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Pet Insurance Tips

March 2, 2020 By admin Leave a Comment

The pet insurance industry has become increasingly diverse and complicated over the past several years. The structure remains very different from what you are accustomed to with your own health insurance but at its’ premise it serves the same purpose which is to lessen the financial burden when unexpected illness and accidents happen. At Charleston Harbor Veterinarians we have seen an uptick in the number of our clients and patients who are covered by a pet insurance policy and have witnessed first hand the benefit it can provide. Most often, those who are covered by a policy are able to make decisions to provide the best possible care for their pet without hesitation as they’ve removed the financial consideration. We also see these pets sooner in the onset of illness or after injury compared to pets without an insurance policy which can absolutely deliver a better medical outcome than waiting for things to worsen before visiting the vet.

Tools to Select a Policy

So while for many pet owners pet insurance may be a great option, the question remains, which one should you choose. In truth, we see a multitude of different insurance companies with happy clients for each of them. The best company and policy is different for each pet and each person. Therefore, we like to recommend to our clients who ask about pet insurance that they use a free tool called Pawlicy Advisor that helps you evaluate your insurance options and find the best price. Visit their website at https://www.pawlicy.com/advice where you’ll enter info about your pet and quickly receive a recommendation on the best policy for you. Pawlicy Advisor collects no money from you and you pay no more for a policy than you would have without their recommendation. Often you’ll pay less than if you didn’t use their recommendation in fact.

For additional information about pet insurance, we also like Pawlicy Advisor’s blog on “What is Pet Insurance“.

While Pawlicy Advisor is actively growing their list of companies they can recommend from, not every option is currently included. You may also want to separately research options from Nationwide, HealthyPaws, Progressive and Embrace.

Other payment options

If pet insurance still isn’t right for you or the idea of making monthly premium payments or annual fees is not appealing, we wanted to mention two other options to help you pay for unexpected or large veterinary expenses.

CareCredit and Scratchpay both offer veterinary specific payment plan options featuring a variety of payment plans. You can choose from short term plans that allow you to just spread out payment over anywhere from 5 weeks to a few months and require no more than a soft credit check or more traditional longer term financing options. Charleston Harbor Veterinarians is an approved vet clinic for both of these options if you choose to go that route.

CBD for Pets: The What, Why and How’s You Need to Know

March 23, 2019 By admin Leave a Comment

CBD oil is the probably the biggest current trend in pet supplements and we receive questions daily about its use. Just to clear the air and to protect our patients from the many shoddy or potentially dangerous products out there, here are some points to consider when choosing a CBD product…for a human or a dog!

What is CBD?

Cannabinoid is a broad term covering compounds found in cannabis (marijuana) and hemp. Not all cannabinoids are the same and they aren’t all suitable for your pets. Some of the better-known cannabinoids are THC and CBD, however there are over 140 different cannabinoids present in hemp plants.

THC is best known for psychoactive properties and is toxic to pets.
CBD and CBDa are the cannabinoids found to be therapeutic.

Why use it?

Currently the most widely studied and supported use for CBD oil in dogs is to improve joint function usually associated with arthritis. Most owners will see an improvement within two weeks if their pet is responsive to CBD oil. While more studies need to be conducted, there is also anecdotal support to use it to treat seizures and anxiety.

How to choose a product:

1. The manufacturer or distributor should be able to provide you with a purity certificate for EACH batch they produce.
  - A purity certificate is completed by an independent third party.
  - It will show the concentration of CBD.
  - It will also prove that the product does not have dangerous heavy metals, pesticides, and mycotoxins that can be found in plants.
2. The certificate should show THC levels under 0.3%
3. The company should have completed their own studies on their own product showing efficacy and safety!
4. The product should provide clear dosing recommendations based on the size of your pet.
5. AND…
6. Make sure you check in with your vet if your dog is on other medications. For example – pets on gabapentin will need to reduce their dose to avoid excessive sedation!

If you are considering CBD for your pet, we offer a line of CBD oil and treats at the clinic that we are confident recommending based on this criteria. We have seen positive results for many of our patients who have given it a try so please contact us if you are interested.

