Vets Insisting on another call out and exam

[Gingerwitch]

My old horse has been on medication for the past 8 years - first bute - then changed to Danilon. She is on one satchet per day, and two if she is really bad with her arthritus. Vets last saw her in May which ended up costing me £800 - prior to this i have spent thousands on x-rays, cartrophen, injections etc and all have said she is 2/10th lame due to arthritus in most of her hind joints

I phoned up for a repeat perscription of the danilon today (as i usually do)- and they have refused unless i pay for a call out and examination which will cost me approx £75.00.

Do you think this is fair - i am just angry as over the past 8 years i have spent huge amounts of money with them and have seen at least 7 different vets from the practice - and they all to a man have diagnosed arthritus and told me to treat with bute etc - i was even told i could give upto 3 sachets of bute per day. Now is this just the jobs worth on reception (she is rather a madam on a good day) or do they have a point?

 

[Cazza525]

I would buy the danilon elsewhere and only call the vet out in the future if needed. You can buy it prescription free off the net.

 

[LadyRascasse]

i would ask to speak to your vet directly, never had that problem with repeat prescriptions.

 

[Gingerwitch]

Cazza525 - where can you get it prescription free off the net - all the sites i have seen are "with perscription" and my vets wont do that - well so the receptionist says

 

[billypickles]

my vet wanst to see my old lad evry year cos he has bute most of the time for arthiritus. i take him to them so it costs less.
ask them how much they want to see him. it isnt a year yet?

 

[ofcourseyoucan]

usually if they have seen the animal in the last 12 months then they can do a repeat prescription for danilon, bute etc. i think this is guide lines from BEVA. could you ask the last vet to see horse phone you direct? i have an oldie on danilon and get a repeat prescription as req within a 12 month period. he is assessed annually, his meds very according to how he is in himself and the ground conditions.

 

[LeFox]

[ QUOTE ]
Cazza525 - where can you get it prescription free off the net - all the sites i have seen are "with perscription" and my vets wont do that - well so the receptionist says

[/ QUOTE ]

Then I would be changing vets I'm afraid.

 

[Keltic]

[ QUOTE ]
I would buy the danilon elsewhere and only call the vet out in the future if needed. You can buy it prescription free off the net.

[/ QUOTE ]

Please show me where from?? Im in the same situation as the op!!

 

[Cazza525]

Hiya, unfortunately, the only place I got 60 sachets of danilon no longer does prescription free. I will research further for you. X

 

[Gingerwitch]

I did phone another local vets - but they want £70.00 for a box of danilon, after intial vist - where current vet wants £45.00 -

I use one sachet a day - and 60 in a box - so its a bit of a steep increase.

Now i dont normally mind shelling out any amount of money for the horses.... but i feel like i am handing over cash for nothing - what is the vet going to acheive? They will then want to x-ray to see changes in the joints, take blood samples etc... why she is 23, retired and in good health apart from being a bit doddery on the legs. She cant be mended, its old age - and i am afriad it just makes me feel like a cash cow, as it is money for old rope.

 

[SnowandSunshine]

I think you might find other vets are the same. They have guidelines they have to go by. Some vets are a little more relaxed but I was told they are required by law to see the horse every 6 months.

I had the same problem, called vet to see my mare on basis she might need bute etc for arthritis. Vet said shes ok for now but if it gets any worse let us know and you won't need another call out. When I did call them back about 10 months later they told me they needed to see her again as there was an interval of over 6 months.

Could you try to speak to the actual vet who dealt with your horse rather than the receptionist? They may be more prepared to 'bend the rules'.

 

[Gingerwitch]

You know - i dont even object to the call out fee - its the exam fee - £35.00 - to watch me trot a horse who is obviously lame - to feel round joints that are obviously stiff - and take approx 3 mins.

