Do These Vet Bills Look Reasonable?

I took my pooch to the after hours vet clinic tonight because of a urinary blockage.
I spotted the little bugger lifting his leg, but nothing coming out, he had stones removed a few years ago, so I always keep a watchful eye on him.

I’m not asking for any professional to ‘rat out’ a fellow vet or anything, I just want to know if the bill looks reasonable.

I’ve owned dogs for a long time but lately it’s turned into such a big business, I cringe anytime I go in (which is a lot)

So it turned out he had a blockage (stone), and I left him there from 9pm until 2am.

This clinic is open all night to the public (12 or so local vets got together and opened up a shared co-op after hours. They take turns running it each week.

Here’s the break down of fees, I would like to know if they seem reasonable, or if there’s anything there which might be excessive.

Thanks

~ $ 149.50 : Anesthetic Fee

~ $ 30.55 : 5 mg Metacam

~ $ 179.50 : IV Fluids During Surgery

~ $ 81.00 : Nursing Professional Care (12 hours)

~ $ 69.00 : Urinalysis

~ $145.00 : After Hours Exam

~ $ 61.00 : Urinary Catheterization

~ $ 88.50 : Radiograph Set Up & Develop

~ $ 95.50 : Radiograph - Split Plate

$899.55 = Grand Total

My dad the veterinarian has been retired for some years now, but the only fee that seems high is $179.50 for IV fluids.

After hours is gonna cost you.

Considering that they all share the duties of running the after-hours, I don’t feel that the exam fee is particularly fair, nor the Nursing professional care. Unless your pooch was being handled for that time, hanging out and checking on him when you have to be there anyway, and probably are doing any number of other things for that time ought not be billable IMHO. Considering that you did the right thing and spent the money for all the corrective care, they should have comped the exam fee. it feels like you are getting nailed for the same thing twice.

Of course INANA vet. And YMMV

For emergency veterinary care there really is no such thing as “reasonable” anymore. In my practice, during “regular hours” $800 would get you all that you got plus a cystotomy, urethrostomy, and stone analysis. From what I can tell looking at the OP, the dog was anesthetized and the stone pushed back into the urinary bladder. I have done that for the price of anesthesia and catheterization (less than $100).

However, you needed emergency care and probably had little opportunity to shop around. That is one reason why I use an answering service and offer to see my clients’ emergencies. I woulda still raped you a bit, but I would have taken less than a third of what they did if all I did was retropulse the stone.

Addendum: Location, location, location. Everything I’ve said pertains to Western Pennsylvania. YMMV. Burmashave.

One liter of Lactated Ringers costs me $1.40. That is a helluva markup, but I do not see a separate fee for the catheter and its placement. During regular hours, I charge $30 to place an IV cath and $15 for each liter of fluid administered. For very small patients requiring a pump for fluids there is an extra $30 charge.

Thanks for the reply vetbridge,

I think there is a charge of $50-something bucks for the cathator somewhere in that list.

The only things that felt ‘severe’ to me was the IV fluids charge, and the Xray.

I might take the bill to my vet (since he owns 1/12 of the business and ask him if it looks ok to him. We have 6 dogs, so he gerts a lot of business from us.

Man by bum hurts, ouch.

Is that normal? Just shoving the stone back into the bladder? It seems like a pretty good recipe for the poor thing having another urinary blockage next week.

Also, you were billed for 12 hours of nurse time, but from your OP the dog was only at the clinic for 5 hours, and was probably just sitting in a cage for the first half hour or so.

I believe the Emergency Practice would explain that they stabilized the dog. The dog now can go to the OP’s regular veterinarian for cystotomy, stone analysis, etc. Not how I would have handled a similar case, but in my situation I am usually both emergency and regular veterinarian.

In certain situations, the emergency veterinarian doing more than what is needed to address the immediate crisis could lead to state sanctions (varies by state).

That seems like a lot for radiographs – I’m not quite sure what split plate is but I’m guessing they did two views using the same plate.

I’m used to equine, where digital radiographs per view are around $40-70, although some places have a minimum fee (e.g., $100 for one or two views, $50/view after the first two views) for taking out and setting up the machine. No additional processing or interpretation fee – and these are for direct digital* (which technology also provides significantly superior image quality to films rads these days) systems that cost around $80,000 (cost of one system I’ve seen, don’t know what competitors cost) to purchase.

In equine, the exam fees, meds, etc., are generally the same as during regular hours, and then a blanket emergency fee is added on at the end. The emergency fee varies widely by practice and region, but the other items are not marked up more than usual.

As mentioned above, that’s a helluva markup for IV fluids.

*Meaning that the image pops up on a computer screen instantly. You can then manipulate the image to adjust contrast and brightness, zoom in (with seemingly no limit on resolution), lighten/darken, use edge enhancement, and measure.

Some of those fees seem higher than ours but I’ve seen bills from other parts of the country and I think we average a bit lower here. What part of the country are you in?

But really as vetbridge said, you really can’t do much price shopping in an emergency - when you need the service you need it right away.

Kingston, Ontario
Population 160,000

I’m going to talk to my vet on Monday (in a nice way of course, and ask him to take a look at it.
We’ve been going to him for 20 years.

You’re in Canada? So $900 is like $45 worth of real money, right? :slight_smile:

Sorry, couldn’t resist.

Haven’t been keeping up with the exchange rates, have we?

$6.75 an hour is unreasonable for having trained folks with the tools and skills to save the animals life if need be monitor it? Like many businesses part of what you are paying for is maintainance of availablility. If it costs $1000 a day total to provide services they will need be bringing in $1200-$1500 to make sure they do not lose money overall with the occasional slow day.

This is a good point that I hadn’t considered. Still, 6.75 is near minimum wage, something that most people actively work for. While I agree with your point, I still feel that simply paying out someone that rate who is going to be there anyway feels a bit off to me. Certainly it’s less than that person’s hourly or salary rate, but it’s asking the customer to pay for the time regardless of how much care, if any, was actually performed. I don’t bill my clients for “on call” time, only if they welch out on an appointment, or actual working time. I can understand the cost now, but it still feels wrong to me. Of course, when one is dealing with the medical profession, one can be expected to be billed for farting in the wrong direction so perhaps I’m way off base.

$16.20/hour. Remember, the dog was there for 5 hours, not 12. I would be weary of anyone who charges for 12 units of service and only provides 5.

I suppose OP should be lucky they didn’t line-item the electricity and tap water that got used during the visit.

I’d also be curious to know, aside from labor, what costs of doing business are incurred during a late-night visit that would not be incurred during a daytime visit? Does the rent go up?

Maybe they bill in 12 hour increments for postop care. We have a 1 hour minimum for our service even if my tech shows up and plugs the dead computer back in and it magically works perfectly after that.

Many night shift employees do get paid more than day shift, in addition, night shifts in many 24 hour businesses tend to do lower volume for the same overhead, thus extra charge offsets the lower customer volume.

Oh, we have. But I have still reserved the right to use jokes against Canadian money in perpetuity…

Even in minimum wage jobs the business usually is billing their time at about $30-$40/hr. So if a $12.00 pizza involves $3 in total labor employees will average 10-15 pizza an hour each.

As you’d guess, labor is the big one. You need to pay more to attract and retain quality employees. Emergency clinics also have record keeping costs different than regular hour practices, as they fax summaries to the referring practice.

The current trend is for veterinary emergency clinics to employ clinicians who are board certified in emergency/critical care medicine. That is great if your pet is hit by a car and has complicated trauma. But, if your dog steps on a piece of glass and needs its pad sutured, it is extreme overkill.