~ Dr. Christa Kahuda

The FDA Alert on Nexgard, Bravecto, Simparica and Credelio: What You Need to Know

September 24, 2018 By admin Leave a Comment

On Thursday, September 20, 2018, the U.S. Food and Drug Administration (FDA) issued an alert concerning Isoxazoline flea and tick preventatives. These products include Nexgard, Bravecto, Simparica and Credelio. The alert is for potential neurologic side effects of these products.

Background:

The information that the FDA is providing is not necessarily new. Before releasing a pharmaceutical product to become available for animal use, rigorous safety studies must be completed to receive FDA approval. During the process of testing these flea and tick medications, rarely, neurologic side effects were noted, including muscle tremors, stumbling, and seizures. After 3 ½ years of prescribing these products we have had one patient experience seizures shortly after administration of an isoxazoline product and alerted the manufacturer. The patient has had no further seizures or other side effects since discontinuing the product. However, other rare side effects such as brief nausea or diarrhea were reported more often. These products are labeled as prescription and we require a physical examination of your pet prior to sending home the first dose due to these types of reasons.

After a medication is released by the FDA to be freely prescribed to the general population, the FDA continues to monitor the medication’s effectiveness and safety. This is general rule for all pharmaceuticals, and we think this is an important one. Once a pharmaceutical enters the general population, it is used by thousands and potentially millions more pet patients than could ever be tested through clinical trials. With the higher numbers of product use, sometimes side effects that were not known previously become evident. At that time, the FDA may elect to submit alerts to veterinarians and the general population, change the labeling of a product, or completely remove it from distribution.

Flea and tick concerns:

Veterinarians do know that diseases caused by fleas are exceptionally common in the South Carolina lowcountry. Fleas cause significant pathology/discomfort for our pets, can spread diseases to people and when severe, can be life threatening. It is not uncommon for our practice to see multiple appointments with our patients each day that involve skin infections and discomfort secondary to flea bites and flea infestations. We often use antibiotics and anti-inflammatory products to treat these conditions. Those products unfortunately can also have adverse side effects for the patient.

The Companion Animal Parasite Council (CAPC) is formed of a group of veterinarians dedicated to tracking the prevalence of parasites affecting our pets. CAPC has reported annual increases in tick borne diseases (including Lyme disease) and continue to recommend year-round flea and tick preventatives for all at risk dogs and cats. At Charleston Harbor Vets we have begun to test for tick borne diseases annually and have found that many dogs have been exposed to diseases such as Lyme disease indicating that our local population is at risk.

Summary:

Unfortunately we do not have a proven safe and 100% effective product for our pets to prevent flea and tick infestations. However we have found that neurologic side effects are much lower when using these products than the risk of disease if we chose not to use them. Currently, our team continues to recommend Nexgard and uses it consistently for prevention for our own dogs. However, if you have any questions or concerns please call, email, or make an appointment to meet with a doctor. We can discuss the risks and benefits and help you find the right products for you and your pet.

-Dr. Blackwood and Dr. Kahuda

A Day in the Life of a Spay at CHV

February 4, 2018 By admin Leave a Comment

By: Dr. Janette Blackwood, Charleston Harbor Veterinarians

At Charleston Harbor Veterinarians, we receive multiple questions from our clients about the spay and neuter process. These questions range from asking how do we keep our patients comfortable to why is there a price difference between us and the local SPCA practices. To help answer those questions and more, we were fortunate to have our patient Kona volunteer to have her experience documented for this blog and to show a “behind the scenes look” at how CHV handles our spay process from start to end.

My first experience having a pet spayed was unfortunately not the best. This was back in the 1990s and I was a child. We dropped our cat off at the veterinary clinic in our small town in Georgia and picked her up the next day. I remember my entire family being squeamish and not wanting to look at her incision, but short of paying the bill, that was the extent our our involvement in her spay procedure. I don’t ever remember meeting her doctor or surgical nurse. Several years later, I was a teenager and looking to pursue a career in veterinary medicine. I excitedly received my first job at that same veterinary practice. I was dismayed to watch the process. At this time, I found out that this particular veterinary practice had a habit of reusing surgical instruments as there were often more procedures scheduled in a morning than the surgical packs or technical staff available.

What I saw a couple of decades ago shaped how I decided I would practice veterinary surgery in the future. Finding a veterinary partner in Dr. Kahuda was very exciting for me, as we quickly realized that we shared almost identical goals in how we wanted our surgical protocol and team to operate.

