COVER STORY : When Pets Become Patients

Rudy Nusic used to think James Herriots’ novels were too good to be true--but not since his wife, Dr. Evelyn Nusic, began tooling around North County in her mobile veterinarian clinic two years ago.

“She comes home with some pretty incredible stories,” he said.

Nusic and her colleagues are licensed to treat all species, but most focus on companion animals--dogs, cats, birds and exotics, which Nusic calls pocket pets--reptiles and rodents.

While North County continues to grow, its pet population does likewise. An estimated 60% of households have at least one companion pet. Increased urbanization and a desire for “low-maintenance” animals have made cats the No. 1 household pet in the United States, followed by birds and dogs.

As with humans, animal longevity has received a boost from advanced medical technology. Veterinarians routinely use human medical equipment--sonographs, bronchoscopes and endoscopes--for diagnostic tools.

There are about 400 licensed veterinarians in San Diego County. Specialty veterinarians perform intricate surgeries in operating rooms similar to those in human hospitals. Today it is not uncommon for a household pet to undergo heart surgery or cancer treatment.

According to the San Diego County Veterinarian Medical Assn., North County has board-certified veterinary specialists in anesthesiology, dermatology, family and general practice, dentistry, internal medicine, oncology, and surgery. There are also veterinarians who have a special interest in areas where certification may not be available such as avian (birds) medicine and reproduction.

Technology and talent do not come without a premium. “Vet care is not for the ordinary person any more,” said Norma Brennan, a volunteer for Mercy Crusade--an organization that helps low-income families with veterinary expenses. “I will have 20 to 25 calls a day, and most are heartbreaking,” she said.

Vets say human medical expenses tend to be included in the family budget. This is usually not the case with pet health care expenses.

Pet insurance is an option for some pet owners. However, most professionals in the animal field agree these plans have a long way to go before providing adequate coverage.

Following is a look at a few of the many veterinary organizations in North County offering health services for household pets--primarily cats, dogs and birds.

ANIMAL HOSPITALS, CLINICS

Prevalent in North County are animal hospitals or clinics where pets are treated by a licensed “family” vet. Veterinarians usually own or are affiliated with a hospital, such as Acacia Animal Hospital in Escondido.

Owned by Dr. Gary Gallerstein, Acacia is a mixed, small-animal practice with a 2,000 square foot work space and $50,000 worth of diagnostic equipment. There are two treatment rooms, a large central work area with a lab and pharmacy, boarding cages for 34 animals, and a fully computerized office and reception area.

Acacia is one of the few veterinary hospitals in the area to voluntarily participate in the American Animal Hospital Assn., which conducts regular inspections to meet stringent standards.

“It brings your quality of care right up to the top,” said Heather Acker, hospital administrator and veterinary technician.

While Gallerstein has treated everything from a frog hit by a piano to an injured mountain lion over the past 13 years, he is best known as the “birdman” for North County. He has written a book entitled Bird Owner’s Home Health and Care Handbook, and local bird owners often find their way to his office.

Bird examinations range from $27 to $31, while exams for dogs and cats cost $27. When Gallerstein tests a bird for parrot fever, the cost is $37.25. On the average, bird X-rays cost $43 to $50.

Gallerstein and his associate see 35 to 50 patients daily. If emergencies occur after normal working hours, patients are referred to the North County Emergency Animal Clinic; however, birds may be routed elsewhere.

Sophisticated computer software allows Gallerstein to quickly generate patient education materials. Other features enable him to send EKG tracings via trans telephonic equipment to the East Coast for analysis. Results can be received within an hour, said Acker, which increases an animal’s chances for survival and reassures its owner.

Acacia Animal Hospital

1326 W. Mission Road, Escondido. Telephone 745-8115. Hours: Monday-Thursday 7 a.m.-6 p.m. Friday-Saturday 8 a.m.-5 p.m.

EMERGENCY ANIMAL CARE

When a stray animal is hit by a car or the family cat gets into a fight at 3 a.m., it can be difficult finding a veterinarian.

