Of the offices, not of the partic.i.p.ating vets (although hot-ness is a bonus in any professional you're likely to be seeing on a regular basis). The waiting room should be clean but not sterile, with comfortable chairs and a good use of s.p.a.ce, including enough room to keep the nervous dogs from being intimidated by the bullies. The back areas where overnight patients stay and lab work is conducted should be spotless-ditto the vet techs-and the cages should be s.p.a.cious. And yes, any reputable vet should allow you to tour this back area on the spur of the moment, i.e., without having to yell, "Heads up, pet owner incoming."

BASIC EQUIPMENT.

Again, of the office, not the vets. Things such as onsite x-ray equipment, laboratory, and pharmacy mean your dog can get diagnosed and treated expeditiously, and you don't have to run around or phone a lot of different facilities.

NUMBER AND QUALITY OF PARTIc.i.p.aTING VETS.

If you have an emergency and your "primary" isn't available, it's comforting to know that other trustworthy docs have immediate access to your dog's records. You don't have to like the other vets as much as you do your own, but it's desirable for you to consider them competent. Ideally, a practice should be diverse, including a fresh-out-of-school newbie versed in the latest equipment and techniques as well as a senior person with lots of surgical experience. If there's a clinic in your city affiliated with a university department of veterinary science or college of veterinary medicine, you've hit the jackpot.

COST.

The fees for basic procedures such as exams and vaccinations should be in the same ballpark as those of other vets in your town; phone around and ask. Don't consider a practice that makes you feel guilty or cheap for inquiring; it'll only get worse down the road if you're faced with deciding whether you can afford an expensive life-saving procedure (but see question 28). Nix any vet who tries to minimize your financial concerns.

Be suspicious of cutesy names like Paws or The Pet Center. They tend to signify either superficial glitz-soft music, Earth tones, the latest issues of Dog Fancy Dog Fancy instead of three-year-old copies of the instead of three-year-old copies of the Economist, Economist, all which will cost you-or bare bones facilities that need a gimmick to draw patients in. all which will cost you-or bare bones facilities that need a gimmick to draw patients in.

STAFF.

Quant.i.ty-enough people in the office to ensure efficiency in a large practice-and quality are both important. Staff members should be able to answer basic questions about medical procedures as well as about payment plans, and they should be welcoming to canine patients, no matter how smelly and drooly. If your dog isn't as cute as, say, my Frankie, the receptionist should at least comment on her sweetness, perhaps, or his friendliness. Note: Note: The flattery requirement is waived for dogs who make the staff cower behind their desks. The flattery requirement is waived for dogs who make the staff cower behind their desks.

Things to look for in a vet include the following traits.

ACCREDITATION.

While your dog is being weighed, take a peek at the diploma on the wall. You want someone with at least a DVM (Doctor of Veterinary Medicine) or equivalent degree (for example, a BVMS or Bachelor of Veterinary Medicine and Surgery, offered in the United Kingdom), preferably from a country you've heard of where they don't eat small domestic animals.

DOGSIDE MANNER.

Not all vets are equally kind to their pet patients; I've encountered some who are downright brusque. No pup likes to be probed and prodded but the best vets are skilled in minimizing doggie discomfort with gentle handling, soothing tones-and a well-paced plying of treats. (People doctors should consider adopting this last technique; I'd bet a few G.o.diva chocolates would go a long way toward mitigating the stress of a gynecological exam.) PEOPLE SKILLS.

Sure, the vet's att.i.tude toward your dog is foremost, but you need to be able to provide follow-up care, so instructions need to be clear. And there's no excuse for a vet to be patronizing; remember, a good part of her day is spent inserting thermometers into small animal b.u.t.ts. Finally, as with the members of his staff, a vet should say flattering things about your dog-or at least should avoid insults. One vet told me that Frankie was "weird" and a "bad patient" because he wouldn't pee for the techs who walked him during an all-day diagnostic stay. Frankie is an extremely skilled urinater when he so desires, thank you very much, but he's not a pee-on-demand pup.

25. HOW SOON DO I NEED TO BRING MY DOG TO THE VET?.

Very soon. If you get a dog who hasn't had a verified health exam or thorough temperament evaluation, don't even take her home; head straight for the vet. Sad but true: If something is seriously wrong you need to know before you bond with the pup and spend vast quant.i.ties of money and emotional energy on her.

