The bigger question I have is , WHY they try to guilt you into things that do not need done.  I am a rescuer of puppymill dogs, I have seen it all and am very knowledgable.  A foster mom of mine took an extremely emaciated mill dog into the loacl ER Vet, rather than drive the 45 minutes to meet our normal vet, after the dog collapsed.  I spoke to them on the phone and they were trying to rack it up , by wanting x-rays of a dog that has never left a 2x2 cage in her life.  Was obviously dehydrated and starved to the most ignorant person on the planet. 

I am sure I thoughly piss off the Vet on the phone , she had no interest in listening to me at all.  How can you treat an animal , without listening to what the problem is.   

I phoned my own Vet who immediately told me we fed her to much to fast and to stop it.   NO CHARGE for this advice, or any on the phone advice. ( Must be that $20k a year I spend in his office. ) I picked her up from the ER clinic the next morning after they gave her the fluids and took her to my own Vet.  Where she stayed another week in intensive care. No x-rays were called for , she was STARVED on purpose as she quit producing.

Mary Stickney   and Susie  www.maryshouse.us/susie-peke.htm

Mary Stickney June 19th, 2009 01:53:21 PM

I don't use emergency clinics frequently.

I totally understand charging double for after-hours tech and vet time., maybe even a bit more. This walk through the door fee charge followed by a consultation fee seems out-of-line. Clients are paying twice.

Where I would draw the line would be higher rates for medications, X-rays, blood work etc. Why would these be any more costly during the night? The supplies cost the same and the equipment is there.

No regular human hospital would double the rates (at least not in Canada) if you had a heart attack during the night.

Jean June 19th, 2009 01:55:52 PM

The only thing my E-vet charges more for is the actual clinic fee, it's twice as much as normal daytime hours and thankfully he will do an on the phone consult to find out if it's something that can wait until the morning rather than say 'bring them in' as I've had one after hours clinic do for something that should have waited until morning.

I don't understand why medicine, blood workups, xrays would be more though as another poster mentioned, doesn't make sense.

Katrina June 19th, 2009 02:00:30 PM

My emergency vet charges a $200 walk-though-the-door fee, and then around 1.5-2x the normal cost for everything else (including the actual meeting with the vet).  This is not what bothers me though.  What bothers me is that (1) the closest 24/7 emergency vet that will see birds is an hour and a half drive away from me, and (2) they do not have an avian vet on staff 24/7 so who I actually see when I walk in the door is a generic "emergency vet" who may have minimal training in avians.  Why should I pay the same premium as someone with a large cat or dog, when chances are the vet treating my little conure or cockatiel has never actually worked on a bird?  Also the cat and dog owners can look elsewhere if they find it too costly at this hospital, and likely don't have to drive an hour and a half to get it. 

zandperl June 19th, 2009 02:13:08 PM

Like when an after hours euthanasia that couldn't wait went for $600 instead of $150.

Could you explain that a little.  Both numbers.

PBurns June 19th, 2009 02:19:16 PM

Not all emergencies are after-hours, and the whole "I'll see your emergency when you bring it in and for however long it needs" really is a premium, worth the price. 

We had 2 dogs getting their annual exams when an emergency came in last month.  Our vet had to leave in the middle of the exam, was gone for as long as it took an off-duty vet to make it into the hospital and take over.  Once she wrapped up our visit, I know she went back and both vets were working on that emergency (while regular appointments stacked up in the waiting room).  We told them repeatedly that we didn't mind, we didn't have anywhere to be and if it were our dog, we'd certainly want her on the emergency, not the non-urgent regular apptmt.  Even so, they ended up dicounting our visit and giving us part of it for free.  That emergency took one vet away from regular work, brought in a vet who was off-duty, and cost them income from our appointment and likely the next few after us.

I can completely understand emergency fees, during business hours or after.  During, you're disrupting the schedule and you're paying a premium to get your pet cared for NOW.  After hours, you're paying a premium because you can't wait for a regular appointment during regular hours.  Just to have someone on duty is an inconvenience, and so it costs more.

I might be more bitter on this if my most recent emergency vet visit hadn't been, by sheer coincidence, my regular vet on duty.  She knows our dog well :) and was willing to accomodate his quirks (and resultingly it ended up less expensive).  But even so, simply having a vet available at all for an immediate emergency is a privilege, not a right.  It's appropriate to pay extra.

Galadriel June 19th, 2009 02:22:40 PM

I'd consider double the normal rate fair. I fully understand and accept that I'm going to have to pay a premium on emergency services performed outside normal business hours (and I charge a premium for rush jobs in my own industry, that require me to work late or long hours.) If there's a premium charge for shipping and processing lab work faster than average then that's fair, too.

I think when you're getting beyond 2-3 times the usual price (and three times the normal price would be pushing it for me) then that's just getting exploitive. You're taking advantage of people who have few or no other choices, during a very distressing and emotional time. Adding on services that aren't necessary but that will help rack up the bill is down right abusive - only necessary procedures should be recommended and performed at emergency rates (or procedures that are requested by the client, though I think it behooves vets to inform clients when situations they are panicked about aren't genuine emergencies.)

I don't think a 1000% markup is justifiable - there's no way that is related to actual increase in expenses, and if doing emergency work is so inconvenient to you that you feel it's only worth your time if you mark it up that much, then you should leave emergency services to someone else.

When it comes right down to it, emergency vet or regular vet, your clients should be able to trust you to be looking out for your best interests. Services and advice should be provided with what is right and reasonable for the pet, not with their own pocketbook top of mind. Vets and their staff deserve to be fairly compensated for the crappy scheduling and rush nature of emergency care, but they also need to treat their clients fairly and with respect - we're real people, not dollar signs.

Quite frankly, even though I believe double the normal rate for emergency services is reasonable, I'd still have a hard time swallowing it (it'd have to be a real emergency.) I find routine vet care to be pretty expensive (though I understand why and I don't begrudge vets the rates they charge at all.) Maybe part of it is living in Canada with socialized health care, where the costs for medical care are invisible (paid by taxes.) Going to the emergency room, getting a check up, even having surgery costs me nothing out of pocket. When you compare that to the regular cost of vet care, it's kind of shocking. Paying double even more so.

Anlina Sheng - abnormalloveofcats.com June 19th, 2009 02:24:27 PM

I know the one I just used this week was high. But the dog was very sick. VERY sick. I had no complaints about the ER portion. But at 8:30 in the morning I was asked if I wanted him transferred to the internist side (I took over care at that point) and said yes...they asked me for another deposit. (Owner paid the first  one for the ER) So at 9:00 they did an official intake (which by the way left him in the same building, same cage same everything, just a specialty intern doc looking at him, not the ER docs). I didnt care, I was trying to save him. 850 bucks. Within 3 hours (and after only doing a sonogram) she tells me she isn't sure of his prognosis, its very bleak. (this informaion was known from prior - as she said the sono showed not much they didnt already know) So I made the tough choice to let him go.

