Thinking of brightening up Lockdown 3.0 with a puppy? Perhaps read this first.

Bloody hell, yes I think we are all glad to be seeing the tail end of this car crash of a year. Such a shame about Christmas, isn’t it? We were SO looking forward to just a bit of normality, but oh well. It is what it is. At least Bill Bailey won Strictly – did you see it? Brightened up a dire evening didn’t it?

Ah, you are thinking of getting a dog – I never saw you as a doggy person! Ooh – a cockapoo! Great! Do I have any advice, as your only vet friend?

Well, firstly, please DON’T call it Teddy. I’ve vaccinated at least 15 of those since lockdown 1.0. Ha! Oh, any genuinely useful advice? Okay. Well, where to start? I think we know each other well enough to drop the filters. So here it goes.

You need to decide whether you really want to get a dog in the first place. Yes we all want a paw to clasp right now; COVID-safe contact from a fellow mammal: something we have all been deprived of! Affection without conditions (other than edible ones!). A reason to get out of the house, to pound the pavements, and explore forests, fields and reserves. Yes it sounds trite – but unconditional love is what everyone wants right now and is precisely what a dog can offer.

But think about this: would you have got a dog a year ago? If you didn’t think you were in a position a year ago to get a dog, will you be any more able to look after one once normality returns? When you aren’t working from home, and have a more enviable social calendar? And what might your lifestyle look like in 5, 10 or even 15 years time – will a dog still fit into your life still then?

Cockapoos are intelligent and energetic dogs. It’ll need to be walked twice a day – come rain or shine, including those dank, dark, Autumn mornings, and the nights you get home from work and just want to collapse on the sofa. You’ll have a school run to do before long. And won’t you both be out of the house most of the day? You would need to consider paying a dog walker or doggy day care if it’ll be on its own most of the day.

Looking after a puppy is a huge time commitment. It’s really important to get training right – obviously toilet training and teaching commands etc. But things can go very wrong: you don’t want a dog that rips apart furniture and barks relentlessly when you leave the house – a sure fire way to upset your new neighbours. You need to put in the work to make sure it doesn’t end up aggressive towards other dogs, or children. Some dogs cannot be trusted alone with children – it takes time to get it right, and a small number of dogs can become a problem despite your best intentions. Like all vets, I’ve had the heart-wrenching task of euthanising aggressive dogs – most of the time nobody intended the dog to end up that way. Clearly that is the absolute worst case scenario.

Then there’s the financial commitment. The upwards of two grand you would likely pay for the puppy is just the very start. Obviously you’ll need to pay for food – though this can end up being as costly as feeding a child when it comes to some of the more premium foods on the market. There’s the cost of dog walkers and training classes. It’ll need regular grooming – the average dog groom is more expensive than my hair cuts at the barbers!

Who will look after the dog when you go on holiday? Paying for kennels or a ‘home from home’ type arrangement can be pricey. Thanks to Brexit, as of January it’ll no longer be as straightforward as it has been to bring a dog along to Europe on your holidays. Each time you want to take your dog into the EU, you would need your vet to issue a new Animal Health Certificate.

On the subject of vet bills, you’ll need to think about preventative healthcare; annual vaccinations and health checks, as well as neutering and preventative flea and worming treatment all add up. And what about if they fall ill? It’s a personal choice whether or not you decide to get insurance (though I would advise that you do). If you do, remember the premiums will always go up, not down. They might be £30 a month now, but when they get to old age, there’s a possibility you’ll be paying more for pet insurance than your home, life and car insurance combined!

This is for good reason; there is no NHS for pets. If things go wrong, it is your responsibility to pay. And private healthcare has an expensive price-tag. If your dog decides to swallow a stone, you could easily end up paying £2000+ for surgery and treatment. It is not uncommon for dogs to rupture cruciate ligaments in both knees over their lifetime, requiring surgery. An MRI scan and surgery for a slipped disc: £4000+.

Even treatments for skin allergies, which are unfortunately very common in cockapoos, can be very costly in the long term; one of the gold standard treatments is a monthly injection which costs about £100 per treatment. Sadly, many are unprepared for these sorts of costs for common problems; and although there is often a cheaper option, in many circumstances a cheap option simply does not exist.

A dog cannot brush their own teeth – you really ought to try to get into a habit of brushing their teeth from a young age. Yes perhaps it does sound ludicrous – some days I barely remember to brush my own. But if you don’t, you are likely to have to pay for multiple general anaesthetics for dental procedures, adding up to hundreds or even thousands or pounds over the dog’s lifetime, to properly clean the teeth and extract ‘rotten’ ones.

Where are you thinking of getting him from? You must extremely careful when searching online. Don’t get Petfished! It is now illegal to sell puppies from a puppy farm. However, sadly it’s just far too easy to fall prey to unscrupulous dealers masquerading as breeders on the web, taking advantage of lockdown restrictions and high demand. Partly it’s an ethical issue – the breeding bitches and puppies can be kept in really awful conditions. But there’s also a very real chance you could end up buying a pup that falls ill almost immediately with an infection like Parvovirus, and if this is the case you could easily end up with a substantial vet bill and a dead puppy.

Although he might look adorable in his weekly posts to his doggy friends on Instagram when he is fresh and new, one day he will be a doddery, possibly quite smelly and/or incontinent elderly dog, whose quality of life is your responsibility to look after. It is a privilege and a joy, but it is also a very significant commitment in terms of time, finances, and emotion to own a dog.

Oh no, I’m sorry I didn’t meant to put you off! Yes, perhaps best to wait a little while before making any decisions. See how 2021 pans out!

Animal charities are predicting a dog welfare crisis over the coming year. A wagging tail might sound like the easy remedy to the dud hand 2020 has dealt us, but a dog is not just for lockdown. It can be a pleasure to share your home with a dog, and if you are prepared for all of the above, then go ahead and enjoy having a new family member. But nobody should ever buy a dog on impulse.


