The cost of things: July 2013

Tags

acepromazine, blood tests, budgeting, pet finances, vet

Another month, another barrage of expenses…

This is my third year of tracking our pet finances here at the House of Two Bows. This is an ongoing effort to get a practical sense of what it costs to keep two 20 ~ 30 pound adult dogs in an area of the US with relatively high costs of living. Previous posts in this series can be found under the category of finances.

The Cost of (Pet) Things for July 2013:

• Food: $76 [previous month, $14]
• Treats: $5 [previous, $28]
• Grooming: $0 [previous, $0]
• Accessories and misc: $0 [previous, $0]
• Vet & Medical: $289 [previous, $0]
• TOTAL: $370 (running average for 2013 ~$172/month)

WARNING (a reminder to myself, to cushion the blow): For July and into August, I am in stockpile mode. Expenses for the Bows are expected to plummet after that, because I am not going to be here to buy them things, and I am the primary purchaser of supplies at the House of Two Bows. I’ll explain shortly; details are hard to divulge at the moment.

Food expenses weren’t nearly as bad as anticipated, given all that I purchased: approximately 20 pounds of raw chicken portions, several pounds of organs, and ten pounds of whole sardines. I’ve portioned things out and really can’t stuff anymore into the freezer unless I eject all the human food. This should be enough raw meat to last several months (since they’re not on a fully raw diet), supplemented by occasional purchases of turkey parts when they roll back into season, and other freshly butchered meats.

Rounding out the food expenses for the month were the usual tubs of plain yogurt, a small stack of Weruva canned food that will serve as emergency rations, and joint supplements purchased from Prime Pet Supply.

Treat expenses were simply 2 pounds of chicken hearts, which are sitting in the dehydrator as I type. We also got a boost from the folks at Chewy.com in exchange for another review coming up shortly…

Veterinary and medical expenses were the biggies this month. Bowdu’s last veterinary checkup was October 2012, and Bowpi’s was just this last March 2013. Knowing what a pain he can be to examine, the vet seems to be doing us a favor by letting us prolong Bowdu’s blood draws (to check thyroid function) to once every 8 to 10 months, instead of every 6 months as is typically required. However, they still want us to come in for physical exams before signing off on his Soloxine prescription.

So Bowdu got dosed up with Acepromazine (he takes just one 25mg pill beforehand, but we keep a couple extra on hand for future occasions), and I brought them both in for an exam. Might as well, since I’m going to be away for a while, right? I’m a little miffed though, because I had scheduled an appointment with a new receptionist and asked explicitly if bringing both Bows together would count as one visitation fee — and she said yes. I should have known better, as the final bill accounted for each of them separately.

VET BILL
• Acepromazine (25 mg @ 3 tablets), $16.09
• Office call: annual exam, 2 @ $56 $50.40 = $100.80
• Total body function (includes thyroid), $169 $152.10
• Canine rabies, 3 year booster, $21.75 $19.58
• TOTAL BILL: $288.57 (after 10% student discount)

I expressed that it wasn’t what I was expecting, but I didn’t argue. Each Bow did occupy a separate appointment slot, after all. But I knew there was nothing wrong with Bowpi, and really didn’t need to shell out $50 for the vet to tell me that she needs to lose about a pound, because I know, I know… I blame summer communication issues between meals, as RJ has been handling breakfast and I’ve been doing their dinners, and it’s hard to balance portions day by day when each side isn’t monitoring what the other’s doing. Grr…

Anyway, Bowdu’s bloodwork and three-year rabies booster comprised most of the hefty bill. On the upshot, he didn’t utter a single shriek this time, and we were told that he does seem to be getting better with each visit. That doesn’t mean he’s learning to enjoy the vet. He’s just resigning himself to the experience — sedative, Thundershirt, basket muzzle and all…

For those of you with multiple dogs, I’m curious about your vet experiences. I understand the logic behind individual consultation fees, but I am wondering — does your vet offer multi-pet discounts?

I’m griping out of surprise because this is the first time since getting Bowpi that we have been charged for two separate consultations. We’ve had first-time intake appointments accounting for both dogs with two different vets (including this one), and were only charged a single visitation fee each time. Perhaps intake appointments are automatically blocked across two time slots, so the single fee was an introductory courtesy. At any rate, I now know that this is my vet’s policy so I won’t be surprised next time. I preferred bringing them in one at a time, anyway.

Bowdu’s annual thyroid test — glad that’s out of the way

Tags

acepromazine, anxiety, basket muzzles, canine hypothyroidism, dog muzzles, thundershirt, vet

Whenever I post pictures of Bowdu in a muzzle, he gets invited to photo pools for muzzled pets, which honestly creeps me out… Not sure if the addition of Bowdu’s “corset” just adds to the flames, but you know what? As long as you freaky furries keep your paws on your side of the screen, I’ll just carry on with business as usual here.

