The Canine Annual Exam One of the most difficult questions we are asked at Dogwood Vet Clinic is how much does an annual exam cost. That’s an easy answer, $39.50, but what you really want to know is how much does the total visit cost. The answer to that question is the one that applies all too commonly in medicine, the one we love to hate, “it depends”. Why is there so much variety in the cost of an annual? Let me walk you through the recommended testing and vaccination options for pets here in Louisville and Prospect, Kentucky and help shed some light on what goes into your pet’s annual visit! We’ll start just with dogs on this post to keep this post as short as possible, but we will have a second post for the cats soon! The Exam This is the most important part of your visit! Our pets can’t tell us what is going on, but there is so much we can detect from a physical exam. In one year, your pet ages 5-9 human years (1-year old pet ~ 7-year-old child). For this reason, we recommend twice annual examination to help us detect abnormalities early, manage conditions or even better, prevent them. Many pet owners have had the heartbreaking experience of having a pet diagnosed with a serious disease that put their pet in critical condition requiring emergency care. These pet owners can attest to how quickly some of these conditions can manifest. Performing an exam every 6 months increases our chances of detecting disease processes early and managing them so that hopefully they don’t lead to a medical crisis for your pet. We consider pets to be adults by age 3-4 and entering the geriatric stage by age 7. We will discuss what tests are best for your pet to keep him or her healthy, active and happy. Together we will come to a decision that works for you and your budget. Fecal Intestinal Parasite Test This a perfect time to introduce an important term to us as veterinarians and to general public health. Some of the most commonly diagnosed intestinal parasites (better known by some as worms) are zoonotic; this means that the disease can be transmitted from animals to people. When these parasites are in an unfamiliar host, such as a human, they can undergo what we call aberrant migration and move from the gastrointestinal tract to dangerous locations like the eye or the brain. All dogs need to be on monthly intestinal parasite prevention not just for their health but also for yours. Although we think this is extremely important for all pets, we stress even more the importance of parasite screening and prevention in households with children. We follow the guidelines of the Companion Animal Parasite Council which recommends 4 intestinal parasite tests in the first year of life and then twice yearly thereafter. 4DX Heartworm, Erlichia, Anaplasma, and Lyme Test Heartworm disease could, and should, have its own blog post. But we’ll just go over some of the nuts and bolts of the disease. An annual heartworm test is recommended for all canine patients as well as monthly heartworm prevention. Heartworm disease is transmitted by mosquitos, and although yes, there are less mosquitos in the wintertime, we all know with the temperate weather we have here in Louisville and Prospect, Kentucky there is the occasional 50, 60 even 70 degree day during the winter months. One bite from a mosquito is all it takes for your dog to get infected. Heartworm disease can potentially be fatal or shorten the lifespan of your pet due to the cardiovascular insults it causes. An annual screening for heartworm disease makes sure that heartworm positive dogs get the proper treatment and care before serious, long lasting, non-reversible damages are done to the heart. Annual Heartworm testing is considered a minimum requirement for proper care of your dog at our practice. We purchase tests that also test for common tick borne disease as we think it is best medicine to test for these diseases as well. As mentioned in our Tick Season blog post, these diseases can cause a variety of clinical signs including, but not limited to the following: paralysis, fever, lethargy, inappetence, arthritis of multiple joints, and multiple organ dysfunction. Rabies Vaccine Most of us know that rabies vaccination is an absolute minimum requirement for our pets and is required by law. Rabies is another zoonotic disease. Another important descriptor of rabies is that it has an almost 100% fatality rate and still today 1-2 humans die per year from Rabies in the United States. So, it’s a no-brainer than your pet NEEDS to be vaccinated against rabies! But one thing you may not know is that depending on your pet’s age he or she may be able to receive this vaccine every three years instead of annually, bringing down the cost of your yearly visit for two years following the administration of the three year vaccine. DAPPv- Distemper, Adenovirus, Parainfluenza, and Parvo Vaccine I’ll refrain from going in too much depth about these diseases. This is a combination vaccine, one shot that protects against these viral diseases. The big one that most people are familiar with is parvovirus which is highly contagious and can be fatal. The same is true of distemper and adenovirus (also known as canine hepatitis). Distemper virus can attack most systems in the body, even causing neurologic disease, including seizures. This is a core vaccine, meaning the American