Last week we began our look at pet oral hygiene clinics, typically held at grooming facilities by people who, according to The California Veterinarian Medical Board and California Department of Consumer Affairs, perform illegal dental procedures.

First, the State of California does not recognize the title “pet oral hygienist” and believes the use of this term is misleading. Second, pnly a veterinarian may use motorized or sharp scalars — required to get under the gum — for proper plaque and tartar removal.

“It is medically impossible to perform an adequate cleaning without these instruments.

It is, however, legal to brush an animal’s teeth, to use gauze, floss or toothpastes, and anyone — including pet owners — may do so. “But this is not sufficient,” maintains Dr. Lee Fausett of the Hanford Veterinary Hospital.

As the following story illustrates, a visit to a “pet oral clinic” may indeed give you back a dog or cat with pretty teeth — and a life-threatening oral disease.

But Mr. Wiggles never complained

For years, Sylvia took her 10-year-old  pooch, “Mr. Wiggles,” to a Los Angeles pet groomer every few months for hair trimming and “an all-around appearance tuneup.”  This included teeth cleaning and polishing when the groomer would hold oral hygiene “clinics,” returning “a lovely mutt with gleaming teeth,” our Porterville reader stated.

“But about a year ago, I noticed that Mr. Wiggles seemed to be less hungry than normal, began to lose weight, was chewing in an odd way, which was pointed  out to the groomer, who told me that it was normal for an aging dog to show that kind of eating behavior and to just give him soft food.”

This was nonsense, but Sylvia didn’t know it. In fact, her dog was in horrible pain, and very ill, but Mr. Wiggles “never seemed to complain, he never cried or gave any indication that things were not normal.”

Sylvia would soon learn what countless other pet owners discover about how dogs and cats react when in pain. But first, things had to get much worse.

“When we detected his very bad breath, and our normally affectionate dog wanted nothing to do with anyone, we took him to a veterinarian, and were astonished to learn that he had a mouth filled with rotting teeth, had horrible gum problems, as well as a nasty abscess! The vet had to extract several teeth, put him on strong antibiotics, but a few weeks later, our very own Mr. Wiggles was himself again.

“The vet explained that for a very long time, untreated gum disease caused terrible pain, systemic infection, and that the groomer obviously didn’t notice or care.”

“All it would have taken was for your groomer or his so-called dog hygienist to just examine the mouth carefully — if they even knew what to look for! White teeth is no assurance of good oral health,” the doctor noted.

“Now, we tell our friends to take their dogs to a real vet for dental care. But the strangest thing was that we did not realize our dog was in pain. We all feel so guilty, and are lucky he pulled through. ” Sylvia told us, cute little Mr. Wiggles in her lap, a happy pooch generous with licks — and we got several!

A very common, sometimes deadly story

“Your reader was lucky,” Dr. Fausett told You and the Law.

“Animals by instinct, when in pain, do not draw attention to themselves. Even in a pack, an injured dog remains quiet so as to not become prey, a target, revealing weakness.

“There are case studies showing that cats and dogs can be very good actors, hiding illness and pain, trying to appear as normal as possible, and this makes it difficult for pet owners to know what’s really going on.

“So, it’s when eating or other behavior has changed,  you need to assume something is wrong and take action,” added Dr. Rhett Swasey, who practices veterinarian medicine with Fausett at the Hanford Veterinary Hospital and seconded Fausett’s comments:

“White teeth — a dog’s or our own — does not mean healthy teeth or gums. And it is medically impossible to do a proper job of teeth cleaning unless you can get under the gum, scrape away the plaque with appropriate ultrasonic or mechanical means, all of which requires being licensed by the state. The absolute majority of these grooming facilities are not licensed to perform services which a vet is licensed to do,” he stressed.

“A good groomer is part of a team, and should keep owners informed of their dog’s general health.  But groomers must also know their limits and stay away from performing services — such as illegal forms of teeth cleaning,” Swasey and Fausett both firmly maintain.

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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Most of us who own pets consider them to be members of the family, and today’s story will be of special interest to pet owners everywhere. But consider this:

Chances are that many of our pet-owner readers are letting their pets down by neglecting oral and dental health. That’s right, just as we two-legged critters need to maintain our own dental hygiene, our pets are no different, only we can’t hand them a tooth brush and tube of toothpaste and expect anything but an enormous mess.

“But, Beav, I know that, and am aware of the importance of teeth cleaning,” you might be thinking. “My groomer has wonderful dental clinics, and returns my dog to me with gleaming teeth, because their pet dental hygienist does such a good job.”

