're flexible, asking for an appointment at a slower time of day is a good move too.
• Lastly, the discount walk-in shot clinic is almost guaranteed to have a waiting room full of chaos; that's one of many arguments for paying a little more to see the doctor down the street.

Better Living Through Chemistry
Of course, there are a few pets out there who just aren't going to adapt well to the clinic, car, or carrier no matter what you try. For those guys, there are varying levels of "chemical intervention" we can try to help them out.

What, you don't recognize Benadryl?

• Mild Anxiety: Pheromone sprays or collars like Feliway and D.A.P. may be helpful. They're also useful initially in conjunction with the above techniques to take the edge off.
• Moderate Anxiety: Ask your vet about trying Benadryl. It often provides some sedation and is quite safe for most animals at the proper dose - again, ask your vet.
• Severe Anxiety: There are several sedatives and anxiolytics that can be life-savers for dogs that truly need them; all have the potential for significant side-effects and require a prescription, however, so a good chat with your vet is in order. Furthermore, pets who need this level of intervention for a trip to the vet likely have other behavior issues that need addressed.

Lastly, but probably most important - if the stress of veterinary visits is truly tough on you and your pet, consider making an appointment solely to discuss this issue and come up with a plan of attack. You can even consider a consultation without your pet, if need be. Fortunately, though, most dogs and cats can learn to manage a trip to the vet with a just a bit of work and forethought on your part. I'm really not that bad. Plus, I have treats.

Beware the Chinese Chicken

True story.

No, a drumstick will not make your brain stop tickin'. However, over the last year the FDA has reported a rather dramatic increase in reports of pet illness that may be related to chicken jerky treats made in China. Concerns are now extending to duck and sweet potato products. Problems have ranged from vomiting and diarrhea to kidney failure and death; however, I should emphasize that no direct link or cause has been identified yet, and nothing has been recalled as of yet. In other words - don't panic.

On the other hand, there have been more than enough reports to warrant avoiding Chinese-made jerky treats and tossing any you may have bought, just to be on the safe side. Frankly, China has jack for safety regulations, a fact underscored by several recalls of very dangerous products produced there in recent years.  I try to avoid anything with "Made in China" on the back, period. Sorry, Beijing.

This is also a good opportunity to point out two great resources for information about pet food and product recalls. The American Veterinary Medical Association maintains two recall lists, one for foods and another for pet products:

• Pet Food Safety Recalls and Alerts (AVMA) 
• Pet Product Safety Recalls and Alerts (AVMA)

Of note, several brands of thyroid medication were also recently recalled. Manufacturing issues may have led to non-uniform pills (that is, varying drug strengths); this probably won't cause serious side effects, but if your dog is on thyroid meds you should ring your vet's office to see if you've received any of the problem lots. Also, some Petco food bowls were recalled due to radioactivity. I couldn't make this stuff up.

Out Of The Kitchen And Into The ER: Four Dangerous Foods For Pets

Folks often ask me if this-or-that food is okay for pets. I like to tell them all people foods are "toxic" to animals, since even moderate quantities can lead to a chronic condition proven to shorten lifespans and known colloquially as FAT, or Food-Amplified Tissue syndrome. You can read more about that in this article. Furthermore, anyone whose Lab has ever raided the trash can can tell you that enough of anything a pet isn't used to eating can result in a few days of sickness (and maybe a visit from the carpet cleaners). Of course, some things in the kitchen can harm your pet much more quickly and severely, and today's article covers the four biggest culprits.

Lets start with a few general notes. First off, if you are concerned about something Muffy indiscriminately scarfed down the first thing to do is call your vet. If they aren't open, try the nearest pet emergency hospital or Animal Poison Control. They can tell you if you should freak out, how much you should freak out, and what you should do next (after they get you to stop freaking out). The risk is usually going to depend on how much toxin went into how much dog; that is, a nibble of onion or milk chocolate probably won't faze a Great Dane, but it could be enough to kill your 2-pound chihuahua. Cats also tend to be more sensitive to most toxins, food or otherwise.

Anyone else suddenly craving Italian?

Onions and Garlic
Plants in these families contain sulfur compounds that can damage red blood cells, causing them to rupture. Since red blood cells are responsible for carrying oxygen to the body's cells, and those cells need oxygen, this is kind of bad. Common signs logically include weakness and pale gums; however, these problems occur hours to days after exposure. Note that garlic and onion powders are just as dangerous, and may be used in processed human foods in significant portions - just one more reason to keep pets out of the people food!

