Two questions about the economics of veterinarian bills

In My Humble Opinion
21

None of the vets I work for would have an owner sign an authorization for euthanasia without every intention of carrying it out. If the pet is otherwise viable if this one thing (illness, injury) can be fixed, and it’s only money that’s in the way, then the owner can surrender the pet to the hospital.

This doesn’t happen as often as it used to, though, because the pets for adoption got a bit out of hand and expensive. Now, if there’s an employee present at the time of the surrender, who is willing to take on the expense (with their significant discount), and who will be taking the pet home themselves, only in that circumstance can the pet be surrendered. Basically, the hospital has to know the pet already has a home to go to as soon as it’s healthy. Another sign of the current times.

Myself, I adopted the bestest kitty ever this year, I named him Chico. Two months after I adopted him he ended up with a urinary obstruction, and because of other complications during hospitalization that had to do with his liver shunt and the fact that the u-cath irritated his bladder to volcano-like inflammation, he was hospitalized for 4 days, and then again just 2 weeks ago.

If I didn’t work at animal hospitals, between his time hospitalized, the ultrasounds he got, the bloodwork, the urinalysis, x-rays, urinary catheters, IV catheters, etc, etc, he would have cost me over $3,000 this year. With my discounts, my total outlay has been about $800.

As to the animal vs. human health care, especially in terms of surgery, don’t forget pretty much ALL of the equipment, including surgical instruments, in human care are disposable. It all gets thrown out. That’s very expensive. Vet hospitals clean, sterilize, and re-use their surgical equipment. Much less expensive in the long run when a $1,000 surgical pack can last 5 years or more with proper care!

22

Glad your pup is doing okay!

I think it’s very common for pets to be put to sleep when owners can’t afford treatment. I went through this as a child with a couple pets. Honestly, although I love my two dogs and two cats, there are few expensive medical treatments I would shell out for even if I had cash to burn (I don’t - I have credit and essential savings). It depends on the situation, of course. For traumatic injury, or a condition such as severe hip dysplasia, where with the right surgery there’s a good prognosis for being mobile and pain-free, I would spend quite a bit. Major cancer treatment beyond pain management, never. Most other degenerative conditions, ditto. I have few issues with euthanasia and animal death. I miss em, but it’s not that hard for me to move on.

I do spend extra money on preventative care (feeding them the optimal diet carnivore diet), and the y all have zero health problems so far, thankfully.

23

Sampiro, here’s some get well wishes for your pup, hope he heals up soon.

This summer I had a sad enmergency with a beloved cat, a brain infection, and had to take her in the middle of the night, on a Friday, of course… to the Emergency clinic, and then to the State Vet School. Each step of treatment had to be decided and then an advance and credit card for the rest. I’d expect that sort of payment would help keep costs down.

She was at the Vet School for 10 days, and, yep, it cost a lot, and they ultimately weren’t able to save her :(:frowning: , but got tremendous care by the neurological docs there. One thing of great note; they said, “Well, we don’t get many cats…” and, it was true, she was the only cat in the ICU. Just dogs, so that really says a lot about how people value one type of pet over the other. No judgement here, I just thought it odd.

That did give me extra reason to go ahead with her treatment, hoping for her to be saved, but then, to help other cats by allowing the student vets to get experience treating her, gaining knowledge with a weird problem, down to the MRIs and umpteen tests. They weren’t able to save her, but I was so impressed by the level of care and compassion she recieved. In talking to one really outstanding resident neurologist, who had been up for a lonnnnggg rotation: He said that his brother was an MD resident, and they had compared notes, and the brother had said the Vet’s rotations were rougher. He wasn’t bragging, just related it lightly while looking tired, as I told him how much I appreciated all he had done for my sweet cat.

That experience really showed me, through all the emergency care freakout emotions had, how caring and committed people who go into Veterinary medicine are. They always called back to discuss options, even in wee hours after long shifts, listened at length to all questions and explained everything in detail. Getting all sniffly sad here again in remembering all that, but, veterinarians are really incredible people.

24

Just random thoughts from a former volunteer, vet student, and now resident (in pathology).

