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  1. #1
    Join Date
    Jan. 15, 2003
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    Virginia
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    Default Why is this? Small animal vet vs. large animal vet

    First of all, I DO appreciate the services provided by all vets, including the emergency service we visited last night with our dog. But, I do feel compelled to question why.

    Yesterday, a small hotspot on my dog's neck turned into a festering oozing mess. We could not keep her from digging at it, and by 5pm yesterday, it was obvious that she couldn't wait until Monday to be seen. She would not let us clip or clean it at that point...I am not familiar with sedating dogs like I would with one of my horses.

    So, off to the emergency vet.

    Quote for sedating, clipping and cleaning, and drugs? $745. I was well-prepared for $400.

    Well, I don't want to sound ungrateful, but after calling my husband, I question the estimate. Takes approximately 30 seconds to knock $200 off the quote. My take? They know they have you. There you are, with a pet you love, and no other options. And the vet was rude.

    As I'm sitting in the waiting room later waiting to pick her up, I speak to a sweet old lady, 80ish, with her teacup terrier. She is worried to death. It is her 3rd appointment that week...neither normal appointment with her regular vet told her anything. So now she'll be paying huge amounts of money to have an emergency vet give it a try. This dog is all she has and she lives on a very modest retirement. She says she doesn't know how she'll pay for this. I silently wonder if she'll question the bill at all and have them take unnecessary procedures off or if they'll suceed in robbing her.

    There were other sad stories there as well, including a foreign lady who was completely sobbing, saying her dog was her best friend and she couldn't lose her. Dog honestly didn't look that bad, but it was obvious she didn't have a bottomless pocketbook either. I wonder if she'll even be able to understand her estimate and the pricing...her english was not great. Another easy target.

    When I called in to this office, I asked about fees. My horse vet will charge an emergency call fee ($150, I think) on top of all of his regular fees for an emergency. That is basically it. And he'll come to me any time day or night.

    An emergency small-animal vet charges an emergency fee, AND raises ALL of his fees to roughly double what they would be a normal vet during normal operating hours. So I paid $19.50 for a roll of vetrap and $26 for an $8 tube of ointment. Which is why a $200 appointment almost cost me $745 last night...and did cost me $475. They actually wanted to keep her 24 hours on fluids! I picked her up last night at 11pm.

    If I'd had the same thing done to my horse last night at 8pm, I probably wouldn't have paid more than $300-400 for it.

    Can someone in the vet field explain why this is okay? We are pricing poor little old ladies right out of animal ownership...



  2. #2
    Join Date
    Apr. 14, 2003
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    Shenandoah Valley, VA
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    1,356

    Default

    $19.50 for a roll of vet wrap is inexcusable. But this topic was discussed at heated length not too long ago. Here is a link:
    http://www.chronicleforums.com/Forum...d.php?t=211552



  3. #3
    Join Date
    Nov. 26, 2003
    Location
    NE FL
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    6,479

    Default

    Wow. I don't think it's all E Vets. Two weeks ago today, (right about this time) I rushed my lab Megan over to our e vet after she was bitten by a 5' rattler. I have used them before, and although they are not cheap, they are very good and all the staff has always been great.
    My dog did not survive, she died that afternoon.
    The total bill including private cremation was $1300.
    that included the cremation and return of an 85 lb dog, an $800 dose of antivenin, the whole day on iv pain meds (and she got the good stuff) and antibiotics, fluids, and at the end they had to tube her, put her on oxygen, do cpr and also 2 injections of whatever they give them to try to restart their heart.
    So even though that is a lot of $$ to me, I would not hesitate to do it again and do not feel as though I were overcharged at all.

    The OP on the other hand, did get stuck.
    "Perhaps the final test of anybody's love of dogs is their willingness to permit them to make a camping ground of the bed" -Henry T. Merwin



  4. #4
    Join Date
    Jul. 14, 2000
    Location
    midwest
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    10,168

    Default

    Does your small animal vet not provide emergency services? I will only use practices which offer 24 hour care for the reasons above. It is expensive to maintain a 24 hour walk in facility and those expenses are billed out to the customer. I cringe at the mark-up prices you quote but that is a fact of business.

    As for folks in the waiting room.....it tugs are your heart but there could be more to the stories. Perhaps in the case of the 80 something woman the regular vet said "lets treat it like this for 5 days and see how Tommy Terrier does." Well, she loves her dog, he isn't improving by her standards so she seeks weekend advice. Does that make sense?

    I hope in the example of the second lady that her dogs problem was also a simple fix and I hope your dog continues to improve. Those hotspots can go south quickly.