Grapes and Raisins
These can trash your pet's kidneys. Kidneys are rather important. Raisins are more potent in this regard, which shouldn't be surprising since they are basically grapes minus the water - and water, at least, is good for kidneys.

Before anyone asks -yes, some dogs and cats seem to tolerate grapes and raisins just fine, and we aren't sure exactly what the mechanism for the toxicity is in the first place. On the other hand, some pets die from eating these. Just keep them out of them, okay?


Chocolate

Fortunately, there is nothing wrong with
eating chocolate in front of your pet.
Which I think I shall now do.

Cocoa contains stimulants that are very dangerous for pets. Early signs include vomiting and diarrhea, leading to extreme excitement and agitation (imagine your chihuahua on three cups of espresso), and even death.

But wait - a culinary lesson! Chocolate is a blend of sugar, fats, and cocoa; the amount of these determines the type, flavor, and quality of the chocolate. Milk chocolate has little actual cocoa, dark has a good bit, and semi-sweet or baker's chocolate is mostly cocoa. This is important because the more cocoa, the more danger for your pet. White chocolate is made with cocoa butter rather than actual cocoa powder, and so is fairly harmless unless they try to eat their weight. How much is too much? Check out this excellent interactive chart from National Geographic. But remember, each dog is different - contact your vet if you are worried!


Xylitol (that's a sweetener, not a Russian side dish)
This is present in many sugar-free gums, mints, vitamins and even toothpaste. Within 30 minutes of ingestion it may cause a dog's blood sugar to drop to dangerous levels, resulting in seizures, coma, or death. Worse yet, even if they don't show these signs some dogs may develop liver failure hours to days later. Because of this overnight hospitalization and monitoring is advisable in most cases.

Lastly, this list is not exhaustive. These are the most common and dangerous food items; other things like macadamia nuts, avocados, and fruit seeds may be harmful as well. APC has a nice question-and-answer list covering the good, bad, and mostly-harmless foods folks often ask about. But definately keep Muffy out of  your stash of sugar-free, chocolate covered raisins dusted in onion powder! You can send me some, though. That sounds tasty.

Anesthesia - Keeping The Big Sleep Safe

Few things make owners as nervous as anesthesia. Heck, when I was first unleashed upon the world as "Dr. Rowland" anesthesia wracked my nerves way more than surgery. I distinctly remember the first time I knocked a patient out - I calculated the dose, double-checked it, then looked it up and checked it again, then read the drug monogram for the Nth time and checked the dose several more times. I've gotten over that, of course. Wouldn't see many patients at that rate!

Here's the thing - with the right drugs, good monitoring, and a relatively healthy patient anesthesia is quite safe. But anesthesia is never without risk, and should never be taken lightly. Today's article is geared toward relieving the anxiety most of us feel when our pets need to be anesthetized - by giving you knowledge about what the risks really are, and what we (vets and owners) can do to minimize them.

Monitoring
Guess what the best way to miss a problem is? Not looking for it.

A fully-functional veterinary monitor.

Anesthetic drugs don't just cause loss of consciousness - they may affect heart rate, blood pressure, respiration and more. In case you don't know, these things are kind of important. The body has needs - nutrients, oxygen, and removal of waste products produced by using those things. Respiration and circulation are how the body gets it done. So it only makes sense to closely monitor how all that's working, right? And since a living body is a pretty complicated bugger, there are many things that can go wrong and many things we can watch to recognize problems and address them before they get out of hand. Here's what I consider minimum monitoring for most procedures:

• Heart rate and blood pressure - These are the main determinants of blood flow, but they can also clue us in on "depth" of anesthesia and even other problems like blood loss.
• Electrocardiogram (ECG) - That's the green wave with the reassuring beep on the TV hospital shows. The heart is a complicated pump running on electricity; an ECG looks at that electricity to identify problems with rate, rhythm, or coordination of the heart.
• Respiratory rate and blood oxygenation - Blood flow to your pet's tissues does little good if it doesn't have oxygen. And, even if you are breathing, lung or circulation problems can keep the body from getting the oxygen it needs.

Except for pulse and respiration, all those require special equipment to monitor. But this belies an important question - who monitors the monitors? Indeed, the most important monitor of all is the human being keeping track of, interpreting, and responding to all this information. Since the veterinarian is usually kind of busy -cutting this, stitching up that, and keeping sterile all the while - the best monitor is a living, breathing, highly-trained veterinary technician. They keep an eye on all that data for problems, address the minor stuff, and let me know when I need to stop playing with this or that organ and focus on what the rest of the patient is doing. Plus they monitor important stuff no machine can, like reflexes and gum color, and administer whatever treatment the vet deems necessary if problems do arise. 

