The Sanctity of the Human-Animal Bond is Broken
...preyed upon by big Business, big Pharma, and big Ag.
I received a call from a client last week whom I had not heard from for 15 years. She is an older retired woman, living alone with her dogs and cats. She was in tears when she reached me. Her 16 year old Westie could no longer walk and was spending the day and nights whimpering and crying. Her veterinarian referred her to a neurologist who wanted to perform a $3000 MRI. She did not want to put the dog through the MRI or surgery and was just looking for someone to help her make the toughest decision any dog owner ever has to make. But not one of the vets she spoke with perceived that.
It is situations like this that have motivated me to write these essays, if nothing else than for my own mental health.
Animals have slowly made their way into our lives, first through the basic survival needs of food, protection, clothing, and transportation, among other things. Domestication of previously wild species has been under way for thousands of years, the lives of animals and humans woven together through the ages.
In modern times, domesticated animals have crept deeper into our everyday lives, into our hearts and into our psyches, through the cracks and crevasses of our wounds. In current times where human companionship, community and family support has become a rare commodity, dogs, cats and other species, have stepped up to fill the void. They offer us the social connection we crave as humans and the special gift of unconditional love and compassion. They are in service to humanity, as we make our way through all our trials and tribulations, attempting to heal century old wounds and traumas.
For many people, these animals are emotional lifelines, the thing that gets them out of bed in the morning, the thing that motivates them to live another day in their body. They comfort the chronically ill and provide companionship to the elderly. They give grounding and friendship as emotional and physical support working animals. They see us through all the challenges in life: marriages, break-ups, earning degrees, moving away from friends and family, the death of loved ones.
Ask any person who has that special dog or cat in their life, and they will tell you they will do whatever is necessary to keep them healthy and alive, next to their side.
Unfortunately, there are entities out there who realize this and use this very special bond in their favor, to increase the profits in their bank accounts. Corporate entities set their sights on the animal world 10 - 15 years ago. They saw the billions of dollars that pet owners were willing to spend on food, treats, toys, and medical care for their fur-babies and wanted to cash in.
Corporate culture is like a parasite, feeding on relationships of compassion and empathy, siphoning off the energy in terms of dollars. They are structured so that the individual employee becomes subsumed, swallowed up within a culture designed to remove individual responsibility, and reward individuals for working on the team, for the good of the team and walking away with bonuses if they ignore the potential harm or risks involved down the road.
Corporate entities have infiltrated the pet food industry, and made their way into veterinary medicine. Small independent neighborhood vet clinics have been gobbled up creating national chain clinics. Theses same entities have infiltrated veterinary schools, training general practitioners to work in their facilities, according to their model of veterinary medicine.
Gone are the days of veterinarians getting a good basic education in surgery and medicine, learning how to read radiographs and perform basic surgical procedures so that when they go out in practice, they may not have done a procedure but they have the basics to work their way through it.
They are not being trained on the basics of restraining animals, drawing blood samples, trimming nails, because that is now the work of a technician. I have heard stories from instructors in veterinary schools who have students afraid or unwilling to even touch an animal with their bare hands. They question whether they have had any experience around animals at all.
When I applied to veterinary school in the 1990s, an applicant had to prove they had animal handling experience of some kind to even be considered for one of the 84 spots that had 600 applicants.
Last week I had a client go in for a wellness exam with her Doberman and she asked the veterinarian to trim her dogs nails. Reggie is a very sweet dog, but the vet refused, saying she could not trim nails, acting fearful of the dog. I guess she did not have any technicians available to help hold him or to trim the nails?!?! My client ended up making a special trip to the groomer to get them trimmed.
It appears that veterinarians are graduating as general practitioners that are trained to refer to specialists and have very little diagnostic or treatment skills themselves, a situation that is putting animals at risk and placing veterinarians between practice managers and the client standing in front of them with the sick pet.
A few months ago I had a client with a dog that possibly had bloat, a condition where the stomach bloats and twists and can kill a dog very quickly. The saying I learned in school was, “never let the sun set on a bloat or pyometra”. She called me from the local emergency clinic where she went for radiographs. I asked her what the results were and the young vet had told her they would get the results in the morning when the board-certified radiologist had a chance to look at them. I told her to start calling around for a clinic that had a vet who could read the radiographs and get the dog over there ASAP. Her dog could have died while waiting for the specialist.
The other important change is that they are taught to offer the “gold standard” of care, and nothing less. They will present a whole list of diagnostics and procedures to a client, with a total of several thousands of dollars and expect them to agree to all of it, all at once. After all, the pet insurance company will pay for it anyways, right? And if you don’t have pet insurance, you better well get it.
I learned to present the client with options, explaining my thought process on why I wanted to certain diagnostics or procedures and proceeding step wise through a case, depending upon the budget of the client and the needs of the patient. Now they are taught that it is the "gold standard" or the door. And I have had clients literally been shown the door if they did not agree to everything on the estimate.
A case that comes to mind is a 14 year old Weimaraner who had been in chronic kidney failure for 2 years. The client wanted to give him IV fluids overnight and check the kidney values in the morning to see if he showed any improvement before deciding to euthanize him. I personally had a discussion with the veterinarian on the case and we all agreed to the plan. An hour later my client called, saying the practice manager had presented a $3000 estimate to her that included an ultrasound and kidney biopsy. The manager refused to remove the kidney biopsy from the estimate stating that the dog had to have it if they were going to hospitalize him overnight. Not wanting to put her dog through a kidney biopsy during the last days of his life, she ended up taking her dog out of the clinic and returned back home.