  5. #5
    Join Date
    Nov. 26, 2003
    Location
    NE FL
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    6,479

    Default

    I don't know about the OP's vet, but my regular vet is only open during normal hours *8-6 during the week, 8-2 on saturdays) and the e vets in my area are open from 5p -8a during the week and from 5p Friday to 8 am monday, and on holidays.

    My vet has and will handle emergencies that happen during their hours, but after hours you go to the e vet.
    "Perhaps the final test of anybody's love of dogs is their willingness to permit them to make a camping ground of the bed" -Henry T. Merwin



  6. #6
    Join Date
    Feb. 6, 2000
    Location
    MA
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    12,588

    Default

    Quote Originally Posted by SLW View Post
    Does your small animal vet not provide emergency services? I will only use practices which offer 24 hour care for the reasons above. It is expensive to maintain a 24 hour walk in facility and those expenses are billed out to the customer. I cringe at the mark-up prices you quote but that is a fact of business.
    OTOH, I'd prefer that the DVM performing surgery on my dog at 8 AM hadn't been called out of bed at 2 AM for an emergency...
    "It's like a Russian nesting doll of train wrecks."--CaitlinandTheBay

    ...just settin' on the Group W bench.



  7. #7
    Join Date
    Nov. 2, 2006
    Location
    Maine
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    1,784

    Default

    I'm half of a two doctor practice. It's just not realistic for many small practices to offer 24 hour care, if you've got 4 or 5 doctors it might be feasible. Part of this is the availability of fully staffed emergency clinics. If push came to shove in a lawsuit, with three e-clinics within 15 to 45 minutes away, I cannot meet the standard of care for the area after hours. Standard of care does vary in parts of the country. Here it would be considered unacceptable for me to leave an animal on an I.V. overnight and hope for the best. Others parts of the country this maybe okay. If your pet is sick enough to need to be hospitalized than they likely need someone there with them. This gets pricey. As does having the after hours facility which may or may not be in use. It's similar to the idea that receiving care for a sore throat in the human ER is way pricier than going to a primary care.

    I'm with Ghazzu on this one; you want the doctor doing your dog's surgery to be rested. If I'm to provide good care to those I see during the day, I can't be up all night.



  8. #8
    Join Date
    Jul. 14, 2000
    Location
    midwest
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    10,168

    Default

    Good points G & M and let me clear up a few things. If the OP called the clinic where I work the Doc on call would have seen her dog and treated the hot spot with after hours fees applied.

    If the OP called the Doc on call and said "my dog has been hit by a car, is throwing up blood and I want to do everything possible to save it" she would have been referred up to a city emergency clinic.



  9. #9
    Join Date
    Jan. 16, 2002
    Location
    West Coast of Michigan
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    36,321

    Default

    Sounds like the OP's dog really couldn't wait, but I wonder about the demographics (that's probably not the right word, LOL) of the typical veterinary ER--what percentage of clients are TRULY emergencies, and what percentage are animals owned by people that just can't be bothered to do some basic wound care, or to make an appointment, or to take care of their animals properly in the first place?

    Somehow there's got to be a premium placed on a vet's time off--or a larger supply of vets to man the after-hours clinics. Or something.. Given the spasms that human medicine is going through (and it's going to get worse before it gets better) I sort of find myself musing, now and then, on the differences between a "cash only" system like vets have and the "anyone, any time" ERs that humans have available, in which maybe one in fifteen patients is truly an "emergency" patient.
    Click here before you buy.



  10. #10
    Join Date
    Jul. 13, 2008
    Posts
    2,782

    Default

    Quote Originally Posted by BelladonnaLily View Post
    Quote for sedating, clipping and cleaning, and drugs? $745. I was well-prepared for $400. Well, I don't want to sound ungrateful, but after calling my husband, I question the estimate. Takes approximately 30 seconds to knock $200 off the quote. My take? They know they have you. There you are, with a pet you love, and no other options. And the vet was rude.
    As somebody mentioned on the earlier thread, the quotes given at vet ERs are often on the high side, as they are estimates which try to give you the worst-case price so you know what you might be getting into. At least, that's how my emergency vet works.

    A rude vet is a bad thing though; unprofessional as well as aggravating. I'd question their professionalism elsewhere.



  11. #11
    Join Date
    Nov. 2, 2006
    Location
    Maine
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    Default

    One of my techs works in the local ER periodically for some extra income. She reports that it is very hit or miss. Some nights she'll read an entire book, others she doesn't get the chance to pee. Probably 90% of what comes in are things that can't wait for morning for the regular vet. They do see ones (i.e. dog has been vomiting since Wed and by Sat night it won't move) that wouldn't be there if the owner had sought care at the regular vet sooner.



