Dog Pod - Episode 12
Pet Insurance with Vet Dr Kevin

Dog Pod - Episode 12 - Pet Insurance with Dr Kevin.jpg__PID:3137dd50-e4a4-428c-b62d-4300ba2976b6

Episode 12 "Pet Insurance" The Good, The Bad and The Ugly When It Comes to Insuring Your Dog - brought to you by Dog Cloud.

Learn from expert VET, Dr.Kevin Cruickshank as he explains...
- What to look for in Pet Insurance for Your Dog
- Should you have an excess or not?- How gaps work?
- Can you insure rescue dogs?
- How waiting periods work?
- Pre-existing conditions and are they covered or not?
- Should you change policies and shop around across your dog's life?

Learn all this and more on this podcast episode on Pet Insurance.

Listen to episode Here

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Scott: Well, hello and welcome to another episode of Dog Pod brought to you by Dog Cloud. We are sitting here with our infamous, you are going to be infamous by the time you have done twenty of these episodes, Kevin [inaudible], Dr. Kevin Cruickshank from Gold Coast Vet Surgery. Welcome back.

Dr. Kevin Cruickshank: Thanks very much, Scott, but more out of breath today after our run.

Scott: Yes. We were hanging out near Nerang State Forest and --

Kevin: Yes. Nerang State Forest.

Scott: A bit of road noise in the background, but it is a nice morning here on the Gold Coast. This week, well, this time, this episode we thought we talked about pet insurance. It is one we spoke about a little briefly that we might cover last time. I know you are a wealth of knowledge on this and a lot of new puppies during the COVID-19 sort of era. Probably --

Kevin: I am certainly very passionate about pet insurance. The last thing I want to be is an insurance salesman, but the reason that I am so passionate about it is, that is the hardest part of our job. I really do not enjoy giving people a vet bill. And if we can take -- Yes. It might be hard to believe but it is really true. I wish I could just do all our work for nothing. But if we can take the financial worry away from people, they can then be much more focused just on the medical concerns and finding the best options and treatment for their pet, rather than having to have an overriding consideration. "Yes, that is lovely, but how much is it going to cost?" When the insurance company is paying, then they can really focus more on what is best for their pets. So yes, we know vet practices sell pet insurance directly and we do get a lot of questions about it. I suppose also that just the general, sort of, disclaimer that anything we talking about today is just general advice and not specific to any particular products. I have no links or affiliations with any particular products, but I will give you my honest opinion and talk about the good, the bad, and the ugly of pet insurance.

Scott: Yes. Well, I feel like a real newbie to pet insurance because my previous dog, that was gone about five, six years ago, it just felt like pet insurance was not, maybe it was around then, but I was not really aware of it. How long has it been around?

Kevin: It was around a good twenty, twenty-five-plus years in various different forms. But well-established, probably, in the last ten to fifteen years, it is become a lot more commonplace. And even the last five years, much more available. There have been some very proactive insurance companies that have made their products much more usable, more cost-effective in that, as well. So, there is a far greater awareness, definitely, in the last five years about pet insurance.There has been quite an explosion of different products that are available and that makes it extremely confusing for people. "What do we choose? Where do we go? What is the difference between these different ones?" And in the Australian situation, you will see that a lot of them start to look extremely similar and familiar, in terms of their terms and conditions, all look exactly the same. And you can even notice that the contact address for sending in details in is actually the same. There is one big provider that then is marketed in a various different brands and that is a company called PetSure. They do not make any secret that underwritten all by the same company, which is Highlights. But the actual individual brands do vary slightly certainly in what they cost and then various limits on that sort of thing. And I think that is what will be helpful for people if we just talk through what to look for when you are getting quotes. Because like any shopping, I really recommend people get three or four quotes these days. It is very easy, it is online and see what meets your needs.

Scott: As we get into it, I thought those two things might be really good to chat about on is, one is how it looks, the upfront, the waiting periods all that sort of stuff, how much do you get back? But the second thing I think that might be good, and then I can just let you run with this, is when something actually happens to your dog and you bring them in to a vet, what is the process to claim? I thought that might be another good part --

Kevin: Absolutely. That is a very good way to also look for in choosing your pet insurance in terms of how they handle claims, how much are you expecting to be out of pocket when it comes to a claim, as well? Also, I think there is quite a big, right at the beginning, there are different styles of policy. So, there is actually one style that I recom-- It is better than nothing at all, but I really recommend people stay away. We see a lot of people thinking that they well covered and insured and in the meantime, it is a very limited cover. And that is a type, style of policy called Accident Only. To the uninitiated, that seems, "Well, I really just want to be insured for those big, unexpected accidents. My dog breaks its leg, that sort of thing, and have that covered". So, all accidents, really. But what an insurance company defines as an accident and what you and I understand in the English term of that is quite different. These Accident Only policies cover only a certain set of defined, and for most of them, it is just six defined conditions. So for example, they will cover a broken leg, but they would not cover a sprained or twisted joint. So, if the dog jumps off the sofa and really hurts its leg but it has not broken it, you might still have a lot of expense of x-rays, maybe being in a cast or anything like that, but it would not be covered simply because it was not actually defined as a break.

Scott: First cast.

Kevin: So, they are very cheap and that is the type of thing, also. If something looks too, you know, they are not a con.

Scott: No. You get what you pay for, right?