Anyway, this is how we suited up Bowdu for his vet visit on Wednesday morning. His basket muzzle is hanging a little loose, and it was cinched up tight when we got closer to the vet. I had the Thundershirt on him during our walk around the block, and he didn’t seem to think anything of it. The Acepromazine had started to kick in, but I’d only administered it about 80 minutes before the examination (the instructions recommended dosing him one to two hours before showtime). Note to self for future reference: Bowdu needs closer to two hours for the sedative to reach maximum effect.

Between the suit, the mask, and the drugs, we were able to draw another round of blood without having to completely put him under. It’s not a pretty solution overall, but if this is what it takes to get the job done once a year, then hell — I’m satisfied. It’s hard to tell what really helped the situation. Maybe all of it. I had my doubts about the Thundershirt, but since we have it now, we’ll probably use it again. Besides, Bowdu did let a vet tech physically pick him up, which he’s never submitted quietly to before!

The biggest advantage of the Thundershirt was that it very clearly flagged him as a “special care” dog and abbreviated my need to offer handling suggestions. A couple of the techs actually appeared to move more delicately and speak soothingly around him because they saw the Thundershirt and immediately understood its implications. Or perhaps it’s just a natural reaction to the absurdity of dogs in clothing.

Bowdu’s never going to be comfortable at the vet, no matter how much cheese, bacon, or pasture-fed dehydrated goat liver he gets while he’s there. He willingly enters the lobby and partakes of their hypoallergenic cookies, as we’ve done dozens of times during our “fun” visits throughout the year, but the instant he’s taken into an exam room, he knows the stakes are different. He’s really too wily to be fooled.

Wednesday’s vet bill:

• Office call, $56
• DHPP vaccine (3 year booster), $24.50 (after student discount)
• Bloodwork: total body function, $169
• TOTAL: $249.50

Thyroid numbers (blood drawn approximately 9 hours after his last dose of 0.2 mg Soloxine which he gets 2x a day, twelve hours apart):

• Free T4 (ng/dL): 1.6 (reference range 0.6 ~ 3.7)
• Free T4 (pmol/L): 20.6 (ref. range 7.7 ~ 47.6)
• T4 (ug/dL): 1.7 (ref. range 1.0 ~ 4.0)

Ace Face, recap

Tags

acepromazine, sedation, vet

The previous post included a picture of Bowdu’s “Ace Face” as I imagined it, based on a picture I took of his mellowness riding in the car (a favorite, soothing activity).

This is his real Ace Face.

12 October 2011

Within 30 minutes of swallowing his pill, he was dragging his feet around the house. In the above picture, I interrupted his sunbathing about an hour after dosing, but it’s all cooool, man… That’s because he had no idea that a trip to the vet was imminent.

At the vet.

Truth is, he remained fairly alert, though there was a lingering dullness to his eyes to suggest that he wasn’t all there. But he was ambulatory, and if he could move, he could still bite. He walked himself into the vet’s examination room just fine, and was still pretty quick to back away when the stethoscope came out (nope, he can’t even handle that non-invasive procedure). He snapped a couple times at approaching hands when we were trying to muzzle him. They were fearful, back off snaps and not aggressive, lunging biting. Though he didn’t look like he was serious about making contact, we still didn’t want any techs or docs getting hurt!

So I let the professionals take him to the next room for his blood draw, where I heard three long shrieks expressing his extreme displeasure… then there was silence, at which point I figured that they had stabbed him with a knock-out dose of Dormitor or something. Many minutes passed. I remained in the examination room, waiting for an update. Then I heard his tags jangling down the short corridor and soon, he was pulling the vet back on the other end of the leash.

Yesterday’s damage:

Office Call, $53.00
Acepromazine (Quantity: 3), $15.82
Total body function [complete bloodwork], $163.00
T3/free T3 test [requested in addition to fT4/T4], $100 $60

TOTAL: $291.82

Do you notice what’s missing from this pricey bill?

No tranquilizers/reversers! The vet reported that once they were able to get “a good grip” on Bowdu, he was “actually pretty good.” I didn’t ask for details; I was just relieved that nobody got hurt during the process, including my dog.

Given the relative “success” of this vet visit, the doctor seemed to think that pre-dosing with Ace was a viable option. So as long as this temporary remedy works, we’ll use it, though I will refrain from singing its praises until I’ve seen it in action a few more times, preferably in a few different contexts.

Honestly, Bowdu’s never going to be completely comfortable at the vet, no matter how many hot dogs I ask them to stuff down his throat. But at least he was willing to accept treats even in the exam room, so overall it did seem to go better than it has in the past.

Acepromazine, a prelude to the vet

Tags

acepromazine, sedatives, socialization, vet

Bowdu has a vet appointment today for his annual blood draw to check his thyroid levels. Since he has proven to be so unmanageable during these routine visits, we got a mild sedative to administer beforehand.

