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Sick Kitty and ER Vet issues (long and kind of rant-ish)

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  • Sick Kitty and ER Vet issues (long and kind of rant-ish)

    I had to take my new kitty, Sheldon, to the emergency vet this morning. I adopted him from the SPCA three weeks ago. He's...elderly. And came to me underweight. Because he was skinny, we did bloodwork (CBC, T4, Kidney and Liver enzymes), and everything was perfectly normal. He's been doing really well since then, gaining weight, and being quite the charachter.

    Yesterday, he seemed a little "off". He was eating well, drinking, peeing, pooping, and wanting petted, but his balance seemed not right. I notated it, and figured if he wasn't better, I'd make a vet appointment.

    This morning, he was definatly ataxic in his rear end, and was having trouble getting around. So, he got loaded up and taken to the ER.

    Holey Moley Batman! Is the ER expensive. I work for an equine vet, and I'm well aware of the expenses of running a vet hospital, even an emergency one (10 years as a small animal emergency vet tech in Florida), but good gravy! The initial estimate was over $1000, they wanted to do full bloodwork (which was done three weeks ago), chest xrays, pelvic x rays, urinalysis. Oh, and they send the rads to a board certified radiologist ($65 each). I'm afraid I had to veto most of that. I ok'd the pelvic x rays, and allowed them to check his blood glucose because we hadn't done that three weeks ago. I'm still going to be paying around $500, but sheesh. Small animal vet services are WAY more expensive that large animal. I haven't paid retail in so long, I'm spoiled I guess. I had to almost chuckle. $100 for sedation. Seriously? They pay about $20.00 for a bottle of xylazine, and they give him maybe 1/2 cc of that 20 ml bottle. So what's the mark up on that?

    Anyway, I dropped him off at 1pm. It's now 6:08 and they haven't even looked at him. I am about to call them again, and then I'm going to get him. If he's not serious enough to warrent pulling blood and doing xrays while staying at the vets for five hours, chances are he'll make it to tomorrow and my normal vet. I'm kind of peeved to be honest. The vet was all worried about him being hypoglycemic or in diabetic crisis (didn't see that myself, but ok). Um...if he is, don't you think you should have checked the glucose when he came in, not five hours later. If he was hypoglycemic, he's likely dead by now.

  • #2
    Jeez. How annoying. I really hate having to run cats to the emergency clinic. Of course, my cats tend to schedule their medical crises on three day holiday weekends. The cost is annoying enough, but it really steams me when the end result is a huge bill and a comment of "Yeah, he looks sick, we'll fax the blood work to your regular vet so you can discuss it with them in the morning." Dude, the fact that this cat has been dry heaving non-stop for 24 hours was a clue that the cat is sick. Could you have told me you weren't equipped to do a barium test before you ran up several hundred dollars in irrelevant blood work?


    • #3
      I won't use the ER here. Thankfully, my vet takes calls up to 9:30 every night if it's an emergency. If it's so bad I can't wait for morning...I'll take them up to the equine vet clinic where my daughter works.


      • #4
        I have had nothing but bad experiences at emergency clinics. I don't think I've ever had a correct diagnosis at one--nor an inexpensive one.

        If I were you, I'd definitely go pick up my cat. If they haven't even bothered to look by now, he's probably okay to wait for your regular vet tomorrow.


        • #5
          Most be something in the air. I was in the ER with my elderly orange boy this AM. He was just off, then I saw him straining in the liter box, couldn't tell if he was trying to urinate or defecate.

          Got to the ER and was greeted by a very friendly vet student, who turned out to be one of my former students of six years ago. And she remembered my cat from her flute lessons from years back.

          I was there two hours with him running blood work. He had a fever and a swollen rectum. They believe he has an anal gland infection (poor old guy)...so pain killers, fluids, blood work, exam came to 468.00 (blood panel was 227.00)...

          Thank goodness for my Care Credit card, not such a bad bite when you have 6 months to pay the balance interest free.


          • #6
            Absolutely understandable that you're frustrated that he hasn't been looked at yet.


            • #7
              I'm glad ER vets exist....that said...MY GOD! The mark-up for everything done after 5:30pm and before 8:00AM is unreal. I totally agree, OP, that it is outrageous. Yes, I get that they are open when other vets are not, but still...

              I have a $400 kitten. He was free, but the two xrays and sub-q fluids cost me the money. Damn thing ate a string...on a Sunday...of course.