Kevin: Yes. You got very, very limited cover. The other type of thing that people often confuse with insurance, and I would really like to distinguish between that is, some of the big veterinary chains in the corporate groups offer things that are called Wellness Plans. But it is often presented very similar as an equivalent to pet insurance and it really is not that. So, these would be things like a program called Best for Pet or Healthy Pets Plus, which is offered by some of the national corporate chains of vet practices. It is a subscription service and, basically, you can get a blood test once a year, and then they will offer some discounts on treatments or free consultations. But it is definitely not a substitute for pet insurance. You are restricted to only using those clinics. So for example, if your pet is, in quite a severe way, it needs to be referred to a specialist centre, those special centres normally are not part of the same chain, and so then, you do not get any discounts on that treatment. Whereas true pet insurance, you are free to go to any vet practice, go to any specialists and your stool will also be covered. Coming on to what you are asking about at the claiming time, and that is a very important consideration in choosing your policies between the different styles. And fundamentally, there is either you have a fixed excess and all the rest is a hundred percent reimbursed, or, and probably, the more common form is that you are out of pocket a fixed percentage. So, they will cover eighty percent of the cost, so you will be out of pocket twenty percent. That is the most common scenario.

Scott: So, one-thousand-dollar bill will cost you two hundred bucks?

Kevin: That is right.

Scott: And there would be no excess on that? Because the twenty percent is the excess.

Kevin: Correct. So, those policies are often a little bit cheaper. I am going to use some brand names so that it is familiar to people. There is only one company that is offering the fixed excess and that is the company called Petplan. It can be really advantageous because that fixed excess is not per time you go to the vet, it is per problem. So, if you have to go, you go in there unwell, they give you some medication. A day or two later, still not well. So, you have some blood tests, and then you back another few days later for x-rays. You still are only out of pocket a hundred and fifty dollars, no matter how big your bill gets. And even if you referred to another practice, like a specialist hospital, if it is still the same condition, that has still only cost you a hundred and fifty dollars. So, you might have a five-thousand-dollar surgery bill, and it has cost you a hundred and fifty dollars. With the eighty-twenty percent, that five-thousand-dollar bill is still cost you a thousand. But the Petplan policies are a fair bit more -- That is one of the reasons for that. And what people do not necessarily notice in the small print is that at a certain age, and that does differ for different breeds, for most breeds that is at eight years of age, they change over to, as well as charging the hundred-and-fifty-dollar fixed excess, and that is for dogs. It is a slightly lower excess for cats. They change over to also doing the eighty percent-twenty percent.

Scott: Once they hit [inaudible].

Kevin: At eight years of age. And then at ten years of age, they actually change to thirty-five percent-sixty-five percent. They cover sixty-five percent. And if you have been used to, for eight or ten years, getting a hundred percent back, that can be a bit of a nasty surprise because often, a lot of the things, medical problems start to go wrong when dogs and cats get older.

Scott: Are aging. Yes, of course.

Kevin: So, you may way up that, even though you are going to pay a little bit, have a bit more out of pocket with eighty percent-twenty percent, that is going to be compensated by the lower premiums you are paying every month. And the fact that when they get much older, you are going to be on eighty percent-twenty percent anyway. Another fundamental thing, and this actually causes a lot of confusion when people are looking at pet insurance, is the idea of waiting periods, or what is called also pre-existing conditions. So, in a lot of human private health insurance, if you serve a long waiting period, and that might be a year, it might be eighteen months, then those conditions are covered. With pet insurance, most pre-existing conditions never become covered. So, if your dog has had an eye problem, then eye problems for that particular eye will never be covered by an insurance company. So, that is quite relevant, as well, that lots of other styles of insurance, it is recommended every year or two, maybe get a quote and consider changing it, you might save a bit getting good deals. With pet insurance, be very, very careful about changing companies once you are established. You can do it, but anything that is covered by your current company will not be covered by the new company. I guess, it is similar to having had an accident in your car and then going and asking if an insurance company will now, "If I take up comprehensive insurance with you, will you repair my car?" And they never will, because that damage or the illness was there before you took up the insurance. And that is why I am so strong in recommending to new puppies to take out pet insurance because they have got a clean slate. There are no marks against them. Everything will be covered. It is, probably, the area that causes the most dissatisfaction with pet insurance is pre-existing conditions leading to something not being covered because they are very, very broad. If your dog has just had some limping on its back leg before you took up the insurance, then, even if it is a very specific thing that genuinely happens much later after you have got the insurance, because there was a vague question over a limp on that leg, they will not cover any condition related to that even years later.

Scott: What about stuff like diarrhoea and stomach upsets? Like, we had this with Luna the other week, young puppy, and we bought it to see you, and tummy was not good [inaudible]. She was not really vomiting or anything, but antibiotics, and it goes on her history and --

Kevin: [Inaudible].

Scott: And then, what happens?

Kevin: So then, certainly at the very beginning of any insurance, it would be very unlikely, in the first year or perhaps even the first two, that they would cover anything to do with diarrhoea. Some of the companies will, after a period of time, say, she is gone three or five years and not had any recurring diarrhoea problems. And then, you did have some diarrhoea, that is very, very clearly unrelated. It was a little bug that she had when she was a puppy. They will review those exclusions, but it is not a guarantee. And it is only certain conditions that they will review.

Scott: We got a truck rolling in here, just to make our life fun. I just thought about, with pre-existing conditions. A lot of people, during COVID especially, fantastically took up rescue dogs. And rescue dogs have normally got a little bit more age on their side. They might be one or two years old or even older. Where does the pet insurance company stand with that? Because we want to encourage people to --

Kevin: They will still, definitely, insure them, and that is just a risk. If they cannot establish a history then, there is nothing that they can preclude. But very often those rescue dogs have had a vet check before they get rehomed. And so something may have been picked up then. So, the insurance companies do get the medical notes from any vet that has treated the pet before, when they are assessing a claim, and look through that. The good thing is that the majority of them are actually not out there trying to duck and dive. I do not have any particular insurance company that I would recommend to steer clear because they are really difficult about claims. Obviously, that is the perception that people often have. But some of the new policies, they really seem to have the approach of how can we pay this claim rather than how can we get out of it? Yeah. If there has been a genuine misunderstanding about something, they have misinterpreted a claim, very often there is always a review process you can ask to be reviewed. And you can ask your vet, sometimes, even to just write a letter of clarification or explanation to query things. They do listen to feedback and take that on board. But as I said at the beginning, rather have no pre-existing issues on by taking up pet insurance very early on in getting a puppy because then there is no room to argue, everything would be covered.