  12. #12
    Join Date
    Apr. 12, 2004
    Location
    new england
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    323

    Default

    SLW , you would be suprised at the things people will call you for in the middle of the night. Our practice used to cover calls after hours and though it may seem simple for your
    doc to come out and meet someone to treat a hot spot, but, multiply that by two hotspots, an ear infection that can't possibly wait until morning , dog with diarrhea that is becoming "dehydrated" only to return home after the fourth rather inane call at 4am only to have to answer a phone call about what the appropriate dose for aspiring is for a dog that will NOT be coming to see you in the morning because your prices are too high..;.. Only then to get up and work your regular 8a-7p shift the next day. I am very glad not to do after hours call anymore but will fit just about anything I can in during the time I am there.

    It is just not feasible anymore for the general practice to cover calls and as stated previously, more than 80% of things that really need to be seen after hours would be negligence for me to treat the way I could unassisted after hours. Of the many things that can absolutely wait until morning, I would be faced with angry, belligerent clients if I would not come and meet them (after all, it is still an emergency in their eye), and then when I did many would complain about the $85 emergency fee charged !

    Unfortunately emergency clinics often have amazingly high overhead. Most of them in my area support multiple boarded specialists, all the best toys including CT and MRI, flouroscopy etc so the prices on ALL the services must go up to meet the costs to run.



  13. #13
    Join Date
    Jul. 31, 1999
    Posts
    3,167

    Default

    Unfortunately emergency clinics often have amazingly high overhead. Most of them in my area support multiple boarded specialists, all the best toys including CT and MRI, flouroscopy etc so the prices on ALL the services must go up to meet the costs to run.
    This was going to be my explanation as well--many emergency/after hours vets are "Emergency/Critical Care" boarded. More schooling=higher prices. You also have to pay your staff a lot more to work over night. I sure as heck wouldn't accept $9/hour (what I currently make as a vet assistant) if I had to work from 5pm-8am (when our local after hours clinic is open). They also have to have all kinds of "stuff" (equipment, medications, etc) on hand that your average vet may not have to worry about as much.

    Were you checking out when you complained about the price? Or checking in? If you were checking in, the price quoted was probably just an estimate, and when you complained, they probably decided to not do bloodwork or whatever. I agree though that the vet being an ass is inexcusable. I've met a lot of unhappy vets...Definitely makes me question what I'm about to get myself into...

    Was this an emergency clinic that your "regular" vet recommends (if you have a choice in your area)? If so, I'd give them a call tomorrow and let them know that you were not pleased with the service you received. If not, I'd still give them a call and find out which local after hours clinic they do recommend (and where their clients have been happy in the past).



  14. #14
    Join Date
    Feb. 15, 2004
    Location
    Ontario
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    7,702

    Default

    We may be comparing apples to oranges here, but in our case, my dog developed a hot spot within hours on a Friday. Called at 11 30 am, was seen and treated at 2 pm. Total bill: $150.49 (Cdn)... and my husband thought it was a lot!!!! Sheesh... he never saw the $1000+ bill for a previous dog, but even then, I thought that the amount of care/surgery, etc., it was well worth it.
    I tend to overreact and call the vet early so I do NOT have to deal with the emergency clinic.



  15. #15
    Join Date
    Mar. 9, 2006
    Location
    Raleigh, NC
    Posts
    1,696

    Default

    I must say, even for an Eclinic, that is a whole lot of money for a hot spot. I would love the total breakdown if you didn't mind...

    If I saw a hot spot in a really big dog, on emergency (during our hours), and charged for every little thing...Hmmm...emergency exam fee + wound treatment + Betagen spray + Convenia (an expensive antibiotic for a large dog) ... jeez what else is there? Even with that I'm guestimating less than $250. If there was an associated ear infection add ear cytology + ear flush + ear medicine and the most would still be less than $350. And I would say I work for one of the more $$ clinics in the area. If the pet needed sedation, of course, that could add the real bucks...if they require pre-anesth bloodwork, charge for all monitoring by the minute, etc. Still, hard to imagine.

    My clinic has 9 doctors (well, usually...one is on sabbatical, and two are part time). We are open M-F 8-8, Sat 8-4, Sun 1-6. We see lots of "emergencies" on Sundays because other than the Eclinics we are pretty much the only game in town. Today I saw...2 regular vaccine appointments, two really sick cats (one renal failure, one ? puzzler), a limping dog that has a cruciate tear, a recheck of a corneal ulcer, a pet with acute bloody diarrhea, and one uveitis. Only the uveitis client had to pay an emergency fee, because by the time they called, the 2 vets on were booked solid (so we charge the Efee because we are disrupting ours and our other client's schedules to see them). I don't think anyone's bill was $750!

