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New Careers?

While we wait, vet questions.

At this moment, Arthur is at the hospital, presumably about to or already undergoing his feeding tube surgery. We’re waiting to hear from them and haven’t yet. In the mean time, I have a question, which I posted elsewhere earlier, but thought I would share here as well.

As I said earlier, I am not 100% happy with my vet right now, though Liz still does so the opinions expressed here are mine alone.
Questions:

1. Should I start shopping around for a new vet right now or wait until Arthur hopefully recovers?

2. If I do shop around for a new vet, here are the choices I have narrowed down to. Remember that I live in Manhattan.

What do you think of each (my apologies if any of these people find this post on Google and see me talking about them)

Choice #1: The Manhattan Cat Specialists (http://www.manhattancats.com/). This one is recommended highly by my cat sitter Leslie, who has used them for years. She says she can get me a free phone call with the head vet, Dr. Plotnick, just to take my questions and decide whether I want to use them.

A few negatives here:

A. They are very far from my apartment (long, expensive cab ride)
B. They work with the same overpriced hospital (NY Veterinary Services) that my current vet has been tossing us to. The bad side of that is that I’m not a huge fan of NYVS and their extreme charges. The good side, right now, is that it would be an easy transition at the moment, because Dr. Plotnick has a relationship with NYVS so he could easily consult with the doctors there on what they saw and did to Arthur. If I talk to Plotnick, I will ask him whether he performs some of his own surgeries rather than constantly turfing people to the hospital like my current vet. If he can do things like add/remove a feeding tube in his office, maybe his relationship with the NYVS isn’t that problematic.
C. Practice will probably be as expensive or more than I’m paying now.

Positives:

A. My cat sitter knows all the city vets and picked this one.
B. Dr. Plotnick sounds good (http://www.catchannel.com/experts/arnold_plotnick/default.

Choice #2: ASPCA Burgh Memorial Hospital (http://www.aspca.org/aspca-nyc/berg-memorial-animal-hospital.html). A friend of Franny’s recommended I call their head of vet medicine, Dr. Murray. Dr. Murray does not see new patients anymore, but I ended up talking to her administrator for like an hour and the administrator advised me to seek a second opinion and to demand my current vet give me more info.

Pros:
* ASPCA is known for being affordable
* Michelle, the administrator I spoke to, seemed to geniunely care a whole lot about Arthur, calling me about 3 times throughout the day even though I’m not a client (yet) and paid her nothing.

Cons:
* I don’t know a lot about the doctors there
* They have some very poor ratings on Yelp and other online comment services, these talk about long wait times and more of a public clinic atmosphere
* Also, very far from my house.

Choice #3: The Cat Practice (http://www.thecatpractice.com/). I actually don’t know much about this place, except that I found it online and it has really strong user reviews. It’s also only about 15 blocks from my apartment, which is still a cab ride but a short one.

Pros:
* Close to home
* Good reputation (at least as I’ve seen online)
* Web site makes it sound good

Cons:
* Allegedly expensive
* They don’t know me and I don’t know them at all. I have an “in” with the other two vets.

Choice #4: Stick with my current vet. Current vet is located walking distance from my house and does not charge exorbitant prices, except that she is constantly trying to pawn us off on the hospital for procedures / tests I wonder if she could have done in her office. My wife likes her, but I am losing confidence in her after she A.) was slow in returning some phone calls, B.) Would not give us a straight answer about Arthur’s diet or condition and C.) Thought he was fine until I had to ask her nicely to conduct a blood test that she didn’t think was necessary.

Pros:

Close to home
Knows our case very well
Seems like a nice enough person
Her own services are not overpriced, when she’s not sending us to the hospital

Cons:
In my opinion (but not Liz’s), she exercised poor judgment in a number of areas:

a. She would not give us a straight answer about arthur’s food in-take, saying only “if he eats even a tiny amount, that’s ok.” And when I said I had heard / read different, she said “don’t trust the Internet.”
b. If we listened to her, Arthur might be a lot worse right now, because she said he was getting better, until we forced her to do a test.
c. She seems to want to refer us back to the hospital whenever possible. Couldn’t another vet be performing some of the needed procedures/tests – the sonogram, tissue tests, and feeding tube insert — in his/her own office at less cost? When we asked her if she could refer us to a less-expensive hospital, the only option she offered was to not insert the feeding tube and “see what happens.”

