New Client Information
Hearing your pet has heart disease is scary and often leaves you wondering if there is anything you can do. We work with you and your trusted primary care veterinary team to ensure the best possible care; however, we also understand that advanced medical care and surgical intervention can be a stressful situation.
We are so incredibly happy you have entrusted the team of Olympic Veterinary Cardiology (OVC) with the care of your beloved family member. We are committed to complete transparency in our estimates, care, and processes, ensuring that you feel comfortable, well-informed, and empowered throughout the process.
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At OVC, we are committed to providing comprehensive, advanced, and cutting-edge medicine without compromising quality. Our initial evaluations are designed to meet the highest medical standards, ensuring your pet receives thorough and complete care. We believe in honesty and transparency, which is why we will always ensure you are informed of our recommendations, the rationale behind them, and keep you apprised of any changes in your estimate as care continues.
Included in our initial evaluations are the following essential components:
– Consultation with a Board-Certified Veterinary Cardiologist
– Complete Cardiac Physical Examination
– Systemic Blood Pressure Evaluation
– Digital 6-lead Electrocardiogram (ECG or EKG)
– Echocardiogram (2D, M-Mode, Spectral & Color Flow Doppler)
We understand that some estimates you may receive often include an office visit or price of echocardiogram only, lacking the comprehensive diagnostics we perform for every cardiac patient. We do not believe in partial care or incomplete assessments, nor do we believe in masking the price of a complete evaluation. We work to provide you with all the necessary information to best advocate for your pet’s well-being.
Please note that your initial estimate will not have any additional or ‘surprise’ costs, except in the case of a stressed patient who may require extra measures to safely complete the diagnostic studies.
If further diagnostics such as thoracic radiographs, laboratory studies, ambulatory monitors, or additional procedures like pericardiocentesis, thoracocentesis, or surgical intervention are recommended, we will present you with a formal estimate. This estimate will include an explanation of our findings and the medical necessity for these additional studies, allowing you to make an informed decision before proceeding.
Furthermore, you have the option of completing some of our recommended diagnostics through your primary care veterinary office. Regardless of your decision, we will always ensure that you are aware of the next step in your pet’s cardiac care.
To schedule an appointment, a deposit of $250.00 is required. This deposit will be credited towards your final bill upon completion of the evaluation.
Please note the following policies regarding deposits, appointment cancellations, and no-show events:
- Deposit Refund Policy:
- The deposit is fully refundable and allows for rescheduling up to 1 working day before your scheduled appointment.
- Beginning at 8am the working day prior to your scheduled appointment, the deposit becomes non-refundable. In the event of a last-minute reschedule or cancellation, the deposit is forfeited, requiring a second deposit to schedule a new appointment.
- Extreme and unique circumstances will be considered for a waiver of the non-refundable deposit, but this is not guaranteed and is at the sole discretion of OVC.
- If a waiver is granted, you will be required to pre-pay for future appointments in full, but no penalty will be applied.
- Late Cancellations / No Show:
- If two (2) instances of late cancellations or no-show events occur, we may be unable to provide you with any further services.
- Surgical Interventions:
- For surgical interventions, a deposit equal to the lower-end of the estimate is required at the time of booking.
- This deposit remains fully refundable up to 3 working days before the scheduled procedure, after which point it is non-refundable.
- Unique circumstances may allow for surgical appointment re-scheduling without penalty.
We kindly request that if you are unable to keep a scheduled appointment, you promptly contact us via phone or email. This allows us to accommodate schedule changes and ensure that every patient in need of care receives it in a timely manner.
All payment is due at the time of service.
- We do not offer post-visit payment plans, billing, or invoicing; however, we offer the option of pre-payment for services prior to the procedure or appointment.
- Pre-payment is fully refundable if requested prior to 8am on the working day prior to the scheduled appointment (3 working days prior for surgical interventions).
- Personal and cashier’s checks are NOT accepted.
- We do accept all major credit/debit cards as well as cash.