Far from this column to rain on anyone’s parade, but the California Veterinary Medical Association and Department of Consumer Affairs does not recognize that title. Yet, there are indeed clinics all over the state, typically held at grooming facilities, and they do return Fido to his owner with pretty teeth, often violating the law.

But, as you’ll see, beauty is far less than skin deep.

‘Pretty Teeth, alright, Pretty Rotten Teeth’

“Pet owners are not only being scammed, but expose their pets to serious health risk when they take them to so-called oral hygiene clinics, typically held at pet groomer facilities,” Hanford veterinarian Dr. Lee Fausett tells You and the Law.

“There are very real, life-shortening consequences of the cosmetic teeth cleaning these businesses perform, but which typically does nothing to address build-up of plaque, tartar and other below-the-gumline undiagnosed dangerous oral conditions,” he points out.

“Anyone may use a tooth brush, dental floss, topical product or gauze to clean a dog or cat’s teeth, but that is not sufficient to deal with hard tartar or plaque, incredibly common with so many pets for the simple reason that most owners are completely unaware of the connection between oral health and general health.

“In many ways, dogs and cats really are a lot like us, and when we go to a dentist for teeth cleaning, the dentist or hygienist will use a powered instrument — Cavitron — or a sharp instrument, such a hand scalar or scraper. That’s the only way you can remove plaque and tartar, getting under the gum, and assure good tooth and gum health.

“But the only people who can legally perform these services are veterinarians, or a trained person working under the direct supervision of a vet. Under current law, it is illegal for anyone else to use these devices on your pet,” he stressed.

No cavities, but what’s going on under the gumline is the real concern

Dr. Rhett Swasey practices with Fausett and has seen the tragic results of loving dogs and cats whose teeth gleam after a visit to one of these “clinics,”  but are facing horrible — sometimes life-threatening — oral problems as a result:

“Dogs and cats don’t usually get cavities — and so the surface may appear ok — but very similar to us, the biggest concern is what is going on under the gumline, where good periodontal health is critical. There are many dental and general health issues tied directly to the pet’s gum health: bleeding gums, losing teeth, systemic body infections, bladder, heart disease, pain, difficulty chewing — in fact, all the same things that can affect the  owner.

“Often pet owners have a false sense of security, thinking that after their groomer has done a good job of teeth cleaning, and the dog’s teeth look great, that’s it, and Fido has good oral health. But you know the old saying about beauty being skin deep.

“We have one owner who would take her dog every six to eight weeks to a groomer for teeth cleaning, absolutely convinced that her pet was getting excellent care. We needed to extract three teeth, there was so much decay. After the extractions, and a course of antibiotics, her dog was back to it’s old self.

‘Owners Are Generally Unaware Their Pet Is In Pain’

“We see so many dogs — 8, 10, 12 years of age who have never had any professional oral care — and they have horribly severe oral disease, a mouth filled with rotten teeth, teeth falling out, teeth which are held together by the plaque! It is clear to us the owner truly loves the pet, but is simply not aware of just how bad things are — that the dog is in terrible pain — and that a dog can suffer the same health issues as a human, all because of poor or nonexistent oral hygiene,” Dr. Swasey concluded.

But exactly why are owners not aware their pet is suffering? The surprising answer next time.

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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Last week we told you about Samantha, a 20-year-old student at College of the Sequoias in Visalia, California. She took her sick cat to an animal hospital in Fresno, paid $65 for an examination and was later informed by the doctor that it had pneumonia with a 50/50 chance of survival. Treatment could run as high as $500.

Samantha authorized treatment, but the next day, her kitty died and she was billed $350. During our phone conversation, she explained why she should not be required to pay the animal hospital and that “they owe me a refund.”

“This was such an emotional time for me, and they knew it. I loved my little kitty and couldn’t just let her die. I would have felt so guilty. So, I believe they took advantage of my feelings. Besides, the cat would have died anyway, I don’t owe them a thing, and they should refund the $65.

“I know, that if I had no money, they would have been required to treat my cat for free,” she also maintained.

While 20 years of age makes one an adult legally, real-world maturity is always years away, with some people never quite getting there. Samantha was headed in the wrong direction, and we felt it our duty to at least try to help her understand why she owed the money, both legally and morally. Finally, we asked her to send us a photocopy of the check which we urged her to send to the doctor.

Samantha did raise some interesting questions about free veterinary care, balancing feelings with the economics of pet ownership and seeking the answer to a simple question: What if your pet dies — so you still have to pay the vet?

For the answers, we turned to friends of this column, Drs. Lee Fausett and Rhett Swasey of the Hanford Veterinary Hospital in Hanford.