Scott: Yes. Makes sense. This must have created a ton of extra work for you as a vet over the years. I would imagine with --

Kevin: It certainly does. Yes. We have to be very diligent and accurate with our record-keeping because part of your insurance policy is that you give the insurance company the right to request medical notes because they need those to settle claims. So, we do have to send those in very frequently. Technology is on our side, fortunately. Some of them really have now streamlined claims processes. We can integrate from our particular practice management software that at the time of you paying the bill, we actually send in what is called an E-claim, and that sends the tax invoice and the relevant medical notes directly to the pet insurance company. And normally, within three business days of receiving that electronically from us, the client has actually been reimbursed back into their bank accounts. So, it is very good in that regard.Not all of the insurance companies are on any E-claims process. So, definitely, ask that question because it -- Some of them now offer something called GapOnly, which is coming back to that eighty percent-twenty percent. They will assess your claim in real-time, at the closest that we can get to the high cap system, which in Australia is a system where you have got private health similar to an EFTPOS terminal or a credit card terminal, you get your claim paid immediately to the provider. So, what happens with this GapOnly is that the claim is assessed while you wait at the vet counter. It takes about ten minutes, and then that will come back through our payment software and say, "Yes, the insurance company is paying two hundred dollars. You have forty dollars out of pocket you need to pay." And you only pay the Gap and they pay the rest directly to the vet practice. It can be very, very helpful if you have suddenly got a two-thousand-dollar vet bill. And that can even be processed just before you ready to collect your dog. So, there is not even a waiting around. So, asking if your pet insurance offers GapOnly. And then also, it is at the discretion of the vet practice to accept GapOnly and offer it. So, asking your vets, as well, if they offer GapOnly, but that is a great technology. So, just talking about some products in Australia that are available. So, you would have seen insurance offered by a wide range of companies, from RSPCA pet insurance, Medibank Private, Woolworths Pet Insurance. All of those are brands that actually with the PetSure group and they offer the eighty percent-twenty percent situation. When comparing them online, what I suggest people look at is the maximum that they payout per year. Some of them might be quite low, and the figure I am going to say might sound a lot, like eight thousand dollars. It does not go very far if suddenly you have got one condition that might chew up five or six thousand dollars. I am talking about big things like orthopedic surgery or something like that. But I far recommend rather looking at between fifteen and twenty thousand per annum. Remembering also that that figure is going to be fixed for quite a long time before the insurance company changes it over the coming years, and vet fees will go up over the lifetime of your pets. So, looking at that not just how much they are going to charge you per month or per fortnight. Some of the quoting websites will actually quote you on a fortnight basis and that can then suddenly look a lot cheaper if you are comparing to one that charges or quotes on a monthly basis. So, just look at that. Some of them will automatically put in a default excess of say, a hundred dollars. I recommend avoiding that because, or even two hundred dollars, because a lot of your regular vet visits might fall in that hundred to two hundred dollar range. And again, you will be very frustrated and disappointed because everything is falling under that excess and you feel like nothing is getting covered. It means the premium is a little less but rather look at zero excess. You have still going to have that twenty percent out of pocket. If you have got private health with many of the companies, so Medibank, Bupa, HCF, they all offer pet insurance. And then they, very often, offer a discount to members there. So, you might get a discount there. You might have other rewards card with someone like Woolworths that then offers you some discount off your pet insurance. So, looking at other arrangements that you have got. Another company that is independent from that PetSure group is RACQ. We have a lot of our clients insured with them and very happy with their pet insurance coverage. And if you have got multiple policies, again, you can get a discount there.

Scott: And for international listeners, we know that this is very Australian what we are talking about. But you will find very common trends around the world where its major supermarkets, major insurance companies, animal groups, and stuff, that all offer pet insurance as products, as well.

Kevin: Absolutely. Google search in your country of pet insurance, but make sure you comparing apples with apples, check what the claims process is, what sort of excesses you will be up for, and then any exclusions on that. Most companies also will have a waiting period. So that means, typically, the first twenty-one or thirty days that there is no coverage for. So, if you take up pet insurance and five days later, your pet is unwell, unfortunately, they would not be covering them yet. Some of them have an extended waiting period for things like cruciate surgery. But they will send you a form, when you take up your policy, that you can have a check with your vet to say that your dog does not have a cruciate injury and they will shorten that back to the traditional twenty-one or thirty days waiting period. So, it is very worthwhile doing that, just to certify that there is no problem.

Scott: And just for new puppy owners and stuff, as well, cover notes.

Kevin: Yes. So, that is where an insurance company, as part of their marketing, will give you a period, typically, four weeks, and then sometimes, it is six weeks, for absolutely free. It is not a catch. I really recommend people taking advantage of that. You do not have to phone up and cancel at the end of that four-week period, it just lapses. So, the big thing about it is it is normally issued when your pet has had a vet check. And so, it, actually, shortens that waiting period down to three days. If something untoward happens earlier, then you will be covered. It is sort of an opportunity to have some protection, some pet insurance while you are getting quotes from other companies, as well.And it does not cost you anything. If you are interested in taking up with the company that offers that cover note, definitely contact them to convert it into a full paid policy before the expiry of that cover note period. Because then, you will not have to serve any further waiting period. It will just rollover. But even if there is been a one day gap from the end of the cover note, you will then have to serve another waiting period. And if your pup has had a problem during that cover note period, for example, diarrhoea or whatever, if you just roll over, then that would not be a pre-existing condition. But if you actually have had a bit of a gap between the end of the cover note because it is, basically, like writing a new policy if you let it lapse. So, yes. Very worthwhile.

