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Cat Forum / Health and Behavior / September 2004Is my vet too expensive?
I just read a discussion where a vet had quoted $400 to spay a cat and everyone thought that was ridiculous. Well, I suspect my vet's bill would come close to that, by the time you added in pre-op bloodwork, etc. etc. (There's always a lot of etc.) I don't know, because my girls were spayed by the SPCA when I adopted them. Thing is, I've been reasonably happy with the two vets at the practice that my cats usually saw, but they have both left. So earlier this year, we saw a different vet, but now she's gone as well. And I think I'm about to have some complicated and expensive stuff with my Mandy-girl -- she has a bump which they aspirated and the cytology just came back saying it's a mast cell tumor. In short, it may be the right time to switch vets. Price or no, I would probably not even consider changing if the vets we were used to were still there, but they're not. On the other hand, the practice has been there a long time, they have all the records, etc., and a surgery may not be the time to try out a completely new practice. Anyway, I wanted to see what people thought. Here are some items from my recent bills: I can't even find the bill from their annual stuff, but I think it was close to $200 per cat -- exams, bloodwork, fecal and urinalysis, vaccinations, etc. Then I took Mandy back because she was chewing all her hair off, and this had gotten worse, not better, plus she had had a slightly elevated liver value at her annual, so then we had: Recheck exam $23 Fungal culture $36 Skin scraping $18 Bloodwork, just liver values $19 Last week, we went in because there had been a tiny bump in the middle of the chewed-bald area, only it got bigger, plus she had been pooping on the floor sometimes, so this was another $200 visit: Exam/office visit $38 Fecal checks again $23 Anal sac expression $14 Aspiration of the bump $16 Cytology on the aspirate $83 (!) Depo medrol injection (in case the chewing was an allergic reaction) $26 So I haven't talked to the vet yet (just got a phone message) but I've been doing some reading about mast cell tumors, and I'm sure it'll be at least $500 for that surgery, preop/postop stuff, radiology/ultrasound perhaps, plus the vet wants to do a dental cleaning while they have her under (she's never had one before). Now I know this kind of thing would get expensive no matter what, and I'm not complaining about that. I knew what I was getting into and I can afford it. But that doesn't mean I want to pay way more than the going rate. So what do you guys think? Too high, even considering that they're in a relatively expensive location? Catherine Mandy & Judy I pay $43 for a Depo shot. Meanwhile, what have you done with Candace? > Catherine > Mandy & Judy > I just read a discussion where a vet had quoted $400 to spay a cat and > everyone [quoted text clipped - 4 lines] > I don't know, because my girls were spayed by the SPCA when I adopted > them. Community-minded vets subsidize spays themselves by charging reduced fees, other vets bill spays a major surgery (which removal of a major organ actually is). A vet's fees for spay/neuters says a lot about the vet. > Thing is, I've been reasonably happy with the two vets at the practice > that my cats [quoted text clipped - 13 lines] > have all the > records, etc., You should always get a copy of your cats' records for just this reason - you don't have to repeat tests and the new vet has your cats' complete medical history. Also, having a copy of your cats' records could save precious time in the event of an emergency. and a surgery may not be the time to try out a > completely new practice. > [quoted text clipped - 6 lines] > $200 per cat -- exams, bloodwork, fecal and urinalysis, vaccinations, > etc. About right. A CBC with 16-24 chemistries + T4 costs about $100; fecal exam: ~$20; urinalysis: ~$25 + ~$20 for cystocentesis collection; and $35-$40 for a general exam. > Then I took Mandy back because she was chewing all her hair off, and > this had > gotten worse, not better, plus she had had a slightly elevated liver > value at her > annual, so then we had: > Recheck exam $23 Low - but should have been n/c considering all the tests. > Fungal culture $36 High. Shouldn't have been more than $30. > Skin scraping $18 About right - a little on the low side. . > Bloodwork, just liver values $19 Low. > Last week, we went in because there had been a tiny bump in the middle > of > the chewed-bald area, only it got bigger, plus she had been pooping on > the > floor sometimes, so this was another $200 visit: > Exam/office visit $38 OK > Fecal checks again $23 Exam or Flotation? Exam- a little high > Anal sac expression $14 Low > Aspiration of the bump $16 > Cytology on the aspirate $83 (!) $83 is about right for single tissue histopathology - but high for FNA cytology - should've cost $60 max. His cost is about $35. > Depo medrol injection (in case the chewing was an allergic reaction) > $26 High. > So I haven't talked to the vet yet (just got a phone message) but I've > been doing [quoted text clipped - 4 lines] > to do a dental cleaning while they have