“Everything looks worse in black and white,” Paul Simon sings on the album version of “Kodachrome,” though he sometimes alters the line to “everything looks better in black and white” in live performances. Simon says he simply cannot remember which word he used when he wrote it, and that nothing significant should be read into the change, yet the Interwebs are a-tangle with theories and deep thought on the matter (Does everything look better in black and white?).
The line is a lyrical wink anyway, whether taken at face value or in a more interpretive direction; shades of gray lurk in both color and black and white. It is into these murky areas that some veterinarians are wading when it comes to the senior pets who have long colored our lives and whom we love with black-and-white clarity.
With a move about five years ago came the need to find a new vet. After the requisite research, I settled on a doctor whose exam costs seemed reasonable, and whose reputation and new, state-of-the-art facility seemed worth the lengthier drive than other options; Reese, closing in on 7, was battling the early stages of hip dysplasia, and Wyatt, then 2, had recently been diagnosed with an autoimmune disease. Wyatt was first, and he received what I considered a thorough physical exam, the appropriate vaccinations, and a blood test for about $85. Reese followed a couple of months later, receiving a brief physical, and the same shots and blood analysis as Wyatt; the cost, however, was double. Reese, the veterinarian explained when I questioned the disparity, had undergone a “senior exam.” I further challenged how Reese’s checkup differed from Wyatt’s, and was told that it was “more thorough.” We did not stick with that vet long enough for Miles to undergo his fast-approaching “senior exam.”
After moving to a new home a couple years ago, the dogs began visiting a small, nearby animal hospital that had been enthusiastically recommended. The doctors have provided thoughtful, compassionate care at fair prices for everything from annual checkups to the diagnosis of inscrutable lumps to oral surgery, never once charging more for an exam because a dog was elderly. But a few months ago, when reviewing the receipt for Miles’s initial diabetes assessment, I noticed a $143 fee for “senior screen.”
I didn’t give it much consideration at the time, as the visit included a comprehensive exam as well as blood, stool and urine tests, and lab analysis (the total bill arrived at nearly $400). But when we recently returned for a follow-up visit, which featured a five-minutes-tops physical and a blood draw to conduct an in-office check of blood-sugar and enzyme levels, I was again charged $143, in addition to lab costs, for a “senior screen.” As Wyatt the dog and Marge Simpson would say when agitated, Mmmm.
I bit my tongue and paid. Then I went home and pored over previous veterinary records. Reese, who just turned 11, is a senior dog by any definition; he was at the same vet about six months ago for his yearly checkup, vaccinations and blood test, and the total cost was just over $85, with a $55 fee for a “health screen.” Suddenly transformed into a bad TV reporter, I called the veterinary office and pretended to be a prospective client; I asked about the costs of basic exams and vaccinations, and whether there were additional fees for older pets. I was told that the facility had indeed begun charging extra for senior exams because they were “more thorough.” I didn’t bother pressing for specifics.
The idea of a geriatric health screening isn’t inherently a scam, even if some veterinarians’ employment of it is a grift. Dogs are generally considered senior around age 7; like humans, their risk of developing health problems increases with age. A dog’s size, weight, diet and existing medical conditions also play roles; large dogs tend to age faster than small dogs, as do obese dogs versus fit ones, and some breeds are genetically predisposed to specific health concerns. According to the American Animal Hospital Association (AAHA), a quality senior health screening should include the same general services as a routine adult checkup, but with a focus on “areas of increasing concern in the senior pet.” This includes a complete, attentive physical exam in addition to urinalysis, blood work and fecal analysis; further tests, X-rays, or sonography may also be also be indicated. Some veterinarians, however, are charging for geriatric exams based on age alone rather than services rendered.
Compared with human health care, the cost of medical care for pets is relatively inexpensive, and I believe most of those who pursue veterinary medicine do so with noble intentions. But our affection for our pets, our desire to do whatever we can for their health and happiness, and our willingness to trust our veterinarians’ advice leaves us vulnerable to the few who attempt to financially exploit those factors.
When I think back on all the crap I learned from years of canine health issues, the primary lesson is: You’ll save yourself frustration and consternation if you address the costs and details of a senior pet screening, or other medical assessment, with your veterinarian up-front and in black-and-white terms. A handful of unethical vets may lurk in the shadows, but most are motivated by helping pets live long, Kodachrome-colorful lives.