The next line was - its going to be an adition 350 on top of the 850. A small portion of that IS for cremation BUT what the heck? You just had 3000 paid to you for the 3 days he was in the ER. You ONLY looked at the chart and did a sono? I Know darn well that there was no need for the 1200 spent. I honestly did not have the 1200 to spend, but I wanted to do the right thing. WHile I know they worked hard on him, I feel that last bill was highly unfair.

LW June 19th, 2009 02:28:07 PM

We have a 24-hour emergency veterinary clinic minutes from our home. Everyone knows it is $125.0 to walk through the door - pretty much if you live anywhere in the area you know that upfront. When our cocker spaniel injured its back on a Sunday morning, I was happy to go right over. We signed off the on the paperwork to be seen which outlined the cost - again $125.00 to be seen, plus anything extra. The vet came in, examined the dog, listened to his history and prescribed an anti-infammatory and a pain med and encouraged us to take our dog to our regular vet the next day. Offered to take x-rays if it would make us feel better (not because they felt it was needed) but said the pain was probably due to previous abuse (he is a rescue) and age. Total cost? $156.00. When our corgi blew out his knee, repeat performance on a Sunday. Different vet, same deal. Keep the dog comfy until morning since he was not in pain and happy and get to our regular vet. Total cost? $160.00. I checked around with friends and obviously if you have a dog that has been hit by a car or something else which is life-threatening, then yes, there is going to be a fairly high bill. But when I studied our bills I noticed that the costs were marked up to where I thought it was incredibly fair. (I can spend $150.00 at our regular vet in a heartbeat even when nothing is wrong because our dogs are older and seem prone to age related moments).

We do have a veterinarian in our area with a state-of-the-art clinic that we could never afford and emegency care would be out of the question if we had to go there. But they have a clientele that can support them. We are just very lucky to have an emergency clinic that seems fair and doesn't prescribe what is not needed and ultimately offers the owner choices.

On a funny note: When we took our corgi in because he blew out his knee, the vet hobbled in a crutches because he had done the exact same thing to his knee playing rugby the day before. He sat down on the floor t examine Dozer and was so funny and nice.

I know, I know, we are blessed - how else could we afford to take in a 14 year old corgi and an 11 year old cocker spaniel (in addition to our wild child 4 year old corgi?)

Nancy http://www.dozerandcoop.blogspot.com

Nancy in Oregon June 19th, 2009 02:30:51 PM

Great topic.

We have one in the Kansas City area and the rates seems to run about 1 to 1.5x more than non-emergency services.  Many people complain about the rates, but honestly, it's worth every penny when you need the services at an odd hour.

I figure there is an inherant cost with the security/staff late at night.  But I also think that there is more cost associated with the fact that there is staff there, but they aren't always necessarily working. If I come in at 3 am -- I may be paying for the fact that they had no customers at 2 am and need to pay their salaries.

I get that. 1 - 1.5x should be about the right amount though IMO.

Brent June 19th, 2009 02:42:37 PM

I would also like to know the reasoning behind the "euthanasia went for $600".  There MUST be an extraordinary story behind that one.

I also ask you, when you went to vet school, you didn't expect to get rich, nor did you expect emergency shifts would be your lifeline.  Did you?  As far as the rediculous emergency costs many vets charge, it would serve them well to remind themselves WHY they wanted to be a vet.

I've been in both situations, working in the emergency clinic as well as being the client.  As the caregiver, I cringed every time a vet would charge outrageous fees to the owner in most of the cases (i.e., an abcess, a porcupine quill case, a fish hook in the mouth, etc), and wanted to walk out when a vet would charge outrageous fees on a simple procedure, yet the pet stays overnight for observation, at a few bucks an hour for "ICU", and the morning vet gets the "normal business hours" pay for continuing the treatment.  To be fair, major surgery cases most often justify the costs. It's the simpler procedures with a high price that irks me.

I'm also sorry to say, while vets may make double the pay for an emergency shift, most technicians certainly do not.  They will be lucky if they make time and a half. 

Vets really can't compare their emergency clinics with a human emergency clinic.  Humans get to wait around for HOURS before seeing a physician, and usually, that's only an assistant, not a medical doctor.  Insurance often covers emergencies for humans, not so for pet owners without pet insurance.  

Some of it is about competiton.  But, it shouldn't be a competition between price factors affecting the quality of life or saving lives.  Considering the average life of a pet, pet owners often pay more to their vets than their own human physicians.

lexipup June 19th, 2009 02:47:32 PM

I have had similar issues to other commenters. Specifically I have parrots, there are two emergency clinics that service birds in my area, both nearly an hour away. One staffs an avian vet, so you need to call ahead of time to see if they are available, the other prides itself on having one at all times. The one that has one available at all times is a 24/7 clinic who charges $120 for visits 12am-8am and holidays, $95 all other times.

When I took my bird to the (always avian vet staffed) emergency vet last, I was treated by a vet who OBVIOUSLY didn't know the first thing about birds (she told me my bird who was fluffed on the bottom of the cage, panting and vommiting was just having arthritis pain), then they wanted to charge me $600 in diagnostics. She had to consult an off duty vet several times and research in text books. I OK'ed a fecal $30, and the determined cause was a GI infection like I guessed. $20 in antibiotics and my bird pulled through ok.

That case didn't seem like it was very fair, I can understand emergency care being more costly as a convienience factor and high stress levels, but pushing for uncessary tests that can wait, or upcharging routine tests seems obnoxious. Especially when the vet was not any more capable than the $60 er clinic 5 miles down the road from me.

spazzy June 19th, 2009 02:56:40 PM

I guess I have been spoiled by Europe or it is just the vet I go to here in Heidelberg, Germany.  Walking in without an appointment during regular hours will not cost you any more than if you had an appointment; you just have to wait for a break in the appointments and this doesn't usually take long.  For after-hours care there is a 15 Euro (~$23)fee.  That's it.  Prices for services remain the same.  It is less expensive for me to take the dogs in on a Saturday afternoon/evening for routine work than to take time off work.  The way I understand they are set-up that it is primarily a everyday family practice (but not everyone is related), the duty vet has a room with a bed, TV, microwave, etc., and 5 vets rotate through.  Once I needed X-Rays for a broken jaw on a Sunday and I had to come back the next day when a second vet was there due to the need for anesthesia for the X-rays.