her under (she's never had one > before). $500 is a conservative estimate for all that for your vet. > Now I know this kind of thing would get expensive no matter what, and > I'm not [quoted text clipped - 3 lines] > what > do you guys think? Don't act like you can afford it. :) Too high, even considering that they're in a > relatively > expensive location? Region (Northeast, Southeast, etc.), metro status (urban, suburban, rual) and # of FTE vets all have an impact on fees. Good luck. Phil > Catherine > Mandy & Judy >Region (Northeast, Southeast, etc.), metro status (urban, suburban, rual) >and # of FTE vets all have an impact on fees. > >Good luck. Without going into the individual charges you listed, I'd have to say overall they sounded pretty reasonable to me (some maybe high but also some low). It does greatly depend on the part of the country you live in, whether you are in a major urban area, and I think too whether it is a cats only practice. We use a cats only clinic established by a leading feline specialist in a major metropolitan area, and their fees seem similar to what your vet charges. When we found a stray last year we went to a neighborhood vet thinking he would be cheaper (since at that point we were not planning on keeping the cat) but it ended up being considerably more expensive because he charged for nitpicky things our normal vet would have included in the overall exam fee. In short, if you want to change vets because you don't have much confidence in your present one, by all means look around but personally I wouldn't choose a vet based on trying to save a few bucks. >From: yngver@aol.comnospam (Yngver) >In short, if >you want to change vets because you don't have much confidence in your >present >one, by all means look around but personally I wouldn't choose a vet based on >trying to save a few bucks. I agree. The most important thing is the quality of care and if you can afford it, then I would go with the best care you can find. Our cat has asthma and we are now seeing a holistic vet. He's more expensive than the previous vets we went to for her condition. But he is the only one that has been able to help her successfully so it's well worth it to us. Lauren ________ See my cats: http://community.webshots.com/album/56955940rWhxAe Raw Diet Info: http://www.holisticat.com/drjletter.html http://www.geocities.com/rawfeeders/ForCatsOnly.html Declawing Info: http://www.wholecatjournal.com/articles/claws.htm > >From: yngver@aol.comnospam (Yngver) > [quoted text clipped - 3 lines] > I agree. The most important thing is the quality of care and if you can afford > it, then I would go with the best care you can find. Oh, I agree. I'm not going looking for the Dollar Store of vets. But being the most expensive doesn't mean they are the best, so if I could get equally good or better care at a lower price, it might be worth changing. But from what people are saying it sounds like they are not overpriced significantly, so I think I wil stick with them. A little above average I would expect for their location, and just as I'm knowingly, consciously choosing to pay extra for the location of my apartment, I have no problem doing that with the vet. Particularly since, as much as I hate the thought of commuting, it isn't as much as the cats hate riding in the car. I wouldn't make them ride 20 miles instead of 2 just to save 5%. Thanks, y'all. Catherine Mandy & Judy > You should always get a copy of your cats' records for just this reason - > you don't have to repeat tests and the new vet has your cats' complete > medical history. Also, having a copy of your cats' records could save > precious time in the event of an emergency. I guess I hadn't thought about records because up to now they haven't had anything remotely remarkable. URI, fleas, tapeworms when they were little, but since then their worst health problem has been a little excess weight and a mild joint problem until now. (Weight records I have because they print the weight history at the top of the receipt every time.) I'll think about getting their records. They are ten years old, so I suppose they are getting more likely to have health problems now. > > Recheck exam $23 > > Low - but should have been n/c considering all the tests. I see your point, but the vet did spend a lot of time. We discussed it at the annual, but this visit was specifically about the hair chewing (well, and getting the liver values redone). So I don't feel like it was an unreasonable charge. > > Fecal checks again $23 > > Exam or Flotation? Exam- a little high Um, both? There are two listed, flotation and one other. ("Direct" maybe? I'm at work now, don't have it in front of me.) > $83 is about right for single tissue histopathology - but high for FNA > cytology - should've cost $60 max. His cost is about $35. Her. :-) This practice has never had a male vet. What's FNA? > > So I haven't talked to the vet yet (just got a phone message) but I've > > been doing [quoted text clipped - 6 lines] > > $500 is a conservative estimate for all that for your vet. Yeah, I'm actually thinking between $500 and $1000, and just hoping it won't be more than that -- for the first round. Sigh. This was my mental