‘Rip off’ veterinary drug prices are harming profession’s image

Recently there have been a flurry of articles in the media highlighting the escalating cost of veterinary care, and the barrier this can create in treatment of our pets. Last month there were two such pieces in the press; Would you pay £20,000 to save your pet’s life? in the Daily Mail, and an article by Rachel Johnson in The Spectator, which painted a very unflattering image of vets as mercenaries, holding pet owners ‘over a barrel’.

In a previous blog post I tried to address some of the misconceptions the general public has about the real cost of medical care for pets. Much to my surprise, the post went viral, with over 140,000 views in just a few days.

I was flooded with messages from pet owners, which I was very glad to see were overwhelmingly positive. The majority of those commenting and messaging me recognised the dedication and hard work of those within the veterinary industry, and were cognizant of the financial responsibility that accompanies pet ownership.

On the whole, those who responded to the article were accepting of the reasons veterinary care costs what it does. However, one topic cropped up again, and again. The cost of medications.

One day a couple of weeks ago, I was going through the list of prescriptions at a practice I work at regularly as a locum. A client had requested a 180ml bottle of Metacam, a liquid anti-inflammatory pain killer, for his elderly arthritic Labrador, which had been on the medication for several years. The cost of the medication to the client was over £100. Out of interest, I looked up the cost from an online pharmacy. Animed sell the same size bottle for £19.99: that’s an over 400% difference in price. I cringed.

And that’s not a unique example, by any means. A 3.5 gram tube of Optimmune, an eye drop licensed to treat dry eye in dogs, can be purchased for £30.16 online, but as far as I can recall is sold for at least £70 in every practice I have worked in as a locum (please note I do work in London and the South East so prices may be a little cheaper elsewhere). Advocate, a spot-on used for parasite prevention starts at just over £3 per pipette online; you’d have to add a good tenner on to buy the same pipette from most veterinary practices.

For some medication (generally speaking, the cheaper ones), there is little difference in price between veterinary practices and online, where medication can be purchased using a prescription obtained from a vet. But for the overwhelming majority of more costly medications, the difference in price is eye-watering. So much so, that even with a staff discount, many members of veterinary staff who I know purchase their own pets’ pills online, not from the practice they work at.

In simple terms, the reasons for this disparity are twofold:

  1. Many veterinary practices do not have the purchasing power to even BUY medication from a wholesaler at the prices online pharmacies SELL it for. So they could never compete on price with the online pharmacies, even if they sold at cost price. Individual small veterinary practices inevitably do not sell anywhere near the same volume of medication as the online pharmacies. So infrequently used medications that are kept in stock often go out of date, and have to be disposed of.
  2. Traditionally, large mark-ups on medication have been used to cover the very high costs of running a veterinary practice.

So there are legitimate reasons for marking up medication prices – the cash paid doesn’t just line the pockets of practice owners.

But the issue is that the business model pre-dates the arrival of the online pharmacies, which have now been on the scene for years, and look to be a very much permanent fixture. Providing veterinary pharmaceuticals used to be the unique domain of veterinary practices, but that is no longer the case. However, practices are still reliant on money made from selling medications to subsidise other fees; prices for neutering procedures for example are artificially low. Most practices don’t make much, or any profit from spaying cats, and castrating Cockapoos; they charge low fees for these procedures to get the clients and their pets registered with them, and not with the competitor practice (of which there are often many).

What is clear, is that we are not currying favour with the public on this issue. The topic has been the subject of features on Watchdog and Rip Off Britain in recent years, and on these occasions, spokespersons for the profession have leapt to our defence to explain the above reasons for the price difference. The issue is then swept under the carpet for a bit longer.

Prescribing medication appropriately and safely, at the correct dosage is a service provided by a vet that requires knowledge. It is more convenient to get medication immediately and not go through the rigmarole of scanning prescriptions etc. A mark up to account for this is reasonable. But the medication itself is a product like any other. Let’s use apples as as an example. Most people know roughly how much apples should cost, and where they can go to buy them. Say Sainsbury’s were selling a bag of six Granny Smiths for £5, nobody would buy apples from them. £5 is absurdly expensive for a bag of apples – shoppers would feel ripped off. They would head to Tesco, or Asda, or even a corner shop where they are nearer to £1.

Returning to the Metacam example, the practice won’t have been able to purchase the Metacam for £19.99. So it isn’t comparing apples to apples. But it would have paid in most instances under £40 from the wholesaler. The problem is that, unlike with apples, most pet owners would have no idea what Metacam should cost, and many, though a shrinking number, haven’t even heard of the online veterinary pharmacies. So many will just pay over £100 for the bottle, unaware that there is an alternative; that they could pay for a written prescription from the vet (usually £15-20 approx) and save a tidy sum buying the medication elsewhere.

There are medications that veterinary practices will always need to stock that need to be used urgently, for example pain killers, and antibiotics. Waiting 2 days for delivery of ear drops for a dog with a painful ear infection is not at all desirable. But I personally am finding myself cringing more and more often when prescribing medications at substantial mark ups when it could conveniently be purchased by the client elsewhere for a much lower price. When I know that in their shoes, I would be doing just that.

Veterinary practices are required to display a poster stating they can provide written prescriptions, and most vets will happily write prescriptions when requested to do so. Generally speaking I proactively offer written prescriptions, particularly if the pet owner expresses concerns about cost, but don’t always remember to do so, particularly when in a rush. It can feel very uncomfortable breaking the news to a client who has been purchasing medication for their pet’s chronic health condition from a practice for many years, that they could have been saving hundreds of pounds. Likewise, pet owners whose companion is just starting long term meds can react with confusion when I tell them they can make big savings buying online.

There are also some, particularly the elderly who may not be internet-savvy, for whom ordering online is not a viable option. Fine, veterinary practices cannot to match online prices for them, but it does not sit well with me that they have no option but to pay the large mark-up, which may render the medication unaffordable to them.

