Fido and Fluffy can't speak up for themselves, but silence isn't golden when it comes to advocating for your pet's health.

Let's face it: Navigating through the often confusing and pricey world of veterinary medicine requires good communication, knowledge, resources - and chutzpah.

"You have to know the right questions to ask and not be afraid to ask them," said Dr. Nancy Kay, a northern California veterinarian and author of "Speaking for Spot," a how-to guide on how to be your best friend's medical advocate.

The key to success is working with a vet you feel comfortable with, she said, and one who encourages open dialogue and a collaborative approach.

After all, no one knows your animal's antics better than you do.

"You're the team captain," said Kay. "If you're intimidated by your veterinarian it's going to be difficult to say, 'I'd like a cost estimate before going ahead, or I know I can't give an antibiotic twice a day.'"

Open communication can also make it less awkward to ask for a second opinion, which can help you make a more informed decision.

Advice from a second doctor helped Kristen Edmonds decide against cataract surgery for her senior Siberian Husky, G, who also suffered from a cognitive disorder and didn't deal well with stress.

"The second vet made us feel more comfortable that this may not be the right decision for our dog," said Edmonds, who rescues Korean Jindos.

While many pet owners worry it will dent their vet's ego, Dr. Arnold Plotnick is never offended when a client seeks a second opinion.

"In fact, I think it is a sign that the client cares so much for their cat that they want to make absolutely certain they're doing the right thing," said Plotnick, a board-certified internist and cat specialist, who runs Manhattan Cat Specialists.

Asking questions can also help prevent "sticker shock" when you're handed the bill.

A recent study showed that cost is discussed during only 14% of vet visits, and most of the time the client initiates the discussion.

Random calls to 10 vet offices around the city showed a routine exam costs about $65, which covers the vet consultation and physical exam - usually toenail clipping, ear cleaning, heart rate and temperature.

But any additional tests, such as blood work, feces sample, blood pressure and vaccines will hike up the bill.

Still, owners with financial concerns shouldn't be shy about asking for a printed cost estimate before consenting to any additional tests, Plotnick said.

Meanwhile, vaccines are the cause of much controversy, confusion and cost.

It's no longer in your best interest to vaccinate for everything simply because a reminder postcard has arrived in the mailbox.

In the past few years, studies have shown that vaccinations last longer than once believed - and some can be harmful.

The new rule of thumb is to vaccinate dogs for core vaccines - distemper, parvovirus and rabies - every three years.

In some cases, the vaccine effect is life-long, but will vary from dog to dog. A titer test can show how much immunity is still in the blood, but they're not perfect.

Non-core vaccines - such as leptospirosis or bordatella - depend on lifestyle and risk to exposure.
BY Amy Sacks