Malpractice insurance for pets exist, but is less expensive than the human counterparts. I think it is starting to be more and more recommended for veterinarians to have them, especially those that deal with horses (which themselves are insured).

Yes, I’ve seen animals put to death when it was something that could be treatable, manageable, give the animal months if not years, reduce the pain, AND the people seemed to afford it (heck, they were at the vet school, which is the main referral practice in the area). The owners have just said “no”. I’ve seen people who don’t even qualify for the CareCredit struggle and cry and look completely lost trying to figure out what to do when their pets are in trouble. Can you tell which set of owners gets my sympathies?

I’m keeping my mouth shut on euthanasia.

As to why some vets turn around and treat animals that have essentially been abandoned, and give them out to someone else… They’re being (for better or worse) character judges, and in their minds, those owners didn’t deserve the furry bundle of joy.

What is amusing (for me) with reptiles is that most of the basic problems they get are due to poor husbandry. This is true for most exotic (not dog or cat) species. Fix their habitat and their outlook improves. Now, keeping the proper husbandy for each species can be hard, and requires a bit of research and setting up before getting the animal. But it can be done.

Going to veterinary school costs about as much as going to medical schools, I did comparison in terms of tuition prices at some point. The student debts are about the same as our human medicine counterparts. Yet the starting salary is much less than that of a trained doctor. And if you think a specialization improves the salaries… it does, but nowhere near the human counterpart. AND doctors during their residencies get paid more than veterinarians during their residencies.

They are trying to give out incentives for students to move into food animal specialties, and I think last year’s AVMA’s economic survey showed an increase in the starting salaries for food animal- primary veterinarians.

There are charities and funds that help some people. Most of them are local, or associated with big referral practices (or veterinary schools). Low cost spay/neuter programs are available in many places for those who qualify. Or you could get lucky and the veterinarian work out a payment plan or something like that on an individual basis.

25

There was a case in my area where a veterinarian rehomed a dog that was left for euthanasia when the owner could not afford treatment. A month or so after all this happened, the dog got loose and ran off. Days later the dog showed up at the original owners house.

There was threat of legal action and a few days of local TV news stories. The state licensing board investigated. In the end, the veterinarian retired amidst all the controversy.

My veterinarian (different dude) once told me that for every 10 dogs that present needing a C-section, he euthanizes 8. Most people that can afford it have their dogs spayed. Those that choose not to often have no money. The few cesareans he does do are mostly breeders.

26

Out of curiosity (my dogs are both male), any estimates on how much a cesarean costs? I wouldn’t think it would be one of the more expensive but I have no basis greater than a hunch for wondering.

Great post all around KarlGrenze. So what’s the most complicated surgery you’ve ever witnessed? Do vets do transplants for instance?

27

There are some cases of having done transplants (IIRC, kidney transplants), but those reports are few and far in between. They’re expensive surgeries, after all, and I don’t know how they found donor dogs or their criteria for getting the kidneys, etc. I’m sure the owners got a big discount in what probably was a very expensive surgery, because of the risks and novelty.

I don’t think a C-section is among the most expensive surgeries out there, though certainly more expensive than a regular spay. In fact, depending on how it is done, the surgery IS a spay, just with the side benefit of getting squirmy little pups too.

Among the most complicated (and expensive) surgeries are orthopedic and ophthalmic surgeries. Both deal with nifty expensive instruments, and require a bit more knowledge of biomechanics and optics, respectively, than regular surgery. Cool to observe, I don’t want to do it.

28

Three years ago we spent close to 2K for treatments/operations on my husband’s beloved malamute who had cancer. A treatment/operation would be done, Missy would be fine for a couple of months, then tumors would suddenly reappear. The only way we could pay for it was through Care Credit, which not only had a low interest rate, but was accepted by nearly all vets in my area.

Unfortunately we had to put down Missy when her cancer started spreading. We were told by the vet oncologist that her treatment would add on another 2K or thereabouts; in our case, it was a quality of life question since no promises could be made that Missy would go into indefinite remission after the operation. Our vet charged us, I believe, around $100 for both the euthanasia and cremation fee. It’s usually around $300, but she gave us a discount since we’d gotten to be good friends through Missy.