Surgery is such an important event in a pet’s life that at CHV we purposely choose to keep our daily surgical numbers low. While a veterinarian at a high volume practice may be scheduled to spay or neuter 6+ patients in a morning, CHV typically schedules a maximum of 3 surgeries in a day. This number can be much higher even at high quality shelters, whose veterinarians may be scheduled for 20-30 surgeries in a morning. Charleston Harbor Veterinarian’s lower volume allows for more personal attention to each patient and a process that is tailored to their comfort level and specific anesthetic needs.

A Day in the Life of a Spay at CHV

Drop off | Kona is dropped off at our practice between 7:30 and 8:00 am. The night before, her owner received an email that contained her surgical paperwork and instructions to not feed her after midnight. At drop-off, Kona’s owner received the option to speak directly with the surgical team to have any last minute updates, questions, and concerns addressed.

Physical Exam | After drop-off, Molly and I completed Kona’s examination. She was nervous to be at the veterinary hospital, so we tried to ease her anxiety by performing the exam on the floor instead of the treatment table. She also had time to rest and acclimate to the hospital.

Bloodwork | Once it was determined that her physical examination was normal, blood was drawn for preoperative screening. Bloodwork checks are to make sure that Kona is not anemic (does not have a low red blood cell count), has normal electrolytes, is hydrated, and has normal kidney and liver values.

Anesthetic calculations | Kona’s bloodwork was normal! Jesse and I calculated the anesthetic doses that Kona will need during her surgery. Kona’s anesthetic calculations and pharmaceutical choices were based on her age, the results of blood work and physical examination and her history of any previous or concurrent illnesses. Fortunately, Kona is currently a healthy girl so no adjustments to our standard protocol was needed the morning of her surgery.

Pre-medication | Next, Kona received a pre-medication injection. Pre-medication helps provide sedation and a high level of pain control during the upcoming surgery. The injection is placed in the muscle. Kona was given 30 minutes for a final bathroom break and to allow the pre-medication to take effect.

IV catheter placed | All patients receiving general anesthesia at Charleston Harbor Veterinarians have an IV catheter placed. The IV catheter allows for additional anesthetic medication to be delivered intravenously. During surgery, IV fluids will also be administered through this catheter. IV fluids keep our patient hydrated and maintains the patient’s blood pressure at a normal level during anesthesia, both of which helps prevent anesthetic complications. Here, Molly and Tara placed Kona’s IV catheter.

IV induction | Kona’s entire abdomen was clipped in preparation for surgery, and she is transported into the surgical room. On the surgery table she received IV medication from Molly and me to induce her into going into general anesthesia.

Intubation | It is protocol for patients receiving general anesthesia at Charleston Harbor Veterinarians to have an endotracheal tube placed. This plastic tube is placed into the trachea to keep the airway open and to allow a steady stream of both oxygen and anesthetic gas to go into the airway, allowing us to easily adjust the level of anesthesia as needed. This tube also prevents dangerous stomach contents from going down the airway, should the patient start to regurgitate under anesthesia. Molly and I placed the endotracheal tube.

Positioning | Kona was then placed in dorsal recumbency (on her back). She was provided a warming water blanket to help her body maintain a warm, comfortable temperature.

Sterile prep and gowning | Molly performed a sterile abdominal prep on Kona’s skin, as I scrubbed and prepared myself to perform surgery. Afterwards, Molly helped me put on my sterile gown and gloves.

IV fluids start and sterile drapes | Kona’s IV fluids were started. Sterile drapes were placed over Kona’s already sterile, prepped abdomen.

Spay procedure | I performed her spay.

Blood pressure monitoring | Meanwhile, Molly was very busy monitoring Kona under general anesthesia. She monitored and recorded her blood pressure.

Fluids monitoring | Molly monitored that Kona’s fluids were running properly.

More monitoring | Molly monitored and recorded Kona’s pulse ox, heart rate and respiration.

Adjustments | The information that our anesthetic team records helps determine how the patient is doing under general anesthesia. This monitoring allows us to detect small changes under anesthesia early, as that can alert us that a problem could be slowly developing. The goal is to catch small issues early before they could possibly develop into an emergency. Molly adjusted Kona’s anesthesia as necessary during the procedure to ensure at all times that the patient was at proper anesthetic depth.