But North County has at least two clinics that offer emergency care with staff that is specially trained to treat trauma cases. Owned by nine veterinarians, North County Emergency Animal Clinic employs a rotating staff of professionals from 6 p.m. to 8 a.m. weekdays and 24 hours a day on weekends.

“We are an emergency clinic,” said veterinary technician Geri Wagner. “We do not give vaccines, crop ears or do elective surgery.”

Local veterinarians, who do not keep emergency hours, may refer clients via answering machine to the emergency clinic, which can be seen from California 78 in Vista. Wagner says patients are brought in from Temecula to Del Mar, but she suggests that people call first, if possible.

“If we are swamped, we can re-route their animal,” she said. “We will also tell them how to travel with an injured pet and, if the animal has been poisoned, we’ll want to know the active ingredients.”

When strays are bought in by public officials or good Samaritans, the clinic calls North County Animal Control for authorization to stabilize the pet. In return, the emergency clinic receives a minimum, contracted amount for the service. Veterinarians say pet tags may mean the difference between “stabilizing” an animal or performing lifesaving surgery.

Fees are due when services are rendered. Clients receive a high and low estimate before treatment is performed, but fees for initial exams are $40 to $50. When animals must be put to sleep, pet owners can expect to pay on average $75.

Follow-up reports are sent to the patient’s regular veterinarian, where continued care may be necessary. No animals remain in the facility after 8 a.m.

North County Emergency Animal Clinic

1925 W. Vista Way, Vista, telephone 724-7444. Hours: Monday-Friday 6 p.m.-8 a.m., Saturday-Sunday, 24 hours. Animal Emergency Clinic of San Diego

13240 Evening Creek Drive, San Diego (In Sabre Springs Business Park, telephone 748-7387. Hours: Monday-Friday 6 p.m.-8 a.m., weekends Saturday noon to Monday 8 a.m.

REFERRAL CARE

The Veterinary Specialty Referral Hospital of San Diego in Rancho Santa Fe celebrated its first anniversary this summer.

“We are now a private facility that leases property from Helen Woodward Foundation,” said Deborah Cummings, hospital administrator. The change was necessary because the small animal portion of the foundation was a major drain on the endowment originally set up by animal benefactor Helen Woodward.

The center is structured to treat dogs and cats referred by other veterinarians. Dr. Keith Richter, 34, is a certified internist, who devotes 60% of his practice to treating pets with cancer. As a rule, he does not practice general veterinary medicine.

“People who come here are really attached to their animals,” said Richter, “or they wouldn’t bring them here.”

The 6,000-square-foot center is a model facility. A large circular reception area is similar to a modern human hospital; however, it is apparent that animals still have priority--more area is allotted to floor space than seating.

Registered animal technicians tend cages equipped with heated floors and some with oxygen chambers. Human infusion pumps, EKG monitors, endoscopic equipment, and stainless steel treatment tables occupy a large, pristine room.

Another room is outfitted with a $225,000 ultrasound machine that can “measure wall thickness of the heart,” Richter said.

Initial exams cost $55 and require approximately 45 minutes to an hour. If an ultrasound test is ordered, the cost will be $150; ongoing chemotherapy, which may vary from a few months to over a year, can cost $1,000 to $5,000--depending on animal type and cancer severity. In general, Richter said dogs do amazingly well with chemotherapy.

It is not unusual to accrue a $500-$600 bill after a pet undergoes a day of hospitalization at the center for tests that include catheterization, anesthetic, bronchoscopic examination, chest X-rays and extensive lab work. Patients are offered 24-hour care, monitored by trained and licensed staff.

Veterinary Specialty Referral Hospital of San Diego

At the Helen Woodward Center, 6525 Calle del Nido, Rancho Santa Fe, telephone 759-1777. Hours: Monday-Friday 8 a.m. to 5 p.m.

HOUSE CALLS

Finding a small-animal veterinarian who routinely does house calls is not an easy chore. But doctors Ira Feinswog and Mark Nample say Shadowridge Veterinary Clinic is dedicated to providing a “full service hospital that includes house calls.”