29

My father was a veterinarian in small animal practice for almost forty years. IME and his, generally the animal is euthanized. This is rather common.

Because, as mentioned, it is not a charity. I am not aware that my father or his partner ever agreed to euthanize a dog that needed an expensive operation and then operate on the animal and try to find a home for it. It wouldn’t have been ethical, since the client had to pay for the euthanasia, and generally it is unethical to charge for a service and not provide it.

He also didn’t generally vary his fees based on ability to pay, because, as also mentioned, many people will claim poverty if they think they can get away with it. Lots of other people are better at promising to pay than actually forking over. In emergency care, this is especially marked - folks who will say “cure my poor doggie and hang the expense!” sometimes change their tune when they are required to come up with the fee before service is rendered.

Yes, there are some. I recommend talking to them before having the pet treated rather than after.

There are a number of factors. Malpractice insurance is certainly one. The much lower cost of drugs is another. You can often buy the same drugs from the same salesmen, and if it is formulated for humans it costs five or ten times more than for a dog or a cat. Partly that is because dogs and cats are smaller, Partly that is because the standards for animals are not nearly as stringent as for humans. Partly that is because dogs and cats don’t sue. When my dad was in practice, the most you could sue for in cases of veterinary malpractice (that may not be the correct legal term, but you know what I mean) was the fair market value of the animal, and a used dog is not worth that much. And I don’t believe you can recover for the “pain and suffering” of a pet. A cow or race horse or some animal that generates revenue for someone is one thing; Whiskers the kitty is another. A vet might have to pay a few thousand if he shoots a race horse for a hoof infection that could have been treated with a shot of antibiotics, but the same mistake with a mutt doesn’t cost nearly as much.

The major factor in lower vet costs than human medical costs, IMO, is that people tend to value their pets less than humans. Certainly there are any number of folks who will say “my cat is just like my child”, but when the rubber meets the road and they are confronted with the possibility of dropping a significant amount of money on the cat, they don’t really mean “I will spend my life savings on the cat”. Some do, but most are more realisitc.

It is fairly easy to justify spending $18,000 on a child or a spouse. A pet? Most people won’t spend more than they can afford, however much they may regret it.

Regards,
Shodan

30

Depends on the drug. With the advent of generics and some places offer $4 for a month’s worth of prescription drugs, sometimes the veterinarians write the prescription and tell the owners to go get it at the same human pharmacies. Thanks to (IIRC) AMDUCA, veterinarians can prescribe human drugs if there are no equivalent species-specific drugs. They can also prescribe them even if there is an animal specific drug, but that would be “outside” or off-label use… the vet is on his/her own if something happens to the animal. Note that this last use is not rare. Many treatments that are considered standard of practice include use of human drugs (at an appropriate dosage)… The reason is that some pharmaceutical industries have decided that once a drug is approved for human use, they don’t want to go into the research and paperwork to get it animal-labeled.

Also, animal drugs can be more expensive if they have to be compounded due to the animal’s size (too small or too big), or if they have to be put into suspension instead of in a pill or tablet.

Veterinary malpractice is the correct term. I think the exact laws regarding how an owner can sue the vet for damages and malpractice varies by state, with some being like you mentioned, and others also adding suing for the medical costs. There was talk some of my classes about movements to include a “pain and suffering” clause.

31

Yeah, I can believe that. This was a dad and daughter with their bunny, but they had to treat everyone like potential abandoners. And for all I know, maybe they did have respectable-looking families giving fake info and leaving their critter behind.

I had a college roommate who bought an iguana of all things, and sure enough, within two years she had (fortunately) found him a home with a reptile owner with a lot of experience and plenty of room for large reptiles.

