Does this seem right? Vet bill question

[LuvMyTB]

I lost my mare about a month ago--had to euth because of colic. Just got the bill in the mail and was absolutely blown away by the charges:

Trip charge $45
ER fee $100
Physical exam/time $200
Sedation x 4 $180
Banamine injection $22
Phenylephrine x 2 $70
Nasogastric tube $70
Rectal $45
Dipyrone injection $22
Euthanasia $120

Total $849

My mare spent 4 days at UW-Madison last summer and got every test imaginable--it cost me the same as I'm being charged now.

There was no physical exam--my mare was down and thrashing by the time the vet arrived.

The rectal was about 2 seconds because my mare was so bloated she could barely get her hand in. Same with the tubing--barely got the tube in and it didn't work because we could not keep my mare up.

I was expecting the bill to be about $400. I guess I didn't realize that some of these injections were so expensive. This is the highest vet bill I have ever had, and I'm just kind of stunned.

[BuddyRoo]

Again, I'm sorry for your loss.

Regarding the bill....if you consider that about 350 of that is just off the top emergency/farm call related and then another 120 was the euth, that's 470 bucks. When you haul to a clinic during normal office hours, you're not paying by the hour/minute + emergency fee/farm call fees + for euth. So it's forseeable that you could've done quite a few tests with that 470 bucks.

The price on the injections seems in line with what I'm used to paying. The euth is actually quite a bit cheaper than what I paid in 2005. Not sure what kind of sedation was used but that raised my eyebrows as did the exam/time being 200 bucks to be honest + the farm call + the ER fee.

It's pretty standard to charge an "exam fee" as part of the emergency call even though you maybe are attending to the most severe issues and not doing a full exam.

I dunno. In your shoes, I might be inclined to call and inquire about the exam/time in particular.

[Laurierace]

If they sedated four separate times they must have been there for a while. They don't directly charge by the hour but do to a certain extent. I am so sorry for your loss.

[LuvMyTB]

Thanks for the input.

She was there maybe 1.5-2 hours. She sedated once immediately upon arrival, again before attempting the tubing, and then I think 2 good hits before the euth. I believe she used phenobarbitol--that's the hot pink stuff, right?

I also thought the ER fee, trip charge, and euth charge were reasonable. It was all the other stuff that threw me off.

Last year this same horse spiked a 106 temp, same vet came out in the middle of the night, pushed Banamine, rectal exam and then spent FOREVER running 2 bags of fluids--about $500. Two years ago, same horse choked badly, same vet came out on ER call and spent over an hour using lavage to move the blockage--$450.

Just really shocked me. The UW visit last year, the high-temp episode last year, and another colic in January kinda wiped out my animal emergency fund. This will take me a while to pay off. :(

[BuddyRoo]

pentobarbital is normally used for euthanasia.

If doing a "two stage" euth, a sedative is given first and the pentobarb is given once they're relaxed to stop the heart.

phenobarbital is routinely used to control seizures.

Anyway. I'm sorry for your loss...having a big vet bill and no horse--not a good combo. It sucks.

((hugs))

[tarynls]

So very sorry for your loss.

The injection charges are about what I'm used to paying - I paid $25 for banamine, $25 for dipryone and $85 for an injection of dormosedan for sedation (do you know if that's what your vet used?)

The hot pink stuff was pentobarbital and that is the euth drug.

The ER fee plus exam fee do seem to be a little high but then again, the vet was on your farm for about 2 hours....

[Marshfield]

Deepest sympathies on your loss. Given the amount of time the vet was there, which is lumped in with the PE/time fee, that seems pretty reasonable. Given what you describe, I suspect the vet was using the heavy duty and also more expensive pain meds, possibly a Dormosedan and Torb cocktail. Euthanasia fee was actually lower than is often charged.

[BornToRide]

I am very sorry you lost your horse. What I do no understand in general though is why the sedation material cost is still so high after years of use. Seems to me like it could be more reasonably priced by now......

