To My Dog's Vet: No, I don't have to buy HeartGuard from you!

[PunditLisa]

A week ago, Buddy fractured his dewclaw so I took him to the vet. They decided to sedate him to remove the claw. I stopped at the receptionist's desk on the way out and asked for a 6 month supply of HeartGuard. She looked at his file, frowned and said, "It's been awhile since he's had a heartworm test."

"He had his annual in December."

"Oh, well the doctor will probably want to repeat it. If you give heartworm medicine to a dog that has heartworms, he may go into anaphylactic shock."

I smiled and said through gritted teeth, "I have been giving him his heartworm medicine and he's hasn't gone into shock yet."

"But it's been over a year since you've gotten heartworm medicine from us. You can't have been giving it on a regular basis..."

"I don't give my dog heartworm medicine in the winter because there are no FLEAS. I give it to him during the summer months only."

"Well, it's recommended you give it to him each month."

Me: "Well, I don't. Can I please just have the medicine?"

"Well, I'll have to discuss it with Dr. B. I'm sure he'll want to do another test."

Oh, for the love of pete! I was late for an appt so I said, "Fine, you can discuss it with him if you'd like, but know that I am NOT paying for another test. It's a DOG and if he dies of shock, I'll live with it. My husband will pick him up in a half hour on his way home from work. Don't forget to give them to him because you are 1/2 hour from my home."

She takes out a pack and puts it on top of the desk. "That's not a problem." She said sweetly. "IF Dr. B approves."

Husband comes home with Buddy. $150 bill for removing a dewclew, and of course, no freaking Heartworm medicine. Nothing mentioned about a test or anything. So this means 1/2 hour trip to the vet's office to pick it up. I call the office and the lady feigns complete ignorance re my request to give the stuff to my husband (even though both of my kids were standing there and heard the entire discussion), when in reality, I'm sure she just freaking plumb forgot. No big deal; I understand how these things happen. So I nicely ask her to mail it to me. And she says no can do.

"You are 1/2 hour away from my house. I am not making a special trip to pick up heartworm medicine, especially since I wanted to buy them when I was there and you wouldn't let me."

"I'm sorry, but due to postal regulations, I can't mail out medicine."

What a line of shit.

So I get onto the internet, find a pet medicine supplier and fill out their form. Of course, it requires a prescription so they ask for my vet's name, which I gladly give them.

The next day I get an e-mail from the internet supplier, saying that my vet has denied authorization. My blood pressure rises and I call the vet.

"I'm calling re the internet order for heartguard."

Same lady. "Oh, I'm so glad you called. I was going to call you. Dr. B doesn't like working with internet companies."

"Why is that?"

"Because they are getting sued right and left for not taking proper precautions like getting appropriate authorizations."

Me: "Well, they obviously called you to get authorization."

"Yes, but Dr. B doesn't like working with them. He doesn't want to be associated with people who get sued all the time. They are not looking out for your pet's health."

Me: "I understand exactly why Dr. B doesn't want to associate with internet companies. He makes a very nice profit margin on these things and the internet is cutting into his profit. "

"That is not true. It is because he cares about your pet's health and they do not."

"Well, I care about my pet, too. That is why I would like to get some heartworm medicine. Will he authorize it or not?"

"He will not authorize an internet company to provide it, but if you pick up the prescription, you can take it wherever you wish."

Me: "And you are unable to mail me the prescription?"

"It has to be done in person, I'm afraid."

"Ma'am, you just explained to me that the reason you don't want to deal with intenet companies is because they do not care about my pet's health. It's quite clear to me that you dont' care that my pet is out of heartworm medicine because you keep putting up roadblocks preventing me from getting it. Why is this?"

"I'm sure I don't know what you mean."

Me: "You know exactly what I mean. I tell you what, I will come there in person to pick up the prescription. While I'm there I will also ask for my dog's file because I will switch to a vet who is closer to my home. If I have to drive all over creation to get a prescription, then I might as well go to one who is convenient to me."

"That's your prerogative." She said.

"I hope whatever profit you were going to make on this HeartGard was worth losing a client over."

For the love of Christ, has it gotten so bad in veterinary medicine that the profit margin on these things is so essential that they'd risk losing a client? I have news for you. The internet ain't going away. Either be apart of the future or get the hell out of the way.

[lissener]

Man, I'm glad I don't have that woman as a receptionist at MY vet, but then I'm also glad I don't have PunditLisa for a client. Sheesh. I'd probably have handed your folder to you a long time ago. There's profit, and then there's high maintenance clients. As a sometime freelancer, I can tell you that striking a balance between the two is one of the most stressful things about living the freelance life.

[Phlosphr]

Amen!


I feel guiltily lucky that Grissholm's VET is my close personal friend. Why we had our cats spayed and neutered on premise.

However, being that this is the pit I feel obliged to say: _{That sorry mother f*cker of a f*cking b*itch....I hope she covers herself in peanut butter in the nude and goes home to her pet Hedgehog in heat! Bitch.}

[Avarie537]

IIRC from my days as a vet tech, the reason we preferred not to authorize prescriptions for on-line pharmacies is because they are the same companies that routinely contacted us offering to buy our out-of-date product. Why? So they could illegally re-package it and sell it to you on the cheap. I'm sure CrazyCatLady can give you more up-to-date information.

[CrazyCatLady]

I hate to rain on a fine rant, but it would have been very bad medicine (and IIRC, illegal) for her to dispense heartworm prevention without doing a test. In moderate climes like Ohio, there is no completely mosquito-free season (and those are what carry heartworm, not fleas). We get those odd 75-degree days all winter, and I've gotten mosquito bites in January and February. Thus, if your dogs have been off heartworm prevention all winter, they are at risk for being infected. Under those circumstances, I don't know of a single vet who would be willing to dispense heartworm preventative without doing a test. As I've had to tell dozens of clients, I'm so sorry, but we just can't do that.

And as for those internet med services, Merial doesn't sell Heartgard or Frontline to them, or at least they didn't as of three years ago. They flatly refused to do business with them, and there was a reason for that. Many vets flatly refuse to deal with such companies, and it has nothing to do with profits. Frontline and Heartgard aren't particularly profitable items, anyhow. They have a much smaller markup than the foods and shampoos and odor remover and whatnot.

And to be brutally honest, it sounds like you're exactly the client most businesses don't mind losing--rude, combative, and accusatory.