Lee in Germany June 19th, 2009 02:56:53 PM

Honestly, it's great to have emergency services nearby, but how do you really know what's an emergency? Every time I've called for advice I've always asked them, "Is it something that can wait until tomorrow or not?" I've never, ever been told to wait until morning, even when it turns out not to be an actual emergency. When my cat was throwing up and not eating last night, I thought going to the Vet ER, but frankly, I'm still paying off the last visit. I couldn't afford to take him, and I'm so glad he's okay today. I don't think the vet ERs really care that much about our cats and dogs, or us for that matter. They seem to be in it for the money.

Elizabeth June 19th, 2009 03:04:00 PM

Think I'll keep my vets.. I was at a conference, and my brittney past away at my mom's house..  at 11:00 p.m  My brother called, and the vet told him to meet him at the clinic.. The total charge was for handling the body.. and I got a hand written sympathy card.. I've met the vet at 6:30 a.m. when Socks had bronchitis.. I was charged for a visit, and 1/2.. Considering I live on Long Island, I don't think it was too much.. I've never had the need to go to an emergency clinic, and hopefully I won't..

barri June 19th, 2009 03:20:05 PM

As to the euthanasia: I actually did the math for this one about a year back (directly from the invoice) but for some reason I can't find the post. It went like this, though:

About $100 for the emergency fee. About $200 for the drugs (a two-injection protocol) and another $300 for the cremation (not a private).

I was told (when I called to get an explanation) that the E-clinic rents freezer space from the day clinic and that their markup has to be high (even on non-private cremations) to sustain that overhead (BS). And $100 per injection on a cat? (This was a CAT!) That's way more than a 1,000% markup. Nice, right?

I think it's cruel.

Dr. Patty Khuly June 19th, 2009 03:20:46 PM

Elizabeth: Having worked emergency ad nauseum, I can tell you that it's our party line: if you're not sure, bring him in. And how can WE be sure not knowing your pet? 

Lexipup: Right out of school (in 1995) I made $40K a year working three nights a week while still in grad school. It was enough to pay for my business school tuition (and not much more, even then) but it was a fortune back in those days. The ER shifts sucked (bad!) but they were my lifeline. I think a lot of new grads consider them the same way I did then. Only now they make $75K for what I did. But then, my business school runs about $50K a year today, too. 

Dr. Patty Khuly June 19th, 2009 03:29:35 PM

There are several emergency clinics within 30 minutes of my home.  One I don't use after the first time because they do want to give you every test known to veterinary medicine.  The new rage, at least in my area, is that regular veterinary clinics are staying open till about 10:00pm during the week and are open on both Saturday and Sunday.  What will that do to emergency clinics?

My regular vet charges $53.00 for an office visit and the emergency clinic I use charges $93.00.  I really like the vets there and they haven't done anything I believe is unreasonable.  When my CRF cat started walking like she was drunk I raced her in and they kept her overnight and took really good care of her.  That was about 2 years ago and I remember being shocked when I got the bill.  Not because the bill was too high, but because I thought it was so low.  When my puppy got a hook stuck under her eyelid and another one of my dogs ate tampons I was really glad there was someone I liked and trusted to take care of my animals when my regular vet was not available.

Last visit on 12/3/08 to check my puppies eye after getting the hook stuck under her eyelid cost me $148.00

Emergency visit and exam $93.00  Flouresceine Dye Test $25.00  Ketoprofen 100mg/ML Inj $30.00  Is that alot of money?  I didn't think so to make sure my dog's eye was fine.

One more nice thing is that alot of the techs that work at the emergency clinic also work at my regular vets clinic, so it feels comfortable.

C. Lynch June 19th, 2009 03:36:20 PM

Thanks for explaining the euthanasia story.  Talk about adding insult to injury, literally.  How the heck does one get away with a $300 NON-private cremation!  (I won't even get into the two-injection procedure costing $200)

I assume at the time, you were a colleague in practice, and had to conform to such policies?  Darn office politics, can't live with 'em, can't live without 'em.

lexipup June 19th, 2009 03:46:21 PM

I had to take my dog in on an emergency once during Easter weekend.... he had an obstruction.  I didn't care what the bill the was, I just wanted him alive. 

When we came to visit the next morning we took donuts... the Dr. on staff hadn't eaten all night, he was grateful!!

JH June 19th, 2009 03:57:13 PM

Is anyone else out there in a place that has no emergency vets?  We are at least an hour's drive from the nearest one, so all our clients want our vet to take care of it.  He tried at one point to do so, and put himself in the hospital from exhaustion!  Now, if someone calls after 10:00, the answering service is supposed to refer them to the emergency clinic an hour away.  However, many of our clients have the doctor's home number (what can I say, it's a small town!), so they call him directly, and he crawls out of bed to meet them at the clinic.  Last weekend he was removing porcupine quills at 3:00 a.m. - and it wasn't even a pet belonging to a client of ours (don't know how they got his number)!  He needs to set limits, and he needs to charge more for visits like that.  Right now, a regular office visit is $40, and an emergency visit (which he often doesn't charge) is $75.  We need another vet!  If anyone knows of a vet who would like a job in a great small town at a busy, growing practice, send 'em my way!  Of course, after that description, who would want the job!

Sassy June 19th, 2009 04:04:35 PM

Our local emergency vet is fantastic. They automatically tack on an extra $200 for the emergency fee, and that's it -- everything else is the regular price. They do *not* do regular clinic care, they don't do vaccinations, checkups, etc... they're basically like a hospital ER, but for animals.

They're also excellent at triage. I once went with my sick ferret after hours, and while she needed care (broken toe after a spat with another ferret, I wasn't willing to wait until I could *maybe* get an appointment with my regular vet the next day), a dog came in who was at deaths door -- obviously took precedence. We had to wait a LONG time -- about 3 hours, I think. They waived the emergency fee for me due to the fact that we'd waited so long.

Having been back to that clinic a few times (including when my last ferret had to be put down -- I also think they're the most compassionate vets I've ever had the pleasure of working with) I can say that the emergency fee is worth every penny, but at the same time I'm glad they don't gouge. :)

Donna June 19th, 2009 04:24:15 PM

I forget what they're called, but some bigger hospital (human) systems have after-hour clinics that aren't for actual life-threatening emergencies, but for things that still can't wait until normal business hours or weekdays. I'm wondering if private vet offices might benefit doing something similar. I don't know how our current financial crisis is affecting licensed vets, but I bet there'd be at least a few suitable people willing to train to become vet techs to fill the shifts.

If someone's visit to the after-hours animal clinic wasn't jacked-up with unneccessary test and a super expensive walk-through-the-door charge, the vet's office might bring in new regular clients.

Of course there's the extra cost of a licensed vet working after hours, but if newer vets are having a difficult time finding jobs in this economy, use them and have a more experienced vet on call for the heavier cases.