The corporatization of veterinary medicine explains how and why only specific treatment options are provided to clients. It is usually the medication that the corporation got the best deal on from the pharmaceutical company. A current example is the treatment for arthritis, a common condition in any middle age to older dog or cat these days. We have been treating arthritis in dogs for decades and there are many different treatments available. But now, ever since Librela was approved by the FDA last year, clients are being told the only treatment that will help their dog is Librela. Never mind the many different anti-inflammatory medications approved for use in dogs and that we have been using for decades. Never mind rehabilitation, laser, acupuncture, nutrition, supplements and herbs. It is Librela or the highway.
Before Librela it was gabapentin. Gabapentin was the only medication being offered for pain in many clinics and once again the claim was made of “no side effects”. Now information is coming to light that there have been no conclusive studies showing that gabapentin does anything for pain. It has been found to damage the kidneys, depress respiration when used with opioids and is addictive, being placed on controllled substance lists in several states already.
I am beginning to see, over the last year or so, a new terminology showing up in veterinary journals: "SPECTRUM OF CARE". When I read about it, I realize it is the way we were taught how to practice way back when, in the dark ages. We made a list of possible diagnoses, the differential list. Then we made a list of diagnostic tests that could help us narrow down and rule in or out the possibilities. We went over this list with the client, and depending upon their circumstances, we chose what would be feasible for them AND in the best interest of the patient. Sometimes that might be a medication trial, sometimes bloodwork, and then, depending on the bloodwork, radiographs or an ultrasound or even exploratory surgery. We went step by step, in constant communication with the client, sharing the diagnostic results, how the patient was responding to treatment and what to do next. Through all of this, we developed a relationship with the client, working as a team to help the patient, their beloved animal.
Now clients report to me that it is difficult to talk to the veterinarian for more than 5 minutes. Clinic managers will reassure them everything is being done to help their pet, even when a critical cardiac case has yet to be seen by a cardiologist or have an echo done 72 hours into the emergency hospital visit. It sounds a whole lot like our human medical system.
A case of bloody diarrhea in my area now requires a full blood profile, fecal and radiographs when 9 times out of 10 fasting the dog and a short course of meds and probiotics will resolve it. That is the difference between a $200 visit and a $1000 visit, and "this is the gold standard so this is what you have to do".
A case I learned of yesterday was a dog in acute kidney failure that came on rapidly, values rapidly elevating, the dog seizing and showing signs of end stage kidney failure. They charged up $10,000 over 3 days of end-stage hospitalization when there was no chance of regaining kidney function, and no explanation to the client that the animal would not be regaining kidney function.
Essentially, what has happened is that veterinary medicine has been remodeled to operate like the broken human medical system we have all been living with. Pet health insurance companies came in, unregulated, to get everyone signed up on insurance while the corporate clinics began raising prices and training vets to do ALL of the tests and procedures while the patient was hospitalized. The insurance company would pay out the higher bills and increase premiums to the client. In the meantime, deals were made with Big Pet food to get all the patients on commercial pet food with its own set of problems leading to inflammation and chronic disease. And more deals were made with Big Pharma on what drugs were to be stocked on the shelves of the corporate clinics.
They have the whole industry wrapped up in a neat, tidy, money making box built upon the fact that people love their dogs and cats and are willing to do whatever they need to to help them.
What they did not calculate is the recession and inflationary times we are currently in. A vast majority of people are having to cut expenses and with the rising cost of pet health insurance premiums, those are going to be the first to go. No wonder the shelters are filling up with dogs and cats. People cannot afford to feed and care for them. It is a perfect storm and it has hit our shores.
Who really suffers? The animals.
The veterinarians are practicing what they were taught, and it is not nearly what previous generations learned in vet school. In many ways, the vets are stuck between the proverbial rock, the corporate managers, and a hard place, the distraught client with a sick, dying pet. Plus they are graduating with enormous amounts of debt that they are attempting to pay back, working on commission. This is all taking a toll, with veterinary medicine winning the award for the highest suicide rate of all professions.
What has happened to veterinary medicine?
Every animal is now seen as a commodity, an itemized list of diagnostics and treatments adding up to thousands of dollars. I have heard 2 clients describe a local specialist hospital as “the clinic where the Rolex vets practice”. Everyone needs to make a fair wage and be paid for their knowledge and experience. But the practice of medicine includes the practice of compassion. We are not fixing cars or building houses. We are caring for living, breathing beings who are part of someone’s family.
And I know somewhere in the heart of each and every veterinarian out there, they love animals and that is why they chose this profession. It is up to the individual veterinarians, the license holders, to take their profession back and rebuild the trust of pet parents trying to care for their loved ones.
Wow. What a well written article, Josie. Your clients are so fortunate to have you in their lives - animals and humans alike. It's sad to say that I'm not at all surprised by this. Just another arm of Big Pharma, it seems. :(
Beautifully said! My husband has been a small animal vet for 40 years. It’s made him very depressed because he can’t practice like he did years ago and how he would like to practice now. He didn’t want to retire , though he has certainly earned that privilege at 76 years old.
I treat all of my animals homeopathically other than necessary surgeries . I was recently heavily criticized by a ER doc on my choice to not treat my PIMA puppy with a “cocktail of chemo drugs”. She accused me of not being fair and not giving my pup a fighting chance. I told her I’m treating my puppy the way I choose to and indeed he is deeply loved.
It’s very sad. I blame the owners as well though as there is usually another option or two if they do their own research.
Bringing healthcare human and animal back to the way it used to be practiced would be a beautiful thing.