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  1. #1
    Join Date
    Dec. 7, 2003
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    355

    Default what is important to you in a vet practice?

    I am concerned about my ability to choose the best vet practice for the small animals. I've tried two in the area. One is closer, less expensive, practice owner is experienced and compassionate. This practice has associates on and off with varying degrees of, not be rude, but competence in some cases. One radiographed my older lab who had gone off her food and diagnosed pancreatitis. Prescribed metronidazole which was a nightmare getting into her for a week. Went back in, practice owner redoes radiographs, discovers that she is shot through with cancer and my good girl is euthanized on the spot.
    Friend just took her dog in for exhibiting signs of discomfort and pain. Radiographs show nothing, but abdomen is tight and speculation that he is blocked with foreign body. Schedule surgery for next morning. Practice owner does a quick rectal next day and finds a bone fragment up his bum. Close call. This practice has digital xray. Very available for emergencies, but of course, call rotates. Practice owner states they will never get an ultrasound.

    Practice 2 is further away, more expensive, owner vet is only vet there, but has lots of techs. Film based xrays, but has an ultrasound, which is why we started using them. In referred emergency, ER clinic has to redo the xrays digitally to get good images of problem. Vet and staff are very nice, but vet seems to always prescribe Covenia and Rimadyl for everything, then if those don't work, moves on to more extensive diagnostics. Perhaps this is good practice and ultimately saves money on unnecessary tests? Very available for emergencies and you always know who you are going to get.

    I'm so confused. Which would you use?



  2. #2
    Join Date
    Nov. 23, 2001
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    Catharpin, Virginia
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  3. #3
    Join Date
    Jul. 26, 2001
    Location
    Toronto, Canada.
    Posts
    6,367

    Default

    A clinic who will offer you a referral to a specialist when needed. Wasting clients money on un-necessary or poorly done diagnostics is unprofessional.

    Clinic A - diagnosis of pancreatitis on xrays is never done. You can barely, if ever, see "pancreatitis" on radiographs. You can also not "Diagnose" cancer on radiographs, however suggestion of cancer is certainly possible.

    Also the fact that they were going to send your friends dog to surgery based on normal radiographs is rediculous. Surgery is nothing to take lightly, and you want to be SURE there is something there before going in. A referral (sending the rads to a specialist), an ultrasound performed by a boarded radiologist or internist, or heck even a barium series would be warranted here before skipping right to opening the dog up. This would deter me from choosing this hospital.

    Clinic B - an ultrasound is only as good as the operator. Dont forget that. However the availability of having it there is useful for basic things. Further tests are always a client option, if you dont like symptomatic treatment request fruther diagnostics, however many clients appreciate the symptomatic treatment to start and monitor their pets for signs of getting worse. Covenia is a decent antibiotic (and expensive!) especially for those who do not do well with pilling. Film radiographs are just as good as digital - and if you ask a radiologist, often preferred

    Go with the one you feel comfortable with. Look for board certification, this often gives you a clue that you are getting the utmost experienced vets. I would also look at technician certification- are they registered, boarded or joe blows off the street. It is the technicians who do the anesthesias remember. And dont forget, all hospitals do have pricing guidelines to follow with state association guidelines. And in most cases, you get what you pay for.


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  4. #4
    Join Date
    Apr. 1, 2008
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    4,558

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    Diagnostic competency is #1 on my list. I don't expect 100% correct diagnosis, but I do expect more than "well, it could be..." (stab in the dark) all of the time.

    I expect that I am going to have surgery on my pets sooner or later, and I want an estimate and expect the estimate to include the type of anesthesia, fluids and monitoring. If I get a post-it-note with a price, I won't stay with that clinic.

    I expect that blood work wil be SOP for pre surgery and as a diagnostic tool. If it is not offered, I go elsewhere.

    After that, if a practice has more than one vet, and the associates seem to turn over frequently, the techs seem to turn over frequently, I am suspicious. If the practice does not attract and keep good vets, there might be a reason. If the issue is not competency, then there could be in house disagreement about procedures or contention about other issue(s) that could impact care. I want stability in my vet practice, just like I do my human physician.

    If it is a single vet practice, I want to know if they handle their own emergencies or if you will be referred to another clinic. If referrals are common, and it is not an E clinic, then I may frequent that clinic as well so that I know at least one of the vets there.