              On a normal day, that would have been a 1/4 of that. $55 for subQ fluids is ridiculous.

              but...I have a healthy, happy black devil cat running around.
              Proud member of the "Don't rush to kill wildlife" clique!


              • Original Poster

                Sheldon has been retrieved. One set of pelvic x rays and a glucose later, we have a $500 vet bill and no diagnosis. He is still ataxic. *sigh*

                He could have... "cancer, an inner ear infection, or a random neurological problem". Oooookay. I've always joked that when vets don't know what's causing something, they give the animal antibiotics and a steroid. And that's exactly what they tried to give me today. I told them I'd swing into work and pick them up from there. I probably should have just done that in the first place....


                • #9
                  Oh, yes, small animal ER.

                  You need to know that a sedated cat doesn't take the standard (horse) half hour or so to wake up. No, that's 4 hours (or so they say) and so if you time this wrong, you'll be in for an overnight fee. I did plan my visit to not include an overnight stay but I didn't count on the long wake-up time. An expensive lesson learned.

                  Now a hospital fee at my nice vet's clinic is almost 4X the cost of boarding (which is about 1.5X the cost of my horse per day.) So when catness was there for some stuff that includes NQR in the ol' pooping department, I didn't think it was out of line to ask for some data on that. After all, this was hospital care and a presenting symptom. Nope, no clue about poop. No clue about who cleaned litter boxes and when. I just about lost my mind. Were this a horse, that sh!t would not only be known but written down.

                  I'll rearrange my life to avoid taking a pet to an ER.
                  The armchair saddler
                  Politically Pro-Cat


                  • #10
                    I certainly hope they didn't give him xylazine!! Yikes!

                    Ataxic thin old cat = cancer, hyperthyroidism, occult heart disease in my book. Best case scenario you're looking at something infectious like Toxoplasma that can be treated, or hyperthyroidism that can be managed.


                    • #11
                      The compensation rate for staff is just so much higher with an erratic case load. That's a large part of why the fees are so high; you're paying for "convenience". I work a few shifts a month at an area ER to add to the household income. One ER shift is half of what I make for a week at my day job as a small animal generalist. I'm not enough of a night person to do ER work full-time. The ER technicians make double per hour what my day practice techs do. I know one human ER doctor and he moonlights in northern Maine because he gets paid so well for giving up a weekend per month.


                      • #12
                        A few yrs ago my old cat had emergency surgery for a severe infection,, she wasn't acting right oon a fri eve, so I took her to the EV recommended by the vet, not the one. Would choose to use.

                        They do Xrays, vet comes in and attempts to explain them to me, and says that they can't find the cats kidneys! So I ask what the fuzzy kidney size/shape thing is in the kidney area. She has NO IDEA (headdesk)

                        Needless to say I asked them to just give her SubQ and keep her comfy til the real vet opened Sat morn.

                        I reject your reality, and substitute my own- Adam Savage

                        R.I.P Ron Smith, you'll be greatly missed


                        • #13

                          ER is going to be WAY more expensive than regular working hours practice. Why? You have to pay staff to work weekends/overnight shifts. Out of hours practices are simply going to be more.

                          And I highly doubt they stuck your cat in a kennel and ignored him.

                          I work part time in ER, and each animal we admit as a tech gets the "quick assessment test" done. They all get ECG, blood pressure, temp, pulse, resp, mucous membrane check, and initial blood tests (blood glucose, electrolytes, lactate, blood gasses, BUN and PCV). If there is any concern with ANY of the prelim assessments we get a vet to assess animal right away.

                          However, be aware that you are likely not to have the only patient in hospital. With ONE vet working, he/she is responsible for ALL incoming patients, any procedures, major or minor surgeries and ya ton of phone calls.

                          You are paying for quality support staff that can stabilize your pet while the vet may be saving another life.

                          Our facility runs an ER and an ICU with a boarded criticalist....we send patients home (or they dont even survive to go home) with bills at $50,000+. Best advice is to know your financial limits, and stick with it. No sense in running yourself out of house and home for an older kitty.