Pain medication | Towards, the end of the procedure, Kona received a second injection for preventing pain. At the time of discharge from the clinic, she also went home with oral medication to prevent discomfort. Her type of pain medication was chosen again based on her physical examination, blood work and history of any type of other medical issues.

Recovery | After the procedure, Kona is transferred into our surgical recovery area. Kona was provided with a warm air blanket in recovery. Molly sat with her until she was completely awake.

Those who have toured our practice know that we have a relatively open floor plan. This recovery area can be viewed from the surgical suite, the treatment area, the laboratory computers, and even one of our examination rooms. One of the most critical times that an anesthetic mishap can occur is during the recovery period. For this reason, our patients are not left alone until they are fully awake and recovered from general anesthesia, and our floor plan allows for easy monitoring, even during more busy days. Molly in particular is known at CHV for snuggling her patients in recovery, making sure they recover in comfort and given her full attention.

Communication and discharge | Kona’s owner received a phone call from me after the procedure letting her know that Kona had recovered well. Kona was kept in the clinic for a few more hours in order to continue to monitor her recovery. Both Molly and I updated her medical record to include her anesthetic and surgical notes.

At discharge, Kona’s owner met with both Molly and me. Molly sat with Kona’s owner and reviewed Kona’s discharge instructions and pain medications to be administered at home. She told Kona’s owner how to care for her surgical site and how to prevent infections. She also showed Kona’s owner the “cone of shame” that would be needed to be worn until her recheck in 2 weeks.

Follow-up and recheck | Molly called Kona’s owner the next day to check and make sure that Kona had been comfortable overnight at home and was pleased to hear that she did very well.

In 2 weeks, Kona returned for her surgical recheck examination. She had healed very well and her sutures were removed with a little coaxing to lay down.

Clean bill of health | Kona had recovered well and was full of her old energy. She was given permission to stop exercise restriction and return to her regular level of activity.

Janette Blackwood, DVM

Osteoarthritis Pain Management for Our Senior Pets

November 14, 2017 By admin Leave a Comment

Just like with people, it is not unusual for our senior dogs (and cats!) to start getting aches and pains as they age. Owners often note a “slowing down”, which they may perceive and accept as part of the normal aging process. This thought process may lead owners to be resistant to starting a chronic medication for treatment. Osteoarthritis can be a common culprit for “slowing down”, but what owners may not realize is that arthritis can cause significant pain for our pets and limit their quality of life. Sometimes after starting a non-steroidal anti-inflammatory drug, the improvement to a pet’s quality of life can be dramatic.

One of my client’s dogs, Nala, did have such a drastic improvement after starting medication. After the owner excitedly texted to me her third round of pictures showing Nala’s improvement, I asked her to contribute to our clinic blog. My goal is to help other pet owners realize that the judicious use of pain medication tailored to their senior pet’s specific needs can result in improvement in their enjoyment of life and their relationship with the family.

Below is Nala’s story:

Nala is our nearly 11-year-old lab/shepherd mix. We adopted her at 12 weeks old from the SPCA and she has been a ball-loving, chase-loving, active girl her entire life. In the last couple of years, she has certainly slowed. She used to love (and I mean, LOVE) jumping up on her daddy to stretch and hug, but this has completely stopped in the last couple of years. She wants to play catch with the tennis ball for “forever” – but lately after 10 or 15 minutes, she’s exhausted… and later needs help to get up the stairs.

This summer, we noticed further changes. Not only did she not want to play, she would hide in our bedroom upstairs and seemed more distant than usual. It was a significant behavior change for our typically clingy dog who stays in our shadows. We’d been using Cosequin to help with arthritis and it seemed to help for a little while, but wasn’t enough.

We are so grateful that we spoke with Dr. Blackwood. After voicing our concerns, she suggested we try an NSAID Nala could take twice a day. After a couple of weeks, we have a brand new dog. She is back to her super personable, playful, active self. She can play ball for longer periods of time, she is SO happy to jump up on her daddy again, and she is back to hovering in our shadow! We are getting her bloodwork followed regularly to monitor for side effects and are beyond thrilled with the results. As seen in the pictures, she is acting like a puppy again. Our senior dog is beyond happy, which makes us beyond happy as well.

Lori

Janette Blackwood, DVM