Pets are an emotional investment with a real cost

“Samantha’s example is fairly common, and to begin with, there is no such thing as free veterinary care. Society absorbs the cost for human care when someone cannot pay, but nothing like that exists for veterinary care,” Fausett notes.

Swasey next described one family’s reaction when denied free care: “Terribly upset, either having no means of paying or who just go through life always looking for someone else to pay the bill, they created a real scene, yelling, ‘You have to treat our dog, we know how this works!’

“I calmly explained this is not the same as a human emergency room or hospital. Veterinarians can refuse to accept a patient. Once we administer care, with reasonable assurance of being paid as agreed upon, we are obligated to continue, but we can and occasionally must refuse to accept or continue care. It is the economic reality of running a business, having to pay overhead, staff, medication and so on.”

‘They drove off in an expensive new car!’

Fausett considers “pets to be an emotional investment and the dividend is life itself, the joy of playing with your cat or dog, coming home to have your nose licked by this friend who you love and just wants to make you happy.

“But this investment has an emotional price as well,” he cautions.

“It is normal to have guilt feelings — almost a feeling of betrayal — when told that putting your pet to sleep needs to be considered, where treatment could be much more than you can afford or isn’t likely to have the desired outcome.

“Sometimes pet owners face difficult, hard choices that they really do not want to make, and we try to help them come to that. We often have a heart-to-heart discussion about the importance of alleviating suffering when there is something that we cannot treat. There is also a cost to properly take care of the remains of a deceased pet, and the owner is also responsible for that as well.”

Budget for your pet’s health care

“Today, we can treat and cure conditions which only a few years ago meant a death sentence,” Swasey points out. “And, just as with human health care, the expense has gone way up as well. For most people, $2,000 for their dog’s surgery or broken leg would be a major expense.

“So, open a pet health savings account and save at least $100 a month, or consider pet insurance, which runs from $30 to $90 a month. Only about 3 percent of pets in the country are covered, and the need is very large.”

And Samantha?

She sent us a thank you card which read, “I thought about what you told me, about morality and keeping my word.” Inside was a photocopy of her check for the vet.

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

The post What your veterinarian wants you to know appeared first on Dennis Beaver.

Part I

A dog is struck by a car, suffers a badly broken leg and other injuries. Its owners take it to an emergency animal hospital where it is examined by the on-duty vet. He outlines necessary treatment, instructs a tech to administer morphine, then leaves the room.

Within minutes, another tech informs the owners the doctor will not be treating their dog, and orders them to leave the hospital. “The doctor wanted me to tell you the problem isn’t your dog, it’s you,” the husband is told.

They immediately took their dog to another animal hospital where excellent care was provided and today the pooch is making a good recovery.

But why were they told to leave the first hospital? Did this amount to a violation of law or veterinary ethics? Does a vet have the right to refuse care in general?

Those were my reader’s questions; we’ll call him “Jim.” He lives in California’s southern San Joaquin Valley with his family and their 4-year-old German Shepherd, who we’ll call, “Beemer” – both German and fast, just like a BMW.

But on that warm, early summer evening 2010, Beemer wasn’t quite fast enough to avoid a car headed straight for him on one of the many east-west rural highways in this part of the state. “I yelled for Beemer to come to me, but it was too late,” Jim wrote.”

He described the dog’s injuries as “grotesque,” adding, “… and even though, while in law enforcement, I’ve seen worse, still, I was unprepared for the emotional impact in seeing our dog hurt that way.”

Had he stumbled into an emergency animal hospital staffed by uncaring personnel, or was there indeed an explanation for what happened, something about his behavior which led to being ordered out of the hospital? The detailed e-mail and attached 10-page “complaint,” which he intended to file with the veterinary board, provided part of the answer. Only part.

“It was suggested that I contact you for a referral to a lawyer who can sue the hospital and veterinarian. I am filing a complaint with the California Veterinary Board. I am on a mission to do what I can to get his license revoked. He should not be permitted to treat anyone else like that,” my reader told me during a lengthy telephone conversation.

But would that really happen? How does the California Veterinary Medical Board view such incidents? Can a veterinarian legally refuse to treat an animal in this type of a situation? To find out, I phoned the board and spoke with its executive director, Susan Geranen.

Injured pet = high stress and anxiety for owners

“For many people, their dog or cat is considered as a family member. If they see their pet struck by a car, the bond with the pet can be so strong that there is a very emotional reaction comparable to a family member being injured,” she explained.

“In addition to treating the injured animal – especially in an emergency setting – the staff must deal with owners who can be so fearful, so afraid of losing their pet, they just aren’t themselves, can become disruptive, and literally, out of control. This can create a conflict between the doctor and owner making it impossible to provide care.”

