The First Time- Part II

Hey, yo, it’s Bunker again. Here’s Part II of one of dad’s short stories he wrote. Best I can tell, he wrote ‘em a couple of decades ago when he was doing something called large animal work. Heck, I’m an 85 pound lab. Don’t that make me a large animal? Anyhoo, I thought it was a purty good story. It was long though, so I split it in to 2 parts. If you didn’t see the first one it’s here: https://www.fosteranimalhospital.com/blog/?p=149  Later!    Bunker

 

“The First Time”

 

The heifer peacefully went to sleep. Quickly her left side was shaved and scrubbed clean. I put on my gloves, placed the drape over the surgery site, and made a 15” incision. Carefully the uterus was isolated and the calf was removed. Dead. The incision of the uterus was sutured closed. How easy can this be I thought! “We’re almost done Robert,” I grinned!

Suddenly, as if struck by a bolt of lightening, the heifer jerked. Over and over again she struggled against the anesthesia and the ropes. “ Easy girl we’re getting close”, Robert calmly said. In her stunned manner the young cow continued to struggle. Suddenly, the rope came loose from her left rear leg. Drunkenly, she flailed it in the air as the instruments, drape, and I went flying! Gathering myself, I rushed back up to try and secure the leg. Somehow, as if a gift from Above, the heifer settled down. I quickly placed the rope on her leg. Steadying myself, I looked at the horror that was now my incision. Inside the once sterile abdominal cavity were pieces of straw, and dirt, and hair, and muck, and flies. What was becoming a successful surgery would now most likely end in tragedy. The chances of postoperative infection would be very high and would very likely lead to death. I quickly administered more anesthetic and ran to the truck to see if I had anything sterile to flush the abdomen. Much to my dismay, there was only a half clean bucket and some disinfectant.

I went back to the stall and told Robert the bad news. I explained all of the likely complications and said, “We again have 2 choices Robert. We can flush her abdomen with unsterile water and disinfect, load her up on antibiotics, and hope and pray for the best. Or we can put her down and save her from what likely will be much misery. “ Robert gazed confidently at me and said, “Doc I think we can save her. We’ve come too far to quit now. Let’s try. Hell, she’s too mean to die!”
“You’ve got that right!” I said. So I hurriedly mixed the disinfectant, carefully flushed any and all debris I could see. I then hurriedly closed all layers of the incision. The ropes were untied as we anxiously awaited her recovery. Fifteen minutes passed. As if an instant replay, the heifer jerked her head up, realizing the presence of the two of us and sprang to her feet. Remembering my shins and recognizing the menacing, albeit drunk stare, we quickly exited the stall.

“I have to be down this way tomorrow evening. I’ll come by and see her then. Be sure and give her this antibiotic in the morning and we’ll see how she does.”
“Thanks, doc. I really appreciate it.”

The next evening I roared into the dirt drive and saw Robert sitting on the tailgate of his pickup. I fully expected her to be dead. If the calving stress and ensuing anesthesia wouldn’t kill her, the peritonitis would.
“Well, how is she? Did she make it?”
“Take a look for yourself”, he grinned.” She started eating after you left and hasn’t stopped since. Her incision is draining though”.
I peered through the logs at her. She turned towards me and for a moment had a look of gratitude on her face. Then, as if on cue, she whirled and slammed her head against the logs. BAM! We both laughed and knew she was going to be alright.

 

 

Thank Goodness They Were Found

I recently heard about the 2 veterinarians from Virginia that were hiking in Glacier National Park and were “lost”. As it turns out, they encountered severe weather conditions, and were stranded for several days until Park rangers found them. (I have linked an article below)

The great thing is they sounded prepared, before their excursion, for what may lie ahead. My wife and I were in Snowmass, Colorado this summer for a continuing education class in Canine Rehab. We did some sight seeing while there, as we had never been to Colorado before. Snowmass and Aspen are needless to say breathtaking and beautiful. We were breath-taken because of the 10,000 foot altitude and the beauty! We visited Maroon Bells one afternoon. Maroon Bells is one of the most beautiful and one of the most photographed areas in the world. Apparently, it was a favorite of famed photographer Ansel Adams. However, for all of its beauty, it is extremely dangerous hiking. In fact, signs are everywhere about the dangers of hiking. Unfortunately, the day we visited, the body of an unfortunate hiker had been found as he plummeted several hundred feet to his death.
Anyhow, seeing the linked story about the 2 veterinarians and their rescue warmed my heart and I thought I would share it with you. I do not know either of these gentlemen, but as a colleague I share in their happy return home. Enjoy!
https://veterinarynews.dvm360.com/dvm/Veterinary+news/Veterinarians-lost-in-Glacier-National-Park-surviv/ArticleStandard/Article/detail/793191?contextCategoryId=46659

