This is a long overdue post about our experience with vet care in Europe and a health update on Koval the dog. The quick summary is that we’ve been pleased with every experience we’ve had. The prices are cheaper, but that’s because the cost of living and salaries for the locals is a lot less than in the United States. As you read some of my price and cost comparisons, keep that in mind.
A Little About Koval
As of today, Koval is close to turning 14. He was an owner surrender on October 21, 2017 and taken in by Alive Rescue in Chicago (and that is how we come to celebrate his birthday on that date.)
The intake information said he was 7 years old. In that case, he would be turning 16 soon. However, Koval had a dental cleaning and a couple teeth removed in the fall of 2023 while we were back in Chicago and our vet thought he was actually two years younger! So here we are, where he is about to turn 14. But maybe with some of his health issues, he is actually older?
How is Koval?
While I could do a deep dive into every little thing that we and Koval are dealing with, here’s a general overview.
Shortly after our 13 months living in Barcelona and our May 2023 return to Chicago, Koval started to show some hearing loss. It seemed a little temporary at first because he eventually would hear food wrappers again. But then as our year in Chicago went on, he seemed to lose it again. It’s currently to the point where he hears very little, and thunder and fireworks that once bothered him, he doesn’t even notice now. It really sucks to see these changes.
Koval has long had tremors in his back legs which we were never too concerned about. He’d been seeing his Auntie Caragh of Wellness & Wags for canine massage therapy since about the time we adopted him. Then one day in April 2024 he wouldn’t go up the stairs of our apartment building. Our vet prescribed a couple prescriptions and diagnosed arthritis. A few days later he was back to normal and able to go up the stairs.
The tremors are still there and he is showing signs of leg weakness now too. He walks mostly ok, a bit slower and with a weird gait. A few times a week Koval will still bust out and do some zooms. It all just depends on the day.
Koval also has a rather large lipoma in the area near his front armpit. The lipoma is in addition to numerous skin tags that have developed on his skin.
Back to Europe
In late September of this past fall, a couple weeks after arriving in Europe, Koval had some concerning vomit late one night while we were in Aix-en-Provence, France that we thought warranted an emergency vet visit. Our wonderful Airbnb host helped us find one and she actually met us there too. Everyone at the ER vet was really quite lovely and the vet we saw spoke English and even some of the support staff did as well. They did blood work and diagnosed him with pancreatitis and kept him overnight.
We visited him the next day and since we didn’t have a local vet tot take him to, we asked if he could stay another night for observation. They said of course. And this is where the price difference from the US is just jarring:
The two night stay, blood work and a couple of prescriptions came to 520€ / $580 total. I imagine similar in Chicago would have been at least $1,000.
Ultrasounds and a CT Scan
A few days later we made it to Barcelona where we would stay for four and a half months. We scheduled an appointment with the same vet we saw when we lived there two years before. They did blood work as well as an ultrasound. Bloodwork did not show the pancreatitis, but the ultrasound showed an inflamed gallbladder and liver. The recommendation was to schedule a specific heart ultrasound and a CT scan for a closer look to further rule out any tumors.
They also recommended switching to a low fat diet and for Koval to take a liver supplement. Almost immediately, Koval started urinating indoors more frequently. We thought it was a medication side effect but the vet disputed that. Once we looked back, indoor urinating happened a few times in Chicago and earlier after arriving in Europe. So now add in some reduced bladder capacity issue or incontinence to the list of health issues.
This all took place around mid/late-October 2024. The heart ultrasound didn’t require any anesthesia, but the CT scan did. The heart ultrasound basically showed heart disease and that Koval’s valves weren’t functioning completely correctly. He was given a medication called Cardisure, which he still takes.
Thankfully the CT scan didn’t show any tumors, just that the liver and gallbladder were inflamed. It also showed a little stone but not blocking anything. He was given an antibiotic, and they also offered to do a gallbladder aspiration for more testing, but we declined.
