Vet priceing.

[DJL4]

Not wishing to hi-jack a recent thread on dog insurance, as the subject appears to have moved on to vet costs, I thought it best to post a new topic here giving a recent experience of mine ----

 

Although it's perfectly understandable that anyone in business has to cover costs and at the end of the day make some profit, I do think however that "some" vets have a tendency to inflate costs which in turn makes us "clients" very suspicious.

Whilst I also realise that different vets have different overheads and some may well have the latest all singing all dancing modern equipment which has to be paid for, I find it hard to believe some of the price variations for specific treatments.

As an example a couple of months back I enquired at our regular vet for a quote to have my young Lab's Hips & Elbows x-rayed & scored. This quote came out at just over £500 with the cost of the BVA scoring £103.50 included. I phoned another local vet and this time it was £650 plus the BVA fee.

With these obvious price variations I decided to look slightly further afieled than my immediate "local" vets and found another very well respected practice who's quote seemed considerably different to those I'd had prviously -

Hip xrays = £90.75

Elbow xrays £78.75

General Anaesthetic = £27.20

Total = £196.70 + £103.50 for BVA scoring = £300.20p

I fail to understand why, taking the example of the general anesthetic in particular, costs quoted to me varied between £27.50 & £180! How can this be so?

Needless to say I went with this confirmed quote and the Lab in question's scores have come back fine...... Much to my relief!

You can easily see why people would be reluctant to health screen/score dogs when there is so much variation in prices. To pay out £600 plus only to find your dogs scores come back badly is a pill many would find hard to swallow.

The above quotes mentioned were all from respected practices in my local area (SE Kent). Are these variations also seen nationally?

Maybe Apache would like to comment on the above from his own viewpoint?

 

PS - If anyone is thinking of having they're own dog scored in the future and are from the same area as myself I'd be more than happy to give them contact details of the practice I used.

 

DaveL

[al4x]

Mine wasn't much over £100 but done with a number of others and without a general. Really good X-rays and came back with a good score. But this was someone who had pretty much just set up to do this.

[apache]

It's in a way sad to say that there are no minimum standards in this country for the provision of veterinary care. You have a whole cross section of practices some where the pet is looked after to human standards - they get intubated, monitored by highly trained staff (some specialise in anaesthetics) the animal will have it's heart and breathing monitored throughout. The practice may routinely take blood to check no underlying health issues and they may use a highly sophisticated digital x-ray set up costing tens of thousands of pounds.

 

At the other end of the spectrum you have people operating out of a garage. The vet may be alone with no other support staff 'monitoring' (or not) the anaesthetic whilst taking the x-rays using cat litter trays filled with developing chemicals and a 50 year old x-ray machine.

 

Your dog is in much safer hands with the monitoring of the highly trained staff and the care given in the first example is where I'd rather have my dog.

 

As a practice we sit somewhere in the middle in terms of standards and charge just a little bit more than your cheapest quote (our anaesthetic is dearer, but x-rays a bit cheaper).

 

The only way the latter practice can make money with such low fee levels is by cutting corners at the expense of your dog.

 

Average vet practice profitability is around 8% according to my accountant.

[DJL4]

I would just like to add that I realise Apache, you are not saying the above about all vets. All the practices which I enquired for quotes are all highly regarded with a team of vets & nurses and all have the latest digital x-ray equipment. All have been in practice for many years and although one has recently moved to brand new premises which may well have influenced the quote I was given, all those I asked for quotes are most definitely not working from a garage.

The practice I went to for the x-rays started up in the 60's and currently has three resident vets and at least four nurses. It has built up a reputation for excellent animal care over many years and I'd have no hesitation recommending anyone to it.

I'm still intrigued as to why an anaesthetic cost should be so variable?

 

DaveL

[apache]

Cost of anaesthetics vary depending on the drugs used and the facilities. For example depending on the drugs I have available I could use (at cost price to me) anywhere between about £2 and £50 in drugs depending on the protocol I chose. As a general rule the more modern the drugs the more they cost.

 

A decent monitor for the dog under anaesthetic may cost £6000. An anaesthetic machine is £1000. etc etc. It also depends what they do - some vets will do the hip x-rays under a heavy IV sedation that can be reversed (and that always is cheaper, in terms of drug cost).

 

The standards once you hand your dog over and they take it out the back vary a huge amount. That is my point. You cannot judge from the smart waiting room.

 

You CANNOT provide top quality care for rock bottom prices. It is not possible. Someone doing the same procedure for half the money is cutting corners somewhere.

[loriusgarrulus]

Do you use isoflurane gas as that comes off quick. The kit is expensive to use it though.

