Always call and check to see if your veterinarian is associated with NVA National Veterinary Clinics Headquarters located in Augora HIlls, California. They are located in multiple states across the US..They are horrible. They care about your pets and their clients, HA! Our 4 month old puppy was mishandled with a headrestraint and died 16 hours later. I have letters signed by vets who state the mishandling of our 10 pound puppy resulted in her death. 10 pound puppy loved everyone, how much restraint is needed for a 4 month ld cocker spaniel? VCA Hospital gauges were malfunctioning and crash cart was not set up to save our belowed pupppy. VCA owns these clinics but they are strictly profict and Loss centers. NVA People in Augora California cold, calloused and could care less. They are emotionless. Go back to your local vets who are not owned by VCA. Heartbroken!