As my dog approached middle age they overstated diagnosis, overcharged and tried to manipulate me. Told me he needed x-ray and EKG for heart murmur and instead performed a blood work-up diagnosing liver problem requiring additional expensive blood test that was necessary in order to do tooth cleaning. Two other vets that I consulted negated the liver issue and I had his teeth cleaned at half the price they charged. Since I don't do most of the shots(homeopathic) I believe that they are good for a few years while still a puppy or young. Once they have any issue-they exaggerate the problem and try to "make the season".I refused to talk to a local manager and insisted on hearing from corp.management. Finally did get a call from corp office and they did settle on no further monthly charges. Consensus was Oliver was healthy but did have a heat murmur that we should observe and the liver issue was not a problem Am giving him Milk Thistle and COQ10.