Shreela June 19th, 2009 04:27:43 PM

The emergency vet I've used seems pretty reasonable pricewise. When I brought my cat in after a rough and tumble session with the other cat (ending with a horrifying shriek), I was pretty sure I was dealing with a scratched cornea.

 Yep - we did the dye/flourascope thing and left with some eyes drops for pain and a cone.

 I think the bill was around $200. And at 1:30 AM when this little play accident happened, I was happy to have them available.  And BTW - the cab ride there and back was almost $40.

A friend of mine brought her cat to the same place after she hadn't eaten in several days and started to go down hill rapidly. Because there was no obvious medical problems they did have to run blood tests and do some x-rays. But what do you expect if you bring in an animal with an undetermined serious condition?  Poor kitty had cancer all through her bowel and had to be put to sleep. I think her bill ended up being about $1,000. I think it would have run around $600-700 at our regular vet (we go to the same practice), so this also doesn't seem unreasonable to me.

What I really appreciate is that all the vet techs at my regular vet take a rotation through this ER Vet practice so the coordination of care afterwords is seemless. I received a call from my regular vet the next day asking how my kitty was doing and setting up a follow up appointment.

2CatMom June 19th, 2009 05:36:35 PM

I've only ever had to take a pet to the ER once.  I had a cat vomiting frequently and not eating.  This had started on a Friday and I was told by my regular vet to just keep an eye on her but if it got worse I'd have to take her in.

So of course she gets worse and after a particularly bad repeated vomiting episode a little after midnight Sun. morning I took her to the ER.

They did a digital x-ray, said she was constipated (at this point I had nightmares of having a second megacolon cat), and they gave her an enema and some fluids. 

We waited about an hour or so and the told me to take her home and see if she would poop, mix some pumpkin in her food and force feed her if necessary.  Total cost $160 but I did get a discount of about $40 off of the bill.

So I dutifully did this, and by Monday she was still not eating, not pooping, and still vomiting.  So I took her to my vet who said she had a fever of about 103 and had a respiratory infection, and was not constipated.  The regular vet gave her some antibiotics and she was back to eating one day later and the vomiting ceased.  By the middle of the week she was acting just fine.

So when her sister started doing the same thing I just took her in, we did the same thing, and she also recovered just fine.

I had no issues with $160 for what the ER vets did at all.  However I was a bit ticked off that they apparently misdiagnosed my kitty after all that.

cl June 19th, 2009 05:42:50 PM

My 13 year old Berner mix (it's a miracle a member of this breed lived to double digits in the first place) crashed on us on a Sunday afternoon.  Gums were gray, he was coughing blood and he colapsed on us.  He was in obvious distress when we walked in the door of the ER Clinic.  I was prepared for euthanasia as we walked in, my husband was not.  After soaking us for astronomical fees for an IV as his blood pressure was almost non-existant, and the xray did not show a mass, and blood work came back fine (of course, they told us we could have been too EARLY for the blood work to catch a "bleeder").... when they could not stabalize his respiration, we agreed to "let him go" instead of agreeing for more tests.  The doctor actually had the NERVE to ask "Are you sure you can do that without a diagnosis?"  I wanted to slap this inconsiderate person across the face!!   The whole time we were not allowed to be with our dog.

When we were preparing for his euthanasia, they finally wheeled him into the room.   He was still coughing and he didn't know we were there!  When they wanted another $400 for cremation, even though their bill was already over that, I got on the internet from my husband's cell phone and was able to get in touch with the crematory my vet uses, while I stroked my dogs head.   I didn't even ask her cost (turned out to be $240 including a special urn) and she graciously had us come down with him at 5 pm on a Sunday night.

My husband had me leave the room while the euthanasia was performed and he stayed with our boy.  I am glad I did as it turned out his circulation was so bad that it took a couple minutes for it to work!  My dog was clearly suffering and all they wanted was more $$ for more tests and then tried to make me feel guilty when all I wanted my ailing senior to be at peace.  As my regular vet told me later that night on the phone, my diagnosis was that he was 13 years old.  He was kind and compassionate and told us we did the right thing for our boy.

At the crematory, Buddy's Place, http://www.buddysplacepetcrematorium.com/, Karen was so compasionate and caring, even offering to "take care of him" then and there if we wanted to witness it.  She asked if we had a collar and that is when I realised that the ER Clinic did not give me back my slip lead.  When we left the crematory, I called the ER Clinic and asked them if they could mail it to me.  No they couldn't.  I was not too pleasant at this point and they put the manager on the phone who told me to "just relax"!  I noticed they had our address wrong (mixed up street # with PO Box #) and asked them to correct it, as they told me they are not responsible if it was lost in the mail.

In a few days the lead came - to the wrong address and addressed IN THE NAME OF THE DEAD DOG! Let's stab me while I'm down and rub some salt in that wound!  Bless the postal workers for putting it our box!  At least someone has a brain.

I NEVER will go to this clinic again. and I tell everyone who listens our story  I heard good things with one out of state.  We live in NY but near the VT & MA border so we have some options.  I am actually thinking of visiting the MA clinic one weekend to check them out.

Holly Goldman-Craig June 19th, 2009 05:54:09 PM

We spent about $500 at an emergency vet in a resort area while travelling (Cape Cod) for a big laceration my Manchester terrier got on her chest and under her front leg. (She has fragile skin and was roughhousing while the other dog was tied up to a plastic-coated cable.) It was the middle of the night before we got her back, we arrived while an emergency surgery was in progress and an emergent c/s was waiting. I thought the vet was fantastic and the price was close to a non-emergent wart removal the dog had at our home vet. My only question, which was the same for the wart, was why a simple skin surgery required such fancy anesthesia (propofol, narcotics, d/c with tramadol). A human child getting a skin-only surgery would breathe gas, get no IV or narcotics, and get a rectal Tylenol. (I am a nurse anesthetist.) I want my dogs to get the best and I don't begrudge a cent, but I find the difference in human vs animal medicine interesting.

Mandy June 19th, 2009 06:04:11 PM

The Clinic I take my furkids too has 7 vets now. They have grown slowly over the years starting with only 2 vets. After the clinic closes for the day there is always a vet on call. On the few occassions that I have needed after hours care for one of my crew they were always waiting for me when I arrived at the clinic. There is also an on call room they can stay in. The extra ER fee is $75 but that is just for after hours ER calls, all other costs are the same. I have no problem paying an extra fee for after hours but I think I would have trouble paying double/triple for everything. You can't tell me that costs are doubled/tripled just because they are at 5pm on Sunday. I understand they pay staff more and I totally agree with that. Lots of people in this world work shift work, and it's a good thing all services are not marked up double/triple at night.

