Top-Dog Doctoring for Pets

In the cold operating room, the surgeon starts to sweat.

Through his wet plastic face shield, Dr. Robert L. Rooks peers deep into the open hip of a muscular Rottweiler named Thor. Two technicians pull hard at the opening with retractors, their feet planted in a tug-of-war stance.

“It’s a real tight fit,” Rooks mutters via headset to his four surgical assistants.

It’s the fourth hip replacement of the day for Rooks, who works in a veterinary operating room set up exactly like one for people. The $3,500-a-hip surgical procedure for dogs also is the same as it would be for human patients, from the sutures to the $450 disposable scrubs.

Here, at All-Care Animal Referral Center, Rooks is among the leaders of a veterinary movement that aims to match the sophistication of human medicine. The 24-hour critical-care facility, and a handful of other hospitals nationwide, offer a Mayo Clinic approach to treating pets--top medical and surgical specialists along with the latest technology and treatments.

As one of America’s biggest and most high-tech veterinary hospitals, All-Care receives referrals from around the nation--tricky cases such as brain surgery on a Doberman, back surgery on a cat and an ovarian hysterectomy on a pet desert tortoise. Its 25 veterinarians--and out-of-state specialists who fly in for weekly consultations--use $4 million in advanced equipment purchased from human hospitals, including a Cobalt-60 radiotherapy machine, CT scan and magnetic resonance imager. (No other private veterinary hospital in the nation owns an MRI).

“I want to . . . give a standard of care that is the same as [Children’s Hospital of Orange County] gives for kids,” said Rooks, 42, who recently was named veterinarian of the year by the American Animal Hospital Assn.

Rooks and his colleagues say they offer a range of treatment options and let pet owners decide how far they want to go; some go into debt to pay off medical bills.

The amount of money spent on such pet care has raised ethical questions, as Americans pour $10 billion a year into veterinary medicine, according to the animal hospital association. (They spend $884 billion annually on human health care, the American Medical Assn says).

For advanced pet medicine, veterinarians say, treatment costs about 10% of the price of comparable care for people. But insurance helps take the sting out of bills in human care, while only 1% of U.S. pet owners have coverage for their animals.

The demand for advanced care has boosted the ranks of veterinary specialists. Since 1986, the number has doubled or tripled in fields including internal medicine, cardiology and oncology.

As a result, the type of specialized treatment once available only to people is open to animals. “Just about anything done in human medicine can be done in veterinary medicine,” said UC Davis veterinarian John Pascoe.

Veterinarians who once used to stop at teeth cleanings now perform root canals and orthodontia. They also are using technology designed for people, at times working out arrangements with human hospitals. Veterinarians borrow the MRI machine at Huntington Memorial Hospital in Pasadena to examine dogs with brain tumors.

Veterinary specialists also are prescribing drugs meant for humans, such as Prozac for lonely dogs, and are performing elective procedures including DNA paternity tests on purebred dogs for which breeding papers are important. Other nonemergency care includes DNA gender tests on pet birds such as cockatoos (whose sex is impossible to determine by sight).

“I don’t know where it ends,” said veterinarian Michael Paul, a regional director for the animal hospital association. “Every time I think, ‘This is how far it’ll go,’ someone [surprises] me.”

And only a few private veterinary hospitals go as far as All-Care.

“That hospital is one of those [where] you go, ‘That’s not the real world,’ but [Dr. Rooks] has made it the real world.”

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For fun, Rooks is the veterinarian for musher Susan Butcher’s dogs, four-time winners of the Iditarod race in Alaska.

Otherwise, he’s in surgery seven days a week, as early as 1 a.m. and sometimes until 8 p.m. He doesn’t have a desk. He reviews charts and takes calls standing up. That way, he can move faster.

Rooks grew up on a 1,000-acre farm near Eldora, Iowa, where shelties and Australian shepherds herded cattle.

As a boy, he would make his father mad by trying to sneak his dogs into the house and underneath his covers at night. Now, he sees couples whose dog sleeps between them.

“Back in Iowa,” he said, “a dog was a dog. Here, a dog is part of the family.”

Rooks graduated from Iowa State University and, after a few years of experience as a young veterinarian at a Santa Ana pet hospital, decided to start his own practice with savings and a loan.

