“When our pets are sick, they can't describe their symptoms, so we depend on veterinarians to tell us what's wrong. But are some vets are going too far, and taking advantage of helpless pets and their owners?”
Such is investigative reporter Ana Garcia’s intro for the “Vet Investigation” series undertaken by Los Angeles’ local NBC affiliate. Predictably, it’s generating significant consumer angst…and great ratings for KNBC.
Here’s a snippet of the transcript provided on KNBC’s website:
Dr. Jeff Werber, Century Veterinary Group: The problem is pet parents don't know enough to protect themselves.
Garcia: Dr. Jeff Werber runs his own pet hospital in Culver City, and is the official veterinarian of the legendary Lassie franchise.
Werber: Unscrupulous vets will create fear in the pet parent to maybe do more than needs to be done now.
Garcia: We wanted to know what would happen if we took healthy dogs with common, minor problems in for a checkup. So we went undercover and visited 15 veterinarian clinics all over Southern California, but first we had Dr. Werber examine them.
Garcia: So he looks like a healthy year-old French bulldog?
Werber: Yes he does. Sweet as can be.
Garcia: Guapo's only problem is that he throws up every once in a while. Werber says that could come from eating grass or heartburn.
Werber: Use some Pepcid or any over-the-counter antacids.
Garcia: Before we take Guapo undercover, our insider tells us what to look out for.
Insider: They're going to run a bunch of tests. If a pet comes in for vomiting, offer them this, this, this and this.
Garcia: KNBC Producer Fred Mamoun takes Guapo to the Cahuenga Pet Hospital in Hollywood.
Mamoun (undercover KNBC employee): He threw up a couple of times.
Garcia: Dr. Marina Kotlarenko orders a battery of tests, charges us $395 and recommends we change dog food for the vomiting. Then she claims to discover a new and unrelated problem.
Mamoun (on undercover video): So you scrape the eyelid? I'm confused.
Kotlarenko (on undercover video): I need to scrape, to smoothen it. An eye infection.
Mamoun (on undercover video): How much is that? About 300?
Garcia: Another, $300 for an eye problem our expert and nine other vets didn't see.
Garcia (at Cahuenga Pet Hospital): We want to talk to you about a diagnosis you made about his eyelid.
Garcia: At first, they wouldn't let us in.
Garcia (at Cahuenga Pet Hospital): ...but she won't come out and talk on camera?
Garcia: So we took Guapo and his records inside. Dr. Kotlarenko told me she didn't do anything wrong, and explained eyelid scraping is not done in the states, but she used to do it in Austria. On this visit, she admitted Guapo eyes looked perfect.
This is pretty much exemplary of all the transcripts I read. You’ve got a vet doing her thing and another telling you she’s a fear-mongering money-grubber since he’d never have done any of it.
It’s embarrassing for Dr. Kotlarenko, I’m sure, but would I have done any different? OK, so I have no idea what the eyelid scraping thing is all about. But that doesn’t mean she can’t produce a number of European papers describing it and its proper indications. It doesn’t show she’s being unethical.
Veterinary medicine is a science. It’s not a series of recipes we follow when faced with one obvious problem. $395? That’s an office visit, abdominal X-rays and basic tests (CBC, Chem and fecal). At my place that would come to just under $300, but Dr. Kotlarenko runs an AAHA hospital in Hollywood. The price seems reasonable.
What? You think she shouldn’t have done all those tests?
What do you think would have happened if she hadn’t recommended them and the dog had parasites, evidence of infection or some sort of gastrointestinal cancer she missed because she’d simply put it on Pepcid AC as Lassie’s doc recommended?
Damned if you do…(you know the rest).
Why doesn’t the transcript reflect her whole conversation? I guess it’s not too camera-worthy to have a vet describe what she needs to do and why. Neither is it camera-worthy to show that the “owner” had a chance to decline all of these services in favor of a more “conservative” approach.
Frankly, I’m disgusted by this investigation. But it’s not just the sneaky tactics and the neat editing. And it’s not just that I want to protect my profession’s reputation, which has clearly been undermined by this inflammatory series of local news spots.
What I really abhor is the depiction of veterinary medicine as somehow straightforward and simple; that there’s always one, best way to treat a sick animal.
Medicine is far more complicated than that. Pets are no different than people when it comes down to the complexity of making diagnoses and arriving at treatment options. So why was Dr. Kotlarenko singled out for doing exactly what we’re taught to do in vet school?
