2011年3月9日 星期三

In the veterinary field (5) invoices have to be cold, wet nose through the pay the owners of the

If Max were a 3-year-old boy, his family's insurance would have covered nearly all of the bill. But since this family member walks on four legs, Max's owner, Carrie Parenteau, footed the entire medical cost.


"It's not a question of if you have the money. They're your babies. You find the money," said the Raymond mother of three dogs and a teenage boy. "It'd be like denying my child special tests."


Families in New Hampshire and across the country are facing higher medical costs, fueled partly by advances in technology that often extend people's lifespans. Similar advances in veterinary medicine allow more animals to live longer, but often at a higher cost to families because few carry insurance for pets.


"People with insurance or people with HMOs are not used to paying the actual costs of procedures, and when they bring their pet to a place that provides that kind of technology, then they're faced with what it actually costs to have an MRI done or to have major orthopedic surgery done, which is much lower in veterinary medicine than it is in humans, but much higher than what most people have ever seen," said Brad Taylor, co-owner of Capital Area Veterinary Emergency Service (CAVES) in Concord.


Parenteau found that was true.


"When my kid goes in for an X-ray, his insurance covers most of everything," she said.


Three out of five U.S. households owned a pet in 2008, according to a 2009-10 National Pet Owners survey. Put another way, there were more dogs than kids younger than 18 living in the United States.


In 2009, pet owners spent more than $12 billion on vet care -- $2 billion more than Americans spent on cosmetic surgery.


Former Manchester Public Health Director Fred Rusczek now heads Child Health Services, which serves the medical needs of 2,474 Manchester-area children living below the poverty level. He said $893 would pay for health care, such as immunizations and routine exams, as well as family support services for one child for a year at Child Health Services.


Rusczek also knows about big vet bills, spending at least $5,000 since 2007 on specialized care for two cats, Lexus and Giz, and an English setter, Grady.


"Certainly I've thought of all this: What is the ethical investment to make in one's pet when you know kids can benefit from improved access to make them healthy?" Rusczek said.


"It's fascinating because pet care is following the human care," he said. "I realize what can be done with modern medicine today for dogs."


Families with tighter budgets have more difficulty paying for pet care, translating into more people skipping or delaying their animal's annual exams, according to Melissa Magnuson, a veterinarian who owns All Pets Veterinary Hospital in Nashua and Canobie Lake Veterinary Hospital in Windham.


"It's very similar to human medicine," she said.


And that, she said, results in repercussions. "They wait and wait and wait until an animal is really sick, and it actually costs them a lot more treating a very sick patient, where picking up something early, it will cost a lot less."


Routine dentistry can run $200 to $400, "where if you need an abscessed tooth pulled, that's going to run you $800 or $1,000," Magnuson said.


More people are signing over their pets to Magnuson's vet practices because they can't or won't pay large medical bills. She in turn finds the animals homes where vet care can be afforded.


"If people are into their pets and want to save their pets, they find a way," she said.

110305vetcare_300px (BOB LAPREE) Veterinarian Dr. Deborah Kelloway, assisted by Jamie Dekraai, start a nasal endoscopy on "Max", a dachshund, to try to determine the cause of his persistent sneezing. (BOB LAPREE)


Max's owner turned to plastic.


"To tell you the truth, it's on the credit card and probably will get paid off when the income tax comes in," Parenteau said. "A lot of people do think I'm on the crazy side."


During Max's procedures at the Center for Advanced Veterinary Care in Manchester, anesthesia immobilized his 15.6-pound body. Monitors checking his oxygen level and heart rate were wrapped around his tail.


The dog was placed in the CT scanner, which cost the center's owner, Deborah Kelloway, $100,000 used. A CT scan typically runs clients "a little under $800," said Kelloway, a veterinarian. (That contrasts with a median charge of $1,398 for a human scan in New Hampshire, according to New Hampshire PricePoint, which provides estimated pricing data. Kelloway said other charges, including someone interpreting the scan, would raise the price tag for the human scan.)


After the scan, Kelloway ran a miniature camera up the dog's nose and used alligator forceps to snip a piece of tissue for a lab to biopsy, producing a bloody nose. Max later was put on a regiment of steroids and steroid nasal drops.


"It's almost like an allergic reaction to the environment, just like people have hay fever," Kelloway said of the diagnosis.


Last week, Max's owner said her pooch was "doing much better," and she hopes to wean him from his twice-a-day drops.


Over the past year, Gov. John Lynch and his wife, Susan, spent at least $10,000 of their money on treating four pets for serious conditions at CAVES in Concord.


"The animals meant a lot to us. They're part of our family," said Mrs. Lynch, a medical doctor. "We were able to pay, but for many, many people, every treatment, every pill, every day of stay at a hospital like CAVES is a big decision, and often it's not an option."

110306DrLynch_300px (THOMAS ROY) Dr. Susan Lynch, left, wife of the governor, with their dog, Katie, talks to veterinary tech Renee Kucharski, far right, and veterinarian Karen Gibson at Capital Area Veterinary Emergency Service in Concord. (THOMAS ROY)


Two family cats, Harry Potter and Angel, contracted cancer and were put down. A third cat, Ginny, is being treated for a liver problem. And Katie, a golden retriever, recovered from reconstructive knee surgery.


"The technology for most of what we have in human medicine I think exists for animal medicine from what I've learned from personal experience," Mrs. Lynch said.


People, she said, evaluate humans and pets differently when dealing with medical issues.


"With pets, it's more of a quality-of-life decision," she said. "We'll put humans through really ungodly procedures to prolong their life-spans. We're much better with that with animals. We understand about quality of life and when the right time is to make that decision to back off and stop treating."


The Concord locale also treated 10 police dogs for free over the past two years for such things as porcupine quills, items swallowed and a ruptured spleen, said state police Trooper Dan Needham, who oversees K-9 training.


Needham said his former K-9 partner, King, tore ligaments. "That night, I was told his career was over," he said.


But a vet medically repaired the Dutch shepherd, giving him an additional 18 months on the job, during which time he helped police locate ill-gotten cash and illegal drugs.


More people cited economic reasons for giving up their pets to the Humane Society For Greater Nashua last year. In 2005, only 10 people said they couldn't afford to care for their pets, compared with 93 in 2010. In 2005, 37 people cited moving or landlord restrictions, while 112 gave that reason last year.


And other pet owners are seeking help to pay pet care bills.


"We get phone calls on a daily basis from people who are not willing to give their animals up but are looking for assistance or direction or guidance on where they can go in terms of medical care," said Tammy DeVito, the animal care director.


"Money's always part of the equation," Kelloway said. "How much time are you going to get for what kind of money and what kind of suffering?"


Payment is expected when the animals are treated.


"A typical bill is $2,000 for something big," she said. "We try to work with each pet owner at the level they can afford care."


People expect vets to produce medical results comparable to their children's doctors, she said.


"We have a lot of stress that physicians don't have," Kelloway said. "I don't have a whole (professional support) system for a buffer that goes with a whole set of expectations."


Vets are involved in everything with their practices, including, "'How much is the bill going to be?'" Kelloway said. "Doctors in hospitals, they don't have that. They just do their job."


Taylor also mentioned the intimacy of vet care.


"One of the things I like in veterinary medicine, even though it's a trial, is decisions are made by the pet owner and their veterinarian, and we stand across from the exam room table from each other and make the most reasonable decisions," Taylor said. "A doctor and his patient never talk about whether it's financially reasonable to do a certain test or a certain procedure."


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