A small, fluffy terrier is getting a CT scan in front of me. She has a large tumour behind her right eye so her vet, Dr Laura Cuddy, is scanning her head, chest and abdomen to see what stage the tumour is at and how it's spreading. Wuffles is strapped to a human-sized stretcher; advanced diagnostic imaging machines don't really come in doggy sizes. There's a nurse keeping him under general anaesthetic and closely monitoring his condition. An ECG beeps a few times every second. The whole scene looks as if it's straight out of a medical drama.
Veterinary Specialists Ireland, a small animal veterinary hospital on the outskirts of Summerhill in Meath, is the dream of Cuddy and her husband, Dr Turlough McNally. The private referral hospital has more in common with the Blackrock Clinic than with the practice I grew up taking the family dogs to. Opening in 2019, the state-of-the-art 8,000sq ft surgery is all glass, modern lines and tasteful dog-themed decor. That, and the latest in high-tech medical equipment, including an underwater treadmill, a visiting MRI machine and the CT scanner used to diagnose Wuffles.
Cuddy and McNally both graduated from University College Dublin (UCD) in 2008 with a degree in veterinary medicine. The same week they left for the United States: Cuddy to the University of Florida for a master's in small animal surgery; McNally to Kentucky for a surgical internship at the Hagyard Equine Medical Institute. "We graduated on Monday," McNally says, "I left Ireland on the Tuesday, Laura left on the Wednesday. We started into work the day we arrived off the plane."
McNally returned to Ireland in 2012 to continue working as an equine surgeon while Cuddy returned in 2013 to work in UCD as an assistant professor in a small animal surgery. Veterinary Specialist Ireland opened for business in June, 2019. Initially, McNally continued to work as an equine surgeon (the hospital only deals with dogs, cats, and other small animals), but within a few months things were so busy that he joined full time to manage the practice.
In Ireland pets were traditionally left in the kitchen or out in the shed. We're becoming more like America and as pets become part of the family, people are starting to want more for them
When it comes to the medical care available to animals, “Ireland has traditionally been behind some of the bigger countries on the global scale,” says McNally. “We modelled this facility off places we saw in the US.”
“Ireland is catching up quite rapidly,” Cuddy says. “It has changed a lot in the last 10 years.” In particular, she says, the equipment available in most practices, the medical standards and their willingness to refer to specialists like her for advanced procedures have improved significantly, even in the last three years. “It was always challenging in Ireland to get clients to refer because it isn’t always cheap.”
A significant contributor to this shift is the change in how Irish people view their pets. Most people no longer see them as property – and especially not as garden ornaments. “They’re part of the family now,” says Cuddy. “A lot of our clients don’t see themselves as owners but as guardians watching over them.”
“In Ireland pets were traditionally left in the kitchen or out in the shed,” says McNally, but things are changing. “We’re becoming more like America and as pets become part of the family, people are starting to want more for them. And that’s resulted in people like us trying to fulfil those needs.” Today it’s far more likely that the dog sleeps in the bedroom than in an outdoor kennel. They don’t eat scraps from the table, but have their own custom diets.
Colm De Barra and Donal Cape, co-owners of Dublin Bay Vets, a small animal practice in Clongriffin that also opened in 2019, express identical sentiments. "I think there has been a shift towards pets being more and more family members rather than just animals, or just cats and dogs," says De Barra, who was classmates with Cuddy and McNally in UCD. Cape, who graduated the following year, notes that some of his patients go on far more holidays than he does.
Both De Barra and Cape also practiced internationally. They both spent five years working in Australia and worked together for a time in Melbourne. Again, it was their experience abroad that inspired them to set up their practice at home. "I think the practice of veterinary medicine in Ireland is very much stuck in the mentality of quantity over quality and getting through the numbers," says De Barra, calling it "an incessant conveyer belt". "And maybe that's just an old, bad tradition and maybe it's that there aren't enough vets. It's probably both."
In Australia, he says, “It’s not that they’re better vets but they tend to spend more time with each patient and that lends itself to a happier experience for the client and a more thorough experience for the patient.”
“We wanted to set up something where you just take your time,” says Cape. “That means clients are happier and it’s a much nicer working environment. One way to keep clients happy is to keep staff happy.” All their consultations are 30 minutes long rather than the 15 minutes which is common in many practices.