This is the drug information provided to us by the vet:

—

Pharmaceutical: Acepromazine 25 mg
Dosage: Give 1 tablet orally two hours prior to next visit for sedation
Indications for Use: Your veterinarian has prescribed this drug as a sedative or as a preanesthetic agent.
Side effects: It may cause low blood pressure and low heart rate in all species. This drug in rare cases can cause discolored urine. GI effects are possible side effects of this medication. Intramuscular injections may cause pain. The response to this drug is variable among individual animals. If your animal is overly sedated or not affected at the dose described discontinue use and contact the veterinarian.

* Notify your veterinarian if your animal has ever had any seizures prior to the administration of this drug. This medication can cause animals with a pre existing seizure tendency to have seizures while on this medication. Animals with pre existing heart, liver or kidney disease should be given this drug with caution.

—

The prescription included three pills so we would have some extra on hand, perhaps for a future, unexpected emergency. We could have test-dosed Bowdu just to observe how he would react, as we’ve never tried pre-sedating him before. But we didn’t.

Anticipating the worst makes for clever strategy: either I prove myself right, or I create ample space for relief. I am prepared to have him injected with even heavier sedatives just to complete the blood draw, as has usually been the case. Meanwhile, I’m hoping the Ace will take some of the fight out of him, so it’ll be easier to get in there with a muzzle or any necessary needles.

Or he may be so disoriented, the intended sedative effect will backfire. From Mike Richards, DVM via Vetinfo.com:

Many dogs seem to be able to will themselves to overcome its effects, at least temporarily. This makes it less than ideal as a drug for dealing with aggressive or fearful dogs but there have not been better alternatives for medicating prior to the visit. It works often enough that many vets will try this approach first. We do this when we think it has a chance of helping make an office visit go easier. We just remember to continue to be very careful when examining the dog.

From Terry Kelley CVT, CPDT at Fearfuldogs.com:

Research has shown these drugs [Acepromazine and Chlorpromazine] functions primarily as chemical restraints without affecting the animal’s emotional behavior. While under the effect of Ace, the animal still has a very strong fear, anxiety, avoidance or arousal response, but it does not physically display these reactions and is less able to react. The dog or cat appears calm and relaxed but mentally is lucid and still having an intense emotional reaction to its surroundings. Ace is a dissociative agent and prevents the patient from understanding his environment in a logical manner. So, the actual fear level of the animal is increased. Compounding the situation, the animal is being restrained and it makes a negative association with the entire experience.

[…]

Side effects of Ace include (but are not limited to): increased noise sensitivity and startle response, decreased respiration, bradycardia leading to cardiovascular collapse (dogs and cats), hypotension, erratic thermoregulation leading to hypothermia or hyperthermia, a decrease in seizure thresholds, muscle spasms, excitation and sudden aggression (break-through response), absent pulse, unconsciousness. The duration of Ace also varies in each individual, thus making the fearful or aggressive patient even more unpredictable. Note: Ace should never be used as a tranquilizer for animals traveling due to the erratic thermoregulation effects (inability to control body temperature in cold or hot conditions).

Though the information given by the latter source is much more detailed, it mentions a lot that was not posed as a risk in more general articles. Their emphasis is on behavioral modification rather than a chemical band-aid, an approach which I’m more inclined to strive for. So these words of caution are definitely in my mind as I try to focus on making this a good experience.

We’ve been dropping in for the hell of a hypo-allergenic cookie (Science Diet, blechgk, but a novelty to the Bows nonetheless) several times over the past couple weeks. I keep telling them “It’s the cooookie place!” but they tend to wise up the moment we’re in for a real visit. High value cheesy treats and hot dogs will be on hand. I will be surprised if this manages to work.

I have a pretty pessimistic attitude about Bowdu’s behavior at the vet, even though it’s all our own damn fault. We never did much to actively make the vet a positive experience for him, we just trusted his resilience and ability to bounce back — until he hit his adolescent months. Then suddenly, he decided he no longer wanted any of his orifices violated, he was going to snap and scream, and he was going to get away with it.

We live with the mistakes that we made in Bowdu’s upbringing and training, accepting the wisdom accumulated from trial and error (and I’ll be the first to admit to the abundance of error). But if I could hit the reset button, this is one of the critical things that I would try to change. We could have done a lot more to create positive associations with the vet from puppyhood, but the DD and I both let our deep-seated distrust of doctors and hospitals get in the way. So now, not only are vet visits psychologically stressful for Bowdu, there’s the physiological stress of medication, as well as the extra fees for the pharmaceutical crutches that help us get the job done.

21 September 2011

Atta boy, Ace Face.

FOLLOWUP: Ace Face, Recap