“In these types of conflict situations, it may be best for the animal to be seen by a different doctor, and depending upon how bad it is, there may be little choice but to ask the owner to leave,” she advised.

“His comments were meant to be offensive and arrogant.”

Thinking that we can crawl inside someone’s head and “know” what they intend or mean by certain comments or body language is usually speculation – guessing – at best. In court, if a witness is asked, “And what did he mean by that?? Or, if the witness states, “… and he meant …” a lawyer or the judge will likely object, stating, “Objection! Calls for speculation! Assumes facts not in evidence!” With that in mind, here’s what Jim wrote:

“When the doctor came into the exam room, I told him Beemer had a compound fracture to the right leg. He examined the dog and replied, ‘We’ll give him morphine, take S-rays and he’ll spend the night.’

“I was hoping for more information but said nothing. Then, while sarcastically throwing up his hands, he said, ‘Unless you have a different order; I’ll do anything you want, but you need to calm down.’

“His comment to me was meant to be offensive and arrogant!”

Next week: Just who was offensive and arrogant? And what was found in the exam room after Jim left?

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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Part 2

Last week we began our look into the bizarre situation surrounding a visit to an emergency animal hospital this past July by readers whose German shepherd (Beemer) had just been hit by a car, the accident witnessed by its owner (Jim.) But instead of their dog receiving treatment, after it was given a morphine injection, they were ordered to leave the hospital and go elsewhere. Jim is a police officer who maintained that he did nothing wrong, and the actions of the hospital staff and on-duty vet were completely unjustified.

But there are always two sides to most stories. Jim at first refused to give permission for You and the Law to discuss the incident with the hospital – then stated in writing that it would be OK – and then withdrew that permission. In spite of that, we were able to obtain a far more balanced view of what happened that night. More on those specifics in a moment.

As we discussed last week, there are significant differences in legal obligations where animals and humans are concerned. There are times when a vet or an animal hospital may indeed refuse to treat, but if the patient were human, there would be a duty to provide care.

Reasons why the vet will not treat

“Much like human medicine, there needs to be trust on both sides when the consumer first brings their animal in to see the vet. It’s not a legal relationship at that stage, so much as a trust relationship – the client trusting the veterinarian to take care of their pet and the veterinarian trusting the client to provide accurate health information and trusting the recommendations and treatment of their pet,” commented Susan Geranen, Executive Officer with the California Veterinary Medical Board.

“Veterinarians may legally refuse to treat, where they do not like the pet owner, feel ill at ease in the owner’s presence or are concerned for their own physical safety or the safety of their staff. In human medicine, you are dealing with the patient directly. In veterinary medicine, the patient is the animal. It is the owner who speaks for the animal. There absolutely has to be trust on both sides.”

In a true emergency, must the vet treat an injured animal?

What led to Jim’s contacting You and the Law was his outrage that Beemer was given a morphine shot and then they were all sent away. Even though the dog’s situation was not worsened by the delay in getting to another hospital, Jim still wants to do what he can to “have the vet’s license revoked, because they denied my poor dog appropriate care.”

“It is understandable how someone could be so upset if it’s a human hospital, where there is generally a legal obligation of treating a true emergency. But it is different with an animal hospital. The difference is that there is no legal obligation to treat. Animals in all states are considered as property. Humans are humans with a much higher legal standard of care at medical facilities,” Geranen points out.

“Yet, most vets will try to treat an injured animal, but this is obviously conditional on being able to work with the owner. If an owner becomes loud or disruptive, this may not just make it difficult, but impossible. Where there is reasonable fear of physical injury to staff members from an owner who appears out of control – possibly under the influence of some substance – the vet is facing a conflict that could make it necessary to refuse treatment or even call the authorities,” she maintains.

“The fact that no harm came to the patient is important, especially where the original doctor did a visual assessment and determined that the animal could be transferred with pain mediation only,” she points out.

The hospital’s position

The hospital had every right to discuss non-treatment issues – what the staff observed. Paraphrasing what I was told, “His behavior was demanding, argumentative and frightening. He actually challenged the doctor to a fight!”

“We were seconds away from calling 911 when they all left. Human vomit was found in the exam room, consistent with extreme intoxication.”

During my chat with Jim, something which might partially have explained his actions became clear. He was carrying a far greater burden of guilt than he seemed aware of. For, literally in an instant, that July evening, what had been happy moments for a dog and its master – out playing in their front yard – turned to tragedy. If ever there was a time to keep Beemer leashed, this was it, but nothing ever happened before, so why leash him now?

Why, indeed..

Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.

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