Scott: Yes. That is wonderful.

Kevin: So, I hope this has given a few topics for people to think about.

Scott: Absolutely. Great. So, to sum up, probably, look for the no-gap cover.

Kevin: Yes.

Scott: Or the Gap--

Kevin: GapOnly.

Scott: GapOnly, sorry. And the terms of this will vary as marketing practices around the world. I imagine that every different company called different. Eighty-twenty sounds great. With no excess is probably a good thing to look for. Look for the cover notes where it rolls over into a non-waiting period and get yourself that cover all the way through.

Kevin: Absolutely. And just compare, get quite a few quotes. You can do them online these days. Make sure you are comparing apples with apples with those. And if need be, seek your vet's opinion on policies that you are considering in that. Normally, many vets are happy to discuss that with their clients.

Scott: Wonderful. Awesome. As always, Dr. Kevin Cruikshank, thank you very much for the excellent information. It is always a pleasure.

Kevin: [Inaudible] a pleasure, Scott.

Scott: Thanks, mate. Cheers.

Kevin: Bye.

[END]

Podcast Transcript

Scott: Welcome to another Dog pod. You're here with Scott Groves and Dr. Kevin Cruickshank. We welcome you back again, Dr. Kev.

Dr. Kevin: Thanks Scott. What a beautiful setting. I do not know where people listen to us, but it can't be better than where we are recording it.

Scott: It is a pretty nice part of the world and it is a gorgeous day here again, so welcome everybody. This week we are following on our little three part where we are talking about sort of small, medium, and this week we are up to large dogs. So we thought we thought we'd dive into some of the common issues, and I guess things that dog owners should know about some of the larger breeds, and how they can care for them better, and some of the things that we could talk about as we get into the large breeds. But I think as we cover large breeds, first to probably mention a few of them because we have got giant breeds. We are going to group them all together a little bit today.

Dr. Kevin: Yes, I think it makes a lot of sense to talk about large breeds and giant breeds. We kind of refer to large breed dogs as adult size over twenty-five kilograms, and probably the giant breeds over forty or certainly over fifty kilograms. So a lot of our popular family dogs fall in this these categories. So breeds like Labradors, Golden Retrievers, Rottweilers, Dobermans--they all are large breeds. When we are thinking of giant breeds, you think of the obvious ones like Great Danes, St. Bernard's--

Scott: Bernese Mountain?

Dr. Kevin: Bernese Mountain dogs, they are lovely dogs, really are. And a lot of our Mastiffs as well, Bull Mastiff, and then there'S Neapolitan Mastiffs is a very big dog as well.

Scott: What is the biggest you have seen? Is it typically Great Danes would get as big as any dog?

Dr. Kevin: Great Danes are quite a lean dog actually, so physically in size and how tall they are, yes probably some of the biggest, but may not be the heaviest.

Scott: Right.Dr. Kevin: I think Neapolitan Mastiffs are probably some of the heaviest and and biggest in size. They can be the size of a Great Dane and as stocky as a Rottweiler sort of thing, and we have some very large and muscular Rottweilers. It is not uncommon to see them up sixty-five, seventy kilograms. So that requires a bit of a team effort when we have them in the clinic as well, and we have hydraulic lift tables and lifts to manage those sorts of sizes of dogs as well.

Scott: This is something I was going to ask you about today because in thinking through this because I knew what was coming this week, I thought, you know, as dog start to age, and I know what you guys do, you are essentially almost training them up onto a table at a vet. But what do dog owners do when they have got a really big dog in their home, and the dog starts to struggle later in life.

Dr. Kevin: That is actually quite a practical consideration, definitely. Even just taking them out for walks and getting them into their vehicles, and that sort of thing, you can get a lot of very good either cut purpose-built available in pet stores ramps, and that sort of thing to get into the back of a vehicle. That sort of thing, or a lot of people make their own. So that is a practical consideration because you can not be lifting even a forty, fifty kilogram dog is difficult lifting into the back of an SUV or something like that. And then sometimes ramps over the steps, or stairs at home, if they are starting to battle there as well, that is a consideration. But I see photos of big dogs, German Shepherds, lying up on the bed at home and that sort of things that people that sometimes take top place. And even partners getting relegated to the spare bedroom or something like that. People adjust and accommodate. They also take up a fair bit of space just for their beds and sleeping and that sort of thing as well.

Scott: We are aware of that one. Okay. So let us talk about some of the common issues with the larger dogs. Obviously being longer limbed animals, the hip dysplasia certainly becomes a lot more common as a condition with these larger dogs. Is that a good place to start?

Dr. Kevin: Yes, I think so. I think a lot of what we might be talking about today is orthopaedic conditions. So hips are definitely one that some of them, and interestingly some of the breeds do not have as much of a problem with hips. And then their knee joints moving down the back legs, so the knees or what we refer to as the stifles, and the biggest problem there is cruciate disease--ruptured cruciate ligaments, or the equivalent in humans is an ACL. So we do see that a lot more commonly in a lot of these larger breeds of dogs. And moving to the front legs, elbow dysplasia is now becoming much more recognized than hip dysplasia has been known about for many years, but you can actually get. So when we talk about either hip or elbow dysplasia: it is not actually a disease directly itself, but it is an increased risk of getting severe arthritis in those joints. And that normally means the dysplasia really refers to the bad shape of those joints. So hip joints that aren't a perfect ball and cup shape quite often either the cup part of the joint is too shallow, or the shape of the head which is like the ball part that fits into the joint that shape is incorrect or at an abnormal angle. And so those make those joints often not as stable and that predisposes them to getting severe arthritis. Just because a dog has bad hips visibly, like on an X-ray, does not necessarily mean that they are going to suffer with symptoms of hip dysplasia. You can do other environmental things as well to help minimize that.