If you get a dog with a clean preliminary bill of health, see the vet within the first few weeks of her homecoming. Puppies need a series of vaccinations (see question 30) and healthy older dogs need a "wellness" exam to serve as a baseline for future diagnoses. You'll also want to get some guidelines for what's normal-in addition to those sketched in question 33 -as soon as possible.

26. HOW CAN I MAKE THE MOST OUT OF A VET VISIT?.

By observing a few basic rules of vet-iquette.

GET A NEW ATt.i.tUDE.

Avoid sending stress signals to your dog about an upcoming visit. Puppies don't have any negative preconceptions about doctors, and an adult dog who's new to you might pick up on your positive cues. Try pretending that you're going to a sedate dog park where pups and their people get to spend some quiet quality time together.

BE NICE TO THE SUPPORT STAFF.

They're the ones who put you on hold-or not-when you phone, put the messages on the vet's desk-or not-and generally oil the office wheels. Just as staff members need to say nice things about your dog, you in turn are well advised to compliment staff hairstyles, jewelry, virility-whatever works.

BE ON YOUR BEST BEHAVIOR.

By which I mean, make sure your dog is on his. He may not be fully trained yet but, in the case of a large dog, work on "sit" and "down" commands before you come in, the better to avoid disturbing other patients and their accompanying people. Small pups should be kept in your lap if they're excitable; it's also a good way to keep them from picking up germs from the floor.

BRING ALONG A LIST OF QUESTIONS.

Especially early on, you'll have plenty of things to ask about what to expect. Try to remember to commit these questions to paper-and to take the paper along with you.

TELL THE TRUTH, NO MATTER HOW EMBARRa.s.sING.

If you bring your dog in with stomach distress, don't pretend you didn't see him scarfing down the discarded condoms near your bed. You don't have to say what you were doing-or with whom-while those condoms were being consumed, or even what size they were. Sure, your vet might laugh about it at the bar with his friends later but at least your dog will get the correct treatment.

EXPRESS YOURSELF.

Although it's the vet's responsibility to try to be clear, she's not a mind reader, so follow up on anything you don't understand. And voice your concerns, no matter how peculiar (p.o.o.p eating) or petty (nail clipping) they may seem. As it happens, feces feasting is not all that uncommon, and clipping a dog's nails may help prevent painful infections.

DON'T SECOND-GUESS YOUR VET Reading up on medical issues on the Internet or elsewhere has its limits. It's good to be an informed consumer, the better to ask educated questions, but not useful to argue when your vet expresses an opinion that's based on education and experience-and thus a far greater ability to interpret data. And remember that your vet is looking at your actual dog, not a theoretical on-line case. If you have serious doubts about a diagnosis, it's fine to inquire how the vet arrived at it or ask for clarification. Just don't start your sentence with, "But I read on the Internet ..." It's perfectly fine, on the other hand, to ask your vet if she can recommend some helpful websites.

TAKE NOTES-AND MAKE A PLAN Dogs are notoriously bad at remembering details and even worse at writing things down; you'll be expected to do both if you want to remember what was said during the exam. Perhaps one of the most important things to jot down is the blueprint for what comes next: "So we come back in six months for a follow-up exam?" Or, "I'll make an appointment for a teeth cleaning as soon as that gum infection is cleared up?"

27. SHOULD I GET HEALTH INSURANCE FOR MY DOG?.

h.e.l.l, yes-and the sooner the better. The younger and the healthier your dog, the more insurable she will be and the lower the premiums you'll pay. Pet insurance isn't yet as popular as it's bound to become, which is why it didn't occur to me to get it. Now I kick myself for not having thought to insure Frankie, who, without any predictors, developed diabetes. This chronic, preexisting condition pretty much eliminates my sugar-sweet pup from the pool of insurable pooches. And I can't even claim him as a dependent on my tax returns.

Yes, insurance is an additional monthly expense, but it's an antic.i.p.ated one that you can budget for. Premiums are fairly reasonable and not having to factor in cost when facing the decision of whether to provide treatment-priceless. Why join the ranks of the estimated 73 percent of people willing to go into debt for their pets?

Another reason to get in on pet insurance now: because it's set up so that you pay for treatment up front and fill out the forms for reimburs.e.m.e.nt, vets don't have to deal with a bureaucracy. And pet insurance companies don't dictate conventional treatment choices-yet.

That's not to say you don't have to do research to get the best deal. Things to consider for comprehensive insurance plans-which are different from discount plans where you pay an annual fee in return for lower prices on vet services-are similar to what you'd look for in human plans. Just be sure to read the fine print. In some cases, for example, claims have to be submitted within 60 days to be accepted.