    All of that said, I support three practices in my area. My primary vet has a mother who is terminal with cancer and he has a family so he may not be available all the time. The second choice is a very basic clinic and do not do some diagnostic procedures I want, but the vets are very experienced and competent. The last clinic is very very expensive and they have the lastest and best equipment but you pay for that.

    I also hear and listen to word of mouth for other clinics in the area. One is known for sick animals coming out of surgery and a very high fatality rate. The other, well, he's a voodoo type of guy, and actually has a crystal ball. We don't go there either.

    I'm tough, so bedside manner is not as important to me as competency, but it is an added bonus that my primary clinic vet has sat on the floor with me, while we euthed a young dog and he cried right alongside me. Compassion is important, tho not at the top of my list.

    So which would I use? Both.


    6 members found this post helpful.

  5. #5
    Join Date
    Dec. 25, 2005
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    Default

    I like a clinic that has good diagnostic competency, as threedogpack said, and clinicians that know enough to know when they need a second opinion (and aren't too arrogant to refer). I expect them to practice good medicine and offer all appropriate diagnostics and treatments (even if it might be outside my budget), and they should explain the benefits of each.

    Unfortunately, there are BAD vet clinics out there, but I think sometimes its hard for an outsider to pick them out. There is one in my area that provides substandard, outdated care, but people still go there because they like the doctor and don't know that they are even missing out on anything. The old practice owner even knowingly performed unnecessary surgeries to pad his pocket (and a few other things that would have lost him his license if his techs had ever told on him to the veterinary medical board). But the average pet owner doesn't always know how to recognize good (or bad) medicine, so its hard for them to distinguish substandard care.

    Honestly, the ultrasound does not matter to me, although the vets should recognize when they need to refer out for u/s or at least offer that option. Same with the digital x-rays.

    I hate to judge any practice by a couple of isolated cases. However, IMO, any time a foreign body is suspected, a rectal should be performed.

    You said the other clinic treats everything with Convenia and Rimadyl. But I'd have to ask what issues you had that were treated there. Those could have been very valid treatments.

    I would also ask around. Don't listen to one or two bad reviews... every practice will have those (and a lot of people get pissed off if they have to wait more than 15 minutes and decide the whole experience was just terrible). But if you consistently hear that a particular clinic has issues, I might steer clear.

    AAHA certification shows that the clinic is operating at some level of competency. Thats not to say that non-AAHA certified clinics are bad (there not....) but its a nice thing to look for if you are unsure of the level of care you are going to get.


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  6. #6
    Join Date
    Aug. 30, 2011
    Location
    Massachusetts
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    1,337

    Default

    My number 1 criterium is competency. After that is cost.

    I won't take my animals to see fresh out of vet school vets anymore. Won't get to into my nightmare of going to the ER and dealing with a fresh out of vet school vet, but I was horrified at her incompetency.

    Oh and I just read threedogpack's post - agree %100.

    I also want someone who is willing and experienced enough to treat my pet conservatively if I say, "no I don't want to spend a gabillion dollars going to see some specialist."


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  7. #7
    Join Date
    Dec. 7, 2003
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    355

    Default

    Thanks sid, Squish and Threedog! There is such a wealth of experience on this board and your very considered replies sure reflect that. I am grateful for your perspectives. I am also so grateful to the vets when it goes right and they save a life, and when it goes wrong, I believe that's on me for making the wrong or uninformed choice regarding practitioners. Multiple cancers have been misdiagnosed, surgeries have gone awry or should not have been done in the first place, MRI's have been performed in retrospect unnecessarily (poor paralyzed old kitty should have had a peaceful passing). I live in dread of not adequately protecting my guys from mistakes that will cost them their lives before their time.

    A barium was run on friend's dog I believe, with no conclusive result. Vet did explain that xray suggested cancer, but other symptoms and presentations made her sure that my old girl was done. These vets both quickly refer out to a mega ER with board certified surgeons, neurologists, MRI etc. Very fortunate to have this within one hour's travel. Zero board certified feline vets in the state. Anesthesiology expertise so vital and of such huge concern as my little old kitty with a heart murmur (diagnosed after last dental) needs another dental now. With even human medicine being such a crapshoot, I think one almost has to be a vet to choose a vet! Such a good point about the techs being certified. How to politely ask?? Thanks again for the replies.