At Olympic Veterinary Cardiology, we prioritize the safety and well-being of both our staff and the pets entrusted to our care. We are attentive to signs of stress and fear in our patients, and in certain cases, mild sedation may be recommended to ensure the best possible care for your pet.
Just like a kid going to the dentist, an echo shouldn’t be stressful! – Dr. Maran
While we understand that discussing sedation can be distressing, please be assured that we make every effort to create a stress-free, calm environment. We employ calming pheromones, soothing sounds, and draw upon our team’s decades of experience in animal handling, restraint, and care before considering the need for sedation. However, despite our efforts, some patients may be less cooperative than others – but they deserve the same precise care as any other patient we treat. We do not believe an unwilling disposition should receive a rough, aggressive, or limited diagnostic assessment. Our team is dedicated to comprehensive stress-reduction in our patients and anti-anxiety medications are one tool we leverage.
Under the discretion of the attending cardiologist, we may administer mild sedation using a narcotic (butorphanol) and/or a benzodiazepine (midazolam) to facilitate the evaluation process. These medications can be administered intravenously (IV), intramuscularly (IM), or subcutaneously (SQ) to help reduce stress, anxiety, and fear, while ensuring safe restraint.
Butorphanol is a narcotic agent that causes mild sedation with strong anti-tussive (anti-coughing) effects. It is generally considered safe in cardiac patients, but may result in mild respiratory depression, ataxia, disorientation, hypersalivation, vomiting, or diarrhea (rarely). These typically resolve within a few hours and the sedation impacts are absent within 2-4 hours. We have oxygen available in every treatment room and kennel bank and our team closely monitors all sedated patients.
Midazolam is a benzodiazepine that causes mild sedation and is generally very well tolerated in animals. Occasionally we can see an idiosyncratic excitement (typically in cats, but almost never when combined with butorphanol). This medication can cause sedation, mild disorientation, and hypersalivation (typically resolved in 1-2 hours) and the inclusion of this medication can increase the overall impacts of sedation from butorphanol alone (synergistic effect).
A flat fee of $55.00 will apply in situations where sedation is deemed necessary.
In rare instances where an animal is found to be unresponsive to sedation, presents an excessive risk to client/staff/other animals, or is unapproachable, rescheduling may be necessary. We aim to have a stress free environment where our patients do not experience fear or anxiety. Anti-anxiety sedation is one additional tool in how we care for pets.
Our team will provide further guidance on our policies and necessary deposits for such circumstances.
If you are aware that your pet is particularly stressed in a veterinary environment or have concerns about their tolerance for mild restraint in a lateral position (laying on their side), we can also recommend pre-visit sedation to help reduce the necessary procedures, restraint, and hopefully avoid the need for injectable sedation.
These prescription medications can be provided through your primary care veterinary office and typically involves the administration of medications such as gabapentin and/or trazodone (based on species and the desired level of sedation), both of which are orally administered.
Pre-visit sedation is given approximately 1 hour prior to your arrival to our outpatient center. These medications are considered safe and have shown significant effectiveness in reducing stress during hospital visits, with minimal to no impacts on echocardiographic interpretation.
As a practice, we strongly encourage and may specifically recommend pre-visit sedation for future visits based on observed behaviors. Most patients we provided this recommendation for are due to extreme fear, nervousness, and anxiety (usually not due to aggression).
If a patient is noted to be unreasonably stressed, fearful, or aggressive beyond reasonable measures we reserve the right to discontinue our assessment at any point, reschedule the appointment to a later date and time, and/or require pre-visit sedation for future appointments.
We kindly request that you inform our team upon arrival if pre-visit sedation was utilized, specifically which medication(s) was/were administered and when they were given. We want to ensure accurate interpretation and confirm our records accurately reflect the clinical situation.
In cases where a higher level of sedation is required (such as those requiring chemical immobilization), we will discuss our recommended options with you, specific to each patient, circumstance, and goal for the visit.