SO MY QUESTIONS ARE:

A. Should I switch now or wait until Arthur is better?
B. If I do switch, who to?

Full post on New Cat City

Biopsy Or Not?

So, my wife just got a call from the hospital; Arthur came through the feeding tube surgery ok, though for good measure they are going to charge us for an additional blood test (we don’t know how much yet) b/c they tested his blood clotting to see if he would bleed too much. That means the feeding tube procedure all by itself will have cost well over $1,100.

Liz will be picking up Arthur in a couple of hours and will receive food and instructions at that time. However, they already told her that we need to get his liver test redone in just 2 days. If the test does not show significant improvement on Friday (less than 48 hours from now!), they are saying they would like to do a liver biopsy.
A liver biopsy would involve cutting him open at very significant cost (if a feeding tube is $1,100, and a couple of blood tests is $3,200, what do you think open chest surgery is – $10,000?) so unfortunately I think the hospital is “rooting” for this outcome. The biopsy would, we guess, determine whether he has cancer or not, but if he does, it doesn’t sound like much can be done.
My question: Is less than 48 hours enough time to see the kind of improvement they are looking for? If the test numbers come back the same or worse on Friday, should I go along with their biopsy, ask for more time, or go for a second opinion somewhere that has no association with this hospital?

Full post on New Cat City

Arthur Home With Tube In. More Vet Impressions


So I came home from class tonight (really felt like I couldn’t miss class two weeks in a row) and Liz had picked Arthur up from the vet already and gotten instructions. He is feeling groggy from the anesthesia. Liz was told to keep an eye on Arthur all night tonight to make sure he doesn’t fall asleep with his head in the water or food bowl and presumably to make sure he doesn’t disturb the tube.
The picture above shows Arthur practically passed out in front of the bowl. He did actually eat a 1/3 to 1/2 of the bowl before he laid down again. What concerns me about this tube is the placement. Any time he rubs his head against anything (which he does all the time), he is jostling the tube. Did the vet put it in the wrong place?
He is supposed to get 4 meals a day for a total of 250 calories for the next few days. He is supposed to get his liver values checked again on Friday and hopefully we will see improvement. As I said in an earlier post, the hospital wants to do a biopsy if he doesn’t improve, though Friday is not necessarily a firm deadline for improvement.
I am VERY concerned about the tube. On the one hand, I think it’s necessary to help him consume enough calories. On the other, I think they positioned it very precariously on his neck. If it comes loose, if he vomits, if he bleeds, if anything happens at all, he has to be rushed to the hospital again.
Call me a nattering naybob of negativity but I’m concerned that the hospital doesn’t care about helping Arthur at all. For over $5,000 in medical expenses, not only have they failed to make him better, but his liver numbers actually went up. And they don’t seem even remotely interested in answering questions or providing us with the information we need to help him.
This morning, I brought a printed listed of questions to the hospital. I waited patiently for the doctor to come over and explain the procedure. Then I started asking her questions. She said “it sounds like you put a lot of thought into this, let me take your paper so I can properly answer your questions when you come in later.”
When Liz came in later, she did not get to speak to the doctor, but to a vet tech instead. The vet tech handed her back the paper. You can see in the picture below how seriously she took our questions.
If you click the image, I believe it will enlarge so you can see my Qs and her As or lack there of. The first question, “how much food does Arthur need to eat each day?” is one that she would not explicitly answer for us last week and which our regular vet would not answer either, until the feeding tube was put in today and they finally said “250 calories.”
Was asking about required food intake too much to ask? If we had known about that 250 calorie number over the weekend, we might have been able to act upon that information, feed him high-calorie feed and prevent him from getting worse. Instead, I was shooed away by both the vet and the hospital doctor, both of them annoyed by my questions and telling me things like “if he eats at all, you shouldn’t worry” or “I can’t really tell you how much your cat needs to eat” or “don’t believe things you read on the Internet about how much a cat with fatty liver disease needs to eat.”
Anyhow, right now, we can only pray that the feeding tube works, that Arthur gets better, and that we can move on from this.

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