Luckily, the cost of these appointments and tests were very manageable for us and darn cheaper than if we had them done in Chicago:
Ultrasound, bloodwork, vet visit and a medication: 312.80€ / $346.74
Heart ultrasound: 239€ / $262.75
CT scan, with anesthesia: 625€ / $679.56
Canine Cognitive Dysfunction
Late fall 2024 we thought that most of the health issues were sorted out until Koval started to actively pace and pant nonstop in the afternoon and into the evening. I talked to some trusted friends in Chicago, looked a few things up online and went to the vet. He got diagnosed with Canine Cognitive Dysfunction, a common age-related disease in dogs that affects the brain, causing deterioration similar to Alzheimer’s disease in humans. Also comparable to sundowners syndrome.
The vet prescribed a medication called Plurimen for the CCD. Its main active ingredient is called Selegiline, which is often given to patients with Parkinson’s disease. After almost two months and no improvement, it was decided to stop giving it to Koval. And we didn’t try anything again until summer 2025 in Nice.
A few months ago I found a very informative Facebook group for CCD and so many people are going through this diagnosis with their dogs. I was really quite surprised. It made me look back and view certain actions by Koval in a new light.
The afternoons and nights with the constant pacing and panting have been hard. And it’s still ongoing daily for hours at a time until he maybe finally crashes on the couch around 8 or 9pm.
We tried to nip the indoor urinating from happening by doing more frequent walks. That just became tiring for Nik and I. We were doing them almost every 40 minutes and the time between walks kept shortening as months passed. Koval now wears a belly band (a nicer way of saying doggie diaper, but it really just looks like a fancy dog cummerbund) a lot of the time at home. And it’s fine if he urinates in them. They’re washable and reusable, though we have used disposable ones too.
Canine Physio in Barcelona
While in Barcelona, our main vet referred us to CRAR, a rehab vet for Koval to get treatment on his tremors. For the first time ever, Koval had laser therapy, electrical stimulation therapy and hydrotherapy. Each appointment included a bit of each treatment.
Our experience at CRAR was outstanding. Everyone on staff spoke English, which was very helpful for us. These treatments didn’t fix anything but I think we saw slight improvements after each session.
I don’t have much to compare it to, price-wise, in Chicago but a three-pack of appointments cost 187.70€ / $196.83.
Some misc. medication costs using 1800PetMeds as comparison:
30 Apoquel: ranged from 64€ – 69€ / $89+ (as of October’s Euro to USD exchange rate)
Simparico Trio: 50€ / $103
Vets in Nice
I had gotten a few recommendations for a vet in Nice. We went a few times to get Koval registered locally, medication refills and follow-up ultrasounds. Because of the panting, pacing and urinating we had Koval tested for every possible illness under the sun: Cushings Disease, Kidney disease and diabetes. They all came back negative. Excellent news. I’m just a cut and dry person and wish there was a specific reason for all his ailments, other than “just aging.”
The pricing for those tests in one appointment: 729.45€ / $799
The follow-up heart ultrasound in May showed improvement and downgraded his heart disease. He still takes the medication, so maybe it’s actually working.
We also tried another form of Selegiline in pill form, but two pills in and Koval had explosive diarrhea several times overnight in his crate. Around this time we had just switched vets to a practice closer to our apartment. She didn’t think that would’ve caused it, but I didn’t want to start the pills again to see, so right now he isn’t taking anything specific for the CCD.
While not as much of an issue in Chicago, Koval once again started to get a constant ear infection in his right ear. We’ve had vets thoroughly clean it and prescribe antibiotics for us to spray and it just won’t go away. It’s thick and black, like a clump of coffee grinds. Just not as nice smelling as coffee can be.
So that’s where we’re at. Luckily we have the means to care for Koval without it being too much of a financial burden. But it also shows how out of whack healthcare costs are in the US for both humans and pets.
It’s been hard, challenging, tiring and emotional. Nik and I are trying to enjoy every moment with Koval. We just had an excellent road trip as a family and got some great pictures.