KarlGrenze, I had a ferret with a heart problem who needed digoxin in liquid form. They recommended either a veterinary compounding pharmacy, or just going to a human pharmacy, as human infants/toddlers with heart problems might be prescribed digoxin as well. I work at a medical center, so I went to the outpatient pharmacy at work, and handed over the prescription, with the name “Regina Herder” (Regina was the ferret’s name, ‘Herder’ being my own surname). The pharmacist looked at the scrip, did a double-take, and asked what the weight was of the infant. I told him it was an under-two-pound ferret, not a human, and he visibly relaxed. He thought it was a prescribing error.

32

Thank you for this - any thread where I have to stifle laughter to prevent unwanted coworker attention is a winner.

33

Quite true - I should have said this.

Regards,
Shodan

34

Sampiro, I don’t know about donating to help dogs in general, but most breeds have breed rescue organizations in need of support. Romansperson mentioned greyhound rescue; I support CorgiAid, which provides medical care for corgis and corgi mixes in rescue so they can get healthy enough to be adopted. As your dog is a rat terrier, you might be interested in contributing to American Rat Terrier Rescue; their web site says their dogs are “evaluated for general health and inoculated against distemper, corona, bordetella, paravirus, parvo and rabies. After the Rat Terrier is restored to good physical and emotional health and spayed or neutered the search begins for the best and most appropriate home.”

Look at the “Rescues” link and you’ll see some of the dogs they’ve sponsored: Louie, with his badly broken leg, Lucy with bad skin problems, Earl with epilepsy. Somebody has to pay for that. You say

There you go.

35

The University of Pennsylvania has a kidney transplant service for cats. A suitable donor is found at an animal shelter. One aspect of the program is that the owner of the cat that needs the transplant must adopt the donor kitty.
So, it’s sort of win-win.

It would be unethical for a veterinarian to tell someone that their pet was being euthanized and then so something else with it. A euthanasia permit does not transfer ownership and does not give the vet the right to do whatever he or she feels like doing with the animal. As matter of fact - most laws/ethics guidelines very clearly state that ownership or co-ownership of an animal IS NOT an acceptable form of payment for veterinary services. {This is to prevent the following set of circumstances from happening: A race horse with good potential as a brood mare has a medical problem. The vet. would love to own a piece of her so that he can get a portion of the price of all her foals. So the vet gives some extremely elevated price for treatment, but agrees to co-ownership instead}.

However, there are a fair number of people who would like their pet to get fixed, they just can’t afford it. They bring up the possibility of the vet. fixing it and finding a home for it. The vet. may have them sign over ownership of the animal along with a euthanasia permit. Then, when the animal becomes the property of the veterinary practice, it can be placed.

Where I practice we do it both ways - Either the owner signs a euthanasia permit or they sign a donation form. If their animal is donated they are told that we now hold all rights to the animal and we may try to fix it, or we may euthanize, or anything we please. I tell people that if they really want to know what the animal has and need a post mortem report, they should not donate it.

36

An ex co-worker of mine had a puppy put down because he had mange. It made me so angry I couldn’t speak. I would have taken the dog in a heartbeat.

My vet has done the same thing.

Holy Cow! You just jumped to the top of the Coolest Dopers Ever list.

37

Seconded. I’m just sorry for all the times I saw that “astride my Arabian” status and mistakenly cursed her for giving physical comfort and sensual rewards to terrorists.:wink: Were it not for my sister having my back I’d have availed myself.

I spent a long time at the vet’s today. Mardi’s doing as well as he’s supposed to be, zonked out but recognized me and crawled into my lap, though they said he’s being an ornery patient (which gives me more pride than it should; it’s such a cool thing that a defining family trait passed into our dogs [my mother once woke up from a coma to attack an orderly* and the 18 pound rat terrier fights against a sedative then clings to the bars with his mouth and paws to delay going to sleep and when the assistant removed his cone to bathe him and left to answer a phone call thinking he was passed out she returned to find he had pulled his IV out- sorry for the trouble to them but I love that little boy]).

I had a long talk with the Lesbian on Duty. (Not a judgment call, just an observation and one for which I’m glad-

GODFATHER:
Amerigo Bonasera: “For justice, you to Don Corleone.”

NORTHERN EXPOSURE:
Maurice Minnifield: “You want the best car you can get, you get you a Cadillac from Dee-troit and get a Cadillac, you want the best doctor, you get you a Jew from New York City.”