 

The First Time- Part I

Hey, yo, it’s Bunker again. I’ve been rummagin’ through dad’s computer, and came across some kinda short stories he wrote. Best I can tell, he wrote ’em a couple of decades ago when he was doing something called large animal work. Heck, I’m an 85 pound lab. Don’t that make me a large animal? Anyhoo, I thought it was a purty good story. It was long though, so I split it in to 2 parts. Hope he doesn’t stop me from posting both parts. Later!    Bunker

 

 

“The First Time”

It was a hot summer evening, one of the hottest of the season. The air condition in our new modest home was refreshing. The delicious meal prepared was filling and nourishing. The comfort of my old recliner, accompanied by the cool house and meal, led to a quiet evening slumber.

RING! I reached for the aggravation on the table. “Hello”, I said through my slumber. “Doc, this is Robert Thomas out on Sail Road. I’ve got a heifer in labor and she ain’t able to have it. I need you to come out”, he exclaimed. “There ain’t nothin’ showin’ but the tail!” “How long has she been in labor?” I sleepily asked. “I ain’t sure. I work at the mill first shift and was late checking ‘em today cause my hay was down in the field and I needed to bale it before the rain came. She was fine this mornin’ early.”

I drove excitedly to my first official calving. Oh sure, I had helped dad deliver dozens but never had I flown solo. I had seen all of the problems- breech presentation or a leg or the head turned back were the most common. I felt ready for whatever lay ahead.

I pulled into the dirt drive of the Thomas’ farm and pulled straight down to the barn. It was a typical barn for Cabarrus County. A box shaped log construction with a plywood door leading to the stall the heifer was in. The barn was aged and leaned a little but still seemed sturdy for its purpose. A hayloft was overhead. An open area was to the left that stored the John Deere tractor that still had the hay baler attached. The back of the barn was an open area for feeding and lounging of the livestock.

“Hey doc thanks for comin’.” Robert said with a warm smile. “I’ve known your dad for a long time. I sure hope you’re as good as he is!” Even after being out of school less than 2 weeks it seemed as though I had heard those words a million times! I knew it was true. Dr. Tom was as appreciated and respected as any person in the county. He always was willing to help, whether on the job or off, and people appreciated that. He was a skilled veterinarian, raised on a tobacco and dairy farm, and knew the value of an honest, hard days work. People had the feeling he was “one of them” whether it be his clients or a doctor or lawyer. I could only hope I was half as good as dad. “Well I don’t know if I’ll ever be that good!” I laughed, “but let’s give it a try.”

The heifer was in the box stall and she was definitely not happy about her visitor. BAM her head went against the logs as she made a Herculean effort to knock me back to Concord! “I’ll see if I can get a rope on her,” Robert said. Deftly, he placed the rope gently across her head as he leaned over the planks. Snugly, he tied her in the corner.

I approached her from behind gently. I could see the calf’s tail beneath her own. I carefully reached for her tail. WHIZ! Her right rear leg flashed by me as she made an effort to kick me. Robert pushed her to the side and tried to hold her still. Another attempt to examine resulted in the same response. WHIZ! Except this time she landed a solid hoof on my left shin. “Damn!” I shouted without thinking, “That hurt!” “I’m sorry doc; let’s try again”, the part time farmer said. Carefully I reached for her. She finally began to settle. I seized the tail and put a “tail hold” on her. Paralyzed by this, she was unable to unleash her lethal hooves.

“The calf’s breech”, I told him. “I’ll see if I can turn the back legs up and maybe we can jack him out.” Palpating up to my arm pit, I could barely reach the hooves as they were tucked up near the elbows of the calf. “I don’t know Robert, it’s mighty tight in here. There’s not much room”. I worked continuously with no success. Most breech deliveries are complicated but this one was especially so due to the heifer’s small size.

After what seemed an eternity in the steamy evening, a decision had to be made. “I’m unable to deliver the calf. We have two choices. One is to do a c-section. The other is to put her down. The chance for a successful c-section is limited. It’s only the two of us, we’re in an unsterile environment, and quite frankly I’ve only assisted with these.