“A lot of initiatives in pet healthcare have not been vet-driven but more client-driven,” says De Barra. “I think it’s probably taken the veterinary profession longer than it should to realise that people want the best for their pets. They don’t want the cheapest treatment or the quickest treatment. That is an old-fashioned way to go about things.”
“There are a lot of situations in practice that have serious emotional pressures and I don’t think there’s enough awareness in the industry of this. For example, end-of-life care and euthanasia requires lots of time and attention and sensitivity. But not even that: for some people, a puppy vaccination visit can be an emotional and overwhelming experience.”
They also aim to make the whole vet visit better for their patients. Pre-consultation anxiety medications are available for anxious visitors, and small anxiety-reducing pheromone dispensers are plugged in around the practice. They even play classical music. “It’s been shown to reduce stress,” says Cape.
Younger professionals, she explains, are more likely to 'look at the pup or the kitten as the child – or the third child or the fourth child – in the family as opposed to the pet'
Kathy Enright, owner of Rockhall Veterinary in Limerick, has noticed much the same trends in pet ownership. "We see it all in Limerick. We still see the backyard dog that gets scraps off the table. And then we see the dog that's only fed from a fancy bowl and has a designer bed, that's better minded than I would be in my own home."
Enright graduated from Edinburgh University in 2005. After two years in the UK, she came back to Ireland and worked in practices in Dublin and Galway before starting Rockhall Veterinary in 2017 with her sister, Laura Enright. It started with a single practice on Clare Street, Limerick, though they've quickly expanded. They now have four practices, a 24/7 emergency clinic and 38 staff.
Enright thinks demographics play a role in the change. Younger professionals, she explains, are more likely to “look at the pup or the kitten as the child – or the third child or the fourth child – in the family as opposed to the pet.”
It’s these people who treat pets as family members and want the best for them in all areas of their life that have helped these three practices to flourish. There’s a willingness to pay for medical care – or pay monthly for a pet insurance plan – that didn’t exist in Ireland before. McNally explains that the intense surgical procedures his practice offers, like total hip replacements and ligament repairs, aren’t suddenly available because of advances in animal care, but because owners are asking for it. “It’s driven by owners understanding that more can be done.”
According to Cuddy, "People come and say, 'I want a hip replacement.' They come looking for advanced surgery." Part of this is due to advanced animal surgeries being shown more in the media. "There is some kudos to Noel Fitzpatrick [the UK-based Irish vet known for his Channel 4 show, The Supervet] for raising awareness of a lot of what we do. A lot of times we say, 'Your dog needs a knee surgery, it needs a TPLO,' and they say, 'It's okay, I saw that on Supervet.'"
The number of pets in Ireland is also increasing every year which is also creating business for general practice vets. Every puppy and kitten needs at least three vet visits: two for vaccines in their first few months, then a third to be spayed or neutered at six months to a year.
Exact facts and figures about the number of pets in Ireland are hard to find but, in 2010 the European Pet Food Industry Federation estimated that there were 425,000 dogs and 310,000 cats in Ireland in their annual report. Cats in particular have done well. While the number of households with at least one dog has actually dropped from 26 per cent to 25 per cent, the number of households with at least one cat has risen from 16 per cent to 25 per cent. Separately, the Dublin Society for Prevention of Cruelty to Animals (DSPCA) estimates 70,000 puppies are born here each year.
And this was all happening before the Covid-19 pandemic started a run on animal shelters and dog breeders. For a few months last year, it was almost impossible to get a dog from a charity. Dogs Trust experienced a 134 per cent increase in adoption requests compared with 2019. The price of puppies went "through the roof", according to Brian Gillen, the chief executive of the DSPCA, when he was interviewed for an RTÉ News report. Jack Russell terriers that people would have given away for free were being sold for upwards of €500. More exclusive breeds were selling for thousands.
But you don’t really need these kinds of statistics to see it in action. When I visited Dublin Bay Vets they were refitting the practice to add two new consultation rooms. Since opening, they’ve gone from two vets and two nurses to four vets and five nurses – and they’re still hiring. Rockhall has gone from one practice to four and is planning to expand further.