Elizabeth - from Nova Scotia June 19th, 2009 06:05:04 PM

I actually think at least one local emergency vet is cheaper than my normal vet.  The e-vet has a $70 appt fee, while my normal vet (a certified feline specialist) chargest $89.  I had lilies at my apartment (didn't realize they were lilies - I'll never make that mistake again) and my cat ate a petal.  The bill came to ~$600 - the appt fee, keeping her hospitalized for 22 hours, 2 or 3 kidney function test, catheterization and liquids.  She needed a follow-up appt a couple days later to double check her kidneys, and it was cheaper to go back to the e-vet than my normal vet.  Maybe I need to get a new vet...

alh June 19th, 2009 06:36:54 PM

I feel very fortunate after reading all these stories.  My nearest emergency vet is 10 minutes away and they saved my dog's life when he had bloat.  I have been there various times, sometimes for something that turned out not to be serious and it used to be $60 for the exam,  maybe 1.5x what you'd pay elsewhere.  May be a little more now but what isn't?  The rest of the items - xrays, surgery etc. - were the same as they would be anywhere else.  They refer you for cremation, rather than offering a marked-up service for that.  They do not have anybody on duty in the daytime (except Sundays), you pick up your pet by 8am and take him/her to your regular vet.

I would really love to know how these 1000% markup places justify what they're doing.  Yes, they are a vital service and can charge more because we need them, but it makes no sense to me in terms of animal health care.  If I thought it would be $200 to go to the emergency vet I'd hesitate in cases where it might/might not be something serious.  I might not have taken my dog in for that bloat incident until it was too late - bloat is notorious for causing vague symptoms to begin with.  I might have waited when another dog pulled her staples out and she could have gotten a nasty infection.  Those kinds of fees are just putting a huge disincentive for people to bring in pets for the care they might need.

Anne June 19th, 2009 06:37:00 PM

For me, I think the walk in the door charge is sufficient and beyond that prices should be the same. If you pay 150.00 just to step inside that is already triple a regular charge. Sure, the staff is paid more, but I think the entrance fee covers that salary difference. Beyond that, antibiotics shouldn't cost money after 5:00. That being said, I'd gladly pay every time for peace of mind, especially if your little one spends the night. It's nice to know he won't be alone.

Mary June 19th, 2009 06:58:27 PM

I've had 6 emergency experiences - all were different - 5 were good - 1 was horrendous.  Only 2 were at the same hospital, and both times they were vets I knew from regular practice, so we had no issues and were very comfortable about having our dogs there.  Another good experience was a specialty referral clinic, because of an emergency need that a good vet identified on a Saturday, which was continued and successfully concluded at the clinic.  And the teaching hopsital emergency, while a bad outcome, was handled as best as possible, with emphasis on compassion.

The one bad experience - a greyhound with hyperthermia - regular vet was called to ask an opinion, and said, "Hey, you didn't pay for extra tests before the dental, so I don't know what could possibly be wrong - go to the emergency clinic."  We walked in, were told that our dog, who was breathing so fast and shallow (and had been for 5 hours post dental, would need tests that would run between $500 - $700 (after the $175 walk-in), and when we asked if they had ANY ideas about what the problem was (we'd explained he'd had a dental that afternoon), they said, "Even if we knew, which we don't, we couldn't tell you without these tests."  We asked what tests, they rattled stuff off without explanation and when we asked what they would be looking for, they said, very rudely, they "had no idea."  We asked if they thought the dog would live or die (trying to get some idea of if this was sometime beyond serious or what), and they said, "We already told you we have no idea."  We took the dog home, he had a seizure, we rushed back, he died as we were getting out of the car.  Then they actually said, "Well, with anesthesia complications, a seizure was likely to happen, that's why you should have left him here."  When reminded that they never said anything like that, they said, "It's too bad you didn't want to try for the CareCredit, your dog might have lived." 

It was never about the money, it was about the help - or entire lack thereof - and even though the place has changed hands, and I know a lovely, skilled tech who works there now, I don't know if I could even bring myself to pull into their parking lot ever again.  Thank dog I have other options.

KateH June 19th, 2009 07:06:27 PM

I've had my guys to the emergency vet a few times...

Here in Southern Illinois, the prices vary.

Our regular vet charges about 30% more for an after hours call. The rest of the prices  are the same as daytime.  Color us lucky!

Recently, my pitbull had tightrope curgery, and on a Sunday evening, chewed out two of his fourteen staples.. I called the hospital that did the surgery- the tech I spoke to was VERY upfront and honest about the charge and care.  To walk in  would be $175. And then after that, the tech would put my pup in a crate in the hospital, and in the morning, a vet would check him..so I declined to take him in. Ended up taking out the half-chewed staple, slathered on antibiotic ointment, and wrapped him up. 

I think double the amount of a regular visit is more than fair.  And I personally don't have to have a life or death issue to go in after hours. My bottom line is-Is my pup in distress?  If so, I go...

agadoresmama June 19th, 2009 07:23:18 PM

Patty,

This is an oh so timely post considering what we went through with my 9 year old aussie last weekend. I noticed almost immediately when he wasn't feeling "quite right" saturday night and noticed his stomach starting to bloat. Took him in and sure enough it was gastric torsion. Initial estimate was 4160 to perform the surgery to flip his stomach back and anchor it plus the cost of hospitalization throught he weekend. This was best case. As it turned out, when they got  in there he started bleeding heavily from his liver (DIC) and they added a plasma transfusion ($400). They couldn't get all of the bleeding to stop before they closed and we spent the next two days just waiting to see if his blood work would return to normal (at one point his PCV was around 28%). Throw in a spot in his left middle lobe of his lung that showed up on sunday evening chest x rays. Thankfully, he took a turn for the better around 2AM monday morning and could be transferred to my vet that morning and came home that night. He has steadily improved since then. The total bill at the emergency clinic: 4923 and change. I'd be interested to know how much that might cost in a regular clinic. I really don't know. At the time, all I cared about was saving my dog and we did (so yay!). We are just north of Atlanta in Cherokee County. The doctor at the Cherokee Emergency clinic was superb and at the end of it I don't know that I cared what I paid because my dog is home. It was not something I could afford and it will take a long time to pay off but it was worth it. My only gripe is the 44 dollar consultation fee plus 50 dollar emergency fee so it is 94 dollars no matter what. I kind of think they should have some sort of policy that says "if you ended up paying x amount or more, we waive that silly entry fee". What are your thoughts? What would this have cost if it had been 9AM on a tuesday morning?

Aubrey Kinnaman

Aubrey Kinnaman June 19th, 2009 09:34:53 PM

I guess that if they are only after hours practices, they can and should charge about 1.5 to 2x the cost of a typical office. When you take into consideration that they aren't doing the routine big ticket procedures like spay and neuter or other revenue generators like vaccinations, they deserve to get theextra money so that they can survive as a business and provide the much valued after hours care.