This would be the first time.”

As we discussed his choices, I loosened my grip on the tail. WHAM! Her left rear hoof crashed into my left shin again. “AHH”, I screamed in pain. “We need to decide because if she keeps this up, she’s going to kill me!” I said half laughingly. Robert paused and said, “Well it’s a lot of money but I think we can do it. We’ll keep her up and medicate her whenever we need to Doc after the surgery.”

What a frightening and anxious decision. Doing a c-section in a log barn, w/ dirty, manure covered straw on the floor, cobwebs in the air, and flies galore! What a fun opportunity! I gathered my instrument pack and sterilized gloves. I administered the anesthetic. Unfortunately the field anesthetics available at that time were poor and poorer. Sure at a hospital or university clinic, gas anesthesia would lead to complete and continual sleep. Here, the medicine was given intramuscularly and would last somewhere between 20 and 45 minutes! Therefore, a good tie down of all feet was needed, just in case.

 

 

(Please do not reproduce this article without permission from the author)

 

Arthritis: Pets and Humans And Comparative Medicine

I saw these 2 articles and thought I would share. Many of my last articles have dealt with Canine Arthritis and Obesity. These two articles highlight research that may eventually benefit all. Enjoy!

Article one:  https://trends.aahanet.org/VetNewsArticle.aspx?key=c5f85f93-9c78-4cc5-921d-56bc24f6ca70
Part Two:  https://trends.aahanet.org/NEWStatArticle.aspx?id=NSV10I39&key=d13bdc42-f2e3-45e1-838b-bffb27b638a4

 

All the best,

Steve Foster DVM, CCRT

 

 

 

Being Too Heavy Is Not Fun For Fido!!

 

 

The last article I wrote dealt with a much too common condition we see at Foster Animal Hospital: Canine Obesity.

Just as in the human world, the pet world suffers from obesity too. Many of the pets we see here are overweight, ranging from 2-3 pounds to 40-50 pounds of extra mass. As you can imagine, as the weight goes up, the health problems do too. Why?

Well, obviously, the sheer task of carrying extra pounds stresses the entire body. The heart and lungs are stressed due to the extra workload. Other organs, such as the liver and pancreas, can be affected to the point of severe liver disease and diabetes. The skeleton and joints are affected by having to carry the extra load.

We all know how heavy a 40 pound bag of dog food feels. While you read this, you can probably remember what it was like the last time you carried one. For some of us, it may bring back the feeling of relief you had when you set it down! Now imagine you are a Labrador, that should weigh 70 pounds, but instead you weigh 110 pounds. (Don’t laugh, we see it all the time) Or you are a Schnauzer that should weigh 15 pounds and you weigh 30. (That would be like me, 180 pounds, weighing 360 pounds!) For theses dogs, they never get to set that big bag of dog food down. They are carrying that enormous weight around 24 hours a day and 7 days a week. Carrying this extra weight for months and years causes a breakdown of joints and the support structures. Cartilage breakdown occurs. Joints and backs become painful. Activity levels decrease. Muscle mass atrophies. And before you know it, you have a dog that lays around, he’s hurting, he’s tired, and yes, he’s suffering.

To add to the obesity problem, we know that fat cells produce hormones that are inflammatory in nature. And what is the target of their inflammation? You guessed it- joints and even other areas. So, even though the breakdown from carrying too much weight may not occur for months to years , the INFLAMMATION process can start early. And once that cascade starts, it’s hard to turn around. Inflammation leads to pain, which leads to inactivity, etc., etc. In my mind, I see a young and thriving dog engulfed by a giant arthritis snowball, rolling down the mountain out of control until, CRASH, it’s too late.

For me, as a vet and pet owner, the inflammation part of obesity really drives the point home. And that point is, fat is more than just fat. It’s an active, bad-hormone producing machine that is literally destroying our pet’s joint surfaces. And for me, that is enough to know. I waged war on obesity and fat for myself. I have waged war on obesity and fat for my own pets. And I am waging war on obesity and fat for all of my patients. Being too heavy is not fun for Fido!