Scott: Ok.

Dr. Kevin: Even before we get to actually diagnosing it, trying to reduce these problems in the breeds, they have been known about for a long time. Selective breeding is a very important thing because if we can try and breed from dogs that are known to have better hips than average in the breed, then we can have far less problems, or less likelihood that the offspring are going to have bad hips as well.

Scott: Okay. And if they are above average in that, I guess assessment. They probably should not be breeding. Is that--

Dr. Kevin: Correct. That is the way the selective breeding works. So you get the parents that you are intending to breed with, they need to be an adult dog before these changes can actually be seen on x-rays. So they have x-rays in very specific positions, and then those x-rays--actually your regular vet can look at them and have an opinion as to how good or bad those hips are. But actually there is a list of certified hip scorers that these get sent off to and different countries all have their official schemes. They get sent off to a special radiologist who will then look at very fine criteria and come up with an actual score for each hip, and then it is known from all the dogs over the years that have had been hip scored--this process we refer to as scoring--and you can know the average for the breed. And so if a dog is better than average that's going to be a good one to breed from. If its scores are worse than average, then you rather do not breed from that dog because it is likely to push the shapes of the offspring into a worse position.

Dr. Kevin: The difficulty comes if you have got one really good hip and one not so good hip. And of course dogs are not only born with hip problems, so you have got to look at the rest of it. In a lot of these breeds something like labradors, they can get various genetic eye problems. So cataracts is an example. So you might have everything else in the dog is perfect--It does not carry the genes for the cataract problems, it does not have heart conditions, and one of its hips is marginally bad, and the other is very good--well, you might still choose based on the net assessment of the dog. It is still a good dog to breed. Never forgetting the temperament as well. You really want to choose when you are breeding. So it is a very complicated thing when they are breeding. But if you have got an outlier that has got a really bad, sort of double the average score, well that might knock it out. It is sort of like a veto that everything else might be perfect about the dog breed, but then should not be bred from.

Scott: How much of this comes back to the ethics of breeders?

Dr. Kevin: Very much. It is down to the integrity and the ethics of that individual breeder because there is no compulsion to actually have hip scoring. Obviously if they can provide evidence that the parents have been very healthy and good, they should be able to have a better reputation as a breeder and command a better price for their puppies. So it is in their best interest to do as much of this testing ahead of breeding. But there is no obligation. You do not even have to be a registered breeder to breed. And so that is also my advice to people looking at getting a new puppy: do your research; ask for these bits of information; have the parents been eye-tested, heart-tested and hip-scored.

Dr. Kevin: And nowadays as well as hip scoring, there is also elbow scoring. So the elbows are complicated joint. It is actually three bones coming together. So two below the elbow--the radius and the ulna, and the humerus above. So if there is a little bit of abnormality in the shape, they can very quickly get arthritis later on in those elbows as well. So in the same way the elbows can be scored as well.

Scott: I have got about fifteen questions that has just come out based on what you have just said in the last five minutes. I want to backtrack a little bit a couple of things that we just sort of talked about. Hip dysplasia- I find in conversations with other dog owners, the true definition of dysplasia is quite confusing. Because I think a lot of people think of it like it in terms of displacement where something is moved. So what is the true definition? What is the best way to fully understand dysplasia? You mentioned the shape of the bones.

Dr. Kevin: Yes, so you could put really dysplasia as misshapen. It is just the wrong shape. So it is the how perfect the joint really is. And then what that leads to is, especially so a hip joint is a sort of classic joint, it is a ball in a socket. And if your socket is not really tight around the ball, and so I am using my hands and unfortunately the listeners can not see, but if I mean basically showing a very flat sort of almost an open palm versus a cupped up hand. If it is very flat then there is a lot more wiggle room for the ball part to move around. The body does not like that instability and what it tries to do to stabilize that is create new bone on the edges. That is actually what arthritis is. Arthritis is new bone being put down and it is trying to stabilize the joint, but instead it actually starts impairing the joint and causing pain. So arthritis is inflammation in any joint and very commonly new bits of bone growing around the edges of the joint.

Scott: And that agitates the ligaments?

Dr. Kevin: And it also limits the range of motion of the joints as well, so that is why they have a very stiff, awkward sort of gait. So that is a slow process. Now if you have got a badly shaping hip but you do not overuse that hip, you are probably not going to get a severe wear and tear on that joint, so to speak. And so if you don't over exercise that dog when it is very young, but you also keep up good exercise so that it does not get overweight.

Scott: Yeah. It is a big problem with big dogs.

Dr. Kevin: Absolutely, and yes they are carrying heavy weight. And that is also why that next problem that I spoke about the cruciate ligament problem--

Scott: Yeah, that is what I wanted to circle back to. Let us dive into that. Explain that. When you say cruciate sort of disease, what is actually happening? Like what are you seeing in the joint?