Animals who show severe aggression or profound fear-responses that limit our ability to care for them may require pre-payment or alternative evaluation plans. In exceptionally rare cases, we may be unable to provide cardiac care for patients due to safety concerns and/or may require certification from a behaviorist or appropriate animal trainer to resume care. Should these unlikely situations arise, we will create a custom care plan based on our observations of the pet.
If you have any questions or concerns regarding sedation or our approach to ensuring your pet’s comfort, please do not hesitate to let us know. We are here to provide you with the support and information you need.
Due to Washington State Law (WAC 246-100-197), as well as for our staff safety, a current rabies vaccine is required for all patients.
Patients who are unable to receive a current Rabies vaccination for medical reasons (ie. history of severe vaccine reactions) will require a letter of medical exemption from the primary care veterinarian or board-certified veterinary specialist prior to scheduling an evaluation with Olympic Veterinary Cardiology.
- Unvaccinated animals displaying signs of aggression or intolerance to restraint may be refused services based on risks to staff and current Washington Law.
- Should an unvaccinated animal bite a staff member or another client or animal within the premises of Olympic Veterinary Cardiology’s facility, a report will be filed with Animal Control and local health officials.
To ensure the provision of optimal care for your pet, it is crucial that we have access to accurate and up-to-date medical records. Therefore, prior to your evaluation at our clinic, we require a copy of your pet’s current medical records from all veterinarians who are actively involved in their care. This allows us to have a comprehensive understanding of your pet’s medical history and assists us in tailoring our evaluation and treatment plans accordingly.
As a courtesy, we will submit a records request to your veterinarian of record; however, if we are unable to obtain the records, we may require your assistance.
Upon the completion of our evaluation, we automatically send copies of our records to your primary veterinary care team. However, if you prefer that we do not share our records with them, please communicate this directly to a member of our customer service team. It is important to note that in such cases, an alternate veterinarian of record will need to be designated for your pet.
Please be aware that as a cardiology-only practice, we are unable to serve as your pet’s primary care provider. Therefore, it is essential that you maintain an ongoing relationship with a primary care veterinarian. You have the freedom to change your primary care clinic or veterinarian at any time. However, it is important to understand that failure to have a primary care provider may affect your pet’s eligibility for ongoing care through Olympic Veterinary Cardiology.
For example, studies of congestive heart failure in dogs have shown a specific survival benefit (median survival of 254 days vs. 146 days in Lefbom, et al.) for patients that received collaborative care.
By ensuring accurate and comprehensive medical records, together we can provide the best possible care for your beloved pet.
For the health and safety of all pets entrusted to our care, we maintain a flea-free environment within our clinic. If flea infestation is noted, a single dose of Capstar (nitenpyram) will be administered by our medical staff at a charge of $25.00, which will be added to your invoice and due at the time of discharge from the appointment/hospitalization.
This medication is typically well tolerated, but reported adverse events include (listed in decreasing order of frequency):
- Cats: Hyperactivity, panting, lethargy, itching, vocalization, vomiting, fever, decreased appetite, nervousness, diarrhea, difficulty breathing, salivation, incoordination, seizures, pupil dilation, increased heart rate, and trembling.
- Dogs: Lethargy/depression, vomiting, itching, decreased appetite, diarrhea, hyperactivity, incoordination, trembling, seizures, panting, allergic reactions including hives, vocalization, salivation, fever, and nervousness.
- Reported clinical signs are generally associated with flea die-off and are not related to the medication. Clinical signs are usually self-limiting and resolve without any treatment.
Supplemental Appoinment Information
While we always work to support you and your pet through cardiac disease, we also realize that there may be additional requests for supplemental forms or letters – be it insurance, health registry, contested insurance claims, legal explanatory letters, or other various documents.
We will complete additional paperwork requests as our workflow allows, but this may require the forms be mailed to you or picked up at a later date and time. Immediate completion is not guaranteed.