[Jackmannii]

Originally Posted by CrazyCatLady

I hate to rain on a fine rant, but it would have been very bad medicine (and IIRC, illegal) for her to dispense heartworm prevention without doing a test.

The way I understood the OP, the dog had been getting HeartGuard for some time this mosquito season so if anaphylactic shock was a risk, it would have happened already.

It's OK to have a policy requiring testing if (for some reason) you think the pet owner is flat-out lying to you about the dog having been on the meds already, but in that case causing all the annoyance over the Internet alternative is an invitation to lose a client.

In my current situation I have a good relationship with a couple of highly qualified, caring vets, and I am not about to insist on Internet medication buying to save some dough at the risk of jeopardizing that relationship (statements made in this thread notwithstanding, I think the major resistance to cooperating with Internet med sales among vets is loss of the income derived in selling the drugs out of the office). If I were faced with a vet giving me a hard time as described in the OP, I'd be less willing to do this.

[monstro]

Seems to me that the lady was in the right. She was just doing her job, and you were making it harder.

Originally Posted by PunditLisa

"Fine, you can discuss it with him if you'd like, but know that I am NOT paying for another test. It's a DOG and if he dies of shock, I'll live with it.

You go to the doctor because you trust they have more experience and wisdom than you do. They aren't there to do your bidding; they are there to help your dog, even if its life doesn't seem precious to you.

A doctor wouldn't write a prescription for a diabetic's insulin without doing the appropriate bloodwork beforehand. You wouldn't go to your child's pediatrician demanding a prescription without the required examination.

A veternarian should be treated with the same degree of respect.

[alice_in_wonderland]

Well, I suppose that I'm a fraidy-cat, but when my vet recommends something, I do it. He's never recommended something that I thought was questionable, and I paid quite a bit of $$ for my pooch, so I want to take care of it. I consider the costs to be normal upkeep on my investment (the reason I say investment, is because I think the doggie-kisses I get from my puppy pay dividends to my psyche).

Anyhow - I don't know if it's just the way you wrote your OP, but you do sound rather strident. It makes me wonder if your agressiveness is what caused the assistants reluctance to help you.

[Elenfair]

I kind of understand where you're coming from... but I also understand the vet and his staff.

My guys are also on heartworm preventatives - and I have to be careful what I give since my Aussie is sensitive to Ivermectin which is found in a lot of heartworm meds out there.

We're in Minnesota - we don't have mosquitoes very late into the fall, and I would rather not overmedicate if I can avoid it. Because of this, I give them heartworm meds 6-7 months out of the year.

I do, however, test EVERY YEAR - the test I get covers both heartworm and tickborne diseases (like lyme)... just in case. I'd rather know and treat my dogs if something comes up. Apparently the incidence of lyme has shot up this year - enough so that our vet was considering having his entire staff tested since they were exposed to it so much through dogs coming to the clinic for routine tests turning out positive!

So - all in all - I can sort of understand your frustration, but I also understand the vet - if the dog HAD died, you might have wanted to sue the vet for letting you get the prescription without a test/exam. That said, if you're on constant preventative treatment for heartworm, there should be no need to test every year - every 2 years is often recommended. But that is only if you treat year round.

As for online retailers - some vets work with them, others do not. Heartworm meds aren't exactly a big profit thing... I checked online, and with my vet, and it would have cost me more to buy them online and have them shipped than to just buy them through my vet. YMMV.

[Una Persson]

Originally Posted by monstro

A doctor wouldn't write a prescription for a diabetic's insulin without doing the appropriate bloodwork beforehand.

While I understand the point you were trying to make overall, FTR this specific example is not accurate. I've changed primary care physicians thrice in three years, not forwarding my records any of the times, and they've written me scripts for Humalog, Humulin, test strips, Glucagon injections, and Lantus - all without any actual proof of me being diabetic. I've also walked into the ER of a hospital in a town where I didn't live, asked for insulin, and got it with no tests (freaking expensive, working out to be $150 for one bottle plus syringes...). In fact, I'm quite uncertain of what bloodwork shows that I have Type 1 diabetes, but I imagine there could be something.

I think the OP is dealing with a Vet who is trying desperately to pretend that the Net is changing even their practice, and who is relying on a markup of medicine as a profit center for them. And doctors and vets should not be doing this - they should charge for their services, and not be profiting off of medicine. If this means they need to charge more to make their expenses and acceptable profits, then so be it.

[TeaElle]

I've got to side with PunditLisa to this extent -- the assistant was talking entirely out of her ass when she said that it was illegal for her to mail the medication. There is no such postal regulation at all. If the intent was to make sure that PunditLisa's dog was rechecked for heartworm before the preventative was given, lying and stonewalling and being an obstructionist was not the way to go about it. She should've simply reiterated that the doctor wouldn't allow the preventative to be given under these circumstances and that doggy would have to be evaluated then he could go home with all the HeartGuard he could possibly need. That would've left PunditLisa to decide what was more important to her: getting the dog looked over and getting the medication or avoiding an exam for the dog and not getting the medication.

I'm not sure I see the gripe about a 30 minute drive; I drive 30 minutes to do my grocery shopping or to go to the movies, it's certainly worth 30 minutes to have a good vet take care of a beloved pet, IMO. But knowing PunditLisa's position, it was incumbent upon the assistant to do whatever she could to be sure that the dog was both healthy and that his owner had the medication that he needed without forcing a bothersome return visit. The matter could've been cleared up between the time PunditLisa left the office and the time that her husband came to pick up the dog; what happened thereafter is solely a result of the vet's office dropping the ball.

[scr4]

Originally Posted by Una Persson

I think the OP is dealing with a Vet who is trying desperately to pretend that the Net is changing even their practice, and who is relying on a markup of medicine as a profit center for them.

Then why refuse to sell the medicine without a test?

[dropzone]

My vet's cashier was happy to suggest buying off the net because she claimed their price was comparable. I didn't bother comparing this year. Maybe next year.

Does the anaphylactic shock get triggered if there is only a small (young) infestation? I suppose if it depends on a sensitization the number of worms wouldn't matter but my vet said the main problem is the circulatory system getting clogged with dead worms. Ah, Ivermectin! It'll kill ANYTHING, just about. Wasn't the manufacturer use its profits to supply cheap Ivermectin to Africa to fight River Blindness and Elephantiasis?