[apache]

Yes we use iso. The oxygen costs money. The animal will get two or three drugs as a pre med, and then injected with another drug to make it go to sleep. Only then does a tube go down the throat and it starts breathing oxygen/iso.

[kent]

You know what like most things you need to shop around and ask questions to why? indecently I was once told don't buy from unscored as sometimes the x-ray has been done an an educated guess from the vet was don't waste your money on the score it going to be poor, hence the venor claims they never got it done

[WGD]

Vets are highly trained professionals with a thankless life as far as I can see.

 

Much the same qualifications, sometimes better, than a GP but no NHS to chuck them £100k a year. Many hard years at school, university and in traineeship. An "on call" lifestyle at least in part.

 

The investment in premises and equipment is huge, and then folk moan because although they want the best of treatment, the price of a couple of bags of shopping or a night or out has, once a year, upset them.

 

I'm not a vet, I don't even know any vets other than my own who has seen to my dogs for the last 15 years.

 

You get what you pay for, and sometimes you pay a bit more for good or exceptional service. It's not just vets, and the vets bill is the one I don't grudge.

Edited July 17, 2014 by WGD

[DJL4]

Vets are highly trained professionals with a thankless life as far as I can see.

 

Much the same qualifications, sometimes better, than a GP but no NHS to chuck them £100k a year. Many hard years at school, university and in traineeship. An "on call" lifestyle at least in part.

 

The investment in premises and equipment is huge, and then folk moan because although they want the best of treatment, the price of a couple of bags of shopping or a night or out has, once a year, upset them.

 

I'm not a vet, I don't even know any vets other than my own who has seen to my dogs for the last 15 years.

 

You get what you pay for, and sometimes you pay a bit more for good or exceptional service. It's not just vets, and the vets bill is the one I don't grudge.

 

So are you saying WGD that if I had gone with the £600 plus quote I was given, rather than the £300.20 that I actually went with, I would get £300 plus worth of better service? I think not.

Have to agree with the rest of your post tho.

 

DaveL

[apache]

You dog might have been twice as safe in the practice with better staff, better monitoring etc.

 

The fact is we don't know. This is what makes it so hard to compare.

 

What I am damn sure of is the practice charging twice as much won't be making twice as much from the procedure.

[kent]

You dog might have been twice as safe in the practice with better staff, better monitoring etc.

 

The fact is we don't know. This is what makes it so hard to compare.

 

What I am damn sure of is the practice charging twice as much won't be making twice as much from the procedure.

This last statement i totally agree with but profit or loss is more complex than the wages of staff and fancy gear bought. Likewise quality doesn't always need to cost more. I can for example promise you 100% that Tesco in Clitheroe have higher overheads than the Village shop here, though there are so many levels to it Guess which changes the most for a tin of soup, loaf of bread etc.

[DJL4]

You dog might have been twice as safe in the practice with better staff, better monitoring etc.

 

The fact is we don't know. This is what makes it so hard to compare.

 

What I am damn sure of is the practice charging twice as much won't be making twice as much from the procedure.

 

 

I would have no hesitation agreeing with the above for some of the more complicated vetenary procedures but lets not forget we are only talking here about Hip/Elbow x-raying.

 

You mentioned in an earlier post "As a practice we sit somewhere in the middle in terms of standards and charge just a little bit more than your cheapest quote (our anaesthetic is dearer, but x-rays a bit cheaper)." Are you really saying that if had had gone with the quote of £600+ my dog "might" be twice as safe and get better treatment than if I had come to your own practice?

 

Going on the assumption that by paying more the dog is safer and better cared for lets take the example of those vets that carry out the Hip/Elbow x-rays with only mild sedation or even no sedation at all which I know happens. This in itself is another contensious issue.

The costs are kept even lower in these cases but is a dog that's not given a GA considered to be less safe than one with a full GA?

 

It could be arguaded that by giving a dog no GA or sedation at all, these dogs are in fact far safer and better cared for than those given a full GA. The cost comparisons would be even wider in these cases but going by your own comments the higher quote may still have been the better option.

 

I should add that I'm more than happy to pay for any treatment my dogs may need and with five dogs working 50/60 plus days a season picking up and a further couple of months dogging in the costs can easily mount up even tho they are all insured.... Another thorny subject. I just feel for the more routine procedures such as Hip/Elbow scoring the vast difference in pricing is very hard to justify.

 

　

DaveL

[PERCE]

 

So are you saying WGD that if I had gone with the £600 plus quote I was given, rather than the £300.20 that I actually went with, I would get £300 plus worth of better service? I think not.