- Simple forms, such as single-page insurance certification forms, Orthopedic Foundation for Animals (OFA), or feline screening will be completed at a charge of $25.00 per form.
- More complex forms or letters that require deeper research (such as those when an insurance claim is denied and the client requests we write a letter of explanation) will be completed at a charge of $50.00-$100 per letter (determined based on the workload of each request), unless it is deemed by our medical director that the insurance denial was the result of incomplete or unclear medical records, in which case the fee will be waived or refunded at our sole discretion.
Generally, these additional fees will not be covered by insurance, even if the claim prevails.
Animals entrusted to the care and expertise of Olympic Veterinary Cardiology are welcome in our facility and will receive expert medical and nursing care during working hours. Our Outpatient Cardiac Center offers no option for overnight medical care. All patients must be discharged from hospital by close of business on the day admitted, unless otherwise agreed upon in writing.
If an animal is not retrieved by the owner(s) or appropriate arrangements made for transfer to an overnight-care facility by the designated time of business closure, this may constitute Animal Abandonment under Washington Law (RCW 16.54.010). In this circumstance, appropriate arrangements will be made to ensure the animal is transferred to an animal care and control agency (RCW 16.52.011) or an animal rescue group (RCW 82.04.040) to ensure safety and well-being is maintained.
If animal remains are in the custody of Olympic Veterinary Cardiology for 15 days or greater, this may also constitute abandonment and the remains will be appropriately managed.
Prescription Authorization Requests
- In accordance with Washington State Law (WAC 246-933-200), we require a current (annual) exam in order to prescribe any medications. Some medications may require more frequent exams at the discretion of the veterinarian.
- Please allow 1-2 business days for any medication refill requests.
- Urgent refills/authorization may not be possible and should not be expected.
- To ensure patient safety and accurate dosage, please be prepared to verify the patient’s name, medication name, strength (size/concentration), quantity, instructions (‘twice daily’), and desired pharmacy at each refill request.
- If this information is not initially provided, it may result in processing delays.
- If picking up from our Outpatient Center, please be prepared to verify the same information and patient details prior to our team releasing the medications.
- If a scheduled (controlled) drug is dispensed, we may require that only an authorized account representative obtain this prescription.
- To reduce the risk of patient harm from communication errors, we will only authorize prescriptions through the following secure and traceable methods:
- Physical prescription on WA Pharmacy Commission approved tamper-evident paper (printed or hand-written)
- These are available for pick-up or can be mailed to an address on file at no charge to you.
- This prescription is valid at any licensed pharmacy in the State of Washington; however, compounding will require specific authorization.
- e-prescribing through InstinctScripts (coming soon!).
- Provided at no cost and the authorization will be sent through an encrypted system to your pharmacy of record (within Washington).
- Medication refill through our in-house pharmacy.
- An estimate of the expense can be provided upon request.
- We will not authorize prescriptions to a pharmacy via telephone, fax, or email communication alone.
- Physical prescription on WA Pharmacy Commission approved tamper-evident paper (printed or hand-written)
Many cardiac medications we routinely authorize are available as generic $10 for 90 day supplies through numerous pharmacies. We strongly encourage families explore these programs and consider coupons through www.goodrx.com as there is an opportunity to obtain the essential medications at a very reasonable/competitive price. However, these programs and goodrx.com are independent of Olympic Veterinary Cardiology, PLLC and may have their own terms and conditions. Our prescription authorization remains valid regardless of your participation in any of these or similar programs. OVC does not charge any additional fees for prescription authorization itself.
Due to the complexity of medicine and numerous conditions that impact many of our patients, we believe it is in the best interest of our patients that one doctor remains the primary doctor and prescriber of medications to avoid adverse drug-drug interactions.
We strongly recommend your long-term medications be requested through your primary care veterinarian as this maintains a high degree of continuity and, generally speaking, appointment availability for necessary recheck appointments (laboratory studies). Due to the nature of specialty practice, we are often unable to accommodate short-notice appointments or arrange a quick visit for minor procedures. This is why collaborative care is essential.