estimate: Surgery $100 - $200 (I hope cheaper since this is on the skin, not internal). Anesthesia $50 - $75. Preop bloodwork etc. $80 - $100. Dental cleaning $30 - $50? It sounds like a thoracic X ray may be a good idea to check for any tumors internally. (And if you think you might want one, you go ahead and do it while the cat is sedated rather than have to sedate her again later, right?) I think it was about $40 when the other cat had joint X rays. Same story for abdominal ultrasound. I have zero clue what that costs. Then there will be the pathology on the removed tissue. If looking at aspirate is $83 then I assume looking at an entire tumor, checking the margins, etc. probably costs twice that, at least. Pain meds? Antibiotics? Extra blood tests? It looks like in dogs, at least, bone marrow samples are often done. > Too high, even considering that they're in a > > relatively > > expensive location? > > Region (Northeast, Southeast, etc.), metro status (urban, suburban, rual) > and # of FTE vets all have an impact on fees. I'm in Houston, Texas. Someone else mentioned cat-only vets, which this one isn't. They do dogs, cats, birds, & small exotics. Has had 3 full time vets for a long time though they seem to be in a bit of a transition right now, but I think they are still aiming for 3. Plus the usual flock of assistants, front desk people, etc. They are in a fairly expensive area (Rice U. - Museum District - Southampton, for those of you who know Houston). They're in a house on a street where most of the old houses have been converted to various kinds of businesses. We have no state income tax here and property taxes seem high to me but I've never owned property. So I'm sure that the same vet could charge less if they were in a strip center out in the 'burbs 20 miles from here. But my cats loathe vet visits and the associated car ride, and this vet is 2 miles from my house and a mile from work, so I'm fine with paying extra for that. (I pay an awful lot of rent, too, because I can't stand the thought of commuting.) > Good luck. > > Phil Thanks, Phil. I think I'm worrying about the cost in order to keep my mind off worrying about the cat and what the prognosis is with this thing. Is a false positive very likely in this case (mast cell tumor)? I couldn't get a good idea about prognosis from my web research, except that if it's also in the pancreas or lymphatic system, the prognosis is not so good. But this cat has no symptoms of anything like that (other than a lifelong history of occasional vomiting, which appears to be usually hairballs). It sounds like it's not common enough for it to be well enough studied. The vet is supposed to call me today if possible. I'm feeling a little bad that I didn't take her back sooner, but on the other hand, when I saw the bill, I almost said, "hold on, it's just a little bump, do we really need cytology?" I'm pretty conservative and sometimes suspect they suggest things because "nothing to do, wait and see" upsets some clients. But I'm fine with it if I trust the vet. But I guess I'm glad I let them this time. Catherine Mandy & Judy In the fine newsgroup "rec.pets.cats.health+behav", 03 Sep 2004: > Anyway, I wanted to see what people thought. Here are some > items from my > recent bills: Before going into your details, your vet history shows exactly what I have been through with Shamrock, and yes it gets expensive. Some of what you had done is unfortunately, necessary to rule out things like mites, fleas and ringworm. Though with Shamrock, what he has doesn't even look like ringworm but they cultured anyway. > I can't even find the bill from their annual stuff, but I think > it was close to > $200 per cat -- exams, bloodwork, fecal and urinalysis, > vaccinations, etc. High, but not exorbitantly so. Mine didn't have bloodwork, urinalysis or even fecals at the last exam because for one, they are young, and they are indoor cats with access only to a small outdoor enclosure and only for short periods of time. > Then I took Mandy back because she was chewing all her hair off, > and this had > gotten worse, not better, plus she had had a slightly elevated > liver value at her > annual, so then we had: > Recheck exam $23 Our vet doesn't usually charge for a recheck, but it depends on if it is a follow-up for something specific. > Fungal culture $36 Sounds about what I paid. > Skin scraping $18 Ditto. > Bloodwork, just liver values $19 I think that is fair, but I can't remember how much liver checks were when Shadow had to have them every week. > Last week, we went in because there had been a tiny bump in the > middle of > the chewed-bald area, only it got bigger, plus she had been > pooping on the > floor sometimes, so this was another $200 visit: > Exam/office visit $38 Again, many vets have policies on this, but with all of the other tests and this being a follow-up, my vet would have probably waived it. > Anal sac expression $14 That's about right. > Aspiration of the bump $16 > Cytology on the aspirate $83 (!) Shadow had a liver aspiration and cytology and I think it was more than that, but maybe different organs have different rates? > Depo medrol injection (in case the chewing was an allergic > reaction) > $26 Our vet charges $15 for this, and waives office visit fee since Shamrock is in pretty regular, just for a shot when his itching and biting gets really bad. You sound just like me when Shamrock had to go through all of the tests just to rule out certain conditions and unfortunately they are usually necessary. We switched vets after going through what your going through, and the new vet uses her experience more than test results, and by this, one example is that she bawked when she saw on his records that he was on a topical med that is an anti-fungal, and what he has doesn't look like ringworm and the culture was negative. We used to go to VCA and couldn't get out of the office for under $200, and with two cats who had different problems I spent a bundle on vet bills. I'm happy with our new vet, but if a time comes again where there is a mystery illness or condition, I will ask for a referal to a specialist before any tests are done by the regular vet because in my experience, they will end up referring you out anyway, and with a specialist they may have seen what is going on before, and and skip some of the "ruling-out" tests.  SignatureCheryl > Before going into your details, your vet history shows exactly > what I have been through with Shamrock, and yes it gets expensive. > Some of what you had done is unfortunately, necessary to rule out > things like mites, fleas and ringworm. Though with Shamrock, what > he has doesn't even look like ringworm but they cultured anyway. Yeah, I don't really have a problem with what was done, just whether the prices are reasonable. Mandy's skin looks perfect where she has chewed the hair off -- not a flake, not a spot of red, not a speck of flea dirt. Just the one tiny bump, which has gotten bigger and turns out to be a mast cell tumor. I think I read that these can be itchy, and I wonder if that has been the whole problem all along. But earlier, the vet didn't really think it was fungal, but we didn't have any other ideas except behavioral, so they did the scraping & fungal cultures. What did Shamrock's trouble turn out to be, or has it been determined yet? > High, but not exorbitantly so. Mine didn't have bloodwork, > urinalysis or even fecals at the last exam because for one, they > are young, and they are indoor cats with access only to a small My girls never had urinalysis before, but they are ten years old now, so we need to watch for diabetes, hyperthyroid, kidney problems, and all the other troubles older cats are prone to. Hence the urinalysis and bloodwork that was more expensive than previously, because they run a different one for senior cats. > Shadow had a liver aspiration and cytology and I think it was more > than that, but maybe different organs have different rates? I can't really guess about the cytology itself, but I'd expect actually taking the aspiration would cost more for liver since they have to go inside and possibly use ultrasound or something for guidance. > Our vet charges $15 for this, and waives office visit fee since > Shamrock is in pretty regular, just for a shot when his itching > and biting gets really bad. I think my vet probably would do that too if I was bringing someone in regularly for something like that. Thanks for the feedback, Cheryl. Catherine Mandy & Judy Mandy & Judy's excessively cute picture: http://is.rice.edu/~cathyf/cats.html In the fine newsgroup "rec.pets.cats.health+behav", sunflower42 2004: > What did Shamrock's trouble turn out to be, or has it been > determined yet? Sort of. He was diagnosed with Feline EGC (eosinophilic granuloma complex), either from an allergy, or just idiopathic. If an allergic reaction, it hasn't been found yet. SignatureCheryl i havent had anything serious happen, but for standard stuff my vet gets $12 for an office visit, $14 for rabies, $14 for distemper, $60 for a spay, $50 for a neuter. would have been $96 to get my three cats rabies and distemper, but they even knocked 10% off that. too bad the vet recently died (!!!) and they are in the process of selling off the practice :(. > i havent had anything serious happen, but for standard stuff my vet gets $12 > for an office visit, $14 for rabies, $14 for distemper, $60 for a spay, $50 > for a neuter. These office visit & spay charges are **very** low. Cathy >> i havent had anything serious happen, but for standard stuff my vet gets > $12 [quoted text clipped - 5 lines] > > Cathy I don't know how much longer they'll be around, for now they have visiting vets a couple of days a week until they sell the practice, but it's Clipper City Animal Hospital in Newburyport, MA if anyone is in that area. These were the prices for the shots and office visit a few weeks ago. Don't know the current spay/neuter charge for new clientele. > I just read a discussion where a vet had quoted $400 to spay a cat and > everyone [quoted text clipped - 74 lines] > relatively > expensive location? I don't know what the rates are here for all of the individual items you listed, but... going by a few of them - incl. the office exam charge, I'd say it's about average; doens't strike me as overly pricey, at any rate. Cathy |
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