When Jude's symptoms first appeared, (frequent urination), I had an appointment with a local vet for a canine flu shot, only because it was convenient. Jude's vet is 45 minutes away. The night before, his symptoms became apparent. Once there we caught a urine specimen and there was clearly blood in his urine. To make a long story sort of short; the vet told me that he "didn't have to worry about prostate cancer because he was neutered". I told corrected him and said he was neutered late in life. He called him "she" twice. (easy mistake?) and then ordered over $250 worth of blood tests. Okay, info we could use. My gripe? He NEVER did rectal exam. If he did, he would have felt an enlarged prostate and a tortuous urethra. Now I am not accusing him of contributing to Jude's death. The outcome would have been the same, but I felt I was being set up for churning, with an appointment scheduled for the lab results, etc. The next day I called for the blood work, he diagnosed him with an infection only, which is pretty unusual for a neutered male 11 year old dog who has never had a UTI. I picked up the antibiotics without Jude and five days later was at our vet. Since then I have gotten at least 4 post cards from this practice for everything from vaccinations to dentistry and check ups. Today I called the office. Told them to take me off of their mailing list and said that any vet that doesn't do a rectal exam on a male dog with blood in his urine is providing poor care. Jude passed away from TCC and when I got another dog, I wouldn't consider returning. It probably wasn't nice but I feel better.