                          • #14
                            Originally posted by Arrows Endure View Post
                            Sheldon has been retrieved. One set of pelvic x rays and a glucose later, we have a $500 vet bill and no diagnosis. He is still ataxic. *sigh*

                            He could have... "cancer, an inner ear infection, or a random neurological problem". Oooookay. I've always joked that when vets don't know what's causing something, they give the animal antibiotics and a steroid. And that's exactly what they tried to give me today. I told them I'd swing into work and pick them up from there. I probably should have just done that in the first place....

                            No offense...but since all you LET them do was a BG and pelvic rads, you really limited their diagnostic capabilities. No wonder they couldnt find anything wrong with your cat. If you really want to figure out whats going on with your kitty, further diagnostics would be needed - agreed not all have to be done at an ER, as their primary job is to stabilize your animal until you can get it to a GP vet or to a specialist. Sounds like your kitty needs to see a specialist if you want to work him up further. Declining diagnostics is fine, but dont blame a vet for not giving you a diagnosis then.


                            • #15
                              Originally posted by Calvincrowe View Post
                              I'm glad ER vets exist....that said...MY GOD! The mark-up for everything done after 5:30pm and before 8:00AM is unreal. I totally agree, OP, that it is outrageous. Yes, I get that they are open when other vets are not, but still...

                              I have a $400 kitten. He was free, but the two xrays and sub-q fluids cost me the money. Damn thing ate a string...on a Sunday...of course.

                              On a normal day, that would have been a 1/4 of that. $55 for subQ fluids is ridiculous.

                              but...I have a healthy, happy black devil cat running around.

                              bag of PLA $12
                              Extension set $8
                              Needle $0.25
                              Tech time per 15 min $6
                              ACA time per 15 min to restrain cat $3

                              Comes out to be $28 at Cost for 15 minutes of sub1 fluids. Markup is generally always 100%. $55 is what a GP clinic would likely cost you too.


                              • #16
                                Yikes - so sorry to hear that both your kitty is sick, and that you ended up with a bill like that. My old lady cat was ataxic last weekend - wiped out jumping off her spot on the kitchen island, staggered around like she couldn't find her left hind leg - and to make a long story short, Monday am vet visit uncovered an inner ear infection. The whole bill came to around $250 which included cultures and baytril. The ataxia went away after about 3 days on antibiotics and now she has Horners' Syndrome (look it up if you like weird vet stuff!) that is also expected to go away on its own, eventually. I am so glad I went for the "experienced cat guy" this time... at her age I was adamant that I didn't want to screw around and run up a huge bill, and he was able to cut right to the chase.

                                If your vet hasn't looked deep in his ears, you might suggest it - especially if he has any signs of neurological stuff around his head.


                                • #17
                                  As an ER/CC vet....
                                  Yes, our costs are high. We run 24/7, not 8-6. More expense.
                                  We have more and different equipement that we need.
                                  Our staff have to be a bit "better trained" (I don't mean to offend anyone here, ok).
                                  They have to work evenings, overnights, weekends, holidays. More salary dollars.

                                  As for all the tests suggested....
                                  We dont' know your cat at all.
                                  Your regular vet will "arm chair" us and complain that we did or didn't do something we "should" have. So we tend to recommend alot of stuff so we are thorough and more apt to pick up the wierd things that are seen at ERs but not at day practices.
                                  You can say no.
                                  You can wait until your vet opens later in the day and go there then.
                                  Blood work changes. 3 weeks all was fine. Now it is 3 weeks later and you have a sick cat. We need to know what is happening now in your sick cat, not what was in your healthy cat.
                                  (BTW, Kidney levels: they don't change on blood work until you are down to less than 30% of kidney function left. I see alot of pets that had normal kidney values a month ago and are in failure now. They were at 31% a month ago, now they are at 25%. If you get my drift.)

                                  $100 for sedation? I doubt (hope) your older sick cat did not get xylazine, at any dose. Our drugs are more expensive.

                                  Don't know where in the country you are, or what all was recommended and why but to give you a rough idea if you came to me (numbers not exact since I am not at work so don't have the computer to do a real estimate)...
                                  Emerg fee and exam: 85
                                  CBC/Chem/Lytes: 150
                                  Rads (2 views): 150
                                  Ultrasound: 165
                                  Sedation: 50-100 (depending on how much and how long)
                                  IV cath and fluid set up: 100
                                  Hospitalization: 150 for 24 hr
                                  So you are at $600+ and I havent' started treating your pet yet since I don't know what I am treating.

                                  Oh, go to a human ER sometime and get this same stuff done. It won't be $600, trust me.