[Typo Negative]

If you give heartworm medicine to a dog that has heartworms, he may go into anaphylactic shock.

This makes absolutley no sense to me. If you give him medicine for a condition, and he HAS that condition, it could kill him???

[percypercy]

I've never heard that giving a dog with heartworms Heartguard will send him into shock. In fact, when my sister adopted her dog from the pound, she had a mild case of heartworms that they actually decided to just treat with Heartguard rather than use the old arsenic-based treatment.
-Lil

[Avarie537]

spooje, products like HeartGuard are designed to prevent heartworm infections, not treat them.

[CrazyCatLady]

The risk isn't anaphalactic shock, it's that a chunk of heartworms could break off the main mass and obstruct a major blood vessel. Heartgard and Interceptor work retroactively, by killing any microfilaria (baby heartworms) the dog might have become infected with in the last month. At that stage, you're pretty much guaranteed that there won't be a big enough mass to cause any problems if they all die off at once. After a month or more, though, you don't know how big the mass of worms is until you radiograph the chest, and possibly ultrasound the heart. Killing off a big mass of the buggers all at once is dangerous, because that whole big mass can break loose and float around till it lodges somewhere fun like the pulmonary artery. With mild infections, you can go on and give Heartgard. With moderate infections, you give smaller doses of ivermectin over a period of time. For really bad infections, you have to go with even smaller doses over a longer period.

When a dog in that part of the country has been off preventative for several months, god knows what's in there, and no competent vet is going to dispense more preventative until the dog has tested negative. Even if the dog has been getting the stuff since then. It's simply not good medicine. In a climate like Ohio, if your dog has been off the meds, he needs to be retested. It's just that simple. The part of the story that kills me is that the OP was originally bitching about a $25-$30 test that she wouldn't even have needed if she had followed her vet's instructions. The extra four months of Heartgard would have cost her less than that, even for a huge dog.

[Una Persson]

Originally Posted by scr4

Then why refuse to sell the medicine without a test?

From what it sounds like they're trying to soak the OP for even more money. My understanding at first from the OP is that they blamed "postal regulations", since no test seemed to have been done when her husband brought the dog home - then said that they didn't work with "Internet companies".

And in answer to a claim made earlier, "internet med services" such as www.1800petmeds.com do indeed sell Heartgard and Frontline - in fact, they're even featured on their front page. We buy them that way and save a bundle over our vet's prices.

[lissener]

Originally Posted by Una Persson

. . . We buy them that way and save a bundle over our vet's prices.

No you don't; what your vet can't make by selling meds and food will just average out on your bill.

By buying from your vet, you spend your money locally and help your vet's bottom line. By saving a few cents on the internet, you make it more likely that your vet will have to raise office fees.

There's no such thing as a free lunch.

Plus, you're buying sight unseen from a stranger, rather than from a human being who knows your pet personally. You get what you pay for.

[Una Persson]

It appears you may have a temporary problem with reading comprehension, or perhaps read the thread too quickly. I'll explain.

Originally Posted by lissener

No you don't; what your vet can't make by selling meds and food will just average out on your bill.

By buying from your vet, you spend your money locally and help your vet's bottom line. By saving a few cents on the internet, you make it more likely that your vet will have to raise office fees. There's no such thing as a free lunch.[/

Here's what I posted just a few posts up:

And doctors and vets should not be doing this - they should charge for their services, and not be profiting off of medicine. If this means they need to charge more to make their expenses and acceptable profits, then so be it.

Which is essentially what you said. I said they should charge what their services cost, plus what they need for an acceptable profit. I also said they may have to charge more. I have no problem with this. Fair is fair.

Originally Posted by lissener

Plus, you're buying sight unseen from a stranger, rather than from a human being who knows your pet personally. You get what you pay for.

Irrelevant. One may as well shut down Amazon and all other Net services, as well as mail-order ones, because after all you're not buying from someone you know...not that my vet and I have long, heartfelt conversations about anything. I guess I shouldn't save all that money on health care costs too by buying my insulin and test strips mail-order as well? Oddly, my physician(s) tell me I should buy my own medicine online to save money, why wouldn't that apply for my cats and dogs? And why would one argue against having people cut health care costs for themselves and their pets?

Besides the fact you missed the entire point that my vet, not a stranger, DOES examine my pets, DOES know them personally, and then writes out a prescription based on what their knowledge and experience tells them my pet needs. At that point, aside from inviting my cute little redheaded vet over for some lesbian hot tub action, the need for in-depth interpersonal communication has ended, and what remains is for me to carry out the orders of my vet, acquire the medicine, give it to the animals, and report back to the vet if there are problems.

I'm buying sealed name-brand unexpired medicine for Pete's sake, not herbs ground by ganga smoking hippies in the back of a van plastered with "Adlai Stevenson" bumper stickers.

[astro]

Originally Posted by Una Persson

I'm buying sealed name-brand unexpired medicine for Pete's sake, not herbs ground by ganga smoking hippies in the back of a van plastered with "Adlai Stevenson" bumper stickers.

"Adlai Stevenson"? Man... those would be some ooooold hippies, in fact they might actually be beatniks.

[Una Persson]

Originally Posted by astro

"Adlai Stevenson"? Man... those would be some ooooold hippies, in fact they might actually be beatniks.

It's, like, a hand me down. They, like, got it from Sol's brother, you know, like the one that wrote "Crazy Kool Radiant Cucumber" and "How Now, Brown Bureaucrat?"

[CrazyCatLady]

Originally Posted by scr4

Then why refuse to sell the medicine without a test?

Because giving that medication to a dog with adult heartworms can kill it. Giving out potentially fatal stuff willy-nilly is stupid, dangerous, unethical, and AFAIK, illegal.

Una, no, they are not trying to "soak her" for anything. They refused to sell the meds without the test for the reasons listed above. It's quite possible that the receptionist misunderstood the vet's "Hell, no, we're not mailing her that stuff, and we're not authorizing anything from the internet, either", interpreting it as an issue of mailing meds (which is perfectly legal, given a valid prescription) or with dealing with the internet company (whom he couldn't have given a prescription without doing the test, and has other issues.) It's quite possible that she was just blowing smoke up the OP's ass to make her shut up and go away (which, given the OP's comments when she dropped the dog off, doesn't seem entirely unreasonable). It's quite possible that she was talking out her ass just to be talking out her ass, as this seems to be a fairly common problem with veterinary receptionists who think they know a lot more than they do. I don't know, and it has absolutely no relevance to the initial refusal to dispense the medication. That was medical issue not a matter of cheating, bilking, or fucking with the OP.

