Was this vet bill appropriate and how would you have handled it?(long)

In My Humble Opinion
1

Two topics in one thread!

Here’s the story. I last had my 10 year old hairball factories in for a physical a year ago. At that time, the vet suggested a “routine senior physical” for each at $360 including exam, labs, urine and stool testing and X-rays. I was informed that this was an excellent deal since paying for each element alone would be much more expensive. Since I had not had them in to a doctor in several years (Bad owner!) I bit the bullet and took them in. According to the doctor and the tests, they both had dental disease and needed cleaning and the girl had a small benign lesion (probably a wart) that they could remove at the same time. The total bill was about $900, since I also had to pay for their vaccinations. Other than early kidney disease (slight protein in the urine but normal creatinine) they were otherwise healthy. I asked for an estimate for the dental work since this seemed very expensive. I was told that since they had already had their blood tests, the dental work would be only $400 each with extra for the wart removal and if they needed more than cleaning. I asked for a formal written estimate, which I never got and I let time slip away and never got the dental work (I know, bad BAD cat owner!)

Fast forward to this year. They have been healthy with no obvious problems but I noticed somebody was urinating in multiple small amounts. I was worried about a blockage, so called the vet and was told they had to be seen right away. I couldn’t cancel my work but agreed to drop them off the next day (Friday) and arranged to pick them up on Saturday with a vet appointment then to discuss the results. They told me that since it had been over a year they were due for their yearly senior checks. I asked if the same deal existed for the check and was told that the price for each cat would be about $275 plus vaccinations. I commented that this was less than last year and was told that this was the deal. I then asked how much the overnight boarding would be ($25 each) and how much each vaccination was ($20 each). They asked if I wanted their claws cut and I agreed ($10) each. I mentally added this up and figured that since I had spent close to $900 last year, it would be close to $1000 this year. After asking all these questions and feeling like I has annoyed them enough with the nickel-and-diming, I left them there and came back the next day. The verdict was that they were healthy. Nobody seemed to have bladder stones, and their kidney function had improved. They still needed the dental cleaning and the wart was unchanged (I’ve been watching it). I told them that I would need a written estimate for the dental work since I never got one last year.

I then went to check out and was presented with the bill, for slightly more than $1500. I looked at the charges and found that they had all been accurately quoted except for the senior physical, which was $650 per cat. When I asked why it was so much higher than last year, I was told that they had been undercharging for the area and that this was the new price. I then told them that I had been quoted $275 and I was told that this was the cost for a junior cat physical. They told me that they did not know who had given me the quote but it was wrong and I could pay in installments or they would arrange a convenient 0% credit card that would retroactively charge interest if I missed a payment.

Since I am one of those annoying people who will try to bargain for a price break on a floor sample or damaged goods, I told them that I had left the monsters on the assumption that I would pay ~ $1000 and that I couldn’t and wouldn’t pay 50% more than I had been quoted for the same services. They sent the manager, who went into the back and came back with $500 off as a “good customer discount” and I paid the rest and told them I definitely needed an estimate in writing for the dental work.

Today, I got the estimate with a low price for just the dental work and wart removal and a high price if an extractions were needed. Since the previous year, I was quoted $400 each for dental cleaning and an additional $100 for the wart removal, I was thinking about another $1000. They are asking $1400 minimum and up to $2700 maximum ($450 each for dental work, $500 for the wart, and $500 each for any extractions needed). What I would like to know is if this seems out of line. I know that they need anesthesia but when my cat ate a penny and had a major abdominal resection complicated by breathing problems and a night in ICU, it only cost $3000, including the ER visit. I like this vet but the prices seem a little steep. Do most people spend $750 yearly on a physical for a cat and $500-1000 for dental cleaning?

I do want to do right by the little dustmops and I will be getting additional quotes, but I just wanted to know if I am way off-base and this is the cost of having pets. (For comparison purposes, I charge about $220 for a human senior physical (of which medicare pays $120) but of course that does not include labs and x-rays.)

Finally, was I wrong to bargain for the price? I certainly want people to get what their services are worth but I was upset that it was so much more than I had been quoted and frankly, I would have gotten other quotes if I had known it would be so much.

TL;DR What is a usual amount to pay for a cat senior physical and/or for dental cleaning and possible extraction and wart removal?

2

Wow! I want to be your vet.

Full physical for my 5 year old cat = $120. Dental = $75 to $150, if there were extractions. I know you asked about senior cats, but I can’t believe that they are that much more expensive. Even at double the cost, a physical would be $240 and a dental $300.