[tarynls]

Perhaps Ghazzu can chime in on this but I believe drugs like Dormosedan do not have a generic equalivent (such as xylazine is the generic for Rompun). Perhaps drugs for animals stay under patent for a certain number of years like human drugs do.

[sid]

My review of the charges are well within reason for the time and drugs used for your horse's emergency...even though it could not be saved.

I'm sorry you lost the battle.:(

[paint hunter]

For sedation, your vet probably used a combination of drugs. Detomidine (trade name Dormosedan) is probably, ml for ml, one of the most expensive drugs available to the equine practitioner. There is no generic version available. Xylazine (trade name Rompun) is completely generic now and is relatively inexpensive. Butorphanol (Torbugesic) is a controlled substance, and every ml used must be accounted for in a drug log book. I can tell you that the controlled substances license from the DEA is not cheap. You are also paying for your veterinarian's knowledge in knowing what drug, or drug combination, and the appropriate amount, would be best in the present situation. That education did not come cheap.

I am sorry for your loss.

[Fharoah]

I am so sorry for your loss! My heart felt condolences!

I find your those charges pretty standard, not inexpensive but I am used to higher bills.

[shakeytails]

The only thing that seems a little high to me is the sedation. I know dormosedan is wicked expensive, but I think my vet only charges about $80 for a sedative cocktail. I have no idea about the phenylephrine, since I have never had any dealings with it.

Funny thing- one time my vet was here and needed to give banamine. He asked if I had any (I did), because it would be cheaper for me if he used mine!

Honestly, I really don't think the charges are too far out of line, even though they might be just a bit more than you were expecting.

[FLeckenAwesome]

I'm so sorry for your loss. :(

As far as sedatives... yep, dormosedan is wicked expensive.... about $70 for a 5 mL bottle... and that's VET cost... then you have to add a bit on to cover stocking, inventory, needles, etc. So yeah.. it's pricey! And the small animal version (which I do think is 10 mLs) is twice as bad!! And the same price for the reversal!!
It's great stuff, but man.... pricey.

[PNWjumper]

I had a mare put down 2 years ago and it cost roughly $800. I was upset about it. Every time I'd been involved in a horse being put down in the past the vet waived all charges outside of the actual cost of the drugs (it probably goes without saying that in all cases the horses were regular clients of the vet and people were "good customers").

In my case, I was really only upset about the fact that my vet charged me a $75 "lameness exam fee" for a horse who's leg was CLEARLY broken and NO EXAM was performed (I'm very familiar with her "lameness exam"). And I even would have been [mostly] okay with that fee if I hadn't spent over $1000 over the course of the last 6 months on bodywork alone through that vet on that one horse (in addition to having that same vet do teeth, vacc, and all other misc things for that mare and all of my other horses). IIRC, the total for my mare came out to:

$150 call fee/emerg call fee
$75 lameness exam fee
$350 x-rays
$250 (all) drugs - banamine, sedatives and euthanasia

I was upset enough about the bill and [moreso] the interaction I had with the vet afterwards to not use that person for a while. In the end I decided it was the equivalent of cutting off my nose to spite my face (or however that saying goes) since that vet is an incredible chiro/lameness vet.

Anyhow, I guess my point is that I was pretty surprised by the cost of the euthanasia as well. The fact that it included x-rays certainly left me certain that it wasn't going to be cheap, but I didn't anticipate an $800 bill.

[Paddys Mom]

Sorry for your loss. :cry:

My vet came out on a Sunday at 3am (technically Monday), sedated my old gelding, checked TPR, did a rectal, and euthanised him for about $200.
The bill, while low, was still gut wrenching to receive.

[ponyjumper4]

That seems expensive to me. When I had a mare I had taken in put down, the call to do it was at about $200, the most expensive being the drugs to do it. This was also an appointment and not an emergency as we had done everything we could do by the time we made the decision.

The physical exam/time fee seems ridiculous--I've never been charged anything like that and I've had some long visits.

[HenryisBlaisin']

It seems to me to be in line with current costs. Part of it depends on your area. The $200 exam fee seems, IMO, to be high, but the $150 euth fee seems very low, so those two balance out.