Veterinary Medical Association (AVMA) recommends that all dogs be vaccinated against these diseases. Like the rabies vaccine, this vaccine can be given every three years based on the age of your pet bringing down the cost of your visit the following two years after its administration. Bordetella/Parainfluenza Vaccine Bordetella is commonly known as “kennel cough”. The difficult thing about a pet showing signs of upper respiratory disease, cough, lethargy, fever, etc. is that it is impossible to know if these signs are caused by Bordetella, Flu, Parainfluenza, or even a combination of any of the three. Although not classified as a core vaccine by the AVMA, at Dogwood we require that pets coming into our hospital receive this vaccine to prevent our hospital from become a center of disease transmission. Dogs that encounter other dogs at all, go to the dog park, grooming salon, boarding facility or even the pet store absolutely need to receive this yearly vaccine. Flu Vaccine Many people in Louisville, Kentucky are aware of the outbreak of Canine Flu that initiated in 2017. This is the third respiratory virus that was mentioned above that is often a player in pets with upper respiratory clinical signs. This disease is highly contagious, and it is now usually required by boarding and grooming facilities that your pet be vaccinated yearly against this disease. The good news is that if your pet is showing respiratory signs and we have vaccinated you pet for these potential causes in the last year, the vaccine company will cover the cost of testing and treating your pet. Leptospirosis Vaccine This is another zoonotic disease, which always catches our attention as veterinarians. Traditionally the most common method of transmission of leptospirosis was through infected rodent’s urine contaminating bodies of water, so we worried more about dogs swimming at the lake, who went hiking often or who lived in moist environments. However, lepto can also be transmitted through the soil. Recently we have been seeing more and more cases in toy breed dogs that don’t swim at the lake or hit the hiking trail and there is currently an outbreak in Arizona, which is not the usual moist environment we associate with this disease. Leptospirosis causes acute kidney failure in 80-90% of dogs showing clinical disease, and although the bacteria is treatable, this depends on the degree of kidney damage that has occurred at the time of diagnosis. For a pet that is infected treatment will be expensive, as it will require aggressive supportive care and isolation at a veterinary hospital to prevent disease transmission. This is not considered a core vaccine by the AVMA, but given the severity of the disease, its zoonotic potential, and the high level of effectiveness of the vaccine, we recommend this yearly vaccine for most pets we see at Dogwood Vet Clinic. Lyme Vaccine The prevalence of ticks has been on the rise in the Ohio River Valley, affecting us here in Louisville and Prospect, Kentucky. Although most pets living near our hospital are not living in heavily wooded areas, we do know that recently lyme disease has been diagnosed in some pets living in our suburban area, so we know that it’s here. The flea and tick prevention we most commonly recommend, Nexgard, is approved by the FDA for prevention of Lyme disease. We only recommend this vaccine for dogs that hike, live in proximity with wildlife, and have a high exposure to ticks. Monthly Heartworm, Intestinal Parasite, Flea, and Tick Prevention I’ve mentioned the importance of prevention in earlier parts of this post, but it is certainly important enough to have its own section. Heartworm disease is potentially fatal and easily preventable. The prevalence of heartworms in Kentucky is not as high as in the deep south, however, should your dog become infected, he or she is 100% yours and the statewide percentages and numbers become irrelevant. With the same monthly medicine that prevents Heartworms you can prevent zoonotic intestinal worms. This will keep us all safer with a higher level of public health, plus it comes in the form of a tasty treat that most dogs love! Fleas and ticks, need I say more? No one wants fleas or ticks on their pets, in their homes or on their beds and furniture! These parasites can cause diseases for everyone in your house, and this risk increases dramatically if your pets are not on monthly prevention. But don’t worry, with Heartgard and Nexgard you are eligible for rebates that will help make taking good care of your pets affordable! We’ve finally reached the end! I’m blue in the face just thinking about trying to explain all this great information to you during a 30-minute appointment slot! Hopefully now you can understand why there is so much variation in cost. We let you know which testing and vaccines we recommend based on your pet’s lifestyle and needs and then together we come up with an individualized plan that works best for your pet and your budget. At Dogwood Veterinary Clinic we want you to fully understand what we are doing at each visit and why we are doing it. Hopefully this will help you to value the care we provide and help you to see that we just want to keep you, your family and your pet happy and healthy! Come see us at Dogwood Veterinary Clinic and we are happy to come up with a health care plan for your pet.