You can also see the knock-on effects in other pet services. The Happy Hound pet shop in Sutton, for example, has a four-week waiting list for grooming appointments. "And that's the least it's been all year," says the owner, Emma Jane Sinnott. "It was up to 12 weeks at one point."
And it’s also visible just outside your door. Look around any park or green space and you’re sure to see small puppies frolicking at the end of flexi-leads while their owners follow them around with poo bags at the ready. It’s obvious that Ireland is going wild for pets.
Another big shift has been the kind of breeds people are getting, and that’s also led to a rise in veterinary needs. “Traditionally, people had Labradors and Westies and things like that,” says Cuddy. “Now, it’s French bulldogs and English bulldogs and American bulldogs.There’s a huge growth in these brachycephalic, or flat face, breeds.” Unfortunately, many of these breeds are predisposed to serious health complications, including eye disease, skin infections, dental problems and respiratory issues.
They'll go out and spend the €400 or €500 on the bed and the fancy collar and the lead, but they haven't thought about the medical needs of it and factored that into their decision-making
A 2018 policy document from Veterinary Ireland highlights the issue. It calls on kennel clubs and breeders to work to address the breathing issues, citing UK Kennel Club research that shows half of all brachycephalic breeds have breathing difficulties, with less than 15 per cent of them able to breath like a normal, non-brachycephalic dog.
“It’s difficult to reconcile for us as vets,” says Cuddy, “They are increasing our business, but, ethically, it’s very difficult. We do our best to help the individuals but there’s an issue for breeders to sort out.” She regularly performs brachycephalic airway surgery – a procedure that widens the airways to allow these dogs to breathe better, though it costs upwards of €1,800 depending on the severity of the condition.
Enright considers it an education problem. “When people are choosing what breed to get, they’re not putting the research into it,” she explains. “They’re not aware of the issues and the problems that they have and the needs that they’ll have.
“They’ll go out and spend the €400 or €500 on the bed and the fancy collar and the lead, but they haven’t thought about the medical needs of it and factored that into their decision-making.”
De Barra is even blunter. “You see the same breeds with the same problems all the time.”
Even with people willing to pay, the cost of animal healthcare is going to rise. “The cost of veterinary care is going to increase and people need to be prepared for that,” says Enright. The cost of PPE has gone up 150 per cent and she says she’s had four price increases from her drug suppliers over the past two years and expects another before the end of the year because of the “double whammy” of Brexit and the pandemic. In the past, there would have been a single price increase annually.
And it’s not just one-off costs people need to be concerned about. “People think if he gets run over by a car it’s two grand, three grand, whatever. We’ll fix him. But what people don’t think about is the ongoing cost of medication,” says Cape. “Drugs are expensive.”
Enright recommends her clients either take out pet insurance or set up a bank account for each pet. She tells them to put €30 per month into it for the rest of the pet’s life. “Because when things go wrong or the unexpected happens, you really are covering yourself.”
De Barra and Cape are similarly bullish on pet insurance. “Having a significantly ill pet is a charged environment,” says Cape, “It’s wonderful to take the financial decision out of it.” With that said, he stresses that all the options are presented to their clients regardless of whether they’re insured or not. “It’s very important that every client has all the knowledge on the table, but if you don’t have the ability to continue on with a medication long term, that can be very difficult for everyone involved.”
And, of course, the team at Vet Specialists Ireland benefit from more people having pet insurance. “The clients we get here are disproportionately insured compared to the general population,” says Cuddy, even though some of their procedures aren’t fully covered by most policies. “The implants alone for a full hip replacement cost €2,500 or €3,000 so a €4,000 limit will not get you a full hip replacement. Now most people are willing to top that up.”
It’s clear that veterinary care in Ireland is going to continue to change over the next few years. All the vets I spoke with were optimistic about the direction of the industry around standards of care, and about what clients were prepared to do for the animals. They also all liked the challenges that providing high quality care brings. “We just wanted to be better than everyone else,” says McNally, “And it’s hard for us to be better than everyone else if we don’t have the animals to challenge us or the owners willing to push the boundaries – in a good manner.”
Now it seems Irish pet owners are prepared to push those boundaries. In a good manner.