I should say that there are many clients who are able to and more than happy to pay a premium for the convenience of getting medication immediately from their vets, even when provided with a cheaper alternative. But the situation is confusing and laborious to explain. It certainly does not invite trust.

The profession is suffering from an image crisis, and I can’t help but concur with pet owners who feel that drug mark-ups are excessive; viewed from an outsider perspective, it’s all just a bit murky, when we should be aiming for transparency, and it encourages ‘vet-bashing’. The veterinary industry should not feel apologetic for charging appropriately for its services. But in my opinion, charging £100 for a product, a painkiller, that can be purchased elsewhere for £20 does has a welfare impact; it creates a barrier to appropriate treatment that needn’t be there.

The reality is that if practices start selling medications with lower margins, other prices, such as consultation fees, would have to increase an equivalent amount to cover the losses, so veterinary treatment won’t be cheaper overall as a result. And some have concerns that increasing consultation fees could discourage people seeking veterinary attention if their animal falls sick – far from ideal either.

The whole industry would have to coordinate this change; it can’t be done by individual practices. But perhaps we need to adapt, to move with the times and change the status quo when it comes to these fees.

Source of featured image: Pixabay

Are pet owners in denial when it comes to flat-faced dogs?

Photo by, CC0, via Wikimedia Commons

Earlier this week, I found myself pausing to reflect in the middle of the 6.30pm appointment, which was with Flo, a sweet-natured ten month old English Bulldog who I had not previously met. Flo gazed at me with her big hazelnut eyes, fixated alternately on me, and then determinedly back to the dehydrated chicken treat in my hand. Her tongue lolled out to one side as she panted, such that it looked as though she was grinning at me. Distraction worked wonders, and she sat calmly as I started to examine her.

Her owner had brought her to me because she had been extremely itchy for several months. They had tried various shampoos purchased online, but nothing had seemed to make any difference.

Little Flo’s skin was in an awful state. Her extremely flattened face meant that she had deep folds of skin under her eyes, which were raw and moist due to infection. She tried to yank her leg away in pain as I examined her the very sensitive skin on her feet, which was scarlet red between her pads. Her ear canals were swollen and clogged with thick brown secretions. But by far the worst affected area was her tail; I couldn’t help but reflexively gag at the smell of the pus in the skin folds around her corkscrew tail, which was inverted into her rump. I did my best to clean the ulcerated skin with antiseptic wash as gently as possible, but struggled to get deep into the folds as it was just too uncomfortable for her. Cleaning her ears was a similarly painful affair.

As a reward for being such a cooperative patient, I placed a handful of treats on the floor in front of her. Her underbite was so extreme that, though she tried desperately, she just physically couldn’t pick the treats up, and so I placed them straight into her mouth instead. I felt a pang of despair for her.

‘Hello baby!’, her owner rejoiced as Flo bounded towards her, the sound of her nails scrabbling on the floor. I had to explain that unfortunately we could treat the infections, but not cure Flo of the root problems. Any allergies Flo had developed that were the likely underlying culprit for the sore ears and feet, would probably be a lifelong battle to control, and she would very likely need to be on some form of medication permanently in future. The skin folds would need to be cleaned daily for the rest of her life, but due to the depth of the folds around the tail there would be a high chance it would prove impossible to control the infection and keep Flo comfortable. This could leave no option but to amputate the tail. I could see in her owner’s eyes that she was heartbroken.

I couldn’t help but to continue to dwell on Flo after work that evening; I felt deep sadness for her. But also a profound sense of frustration; because I am sick of seeing dogs like Flo, who are born broken, and need to be fixed.

By the time I see these dogs as puppies, it is too late to tell their adoring owners that these breeds are plagued by health problems; that they should perhaps have thought more carefully before getting one. Because the dog is already part of their family.

Last month, the journal Nature published a study of a population of 22,000 dogs which demonstrated that brachycephalic (flat-faced) dog breeds, including English Bulldogs, French Bulldogs, and Pugs, were on average less healthy their counterparts; they were significantly more likely to suffer from eight of thirty common disorders than non flat-faced breeds. Of course this is just on average – there will be variation within a breed and some individuals will be fortunate and not develop any medical issues that require treatment.

The reason the study is significant, is because it is is the largest study of its kind that shows in black and white that the decision to buy a brachycephalic dog, is a decision to buy a less healthy dog; and that has serious welfare implications.

The popularity of these breeds has soared astronomically in the past decade or so; in the past 2 years the French Bulldog has dropped on and off of the top spot of the list of most popular dog breeds registered with the UK Kennel Club. They are all over YouTube and Instagram; The Beckhams, Lady Gaga, Leo DiCaprio, Dwayne Johnson and Reese Witherspoon all have posted photos of themselves smooching their French Bulldogs, and the net result is that these breeds are considered fashionable.

I can see why they are so popular; they are very sociable dogs, and have great personalities. One just can’t help but be entertained by their variety of facial expressions. As a result of evolution, the human brain is hardwired to be drawn in by round faces and big eyes. These are juvenile features that stimulate the release of hormones such as oxytocin from the brain, which encourage us to be protective of our human offspring. One explanation for the popularity of the flat-faced breeds, is that they hijack these inbuilt pathways. Whether consciously or subconsciously, we treat them like our babies.

But the very features that make us humans find these dogs so adorable, are the ones that make them inherently unhealthy. With selective breeding, over time we have shortened their skulls to the extreme. As a result of having bulging eyes, and often abnormal eyelids, they are 11 times more likely to suffer from corneal ulcers, with pugs being a massive 19 (YES, 19!) times more likely to develop them than the average dog. The most serious of these can result in loss of the eye. As a result of having such shallow eye sockets they can even develop exophthalmos; the eyeball literally pops out.