And yes, dear, PetMeds does sell Frontline and Heartgard. Unless something has changed since that letter we got from Merial three years ago, telling us they didn't sell to these companies and we'd better not be selling it to them either, they are selling illicitly obtained Frontline and Heartgard. I never said they didn't sell the stuff, I said they didn't get if from legitmate sources. Since Merial is the only legitmate source for these medications, and Merial (at that point anyway) doesn't sell to these companies, I stand by the assertion that the Heartgard and Frontline sold on that website are not legitimately obtained products.

[Hanna]

For most medicines, my vet is much cheaper than the internet places. I suppose the multi-pet discount we get helps. I do compare prices and have found that my vet's prices are consistantly cheaper than online, not even including the shipping charges.

I give my dogs heatworm preventitive year round. We don't usually have mosquitoes in December and January here in Wisconsin, but making appointments for all of them before April 1st got to be a hassle since we usually do their annuals in late summer, so I decided to do year round heartworm.

[fierra]

Originally Posted by Boscibo

For most medicines, my vet is much cheaper than the internet places. I suppose the multi-pet discount we get helps. I do compare prices and have found that my vet's prices are consistantly cheaper than online, not even including the shipping charges.

I give my dogs heartworm preventitive year round. We don't usually have mosquitoes in December and January here in Wisconsin, but making appointments for all of them before April 1st got to be a hassle since we usually do their annuals in late summer, so I decided to do year round heartworm.

I save approximately $20 per packet on Frontguard over my local vet's prices (& get free postage too). Their heartworm meds are comparable in price - especially if I don't order them at the same time (too cheap to get free postage), so I tend to get them from the vet. My local vet does have rather expensive prices for a lot of things - their annual vaccinations boosters are $17 per dog each dearer than another (less) local vet - so I took them there. I have no objections to paying for service, but I do object to being stiffed unnecessarily. However, the same local vet also gave me a prescription for my elderly dog's heart medication without me even askig & recommended that I take it to a pharmacist & shop around for whichever is cheapest, so it's an odd mixture.

And like you, I give the meds during the winter too - mostly because I have a very old dog, and it took them the devil's own time to actually manage to get any blood out of her for the initial bloodtest & the vet said that if I faithfully gave her the meds through the winter, we could do it every two years rather than put her through it the next year too. Even ignoring the benefit to the dog (& it so is a benefit), the cost of the meds for an extra 6 months about balances out (or is cheaper) than cost of the blood test.

[Una Persson]

Originally Posted by CrazyCatLady

And yes, dear, PetMeds does sell Frontline and Heartgard. Unless something has changed since that letter we got from Merial three years ago, telling us they didn't sell to these companies and we'd better not be selling it to them either, they are selling illicitly obtained Frontline and Heartgard. I never said they didn't sell the stuff, I said they didn't get if from legitmate sources. Since Merial is the only legitmate source for these medications, and Merial (at that point anyway) doesn't sell to these companies, I stand by the assertion that the Heartgard and Frontline sold on that website are not legitimately obtained products.

First, the condescending "dear" can be omitted in the future. I wasn't condescending to you in any way, shape, or form, and poking at someone posting facts normally isn't an intelligent and viable conversation startegy.

Second, I'd imagine that in fact "something changed" - three years is essentially an eternity in terms of e-commerce timescales, changes in licensing, etc. However, despite your qualifier it really looks like you're making a somewhat bold and clear public assertion/implication that a major online pet medicine corporation is illegally selling prescription medication for pets. I suppose it's possible, but given that these firms are openly and clearly advertising the wares, and findable by a 2-second Google search, I somehow don't think they can be that illicit. Searching Merial's horrid website ("vbscript error 00d00bb0" indeed) does not reveal any clear guide other than it's only available "through your licensed vet", which in itself does not preclude internet sales if the seller has a corporate license as a vet or vets on-staff and has a proper prescription transfer on-record.

You could always mail Merial on this specific, exact subject and post their answer, rather than argue further. In fact, that's what I expect is going to be the only clear way for you to prove your allegation of illegality. Fierra just tried calling them about this, and they are "closed for the evening(?)"...

[Shayna]

Originally Posted by lissener

No you don't; what your vet can't make by selling meds and food will just average out on your bill.

By buying from your vet, you spend your money locally and help your vet's bottom line. By saving a few cents on the internet, you make it more likely that your vet will have to raise office fees.

There's no such thing as a free lunch.

Plus, you're buying sight unseen from a stranger, rather than from a human being who knows your pet personally. You get what you pay for.

Your vet may bleed you for unearned fees by padding your bill for other services, but mine sure doesn't (thank og!). I have a 20 year old cat who was diagnosed with chronic renal failure 3 1/2 years ago. As a result of her condition, she gets quite a bit of medication and prescription-only items. If my vet had refused to submit the prescriptions to online sites and insisted that I purchase them only through her, I would have either had to find a different vet or put my cat down, as their prices are WAY cost prohibitive. Way!

Their office charges $22.43/bag of Lactated Ringer's Solution, $7.50/IV line and $0.60/needle. I always order a 4 month suppy at a time, so if I had had to buy it through their office, the 8 bags of fluid, 4 lines & 80 needles would cost me, including tax, $278.68. The exact same order through valleyvet.com is $52.50 (no sales tax, free shipping); a savings of $226.18. Given that she's been seeing this vet now for 3 years, that's an overall savings of $2,035.61, and that ain't chump change.

I save more than 50% by ordering her heart meds (Norvasc, for treating high blood pressure), through familymeds.com. My vet's office wants $57.00 including tax for a 6 month supply of Advantage, which I can order from petshed.com for $29.95 (free shipping) -- another nearly 50% savings. They want over $10/tube for her Nutri-cal vitamin supplements, for which I pay $4.19 at Valley Vet, and I don't even recall how much they overcharge for the pet version of glyco-flex, which I can buy dirt cheap online, as well.