  8. #8
    Join Date
    Dec. 7, 2003
    Posts
    355

    Default

    Thanks Eventer and Judysmom. It's hard to judge competency for me until it's too late sometimes. The Convenia and Rimadyl have helped lots of times for problems presenting with fevers. When they don't work, more extensive diagnostics are offered and performed. Good to know that Convenia is widely used. Both practices offer surgery, but refer out when it's beyond what they can do or if there's not time to travel the animal. I've always wondered how important the ultrasound capability was. Great to hear that digital xray is not always better.



  9. #9
    Join Date
    Apr. 1, 2008
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    4,558

    Default

    Quote Originally Posted by Kachina View Post
    Thanks sid, Squish and Threedog! There is such a wealth of experience on this board and your very considered replies sure reflect that. I am grateful for your perspectives. I am also so grateful to the vets when it goes right and they save a life, and when it goes wrong, I believe that's on me for making the wrong or uninformed choice regarding practitioners.
    Sometimes we simply cannot know which way to go. Sometimes life just gets in the way and we put off things and sometimes no matter how hard we try, there is only one final choice.


    Multiple cancers have been misdiagnosed, surgeries have gone awry or should not have been done in the first place, MRI's have been performed in retrospect unnecessarily (poor paralyzed old kitty should have had a peaceful passing). I live in dread of not adequately protecting my guys from mistakes that will cost them their lives before their time.
    you know, we can only work with the information we have at hand today and sooner or later we are going to have to just make a decision. None of us live in a perfect world and sooner or later we are going to make a mistake. Personally my biggest regret is not letting them go too soon, but waiting too long. Trying to make it to the appointment I had, when I should have done the deed 3 days sooner. Time has covered up that raw wound but the lesson it taught me has lasted and benefited those who came after.

    How to politely ask?? Thanks again for the replies.
    Simply ask. One of the things I've found as I get older, I just ask the vet. That way you don't put anyone on the spot and as a professional, he's going to answer. If he is offended by that, you have your answer.


    1 members found this post helpful.

  10. #10
    Join Date
    Jul. 14, 2000
    Location
    midwest
    Posts
    10,639

    Default

    Quote Originally Posted by threedogpack View Post
    After that, if a practice has more than one vet, and the associates seem to turn over frequently, the techs seem to turn over frequently, I am suspicious. If the practice does not attract and keep good vets, there might be a reason. If the issue is not competency, then there could be in house disagreement about procedures or contention about other issue(s) that could impact care. I want stability in my vet practice, just like I do my human physician.
    This, ten hundred thousand times over. A practice can have all the bells and whistles and a state of the art facility but if the staff is turning over you can bet there is a underlying problem. That holds true for a human doctors office.

    The vet practice I use had one owner retire last year- that vet was 75 years old but good as gold. He sold to a younger vet, 40 something, who compliments the other owner perfectly. They do horses and small animals. For me, veterinary service is about trust, competence and availability.



  11. #11
    Join Date
    Aug. 30, 2000
    Location
    Greensboro, NC
    Posts
    1,807

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    I think people with large animals are probably the most annoying small animal clients - because I am used to calling the vet, describing symptoms and giving vitals, then getting instructions like "give 10 ccs of Banamine, I'll be there in two hours," etc - I'm not used to be coddled or treated like an idiot, which seems to be unfortunately standard in a lot of small animal practices. I absolutely respect that my vet has far more medical knowledge than me, but I am also unwilling to use one who doesn't listen to my input. He/she is the medical expert, but I spend many hours a day with my dog and am an expert on this particular dog - if I tell you that her behavior has changed and she "just isn't right," I don't expect a magical diagnosis, but I do expect you not to blow off my concerns.

    And, I prefer to spend my money with vets who spend my money wisely. For my horses, for years I have used a vet practice that is probably one of the most high-priced in my area. However, they have ultimately saved me a ton of money because they catch things much earlier than others, make very deliberate recommendations about when to treat aggressively vs conservatively, etc.


    2 members found this post helpful.