Take the following items into account when deciding on pet health insurance.

CHOICE OF VETERINARIAN.

Most plans let you see anyone you like; others are similar to HMOs, limiting you to certain health-care providers.

WAITING PERIOD.

There's usually at least a 10-day wait so that people don't sign up immediately after their dog leaps off a precipice. Check and see when a policy will take effect-and watch your pup like a hawk until then.

RATE GUARANTEE.

Some companies adjust their premiums on a quarterly basis; that means if they pay a claim they can raise your rates in the next period. Make sure the company you choose offers contracts for at least one year, with no fee-rise adjustments if you submit a claim.

RENEWABILITY.

You want a plan that doesn't consider a condition diagnosed after you first contracted with the company as preexisting, and thus as a reason for not renewing your insurance.

EXCLUSIONS.

Typically, dogs younger than six to eight weeks and those older than eight to ten years are ineligible for insurance. Those with preexisting conditions and breed-specific hereditary conditions are generally excluded, too, though in some cases you can pay extra for coverage. Another reason to get a mutt: they're more easily insured.

WELLNESS.

Things like dental care, vaccinations, and heartworm testing should be covered. Some plans don't take care of neutering or spaying, but that shouldn't be a deal breaker as clinics often offer deep discounts for those procedures.

PRESCRIPTIONS.

You often end up spending far more money on medicines than on office visits and services, so be sure your plan offers good coverage.

DEDUCTIBLES.

As with human plans, the higher the deductible, the lower your premium.

SPECIFICITY.

You'll find plans that say they reimburse you for "reasonable and customary fees." That's way too much wiggle room. You're far better off with an insurer that provides a chart detailing what you can expect to get back for what you pay out.

CAPS.

There's usually an annual limit for what a company will reimburse. Find out if there's also a limit to what insurance will pay for a specific incident.

Although you still have fewer choices for pet insurance than for auto or homeowners' insurance, more and more companies are entering the field every month. Those with proven track records include Veterinary Pet Insurance (www.petinsurance.com ) and PetCare ( ) and PetCare (www.petcareinsurance.com). Both the ASPCA (www.aspcapetinsurance.com) and the AKC (www.akcphp.com/BHIACMS/) have recently introduced policies, and the Humane Society features discounts on PetPlan (www.gopetplan.com). Check www.PetInsuranceReview.comto get real people feedback on some of the most widely used plans. get real people feedback on some of the most widely used plans.

28. IS THERE SUCH A THING AS ALTERNATIVE MEDICINE FOR DOGS?.

Naturally. The American Holistic Veterinary Medical a.s.sociation (ahvma.org; log on to find pract.i.tioners in your area) dates back to 1982, and the popularity of its doggie "modalities," including acupuncture, homeopathy, herbal medicine, and chiropractic, parallels that of its human counterparts. The monthly Whole Dog Journal Whole Dog Journal ( (www.whole-dog-journal.com) details the latest in natural dog care, while Natural Remedies Dogs and Cats Wish You Knew Natural Remedies Dogs and Cats Wish You Knew by Viv Harris outlines treatments for problems ranging from allergies to cancer. by Viv Harris outlines treatments for problems ranging from allergies to cancer.

I'm no slave to conventional medicine but my forays into the alternative arena haven't been terribly successful. Most recently, the search for a nutritionist to help with Frankie's diabetes led us to Dr. B., who determined that Frankie's neutering scar was blocking the blood flow to his pancreas. Her suggested remedy: rub flaxseed oil into the area. Initially blissed out by these ministrations-his t.e.s.t.i.c.l.es might be MIA, but his p.e.n.i.s hasn't left the neighborhood-Frankie soon began to squirm away in shame. I immediately ceased treatment. Nevertheless, on our next visit Dr. B. judged the blockage cleared and praised my persistence. I went back to my traditional vet, and Frankie and I resumed our previous, more decorous relationship.

So do what you think works for you and your dog-but not on your own. Take the "complementary" and "integrative" claims of alternative practices seriously: make sure they complement and integrate with the advice of a person who has completed at least four years of veterinary school. The same goes for supplements; just because something's labeled "natural" doesn't mean that it's not naturally toxic to your dog, or that it's not contraindicated with another supplement or medication she's taking.

