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

The BBQ Pit
1

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.

2

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.

3

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: [sub]That sorry mother fcker of a fcking b*itch…I hope she covers herself in peanut butter in the nude and goes home to her pet Hedgehog in heat! Bitch. [/sub]

:slight_smile:

4

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.

5

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.

6

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.

7

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

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.

8

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.

9

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.

10

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.

11

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.

12

Then why refuse to sell the medicine without a test?

13

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?

14

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

15

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

16

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

17

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.

18

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.

19

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.

20

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

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

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.

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.