Vet advice… AIBU about costs.

[MyFairLady22]

My Dog is 11yrs old. She’s a large breed and is therefore a good age. She’s been loved and cared for to within an inch of her life for every moment of those 11 years! She’s on YouMove Max, salmon oil capsules, and prescription anti inflammatory medication from our vet.

In the past few months, she’s been back and forth to the vet with trembling… shaking…wobbling and difficulty getting in the car/on the bed/sofa. I lift her! It’s worsened in the past few weeks. Suddenly, she jerks/mouth snaps/falls. She eats well. Swims. Plays. Gets groomed twice a day (she’s very woolly ☺️).

Now, the vet thinks she’s having myoclonic seizures. A form of late onset epilepsy/fitting but NOT losing consciousness. It is caused by tumours to which the breed is susceptible. I’ve put mats all over the house to prevent slipping; bought two ramps she will not use! Support her on off my bed at night (I’m divorced - she took over the vacant side of the bed pretty quickly!).

This morning, went to the vets for her blood test for the medicine she’s on. The vet last week tested her liver/kidney function and fasted blood sugar which all came back “like a five year old dog’s”She’s pretty healthy but for this degenerative disease process starting recently.

Today, it has been suggested to do a referral to a neurologist. Months ago, my own lovely vet, who knows I’m paying my own bill said “It depends how far you want to go and in reality, WHAT YOU DO with the results; she’s an old girl (for the breed); were she a puppy or aged 5, then that’d be very different”. This helped me enormously. The vet understood that I just don’t have endless funds available and we agreed that scans etc were NOT the way to go.

So, AIBU to feel frantic that now, the vet is suggesting initial diagnostic tests totalling £3,500 as a starting point? It’s like we never had the conversation about costs. My sister has offered to loan me the money but this payment is just the first consultation and scan.

Help please. Am I giving up on man’s best friend? AIBU to think the vet has done a total u-turn on appropriate treatment options?

You know your dog. If her quality of life is deteriorating it’s time to let her go.

With our first lab, we followed the vet’s recommendation of chemotherapy, but it is something I will always regret, and I am so glad that we let her successor go in good time. Instead of a midnight dash to the animal hospital, needing oxygen and having to be euthanised in an unfamiliar place, our second dog was put to sleep in our home, on her bed, surrounded by her family.

I know this is hard… 💐

Please don’t think I’m being heartless, but you’ve got to know when to stop.

A different scenario, but I always remember my friends lovely dog, a big Irish wolf hound that had cancer in its leg.

It was only a matter of time, but the vet suggested amputation, which they did because they loved the dog, but the dog hated it and could hardly get up on three legs being so big and old.

It was actually cruel, and horrible to watch. It died less than six months later because the cancer had of course spread.

The vet made a lot of money out of their heart ache, and prolonged the poor dog suffering.

It’s not unique and I know someone else who ended up spending nearly £10k on a 14 year west highland terrier.

I am sorry that is your experience. Normally one treats for the treatable, mitigates any clinical signs as best one can etc.
No vet refuses to give pain relief

Our ten year old lab had an accident a couple of years ago where she damaged a disc in her spine. It wasn’t age related but is a common injury in labs because they are not brilliant at risk assessment and happily run into solid objects in the pursuit of tennis bslls.
Fortunately she was and still is insured so tests, treatment and rehab were covered.
She recovered about 90% of function with just a little neurological lameness in one back leg that gave her a bit of a peg leg limp.

Just before Christmas she had what appeared to be a stroke, she was wobbly, couldn’t stand up for long and stopped going upstairs or jumping on furniture. A couple of trips to the vet didn’t throw any light on it but she did improve slightly with painkillers.

The vet referred us back to the neurologist who treated her spinal injury. They too were not sure. Provisional diagnosis was tumour, heart disease or back problem. But since she had no real neurological symptoms apart from the pre existing lameness they thought that back pain was low probability.

She underwent CT scan and other tests and the vet rang us and was very happy to tell us it was actually her back. She had some age related changes/ calcification around some of the vertebrae but the cause was a slipped/bulging disc. He said that her existing deficits had masked the classic presentation and it was quite mild but looked worse because of the limp.

She had a big steroid injection and a month of painkillers and crate rest. Since we’d been through the spinal rehab before we were familiar with how long it can take. The previous injury required intense physio from the start. The IVDD (slipped disc) needs complete rest for four weeks then very slow return to normal. She is now back doing hydrotherapy which she loves. And is pretty much back to where she was.

There is a high risk of it relapsing and her needing another steroid injection but we will wait and see.

The problem you have OP is the astronomical cost of an MRI or CT to make a definitive diagnosis. If we hadn’t had insurance we would have been in a position to fund it and even with insurance, because of her age we have to pay 20% of the cost. We do get funding for the hydrotherapy so overall I am expecting to pay around £1000 in total out of the £5000 it will cost us.

Unfortunately they made an incidental finding on the CT suggesting she may have another chronic condition but because she has no clinical symptoms we have made the decision to wait and see. Because she’s an older dog she may well reach a decent age before symptoms develop but the condition increases the risk of a stroke so the decision may be made for us if it progresses.