                                  Hope your kitty got better (I didn't read all the posts)


                                  • #18
                                    Anyone ranting about emergency after hours clinics gets my full support. (Donning flame suit here). The issues aren't always money but how they go about getting it and the way front office staff treats people coming in with often dearly beloved pets in dire straits. OMG. What I have seen, you do not want to know. I have had direct experience with local ER/after hours here and frankly before visiting one of those hell rooms I would get a vet to come out to my home and put my animal to sleep rather than take the animal to the local ER here in this area.

                                    The directly abusive and aggressive behavior of "twenty-somethings with attitude" at local ER in this area toward people who bring animals in, animals that they love and care about and are worried about, is unconscionable and inexcusable.

                                    Corollary issue: what people with pet insurance do not realize is that all pet insurance is reimbursement-based. They may think that an emergency after-hours clinic is going to "accept insurance." They would be wrong.

                                    Strategies ahead of the event to keep in mind: always have a wad of cash ready to throw at these greedy vultures who have zero interest in the welfare of the animal and an overwhelming desire to take as much money as possible from the pet's owner/guardian/whatever - which explains the incredibly repetitive testing they demand; keep in mind that many ERs do not accept checks nor do they always accept credit cards and oh BTW no they are not going to let you leave your bleeding or vomiting or seizing animal there while you run to the atm, "take the animal out of here and come back when you have cash" is the way you likely will be treated. Always always always have at least a thousand dollars cash stashed just in case. Seriously. I have in my six decades of animal guardianship never seen an ER giving you an "estimate" for demanded up-front payment less than a grand. And that estimate will likely be exceeded. Sincere efforts there to exceed it, with more duplicative testing if necessary.

                                    ER clinics need to do these things: a) have a fund for willing people to donate to for those who cannot afford emergency treatment b) have financial aid information readily at hand for same c) take some lessons in basic civility, respect and good manners d) lose the attitude generated by their mistaken belief that they have life and death control over you and your animal.
                                    Surrealism: once an art form. Now indistinguishable from daily life. (Forgot who said that.)


                                    • #19
                                      The cost of pet ERs is outrageous. In the past year my family has spent something like $7k in emergency fees for 2 dogs.
                                      $2k middle of the night Pyometra.
                                      $4k exploratory surgery resulting in cancer diagnosis and 6-8 week projected lifespan.
                                      $1k for second exploratory resulting in euth on the table.

                                      All of which happened after 7pm....expensive, but the first two would have been gone in less than 12 hours without vet intervention. The 3rd instance was only a matter of time, anyway. Had to try for my girl

                                      *ETA that I am very grateful for the existance of ER vets...but my regular vet said the price was probably high*
                                      Last edited by Pirateer; May. 25, 2011, 02:45 PM.


                                      • Original Poster

                                        Wow, I wish I had taken my cat to Meghan's vet clinic. I would have much happier.

                                        I'll clarify a bit for everyone. I worked as an emergency vet tech for five years. I did the midnight to 8am shift. I fully understand the expense and the problems associated with an emergency clinic. I now work as the inventory manager in a large equine hospital. I know what things cost, which means I know what the mark up is.

                                        I don't mind paying what I consider a fair price. I don't mind waiting for the hit by car cat to be seen first. What I mind is unfair charges, and being made to feel like a bad pet owner because I can't drop $1100 on my cat today.

                                        Here is a little breakdown of the charges they quoted me on the estimate....

                                        ER Fee $125.00 (10 am on a Sunday)
                                        Bloodwork (CBC, Chem, Electrolytes) $285
                                        Xrays chest (3 views) $245
                                        Radiologist report $65
                                        Xrays pelvis (2 views) $195
                                        Radiologist report $65
                                        Urinalysis $75
                                        Sedation $100
                                        Biohazard fee $5.50

                                        Total estimate $1160.50

                                        I walked into the clinic, and told them flat out I had about $500 that I could spend. I told her why. And I still get a $1100 estimate. I specifically asked her which tests were necessary, and was told that they all were. So I chose the ones that made sense to me.

                                        In case anyone is interested, bloodwork, ultrasounds, and full xrays were done on Monday. Everything was normal, except he has a bit of arthritis in his pelvis. We think he has an inner ear infection because he had a bit of discharge in one ear, and we can't find anything else. He is better, but still a bit wobbly. And still eating like a pig.