They are predisposed to spinal disorders, with a high incidence of intervertebral disc disease and they frequently are born with abnormal malformed vertebrae. This list of problems is not exhaustive; this review of insurance claims submitted to an American insurance company shows an increase in claims for a wide variety of health conditions for brachycephalic breeds compared to other breeds.

Their wide skulls mean that many have difficulties giving birth naturally as the puppies’ skulls are too large to pass through the pelvic canal. This is so common that many breeders opt to routinely perform an elective Caesarean section, before the dog has a chance to go into labour.

Many owners consider their noisy snorting to be ‘normal for the breed’. It might be what we have come to expect from these dogs, but that doesn’t mean it should be the norm. The snorting is noise created by resistance in their airways; their nostrils are too narrow, the bones in their nasal cavity are too crowded together and they have excessive tissue in their throats. Exercising is the last thing most you would want to do when you have a completely blocked nose from a cold – imagine having this permanently, as well as a throat which feels closed up; none of us is ever going to experience what it is like being one of these dogs, but that is how I imagine it.

This combination of extreme airway issues can lead to BOAS (Brachycephalic Obstructive Airway Syndrome). Dogs with BOAS cannot exercise normally. They often regurgitate food after eating, as the negative pressure they have to create in their chest just to be able to breathe normally sucks back up out of the stomach. We are increasingly recognising that they can suffer from sleep apnoea as a result, and the worst affected individuals can succumb easily to heat stroke in hot weather, and even develop a complete obstruction of their airways, resulting in death. Many of the most severely affected have to undergo major surgery to open up their airways; and this is just to afford them the luxury of breathing normally.

Broadly speaking, the lifespan of a dog correlates inversely with their body weight; smaller dogs live for longer. But brachycephalics live much shorter lives that other dog breeds of a similar size, with an average lifespan of 8.6 years, far shorter than the average 12.7 years.

The evidence is overwhelming. The majority of vets are on the same page on this, as are most organisations that have a role in animal welfare; the RSPCA, the British Veterinary Association, the Dogs Trust have publicly voiced their concerns about the serious animal welfare implications of the surge in ownership of these dogs. But yet these breeds remain extremely popular, and a study recently found that 93% of the owners of brachycephalic breeds would opt for the same breed again. So it doesn’t look like their popularity is going to reduce any time soon.

I certainly do not judge anyone who chooses to have a brachycephalic dog; I have friends who own them. But their popularity is part of the problem; so many people own these dogs that we have become blind to the issues they have. But we desperately have to improve the awareness of the health issues these breeds suffer from, and the very real implications this has on the dog’s welfare.

There are efforts by breed associations and the Kennel Club, such as the Respiratory Function Grading Scheme, that are aiming to reduce the incidence of health problems in these breeds. But the gene pool within these breeds is small, and there is only so much these sorts of scheme can achieve.

Flo demonstrates that just because a dog looks happy, that does not mean it is not suffering. A dog is not a small human, and is not psychologically impacted in the same way by chronic ill-health. They can’t become depressed contemplating the fact that they may never be able to breath normally, for example. But that does not mean they are not suffering.

In selectively breeding these breeds, we have created dogs who often have wonderful personalities, but unfortunately, on average, poor health. For me as a vet, it is crushing being faced with the health issues these broken dogs have every day, and simply having to patch them up. It is the dog that gets the bum deal – and the owner that gets a big bill.

I hope that most, confronted with the full picture, would think a bit harder before getting brachycephalic dog in the first place.

No doggy NHS – a response to vet-bashing

‘You vets do know how to charge, don’t you? Our last cat cost us a bloody fortune on treatment when it got cancer’, the barber told me, the clipper blade vibrating on my temple as he neatened my sideburn. ‘And they had the cheek to charge us when we had to have it put to sleep anyway’. I thought it wise to leave the seal unbroken on that can of worms. I had only had my hair cut two weeks prior, but being the eve of my wedding day, thought I would nip in for a quick tidy up, though I was beginning to regret my decision. Luckily my upcoming nuptials sufficed as an alternative topic of conversation.

By NHS England

What is for certain is that the people of Britain love their pets. We are gripped by the emotional stories of poorly pets on the various popular vet television shows that seem to be on at all times of the day. The iconic James Herriot made a return to screens last month in a brand new remake, achieving viewing figures Channel 5 has historically struggled to reach. ‘SuperVet’ Noel Fitzpatrick has sold out arenas with his live show.  But I find that in reality, the public have a rather more ambivalent attitude to the veterinary profession that cares for their furry companions. For many, their opinion of the profession is coloured by resentment at fees paid for treatment.

This was reinforced for me by a piece written by Rachel Johnson (sister of Boris) in the Spectator last week available here. In the article subtitled ‘are we being sold a pup when it comes to pet care?’ she told the story of how her adorable designer-crossbreed Cockapoo (the most ill-considered portmanteau ever?) became seriously unwell after making the unfortunate decision to swallow a peach stone. Undigestible, and too large make its way out the other end, it caused an obstruction in Ziggy’s intestines, requiring her to have emergency surgery and racking up a bill of £2500.

‘There is no market mechanism, no mix of public or private to keep any sort of lid on fees. Vets have you over a barrel’. My heart sank, because the allusion, put bluntly, is that vets are greedy. Do pet owners really feel like this – as if they are being held hostage in some way by their vet. That presented with an unwell pet and distressed owner, a vet’s intention is to extract as much money as possible? I really hope not.

Private vet fees are not cheap, but this does not mean they are poor value, or over-inflated. The trouble is, most of the UK population has no yardstick in terms of medical fees – we are blessed in this country to have the NHS and so most Brits will thankfully go their whole life without ever being presented with a bill for their own healthcare. Veterinary medical fees are significantly lower than what we would pay to ‘go private’. For the sum paid for Ziggy’s op, Rachel couldn’t have  afforded much from Nuffield’s menu of procedures if it were herself being treated; it wouldn’t cover half of the cost of a bunionectomy. It would enable Rachel to have 1.5 moles removed. Gall bladder removal would set her back £6415, and a hip replacement the princely sum of £13985. By comparison, Ziggy’s enterotomy was a steal.

