Due to my schedule this semester, I thought I would be too exhausted most Wednesdays to make any significant posts. However, I’ve just spent a good chunk of my evening fuming with anger after I received a voicemail message from my soon-to-be ex-vet. Apparently, I deleted it in frustration so I can’t transcribe it here. Basically, they called to tell me –
1. They “don’t deal directly” with 1-800-PETMEDS, with whom I just placed an order for a mere 60 more pills of Soloxine (0.2 mg). My vet could hand me the prescription and I could fax it in myself, but their policy is not to deal with these online pharmacies.
2. Their price on Soloxine is actually “pretty good,” they said. In fact, they could sell us 250 pills of what I want — the whole bottle — for about $24.XX. So this is something I might want to consider.
The second part is what set me off. I call bull. It’s absolutely ridiculous that they sold me 60 pills of Soloxine last time for $24.70, and they turn around and tell me they can offer me the whole bottle for that price only after I decide to go elsewhere to get the prescription filled, as is entirely within my rights by law. They’re probably going to tell me that it’s a different price for loose pills versus the entire bottle, but I still find it absurd that they would charge over eight times more per pill than the cheapest place I was able to find it online (which, for the record, was not 1-800-PETMEDS, but I had some other things I wanted to buy and they price match, which is why I chose them). Oh, by the way, the pills that the vet sold me the first time were set to expire in a month, according to the label.
[EDIT 16 September 2010: Their answer as to why there's such a large difference in price -- one is an "introductory price" for a first- or one-time dose. The second, where they offered me the whole bottle, is a "chronic med price". I find this explanation inadequate. My response was that the first dose is basically a chronic dose, since you're expected to keep the dog on thyroid medication once you start. Hormone supplementation will result in his own thyroids shutting down, if they weren't already mostly non-functional to begin with. If they had actually considered the medication they were offering as more than something to look up on a price chart and ring into the register, they would've known that and have been able to deal with his case in a reasonable, rather than mechanical (dare I say corporate and anonymous?) manner.]
The thing is, we don’t know that we even need 250 pills yet. The standard procedure, as I understand it from Hemopet, from chatting with other hypothyroid dog owners, and as I’ve read in the veterinary literature, is for the dog to go on a 6-8 week therapeutic trial and then return for another blood draw to make sure that the dosage is correct. After the initial dose, thyroids can be retested after 2 weeks, and should be retested after no more than eight weeks at most, as about half of all dogs require a dosage adjustment. One article I read specifically said that dogs with “borderline” levels (as our vet proclaimed them to be) would be fine waiting 6-8 weeks before retest [citation forthcoming]. Given all this, the four weeks that our vet initially gave us seemed conservative, like they were in a hurry to get us back (as if our monthly visits since the month of May weren’t enough!).
However, you might recall that Bowdu was extremely stressed out by the previous blood draw. When I asked specifically what we could do to ease his anxiety before the next visit, if they had any mild relaxants that wouldn’t interfere with the heavier sedatives they’d most certainly have to give him, they professed to have nothing to offer.
It was disappointing to hear them say that they had no suggestions to help either us or themselves. I’m at a loss as to what to do in this situation. The only thing I can think of is to hang out with the vet and a behaviorist in the weeks leading up to the dreaded blood draw. Obviously this is not practical for anyone involved. Bowdu is unfortunately a high maintenance Shiba who does not like being handled by strangers, and every subsequent visit has just escalated into greater anxiety. The next visit is not going to make things any easier, nor help his impression of vets in general.
So we want to push the next visit back as far as possible, and we need more thyroid drugs in the meantime. That’s why I ordered from an online source. I sure as hell didn’t want to get gouged for another vial of drugs that he’s likely going to be on for the rest of his life.
But this vet is not going to make it easy for me to get my prescription filled where I want. Just like they didn’t make it easy for me to get his blood tested where I want. If it’s their policy not to deal with labs or pharmacies outside of their own VCA network, fine. I’m not asking them to bend any rules for us. We’ll just have to find a vet with different policies.
Searching for a good vet is tiring. This is not a personal judgment against the receptionists and vets, as they all seemed genuinely friendly and our interactions were always professional. As far as facilities go, they have some of the nicest I’ve seen (it feels rather unclinical, not like a hospital). Every DVM on staff graduated from top veterinary schools, and there are a couple reputable surgeons among the group. But I don’t need a surgeon. I need someone who knows thyroids and maybe a little bit about my relatively “rare” breeds. I want policies that permit client input. I want a vet with whom I see eye-to-eye on some core principles, like the value of holistic and natural treatments, and is willing to dole out such advice without prodding (fish oil, Epsom salt baths, over-the-counter Benadryl, apple cider vinegar, kelp supplements, baby wipes — not a word of these were ever mentioned by my vets). And I am hoping for a team of more creative diagnosticians, vets who can look outside their tunnel vision (i.e., regarding Bowdu’s problems as merely dermatological the entire time) and stay abreast of the constantly changing field of veterinary medicine.
This is what I’m prepared to tell them tomorrow in my “break up speech” when I get Bowdu’s prescription so we can get it filled elsewhere.
For old time’s sake, here’s a video of what Bowdu used to be like when he was permitted to lick himself freely:
Video taken 15 August 2008