Then there’s the back story to this post that I’ve been holding out on:
Last month I called about ten vets in the L.A. area trying to reach someone who would talk to me about cruciate ligament costs in the area (for my Pet Economics 101 posts on cruciates). The only one who returned my call? Dr. Kotlarenko.
I’m not saying she’s a great vet—I don’t know her personally. I’m just saying she’s one out of ten on the issue of collegiality. So who’s to say the nine other vets who saw nothing in that dog’s eyes are right?—at the expense of her reputation.
The next time Ms. Garcia takes aim at a profession using the very same scare tactics she claims to uncover, I’d hope she’d take a look at her own first. There’s nothing more unseemly than building your reputation and your fame by tearing down others’ indiscriminately from high atop your bully pulpit.
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It would also pay to say a little more about Werber, whether he initiated this story and whether he plans to profit from his raised profile via his new web-business. Full disclosure and all...
emily March 4th, 2008 09:14:00 AM
Dr. Khuly, I think both Stefani and I have posted about our "dark side experiences" with the veterinary profession to remind the readership it exists and the tremendous harm it causes both companion animals and humans. (http://walnut-hill.bravehost.com)
You have been most courageous to comment about the "bad apples" bringing shame to the profession that you and the vast majority have worked so hard at.
My intent is NEVER to malign an entire profession, the subjects I could post positive experiences are numerous, I hope to share 'all' those experiences as well. I sit here bewildered beyond belief when reading the above news story, when the horrendous blatant deception and cruelty I experienced in my home state goes ignored and unchanged. I think you might agree that something is terribly wrong in my 'small' state of New Hampshire.
I personally don't find it puzzling nor alarming for the $300 worth of basic testing, just in the past month, I gratefully expended a bit more for an emergency visit to distinguish symptoms that could confirm IVDD reoccurrance vs. pancreatitis (though not 100% certain, test results leaned to the latter)---I am hugely grateful for that visit!
The "eye lid" thing?---- can't begin to guess or comment. Some GP's are extremely good with eye diagnosis, some are not, and should refer,when in doubt.
Barbara A. Albright March 4th, 2008 02:05:00 PM
I don't know if she is a good vet either, haven't watched the video, although I've intended to. But frankly, I say THANK YOU to anyone brave enough to do an undercover investigation of vets.
This is the only way we found about about Bill Baber and his "heart punch" euths in Tennessee. This is the only way we found about about Howard Baker (in NJ?) With all of the tendency of other vets, like yourself, to reflexively jump to the defense of other vets, the only way consumers can prove anything is with video.
As someone who had a vet lie about things that transpired after they'd given my cat an overdose -- and I have NO video or audio to prove it -- he simply denied that certain records existed, certain conversations took place -- I am certainly grateful to people with the balls and forthought to do these investigations.
I will watch the video and see if I think it's all that damning or not. I am one of those clients who wants EVERY test run so, I may not think so ill of her after watching. But all the same --- I'm all for undercover videos. If there's nothing incriminating, if too much is being made of a vet who is just trying to be thorough -- then discerning consumers like me will take it with a grain of salt.
Stefani March 4th, 2008 06:25:00 PM
Patty - the veterinary profession always cops the raw end of the stick. There was of course the super-critical Consumer Reports article in the July 2003 edition and the recent articles on Salon.com. I think part of the problem is addressed neatly in the JAVMA 15 Feb 08 special report "Impact of the owner-pet and client-veterinarian bond on the care that pets receive" that concludes: "The key factor for maintaining a strong client-veterinarian bond was communication, including thorough explanations and recommendations, which increased the perception that veterinarians only sell to clients the things their pets need."
Our cat recently had an abscess and the veterinarian took the time to show us what needed fixing, what she was going to do, how it was going to be done, and what would happen afterwards. We spent $324 and our Tiddy is doing just fine now and I feel that the fee was commensurate with the care.
If Dr. Kotlarenko had clearly explained why she was proposing her course of treatment, maybe the report wouldn't have baited her so easily?
Alex Krooglik March 4th, 2008 07:37:00 PM
OK, I watched it. And I have to say, I've never heard about it being medicially necessary to "smoothen" eyelids. "I need to smoothen," she said. What kind of medical terminology is that?
Also, the ear infection thing -- wanting to anesthetize a dog that doesn't have an ear infection? I mean, I can see wanting to CULTURE the ear goop -- but anesthetize the dog to deal with a non-existent infection?