    I do know that there is a big difference in hospitalization...for instance for that renal failure cat to have 3 days hospitalization with all the "standard of care" bells and whistles at the 24 hour facility would be in the $2500-3500 range. It would be roughly half to hospitalize at our clinic. BUT, we don't have 24 hour monitoring. So if the catheter kinks at midnight, no one knows until 7 am. Ergo, we don't take in the really critical ones, and if we do, the owner knows the risk.

    Hmm...maybe I should work at an Eclinic...
    From now on, ponyfixer, i'll include foot note references.



  16. #16
    Join Date
    Jan. 15, 2003
    Location
    Virginia
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    Quote Originally Posted by SLW View Post
    Does your small animal vet not provide emergency services? I will only use practices which offer 24 hour care for the reasons above.

    There isn't a small animal vet in the area that will provide 24hr emergency services. They ALL refer you to this clinic. It is the only one around.

    And it isn't exactly 24 hr. They are only open nights and weekends. So while I would expect to pay more because who wants to work those crazy hours, keeping the clinic open nights, as opposed to days, isn't really costing them much more in basic overhead. The increased costs would be in higher salaries for employees. Which is why I DO understand having emergency fees...



  17. #17
    Join Date
    Feb. 6, 2003
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    NorthEast
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    I had an EVet visit last year that cost $750 exactly. Saturday night, got there at 10 pm with my GSD. Had called because that's the place my regular vet has as an after hours emergency call. My dog was creeping around hunched down, tail tucked, pacing, ears back, whining. Temp slightly elevated, gums slightly pale. They asked if he was vomiting or distended belly, etc. Nope. They said bring him right in, sounded like classic bloat. I think we broke some land speed records getting there...husband, daughter and I expecting the worst.
    They meet us in the lobby, take my dog and wisk him off, we fill out paperwork, etc. 1.5 hours later they come back out with our dog...both dog and vet looking sheepish and relieved. No bloat. He had a radiograph done and then just given fluids for slight dehydration and released. Turned out he was nervous from a thunderstorm even though he had never been nervous through storms before. But a lightening strike hit the cell tower right near my house (about 200' from my house) and that freaked him out.
    Yeah, we were shocked at the bill. But we did expect it to be high due to visiting an EVet. Not *that* high though. I figured $400 tops.
    But they had everything necessary there...had he had bloat and needed surgery they could have covered that too. So that's what we're paying for, they have a surgeon there overnight too.
    You jump in the saddle,
    Hold onto the bridle!
    Jump in the line!
    ...Belefonte



  18. #18
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    Jan. 15, 2003
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    Virginia
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    Default

    There was only one vet on call at this particular clinic. I saw 3 vet techs and a receptionist who left at midnight. After that, vet techs answered the phone.

    Pony Fixer, I do not have the original breakdown of $745 as we quickly amended that one to be $500-565 before I left her. They wanted to keep her for 24hrs on fluids and I told them no way. They didn't want me to pick her up after midnight but when they realized I wasn't going to cave, they agreed I could pick her up as soon as she was done, whatever time that was. My total bill wound up $475 and I do have the breakdown on that.
    Ofc fee=$88.00
    Bupren.&Ace.=$44.98
    Fluids=$30.00
    Propofol=$30.54
    Clip&Clean=$31.00
    Isoflurane per minute=$37.50
    Bandage (vetwrap)=$19.50
    Cefazolin=$23.84
    Metacam 5mg/cc inj=$42.05
    Ward Fee, outpatient=$16.00
    Cephalexin,500mg=$20.90
    Cephalexin,250mg=$17.54
    Metacam 1.5 mg/ml 10 ml btl=$48.33
    Animax Cream 7.5ml =$25.26
    Thank You=$0.00 (thought that was a nice touch )

    Turned out I had a 15ml Animax tube here purchased for much less from my horse vet so I could have saved more if I'd thought about it. Next time I'm taking my big old box of supplies so I can hand them a roll of vetwrap and save $20 there too

    Thankfully, she is doing much better tonight. Still looks nasty but acting more like her old self. Thank goodness I have 5 days of normal vet hours if things don't continue to improve



  19. #19
    Join Date
    Feb. 6, 2003
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    NorthEast
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    That vet wrap charge is off the charts.
    I hope you at least got a cool funky colored one for $20!
    (or did it have the Coach insignia on it )
    You jump in the saddle,
    Hold onto the bridle!
    Jump in the line!
    ...Belefonte



  20. #20
    Join Date
    Jan. 15, 2003
    Location
    Virginia
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    Default

    Quote Originally Posted by MistyBlue View Post
    That vet wrap charge is off the charts.
    I hope you at least got a cool funky colored one for $20!
    (or did it have the Coach insignia on it )
    Actually, the vet techs did take the time to draw shoelaces on it...so, that's something.



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