Letter to the editor

Editor’s note: We normally wouldn’t run correspondence that refers to other publications, but this topic is one that several readers have raised. The perception of veterinary pricing in the wider community obviously requires action!

Dear Luke

A recent article was published in the July issue of Choice magazine with the heading “Premium pets – does Fido really need his teeth cleaned?”
The five-page article also had subheadings such as “Is your vet selling you more than you need for your best friend?”, “Price check”, “Going corporate” and, interestingly, “Sheepdog shakedown”.
I urge you to download the article [www.choice.com.au/vetcosts]. My reply to Choice was approved by the AVA and the Australian Veterinary Dental Association and addresses many of the points raised by the article.

I feel this article demonstrates that veterinarians are not adequately communicating to their clients the need for services they perform.

Yours sincerely,

Philip Bloom
Lane Cove, NSW

(The following email was sent to Alan Kirkland, CEO of Choice.)

Dear Mr Kirkland

I read with interest your article on Premium Pets in the July issue of Choice.
You have raised some very interesting points in the article which I found factual but failed to acknowledge the other side of the coin.
My company- iM3, designs and manufactures dental machines and hand instruments for the veterinary profession world wide. Our machines are found in every major veterinary university throughout the world.
Thirty years ago veterinary dentistry was virtually not taught in Australian Universities. I was responsible for bringing Specialists from the USA and UK to teach dentistry to veterinarians throughout Australia. Initially we imported everything we needed and then iM3 began to design and develop our own range. Last year alone we were a part of thirty wet labs where vets from China, Hong Kong, Indonesia, Malaysia, Singapore, Australia, USA Italy, Prague et cetera were taught by specialists.
Your question “does Fido really need his teeth cleaned” implies that by asking the question there is some doubt that they do. A published fact is that 80 per cent of all small animals of two years of age and over have some form of periodontal disease. Plaque disclosing solutions will support this, calculus and tartar along with bad breath will tell the vet that the animal has indeed progressed along the path of periodontal disease, perhaps even past gingivitis to periodontitis (bone loss) which is incurable.
So to answer your question – do they really need their teeth cleaned? – the answer is yes but only if any of the above signs are present. Sparkling teeth and sweet breath will pass the test almost every time.
I think it is important to recognise that animal mouths suffer from the same problems as humans. Bleeding gums, calculus, and bad breath are all signs for a mouth clean up – no vet would do a dental if it was not required.
Everything Dr Gardiner had to say is totally correct. You point out the difference in charges for a similar treatment/product from two practices – well that happens everywhere. My son has a German SUV, he was quoted $780 for a 25,000km service from the distributor, oil change, oil filter and fuel filter and they also take it for a test drive! I thought this was excessive and took it to a service center I regularly use, same special high cost oil, same oil and fuel filter, total cost $430.00 plus the log book (warranty) is stamped.
The public can shop around, as I did. Today the veterinary profession is under economic pressure, certainly in Australia and the USA, from over-graduation. The second-hardest course at University [results in] a first year graduate earning the same as a storeman.
I do not for a moment believe that veterinarians upsell. What may appear to be upselling is the search for more information relative to the patients condition. Blood chemistries are more and more routinely carried out, veterinary dental X-rays have now been recognised for their absolute value. As Professor Verstraete of Davis University in California reported, 27.8 per cent of dogs and 41.7 per cent of cats that showed no abnormal findings on an oral examination, revealed clinically important findings below the gum when an X-ray was taken.
You also mention a case with cancer and the recommendation to have the teeth cleaned. I have had cancer, the first thing any cancer sufferer should do after diagnosis is have their mouth scaled and teeth polished as treatments such as chemotherapy will only exacerbate any preexisting infection.
Some years ago I attended a meeting with the head of the Dental Hospital in Sydney discussing a group of elderly patients, mouths full of inflamed gums, calculus and all of them with cardiac conditions, they extracted all the teeth so there was nowhere for the plaque to attach and produce the bacteria etc and everyone of their cardiac conditions improved. Plaque is generated along and under the gum – when bacteria stick to the surface of the tooth, if left untreated, this bacteria then drains into the blood stream and effects the heart, liver, kidneys and lungs – just the same as in animals, so helping the immune system to fight the cancer or some other health problem is a must, and that is why a healthy mouth is very important.

Diets – regular tooth brushing for pets is regarded as the gold standard along with regular mouth exams. The Hills diet (TD) has received a VOHC approval, ie – its claims to reduce placque have been verified. Some years ago I was engaged in a wholesale company and imported 1000 urinary catheters, three times a year to clear blocked urinary tracts in cats, today with Hills CD diet the incidents have fallen to very small numbers, so diet for cats and dogs is extremely important.
Bones and chews all help to reduce periodontal disease but some breeds are more prone to it than others. Verstraete showed that Cape Hunting dogs had just as bad mouths as our domestic breeds even though they chewed through animal hides and ate raw meat and bones and of course did not live as long as the domestic breeds.

Pricing – Many vets recognise the importance of oral health in cats and dogs and have reduced the cost to encourage owners to come in more regualarly for a scale and polish particularly for those breeds classed as plaque magnets. Charges will vary, but remember a general anaesthetic is involved unlike human dentistry although overall charges are similar to human dentistry. Better health care, particularly oral health has resulted in pets living much longer so you can enjoy their company for much longer.

Yours sincerely,
Philip Bloom