The crux of the matter is that healthcare for a dog is not automatically cheaper to provide, just because the patient has a tail. While it still lags behind human medicine, the standard of veterinary care provided by your average local practice has advanced massively in the past couple of decades, and expectations of the general public have similarly soared. Running a vet practice is a costly endeavour.

Ziggy would have been looked after by a large team of nurses and vets, staffing the practice 24 hours a day during her hospitalisation. Part of the fee Ms Johnson paid would have gone to pay their modest wages, as well as those of support staff such as cleaners, receptionists and administration staff (for reference, most veterinary nurses earn little more than minimum wage, and the average vet salary package [which includes covering the cost of professional fees, insurance, and training] is £42K; substantially less than the £60-90K a human GP earns). There is the cost of all the consumables  – catheters, bungs, fluid lines, syringes, needles, suture materials, drapes, sterile gowns for the surgeons, all of the drugs. The hospital will have been kitted out with all of the expensive equipment utilised in her treatment – the X-ray machine, plates and processor, blood analyser machines, blood pressure monitors, the anaesthetic system, breathing circuits, anaesthetic monitoring equipment, suction, surgical instruments, theatre lights. £2500 sounds like, and is, a lot of money, but the practice is unlikely to have made much of profit margin on the cost of treating little Ziggy

Spending more time than ever confined to their homes, Brits have gone dog-crazy this year. The RSPCA reported earlier this month that Google searches of ‘puppies near me’ increased 650% during lockdown, and imports of dogs from abroad  more than doubled over the same period. With dog breeders swamped with demand, there seems to be no ceiling to what prospective dog owners will pay; a client I saw last week parted with £2700 for a poodle crossbreed puppy. For me, every day in August felt like a puppy-vaccinating groundhog day. And the wave of puppies continues to roll.

But a dog is not just for lockdown. Next year, when we with any luck reach a time when everyone is spending less time working from home, we are waist deep in a recession and the lockdown puppies are no longer puppies, the RSPCA anticipates we will be facing a welfare crisis, triggered by many being no longer able to afford, or having the time to care for their pets.

More times than I care to remember, I have had to manage heartbreaking situations where pet owners have been unable to pay for the cost of their pet’s treatment when they have fallen very ill. Economic euthanasia is an awful reality all vets have had to deal with on occasion. But it is wrong to lay the blame at the door of the vet profession. A dog is a luxury, not an entitlement. Nobody is forced to get one. If your dog eats a peach stone, and has to have it removed from its gut, it is your responsibility to pay for the surgery. There is no doggy NHS, and no such thing as free treatment, though it would make my job much easier if there were. So if you don’t think you can afford to pay for private healthcare for a dog, then you need to think twice about getting one in the first place.

The cockerpoo owners of 2020 want supervet standards for a bargain price, and meeting those expectations is a near-impossible, emotionally exhausting task, such that many disillusioned vets are calling it a day on their careers after just a few years. As a result of the high dropout rate, the profession has arrived at a situation where many vet practices are chronically understaffed. The drivers are complex, but tragically the suicide rate amongst vets is a shocking four times the national average.

Veterinary fees are expensive, and are likely to keep on rising. But let’s be clear; your average vet is not motivated to do their job for money. They do it, because they love animals – the same reason they dreamt of a career fixing poorly pets when they were bandaging teddies aged nine. Sadly, it transpires that money makes being a vet a very tough job for an animal lover.

An extract from this piece was included in The Spectator this week as a letter, responding to Rachel Johnson’s article.

Stop chopping dogs’ ears off

Attribution: American Bully Europa / CC BY-SA (

Ever seen a dog like this? Selective breeding has created enormous variation in appearance between dog breeds, in terms of size, shape, coat colour and muzzle length. But humans haven’t (yet) managed to breed a dog breed without pinnae (ear flaps). This dog wasn’t born without ear flaps – somebody cut them off.

The RSCPA has reported a massive 236% increase in reports of dogs with cropped ears in the past 5 years, and I certainly have seen a larger number of these dogs in practice. Actually, I had never a seen a dog with cropped ears until the past couple of years.

Why do humans crop dogs’ ears? Historically, it was considered by some to have preventative health benefits for working dogs, as smaller, less exposed pinnae were not so susceptible to injury. There is no reputable evidence to support this, and it is a practice that has been largely confined to particular breeds, such as the Dobermann, and not widely performed in all working dogs. However, the huge increase in the practice seen recently is not in working dogs; it is in pets, particularly the ‘American Bully’ type and Cane Corso, and is performed for purely cosmetic reasons.

Ear cropping is considered to be a mutilation and is illegal to perform in the UK. Anybody performing the procedure can be prosecuted under Section 5 of the Animal Welfare Act 2006.

It’s a welfare issue for a number of reasons. Have you ever had an ear piercing? Now imagine having your ear flap cut off – painful right? Given the ‘backstreet’ nature of ear cropping, the puppy is very unlikely to be anaesthetised for the procedure or given adequate (or perhaps any) pain relief. A dog has the same nervous system that will sense this pain as you or I would experience it. And aside from the acute pain caused by the procedure itself, the wound created has to heal, with risks of infection. Animals have evolved to have ear flaps for a reason, and for dogs, as well as having some protective function for the ear canal, are a vital means of expression; a way that dogs communicate their emotions and intentions to other dogs. A dog without ear flaps is very difficult for other dogs to read.

Why has ear cropping become more popular? Ultimately, it is because people like the striking, and intimidating image it gives the dog. Celebrity ownership of these dogs and glamorisation on social media perpetuates the problem. The more people are exposed to these images, it begins to seem normal. Try searching ‘exotic bully’ on Instagram – you’ll be confronted with a plethora of pages all with hundreds of horrifying images of very peculiar looking dogs, all with their ears cropped, that look like they have been given a handful of anabolic steroids with their kibble. One of the captions I stumbled across for a photos was ‘freak of nature’.