I strongly urge you to shop around. I have been amazed at the differences in pricing among vets. The small animal vet I use now (prices quoted above) has been terrific, accessible on the phone, clearly knows her stuff, and hasn’t push procedures that my cat doesn’t need just to pad her bottom line. I’ve been with her for three years now.

3

I think these prices are very high. I had dental work done on a cat in California: cleaning plus extractions (2) for around $350. That included the pre-anesthetic blood work. Here in TX I had the same cleaning plus extractions more recently and it was about $375. (I think the work in California would probably be more now.) I also had a senior physical done in Texas for $45 but it didn’t include any x-rays. What were those for, do you know? It also didn’t include urine and stool testing. I can see the point of those but don’t think they should add on more than $100 or so. It seems like overdoing things to do all those tests annually.

I think your vet is really overselling you and then overcharging you, and I would shop around. Don’t let the vet guilt you into something! You are NOT a bad cat owner. And by the way, what did the vet have to say about the multiple small amounts of urine, which is what took you there in the first place?

4

My vet always gives me a written estimate of all services at the time I drop my cats off. If the bill is going to vary from that, she calls me before performing the service. I am guessing you did not get a similar written estimate when you dropped off your cats. That seems strange to me.

We recently had a kitty need dental work and had 6 extractions. It was in the $750 range.

I second the advice to shop around.

5

I wasn’t sure if I was correct, so I just grabbed the bill:

Cleaning fee: $79.26
Full X-rays: $119.50
Extractions (six): $348

The rest of the bill was for anesthesia and meds and stuff. The total ended up being quite a bit more than the estimate in this case because Smokey ended up having an infection and needed more meds and stuff.

6

Wow. I AM a bad pet owner because I hardly ever get my cats to the vet. They are indoor only cats. My dogs go once a year for rabies, heartworm etc and occasional teeth cleaning. My bill for teeth cleaning 200 for everything but blood work.

7

The area where you live has some factor as to what vets in the area charge, so some answers you get here may not match up to your market, but I’m in Chicago and those charges sound a little steep.

First, well cat exams shouldn’t stretch the budget, and x-rays? If there’s no problem being presented, there’s no reason for xrays at all. Vaccines, as long as they’re on schedule in the beginning, should only be needed every three years. If the boosters last year were really late by a few years, the ones you got this year should be good for three. If the kitties live indoors, and they have no poop problems, then a fecal is also unnecessary. All a vet should be doing for older kitties with no health concerns is: exam, bloodwork, urinalysis, vaccines (once boosters are on-schedule, then those are only every three years).

Your vet is shafting his/her clients if every well pet exam includes x-rays. That’s ridiculous.

I’m not current on what normal dentals these days cost, since I do shelter and ER work, but that pricing still sounds pretty high to me. A dental should include dental x-rays, or they won’t know if any extractions include the whole root and roots left behind can cause problems, nor will they be able to detect resorptive issues that are below the gumline. If the vet is using all/most of the anesthesia and monitoring equipment plus a dedicated anesthesia tech, administering IV fluids and doing x-rays, then I would think $500 plus extractions is reasonable. Even if they have to take the time to section teeth to extract them, the most I’ve seen charged for that is $100 to $150 for a canine that’s difficult (you do have to be careful especially with cat canines, you can break their jaw if you’re not careful and take your time - but still, $500 each is outrageous) The longest cat dental I’ve seen was 3 hours. Even at $100 an hour for the vet to charge extra time, that’s all it is, extra time for difficult extractions, there’s no extra equipment.

Definitely shop around. Of course you pay more for a vet who uses the best quality care and all the equipment and extra people it takes to do that, but this one is doing unnecessary procedures already.

And yes, having you drop off the cats without giving you a written estimate and taking a deposit based on that estimate seems shady to me, too. When we have people leave their pets even for a few hours at the ER, they leave a deposit and also sign forms stating they are leaving their pet in our care, an agreement needed for both parties because what if something happens?

8

I believe the X-rays this year were to see if there were bladder stones which were not seen. They don’t know about the urinary symptoms but suggested prescription food (Hill’s C/D).

The dental breakdown was:
Dental: $235
X-rays:$121
Fluids $35
Preventative water additive (Healthy mouth cat jug) $50
Extractions (if needed $356 for one cat $534 for the other)-not sure if this is per tooth or for all if needed-but the units are 20 for 1st cat and 30 for the second so it sounds like per tooth-how many teeth does a cat have?