When I had to take my dog to an after hours clinic for a euthanasia, the only extra amount I paid compared to the prqactrices that I have worked at since was an after hours fee of $100. That was basically like a cover charge. Anyone who wanted their services paid that up front. I considered it fair. So with exam, one radiograph, the euthanasia and the after hours fee, I walked out about $350 lighter.

Dug June 19th, 2009 10:11:00 PM

My good experience with an emergency clinic was when I discovered that the second cat we had briefly was urinating outside her litter box and leaving blood spots.  Since I was familiar with UTIs in humans, I was sure that the poor kitty was suffering a lot of pain.  The only emergency vet open on a Saturday morning was a speciality practice near the city zoo that is also a morning emergency clinic, so I called there and they told me when to come.  The place was beautiful, with a nicer waiting room than you see at your human HMO, and lots of testimonials on the walls, including a photo of exotic antelopes wearing casts. 

The vet we met was a very nice guy, with great tableside manner.  He explained that the cat had small kidneys already, collected samples for testing, found out she was in kidney failure, arranged for the results of the cultures to be sent to our regular vet, and started the cat on an initial antibiotic pill prescription.  I don't remember the price, but it was a few hundred dollars.  After the culture came back we had to switch pills, but we did pill the cat twice daily, change her to kidney diet, and she did recover.  (She had to be re-homed due to irreconcilable differences with Miss K.)  Her current vet says she doesn't have kidney failure now, so it must have been due to the acute infection.

I would definitely go back there.

Miss Kitty's Mom June 19th, 2009 10:56:28 PM

I've been really lucky to have my emergencies attended by home-based clinics over the years with a couple of exceptions.

One was with Dottie for her eyes, but even then it wasn't a "true" emergency, we chose not to wait the extra day so had the $150 fee tacked on. And another was also with Dottie back in 1998. She started relentless "circling & pacing" without eliminating. After a couple of hours of bringing her in and out to the yard, I called the only small ER and brought her up, because it was in the middle of the night and I didn't have the heart to call the clinic to drag my vet in.

I had no qualms, but the diagnosis was the wrong spot. She had her anal glands expressed which caused her to pee a flood on my shirtsleeve & went home with a few cans of SD something. The next day Dottie passed a stone on the kitchen floor. Her vet called me in the morning and asked how Dottie was and that I shouldn't have been embarrassed to call...that was courteous & concerned.

But I must say, I've been told the gamut of stories about the ER, always about price, but alarmingly some have felt verbally abused on top of the bill by clinic staff & receptionists. One woman told her vet & promptly received her home phone # to prevent repeat. Another friend, post-Pocket, carried a note in her purse written by her vet, in-case her elderly dog needed emergency euthanasia to "please honor wishes and not pressure for additional treatment/tests"...hey, couldn't blame her nervousness and wish I had thought of that myself.

A positive response was a man brought his cat in with saddle-thrombosis & was kindly euthanized without any pressure.

Barbara A. Albright/NH June 19th, 2009 11:28:06 PM

So it's mentioned :)  I've been lucky enough to live near 2 different emergency vets, in two different states, who would tell you if they thought something could wait.  The local emergency vet where I currently live has even recommended I wait on a number of incidents, or given me suggestions over the phone instead of asking me to come in.  I know I'm lucky on this, but hey.  There ARE emergency vets who will say, "yes, you don't need to come in."

Galadriel June 20th, 2009 12:38:45 AM

For anyone who's interested, here's a link with guidelines for what merits an emergency, urgent, or regular appointment (intended for cats, but most apply to dogs, too).

As for the vets who always say "come in", I can sympathize.  It's a pretty big risk to tell any but the most loyal and trusted of clients that something will resolve on its own or can wait to be seen...because what if it doesn't or can't?  It's a huge liability.  Our general practice has a fairly strict "come in now" policy...partly corporate's mandate, but we'd do it anyways b/c it's the safest way to cover our behinds (which is an unfortunate but undisputable facet of veterinary medicine).  Saturdays and Sundays, when we're one of the few places open save the emergency hospitals, are big days for the majority of incoming calls to be, "My pet has/is doing/looks like x, should i bring him/her in?  My regular vet isn't open until Monday".  The standard reply is, "If you're concerned about X, then I'd encourage you to come in and have your pet evaluated".  It's really not about squeezing an office visit fee out of someone...trust me, there are days when I'd love nothing more for them to wait until their regular vet opens.  It's about doing the safest thing for the pet.

anna June 20th, 2009 01:32:56 AM

A sore spot for many, I'm sure.

I had a cat emergency I'll never forget and never forgive a few years back. My cat collapsed shortly after midnight on a Tuesday. I rushed her into the local Emergency Vet. They did an exam and lab work, and kept her under observation until I picked her up at 7:00 AM in the morning to transfer her to the regular vet.

$800. Seriously. This was in Ann Arbor, Michigan.

The cost for the regular vet to keep her for 3 full days and 2 nights, do much more extensive testing and analysis was $350. Then we got around to the weekend again and the regular vet told me that I needed to take her back to the Emergency Vet for the weekend.

I simply couldn't afford it. Plain and simple, this was a very bad time for me and I was cash (and credit) strapped and there was no way around it. And Emergency Vets certainly don't do payment plans, as my local vet would have as they had known me for ages.

I ended up taking her home with me over the weekend and did the best I could alone, but she went downhill fast and I ended up euthanizing her first thing Monday morning.

Anne June 20th, 2009 03:39:47 AM

If you really think about it.. Why should the ER for an animal be different than a human going to the ER.

I was very tempted to call the vet last night even though it wasn't close to an emergency.. Think I was very annoyed.. Socks had an ear that was loaded with what looked like dirt.. It was edematous, and he wasn't very happy.. He was at the hospital last week for a P.E,  had a cyst removed from his back, and his teeth cleaned.. I think picked up a present of ear mites... Will stop at the office to look under the microscope on the way to the vet..  UGHHH

Barri June 20th, 2009 09:04:13 AM

Having been both a veterinary hospital manager and a client walking through the front door of an emergency hospital, I have the "advantage" of seeing this from both sides. I would expect fees to be double or triple exam and meds but no more. I have always been asked if I would like tests etc but never pressured or made to feel less of a good caretaker of my pets at the few times I have had to seek veterinary care.

In practices with multi specialties as well as emergency care, it is frustrating to have to follow their admitting and discharging protocols sometimes, but I don't make the protocols and rules, some business manager does and sometimes that person is not from the veterinary field but sometimes the human medical field and that makes a difference I think.