I asked my vet from the very get-go about her willingness to provide 'scripts to online sources and her reply was, "If you can't afford to pay our office's prices for her supplies, you'll do one of 2 things, find a new vet or put her down, which means I lose all your future business and you may lose your kitty earlier than necessary. If you can afford to continue treatment by ordering her supplies from other sources, then I get your ongoing business for quarterly testing and other needs, and you get to keep your kitty with you for as long as we can keep her healthy. I think it works out to both our advantages that way, and I'm more than happy to accomodate you however I can in order to help ensure a long and happy life for your pet." I run every online source by her before establishing them as a vendor, and she has approved every single one of them. The only caution she gave me was not to buy Advantage from any of the European sources, as the product is often sent over by cargo ship and spends who-knows-how-long sitting in hot warehouses, etc., possibly diminishing its effectiveness. Petshed ships airmail from Australia, so we know the product is safe and effective, so it got the green light.

And in 3 years, I haven't seen their service fees increase a single dime.

I have spent thousands of dollars in their office having my cat's blood, urine & blood pressure checked quarterly, and I have saved thousands of dollars more by having a vet who understands that a pet owner who can't afford treatment for their pet, won't even be a patient at all.

[PunditLisa]

I gave a condensed version of my conversation, but the last time Bud has his heartworm medicine was June 25th (It's a repeating appt on my calendar). That means he was about TWO WEEKS overdue, though it was clear that the receptionist did not believe me when I estimated it had been "about 6 weeks" since his last pill. As soon as I said that, she looked at me suspiciously and started looking in the chart. I assume she saw that I hadn't purchased any HeartGard from them in Dec 03 (which was the date of his last check-up, which included a heartworm test), she assumed that I don't give heartworm medicine to my dog regularly. Which is incorrect. I do give it regularly, but only during the months when fleas are active. This is not open to debate with me and any vet who tries to strong-arm me into giving it year round or not at all will lose me as a client. It's an ELECTIVE medicine and if my dog dies due to heartworms because I fail to give it year round, I'll blame no one but myself.

Now, the reason I didn't buy any Heartgard from them in Dec 03 is because I had some left over from my previous pet who was put to sleep, also a beagle. But it shouldn't matter to them how I obtained it in the past. If I SAY that I give it to him regularly, and if I continue to have him checked annually for heartworms, that should be sufficient, end of story. She should have handed me the heartworm medicine with a smile on her face. It wasn't her job to question whether I was telling the truth. But since she did, and pissed me off in the process, the LEAST she could have done was to follow through and ask the vet instead of forgetting and then pretending that we never had the conversation.

And when I chose to purchase it elsewhere because of her mistake, her response should have been to approve it instead of putting up another roadblock. It has now been another week that's he's gone unprotected. How is this in my dog's best interest? And how is it in the vet's best interest since he lost me as a client?

Face it, if the vet doesn't charge enough for his services and needs to mark up medicines, that's his problem, not mine. I have no problem paying an honest wage for an honest living. I do have a problem with either of them thinking that I because I'm his client, I am OBLIGATED to purchase elective preventative medicines, at inflated rates, from him. Especially when she knew that the reason I was going to an internet company in the first place was because SHE wouldn't sell it to me when I asked. Then, to tell an already annoyed customer that they'd have to come out to pick up a written PRESCRIPTION, and that she couldn't fax it to the internet company or mail it to me....well, she was being deliberately shitty and I don't have any regrets about being pissy right back.

The whole scenario reminds me of my husband's fight with Sears Optical a few years back. Hubby has an uncle who is an optician in North Carolina. He graciously sells contact lenses to family members at cost. However, he requires a prescription from a local optician and he requires it be updated every other year, no exceptions. So a few years back, hubby goes to Sears Optical for a check-up so he can get contact lenses from his uncle. When he leaves, they try to sell him updated contact lenses and/or glasses. He tells her that his uncle is an optician and asks the receptionist for a written prescription. Believe it or not, she refuses to give one. My husband was incredulous. It seems that were under the impression that if they did the exam, he was then obligated to purchase the contact lenses from them! After an ugly scene, she finally agrees to FAX the prescription to his uncle, but she still flat out refuses to give him a written prescription. There are now laws in place that give consumers the right to a written presciption (and this presumably includes vets, too), but it's a shame that a law had to be passed because unscrupulous doctors felt that they had a RIGHT to make a profit on dispensing medicines.

[Elenfair]

Originally Posted by PunditLisa

I do give it regularly, but only during the months when fleas are active.

Gaaah. FLEAS DO NOT CARRY HEARTWORM DISEASE, MOSQUITOS DO.

I don't really have any other comments about the whole shebang... I give both you and the vet's office the benefit of the doubt. Sounds like you need to take yor pets to a new vet that you can get along with.

As for online vet companies getting their hands on Heartguard and such from non-approved sources, that was the last I had heard too. In the last notes we got at for our service dogs, we were warned that no online retailer had the rights to sell their meds online... the reason given? They were afraid people would give the meds to their dogs after the vets would just approve an order without seeing the pet and then start seeing animals die because they already had an infection (see CrazyCatLady's explanation of why this is dangerous).

[Elenfair]

Forgive the non-native english-speaker in me - mosquitoes. Freakin' funky rules for pluralization... grumble...

[PunditLisa]

Under those circumstances, I don't know of a single vet who would be willing to dispense heartworm preventative without doing a test. As I've had to tell dozens of clients, I'm so sorry, but we just can't do that.

Bud has his annual test (inc. heartworm test) in Dec 03. I have been skipping winter months for countless years with all my dogs, and have always been upfront about this practice with the vets. I have never encountered a problem in the past. When Dr. B asked if I needed heartworm preventative in Dec 03, I reiterated that I only dose during non-winter months and that I had enough to last me awhile at home from my previous dog who had to be put to sleep. He never said that I should re-test before giving his first dose of the year. He never said that he couldn't sell it to me unless I dosed year round. Instead, he did recommend that I be diligent about giving it as soon as the weather breaks in the spring and to get an annual heartworm test without fail. That's exactly what I do. And that is exactly why I wasn't about to pay for another heartworm test.

Had Ms. Receptionist questioned him about it, I know he'd have said no problem to sell the stuff to me. It wasn't her place to question me, IMO, but since she did she should have followed through. She didn't. And then she exacerbated the problem by not mailing out the stuff, or if that really wasn't possible, mailing out the stupid written prescription, when she realized she made a simple mistake. Mistakes I can deal with. People who won't admit, let alone correct, their mistakes, I can't.