So what do we do? Well, it starts with the commitment to get our pet’s to their appropriate weight. It begins with a lifestyle change of feeding them what they need, the amount they need, and being able to say no when those big pitiful eyes are staring at us! Once we have that part, which is the hardest part, under control, a regular exercise regimen is in order. Unfortunately for some, that involves a leash and a long walk. Simply going loose in the back yard is not enough. Simply chasing a ball a few times is not enough. (Granted those activities are better than laying by the sofa and eating treats!) Regular brisk exercise is needed to increase the heart rate and boost metabolism. Good regular walks will help build endurance and add muscle mass that helps to shrink those fat cells. (and that’s what actually happens. They shrink but NEVER go away. So any backsliding from controlled diet and exercise will allow them to fill back up with fat!)

However, if your pet is severely overweight, you may need professional help. At Foster Animal Hospital, we can give you guidance on what to do. We can help you understand how overweight your pet may be and offer nutritional guidance to get the ball rolling. We can discuss exercise and help you have a plan in place to help your pet get fit again. If your pet is suffering medically from obesity, we can help make any necessary diagnosis and prescribe treatment that will help him be less painful, happier, and ultimately more active. Possible treatments may include nutraceuticals such as Phycox, prescription medications like Rimadyl, and Certified Canine Rehabilitation. Canine Rehab can include physical rehab therapy and a weight loss exercise program performed at Foster Animal Hospital. Oftentimes, a multi-modal approach is best and gives your beloved pet the best chance to have the highest quality of life possible.

I hope this provides some insight as to why obesity can be so harmful for our beloved pets. Please email me with any questions at: sfoster@fosteranimalhospital.com. Until then…….

All the best,

Steve Foster, DVM, CCRT

 

Is Your Pet Obese, Overweight, or even Pudgy?

If you answered yes to any of the above, then we need to talk! Any degree of being overweight is more harmful than you may realize to your precious pup. The sheer task of carrying extra weight can create a damaging stress to your pet’s back, hips, knees, shoulders, elbows, virtually any joint! Also, fat cells are inflammatory by nature, which starts the degenerative cascade to arthritis. So by eliminating excess body fat, you really can kill two birds with one stone. Below is an excerpt from our most recent Foster Animal Hospital e-newsletter.

According to a recent survey,* more than half of U.S. dogs and cats are overweight. These pets are at a higher risk for developing serious medical problems, including arthritis, diabetes, breathing problems, and some forms of cancer. So how can you slim down your super-sized pet and reduce the risk of these diseases? The answer is easier than you think.

1. SIZE UP YOUR PET
Ask your veterinarian about your pet’s body condition score (or BCS). Using the BCS scale, your veterinarian can easily determine whether your pet is underweight, overweight, or right on track. As a rule, you should be able to feel (but not see) your pet’s ribs through a thin layer of fat and see a defined “waist” between the ribs and hips.

2. MEASURE MEALS
Too many pet owners simply fill the bowl or estimate how much they’re feeding. But did you know that once a cat has received the calories he needs (typically less than 300 per day), adding just one extra teaspoon of dry food each day can add up to a pound of weight gain in a year? Keep in mind that for the average 10-pound cat, this is a 10 percent weight gain!

3. EXERCISE
Exercise and good nutrition are powerful partners to help your pet live a long and healthy life. For dogs, as little as 20 to 30 minutes of daily brisk walking is all it takes to boost immune function, improve cardiovascular health, and reduce many behavioral problems. For cats, try playing chase (using a laser pointer [avoid the eyes], remote-controlled toy, or ball of paper) for five to 15 minutes each day.

Please call us at (704) 786-0104 with any questions or visit your Pet Portal to learn more.
Sincerely,

Foster Animal Hospital, P.A.
(704) 786-0104
petportal@fosteranimalhospital.com

I am hopeful these tips help you. As I have been doing Canine Rehab for many months, the dogs that respond the best are those that have a normal body weight. Through our Rehab program, we are able to speed up weight loss as well. My own personal Lab, Bunker, had become too heavy. We put him on a diet, he lost 15 pounds and acted like a new dog. His old arthritic hips have benefited greatly from just the weight loss alone. His weight loss combined with appropriate arthritis medications and physical rehab therapy have definitely improved his quality of life and extended his life. So start your precious pup today. If you’re unsure how to proceed, let us help. There’s no need in reinventing the wheel! Get started!

 

Bunker Says, “Paying for your Preventive Care Plan is as easy as 1-12! Months that is!”