Our team remains committed, available, and responsive to our veterinary community to provide patient support as necessary. We remain part of your patient’s care team, always.
Please understand that if our records are incomplete (current laboratory studies are not provided), the prescription may be un-necessarily delayed or denied.
Most patients seen for cardiac care are able to pursue numerous recheck diagnostics (blood pressure, laboratory studies, and thoracic radiographs) through their primary care office. We strongly encourage this approach as studies have shown that collaborative care between specialist and primary care providers lead to the longest life-span with highest quality of life. This also significantly reduces the schedule limitations that specialty offices often encounter due to our unique skill sets (we perform diagnostics your primary veterinarian isn’t trained to do – but if they are trained to the others, they’re closer and faster!)
While we are always available to the primary care team for follow up questions and assistance with interpretation, please understand that diagnostics not performed through our office will not receive direct client communication from our office.
Should direct consultation with the family/pet owner be desired regarding these diagnostics, we will schedule a formal recheck appointment (virtual or in person) and will provide an appropriate estimate for these services.
Generally speaking, there is no charge when we consult with a primary care or emergency veterinarian involved in the care of a patient we have previously evaluated regarding current lab results, radiographic reports, and clinical status updates. Extensive follow up conversations, a request for radiographic review/assessment, or electrocardiogram interpretation and management would be considered telemedicine/teleconsulting and additional charges for these services may be billed.
The Olympic Veterinary Cardiology Team is truly exceptional and we have set a goal to re-define the veterinary experience for pets, clients and team members. To this end, you will routinely hear us reference or motto:
‘When you get one of us, you get all of us!’
To prevent schedule chaos when ‘life happens’, we do require that our clients be willing to see any and all of our cardiologists, technicians, assistants, and team members. We are unable to accommodate restrictions on scheduling as it may become necessary for us to re-arrange our clinical schedule due to illness, injury, or numerous other factors.
We will work to accommodate a preference or request for a specific doctor as we know the relationships we forge are powerful and continuity of care is valuable; however, we strive to not cancel or re-schedule appointments on short notice which may delay necessary assessment for your pet. Regardless of scheduling, it remains possible that you may be under the care of a different doctor based on unique circumstances of that day.
Among the many meanings of our motto, please understand that our Licensed Veterinary Technicians (LVTs) and veterinary assistants are highly trained, collaborative, and in close communication with our doctors at all times. Rest assured, any advice, recommendations, or guidance extended from any member of our team is at the behest of our cardiologists and is presented to you only after discussion regarding your pet’s concerns. The information provided by our team comes from our doctors, even if you are not directly speaking with the doctor.
It is often not possible for our cardiologists to immediately answer incoming phone calls – but our entire team is determined to support you and your pet. Questions via phone, email, or drop-in visits may be answered by a member of our team rather than directly by the cardiologist as this will result in faster responses and more rapidly actionable recommendations.
If direct discussion with a cardiologist is desired as part of follow up questions, a recheck consultation (virtual or in person) can be scheduled and an appropriate estimate for this visit can be provided.
Mutual respect is essential for maintaining a positive working relationship. We understand that emotions can run high, worries and fears are common, and the unknown can be distressing. Despite the understandable emotions in caring for pets with complex disease, we are committed to maintaining a professional environment that prioritizes the best interests of your pet.
In order to cultivate a long-term and respectful relationship with those who entrust their beloved pets to our expertise, we want to ensure mutual understanding of expectations. We acknowledge the inherent stress in these situations and strive to communicate openly and directly with you, providing honest information without “sugar coating” or unnecessary financial burden. The following guidelines outline the expected behavior when interacting with our team, yourself, and any pets under our care. We assure you that our team will treat you with the same level of respect outlined below. If you believe that our team has failed to uphold these standards, please contact our Director of Clinical Operations directly so that we can investigate and address the situation appropriately.