Dr. Kevin: So cruciate disease is just a group term for, the most common thing is the actual cruciate ligaments tears, but it does not necessarily snap instantaneously. It is a wear and tear disease. And so we don't often see it in dogs even younger than five. We have a bit of an acronym: fat five and female. Not fully understood why female dogs are a little bit more prone than males. It's like a 60/40 split, so it is not a big difference. But definitely overweight dogs, fat over five years old because it is a wear-and-tear thing. So if that ligament tears 10% you still got 90% of the ligament there. It is like a rope that is fraying. You are not necessarily going to see it. The dog might be a little bit sore for a day or two, and then walking around fine. So you didn't realize that necessary that actually a little bit of the ligament frayed and tore. And then over the years wear-and-tear it suddenly--they might just be doing one exercise, running down some stairs, jumping to catch a ball, or something, and then the last little percentage tears and suddenly they pull up lame.

Dr. Kevin: So that is also to do with, often, the shape of the knee joint itself and various quite technical angles of the bones in that joint. So dogs at stand with a very upright stance. So another large breed that we have not mentioned yet, the Boxers, they are typically a breed that stands with a very upright stance. If you look, they do not have much bend in the knee and the back leg really, they stand quite upright. And that predisposes, puts more strain on that cruciate ligament. So the job of the cruciate ligament is to stabilize the knee joint. It runs inside the joint and it stops the knee moving backwards and forwards in the joint. So when the dogs tear the cruciate ligament, initially it is sore, but it doesn't actually stay that sore longer term, but they still can not use the leg. Because every time they try and take weight, they just have a feeling of it collapsing or giving away on them. So then it is quite a technical thing about the different, but nearly always they need some form of surgery. There's very many different techniques of correcting that, but once they have had that surgery, they normally go very well. They can still unfortunately damage the meniscus in the joint which is part of like the shock absorbency. So definitely--

Scott: So like that gets worn away?

Dr. Kevin: Or tears actually because there is too much movement in the joint and then the meniscus can get a tear in it. So that is often checked during the time of surgery and addressed. If it has got a little tear then we correct that at the centre.

Scott: Yeah. Now that is a great understanding of that. With the breeding, you mentioned the averages. And now I want to circle back to one breed which is the Labradors, and we have spoken about it off podcast, but it is hard to find a good Labrador, you were saying, with good hips because they all tend to be fairly high in some--

Dr. Kevin: But because of breeding and selective breeding over the years, I think there has been a marked improvement in the last fifteen to twenty years.

Scott: That is great.

Dr. Kevin: We used to see it even worse. And that is why these schemes were put in place and through breeders doing the right thing. So yes, you got to be realistic that you can not expect hip scores of zero. But for example in the Labradors, the breed average is about 8.2. And it is a scale that goes right,--there is not necessarily a top point, but very bad hips can be twelve, fifteens sort of thing. So eight is actually in the scheme of things not that bad. And if you have got a dog who has got a four on one hip and a five on the other, that is really doing well better than average. So that is a good. But you might have a dog that has a two on one side and a ten on the other, that becomes a tricky decision and maybe the mother has fours or five so very good, and the father has two, an excellent hip on the one side and and one hip that is not so good. But as we were talking earlier, there might be lots of other considerations that you would still find that an acceptable combination of two dogs because there are so many other factors as well. And yes, you can not really expect to find in many breeds like that, a dog that has no problems with its hips at all.

Dr. Kevin: Another breed that has unfortunately quite a bit of hip dysplasia is German Shepherds. And amazingly even some of the smaller breeds--Pugs, if you look in the average...

Scott: Also Rottweilers as well...

Dr. Kevin: Unfortunately they get on quite a lot of hip dysplasia, they are very prone to cruciate problems as well.

Scott: What can a dog owner do, let's say I have a mate growing up and he always had Rottweilers. And he was always concerned about their hips, I remember even from a young age. What can a dog owner do? Is it matter of just keeping weight off, keeping good exercise, good mobility?

Dr. Kevin: Careful exercise. A tip that I would give people is avoiding, a lot of these breeds love fetching balls and that. But keeping them on the ground and not encouraging them to bounce and jump when they are excited. So throwing frisbees, and jumping up in the air, coming down and landing can be quite a jarring thing either for the knees or the hips. So also having good obedience with their dog that you might actually throw the ball, keep the dog at the side, and once the ball has stopped, let them go and fetch it. Because that sudden trying to stop and chasing a moving ball can be very jarring and damaging as well.

Scott: Yeah. That is a great tip. Excellent love that. With some of the other breeds when you start looking at probably some of the more, I guess winter Saint Bernards, some of the big Huskies, Bernese Mountain dogs--what sort of common conditions might you come across there? And then we will get to Great Danes in a minute.

Dr. Kevin: Quite a lot of them... slobber a lot! And that is the big lips that they have. Funny enough there is a type of cosmetic surgery, technically cosmetic, but it actually can be really helpful to keep that slobber more in their mouths. It is not commonly done. It is something that people know the breed does. It is not a medical problem, but unfortunately also, being considerate to the climate where you live. Like here on the beautiful Gold Coast, having a St. Bernard even a Bernese mountain dog, we have actually got quite a few Bernese Mountain dogs. They are very popular breed at the moment and they cope pretty well with the heat. But St. Bernard, they do suffer a lot and so not exercising them in the heat of the day. They can suffer from heat stroke very easily.

Scott: Would you keep them clippered more?

Dr. Kevin: You certainly can. People are more looking for the authentic breed, would rather not have them shaved. Sometimes that long hairy coat actually provides insulation from the heat just like you find woolly sheep in really hot climates in the outback, and that sort of thing. The wool insulates them from the heat as well. So the to the degree that happens, and also the dogs living in a hotter climate will not develop as thick an undercoat as if they are in a colder climate. They have grown up with it through their lives.

Scott: Yeah adapting over the years. Yeah.