These pages have tens of thousands of followers. What really concerns me is that the ear cropping seems to be just another manifestation of the growing popularity of dogs that have extreme conformations. Many of the most popular breeds right now are the ones that we have moulded into a shape that is almost unrecognisable from the canids we humans bred them from. People seem to want dogs that have a striking and unique appearance, and we have arrived at a point where, frustrated by the boundaries of genetics, we have resorted to cosmetic surgery to make our pets look the way we want them to. They are both companion to us, and fashion accessory. But our society has become increasingly blind to the suffering these extremes cause to the animal.

The vast majority of dog’s with cropped ears are imported. Usually they are bred abroad in countries with a more lax approach to animal welfare, have the mutilation performed at a young age and are imported with pre-cropped ears. Or, they are dogs bred in the UK, but sent abroad as puppies to have the procedure carried out.

The RSPCA have got behind a petition, calling on the government to ban the importation of dog’s with cropped ears, which you can sign here. Please do.

Ultimately the issue is not going to go away whilst these dogs are considered desirable, and the demand for them remains. Though they are in fashion now, hopefully very soon, tiny ear flaps will be SO last season.

What kind of book would Herriot write in 2020?

Earlier this month, the iconic All Creatures Great and Small made a triumphant return to our television screens. Over 3.3 million viewers tuned in to watch the debut episode of the remake which follows the colourful working life of Yorkshire vet James Herriot, making it Channel Five’s most popular show in terms of viewing figures for over 5 years. In the midst of the unease and widespread anxiety the COVID pandemic has fomented, the programme is a soothing hot water bottle antidote of a show; a welcome opportunity for escapism.

Magic potions in the Veterinary Pharmacy of the 1940s in the James Herriot Museum

Last week, the Daily Mail published an interview with the adult children of the real life James Herriot, Alf Wight, who penned the classic series of books the television series is based on. Aside from discussion of the family’s involvement in the production process of the remake, they spoke quite candidly about their father’s struggles with his mental health – something I personally was not aware of. While for the most part their childhood was as idyllic as one might imagine, there were darker times for the family and periods where the author contemplated suicide. What’s more, the real life Siegried Farnon, Donald Sinclair, sadly actually took his own life not long after Wight passed away. Alf Wight’s daughter Rosie felt very much that for her father, it was ‘cathartic getting his feelings out on paper’. Writing seemed to function as an outlet for the real James Herriot; a means to recentre himself and cope with the challenges of life.

For me this was profoundly upsetting to read. James Herriot is a national treasure; an emblem of the veterinary profession. His escapades are what many, particularly those of the older generation, think of when they imagine the work of a vet. James Herriot is a sort of sacred figure and to find out that he and another of the vets depicted were afflicted in this way was quite shocking

We vets are a pretty rare species: just one in every 3300 people in the UK, is a veterinary surgeon. To put that into context, one in every 482 people is a solicitor, and one in 233 is a medical doctor.  So although the vast majority of people may not personally know a vet, the profession is very much in the public consciousness. This is in part because of our national obsession with pets and the plethora of veterinary programmes on television that All Creatures Great and Small is just one of; the Supervet, the Yorkshire Vet and the Vet on The Hill being three of the most popular currently. These shows allow viewers to vicariously experience the day to day work of a vet and therefore most feel they have a good idea of what a vet’s work involves.

Whenever I tell a stranger I have just met what I do for a living, people are eager to here about my job; just this morning in the barbers, as soon as I mentioned that I was a vet, the conversation becomes much more animated. ‘You must love your job?’ I am usually asked. And my reply usually starts ‘yes, there are times I really enjoy it, but…’

Because in some ways, the profession is not in a great place at the moment. Veterinary courses remain heavily oversubscribed, so there is no shortage of intake, but the profession’s workforce is haemorrhaging ; vets are leaving the workforce at a greater rate than they can be replaced. But watching all these vet programs with cute animals and charming owners, it must be hard for those outside of the profession to fathom why this is the case.

Encouraging advances have been made in terms of awareness of mental health problems in wider society in recent times, and it is becoming clear that those who work within our care-giving profession are especially afflicted by such problems, with the suicide rate for vets being 3-4 times the national average. I don’t know many vets who haven’t cried at work at some point. I would consider myself a calm and relatively resilient person, but there are many times I have felt truly overwhelmed. Compassion fatigue and burnout are endemic in the profession.

The reasons for this are complex. Client expectations continue to grow. Nowadays, unlike in Herriot’s time, many pet owners anticipate a human standard of care, and vets need to have command of a huge range of knowledge and techniques. We are GPs, but GPs who over the course of one day might also need to be surgeons, radiographers, radiologists, obstetricians, dermatologists and cardiologists. And while junior doctors have many years more of structured learning and examinations after their five or six year undergraduate course, some unlucky new vets will receive little to no support on qualifying; they are more or less expected to hit the ground running immediately. Perhaps terrifyingly, they are never examined again.

Vets are high-achieving and driven people, and undergo lengthy training to qualify, but having to deal with any problem that might walk through the door is highly challenging especially as our patients are mute and we have to rely on the often unreliable but well-meaning narration of their owner’s (the dog rushed in as an emergency with its guts hanging out that turned out to have an erection springs to mind).

A thorough examination of the reasons vets decide they no longer want to do their job is beyond the scope of this blog. Overall I think that the work of the vet creates a perfect storm for mental health issues to be whipped up. And easy access to euthanasia drugs does not help.

On the whole, I personally can’t bear to watch vet programmes. They are the last thing I want to sit down with a cup of tea and watch after a long tiring day. But I can see why these shows appeal to the animal loving public, particularly when it comes to charming depictions of the work of James Herriot in a simpler time, long ago.