[PunditLisa]

FLEAS DO NOT CARRY HEARTWORM DISEASE, MOSQUITOS DO.

Oh. Well. Same argument, though. Neither fleas NOR mosquitoes are around in December in Ohio. And for the two dozen that MIGHT hatch on a particularly warm day in mid-winter, I'm willing to take the risk considering Bud only goes out to take a piss.

[lissener]

The extreme uniqueness of your situation, Shayna, does not alter the fact that those who do buy from their vet help their vet's bottom line. Thanks for demonstrating the breathtakingly original concept that there's an exception to every rule.

[PunditLisa]

The extreme uniqueness of your situation, Shayna, does not alter the fact that those who do buy from their vet help their vet's bottom line.

Just as buying a $15 bottle of shampoo from my hairdresser helps her bottom line. Would it be unethical of me to buy the same product from another source for significantly less money? And would she be within her rights to refuse to name the product that she used unless I agree to purchase it from her?

[lissener]

Originally Posted by PunditLisa

Just as buying a $15 bottle of shampoo from my hairdresser helps her bottom line. Would it be unethical of me to buy the same product from another source for significantly less money? And would she be within her rights to refuse to name the product that she used unless I agree to purchase it from her?

I never said unethical. I said you get what you pay for.

[TeaElle]

Originally Posted by lissener

I never said unethical. I said you get what you pay for.

And if it's a bottle of SuperTresses that's $15 in the salon or $6 at Target or a box of Heartguard that's $18 from the vet and $11 at cheaperpetmeds.com, you're getting the same thing and paying less, so what's the problem?

Are you actually holding out that the consumer has some obligation to purchase products at a higher price from a local source just because that source is local?

[Elenfair]

Bah.

I don't do preventative meds for heartworm during the winter either. This is Minnesota (previously Ontariariario's Ottawa Valley - shit, you'd have thought I'd have moved further down south, no?)... the skeeters aren't anywhere to be seen.

I do test every year, mostly because it would cost me the same to just do lyme testing (and lyme IS a problem here - a growing one).

Back in Ottawa, my vet required a blood test only every 2 years, assuming you had given the preventative during the summer months (7 months out of the year, according to them - because it can catch an early infestation that, say, could have happened in October so you'd treat November too)... but the vet assumed that when you okayed that you had been dilligent in your giving of the preventative meds.

Find a vet you can work with... it'll be a win win for everyone concerned...

[Duck Duck Goose]

"I'm sorry, but due to postal regulations, I can't mail out medicine."

Just FTR, this is indeed bullshit. You can mail prescription meds perfectly legally, you just need to label the packaging as per instructions.

http://pe.usps.gov/text/dmm/C024.htm

Scroll down to 11.2 Mailing Standards.

And, I mean, it's just stupid on the face of it: how does she think all those mail-order medicine companies stay in business?

[caphis]

Originally Posted by PunditLisa

It has now been another week that's he's gone unprotected. How is this in my dog's best interest?

Look, I sympathize with your scenario, and if you're going to have a pissing war with the vet, then that's your prerogative. However, you're now bringing your dog into this, and you're right-- it's been another week that he's gone unprotected. If you're really going to have this battle of principles with the vet, then you need to hold up your end and go find a new one. By now, your dog could have the Heartgard he needs.

If you haven't had the time in the past week to find a new vet, then I'd say you should cut your losses and get the damn test, and thus the Heartgard. How is it in your dog's best interest that you're having this feud with the veterinarian instead of either getting him the test or finding a vet who will give you his meds? It's not.

Like I said, I understand where you're coming from, and I'm seeing some unwillingness to cooperate from your vet. However, at this point, you should swallow your pride and get the meds -- whether it means getting a re-examination from this vet, or finding a new one.

[Q.E.D.]

Originally Posted by Duck Duck Goose

Just FTR, this is indeed bullshit. You can mail prescription meds perfectly legally, you just need to label the packaging as per instructions.

It's not quite that simple. If you read the cited US Code, 21 USC 1300, et seq., you'll see stuff about needing permits, registration and such. For example from 21 CFR 1301.11:

Persons required to register.

(a) Every person who manufactures, distributes, dispenses, imports, or exports any controlled substance or who proposes to engage in the manufacture, distribution, dispensing, importation or exportation of any controlled substance shall obtain a registration unless exempted by law or pursuant to Secs. 1301.22-1301.26. Only persons actually engaged in such activities are required to obtain a registration; related or affiliated persons who are not engaged in such activities are not required to be registered. (For example, a stockholder or parent corporation of a corporation manufacturing controlled substances is not required to obtain a registration.)

It's entirely possible the vet is not a registered distributor of controlled substances, and therefore cannot legally mail prescription drugs.

[Metacom]

Originally Posted by Q.E.D.

It's entirely possible the vet is not a registered distributor of controlled substances, and therefore cannot legally mail prescription drugs.

"Prescription drug" and "controlled substance" are not the same. Unless heartworm medication can be recreationally abused, it ain't likely to be a controlled substance.

Here's a list of controlled substances.

[peri]

Controlled substances are narrowly defined by the FDA to include those with addiction and abuse risk. See §812. Schedules of controlled substances. Heartworm medication does not fall within those guidelines.

[CrazyCatLady]

Originally Posted by Una Persson

First, the condescending "dear" can be omitted in the future. I wasn't condescending to you in any way, shape, or form, and poking at someone posting facts normally isn't an intelligent and viable conversation startegy.

Second, I'd imagine that in fact "something changed" - three years is essentially an eternity in terms of e-commerce timescales, changes in licensing, etc. However, despite your qualifier it really looks like you're making a somewhat bold and clear public assertion/implication that a major online pet medicine corporation is illegally selling prescription medication for pets. I suppose it's possible, but given that these firms are openly and clearly advertising the wares, and findable by a 2-second Google search, I somehow don't think they can be that illicit. Searching Merial's horrid website ("vbscript error 00d00bb0" indeed) does not reveal any clear guide other than it's only available "through your licensed vet", which in itself does not preclude internet sales if the seller has a corporate license as a vet or vets on-staff and has a proper prescription transfer on-record.

You could always mail Merial on this specific, exact subject and post their answer, rather than argue further. In fact, that's what I expect is going to be the only clear way for you to prove your allegation of illegality. Fierra just tried calling them about this, and they are "closed for the evening(?)"...