That's not just gauging, that's potentially endangering the animals life.
As for tests for vomiting -- I can't criticize that. I want to rule everything out when my pet is puking. I admit I rushed one of my cats to my high end, expensive vet hospital when she had vomited several days straight. $500 worth of xrays and tests - - and they told me just take her home and watch her. I got the big clue that I'd recently started feeding her one food exclusively where previously I had only fed it intermittently. I got rid of that food (wellness) et voila, no more puking.
So, maybe I should have ruled out the food first. Or, maybe the vet should have asked me about dietary changes. Whatever. I didn't really mind paying for xrays and bloodwork, but it didn't turn out to be anything serious. I don't feel that they really "took me" there -- I was the one that was worried because she was puking so long after eating (6+ hours) that I was worried about obstruction.
Stefani March 4th, 2008 10:19:00 PM
<<"That’s an office visit, abdominal X-rays and basic tests (CBC, Chem and fecal). At my place that would come to just under $300, ">>
Out of four places in four different states, average comes to:
office visit: $37
cbc/chem: $39
cheap fecal: $16
x-ray, 2 views: $76
I would consider over $225 to be rather high.
But, frankly, I really don't know any good vets that would run
any tests over a dog that vomited a couple times, presumably
without having a loose stool. Most would sit down and discuss
with the owner what might be triggering the vomiting, such as
scraps, plants, car rides, and so forth. Most any good vet will
send the owner home with just an office visit and explain some
tests will be necessary if the dog continues to vomit. If the owner
perks up as if they would like to pursue some tests right away,
then go ahead and offer to run them right away. Otherwise,
most vets will wait and see and explain vomiting can be normal
or a sign of a serious disease. Then call the owner two or three
days later.
I don't think the investigation was fair because we don't get
to see the whole office visit. A sly person can act with a
sense of deep pocketed urgency and motivate the vet to
offer every last test in the arsenal.
eli March 4th, 2008 10:40:00 PM
Also, a vet that does the opposite of fear mongering, gives
accurate assessments and leans towards the bright side
has a much easier life. Customers will learn to trust you and
when the time comes that a really expensive battery of tests
is needed, customers will not have any hesitation.
eli March 4th, 2008 10:52:00 PM
Ok, so why were they allowing the tests to be done on this little dog?? Isn't that in itself immoral?? That's like trying to bust pitbull fighters by fighting a pitbull.
And also, when you have a dog coming in for vomiting and don't know why-- you HAVE to have those tests! It could be something so severe. It could range from parasites, to an allergic reaction, to a digestive problem. Maybe I'm the one overreacting over this "investigation".
I don't know anything about eyelid scrapings, that's something completely new to me..
ashleigh March 5th, 2008 07:18:00 AM
Eli--which four states? Because I have to say, that's not what those things cost where I am.
My older cat vomits. She used to do so more frequently, before years of careful experimentation finally identified a diet that was easier on her, but the fact remains, she vomits from time to time, more often than my younger cat, or any other cat I've ever had. But early last summer, she vomited, then stopped eating, and became lethargic. _That_ alarmed me. So, off to the vet.
Office visit, basic exam, discussion of why I found the current symptoms alarnming. Fecal, CBC, Chem, and abdominal xrays. Diagnosis, my poor kitty had gas.:) Prescription for, oh, I forget now what it's called. Kidney levels are elevated, still witiin normal range, but on the high end of that, and much higher than at her annual, just a couple of months ago. Recommend another blood panel in about six months, make sure it's not trending higher. Total, just under $400.
Almost six months later, elder kitty vomits, this time with some blood in it. It's late, I don't entirely trust the local emergency clinic, so I wait till morning. No more vomiting, but she's lethargic and not even sniffing her food. Call my vet to explain that I'm bringing her in and suggest they find time in the schedule for me.
I see Dr. R instead of Dr. W this time, but of course he's got her records and notes. Says that some blood in the vomit is not as serious with cats as with humans or dogs; no need to panic. Can do xrays again, of course, and will if I want, but honestly thinks, based on her history and the exam, that it's the same thing. Would like to do the CBC again, to make sure she hasn't headed into renal failure, but otherwise would like to treat the symptoms and see how she does. I agree to this, and go home with the prescription again, plus the recommendation to add a quarter of a Pepcid pill once a day for a few days. Treatment works, plus CBC comes back with results in elder kitty's previously-standard "are you sure this cat is fourteen?" range. Total, $230.