Dr. Kevin: We just got a beautiful example of a German Shepherd walking past, a lovely lean one. They are actually a dog that a lot of people look at them and say they are far too skinny, but they are naturally actually a working dog, and they are very lean. They are very athletic dogs as well. But just seeing that beautiful one walking past reminded me of another condition that unfortunately they very prone to. They have got a very deep chest and breeds with deep chests. And so another one classically is the Great Dane, are prone unfortunately to gastric torsion. And it is a condition that people consider in having those breeds or who have those breeds really need to know about, because it is one of these things that can be an absolute emergency.

Scott: So what happens?

Dr. Kevin: Yeah, what happens with this is that their stomach which is actually hanging in the way that a dog is standing horizontally compared to us standing upright, their stomach is hanging from underneath the back. And for various different reasons, and they are not fully understood, that stomach can actually twist on itself. And then what happens is then the gas that is in the stomach can not get out, the fluid can not get out anywhere. It is of course extremely painful, and the the gas very quickly starts to build up and it actually pushes up against the diaphragm. They battle to breathe and they start to go into a medical type of shock, and within an hour or so, it can be fatal. It causes a lot of problems for the heart. The heart can't circulate the blood of course wind the whole intestine and the stomach is twisted, none of the blood can move through those twisted blood vessels, as well. So it is something that needs emergency treatment right away, whether it is the middle of the night, or daytime, and it very often does happen in the evening time.

Scott: Why is that?

Dr. Kevin: It is often associated with eating too close on exercise. So either eating first and then going and exercising, or even if they have come back from a big walk and then are fed very soon. Some of that is various hypotheses as to what is happening. And if they are swallowing a lot of gas when they are eating, their stomach can fill up. If it fills up with a lot of air and gas, we think it is more prone to twisting on itself. Very much so if they eat and then go and exercise, then the running around this coming back to their shape the deep-chested nature, there is a lot of space for that stomach to twist on itself. So if it is hanging and it has got all the for heavy food and it is swinging from side to side as they run, we think it just suddenly flops right over.

Scott: Pendulums right over?

Dr. Kevin: We have actually got to be also careful in the hospital. If we have got them under anaesthetic, if we are turning them over to operate on the other part of their body, or move them from one area of the hospital into the theatre or something like that, we also got to be very slow and gentle that we do not just flip them too quickly because you can flip their stomach as well.

Scott: Right. Wow so crazy.

Dr. Kevin: It sometimes starts where they don't necessarily have the full torsion where they are not twisted, and they have just got bloat. And then that is easier to address. We normally give them an aneesthetic and put a tube down their throat. Let that gas all out. And if you have caught them then before they have actually twisted, then they do not always need surgery.

Scott: What symptoms is a dog owner going to see?

Dr. Kevin: I think that is really important that we chat through this one because it can start off just looking like the dog's unsettled. It is restless, can not lie down, and you sort of say, "What is wrong? We have just gone for a walk. Why are you so restless?" And then very quickly they will often be trying to vomit, but most times nothing coming out. But just a bit of a retch and a retch, and they look quite quickly over twenty minutes or so, they just seem to get a lot worse. They are uncomfortable. They are lethargic, and then you might notice that their stomach is swelling. And it actually swells right up and it can be taunt like a drum. So you actually just tapping on the stomach, the stomach looks a bit bloated. They might look sort of pregnant, but it can be difficult to miss that. You would think it is so obvious, but a lot of that is underneath the rib cage.

Scott: And that is more stomach than chest? Is that where it is coming out?

Dr. Kevin: Correct. So just behind the chest, there is a whole abdomen area. And by the time you see that, it is definitely a run do not walk situation. Get to an emergency clinic straight away. But yes, the unproductive attempts to vomit, and sudden lethargy, and unsettled nature, those are the most common early symptoms of it.

Scott: Is this just something that can happen quite randomly across these breeds like German Shepherds? Is there no way of pre-checking it as part of a breeding process or part of identifying it--

Dr. Kevin: Different to what we were talking about with the orthopaedic problems, we can't screen for it, and it has not really got a genetic link. So much so that because it is quite a high-risk factor, we do all the work for the Gold Coast police dogs, and progressively they have put each one on a bit of leave and we have done a preventative surgery for them called a gastropexy. What we go in then is before they have ever had any symptoms of it, and we actually go and permanently stitch the stomach to the side of their abdomen, so that it can still bloat up, but that's not life threatening.They could still get a lot of gas building up, but it will not ever twist on itself because it is attached in one point. So it takes a bit of recovery and it is a moderately costly operation, but I think in any of the breeds that are prone to it--so your Great Danes, your German Shepherds, Dobermans, and deep-chested dogs--it's well worth considering. We often offer that if we desexing one of those breads, whether it is a male or a female, to do that operation at the same time. Because they are still a young dog, they are under anaesthetic anyway. Moderately costly operation. It is technically very challenging for us, but they recover so well. There is very little complications or problems and it is a lifelong prevention for them.

Scott: Yeah. That's great.

Dr. Kevin: That is a very good thing to get done early.

Scott: It is a very good thing to be aware of, is it not?

Dr. Kevin: Absolutely. So it is called, just for people listening, gastric torsion or it also goes under the acronym of a GDV-gastric dilatation volvulus is a bit just remember GDV.

Scott: Internationally does it have any other names?

Dr. Kevin: Also referred to just as bloat.

Scott: Okay.

Dr. Kevin: So gastric torsion, bloat, GDV, they are the most common names for it. And so the other tips for people preventing it is not feeding your dog and then exercising. And I am not just talking about going for a walk, even just bouncing a ball, throwing, playing around in the backyard or in the kitchen or whatever soon after eating. Also not waiting quite a long period once it has gone for a walk, recovering from that so that it is not--

Scott: How long are we talking about?