As a result we no longer let her exercise off lead, which is sad but she is still enjoying life and is not in pain. It was really distressing when I found her in the garden collapsed due to the pain from the bulging disc and it’s a small price to pay to prevent it recurring.

A consultation with the neurologist will cost around £200-300, they won’t insist on treatment but on examination may be able to pin down what is going on. Then you can make a sensible decision. Even if it’s an easy diagnosis the treatment/drugs required may be expensive.

Our dog is doing fine again so it was the right decision to investigate and treat but had she been closer to her maximum age. 14-16, we may have consider a different course of action. She’s relatively middle aged and still looks like a 4 yr old but if she’d been struggling prior to her accident our decision would have been different. If she’d been more middle aged in her behaviour she probably wouldn’t have run into the solid object in the first place.

Time to let go op. ❤️

We had our dog PTS recently, she was 10.
diagnosed with a probable brain tumour last summer - had what they called resting seizures
We could have had a scan (4 grand)
We didn't, we just keep her comfortable and happy for as long as we could And I would do that again

This says it all. Your dog is a very good age for a large breed. Just give the best you can for us long as you can, but don't pursue investigations - why put your beloved animal through the trauma?

This. ^ @MyFairLady22 As has been said, vet practices push and push and PUSH you to get 1000s and 1000s of pounds worth of treatment for your dog or cat, even if they are 90-95% of the way through their life, and very VERY poorly.

We had an 18 year old cat who had arthritis, kidney and liver issues, a heart murmuration, and an underactive thyroid. She was also 80% deaf, and developing cataracts. She had plodded along for a year to a year and a half with her arthritis (with YouMove) her hearing almost gone, and her eyesight waning, (down to 50% or so,) and she had a mass near her stomach that had been spotted a month earlier, but she suddenly went downhill over a few DAYS and lost the will to live, shortly after her 18th birthday.

She wouldn't even look at us she refused to be held or picked up, she faced the wall, and she had just checked out. She was done. She knew it. We knew it.

We took her to the vet with the intention of PTS, and the vet gave us about 10 different options of things we could do for her, including having her taken away to a clinic for a week or two for 'tests.' If we had gone ahead and said yes, we would have had a bill for around £9K to £10K. And that was just for starters!

We were like ' 'errr actually, we don't want to put her through that. She's a very old lady, and she has multiple things wrong with her, and she is really suffering. We want to choose euthanasia.' She said 'OK, that's fine, that is the kindest thing to do, and she is very old...' We thought 'why on earth suggest all this bloody treatment then?!'

I agree, it is about making money. But it is often not the fault of the individual veterinary surgeon. I feel sorry for them, but it's an absolute disgrace how the companies fleece people now. Some people might think they have no option other than forking out 1000s and 1000s of £££! Some people have nearly bankrupted themselves paying exhorbitant vet bills, only to have their pet die 6-8 months later anyway! (Because they were very old!) There is very little care or thought for the welfare of the animal, or the owner. It's all about the £££££!

@MyFairLady22 I would PTS at this point, (well soon-ish anyway, when you think doggo is suffering.) She is gorgeous by the way! 😍

I’m very grateful to say that my local vets have always been very understanding when my animals needed to be PTS. Even one that I called as an emergency and had never been to before, just did it first thing in the morning after I booked with no fuss at all and great kindness.

I’m eternally grateful for that: it had to be done and it was obvious it had to be done but it was no issue. They were so good that I changed the practice to them because they were nearer.

I have never had any problem and I’ve always been able to talk openly and frankly about timescales and identifying the right moment. I appreciate this is not everyone’s experience but I do have to record here that it has been mine.

I wouldn’t put a large breed 11yo dog through this for that sort of money. Realistically what’s the treatment going to be and what side effects would there be and how much time would it buy?

and I say this as someone who just spent nearly 2k on a 12yo dog with an acute out of hours event.

id concentrate on pain relief and quality of life.

Honestly, when my time comes I’d like to go like my last cat and dog. Still feeling okay much of the time but struggling a bit and feeling that this is not going to get better….. in my bed, drifting away after a good day filled with love and with my loved ones holding me…

Pet insurance now means owners are expected to pursue all avenues to treat old and sick animals, and programmes like Super Vet suggest that there are no hopeless cases. In reality I don't think this does pets or owners any favours in the long run. You love your dog and have given her a wonderful life. Do what you believe to be in her interests, which doesn't have to mean taking every course of action the vet profession can offer. You clearly have a good sense of proportion and understand the importance of quality over length of a dog's life. Trust your instincts and back yourself to make the right decision, irrespective of what the vet industry offers.

I did ask. It was a “no”.