We do not tolerate the following behaviors from our clients or employees:
- Verbal abuse, making malicious or harmful statements about others, using profanity, or displaying disrespect.
- Any form of harassment.
- Discriminatory comments or actions.
- Intimidation tactics or threatening behaviors, comments, or actions.
- Allowing a pet to intimidate or threaten any person or another animal.
- Publicly disclosing another person’s private information.
- Suspected intoxication from alcohol or behavior-altering drugs.
- Failure to comply with company policies and reasonable requests, including leashing or restraining of pets.
In cases where human and/or animal behavior becomes problematic, we reserve the right to immediately discontinue services. This policy is strictly enforced, and non-compliance will result in appropriate corrective measures, which may include asking individuals to leave the premises and involving law enforcement, if necessary. Failure to comply with requests to leave the premises will be treated as trespassing and will be referred to appropriate law enforcement.
We sincerely appreciate your understanding, respect, and open communication as we strive to create a safe, welcoming, and supportive environment for our clients, staff, and patients.
Olympic Veterinary Cardiology, PLLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. In addition, we fully comply with applicable State of Washington laws and do not discriminate on the basis of creed, gender, gender expression or identity, sexual orientation, marital status, religion, honorably discharged veteran or military status, or the use of a trained dog guide or service animal by a person with a disability.
We strive to create a welcoming, supportive, and optimal environment for all our clients and patients, including those who have service animals and individuals with various disabilities. We recognize and respect the unique responsibility entrusted to us when caring for service animals and accommodating clients with disabilities.
To ensure a smooth and comfortable experience during your visit, we kindly request that you contact us in advance or inform us at the time of scheduling if you require any accommodations. By notifying us of any unique circumstances, we can take proactive measures to avoid delays or inconveniences. We are committed to accommodating your needs as they arise.
During certain parts of your visit, it may be necessary for your service animal to be temporarily separated from you due to specific procedures or areas where client access is restricted (such as exposure to ionizing radiation, surgical procedures, or treatment areas). We prioritize your safety and comfort during these periods and welcome your communication regarding how we can best support you through these brief separations. We understand that service animals play vital roles, and any information you can provide prior to the appointment will greatly assist us in ensuring a seamless and safe experience for you.
It is essential to note that, due to the nature of healthcare and the potentially serious conditions we encounter as cardiologists, there is a possibility that a patient may be deemed unfit for service in an acute or chronic state. We strongly encourage you to be prepared for such adverse situations. If an adverse situation is unavoidable, we will work closely with you to find solutions that prioritize your safety and the safety of your service animal. This may include rescheduling procedures for another day, arranging transportation home, or assisting in contacting resources necessary to support your well-being.
Examples of acute situations may involve surgical procedures or mandatory sedation that temporarily prevents the service animal from safely performing its duties for a few hours. Chronic situations may arise when a severe disease diagnosis raises concerns about the service animal’s ability to fulfill its required functions (e.g., collapse/syncope, heart failure, or the need for pacemaker implantation).
We are dedicated to assisting you and your service animal throughout the entire process, and we appreciate your cooperation and understanding as we work together to ensure a positive experience and the highest level of care.
We are committed to creating an inclusive environment where language barriers do not hinder effective communication. In line with this commitment, we are proud to offer remote interpretation services that cover a wide range of languages and dialects, with over 300 options available from around the world. On-demand interpretation services are available for many languages; however, advanced scheduling ensures access with a qualified Interpretation Specialist.
If you require any language services, including American Sign Language (ASL) through video-based interpretation, please inform us in advance whenever possible. Our goal is to ensure that you are fully informed and empowered throughout your experience. There are no additional fees associated with utilizing our language support services.
Our team may also offer you language services if we believe a language barrier is preventing complete communication. There is no cost to you for the use of this service, but we will only utilize this system with your consent.
We are proud to offer this service to foster a welcoming clinic environment that addresses the linguistic needs of our diverse clientele. A language barrier will not compromise your care.