Wart removal-$500-$850 (this is a 2-3 mm nodule that would take at most one stitch)-covers pain meds and biopsy.

As far as vaccines go, they say they don’t give the 3-year rabies. I’m a little upset because they gave me the papers for them with the tags stapled on but they both had the same cat’s name.

I am also in the DC area which is very expensive. I went to this clinic because I really liked my initial vet who has unfortunately now died. I don’t mind seeing another vet but I don’t want to have to pay for an entire consultation and repeat labs when they were just done. It is also very stressful for the cats (and me) to get them into the carrier and to the vet. Would a new vet require an extensive initial visit before doing dental work?

9

The new vet should be satisfied with records sent from the old one. They would be mostly concerned to see recent bloodwork to make sure they’re healthy for anesthesia. Whether they would want an initial visit to meet you and do a physical on kitties, or will be fine scheduling the dentals with forwarded records first, depends on the vet.

Honestly the wart removal sounds like a ripoff since the cat will already be anesthetized. It could be 2-3 stitches if the vet takes huge margins, but really that sounds to me like a lot. The lab charge for the biopsy may be the culprit, but they should be able to itemize that. The Idexx lab I use would charge me $100 and then it’s my discretion how much to charge the client, but seriously they shouldn’t charge more than $200 for the biopsy. And then where is the rest of the expense, the cat is already anesthetized, the excision will take a whole couple minutes. I would have a problem with the amount of that charge.

As to tooth extractions, cats have 30 teeth. If they’re 10 years old and never had dentals before, it’s possible they need whole or nearly whole mouth extractions, but that’s not usual without some other pathology like FIV or chronic stomatitis happening. If the “unit” quote really is per tooth, then they’re planning to take pretty much all of them out. That’s some pretty horrific dental disease I would think you’d already be aware of due to super-stank breath and teeth already rotting and falling out. Like, you would already be noticing a problem on that scale with cherry red gums and brown teeth and lots of goo. So, I don’t think I can really have an opinion on that without seeing your poor kitties’ mouths.

With the complaint this year of inappropriate urination, a single lateral x-ray for each (if you didn’t know who was doing the peeing) seems reasonable. It sounds like they were done for no reason last year though? If the vet thinks there may be a case of idiopathic cystitis going on, then the Rx for c/d is also reasonable, though you may get similar results by feeding canned food only (any brand - I feed mine Friskies for reals) and adding some water as well. (I add 3 tablespoons water to each 5.5oz can) Also adding a fountain to encourage drinking more can really help a cystitis cat.

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Also, if you do change vets, I recommend you pick up the records from your current vet and deliver them yourself. This is based on my experience. I even had to go twice because they “couldn’t find” the file the first time. (Note: have had similar experiences with people doctors!)

11

You are way overpaying, and yearly x-raying as part of a wellness check is not appropriate.
You shouldn’t choose your vet based on price, but this one sounds downright unethical.

12

I live in NYC and those prices seem extremely high to me. I’ve had a cat to the specialist/emergency vet at 3am on a sunday, they did a physical exam, blood tests, put her in an oxygen cube, did an ultrasound and finally a surgical procedure with anesthesia, all on an emergency basis, and it cost about $500.

$275 for a standard well-cat physical is outrageous. I think my vet’s basic wellness exam is about $85. We don’t live in a poor area of NYC either.

Also, my vet wouldn’t dream of doing work without me signing off on a list of agreed procedures with specific (not estimated) prices.

The whole thing seems quite shady/unethical to me. Especially the yearly vaccinations when they are not even recommended anymore. (see, American Association of Feline Practitioners recommends most boosters every 3 years for indoor pet cats).

13

Er… what? Biopsy? For a wart? From a cat?

14

There’s a lot that sounds wonky about this, tbh. Routine screening radiographs on healthy animals, not giving you a written quote, misquoting you and telling you they have no idea who gave you the estimate…it’s all very :dubious:

Standard recommendations around here are for an exam, vaccines, and fecal every year, and a full panel with thyroid for everyone over 7. (And a heartworm test for dogs.) That runs around $200. Urinalysis if the pet is having problems, has had problems in the past, or the kidney values have been wonky previously, and that’s another $30 or so. Films are only for specific medical complaints, never just on the off chance the owner hasn’t noticed something that will show up on films. I don’t even know how you’d take diagnostic quality x-rays without knowing where to focus and what sort of tissue you’re most interested in.