That "condescending" dear is just a part of my speech pattern. I call lots of people dear, honey, sweetie, darlin', etc. Get the fuck over yourself. Or don't, I don't really give a rat's ass either way.

Your imaginings really have no relevance to this discussion, nor do your rebuttals of points I didn't make. The point I made was that three years ago, while the internet companies were selling Heartgard and Frontline, Merial sent a mass mailing to vet clinics saying that they did not sell these products to such companies, nor did they approve the resale of these products to them. To my knowlege, this situation has not changed. If you have proof that this has changed, I'll be perfectly happy to amend my post to read that Merial used to refuse to sell to the internet companies. If you have no such proof, or Merial tells you this is still the case, I'll be expecting an apology for basically calling me a liar.

Elenfair, the climate in Minnesota and the climate in southern Ohio are different enough that we have a reasonable concern about heartworms during the winter. (I'm not from Ohio, but I lived in Kentucky for 26 years, 8 of them roughly an hour southeast of the OP. The climate's not significantly different.) We get a lot of cold weather, but we also routinely have weeks of 50+ degree weather throughout the winter, with occasional outlier days where it gets above 70. We just don't have long enough stretches of cold enough weather to completely kill off the mosquitoes, so heartworm is always an issue. If someone does year-round heartworm prevention, we test every other year. If they've missed more than one dose, we retest 'em before dispensing any more. That's standard practice for every vet I've ever known.

And somehow, it seemed like I always wound up having this discussion with owners on days when it was 12 degrees outside. They would always gesture out the window to the snow and say, "You're telling this isn't too cold for mosquitoes?" and I'd have to remind them of last week, when we were wearing shorts. It was never a fun conversation, and I got accused of being a horrid, unfeeling person out to rip people off quite frequently. (Pretty standard part of the job, that. If such accusations upset or offend you, you're in the wrong field.) When I whipped out my calculator and proved to them that year-round prevention would save them money, though, I was suddenly Mother Theresa and St. Francis all wrapped up in cheesecake and dipped in chocolate sauce, the very personification of love and compassion for all God's creatures. Some people.

PL, out of curiosity, if the trip to the vet's is such a big deal, why didn't you go on and stock up at the annual visit? I know you had some at home, but since you didn't have enough to last the whole summer, you were going to have to make a special trip over there just for Heartgard anyway. (Unless you were figuring on someone getting sick or hurt before then; in day practice we always had a few clients who could count on exactly that.) If you don't already do so, buy your Heartgard in the 12-pack. Not only is it cheaper than two of the 6-packs, I think Merial still offers $5 rebates on the 12-packs. Don't hold me to the rebate thing, though; since my current clinic doesn't do primary care, we don't sell Heartgard and we're not entirely up to date on the promotions. Similarly, the 6-pack of Frontline is cheaper than 2 3-packs and I think they still send you a coupon for future purchases of Frontline.

[Archergal]

My vet does price-matching for Internet drugs. That's a win-win situation all around. I get better prices (sometimes significantly better) and the vet gets my business and good will. It's worth asking if your vet will do the same.

[Jackmannii]

I'd like to see some cites (if any exist) showing that heartworm infections are transmitted to dogs over the winter in climates such as Cincinnati's.

The descriptions of balmy winters in that locale not withstanding, the "weeks of 50+ weather" in the winter are an illusion, even stretching things to include the Lexington KY area (where I used to live). Mosquitoes get killed off or go into hibernation in wintertime, and brief thaws should not bring them suddenly back to life to menace one's pets.

Absent some solid documentation regarding real-life infection risks, it makes no more sense to me to continue heartworm medication over the winter in my part of the country, than to keep spraying DEET on myself whenever I go outdoors in the winter (under the assumption that a stray mosquito might emerge to give me West Nile virus).



Dearie.

[Una Persson]

Originally Posted by CrazyCatLady

That "condescending" dear is just a part of my speech pattern. I call lots of people dear, honey, sweetie, darlin', etc. Get the fuck over yourself. Or don't, I don't really give a rat's ass either way.

You'll have to pardon me, I don't hang out in the Pit a lot anymore. Are you often like this? Because if you are, I'll just ignore you from now on whenever you act this combative. However, if I really was out of order, then maybe a broader sampling of the Pit population will have to confirm that, because I can't really put much weighting on anything you say.

Your imaginings really have no relevance to this discussion, nor do your rebuttals of points I didn't make. The point I made was that three years ago, while the internet companies were selling Heartgard and Frontline, Merial sent a mass mailing to vet clinics saying that they did not sell these products to such companies, nor did they approve the resale of these products to them. To my knowlege, this situation has not changed. If you have proof that this has changed, I'll be perfectly happy to amend my post to read that Merial used to refuse to sell to the internet companies. If you have no such proof, or Merial tells you this is still the case, I'll be expecting an apology for basically calling me a liar.

I'm sorry, you don't understand how logical argument works. You made an assertion right here in this thread, with your only proof being a letter you received 3 years ago. Your assertion ended with this, which I will quote:

Since Merial is the only legitmate source for these medications, and Merial (at that point anyway) doesn't sell to these companies, I stand by the assertion that the Heartgard and Frontline sold on that website are not legitimately obtained products.

There's nothing ambiguous about that - you said that a major online company was selling illicit (your term, earlier, same post) medicine. I said that's a bold statement to make based on flimsy evidence. Especially since online and Net business is so dynamic and changing. Aside from the fact that Occam's Razor would tell us that it's unlikely a major pharmaceutical company would willfully overlook a large Net retailer illegally selling their products in the same country...

You somehow took offense YET AGAIN at that, and decided to be rude back again. I sorta wonder why, and sorta don't care. An odd duality of emotion.