I am not pleeding poverty by any means but you feel like saying - ok come and view the horse and if it isnt arthritus i wont pay for the visit

 

[Bethie]

As alexe says, vets now can't give a repeat prescription for drugs if they haven't seen the animal in the past 6 months. So its not just your vet being funny with you.

 

[star]

unfortunately we're not allowed to keep handing out prescription meds without checking the animal at least once a year and preferably every 6mths. We need to be able to justify that the animal is under our care which at least involves a physical exam and with animals on long term drugs a blood test to monitor their liver/kidneys is a sensible idea.

 

[Gingerwitch]

star - what about the people that are struggling financially? by doing this legislation is potentially causing suffering to some poor creatures. Face it £70 quid is 3 months pain relief for the horse....
Why cant a review be done at "vacination"?

Does the amount of much money that has been made from the clients horse having "arthriuts" ever get taken into consideration - serioulsy i must have spent ove £5k on the various treatments, visits, x-rays, injections etc.... this time last year they wanted to do a full limb x-ray set to see all of her arthritic joints - i refused and basically said enough was enough - i could not spend more thousands on something that was not going to be cured.

Must admit as i have stopped playing nicely with my cheque book - things do seam to have changed to be the letter of the law.....

 

[ester]

I dont think it is unreasonable, I think it would be very bad practice for vets to continue to do repeat perscriptions having not seen the animal in question in the last 12 months, perhaps in future it would be advised that you ask for a review at the same time as vaccs. I dont think the amount of money you have spent previously is really relevant tbh.

 

[Gingerwitch]

Ester - the problem is she was seen in May - i begrudgingly can understand a yearly visit requirement but this is a long term chronic illness that is only set to get worse rather than better - so i do object to a 6 montly visit requirement... and i do think that the money spent is most relevant to the matter.

The other choice is to stop being milked and let the horse suffer a greater degree of pain - now that is what i class as unreasonable.

 

[Flame_]

This time I would take your horse to the vets to avoid paying the callout and long term I'd change vets to a practice that are happy to work around stupid EU rules.

 

[Gingerwitch]

Arhhhh the EU interfeering again as usual and good old UK follows along like the little lamb to the slaughter.

Pity we are not in France - they may be garlic eating surrender monkeys but they do stick up for them selves!

Apologies if you are french and dont eat garlic, or surrender

 

[Flame_]

[ QUOTE ]
I dont think it is unreasonable, I think it would be very bad practice for vets to continue to do repeat perscriptions having not seen the animal in question in the last 12 months,

[/ QUOTE ]
But what good would coming out do? I have an old pony on long term bute. Her alternatives are - stay comfortable on bute, stay uncomfortable off bute or be pts. I ask for a review if vet's there anyway but this really annoys me. I won't spend money on a vet call out for them to say, hmmm its a bit stiff here's some bute, when that's already been the successful approach for the last 15 years.

 

[Gingerwitch]

Flame - Just my point - and what makes it worse is that you are left to up and down the dose to suit "as you know your horse better than we do"

 

[ester]

but as star says blood tests are also advisable for horses on long term bute.

fwiw i know its different my cat is on long term medication, he is doing amazingly well on it, vet prescribes 3 months at a time but does like to seem him every 6-9 months, I know he is great, she doesnt so I dont mind this.

thankfully I wouldnt have this issue as my vet has free call out days for different areas.

 

[star]

we dont make the rules we have to follow. unless we want to get struck off we're not allowed to prescribe meds without being able to justify that the animal is under our care. for some cases, this can mean a visit every 12 mths (and is fine to tie in with vaccination), for others it can mean a check every 6mths or somewhere in between.

i do understand that with an old horse who needs bute to keep it comfy then a visit isn't going to change anything, but it's something we have to do. i know it's more money to find but unfortunately that's horses for you - they're expensive creatures. you really cant blame your vet for sticking to the rules.

