Vet Times letter Feb 11th

Re: Vet Times letter Feb 11th

James Laidlaw — Sat, 09 Feb 2013 15:37:41 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="James Laidlaw"]Comprehensive Oral Health Assessment and Treatment. I think. Something that makes more sense than "a dental", or maybe not!? If you think £300 is unreasonable for a ga, denatal and some surgical extractions I think you should do a stint of locumming in London Town! You'd be surprised. Last time I had my teeth scaled and polished by a dental technician - note, not a dentist - was a few years back for £60 in south Devon. Add in a general anaesthetic, pre op bloods, IVFT, some extractions, local, pain relief, X-rays, suture material and where do you end up?

[/quote]

Leave out the prices in the Great Wen, 'cos they're different from everyone else.

Anyway, yes, you could probably easily jack it up to £250 plus VAT with all that, but this cat is said to have "gingivitis". And it can't be that bad, 'cos it's going to be cured with homeopathy!

[/quote] That's a shocking assumption to finish with for you Evelyn!!!

Re: Vet Times letter Feb 11th

Martin Whiting — Sat, 09 Feb 2013 15:14:52 GMT

[quote user="Michael Woodhouse"]

[quote user="Sarah Keir"]

Can a vet registered on the non-practising register diagnose and treat with 'medicine'.

[/quote]

Diagnose - no, but someone has already done that.

Sugar pills are not medicine.

[/quote]

It's an interesting point, but the VMR 2011 are quite clear and simultaneously ambiguous!

To diagnose and treat you must be a practicing vet (thats from the Vet Surgeons Act) but does Homeopathy count as a treatment? Well according to both the RCVS and the VMD yes it does. The RCVS say for anyone to treat with homeopathy they must be a practicing vet. The VMD stipulate in Sched 4 of VMR 2011 the certain types of homeopathy that may be given by anyone and those that must be given by a vet.

So the views of the VMD and the RCVS are slightly conflicted on when a homeopathic remedy is given as treatment. Interestingly though, although all other medicines are about the prescription of them, homeopathy is catagorised by its administration.

Re: Vet Times letter Feb 11th

Evelyn Barbour-Hill — Sat, 09 Feb 2013 14:40:05 GMT

[quote user="james herriot lied"]Which brings to mind the apocryphal tale of the Brooklyn housewife who said, on being arrested for her husband's murder, 'Whaddaya mean, he's dead? I stabbed him loadsa times already and he never died before.'[/quote]

Oh yes. "He ran onto the knife accidentally. He ran onto it accidentally six times!" (Chicago)

Re: Vet Times letter Feb 11th

Evelyn Barbour-Hill — Sat, 09 Feb 2013 14:37:32 GMT

[/quote]

Leave out the prices in the Great Wen, 'cos they're different from everyone else.

Anyway, yes, you could probably easily jack it up to £250 plus VAT with all that, but this cat is said to have "gingivitis". And it can't be that bad, 'cos it's going to be cured with homeopathy!

Re: Vet Times letter Feb 11th

Iain McAllister — Sat, 09 Feb 2013 10:45:35 GMT

Am sure the VT editor is having a good chuckle over this - to be honest we have a very sketchy view of the facts concerning this pet - therefore it is not worth the debate - there are better uses of our time...

Re: Vet Times letter Feb 11th

James Laidlaw — Sat, 09 Feb 2013 07:44:09 GMT

Comprehensive Oral Health Assessment and Treatment. I think. Something that makes more sense than "a dental", or maybe not!? If you think £300 is unreasonable for a ga, denatal and some surgical extractions I think you should do a stint of locumming in London Town! You'd be surprised. Last time I had my teeth scaled and polished by a dental technician - note, not a dentist - was a few years back for £60 in south Devon. Add in a general anaesthetic, pre op bloods, IVFT, some extractions, local, pain relief, X-rays, suture material and where do you end up?

Re: Vet Times letter Feb 11th

james herriot lied — Fri, 08 Feb 2013 19:12:16 GMT

[quote user="Martin Atkinson"]

As for libellous - I've written far worse than that.

[/quote]

Which brings to mind the apocryphal tale of the Brooklyn housewife who said, on being arrested for her husband's murder, 'Whaddaya mean, he's dead? I stabbed him loadsa times already and he never died before.'

I just feel that if you want to take the guy to task for his letter - which was a bit of a curate's egg, to be fair - then you need to maintain a certain dignity; essentially, at the moment you're berating him for being a fraudster and a cr*p vet throughout his career (and as an aside, whilst his anaesthetic techniques forty years ago may NOW be outdated, forty years ago they probably weren't - so have a care on that accusation).

Very little positivity will come of being miserably uncharitable to an octogenarian; a pyrrhic victory at best and a moral defeat more likely.