Turns out that's not the case - 1800PetMeds is NOT selling illegitimately obtained products. I phoned Merial this morning (1-888-Merial1), something you could have done yourself this morning if in fact you had wanted to know the truth, instead of trying to engage in yet another Pit fight. According to the Merial rep I spoke to:

* Merial does not sell directly to 1800PetMeds.
* However, there is nothing illegal whatsoever in PetMeds re-selling the items so long as they obtained the items through a licensed vet and/or veterinary sales avenue. Nor is it a violation of any sales terms and conditions with a licensed vet and distributor. "We can't control what happens after the first sale".
* They had, as of today, received no legal complaints about 1800PetMeds.
* They knew of no regulatory agency doing any investigation into 1800PetMeds, nor was she aware that Merial had ever asked for such an investigation.
* As far as the representative was aware, this was true for all 50 States, but she was not sure about Canada, Mexico, or other international sales.
* In fact, the representative recommended I use 1800PetMeds if they were significantly cheaper than my vet, as they would "rather see (my) dog treated than not if money is tight".
* The only downside she (the rep) said there was is that they can quickly contact the vet in case there is a problem with a specific lot number of medicine, whereas they can't guarantee being able to contact you directly via 1800PetMeds since they do not communicate directly with said company.
* However, she also said my vet should be the one to contact me to check if they knew there was an issue with ANY lots, since many vets evidently don't record a database of lot numbers given out to customers. Therefore, that aspect is of limited use.

Maybe you should get off your "expecting an apology" high horse and put your money where your mouth is and apologize to me for being a rude and inconsiderate person - since I was correct, and I wasn't the one attacking or flaming you. I think it says a lot about you that you're trying your best to get into a good old-fashioned Pit fight with someone who is mainly posting factual and reasoned rebuttals to your claims.

[Sauron]

Y'know, I hang out in the Pit a fair amount. I like to think that I have destroyed the arguments/positions of other posters occasionally, and I've also had mine dissected and trashed. But I swear, I've never been able to thoroughly dismantle a post like Una Persson just did.

I am in awe.

[CrazyCatLady]

Am I often like what, exactly, Una? Am I often prone to calling people with whom I'm having a friendly discussion "dear" or "honey" or "sweetie" or "darlin'". Yes. Yes I am. Am I often prone to telling people who manufacture offense where none was intended to get the hell over themselves? Yes, I am. Am I often indifferent as to whether or not such people actually do get the hell over themselves? You bet; I have no control over the emotions and actions of other people, and there are far too many things I can control to spend much time worrying about the stuff I can't.

I originally said that unless something had changed the Merial products sold online weren't obtained through legitimate channels. Your response was that they did so sell Merial products, so obviously I was wrong. Quite the reasoned, logical response, that. (We'll leave out your baseless accusations that the OP's vet was ripping her off, as you seem so eager to ignore that part of my response to that post.) I responded that I never said they didn't sell it, just that the last I knew they weren't authorized by Merial to sell it. If you have a problem comprehending that "Well, they do so sell it, so there!" is not an appropriate response to "The stuff they sell isn't obtained through legitimate channels," you have some really huge honkin' problems. They are, however, your problems and not mine. Frankly, I think it says quite a lot about you that you're trying to create a fight where none exists, but that's just me.

Anyhoo, I would like to state for the record that although Merial has not ever and does not now sell to online pet pharmacies, they do not at this time have a policy against veterinarians reselling their medications to such companies. Thank you, that is all.

[Sauron]

Oh, and to shoot down the "one warm day in the middle of the winter puts your dog at risk for heartworms" theory, see the information on this Web site.

Some of the salient info: "In a study entitled 'Seasonal Timing of Heartworm Chemoprophylaxis (Heartworm Meds) in the United States', Dr. David Knight and James Lok of the American Heartworm Society have taken the guesswork out of when to start and stop heartworm prevention. It was found that specific conditions must exist in order for the larvae in the mosquito to move on to stage L3, allowing the mosquito to pass on heartworm through its mouthparts. The larvae require approximately 30 consecutive days of 60-degree weather where the temperature does not dip below 57F (14C) in order to reach this condition.

"Simply put, it must stay above 60 degrees for 30 consecutive days AND nights for the larvae to progress to stage L3 and be passed through the mouthparts of a mosquito to a host animal. If the temperature dips below 57F the maturation is retarded and cannot continue. This process would become accelerated if there were two weeks of temperature at or above 80F (27C), days AND nights. As a result, heartworm disease is not only geographically limited, but also seasonally limited. For many of us this means that year round heartworm prevention is totally unnecessary." {Bolding mine - Sauron}

The American Heartworm Society confirms this report: "Laboratory studies indicate that development and maturation requires the equivalent of a steady 24-hour daily temperature in excess of 64^oF (18^oC) for approximately one month. Intermittent diurnal declines in temperature below the developmental threshold of 57^oF (14^oC) for only a few hours retard maturation, even when the average daily temperature supports continued development. At 80^oF (27^oC), 10 to 14 days are required for development of microfilariae to the infective stage."

In the Ohio area, the recommended dates for heartworm medicine dosage begin in June and end in November. It appears to me that any vet who recommends and dispenses year-round dosages of heartworm medicine in that area is overmedicating dogs with little or no benefit to the animals. I dunno if you'd wanna classify that as "ripping somebody off," but it does tend to put their actions in a slightly different light than that of simply looking out for the best interests of the animal.

[CrazyCatLady]

Jackmanii, honey, I don't know that the risk of getting heartworm over the winter is really any higher than that of an adult dog getting parvo, and I've never even heard a rumor about a dog over the age of a year and a half getting parvo. Still, every vet I've ever dealt with has recommended yearly parvo vaccines for adult dogs. Some of them recommend getting a booster three weeks later if you're more than a couple months late, and some recommend six-month boosters for adult dogs. The latter was the protocol at my previous practice, which was in an area with a very high incidence of parvo. (Other clinics in town didn't even keep parvo tests in stock because they didn't need them; if we had less than two full boxes at any point during the summer, we were running really low.) Every practice evaluates the risk of a given situation and makes its own protocols. At every vet clinic where I've ever been a customer or an employee, the owning vet has felt the risk of winter heartworm infection was great enough to require either year-round preventative or annual testing.

What research did they base this decision on? I don't know. I can't even say for sure that any peer-reviewed studies in that region have been done. I just know the protocol the vets I've dealt with use, and the explanation they have always given me for that protocol. Since it's always been the same protocol and the same explanation, it's honestly never occured to me that they might just be pulling out of their asses.

Of course, heartworm preventative is somewhat different from parvovirus vaccination. You can't kill a dog with a parvo vaccine. (Unless it has an anaphalactic reaction, which is vanishingly rare and would happen right there in the office where you can tube it and give IV drugs immediately, so you'd have a decent chance of pulling it through.) You can, however, kill a dog with heartworm preventative. Vets tend to be understandably cautious when it comes to potentially killing their patients.