I had an opportunity to work with a great vet a few years ago, with one of the top clinics in his region, if not the country. He says that the reason you pay more for a farm call is twofold-one is simple wear and tear on the mobile medical unit, gas, mileage, the time it takes to clean and restock the unit afterward, etc. The other factor is that, depending on the distance and time it takes to get there, coupled with the time spent at your farm keeps him from seeing other patients. In the clinic, he can see several patitents for exams etc. in the amount of time it takes to get to the farm and back.

The other reason for rising costs is the same as it is for people-insurance costs are through the roof for vets, and everybody pays for the frivolous lawsuits that have pervaded our society. There are not a lot of very wealthy vets running around, despite what we, as owners, see as high costs.

[foggybok]

I am very sorry for the loss of your horse.

The charges seem reasonable, depending on your area. The "exam" fee seems OK, since the vet spent 2 hours working on the horse. "Exam" can cover a lot of things, not neccesarily an exam per se....In the area I was previously, a simple colic was 500.00 and up, with the multiple drugs and euthanasia, this seems about right.

As a vet, one of the hardest things is to do is send someone a bill after they have lost an animal. Unfortunately, we have to bill for our services, even if we can't save them. :cry:

[LuvMyTB]

Thanks again for all the input.

Yes, I am fairly sure she used Dormosedan. The mare was pretty violent.

I have not had to euth a horse before, but in talking to people afterwards I was told I could expect it to be around $400-$450.

Like others have said--I just simply wasn't expecting a bill this high. I think it hit me doubly-hard getting a bill that said "euthanasia" on it--4 weeks to the day that my mare died.

The other upsetting part--and this doesn't really have to do with $$--is that looking back at how many drugs were used and how much time was spent, when the mare was obviously (in retrospect) dying....I really wish that we had made the call much, much earlier.

The fact that she was sedated by the vet to that extent (on top of an initial Dipryone shot given at onset of colic) shows that she was beyond help, in my opinion. So now I regret not making the decision to let my poor girl go even earlier. :(

[paint hunter]

Please don't kick yourself for your decision. No doubt your vet knew it wasn't good from the start. I've seen/done enough colics that you get a feeling within the first 10 minutes or so that it doesn't look good. However, it often takes a while for the client to come to the same point. I really think the client/owner goes through the 5 stages of death and dying that Elizabeth Kubler Ross wrote about. I see it all the time. The owner is in shock that it is really serious, then denial, that it's really bad, bargaining to see if something will work, and finally acceptance that it's time to let go. If I push the client at the very start, they may have second thoughts several weeks later that maybe they could have tried something else, etc. If your vet gives you time to process the situation, although it often takes a bit of time, you will more than likely come up with the correct choice, and you will be able to sleep with your decision. Sometimes this means keeping the horse heavily drugged until the owner is comfortable letting go. And, seeing sometimes that we can't control their pain, no matter what drug is used, is enough to help them with their decision.

With respect to your vet waiting 4 weeks to send the bill..... Many of us wait a period of time before sending the bill as we want to allow the client a bit of time to grieve before being reminded of the event via a bill. I try to send a condolence card shortly after the event, but try to wait several weeks before billing. And yes, we would love to be independantly wealthy and work for free, but unfortunately my mortgage lender doesn't think in the same way.

The actual euthanasia fee also covers the time spent. Even for elective euthanasias, I block out a good period of time as I don't want to be rushed, I don't want the client to feel rushed. It is a very emotional time and I want it to be a "positive" event for the owner. There is also alot of client counseling that goes on, as I try to explain what to expect, how the horse may react, possible complications. Your euthanasia fee paid is actually low for my area.

I hope your memories of your horse give you comfort....

[Auventera Two]

That does seem incredibly high to me. Including an emergency call, my vet charges around $400 to euthanize a horse. It cost about $125 to euthanize our cow, and that included an emergency charge also.

[LuvMyTB]

painthunter--I was in no way criticizing my vet for when she sent the bill! In fact, I usually have to wait MONTHS for an invoice, so I was glad this one was timely. It was just a bad coincidence to arrive on that day, that's all.