Couple of months later, again, vomit, lethargy, not eating. No blood in the vomit this time. Call the vet, talk to Dr. R. "Does anything seem different from previous episodes? No? Try the Pepcid first, and call if she doesn't improve quickly." Total, $0.
I love my vets. They take me serioiusly, but they don't encourage panic.
I don't know anything about this Dr. Kotlarenko, and I haven't watched the video, but the _prices_ don't sound out of line, especially given that she's in Hollywood.
Lis March 5th, 2008 07:29:00 AM
Regarding some quoted prices, a CBC/chem for $39 is a steal - and I wonder if we're comparing apples to apples here. Are we talking an automated CBC or a manual count and some hematocrit tubes (the automation is more expensive in terms of equipment, and you'd expect a higher price as a result)? Regarding the chemistry, is this a total panel or just a liver or kidney panel? I'd be shocked if I could get a full CBC/chem12 (with or w/out a manual differential) at any hospital for under $80 - and I've worked at several. Is that fecal exam performed just as a floatation, or is it centrifuged and also direct-smeared and stained? The radiograph charges are pretty cheap, too. It's important to understand these differences (and whether or not you feel they're worth paying for) when you compare prices at different clinics.
" Otherwise, most vets will wait and see and explain vomiting can be normal or a sign of a serious disease."
You've hit the nail on the head, but maybe not how you've intended. Yes, it COULD be, and is probably, nothing. But it also could be pancreatitis, foreign body, etc., etc...and you'd miss every single one of those problems w/out some basic testing. The list of differentials w/intermittent vomiting is staggering. What's best FOR THE PET is to make sure you're not dealing w/something serious and to run any reasonable tests that could narrow your diagnosis as long as they don't involve any more harm to the pet than is reasonable (pets will survive a blood draw and fecal collection just fine) and to maybe send home some fairly innocuous medications (cimetidine, etc.) in the meantime to help the pet feel better. What's best FOR YOUR POCKETBOOK may be totally different - either no diagnostics or diagnostics postponed until it's obvious the pet is in trouble. I'm not saying the second option isn't understandable - you do the best you can. But I wish people would rethink what their definition of a "good" vet is - is your definition of a "good" vet the one that saves you the most expense, betting the odds that your pet is fine (even if they're good odds)? Or is your definition of a "good" vet the one who always puts forth recommendations that are in the best interest of the pet, regardless of the cost? Or is it a combination? Apples to oranges.
Either way, the ultimate responsibility is on the shoulders of the pet owner. You can decline diagnostics if you want to, but don't you dare come back and threaten lack of care if your pet goes downhill (assuming the risks have been explained to you - if not, that's a whole other can of worms). Doctors are not psychics, they are not gods, and they are not magicians. They have tools at their disposal and they know how to use those tools to help your pet, but they can't do anything but make an educated guess (and quite a good one, most of the time) if their hands have been tied w/a refusal to run diagnostics. The problem is that a guess may be better for your pocketbook but not your pet, and I have a feeling some people resent the responsibility of having to choose.
anna March 5th, 2008 03:34:00 PM
Well said Anna.
I haven't watched the video....but I have little-to-no interest in this type of typical "investigative" reporting (unless it's about waiters sneezing in food - ew).
It seems to me, that the grain of salt here needs to be that fact that these people are taking an animal into a new vet that has ZERO history with this pet and owner. So, aside from gathering background on the new patient, after hearing the symptoms I know if I were the medical professional, I would play it on the safe side an order a battery of tests to see what I'm dealing with. If I have no history with an owner or pet, doesn't that make sense? I would ideally want previous health records, but if that is not what's happening, I guess I need to start from scratch and rule out underlying issues. So, right there you're racking up a bill for tests.
As for the specifics of the video, I can't comment.
Creature of Habit March 5th, 2008 05:16:00 PM
Yes, I'm referring to lower quality tests, chem12 probably not chem18,
flotation only, basic x-ray equipment, and so forth.
The argument about "what's best for the pet" makes sense, but
$500 could be spent on diagnostics for the insignificant vomiting
issue only to have the dog go home and bust an ACL. Most owners
don't have an infinite rainy day fund, so each situation is different.
eli March 5th, 2008 05:27:00 PM
Didnt see the video. And I am from Germany, so legislature considering veterinary medicine may be different here- So forgive me if what I say doesnt aply to the current case.