29. HOW WILL NEUTERING OR SPAYING AFFECT MY DOG?.

Perhaps a more relevant question is how will it affect you you? There's no evidence that "fixing" causes adverse medical reactions; quite the opposite, in fact. The notion that altering interferes with the development of certain breeds' distinctive look has been debunked, too. Instead, it's been shown that the accompanying growth slowdown allows joints and bones to develop correctly. Dogs that have been neutered or spayed tend to grow larger than their unfixed littermates, too. Moreover, dogs don't have ego issues connected with their s.e.x organs, nor do they sentimentalize motherhood. So if you're not a breeder, any reservations about having your dog's uterus or t.e.s.t.i.c.l.es removed are pure projection. (Admit it, the anatomical precision of that description made you more uncomfortable than the terms spaying or neutering. Your dog, on the other hand, would react equally-i.e., not at all-to either expression.) A prime reason to spay or neuter your dog is to be a good global citizen. One busy b.i.t.c.h can produce as many as 67,000 descendants, exponentially, in six years, and some six to eight million dogs and cats are euthanized annually in the United States alone. Dogs don't have impulse control and they don't practice safe s.e.x, so it's up to you to ensure that they don't contribute to the misery of their species.

But spaying and neutering offer less altruistic benefits. A female who's been spayed won't go into heat, as her twice-yearly reproductive cycles are called-which means less mess for you, less discomfort for her (although as far as I know, no studies have been done about doggie menstrual cramps and PMS), and less upheaval for everyone because hordes of panting male suitors won't be coming to call. Spayed females also run a lower risk of mammary gland (breast) cancer-not to mention zero risk of uterine and ovarian cancer.

For males, early neutering can minimize aggression; roaming (guy pups are literally heat-seeking missiles, always on the prowl for those busy b.i.t.c.hes); and, in some cases, marking (thus allowing you to take a walk without stopping every two seconds for pee dispersal). Neutering may also keep males from humping inappropriate love objects like the legs of your houseguests. Without the distraction of raging hormones, they're also better able to concentrate on training. Naturally, neutering also eliminates the possibility of testicular cancer.

Those who have a problem with unmanning-und.o.g.g.i.ng?-their pooches can pretend it didn't happen by investing in Neuticles (www.neuticles.com).21 Allowing your dog "to retain his natural look" and "self-esteem," these silicon nut subst.i.tutes are available in three sizes and three degrees of firmness. Prices range from $109 per pair for the original rigid ones for small dogs to $1,799 for a customized set of the more pliant ones. I shudder to think how many dog b.a.l.l.s needed to be handled to perfect this invention. Allowing your dog "to retain his natural look" and "self-esteem," these silicon nut subst.i.tutes are available in three sizes and three degrees of firmness. Prices range from $109 per pair for the original rigid ones for small dogs to $1,799 for a customized set of the more pliant ones. I shudder to think how many dog b.a.l.l.s needed to be handled to perfect this invention.

The jury is still out on the best age for spaying and neutering. Conventional wisdom once had it that females should be allowed to go through one heat cycle before surgery, but that's no longer advised (presumably to the dismay of the manufacturers of b.i.t.c.h Britches, also called season panties). The suggested spaying age is now five to six months, preceding the first heat. Similarly, where four to six months used to be the recommended age for neutering, some vets now say that males as young as eight weeks can safely undergo the operation (though you'd have to wait a while to insert adult-size Neuticles). Although vet consensus is that it's best to neuter early, before the behaviors the procedure are meant to prevent become ingrained, most agree that neutering can be useful in diminishing aggression later in life, too. Apparently, testosterone poisoning isn't limited to the very young.

30. WHAT'S THE LATEST WORD ON VACCINATIONS?

Individualize. There's no question that vaccinations are essential to your dog's health, but views on the efficacy, frequency, risk, and even type of shots required have shifted in recent years. Annual boosters are no longer advised for most vaccines, for example; three-year updates are now considered sufficient. Similarly, because research has shown that not all vaccines remain effective for the same length of time, the practice of bundling-putting several vaccines together in a single shot-is becoming less common.22 In short, a no-shot-fits-all philosophy is emerging. A responsible vet should take the age, breed, habits, and immune system of your dog-as well as the region in which you live-into account when determining which inoculations to give. In short, a no-shot-fits-all philosophy is emerging. A responsible vet should take the age, breed, habits, and immune system of your dog-as well as the region in which you live-into account when determining which inoculations to give.