  12. #12
    Join Date
    Oct. 5, 2007
    Posts
    282

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    The vet I just let left has everything state of the art and for the most part I was willing to pay for it. There were a few raised eye brows at some of the charges on my cats bill. $300 to use the room and then equipment charges on top of that. Stiches were treated as a full surgery and nickle and dimed every penny.

    When Shade had a ear infection, it was Dental awareness month. Great they checked her teeth and told me for a 10yr old dog they look amazing. No issues, but could use a brushing. The vet wanted me to have the full dental cleaning with anesthesia anyway. Sorry but at that point it is a cash grab and nothing more. You do NOT put an aged pet under anesthesia for cosmetic reasons that a tooth brush will fix. I had no problem telling her so.

    The new vet is beyond my expectations. There are 2 of them and they are in it for the animals - it is THAT obvious. Shade is not doing so well, and we have been in contact daily. Not just passing messages via staff, they take my call each time.

    Then there is the extra stuff that makes this place special. It was an expensive surgery but came in $600 less than reg vet and had a full spa treatment included free. (teeth brushed, ears cleaned, nails trimmed, anal glands (which have never been done - ew), a full bath and a new bandana to come home in. And free food to try and coax her to eat.

    The extras were totally unexpected and very much appreciated. This new vet is 30-45 min and 2 cities away and our regular vet is 5 mins up the road.


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  13. #13
    Join Date
    Aug. 22, 2000
    Location
    CT
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    2,482

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    Around here it seems that more vets have gone to the system that is more like human medicine - a basic veterinary practice that associates with a referral hospital for difficult or specialized diagnostics, care and surgery. Virtually no primary vets always do their own emergencies! I understand, but I miss that model where the vet attending your urgently injured or sick animal already knew you and the pet.

    As I have gotten older, I have learned, in both animal and human medicine, to advocate and question appropriately. I would want to believe that my vet is competent and realistic (this is where new vets too often want to do too many tests or procedures). I have also learned not to be shy to tell a doctor or vet that I want a second opinion. It has never been an issue.

    My current vet offers basic service. The vets are competent, realistic and willing to send to an associated referral clinic (40 miles away) when necessary. On a referral basis, the clinic is excellent -pricey but upfront about costs and benefits. For emergencies, there is a local e-clinic. Unfortunately that is a bit of a crapshoot with different vets. I would feel like I needed to be very careful of any recommendations and stick to the basics until I got another opinion if at all possible - if not possible, we do the best we can.


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  14. #14
    Join Date
    Dec. 17, 2007
    Location
    Meadowview VA
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    2,201

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    Availability because of potential emergencies. We use 3 vets in our area for all the menagerie. One will do horses, cats, dogs, but he has his own practice so not available for emergencies. I will say the horses expressions are: "did i just get a shot?' he is that good . The lg. animal vet we depend on has three vets, so emergency= them, and they are very well respected. We use them for all horse "stuff" now.
    There is a great sm animal vet practice with multiple vets q 5 miles from us, open 7 a.m to midnight. They are very good...but I called regarding a spay/ neuter for 2 dogs. $479!!!!! I realize that included a lot such as exam blood work, etc. but that was per dog. We have used them twice around 9pm for dogs eating stupid stuff and doxie w/ blood in her urine.
    So for spay/ neuter we took them to a great non-profit place. Both dogs done, rabies shot, shot for pain =$144.



  15. #15
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    Sep. 7, 2009
    Location
    Lexington, KY
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    20,128

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    After running through 4 small animal vets after moving here, I finally found a keeper. They are just thorough enough without being absurd. There are three vets in the practice (one is very new, and so far I'm not a fan), but they make every effort that your dog sees their usual vet. I can call them up to 10:00 at night for an emergency. They have all the tools...in house lab, ultrasound, digital ex-ray, laser surgery. And to top it off, they're not expensive.

    I did have to kiss a lot of frogs first, but finally I found one I really like. Be persistent. The clinic owner (and my vet) also uses my farrier, which is how I found them. He totally understands that horse people tend to be more directly involved and knowledgeable about their animal's care.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant



  16. #16
    Join Date
    Aug. 4, 2009
    Posts
    82

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    Being from the lab side...

    Look for attention to detail. You would be shocked by the number of unlabeled and mislabeled samples that we get daily.