ME:
“You want the hightest caliber of post-op dog care, get you a middle aged lesbian vet assistant (and a Trekkie to boot).”

Anyway, we talked for a long while, super cool super caring woman. I asked about a couple of the things in this thread, including the ratio of cats to dogs. She’s been in the business for many years and said it’s the same here- way more dogs in the hospital than cats. She also said that while she herself is a dog person and while she loves cats she’s very grateful, because while Mardi has been ‘difficult’ (good boy!) he’s docile as a newborn pup compared to most cats who she says are by far the worst patients of household mammalian pets. (This particular clinic doesn’t treat birds or reptiles.)

Because they’re so much closer to the jungle or the savannas than dogs and are much more independent and feral they’re not likely to show pain until it’s unbearable, which often means by the time they come to the vet they require major surgery. She said that cats fight surgery every step of the way and that if they haven’t been declawed they often have to be as they’ll scratch and bite and attack any way they can from the time they’re brought in til they leave; she still has scars from a Persian years ago who didn’t particularly want to be anesthetized. After surgery they’re much harder to control, much more skilled at getting out of their cones or other restraints, and like my mother they only know that “I’m uncomfortable as hell and that bitch over there has something to do with it” [pretty much her words].

Just curious: is this the experience of others who’ve worked at vets?

*My mother was in ICU on amnesiac drugs and floating in and out of consciousness, rarely had any idea where she was or when it was on those occasions she had consciousness. When she came too after her medication had been reduced and she was in her first lucid moment in days it was to see a black male respiratory therapist with gold capped teeth hovering over her and checking her ventilation tube [she’d had a tracheotomy]. She reverted to wrestling training from 40+ years before to attack. He was stunned not just at the attack but the strength of the old woman. When she calmed down she apologized, and the nurse himself said “Look, you’re an old white lady, don’t know where you are except you’re in a bed, and there’s a big black guy with gold teeth in your face and holding you down… no offense taken, I’d have done the same thing. But damn baby, for a woman your age you got some serious adrenoline…”.

38

Ohio State provides free chemotherapy medications for all greyhounds, as well as free consultations for vets and owners on any greyhound health issue. I volunteer with the Greyhound Health and Wellness Program, and have seen firsthand how much time these consultations take out of their “normal” day… 3-4 hours, and they have clinic duty 7am-6pm every day on top of that. The stories of the dogs they have helped financially or paid for entirely is amazing, especially considering it is entirely funded by donations and the school itself does not pay a dime of it. These people truly are selfless, and spend their own money traveling to speak in educational forums around the world on top of all of that. As a greyhound owner, I feel very fortunate to live in Ohio and have Dr. Couto and his staff available for my pets. I know that they could not be in better hands.

One of my greyhounds was attacked by another dog the evening before Thanksgiving, and has already had 2 reconstructive surgeries in an attempt to save his leg. Though they are not involved in his care (he’s a surgical case), the doctors in the GHWP have all sought him out and spent time with him, even if it was just to get him out of his cage for a while and scratch behind his ears. Without us even asking, the GHWP offered to help allay some of the cost of his care as well, knowing that it would be astronomical.

We’ve already paid $1000 for his first surgery, and he’s been in the ICU since last week. We were told this morning that we still owe $2500, and that’s after the GHWP covered some of the cost. We’ve had a very tough year - we’ve had 2 greyhounds die since February, and just managed to pay off the over $10k in credit card debt we’d racked up in paying for their care. At Christmas, and at a time when we can ill afford any additional expenses, the GHWP has truly been a godsend. Without their assistance, we would have been in a situation where we would have had to seriously consider euthanizing.

39

Ask at your vet if they have programs for helping people who can’t afford bills. I occasionally also will throw some money toward the Humane Society’s account at my vet.

40

Uh, yeah. My jaw dropped. That was the coolest thing I’ve seen on these boards in my 8+ years, truthbot.

Does anyone have pet insurance? This thread made me look up some quotes. ASPCA seems to have decent rates that I wouldn’t feel ridiculous paying.