 

[virtual]

Imagine if a vet continued to issue repeat prescriptions without seeing the horse and this caused harm to the horse - perhaps the medication was no longer required or the horse was having side effects such as liver or kidney problems. The vet issuing the prescription would be at fault and could loose their registration if found to be negligent.

I know it's a hassle and expensive and in some cases probably unnecessary, but I can see it from the vets' point of view too.

 

[Flame_]

[ QUOTE ]
but as star says blood tests are also advisable for horses on long term bute.


[/ QUOTE ]
We're talking about old horses with low values. I can't speak for OP, but if Flame were to be ill she'd be pts, she's had a good long life, but to maintain her day to day quality of life she needs a constant supply of bute. The vets don't have to take bloods to give the medication anyway, they just have to come and log a visit and exam, and what can they see? Yep, "old pony, slightly unsound, requires mild pain relief."

 

[star]

[ QUOTE ]
[ QUOTE ]
but as star says blood tests are also advisable for horses on long term bute.


[/ QUOTE ]
We're talking about old horses with low values. I can't speak for OP, but if Flame were to be ill she'd be pts, she's had a good long life, but to maintain her day to day quality of life she needs a constant supply of bute. The vets don't have to take bloods to give the medication anyway, they just have to come and log a visit and exam, and what can they see? Yep, "old pony, slightly unsound, requires mild pain relief."

[/ QUOTE ]

i really do appreciate that - my friend has a horse just the same. i think his joints will give out before the bute causes him a problem, but we still have to check him every year so that I can say he's under my care. i dont bother with blood testing him, but this is advisable for some.

 

[katrinamward]

In agreement with Star, I know folks that callouts cost money but we vets are responsible for the well being of your animal. If complications were to arise due to long term treatment and we hadnt seen the animal recently not only would our neck be on the line legally but also i'm sure many owners would point the finger too and of course the most important thing here is that we would not be protecting the animal's welfare!

As Star mentioned long term use of NSAIDs can lead to liver and kidney damage and gastric ulceration. I've had to put down 6 horses in the last 2 months due to liver failure and i can tell you its not nice! The other problem is that not everyone is honest in their use of bute/danilon. Sometimes a drug prescribed for one animal will end up migrating around the yard and being used for other animals that may not be used in the correct circumstances therefore endangering the horse. The other thing that most horse owners dont know is that bute currently isnt licenced for use in the horse so we have to use it under a system called the cascade. Where we can use a drug that is licensed in other animals as long as there is not another appropriate drug available that is licensed for that species. Therefore we have to be extra vigiliant.

In our practice we are happy to provide a prescription with instructions for several repeats for a small admin fee. (about a fiver i think) and will try to combine our checkups with other routine work such as vaccinations in which case we wont charge an extra examination fee, or visits to other animals on the yard. And of course we are very happy for you to bring your animal to us.

Please dont think we are all out to rip you off. The majority of vets really dont want to force visits on you or high bills. But we do have a duty of care to our patient; your horse and have to act in a way that makes sure we look after their best interests.

 

[star]

[ QUOTE ]
The other thing that most horse owners dont know is that bute currently isnt licenced for use in the horse so we have to use it under a system called the cascade. Where we can use a drug that is licensed in other animals as long as there is not another appropriate drug available that is licensed for that species. Therefore we have to be extra vigiliant.


[/ QUOTE ]

erm???

bute is licensed for horses as Pro-Dynam and Equipalazone. Danilon is also licensed for horses. There's no cascade involved in prescribing bute. The only thing we have to make sure is that the passport has been signed at the back to say the horse wont be going into the human food chain.

 

[katrinamward]

Oh great thanks for embarrassing me in front of everyone! Thought we vets werent meant to question each other in front of clients but maybe just tactfully point it out privately. I was quoting the senior equine partner at my practice who always tells our clients that.I did think it odd when he first told me but didnt question him. I'll go and look it up myself.

 

[ester]

well I was going to question you anyway, thought otherwise they might not be able to put a horse on the packet of equipalazone.