He launched All-Care in 1986 and every year began to offer more advances, starting off with a few specialists.

“From that, we went, ‘OK, the heart specialist has to have an ultrasound.’. . . So then you step up, and you keep stepping up,” he said.

In recent years, the restructuring of human health care has left its mark on veterinary medicine. The consolidation or closing of hospitals has meant that medical staff and equipment from human care have become available for veterinary medicine. One All-Care technician, for instance, works part-time as a registered nurse for people.

These days, All-Care handles 38,000 patients annually, said William Bookout, its chief executive officer. This year’s patient load is up 42% from the same time last year.

The hospital tries to work out financing options or discounts for owners who can’t afford treatment, Bookout said. “There is nobody that walks into this clinic that goes away without us trying to help them.”

But as a private hospital, it has to draw lines, he said, the way human hospitals do.

It does treat emergency cases from Orange County Animal Control for free, such as a duck that had a 10-inch crossbow arrow through its neck after being shot in a Huntington Beach park. Thanks to antibiotics and surgery to remove the arrow, the duck recovered.

Two ambulances also pick up emergency cases--and patients arriving at the airport. Earlier this year, Anabelle, a Great Dane with a fractured pelvis, was flown in from Cabo San Lucas.

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“Welcome to the zoo,” Rooks said, greeting visitors in a soft voice.

Around him, small dogs yapped and sick dogs coughed at the 14,000-square-foot hospital, tucked away in a quiet industrial park. Assistants sprinted to the emergency room, talking into cellular phones. Three or four veterinarians consulted on a single case.

Dr. Craig S. Bergstrom coaxed a trembling dachshund into taking a few steps in a 500-gallon hydrotherapy whirlpool built for people.

A German shepherd with a possible brain tumor slid through the MRI chamber, spread-eagled on its stomach and under anesthesia. Afterward, a technician checked its pulse by holding its tongue.

On another day, after nearly two hours in surgery, Thor the Rottweiler had a new left hip made of a polyethylene cup and cobalt chrome implant. The limping 105-pounder had checked in two days before the operation to undergo a battery of tests.

One other morning, just before 5, Rooks finished spinal cord surgery on a 17-pound Lhasa apso named Wally. A technician closed the dog up with surgical staples. Wally’s fur would grow back over the scar, but Rook frowned over a slightly crooked staple.

“Take this one out,” he said. “It’s not pretty.”

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Hometown veterinarians once handled all cases, traveling from farm to farm, and putting to sleep animals that could not be helped with the contents of a little black bag.

Now, in New York City, the nine-story Animal Medical Center sees 62,000 patients a year for electrocardiograms and an array of other procedures.

In Denver, owners from around the world bring their animals to Colorado State University’s veterinary cancer center, camping out in the parking lot to await treatment. The center has 30 doctors--twice as many as University Hospital’s human oncology unit in Denver.

“We had people come in today that would have sold their home to treat their dog,” said Colorado State veterinarian Steve Withrow. But the dog was beyond treatment. (In most cases, doctors can treat animals with cancer.)

“It’s not so much ‘Can you do it,’ but can the owners afford it?” Withrow said.

Only 75,000 cats and dogs in the United States are covered by insurance policies, according to Veterinary Pet Insurance of Anaheim, the country’s only licensed provider. (Americans own 63 million cats, 54 million dogs and 29 million other small pets). Premiums range from $59 to $159 a year, for dogs and cats only.

The advances in veterinary medicine have not prompted an increase in malpractice lawsuits against veterinarians, which are still uncommon, Bookout said. In civil courts, because animals are considered property and not subject to pain and suffering, any monetary judgment would be relatively small.

Pets have become more important in families’ lives as families get smaller, and as fewer people have children, experts say. And in busy, fast-changing lives, people rely more on pets for stability and emotional connections, said psychologist Ellen Glaser, whose clients in West Los Angeles include bereaved pet owners.

“Sometimes, it’s not as easy for people to give to other people [the way they do to pets], and sometimes, it’s not always as well received,” she said.