I feel that clients are often not aware of the case management time a vet spends on cases (not just for emergencies), emails and phone correspondence etc...which oftentimes are not charged for (but should be).

Teri and the cats of Furrydance June 20th, 2009 01:42:02 PM

I am a veterinary technician that works in a smaller GP clinic.  We share our emergencey calls with the other 3 local vet hospitals, rotating the nights and weekends.  When the Dr. comes to the clinic he calls a tech in with him.  Our base price for an office closed, after hours or weekend call is $150, plus treatments.  If the technician or Dr. stays with the pet more than an hour, the "extended" office call is $180.  All treatments (bloodwork, Xrays, antibiotics, etc,) are the same price as a daytime exam. NO additional fees.  I have only seen a few people complain about the price - they being the ones who declined a regular exam during working hours, or had a rather simple problem that could have waited until morning but the owner insisted. We charge the same to open the door for you whether you have a true emergency or a broken toenail..

Wade June 21st, 2009 02:27:09 PM

As a small animal rescuer, I've spent a lot of time at the emergency vets -- a lot more than I'd want to.

In our area, ONE e-vet accepts exotics.  Even the vet school wont' take exotics after hours, they refer us to the same clinic.  And that clinic is so hit or miss that it's always a nightmare.  While I have had extremely knowledgeable vets that were compassionate and helpful, my last visit was so abyssmal that I ended up calling every other emergency vet in the area, begging me to let me bring my foster-rat in.

This rat had had a surgery on Friday, and the glue from the surgical site had come loose.  Our vet was apologetic -- his preferred brand of glue had been discontinued and this was his "new" brand.  Anyway, I go in expecting and willing to pay around $300 essentially to gas a rat for 15 minutes and reglue the thing.  My estimate?  $675.  Just for the resuturing.  That was in addition to my $100 walk-in fee (which we affectionately call the "pay-to-play").  The wound itself hadn't even torn at all, and the rat was calm and sedate.

In addition, I learned all sorts of interesting things.  The vet on duty was a wealth of knowledge, informing me that my rat was fat, and that was why she had tumors in the first place (ignoring my explanation that she had confirmed inoperable abdominal tumors that we'd found post surgery), and that I had made her fat with all the fatty things I was feeding her (ignoring as I explained that she was post surgery and getting a lot of treats and additional delicious things to help get her appetite back in gear).

I turned down the resuture, and instead they charged me $50 to wrap a bandage around her, which she denuded herself of before we managed to pull out of the parking lot.

Epiphany June 22nd, 2009 09:02:25 AM

I live in a rural community in Ontario, Canada, and feel lucky to do so, especially after having lived in downtown Toronto, home of 1,00% ER mark ups.

Here, if I have an after hours emerg (as I did two Sundays ago, when my French Bulldog bitch went into labor three days early), I simply call my regular clinic. They page whoever is on call (a job shared between two neighbouring clinics), and they call me back. I then arrange to meet them at whichever of the two clinics is on rotation.

The fee? Exactly what I'd usually pay for services, plus as a $200 emergency fee (which had been $150 for years, and only went up this spring). I know a few people who complain about how 'exorbitant' this fee is - proof that they've never had to take a pet to a traditional emergency clinic, where an extra $200 would be what it costs just to walk in the door.

I'm also lucky that any of the veterinarians on call at any given time is a vet that I'd gladly take my dogs to no matter what time of the day or night.

BTW, I send them a fruit basket every single time they have to come out for me in the middle of the night. It seems the least I can do :)

FrogDog Blog

Frogdogz June 22nd, 2009 10:40:23 AM

I appreciate you blogging about this.

I have paid so many thousands in vet ER care in the last 5 years of my life, it's staggering.  From Toonces post-Overdose focal facial seizures that sometimes wouldn't stop, to my mom's elderly yorkie with kidney failure who may-or-may-not have a brain tumor, to my youngest boy kitty who likes nothing better in teh world than to eat stringlike things, my head spins when I look at the numbers.

The 1000% markups are discouraging.  I have never openly balked at one of the bills, but what goes on in my heart and mind are something like despair and panic when I think about the credit card bills.  In the moment, it's not a question of whether or not I'll pay -- I'll pay -- but I also know I'm fortunate to still have a credit line that isn't maxed out.

I don't know what the answer is.  As you know, I only go to places with licensed techs, 24-hour supervision, and vets I "kinda sorta trust" to the extent I trust any vets anymore.  These things come with a price that I am more than willing to pay because I am trying NEVER to go through the horrible heartbreak again of getting less than competent care.  Whatever I have to pay, I will pay, somehow.

But it does hurt, and there could be a day when I just don't have it, and I don't know what I'd do, and my heart goes out to people in that situation.

I recall in particular:

Being charged $45 for one subq administration.  (Having ordered LRS myself, I know that an entire bag of the stuff costs less than $5, and I could have administered it myself, it takes all of 2 minutes)

Having the ER vet suggest that we do X-rays for the 3rd time in a week on the yorkie, who was brought in for panting for the 3rd time that week.  Uh, lets see:  He was here for the SAME thing 2x this week and his xrays were clear.  What makes you think they are going to NOT be clear now, since it's the SAME symptom and he had xrays a couple of days ago?  ($300+ each time).

I appreciate the conscientiousness of wanting to rule out EVERYTHING all the time, but sometimes its just stupid.  You don't need to run ALL the tests EVERY single time.  The 25 year olds don't know any better (and they are usually the ones on duty at 2am).  They ahve no choice but to run every test imaginable because they lack clinical experience to help them narrow things down.  I DO however, expect more experienced vets not to take that approach of "Let's just try EVERYTHING and see what sticks."  Unfortunately, at some corporate chains, it is a matter of POLICY to run EVERY test every time, both for revenue purposes and for liability reasons.  Since I personally know how truly rare vet mal prosecutions are, much less awards, I find the latter rationale sadly and ironically amusing in an extremely disturbing way.

stefani June 22nd, 2009 12:12:15 PM

I love my ER vet - i should since i've been there twice in the lst 3 days (2 dogs, 2 different issues)

The cost for the ER exam and Consult? $100.

Everything else is the same as my normal vet.

My frenchie had a swollen face due to an insect bite reaction - it only took 1 hour and we were out of there for $172.

When our new puppy was bloated (ended up being for water, but you never chance bloat with large breeds) it cost about $250 for xrays and consult. Same for when another of my frenchies ate 2lbs of birdseed and needed x-rays and vomit meds.

I don't know what i'd do in an emergency if i knew it could cost me over $500...