Re: Vet Times letter Feb 11th

Evelyn Barbour-Hill — Fri, 08 Feb 2013 18:49:56 GMT

[quote user="Martin Atkinson"] OK should be Dinovet.[/quote]

"Terrible vet" ??? Mixed Greek and Latin roots, though, not really approved of.

[quote user="james herriot lied"]Bearing in mind that the original letter is in a veterinary journal,[/quote]

No, it's in Veterinary Times

Re: Vet Times letter Feb 11th

Cat Henstridge — Fri, 08 Feb 2013 16:14:19 GMT

Maybe what we should also be discussing from this weeks VT is the news that two more universities are considering opening a cash cow veterinary school now Surrey has broken ranks and also the letter pointing out the PSS has very little effect on clinical standards.

Quite an interesting issue this weeks!

Re: Vet Times letter Feb 11th

Martin Atkinson — Fri, 08 Feb 2013 15:57:02 GMT

[quote user="james herriot lied"]Martin, you really oughtn't to send that letter: it's actually pretty dismissive, offensive and somewhat libellous. [/quote] It was meant to be dismissive if not overtly offensive because the writer's letter was thus. As for libellous - I've written far worse than that.

Re: Vet Times letter Feb 11th

Martin Atkinson — Fri, 08 Feb 2013 15:53:52 GMT

[quote user="bob lehner"]

Good letter from Mr A - but what is a 'Dynovet' - is it something very dynamic as in ' Dyno-Rod' (doesn't seem quite right in this context) - or perhaps pertaining to ' Dynosaurs' , (or even 'Dinosaurs' )?

[/quote] OK should be Dinovet.

Re: Vet Times letter Feb 11th

james herriot lied — Fri, 08 Feb 2013 15:51:00 GMT

Martin, you really oughtn't to send that letter: it's actually pretty dismissive, offensive and somewhat libellous. Bearing in mind that the original letter is in a veterinary journal, it might also be somewhat redundant to reply. The vet in question may well have been a very good and valued member of the profession whilst in practice and although I take some exception to his letter, I'd be minded to follow the GtoPC in terms of not making such disparaging or personal remarks in your reply.

On here, completely different set of rule, obviously

Re: Vet Times letter Feb 11th

bob lehner — Fri, 08 Feb 2013 15:21:48 GMT

Re: Vet Times letter Feb 11th

Bob Russell — Fri, 08 Feb 2013 15:06:50 GMT

Homeopathy is a philosophy not medicine.

A diagnosis makes little or no difference to the success of treatment (according to all proper papers). The danger lies with the gullibility of individual clients who may delay or not give the best conventional treatment available.

I have recently lost a client because I advised them to keep their insurance money for proper treatment rather than bulls*it with sugar pills. The dog has a high grade (behaving) mast cell tumour on its leg and the homeopath suggested amputation!

I am not sure what the homeopathic technique is for amputation! Fortunately the dog is now in the hands of a colleague I trust at another practice in the area so I am sure it will be treated appropriately!

Re: Vet Times letter Feb 11th

Evelyn Barbour-Hill — Fri, 08 Feb 2013 14:55:32 GMT

[quote user="James Laidlaw"]

[quote user="Evelyn Barbour-Hill"]

I'm just baffled by this £300 "treatment" for "gingivitis" .

[/quote]

Well, it is a second hand comment from a disgruntled client via a vet who doesn't really believe in medicine, so I would assume this may more relate to COHAT as they say in the US of A. Might include extractions and could be quite reasonable depending on where in the country they are.

[/quote]

COHAT? Please translate, if it's not obscene

Gingivitis doesn't require extractions. Even if it did, it would be quite creative to get the cost to £300.

Re: Vet Times letter Feb 11th

Sarah Keir — Fri, 08 Feb 2013 14:50:58 GMT

Martin, I was going to write in here that I couldn't read you letter due to it being cropped but actually it is now fully readable - is this a formatting problem?

Is this vet acting illegally? Mr Francis Hunter is on the non-practising list (checked on RCVS website) but is now recommending a course of treatment. Is this allowed? I know homeopathy is a placebo but homeopathists peddle it as a medicine therefore should they not have still be practising members?

Re: Vet Times letter Feb 11th

Martin Atkinson — Fri, 08 Feb 2013 14:40:25 GMT

I'm already on the case, here is my reply to the Vet Times:

Dear Editor I read Francis E Hunter's letter (Feb 11, 2013 edition) first with some sympathy, then anger and finally disbelief. I initially wasn't going to respond as it barely deserves a reply and thought that I should really feel sorry for an octogenarian 'dynovet' and dismiss his ramblings but finally felt I had to put finger to keyboard. Francis has a point with the potential for vets over-charging to make up for drop in footfall and this does occur but in reality the figures he was quoting, although a little over what I would charge, are not outrageous and let's not forget there as many vets doing the opposite - charging loss leader fees, cutting corners and practising 'stack 'em high and sell 'em cheap' tactics to get bums on seats. He then started to fall apart with his assertion that old cats shouldn't be given anaesthetics because 'they die 3-4 weeks later'! Well maybe they did in your day Francis but that was because you used outdated anaesthetic techniques and didn't perform the blood tests you're so opposed to and thus didn't find the old cats had renal disease so your poor fluid and anaesthetic management compromised their renal perfusion and you tipped them into renal failure. Things then went from bad to worse with the suggestion that homoeopathic medication could treat hyperthyroidisn and severe periodontal disease. Who is the one conning the client now I ask? We've gone from supposedly rip-off prices for good practice to misleading and falsely raising expectations by purveying snake oil. At 63 I may be getting to dynovet status myself soon but thank God I still practice honest, quality medicine. Leave veterinary practice to those who know what they're doing Francis and keep your quill in the drawer where it belongs.

Re: Vet Times letter Feb 11th

James Laidlaw — Fri, 08 Feb 2013 14:11:41 GMT

[quote user="Evelyn Barbour-Hill"]

I'm just baffled by this £300 "treatment" for "gingivitis" .

[/quote]

Re: Vet Times letter Feb 11th

james herriot lied — Fri, 08 Feb 2013 13:39:42 GMT

[quote user="Evelyn Barbour-Hill"]

I'm just baffled by this £300 "treatment" for "gingivitis" .

[/quote]

Me too. They must be cutting some big corners if they can afford to offer it at that price. I bet they're not even doing weekly x-rays for that.

Re: Vet Times letter Feb 11th

Jo Cobbett — Fri, 08 Feb 2013 10:59:45 GMT

I've just read this letter, and when I reached the bit about homeopathy I started laughing. One of my colleagues immediately said "are you reading the homeopathy letter in the Vet Times?". This would be the only suitable response if it wasn't so sad that the cat is now no longer receiving appropriate treatment.

I suspect the original vet listed the options, including thryoidectomy at £430, but I would surprised (and disappointed) if they told the owner that this was the only option.

Re: Vet Times letter Feb 11th

Mark Frost — Fri, 08 Feb 2013 10:21:38 GMT

I was also pretty annoyed by this letter.

As pointed out by the OP here, did the letter author request a history from the original vet? We all know that the clients view and clinical record often don't match (and it is absolutely our challenge in communication to try and make sure they DO match), and that is why communication between professional colleagues is so important before providing an opinion, (especially a negative one). If the cat was mine, I would follow likely follow the course of action recommended by the original vet (depending on the actual findings), however I would give an owner all of the options and help them make the decision that is right for them and the cat. Not everyone can afford every options, however it isn't my job to decide who can and who can't.

I thought the letter was a little misguided initially but with the remarks regarding homeopathy I lost all interest - I fail to see how someone who can sell (I assume he didn't work for free throughout his career) a treatment with such a lack of real evidence can comment on anyone else's income. I occasionally use treatments that don't have the base of evidence I would like, however I don't pretend they are something they are not and give the client a balanced view on the pros/cons depending on the situation.

Re: Vet Times letter Feb 11th

CatherineThomas — Fri, 08 Feb 2013 09:53:10 GMT

[quote user="Clive Ansell"]

[quote user="Mark Holmes"]

If stabilising a cushings dog, 4 weekly ACTH stimn tests?

[/quote]

But Its a cat with hyperthyroidism, why a monthly blood test and why £100 (if indeed it is)

[/quote]

If it's an unstable hyperthyroid cat it would need monthly blood tests. Our charges for felimazole monitoring come to about £70 including a sampling fee and the lab fees for T4 and basic biochem. If the cost of the felimazole or vidalta is added in it would be over £100.

Re: Vet Times letter Feb 11th

Bob Russell — Fri, 08 Feb 2013 09:36:22 GMT

Hyperthyroid monitoring can be adjusted to owners finances. The cheapest can be done by the owner at home - appetite monitoring and weighing the cat. Money is better spent on medication even if supervision is this basic.

Presumably if the operation takes place the blood tests will need to be done less frequently!

Homeopathy of course is as safe (or dangerous) in unqualified as qualified hands.

i suspect this was a vet offering all the options and estimates to someone who did not take it all in and assumed these were recommendations for treatment not 'choices'. One of the dangers of being 'open and honest about prices and options' leading to confusion. On the other hand it may have been profiteering!

Re: Vet Times letter Feb 11th

Clive Ansell — Thu, 07 Feb 2013 22:45:54 GMT

[quote user="Mark Holmes"]

If stabilising a cushings dog, 4 weekly ACTH stimn tests?

[/quote]

But Its a cat with hyperthyroidism, why a monthly blood test and why £100 (if indeed it is)

Re: Vet Times letter Feb 11th

Evelyn Barbour-Hill — Thu, 07 Feb 2013 22:26:51 GMT

I'm just baffled by this £300 "treatment" for "gingivitis" .