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  17. #17
    Join Date
    Aug. 12, 2010
    Location
    Westford, Massachusetts
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    4,111

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    Quote Originally Posted by Pookah View Post
    I think people with large animals are probably the most annoying small animal clients - because I am used to calling the vet, describing symptoms and giving vitals, then getting instructions like "give 10 ccs of Banamine, I'll be there in two hours," etc - I'm not used to be coddled or treated like an idiot, which seems to be unfortunately standard in a lot of small animal practices. I absolutely respect that my vet has far more medical knowledge than me, but I am also unwilling to use one who doesn't listen to my input. He/she is the medical expert, but I spend many hours a day with my dog and am an expert on this particular dog - if I tell you that her behavior has changed and she "just isn't right," I don't expect a magical diagnosis, but I do expect you not to blow off my concerns.

    And, I prefer to spend my money with vets who spend my money wisely. For my horses, for years I have used a vet practice that is probably one of the most high-priced in my area. However, they have ultimately saved me a ton of money because they catch things much earlier than others, make very deliberate recommendations about when to treat aggressively vs conservatively, etc.
    I agree...which is why I far prefer a mixed practice for my pets. Our vets do both large and small animals (and has enough staff to have at least one vet in the clinic while another is out making farm rounds). All the vets do both large and small animals. They do not treat me like I'm stupid, they explain everything and if something can be safely handled at home (some shots, stitch removal...), they'll instruct on how to do it.



  18. #18
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    Jun. 10, 2009
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    1,683

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    Open until 6 or 6:30pm on weekdays, at least half a day Saturday, and Sunday for pick ups. Affordable prices. Quality care.

    I love my current vet, and am very sad I'm moving to a new city. At our first appointment one of the techs called dibs on my puppy and we get her at every single appointment. If another tech shows us to the room, my tech quickly swoops in and claims us. The vet is always excited to see us, considers all options for even minor problems, discusses them with me and lets me decide. When I've called and gotten advice on taking care of something at home- the vet agreed that I didn't need to bring her in and even called me to follow up and make sure my dog was OK. Panda is always very excited to go to the vet and I definitely feel loved there!



  19. #19
    Join Date
    Jul. 19, 2003
    Location
    Middleburg, VA
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    13,344

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    I am going through the same struggle. My dog and I were very spoiled for several years by having a good friend and boarder as her vet. She was an ambulatory/house call vet, so she would often look at Stella at the barn when she brought her son to ride, or sometimes I would swing by her house on my way to or from the farm. She was smart, practical (she never did anything we weren't 100% sure we needed to do...she was big on the KISS principle...which is good fore Stella since she is a HORRIBLE patient), Stella loved her, and she was cheap (and often free!). When I moved away 18 months or so ago, it became too inconvenient to get Stella to her, so now I'm struggling to find a practice and a vet that I A) trust B) actually LIKE C) doesn't treat me like an idiot and D) doesn't cost me a small fortune every time I go in.

    I took Stella in to the large, popular practice most of my boarders use last summer for some itchy skin and found the whole ordeal very unsatisfactory. The vet was an ass, I got ROBBED in the medication department (he prescribed her some ointment which I found out AFTER the fact was a tube of house brand athlete's foot cream that was marked up probably triple, not to mention the HUGE mark up on the other drug....none of which worked), the staff was not necessarily rude but definitely not friendly, and the diagnosis process was a JOKE.

    I haven't gone back since and now really need to buckle down and find SOMEONE, as dog and cats all need routine stuff.

    Have you asked your horse vet? Mine has given me several suggestions (a couple of alums from his vet school and a client of his). Considering he is a good vet AND he knows I'm no idiot, he knows that I am extremely particular about my animals care, so I will be looking into his suggestions (wish one of them wasn't the complete opposite direction from where I typically do everything!).

    I feel your pain!



  20. #20
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    Mar. 25, 2011
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    423

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    Working in a specialty/referral practice, I will say that something that has become very important to me, is a vet that admits when the pet needs a referral to a specialist. Many times, we see pets where the vet continued to try to treat and didn't send it over until the pet was a complete mess/dying or died, and in the long run, did NOT save the owner any money. I have seen a couple of cases that just breaks my heart...however, you don't know how resistant the owner was to bring the pet over. I also talk to a lot of vets who are such advocates for the pets and practically beg for the owners to bring them over to save their lives.



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