But, she added: “I think it’s unfair to characterize someone as a nut or weird if they treat their pets as a family member. . . . It’s different if you’re feeding the dog steak and giving your kid cereal. But animals teach love. They teach reciprocity. They teach a lot.”

According to a 1995 survey by the animal hospital association, 70% of U.S. pet owners think of their animals as children.

In ethics classes, students debate how far veterinary medicine should go, said Bernard Rollin, a Colorado State philosophy professor who teaches veterinary ethics. Some students wonder why pet owners spend so much money on their animals.

“In the end, we all pick different,” Rollin tells them. “Maybe you support Little League or Boy Scouts and someone [says], ‘You should be giving to cancer.’ ”

“I’d rather live with filthy rich [people] who care enough about their animals to [save them] than spend $175,000 on a handcrafted yahoo-mobile.”

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Nancy Crocco and her boxer, Max, waited for an All-Care doctor to examine her other dog, Simba. On the long drive from Oceanside, the dogs split a McDonald’s cheeseburger for lunch, she whispered.

Crocco, 33, shot a guilty glance around the room. She didn’t want the doctors to hear.

Simba is recovering from hip and knee surgery. The dog had ruptured a ligament in her knee and couldn’t chase squirrels and rabbits anymore.

Crocco, a dental assistant, and her husband, Kirk, a Navy chaplain, decided to cancel a vacation along the California coast to pay Simba’s $5,000 bills.

“The $35 for the [padded] bandage was like, ‘Yeah, right,’ ” she said. “But I don’t want to talk about the money too much. The main thing is she’s doing great, and you can’t put a price on that.”

On another day, Jeanne Gintile’s fluffy white dog napped in her arms. Gintile’s black dress was covered in short white hairs.

Her dog, 12-year-old Bella, had been diagnosed as having a brain tumor and blood cancer. Bella’s bills, for radiation therapy and other expenses, totaled $12,000, said Gintile, 43, of Burbank. The price was worth it, she said.

“[The technology] is mind-boggling,” said the Caltrans supervisor. “But the thing about this place is not just what they do, but that they have the heart behind it.”

No one complains when Sheila Callaghan stays long past All-Care’s visiting hours with her graying Airedale, Willy, 11, who has cancer. She makes her own tea in the hospital’s staff room and watches the parade of pets, including a potbellied pig with pink nail polish.

Callaghan, 47, holds vigil during Willy’s chemotherapy and other treatments. Doctors removed his spleen and part of his liver.

Willy, who has an L.L. Bean dog bed, likes to chase soap bubbles and pirouette around the house. His medical bills are in the thousands, said Callaghan, a deputy district attorney in Los Angeles County.

“I’d hand over my gold card and wouldn’t look--it’s a few vacations,” she said.

Bob Smith, 46, took his sick chow chow, Munchkin, to three animal hospitals in five days in January before he heard about All-Care. One hospital gave him a wooden pallet on which to haul his dog inside.

Munchkin, whose stomach had twisted violently, was in critical condition.

“The thing was,” said Smith, a Laguna Beach computer consultant, “Munchkin was my partner, and he was in trouble. If I had to move heaven and earth to save the dog, I was going to do it.”

At All-Care, the staff let him sit by Munchkin’s side after surgery and other treatments for a week, almost 24 hours a day.

Rooks and Dr. Linda Hall--a former registered nurse--tried everything, Smith said. But Munchkin died Feb. 15.

Smith cried, and both doctors cried with him.

The staff takes each death hard.

Recently, they rallied to try to save Oscar, an 8-year-old bull mastiff with a bad heart. Oscar’s tongue had turned a deathly shade of blue.

“Doctor to ER, stat,” the paging system announced.

A team of 10 doctors and technicians hooked the chubby dog to intravenous fluids, oxygen and monitors on a stainless steel table covered with soft fleece.

For 15 minutes, the doctors tried cardiopulmonary resuscitation, pumping hard on Oscar’s chest. No heartbeat, no pulse.

Rooks plunged a 1.5-cc syringe of adrenaline into the dog’s heart. Still nothing. Finally, another doctor declared the dog dead.

It was just before noon, and the day’s schedule was pressing. Dr. Brent Hess turned to go--but not before he stopped to give the dog’s face a last caress.

Times researcher Lois Hooker contributed to this story.