I certainly do not begrudge anyone sharing in the joys of our job, but I do think it would be helpful to shine a bit more light on the more sobering aspects of being a vet. To share in our lows as well as giddy highs. I think that’s why the Herriot family interview really struck a chord with me as it did just that.

Link to the Daily Mail piece:

The customer knows best, right?

This gem popped up on my YouTube homepage today

In the clip, Dr House from the eponymous US TV series is seen in a consultation with a worried mother and her young baby who is mildly unwell. The mother becomes disgruntled when asked whether the reason she has missed her child’s vaccination dates is that she thinks vaccines don’t work. ‘I think some multinational pharmaceutical company wants me to think they work. Pad their bottom line’. In classic blunt House fashion, he confronts the mother with the fact that even a business selling coffins for small children is a money making enterprise, and perhaps she might want to spend her money on something that has the potential to save her child’s life.

Though my patients are furry, as someone in the medical realm who deals with the general public all day every day, I could empathise with House’s sentiment watching the clip. I’ve felt the same sense of frustration welling up inside of me at times. I’m pretty sure most vets would agree with me saying that it seems increasingly commonplace for pet owners to rebut evidence-based veterinary advice, or at least question it, in favour of something they have either read on the internet, or advice from Jan from pilates. The fervent anti-vaxxers do not only exist the the realm of human medicine. At times I find myself having to make a conscious effort to force my eyeballs not to roll.

It’s very easy in these situations to be driven down a path towards misanthropy.

I can empathise with the reasons why pet owners might want to do their own research: they just want to do the best for their pet and be reassured that what the vet has told them is indeed correct. Seemingly infinite information is available everywhere at any time via the internet in our pocket. Anybody who wants to can tap away and do their own studies on any topic they please. Veterinary medicine is no different, but unlike doing research on what car insurance to get, the best way to rid your garden of snails or finding DIY instructional videos, pet owners are seeking information about the best way to look after a living being who they usually love dearly. So things can understandably get a whole lot more emotional, particularly when a pet is very sick.

As veterinarians, we are trained to practice evidence based medicine – to base our advice where possible on research and information which is gained empirically, and this approach is the cornerstone of modern medical practice. As students, as well as laying down the bedrock of knowledge in veterinary medicine, all vets are taught how to critically evaluate information in a scientific manner. I certainly don’t always know everything, but like all vets have been given the tools to keep developing and expanding my knowledge.

The internet can be a real minefield. The internet affords us all with freedom of expression. But whilst this is considered indispensable in Western democratic society, when it comes to incorrect medical advice it can be really harmful. Accountability is practically non-existent online. The issue is that on the internet, absolutely anybody with any level of expertise can erect their own soapbox and present themselves as an expert in an area that they have absolutely no formal training in. The internet is also a place where emotional individual stories capture attention and go viral in a way that more reliable sources of facts and figures just can’t compete with, even if presented in an interesting way.

The ‘Lepto 4 vaccine’ debate is a classic example of this. It is a vaccination that is widely used to protect dogs against 4 different serovars or types of leptospirosis, a bacterial infection which is transmitted primarily via the urine of rodents. It is an infection that in dogs is challenging to diagnose, difficult to treat and has an extremely high mortality rate in dogs that become ill with it (shown to be 40-60% in various studies).

As a general rule when talking about both humans and animals, vaccinations are given most widely for infections that are either very common in a population, even if infection causes mild, but still significant disease, or if the disease caused by the infection has a high mortality rate. This infection falls into the high mortality rate category. Additional to this, the infection is zoonotic meaning it is one that human owners can pick up from their dogs, making it even more important to vaccinate against.

Here is some useful and reliable information of leptospirosis and vaccination against it in dogs:

My dog’s had the L2 but not the L4 – should I upgrade?

The first is a review paper with a lot of technical jargon. The second is a well referenced information page directed at pet owners so is more accessible.

Whenever a vaccination is given, there is always a small risk of a ‘vaccine reaction’. For the Lepto 4 vaccine, the incidence of suspected adverse reactions is 7 in 10,000, or 1 in 1429. As this is ‘suspected’ cases this will include some cases that are reported but not proven to be linked to the vaccination, and will include many minor reactions that are easily treated, such as swelling at the site of injection. Speaking from my own personal experience, in 5 years of being a vet and using the Lepto 4 vaccine for the majority of that period many times every single day, I have never seen an animal become seriously unwell following vaccination. That’s not to say it doesn’t happen, and that it isn’t awfully sad when it does. However, it is extremely rare and the benefits brought around by vaccination outweigh this risk.

Despite this, in a movement initially gaslit by several inaccurate and sensationalist stories in the press, a really high proportion of new puppy owners come to me for their new family member’s first health check and immediately tell me that they do not want their dog to be given the Lepto 4 vaccination, because it is dangerous. They have often been told by their breeder or have read online that it kills dogs. There are angry communities of outraged people that have sprung up on social media, echo chambers where pet owners go to be share their experiences of the awful Lepto 4 vaccination and declare war on the corrupt companies that manufacture them and the disgusting money-grabbing vets that administer them.

We live in an era where the line between fact and fake news is increasingly greyed and even everything that Donald Trump, the ‘leader of the free world’ says, has to be fact checked. The relationship between the vet and pet owner sadly nowadays can often begin on a delicate footing where trust is not assumed.

A growing contempt for and distrust of modern medicine by some is not the only factor. When it comes to the relationship between the vet and the pet owner, money is a definite influence when it comes to trust issues.

While I know from speaking to friends who are NHS doctors that it is commonplace for people to question medical advice, cost doesn’t really play a role because it is largely taken out of the equation in human healthcare in the UK (thankfully). As a vet, every treatment or piece of advice I give generally has an associated cost, and this can frequently act as a barrier to the best treatment. It costs £40 to take my advice and give the Lepto 4 vaccine – the hurdle that I have to jump is proving I don’t have a vested interest. That I am giving the vaccine because I believe it is the right thing to do for the dog, and backed up by the science. I wonder how if pet owner attitudes would change if the same treatment was free?