Sarah June 23rd, 2009 10:36:32 AM

I've taken my dog to an e-vet once and hope to never repeat the experience.  My husband and I were stuck, because our dog was vomitting and had diarrhea and was generally lethargic, pale gums - the whole bit - and we were leaving town that afternoon (with the dog) and NEEDED to get in to see someone.  Now, I knew that she probably had gotten into something in the yard (we later figured out she'd eaten grass that was recently fertilized) and although her condition was not life-threatening, it was going to make her a lot more comfortable if we could get some fluids into her and get some anti-nausea meds.  The e-vet wanted to work up a whole panel, keep her overnight with an IV, take x-rays to rule out an obstruction (even though my dog has no history of eating non-food items).  The cost was over $500.  I called my vet and PLEADED with them to please see us for a 5-minute visit (long story why they couldn't originally) and they did.  $50 later we had meds, our dog had an injection, and we had instructions for care from the vet.  Tell me that e-vet wasn't trying to take advantage of us???  Left a very sour taste in my mouth.

Michelle June 23rd, 2009 03:04:13 PM

I have three parrots, two bunnies, and a dog. I understand and accept that I need to shell out more for the veterinary care for the exotics because it is more specialized. That doesn't, however, excuse what happened a couple of months ago with my then-six-month Jardine parrot and our local e-vet.

She jumped (didn't even try to flap her wings) off of her playstand, and hit the ground, hard. Moments later she was bleeding from her vent. First a few drops then a steady stream of bright red blood. Horrified, I bundled her into the car with my boyfriend and they sped off to our veterinarian's office. Horribly, his office wasn't open (it was 8:30 AM) and wouldn't be open for 30 more minutes. There was an e-vet nearby, and an e-vet 20 minutes away, without traffic. With the bird's eyes growing heavy, my boyfriend opted for the closest option.

She had to be stiched up immediately. But! It would cost $700 because it wasn't the vet's "specialty." With our vet that figure would have been around $300. My boyfriend pointed out that the good doctor shouldn't be operating on her if it wasn't his specialty, let alone more than doubling the price for something he could do half as well. But what choice did we have? She was a young, otherwise healthy baby parrot, who we were responsible for. We operated. We also learned that the difference between 30 minutes is $400.

And that, boys and girls, is how credit card debt gets started.

Chelsea June 23rd, 2009 07:17:04 PM

Had a similar situation last year when our cat, Jazzy, got sick.  It was a Saturday afternoon, we were out of town, and our pet sitter had no choice but to take her to the emergency vet.  They charged us $800 and ultimately had to euthanize her (within 2 hours of her arrival).  There was a walk in the door fee and blood work fees, etc.  And, when I spoke with the vet, she wanted to try to treat her (despite her saying she didn't think there would be a good outcome).  How I wish I had been home and had been able to take her to Dr. K... 

Jayne Bersok June 24th, 2009 08:50:07 AM

Comparing the cost of Veterinary Emergency Care to Veterinary General Day Practices isn't really an apples to apples kinda thing across the board.

Dr. Khuly's thinking regarding the only difference in expenses between the ER Practice and the General Day practice is the labor expense - with the assumption that the ER has to pay more for staff  - but everything else is the same expense is only partly true sometimes and only part of the whole story.

Some ER practices - and almost all ER practices associated with Specialty Referral Centers - will have significantly more equipment including more advanced diagnostic, treatment, and surgical equipment that the average day practice - often times they will have equipment such as Ultrasounds, Digital Radiography, Nebulizers, endoscopy units, improved monitoring equipment as well as specialized medical therapies - blood packs for tranfusions, specific emergency drugs etc.

Sure some GP's have these things in their hospitals, but many do not, and the expense of having them at the ready for emergency care has to be covered. Sure these additional expenses should be borne by only those clients that truly need them, but the fact it that everyone who uses the ER ends up paying for them through some portion of their bill - while those whose pets truly do need those individual things do pay more - often quite a bit more - they rarely pay enough to truly and completely pay their fair share. In this case, everyone pays something extra so that these things are available - and those that truly need them get the benefit of not having to pay for them on their own.

Additionly, the other part of the story left unsaid is the fact that there are two totally different revenue streams for these practices to 'live off of'. A General Day Practice generates money on both wellness care (Exams, basic wellness diagnostic tests, vaccines and preventative medications) as well as routine surgeries, dental procedures and then also on illness and injury care, boarding, over the counter sales of dog food etc etc.

And what we do know is that historically, Veterinarians in General Practice have basicly subsidized the 'true cost' of illness and injury care by generating more revenue profit from their wellness care and charging less for their illness care - thus perhaps Wellness Care fees have been disproportionately higher than necessary so as to keep the costs of Illness and Injury care from being much much higher. (Though we have obviously seen even wellness care fees go up in the last decade).

General Day Practices with a doctor 'on-call' who meets you at the clinic at night do nto carry the extra staff and doctor during all the overnight hours - and they do have these wellness revenue streams. They also may or may not have the more advanced or cutting edge diagnostics or care treament options on hand. So for them to charge a premium just on the ER exam may make financial sense.

24 hour practices that run as GP during the day and ER at night also have these revenue streams, but they then also have staff and doctors there 24 hours a day and often they are expected to have the more advanced treatment options on hand along with all the drugs and supplies that go with it.

On the otherside, ER only practices (and ER / Specialty combination) do not have the wellness care stream of revenue to help keep their hospital business afloat - there is no higher mark-up on wellness care / preventative medications (heartworm, flea/tick etc) to help keep the costs of Illness and Injury Care lower.

Perhaps this explains part of the gap we see - certainly not all of it - but at least part.

Dr. Mac July 1st, 2009 09:13:56 PM

I'm responding before I read all of the comments.  Here's my take:

First off, I'm lucky, in that I have a vet's office where the vets talk to me like I have a brain.  I have a little more information/knowledge than maybe someone who goes to a different vet might have.  I also have multiple cats, so I've seen some things and generally know how to guage for myself what can wait and what can't.

That said, the e-vet I choose to use, about half an hour from my house, is only SLIGHTLY higher than my vet, and in any case, I have no problem paying a bit more for e-care, because...it's an EMERGENCY, and I want to save my cat!  There's another e-vet about the same distance away in the opposite direction from my house.  They wanted about $400 just to SEE my cat, so unless I run out of choices, I will not give them my business.  It felt like gouging, not like charging more out of a need.  (Plus, the one time I called them, they were snotty and rude on the phone. Not a way to get a cusomer in the door.)

My chosen e-vet has a very good reputation, and the staff are very kind and knowledgeable.  I have no issue giving them my money at all.

I fully understand why an e-vet would charge more, but you're right, Dr. Khuly:  There is reasonable, and then there is insane.

As far as how much I would actually spend on one of my cats' e-care, it depends on all of the factors that come into play in other situations:  Age of the cat, prognosis, quality of life going forward, etc.

Jen M, Maryland

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