So Dr. Jeff Werber examines the animals first and proclaims they are healthy. Assuring the viewers that the dog is completly healthy without running any tests? A bold claim indeed. Shure, you can say from just seeing a healthy dog for a few minutes and doing simple non-expensive tests that there is no indication for expensive tests. But you cannot be shure the dog is completly healthy. I just want to point out that if a pet owner wants assurance from a vet that an animal is healthy (done before selling/buying expensive animals, or allowing expensive animals to breed) it is quite a procedure - and if the vet doesnt find problems which later turn up, he often is in for hell lot of compensational payments (at least here in Germany, I dont know how this legal problem is handled in the US). Claiming that an animal is healthy without lab diagnostics and x-ray? Risky.
Would be interesting what Dr. Werber charges for proclaiming a dog as completly healthy. If he does the whole lab diagnostics, he probably wouldnt be that much more cost-efficient than Dr. Kotlarenko (who just did a COMPLETE check-up. Which I would, too, if the owner REALLY wanted to know what could be wrong - and I assume that the undercover pet owner came with the question "what does he have?"). If he doesnt, i`ll suggest you bring your dogs (even better, your expensive racing-horses) to him for certification before selling them - that way, alot of hidden problems of your animal wont decrease the price, while he is giving his word for their healthyness...
Felix March 5th, 2008 05:40:00 PM
To me a "good" vet is one that is friendly, intelligent, and really cares. If they can show compassion for their job then they are good with me. Now they need to know what they're doing and not take advantage of me neither. My vet is nothing but honest with me and if I take my pet in and he says that he needs to run a few tests, I'd let him. I don't know if I'd let him do an eyelid scraping lol. That's just too weird for me. He's handled my dogs and rats and was gentle as a lamb with them all.
ashleigh March 5th, 2008 10:16:00 PM
He could say they were healthy because they were his long term clients. Hence my suspicion the media helped one vet set up the whole story for them, they just bring the secret cameras. Curious minds wonder what the motivation was....
I have no doubt at all vet performance varies, but where one does a little eye lid scraping another sells his clients his own named-brand of aromatherapy shampoos. Not sure there is a huge difference there.
Maybe next month they will take dogs that are long term clients of another practise to groups including Werber's own and see what happens?
emily March 7th, 2008 01:41:00 PM
I use to work for Dr. Jeff Werber when he opened his practice over 15 years ago and he is by far the most committed amazing doctor whom absoultely cares about the animals. I am now a rep in the veterinary industry for amazing innovative products and am sickened and disappointed how I am faced every day with many doctors being more committed to their contracts on getting the "best deals" on products than to their commitment to exploring every possible solution for their patients. Or saying they are "not interested" when they do not even know what they are saying no to! Regarding the products I rep, there are almost 100 entries on the internet about pet owners whom spent tons of money at doctors and then they switched DVMS or heard word of mouth about our products which brought relief and offered long term management, in a way they could afford with no side effects. Says something doesn't it? Unfortunately its the doctors whom are causing people to realize that they must do some serious home work. How we now mistrust human doctors and drug companies, seems the same is following with Veterinarian side. Thank goodness there are many amazing ones like Dr. Werber, and I applaud him for taking a stand. Anyone whom questions his intentions does not know him and should take the opportunity to do so before making judgements!
anonymous June 6th, 2008 12:02:00 PM
From one anonymous to onother one. I think Dr. Jeff Werber is more interesting to sell his chip quality dog and cat shampoos on the internet - www.jeffwerberproducts.com - then dedicate 100% of his time to veterinary profession. Here is what some of his clients say: “Unfortunately, the GREED MONSTER got a hold of this guy and his wife and has ruined his very fine reputation!” “...I've never gotten out of the place for less than $100 (even for a simple vaccination visit) and I've witnesses at least three people becoming very upset and surprised when they hear that the bill is around $700 upon checking out.” “…my bill for a checkup for an ear infection was 156.00.That included an unauthorized ear plucking session, 3 medications and a waste disposal fee… I felt ripped off and silly for even going there.” “Your card is going to smoke and melt because of the fees they charge. $600 for an examination. Another $400 for treatment. And then another $400 for a follow-up. This is not for kitty leukemia or anything exotic, either. Just a simple infected bite.”
anonymous February 14th, 2009 06:14:09 PM
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