It can be exhausting to fight against this lack of trust all the time. On occasions it is frankly quite upsetting. Like most other vets, I’ve had to make a lot of sacrifices in my life to get to this point in my career. And the main reason why I continue to do my job is a love for animals; the same little fire that burned inside me as a child and set me on the arduous path to become a vet.

So while adopting House’s rude manner is likely to be counterproductive, vets like me should be unapologetic about taking a firm stance against pseudo-science, misinformation and quackery. Because it is so important for our animal patients that we remain champions of rational evidence-based medicine and firm advocates that we should be the primary port of call for health advice for pets, not Dr Google.

Introductions – who am I?

So here goes nothing.. My very first post. Dangled and then delicately dropped into the black void of the internet.

It’s a little unnerving putting stuff out there for the first time. I’ve done a modest amount of freelance writing in the past – factsheets about various health issues in dogs and cats which have been published online, and a couple of articles in veterinary print publications. But a blog feels different – it’s somehow infinitely more personal.

I think that is down the the nature of the internet – a marvellous place for free exchange of ideas, but also a place where we are all somewhat dangerously anonymised. I will endeavour to ensure the information I give here is evidence-based where possible, and my own opinions are as well-informed as I can manage. Nevertheless you may disagree entirely with what I say – if this is the case, please be kind. If you wouldn’t say it to my face in my consultation room, please don’t post it on here.

I’m Ben, and I work as a small animal vet – looking after pet dogs, cats, rabbits, rodents and the occasional stray pigeon. Like most, I decided I wanted to be a vet from a young age, and what motivated me to do so was a love for animals. Bottle feeding lambs at the petting farm. The hundreds of hours I spent in the garden on balmy summer afternoons with our Staffordshire Bull Terrier Bessie, both getting intense enjoyment from playing the in erratic water spray from the Crazy Daisy attached to the hose (remember them??). The school holiday visits to London Zoo with my grandparents, giggling at the clumsy penguins slipping around, and marvelling at the giraffes towering high above me. The idea of doing any other job when I grew up never even edged into my mind.

That love for animals is still very much my driving force and passion. But having been in practice for 5 years now, and with my twenties about to fade behind me, I’ve become reflective.

It has become very clear to me that there are some major issues relating to the way our society treats animals that I can do precious little about from my consultation room.

What I really want to do is educate the animal-loving public, about issues that are close to my heart; to clear up very common misconceptions about the veterinary profession and animal health and welfare. I won’t have all the answers. But I hope to challenge your views, and in doing so, perhaps drive some positive change.

Pedigree is NOT perfection

My parents recently sought my advice on choosing a dog breed. By the time I had listed the breeds they shouldn’t get, there were very few options left.

In the end, they settled on a delightful liquorice all-sort mixed breed they have named Mollie, who I have only met over FaceTime so far as my parents live in Spain (gracias a Corona). She looks a bit scruffy like a border terrier, but with aeroplane ears and the markings of a Rottweiler – she is what many would term a mutt.

Pedigree is a word that has fairly positive connotations; to have a pedigree is to have a history, to have ‘impeccable breeding’. It is a sort of stamp of quality and approval. But the longer I have been a vet, the clearer it has become that a pedigree dog is, by default, usually a less healthy one.

I am by no means saying that a dog of no fixed breed is never going to become unwell. Nor am I saying that a every pedigree dog is going to live a life of poor health. But sadly many do. I know this because I treat them every day.

One way to get a rough indication of how prone to ill health certain dog breeds are, is to compare quotes for pet insurance.

I obtained quotes online on 23/08/20 from Petplan for an 8 week old female puppy named Poppy for a classic lifetime policy .

BreedMonthly Premium
Crossbreed: Jack Russell x Border Terrier£27.30
French Bulldog£136.23
Labrador Retriever£49.07
Cavalier King Charles Spaniel£44.42
Quotes obtained from on 23.08.2020 for a classic lifetime policy covering £4000 fees per year, excess of £110 per condition

It should be highlighted that pet insurance premiums are calculated using complex algorithms and will be affected by a variety of factors: for example a large breed of dog with an equal likelihood of falling ill as a small breed of dog will need larger doses of any medications, which will automatically mean a more expensive vet bill. Large breeds have a much shorter life expectancy than small breeds – a Great Dane will be slowing down by 5 years of age, whereas a Jack Russell might live into its late teens. Also, just because a breed is comparatively cheap to insure as a puppy, that doesn’t mean they are a healthy breed. It may be that the health issues they might be prone to develop in later life, meaning the premiums will probably creep up more steeply at an older age.

What it makes abundantly clear however is that not all dogs are equal in terms of health. Dog breeds are a product of selective breeding – humans have moulded each breed into what we want them to be primarily on the basis of appearance, as well as temperament. A dog of a specific breed has a characteristic size, body and head shape, range of coat colours and textures, which the various national Kennel Clubs will refer to as the ‘Breed Standard’, or a similar term.

Unfortunately, a by-product of selective breeding for the above characteristics is that in the cases of many breeds, we have bred for extremes of conformation which cause real suffering for the pet. And also because individuals within a breed are genetically very similar to each other, we have inadvertently arrived at a situation whereby as well as looking a particular way, each breed is predisposed to its own list of diseases, some of which are extremely prevalent.

Should our pets experience suffering as a result of our requirement for them to look a particular way? I think most people would agree on the answer being no. It’s tragic. However, the fact remains that some of the most unhealthy breeds of dog are the most popular in the UK right now – the French Bulldog has been in the top 5 for some time now .

So where is it going wrong, and is anyone to blame? The pet owners themselves who choose buy these dogs? Vets? The Kennel Club? There is no simple answer, but bringing these issues into the consciousness of everyone who cares about dogs and encouraging conversations can only be a helpful thing.

This is a subject close to my heart and one I will be returning regularly to in future posts.