Yo hey, just a follow-up on those Preventive Care Plans. Some have wondered about that there special financing. Well, it’s purty simple really. There’s this deal called PaymentBanc. And what it is, is, if you have a checking account and it accepts automatic withdrawals and you pass a short qualifier thingy, you can pay for those Plans with 12 equal payments over 12 months. ( that qualifier thingy ain’t no credit check and it don’t hit your credit rating ) Now there is a non-refundable processing fee of $35. Ya gotta pay that up front along with the first monthly payment. After that, you’re good as gold for 11 months more. If that doesn’t interest ya, they still take cash, checks, all major credit cards, and Care Credit. Now I don’t know about youins, but if I’m a human owner of the greatest species in the world (you know I’m a Lab so that would be us K-9’s, but the purry ones are cool too), I’d be all over that. You know what I mean? So, give’em a call and they’ll be glad to answer your questions and take any glowing reviews of this here blog you want to give ’em. Oh and hopefully in the next couple weeks, the website will be updated with the details of each plan. (Details- for a dog that sounds painful.) Anyhoo, check it out at www.fosteranimalhospital.com. Thanks y’all! Check ya later!

Bunker is Back!!

Hey y’all, well it’s me again Bunker. I’ve been gone from this site awhile, cause Dad has been very protective of his computer. I think he’s still mad about the cheese incident. Well, I was nosin’ around his stuff and saw something about PCP. Now, I may be an old outdoor Lab but I’m pretty sure I know what PCP is. So I started freaking out about this. I mean, my dad’s a good dude but I was pretty shocked he’d be knowin’ about PCP. So I got to thinkin’, maybe he meant PCB. I’m a little less aware of PCB. So, of course, I googled it and found out it’s some banned chemical from way back. Now what am I gonna do? Dad’s either a drug dealer or dealing in contraband from the 70’s!
Well to make a long story short, he weren’t talking about either of those. He was talking about a new thing at his dog doctor place that can be shortened to PCP. It seems his PCP’s are short for Preventive Care Plans. Evidently, they are some great deal for his patients and their parents. What they done did, is bundled a lot of Preventive Care services into an annual plan, discounted ’em up to 25%, and are sellin’ those darned things like hotcakes. Oh and to make it even better, they have special financing where you can pay for it over a whole year. Well, bust my britches! (Oh wait, I don’t wear britches.) Anyhoo, I found these here FAQ’s and decided I’d share ’em with you good folks. Enjoy! (Oh, and I guess this is the part where I tell ya to call us, uh them, today!!)

Preventive Care Plans FAQ’s

1. What are Preventive Care Plans?
Preventive Care Plans are yearly plans designed to meet your pet’s annual requirements for veterinary recommended health care, vaccinations and testing. These plans offer services to your pet for an entire year from the agreement date.

2. What is included in a Preventive Care Plan?
Each plan includes veterinarian recommended services to keep your pet happy and healthy throughout the year. These services include an Annual Preventive Care Examination, recommended vaccinations, annually recommended tests and more. Please refer to our Preventive Care Plan layouts for detailed information.

3. Can I sign up for my Preventive Care Plan online?
Currently, all applicants must complete the Preventive Care Plan application process in person at one of our two convenient locations. To apply for the PaymentBanc monthly drafting payment option, two forms of identification are required, including one photo I.D. We also recommend that you bring a voided check for account verification.

4. Do I receive a discount for the services in my Preventive Care Plan?
Yes. All services in our Preventive Care Plans are discounted.

5. Do I receive any additional discounts outside of my Preventive Care Plan?
Yes. When your pet is enrolled in a Preventive Care Plan, all additional products and services purchased for that pet will be discounted during the enrollment year. (Discount percentages vary by plan.)

6. Does the Preventive Care Plan cover my pet if he is sick?
In addition to the Preventive Care Examination, each plan includes at least one free office visit annually. This office visit may be used for sick or injured visits. Although Preventive Care Plans do not cover additional costs associated with sick or injured visits, each pet will receive a discount for all additional services and products. (Discount percentages vary by plan.)

7. I have Unlimited Free Office Visits with my plan. Do I need an appointment?
Yes. We require a scheduled appointment for all visits. This ensures that your wait time is kept to a minimum. Your pet will also receive the benefit of a full 30-minute appointment time with the veterinarian. If you are unable to schedule an appointment during our available appointment times, a drop-off visit is also available. Please see our staff for more information.