Vaccines fall into two basic categories: the core group, which protect against diseases that are particularly dangerous, are easily transmitted, and/or are dangerous to humans, including distemper, adenovirus, parvovirus, and rabies; and the noncore group, recommended for dogs at specific risk. Desert-dwelling dogs don't have to worry about Lyme disease, for example, as those who live in humid, tick-rich areas do; and pups who don't go to doggie daycare or engage in group overnight sleepaways need not be inoculated against kennel cough. Even with core group medications, however, vaccinations should be considered on an individual basis. The risks of vaccinating very old dogs, dogs with compromised immune systems, and certain toy breeds, say, may outweigh the benefits.

Lately, there's been a good deal of interest in t.i.ter tests, which determine the continuing effectiveness of a vaccine by measuring the level of antibodies present in the blood. At this point, however, many of these tests aren't considered accurate enough to justify their expense. Results are not consistent for all diseases-many researchers consider only those for distemper and parvo reliable-or even for all breeds.

The bottom line: A series of core group shots are recommended for puppies as soon as they've lost their mothers' immunity, at around four weeks; at the latest, these initial shots should be given at six months. After two years of age, tread-or shoot-lightly. Don't second guess your vet, but stay informed.

31. AT WHAT AGE SHOULD I GET MY DOG'S EARS CROPPED AND TAIL DOCKED?

At no age, if most veterinarians have their say. Cropping and docking have been outlawed in many countries, and the American Veterinary Medical a.s.sociation's policy statement dubs these surgeries "not medically indicated, nor of benefit to the patient," noting that they "cause pain and distress."

Historically, tail docking, or surgical shortening, helped prevent working dogs from getting injured. For example, overlong tails of hunting dogs running through brush to retrieve prey might get burrs caught in them, and sheepdogs might be mistaken for wolves threatening the herds and get shot in error. Cutting and bandaging a dog's ears to make them stand upright, on the other hand, was always purely aesthetic, done to make guard dogs like Boxers and Dobermans look fierce and alert. Now most of these cosmetic procedures are performed-usually without anesthesia in early puppyhood-to make dogs conform to the American Kennel Club's breed registry standards.

In addition to being cruel and-except in working dogs-useless, tail docking also interferes with communication. How can you know what your dog is trying to tell you if he doesn't have a tail? And I think cropped ears make a pup appear not so much fierce as astonished-the same look you get from a too-tight facelift.

32. WHAT'S THE BEST WAY TO KEEP MY DOG HEALTHY?

Dogs need to do the same things that we need to do to stay in shape: eat well and get plenty of exercise. Luckily, it's an easier regimen to enforce than to stick to: your dog can't binge on junk food unless you provide it (or he lucks into a McDonald's dumpster), and you'll never hear him complain, "Sorry, I'm just not up for walking today."23 When it comes to disease, human-canine principles converge, too, with prevention, early detection, and early correction being key.

PREVENTION.

To keep your dog from getting seriously ill you need to ...

Vaccinate (see question 30)De-bugBrush teeth Parasites such as heartworm, fleas, ticks, and mosquitoes are more than just nuisances to dogs; they can be deadly. Pet store shelves are filled with products to eliminate them: pills, topical creams, single doses, combinations ... But don't use anything without consulting your vet.24 If your dog already has heartworm, for example, and you give him preventative medication for it, the nuked worms can clog his cardiovascular system (how's that for a scare tactic?). And cat medications-even if they look the same as dog remedies and are on sale-can make your dog sick. What part of "different species" don't you understand? If your dog already has heartworm, for example, and you give him preventative medication for it, the nuked worms can clog his cardiovascular system (how's that for a scare tactic?). And cat medications-even if they look the same as dog remedies and are on sale-can make your dog sick. What part of "different species" don't you understand?

Yes, you need to brush your dog's teeth. I'll explain why in Chapter 4.

EARLY DETECTION.

Early detection is important in maintaining your dog's health.

BE HANDS ON-LITERALLY One of the advantages of brushing your dog's coat regularly is that you can feel for any new growths or scabs. While you've got him in that pleasure zone of grooming, peer into and sniff at his ears (there's more on all this in Chapter 5).

Be observant A change in habits-especially drinking, eating, and elimination-can presage illness.

See your vet annually Take your dog for a yearly vet visit (twice a year for a senior pet), even if your dog seems fine.

Early correction Don't procrastinate. If you don't take care of a health problem as soon as you discover it, it can get out of hand-and thus become even more expensive to deal with than it was initially.