Dr. Kevin: I would wait up to an hour before feeding, and that is thought to be because they are still breathing up quite heavily, and they are probably sucking in a lot more air when they eating their food. They are enthusiastic to eat their food and suck up air.

Scott: Some big dogs eat at a million miles an hour too--

Dr. Kevin: Absolutely. Some people are very critical of feeding dry foods then to these breeds because the dry food itself can swell up and bloat. I don't think there is a direct big problem, that has been looked at and researched a lot. But sometimes adding some water to that food can be a helpful thing. Feeding twice a day instead of once a day so that they are getting a bit of a smaller meal each time.

Scott: Right. So it's not a big large meal? Yeah, right.

Dr. Kevin: Yeah. So those are things sometimes it is thought also feeding a bit from a height, so putting the food bowl up on a little bit of a platform, on a step, then they not bending down as much. The thought is maybe they are not going to suck in as much air. That's not such a big issue there.

Scott: Yeah, great. Have we missed anything with the larger dogs?

Dr. Kevin: Quite a few of them unfortunately are prone to ear infections. Again, sometimes to do with their behaviours. So dogs that love swimming are going to get more ear infections--so your Labradors, Golden Retrievers, unfortunately. The dogs with either floppy ears coming down or big ears that are like big funnels and let everything go in, like a German Shepherd, unfortunately can be quite prone to ear infections. And skin infections, some of them, unfortunately I keep seeming to be picking today on German Shepherds, but some of them--

Scott: They are really popular, aren't they? I mean they are used as police dogs almost all over the world. They are beautiful dogs. Very intelligent.

Dr. Kevin: But unfortunately they do just seem to be quite prone to certain skin allergies, very sensitive skins as well. Seem to get yeast infections quite easily. So ear infections, my tip there is pick up on it early because they can become chronic recurring problems. Head-shaking is one of the first signs just seeing a dirty waxy area at the outside.

Scott: Okay, and in terms of prevention and maintenance, same with the sort of stuff we spoke about with some of the medium dogs or the fairy dogs, keeping clippered.

Dr. Kevin: Yes. Sometimes a routine cleaning with an ear cleaning liquid. Certainly after swimming it is a very good idea. Once a week or once a fortnight just doing an air cleaner is good.

Scott: In the medium dogs and in multiple other episodes, we have talked a fair bit about teeth and dental hygiene. Big dogs naturally have pretty strong bites and I imagine they are, I don't imagine I know, they are biting into all sorts of different things, particularly through either boredom and other stuff as well. Bones as we spoke about in the last episode with medium dogs, and the danger of bones. Talk us through teeth and dental with large dogs. What do we need to be aware of?

Dr. Kevin: Fortunately, I think it is one of the things that they seem to suffer a lot less with. We do not see as rapid a build up of calculus and tartar on them, with one exception being Greyhounds. Unfortunately, they, for whatever reason their local immunity in their mouth, they suffer from a lot of very bad dental disease. Greyhounds do, almost irrespective of diet, and that sort of thing. So Greyhounds having them have a scale and polish early to try and look after those teeth. Keep them healthy is a very good thing.

Scott: Is it the same for Whippets or some of those long snitch breed?

Dr. Kevin: No, no, sure because those long-snouted dogs definitely. Whippets, Italian Greyhounds also seemed to have, and again a smaller breed but a Dachshund, those long snout seem to just also get dental disease a lot worse. But for the rest of them, the large breeds have far slower buildup of tartar. Some of that is diet-related and chewing on things, but I think it is just more a lucky thing that theirs are not as bad.

Scott: Is it because they got bigger mouths?

Dr. Kevin: I think so. The teeth are not as crowded in, definitely. And and also the type of diet, and how much they spoilt, and soft foods, and that sort of thing. But some big breeds, like Rottweilers, tend to get a lot of chipped and actually broken teeth because they have got such a strong jaw and they might be chewing on something that they should not be. So we do see them having quite a few broken teeth sometimes. But teeth problems not too bad. And as a general rule, skin problems not too bad other than like I am saying some of the German Shepherds can be prone to skin allergies.

Scott: Is the skin allergies noticed in the same areas as we spoke about in the last episode with Bulldogs? Is it a lot of groin?

Dr. Kevin: Yes. Lower ventral abdomen and in their groin area. Their paws, quite a few of them get a lot of skin infections in between the toes and their paws. And then some are more breed-specific, Boxers are quite prone to some hormonal skin problems, having an under active thyroid gland sometimes as well. So that is something they suffer with a bit.

Scott: Interesting. Well as always you are a wealth of knowledge, Dr. Kevin. Thank you for being with us. I do not think there is anything else before--

Dr. Kevin: I think they are a lovely group of dogs, that are working dogs. They can be family dogs. Wonderful, you know that you can get out and do a lot being--

Scott: Just because they're big, I think some people fear them, don't they? And like Great Danes are some of the biggest sooks on earth.

Dr. Kevin: But it is also very important to do good obedience work in the early stages so that you have got control of a big dog, because some of them can be very aggressive. And we have not had really much time to talk about behavioural issues, but you can have behavioural problems with some of them, and you want to have good control. So good socialization when they are young and dog training would be my closing remarks.

Scott: Might make a good topic for our next next podcast.

Dr. Kevin: Indeed.

Scott: Thanks so much for joining us. And as always if anyone has got any questions, just follow us on all the socials and feel free to fire through questions and ask Dr. Kevin, and we will do our best to answer them on the next one. But thank you for joining us.

Dr. Kevin: It would be a pleasure to shoutout and answer anyone's questions indeed.

Scott: See you next time. Thank you.

Dr. Kevin: All the best.

[END]

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