How Do I Know You're Healthy?

A 2008 British study showed that anesthetic risk increased almost 7 times for patients with significant systemic disease. That's not exactly surprising, but I'd go farther and say the most common reason for anesthetic problems in patients we think are healthy is that they aren't healthy. Pets with early or mild disease often compensate well and show no outward problems - until we knock them out with a bunch of drugs that reduce their ability to compensate. Here's what I recommend before any anesthetic procedure, to feel reasonably comfortable your pet is healthy:

Occasionally, bloodwork is really surprising.
This pet appears to be possessed by demons.
(okay, not really...)

• A Good History & Physical Exam - The importance of these can't be overstated. Changes in appetite, activity level, urination or other behaviors are major clues to systemic problems. Likewise, many problems with the heart and lungs can be heard with a stethoscope. Some diseases leave early signs that can be seen with a good look at the eyes, skin, or mouth. And more than once I've felt something that shouldn't be there in the abdomen of an outwardly normal patient.
• Basic Bloodwork - Simple blood tests can identify problems with the liver or kidneys that may not cause clinical problems in your pet - until we challenge them with a bunch of anesthetic drugs. A blood count can also catch problems like anemia or inflammation, which in turn may be clues to undiagnosed infections or immune diseases.

Realistically, even if we ran thousands of dollars worth of MRI's and fancy bloodwork we couldn't be 100% sure your pet didn't have some strange, subtle disease. But those simple things will rule out the majority of problems without breaking the bank - a simple blood panel runs about $40-$60 most places. 

Anesthetic Drugs

The drugs used for anesthesia are really your vet's prerogative, and far beyond the scope of this article. However, it's worth briefly mentioning two things about drug choices. First off, when we do find a health issue with a pet that requires anesthesia we use that knowledge to select the safest anesthetic drugs for the condition. Each drug has it's own profile of side-effects that may impact the heart, liver, kidneys, etc; none are without side effects, but we can choose those least likely to aggravate the patient's individual problems.

Secondly, pain and stress also impact many of the things we worry about during anesthesia - heart rate, blood pressure, and even the heart's electrical rhythm. While I haven't came across any studies establishing that good pain control leads to safer anesthesia, it stands to reason that a less stressed, pain-free patient should handle anesthesia better. Most of us nowadays provide sedation prior to inducing anesthesia and various kinds of pain relief (analgesia) during procedures for just this reason.

What Should You Do With This Knowledge?

Here's the point - understanding all this means you can make informed choices when your pet needs anesthesia. Here are some questions you should now be able to ask when choosing a vet for a procedure:

• What kind of things do you monitor when Muffy's asleep?
• Is there a person watching Muffy while he's out? What kind of training do they have?
• What kind of bloodwork do you recommend? 
• Based on your exam, do you think Muffy's okay for anesthesia? Is there anything else we should check?
• If the procedure may be painful, what kind of pain control do you provide?
• Do you have any other questions about Muffy, Doc? (That is a smart owner question.)

So, why tell you all this? Thing is, many great, smart veterinarians don't do all the things they'd like to or feel they should because of financial reasons - that is, you won't pay for it. Not every clinic provides all these services, and many clinics that do offer everything mentioned above make them "optional" for an additional fee. Those monitors I talked about run $3,000-$10,000, with a life expectancy of a few years. The technician monitoring the monitors is $13-25 per hour. If you won't pay for it, we can't pay for it - or we have to cut costs somewhere else, which isn't good for your pet either. Honestly, I don't put the blame for that on pet owners, but squarely on we vets - we can't expect you to pay more if you don't understand why the extra money is worthwhile. Hopefully now you do, and can make informed decisions about who treats your pet and how. The most expensive place in town may not necessarily be the best, but I can pretty much guarantee if you price-shop around for the cheapest place your pet is missing out on some or all of these safety measures. 

Likewise, some vets make good arguments that some of the things discussed here aren't necessary. And maybe they aren't strictly necessary - the vast majority of outwardly health animals are indeed healthy, and would probably be fine if knocked out with a 20-year old drug protocol and ignored. Bear that in mind if you truly can't afford the extra money for all the "best" care. But most of us can handle an extra $100-150 for good monitoring, pain control, and some basic bloodwork; the peace of mind it buys is worth a lot more, if you ask me.