They have integrated approximately 100 regular house call patients into their Vista practice. Most of these calls involve visits to homes of senior citizens. Feinswog enjoys the interaction with house call patients. “We treated one woman’s cat for a long time and, when it died, we surprised her with a kitten as a replacement,” he said.

Their route covers a 20-mile radius and includes Escondido, Temecula, Encinitas, Carlsbad, Oceanside, San Marcos, and Vista.

House calls cost $20, regardless of where a patient lives. Dr. Feinswog usually recommends a health exam, which if performed, costs another $20. Vaccines cost from a low of $5.50 to a high of $11 for injections covering problems like Feline Urologic Syndrome. “If a vaccine has a patent, you pay a bundle,” Feinswog said. Pet owners are quoted fees in advance, because payment for house calls is due when services are rendered.

When a patient requires hospitalization, Feinswog or Nample transport the animal to their clinic. In certain cases, a specialist may also be called in, but pet owners are advised first of the necessity.

While most vets balk at house calls, Feinswog sees it differently: “Our practice is very personalized.”

Shadowridge Village Veterinary Clinic

751 Shadowridge Road, Vista, telephone 727-7900. Hours: Monday-Friday 7:30 to 6 p.m., Saturday 9 a.m. to 1 p.m.

MOBILE CARE

Difficult as it may be to find a vet who does house calls, consider the odds of finding one who operates a practice out of a vehicle.

Enter Dr. Evelyn Nusic, one of about 200 mobile veterinarians in the United States and Canada. Her office is a 24-foot Dogen mobile home that travels through the mountain roads of Julian and other rural areas in North County. She visits approximately five to six homes a day, and many stops require medical attention for multiple pets.

She typically travels within a 15-mile radius. “I cover north of Interstate 8 and east of Interstate 15,” she said. Her fees are dependent upon distance and time. For instance, seeing a patient in her hometown of Ramona would be less expensive than taking a call in Temecula.

Nusic says most of her calls require medical exams, medication, dental care, and shots. Mobile exams average $30 to $35 and X-rays $55. Payment is expected when services are performed.

Her rolling practice is specially designed and equipped with a gas anesthesia machine, surgery table, complete dentistry unit, X-ray machine and small lab and pharmacy.

Cases that require intensive care either end up in the Nusic guest bathroom for a week at a time or at a veterinary hospital where Nusic has privileges.

Nusic’s patients are being temporarily handled by other doctors while she is on maternity leave. She plans to return to her mobile practice next month.

Mobile Pet Clinic of San Diego

Telephone 788-6850.

SPECIAL INTEREST AND CERTIFIED CARE

Veterinarians on the so called “cutting edge” are the ones who do hip replacements for hip dysplasia; balloon angioplasty for heart disease; beak reconstruction for destroyed beaks, and skin grafting for burn victims.

In the field of animal reproduction, Dr. Priscilla Stockner is considered “cutting edge.” She and assistant Carol Bardwick operate Canine and Feline Reproduction Veterinary Management Services in Escondido--a practice that focuses on artificial insemination for purebred dogs and cats.

Stockner, a licensed veterinarian, also has a degree in reproductive physiology and has been involved in frozen semen banking since the 1970s. Bardwick says Stockner is known for her work with genetically based diseases in dogs and cats.

Stockner maintains an extensive sperm bank and a library with books and videotapes on animal reproductive technology. Telephone consultations related to breeding cats and dogs cost $35. “Do it yourself” cooled semen kits are sold for $75, and frozen specimens can be stored in Stockner’s bank for $75 a year.

The cost to artificially inseminate two dogs is $150. Fees for genetic screening normally cost $500 per animal which includes X-rays, lab work and diagnosis.

“The worst thing is to spend $500 to $600 on a puppy and find it has hip dysplasia” said Bardwick. By evaluating purebred dogs and cats for breeding purposes, she said that genetically based diseases can be avoided.

Canine and Feline Reproduction Veterinary Management Services

340 State Place, Escondido, telephone 739-1091. Hours: Monday-Friday 10 a.m. to 5 p.m.