It's very odd that they won't offer anything without scans
Our vets would have treated the seizures but said the side effects probably weren't worth it
She did have daily pain relief (Arthrocam (?)in case she was in any pain

OP are there other vet practices near you. Remember you can register at a new vet anytime. It would concern me that they are not prepared to do anything without a very expensive scan. I am always one to back a vet as I think they get a hard time on here and in RL as I fully accept vet care comes at a cost and isn’t like the NHS for humans but equally I would be happy to get another opinion or move vets if I felt pushed in a direction I thought wasn’t best for my dog.

This is absolutely untrue.

UK Vets would never ever be told they can't suggest PTS. That would be completely unethical and probably breaking animal welfare laws. At graduation vets swear to "protect the welfare of animals under their care"

It is not the general rule that vets "are obliged to push for tests"....I know some people feel they are being pushed.. but in reality good vets should discuss all the options available..from euthanasia to advanced tertiary referral.

A good vet should also guide the client with recommended actions appropriate for the pet, the client and the contexts. Vets are educated to make these recommendations and it's not fair to just lay the options out and say "you choose"

With respect to no treatment without a diagnosis...it depends on the treatment being considered. You wouldn't start a course of specific chemotherapy, risking serious side effects without a solid diagnosis.

Some Anti-seizure medications might be reasonable with good client discussions first.

What would be probable treatment and outcome from the possible tests? If costly invasive treatment leading to not a great deal of quality or length of life then what's the point? Why know if knowing creates steps that are unpalatable or undoable anyway?
It's so very hard and you have my sympathies but quiet a few people I know wish they'd gone sooner rather than later......

Many vets are massively over interventionist. I have many times been told by a vet what they suggest for my pet, then when I ask for a less invasive option to try first I’m given one, and it’s always cheaper. A vet wanted to X-ray my cat after cruciate ligament surgery as there was more movement than he wanted to see at two months in. I asked if this was free follow up to the operation. It was not. I asked what would be the outcome of the X-ray, would he redo the surgery. He said no, another month of rest. I said why not just do another month of rest then. Cat was fine. X-ray absolutely unnecessary. A bit of push back saved me hundreds of pounds. This is how many vets (organisations) operate nowadays.

Ask the vet for Metacam, its a total game changer. And don't forget paracetamol, which is very effective for dogs and cheap!

I agree to some respect regarding interventions, but this is not the same as saying vets are told not to offer euthanasia.

They are taught the "gold standard"...at university and so they should for full knowledge. Advanced care is now more readily available..referral centres, in practice CT scanners, many vets doing post graduate qualifications, dedicated night staff etc etc.

We want what is the "best" for our patients and that is not always gold standard...(a term I really hate) as it implies silver or bronze options are not also good and appropriate.

I would counter for every client who thinks the vet is doing the hard sell..there will be a client who says "I wasn't offered tests" "I was fobbed off" "they didn't even do an x-ray when the joint was wobbly after cruciate surgery". It sometimes feels like we can't do right for doing wrong 💔

Vets study science, but it's an art to communicate effectively. I would encourage owners to have honest conversations about their wishes, finances and attitudes to interventions. Give the vets a chance to work with you rather than assuming what they suggest is down to greed.

If silver or bronze approach is taken, the costs, risks and outcomes (like with gold standard) should be discussed as they will be different.

Well done for communicating your wishes to your vet and being comfortable with a more conservative wait and see approach.

I wish more people would speak up than assume the worse of their vet

Your vet was probably concerned that the surgical outcome of a procedure (they were responsible for) wasn't ideal - not a nice feeling at all! they probably wanted to check for other other issues...I know this is what I would feel rather thinking "kerr -ching!"

Glad your cat is well :)

Help please. Am I giving up on man’s best friend? AIBU to think the vet has done a total u-turn on appropriate treatment options?

I am really sorry you are in this situation, but I think you are being unreasonable to think the vet has done a U-turn on treatment options. The dog's old, the vet isn't sure what's wrong with her. There are several options to pursue, and the vet isn't sure which is most likely. They've given you the options of different tests which might identify the cause, that cost different amounts. There's no U-turn there. It's what many people go through when waiting for a diagnosis from symptoms that are quite wide ranging.

I’m so sorry. You know where you are and if you need to hear that it’s ok to let go - it’s ok it’s time. Part of loving them is making the hard choices when they are too unwell to go on. Having recently been through this myself I can honestly say it’s the hardest decision I’ve ever made but also the kindest.

Like a lot of dog owners on this thread I would say better a week too early than a day too late. It’s hard when they seem generally content but remember that they don’t have any concept of death and they rely on us to make the best decisions for their welfare in the end.

Regardless of the cost I am not in favour of long drawn out treatment for elderly pets. They have a natural lifespan.

she said she was unable to say as it was not within her knowledge base. It’s specialist referral stuff.

That makes me really cross. Because an old dog is within her knowledge base.

Personally I would get a second opinion, you can treat without diagnosis.

I have a friend who was in a similar situation- much loved older dog, who had on off illness, but did have insurance and did all the treatment.She told me she very much regretted it. She had him in at the vet hospital with all the meds, the operation for cancer, everything The poor thing still suffered a lot and still died within a few months.
Its the hardest of choices- but with animals it’s often said it’s ’better a week too early than a day too late.’