Not giving someone an estimate is just plain bullshit, especially for something basic like a dental. If they have a standard price for a senior annual, they have a standard price for an uncomplicated dental. Every practice I ever worked in that did primary care has had a list of “quick quotes” for the stuff people price shop the most–routine vaccines, spays, neuters, dentals, etc. If for some reason your pet is likely to not be a standard dental–high grade dental disease with probably extractions, increased anesthetic risk, etc, it’s their job to check with the vet and call you later, or mail you an estimate. Don’t even get me started on a practice that will let you leave a pet off without signed consent forms and a signed estimate.

Also, bullshit they don’t know who gave you that quote. If they pulled that price up in the computer, they’re supposed to save that estimate, and the saved estimate shows up under the login of the person who put it together. If the person checking you in just told you orally, he or she remembers someone dropping off two cats, one of whom has a potential blockage. Believe me, checking in something that can turn into emergency surgery and jack up the whole schedule sticks in your mind.

15

I’ll agree with the others that those prices sound high. But more, this place doesn’t seem to be run the way I want the vet I go to to be run. I want things in writing. I don’t want surprises in my bill. I want to be consulted about things (obviously, not in the middle of surgery). And I want them to stand by what they say.

16

Even with blood tests my cat’s basic wellness exam comes to $115. $45 for the exam, $70 for the blood test. And I’m in a fairly to-do sort of area just outside of NYC. Granted, he’s not a senior cat but $650 sounds ridiculous regardless.

Extractions are pricey stuff if you have to get a lot. My poor cat needed to have ~90% of his teeth removed due to stomatitis and the whole bill, with cleaning of the few remaining teeth, with anasthesia and painkillers and everything, was $1,800. That your vet would ask for $500 for “any” extractions needed is just off the wall. I know it’s going to be $200 for the anasthesia and the painkillers alone, but a single tooth by itself shouldn’t cost more than $120 to remove if it’s complicated, and closer to $50 if it’s easy to get out.

The whole business sounds a bit fishy and I’d ask around at other vets. Definitely get written estimates. I wouldn’t continue business at your vet if they’re going to do bait and switch tactics on estimates they refuse to put in writing.

17

You need to find a different vet. I think this one graduated from the P.T. Barnum School of Veterinary Medicine.

They are going to try to upsell you on everything they can think of, from now on. The part where they jack up the price by 50% and then give you a “Good Customer” discount when you complain is more or less definitive. What it means is “oops, she didn’t fall for it, so we better try to schedule a senior-cat exam every year with X-rays and lab tests on an asymtomatic cat until she wises up”. $800 to remove a wart?

Find another vet.

Regards,
Shodan, Whose Father Was in Small Animal Practice for 40 Years

18

I’d leave based solely on the switcheroo on the price of the physicals. $650 for an annual visit is ridiculous. And jumping the rate from $275 “junior cat” to $650 “senior cat” is equally ridiculous.

19

As best as I can tell, the dental quote looks to be about $450 for each cat with another $17-18 for each tooth they extract. Based on what I see here, the dental X-ray price seems OK but the $235 for the entire dental cleaning and anesthesia may be high. They tell me they can’t tell if any teeth need extraction until they get in and examine them.

As for the wart removal, it does sound somewhat high. Last year I could swear the vet told me it would be about $100 extra to remove it which sounded reasonable.

Also, it’s not that they refused to give me an estimate. I literally had to rush to drop the cats off on my way to work and I was asking quickly. They did have me sign a consent which listed all of the procedures but just not the prices but I asked about each individual thing (boarding, clipping claws, vaccinations) and all of the prices they gave me were accurate except for the senior physical price. Like I noted above, they did give me a written estimate for the dental and the wart removal with both a baseline price if there are no complications and a high price (and like I said, I assume that the extra $500+ dollars for extractions is if they have to pull every tooth, which I think is doubtful).

It sounds as if the major concern that people have is the X-ray. To be honest, I did it last year because it was included as part of the physical and because Boris has asthma. This year, they told me it would help to show if there were bladder stones. The labs seem pretty standard, though and they were included in the physical price. Both of the cats also have some protein in their urine, which does suggest early kidney disease, so I think a yearly urine is appropriate. This practice does actually recommend that senior cats get a routine check every 6 months and a full physical yearly, but I think that this is ridiculous.

I actually like the vet himself, but the practice is run by a big group and I don’t think he sets the prices himself. I think I may check around on the dental, but I am hoping I can find somebody to do it without requiring a lot of additional testing and visits first. I just worry because Boris almost died the last time he had anesthesia which is partially why I put off the cleaning last year.

20

Also-I don’t have any recent pictures but I do know the rules, so here isBoris as a kitten.