8. How can I pay for my Preventive Care Plan?
We have two options for payment of your Preventive Care Plan. Both options allow you to receive your plan’s services immediately.
• We now offer a monthly auto-drafting payment option which divides the cost of your plan by 12 monthly payments. PaymentBanc is a trusted payment option available to those with an active checking account that accepts automatic drafting. There is an application process to verify approval for this payment option. A non-refundable registration fee of $35 is required at the time of acceptance.
• We also accept payment in full at the time of your Preventive Care Plan purchase. Accepted methods of payment include Cash, Check, Visa, Mastercard, American Express, Discover & Care Credit.

9. How much money do I have to put down if I purchase my plan using PaymentBanc?
If you are approved for the 12-month auto-drafting payment option through PaymentBanc, your plan price will be divided into 12 equal monthly payments. You will be required to pay the non-refundable $35 registration fee along with the first month’s payment for the chosen plan.

10. What happens if my payment is not available on the selected draft date?
If the appropriate payment amount is not available in the provided account as established in your PaymentBanc agreement, a $20.00 fee for Insufficient Funds will be assessed to your account. PaymentBanc will contact you immediately should there be any problem drafting your payment. If there is continued failure to pay, Foster Animal Hospital holds the right to immediately terminate all plans associated with the insufficient account. Foster Animal Hospital reserves the right to cancel any plan at any time.

11. What happens to my pet’s Preventive Care Plan at the anniversary date?
You will be notified of your plan’s anniversary date approximately one month in advance. All Preventive Care Plans will renew automatically at the same plan level unless you specify a change. If you are paying for your plan in full at the time of renewal, your payment will be required before plan services and discounts may be used. If you are enrolled with PaymentBanc, you will be billed for the non-refundable Plan Renewal Fee of $25 at the time of your plan’s anniversary date. If a plan holder does not pay their Plan Renewal Fee within 30 days from their plan’s anniversary date, their plan services and discounts will be suspended.

12. What if I renew my plan after the first year but haven’t used all the services?
Services cannot be transferred or carried over from year to year or from plan to plan. We do not provide refunds for unused services. Any remaining services left on your plan at the time of its anniversary date will be removed at the time of renewal.

13. I chose a Preventive Care Plan a few months ago. Can I choose a different plan now?
Each Preventive Care Plan is designed to provide 12 months of Preventive Care services. If you decide that the level you originally purchased is not providing the proper coverage you prefer for your pet, you may upgrade your plan at any time. You may not, however, downgrade your plan until its anniversary date. If you upgrade your plan prior to the anniversary date, the difference of the plan prices will be assessed and divided among your remaining monthly payments. You may also pay for this pricing difference in full at the time of your upgrade.

14. Can I transfer my Preventive Care Plan to another pet, clinic, or owner?
No. Preventive Care Plans are unique to Foster Animal Hospital and Foster Animal Clinic at Parkway Commons. They cannot be transferred to any other veterinary facility. Plans cannot be transferred to any other pet or owner during their 12-month duration. You may cancel the plan at the end of the 12 months.

15. I have multiple pets. Can I have a plan for each pet?
It is recommended that each pet in your household have a Preventive Care Plan to ensure that they are healthy and able to receive recommended veterinary services throughout the year. Each pet can have a separate plan and 12-month payment cycle. Services cannot be shared between pets or plans. If you decide to pursue PaymentBanc’s monthly payment option, a non-refundable registration fee of $35 will be required for each individual plan at the time of acceptance.

16. I have multiple pets of the same breed and color. Do they require specific identification?
All multi-pet families with similar pets are required to be identified with microchips unless all pets in the household are currently covered under a Preventive Care Plan.

17. What if I want to cancel my plan before the anniversary date?
You may not cancel your plan prior to the anniversary date. If you decide that you do not want your plan to renew at its anniversary date, you may call us at any time to request a non-renewal.

18. Will I receive a reimbursement if my pet passes away or if I have an unexpected move out of state before the anniversary date?
The responsible plan holder will be required to pay the remaining balance of payments or the full retail price for services already rendered – whichever is less. If a plan holder is found to have paid more than the above requirements, a refund will be granted for the difference, minus the registration fee. A 30-day notice is required for all cancellation and reimbursement requests.

19. I signed up for a Preventive Care Plan but I haven’t used any services.
If a responsible plan holder wishes to cancel their plan prior to redeeming their plan’s services or any additional services that have been discounted while holding the Preventive Care Plan status, the entire amount paid toward their plan will be refunded, minus the registration fee. A 30-day notice is required for all cancellation and refund requests.