Have to agree with the rest of your post tho.

 

DaveL

 

I paid £267 for elbows + hips & including BVA fee earlier this year with my regular vets.

 

I'm not sure of price or actual location but somebody took a bitch that I bred to a vet in Cheshire where they take the pictures without a GA, must work as they got 0 elbow & 0,0 hips.

Edited July 18, 2014 by PERCE

[DJL4]

 

I paid £267 for elbows + hips & including BVA fee earlier this year with my regular vets.

 

I'm not sure of price or actual location but somebody took a bitch that I bred to a vet in Cheshire where they take the pictures without a GA, must work as they got 0 elbow & 0,0 hips.

 

Not to far away from what I payed then Perce which seems pretty fair, although maybe we both ought to have forked out the £600 plus and we could rest assured our dogs would have been safer and better treated ......

Happy chap with the zero scores I'll bet.

 

DaveL

[Peskyfoxs]

I just had one of my gsd's hips and elbows done, under sedation for £140'ish (there was an offer on so alittle cheasper than normal) excluding BVA fees obviously. Been using the same vets for years and although they are about 2 hours away his guess at the BVA score is usally within a point or 2 and you stay with the dog all the time except stepping out as the xrays are taken. Hampton vet group in Malpas Cheshire with Euan Bryson

 

I also think the think the quality of the xray and position make a difference to score, plus vets knowledge as one vet years ago told me my dog had horrendous hip displacia and would need to be put down in a year or 2... BVA score 4-4 0 elbows never had hip problems throughout her life.

This might be the one I use too

 

 

I paid £267 for elbows + hips & including BVA fee earlier this year with my regular vets.

 

I'm not sure of price or actual location but somebody took a bitch that I bred to a vet in Cheshire where they take the pictures without a GA, must work as they got 0 elbow & 0,0 hips.

 

Edited July 18, 2014 by Peskyfoxs

[apache]

 

You mentioned in an earlier post "As a practice we sit somewhere in the middle in terms of standards and charge just a little bit more than your cheapest quote (our anaesthetic is dearer, but x-rays a bit cheaper)." Are you really saying that if had had gone with the quote of £600+ my dog "might" be twice as safe and get better treatment than if I had come to your own practice?

 

Our anaesthetics are monitored by a member of staff trained in house. They are very competent as they have been doing it many years, but I suspect a qualified vet nurse would be better and be able to work autonomously. We now have full monitoring equipment (capnograph, pulse ox, ECG, blood pressure) but we didn't have any of those available when we bought the practice a few years ago. Many vet practices still rely on very little monitoring equipment and potentially miss early signs of trouble. I'm personally happy that our standards have improved in the last few years, but the cost has risen to reflect that (only a small amount).

 

There is no doubt that exposure to x-rays cause cancer. Practices doing hip and elbow scores on dogs that are not even sedated must be holding the animals. That is against our local policies for radiation safety and potentially putting their employees at increased risk of cancer due to unnecessary exposure to the radiation. Putting the dog into the correct position for the hips is uncomfortable for the dog and raises an ethical issue of causing pain with nothing to alleviate that (the sedatives used do have painkilling properties). They cannot be following accepted safe working practices with radiation and that is a really serious concern. What other corners are they cutting? This isn't funny.

 

(to clarify 'our local policy' is written by a specialist radiation protection advisor who we have to employ who comes to the practice to ensure we are using the equipment in a safe and legal manner. Having one employed is a legal requirement for anyone taking x-rays)

[al4x]

Or they have an X-ray specialist who simply takes X-rays for hips as mine did, no corners cut and top quality X-rays. Don't forget most vets will be amateur radiologists and not do many for hip scores.

 

Vets and pricing is an interesting one as round here vets are being bought up by venture capital companies so anyone who suggests profits are low isn't working down here. I've paid top money and had vets a year out of vet school nearly kill my dog only saved after taking to one who operated out of a back room at that stage but with 30 years experience and still not afraid to consult a book. You ultimately pay your money and take your chances but this example is a bad one as it's something most vets do very little of and where you are best asking people who breed regularly for reconendations

[sitsinhedges]

Vets like all other people will charge what they can get away with, that's just business.

 

Ridiculous vet fees are one of the things that stop me from getting another dog.

[dorianbuilders]

Good that you got good scores Dave, I've just had mine done and that including a removal of a benign tumour with lab tests for that came in at around £500.

But what I must say is that you would hope most vets/radiologists would be able to look at the xrays and tell you if it was worth sending them to the BVA first, as that would save you another £100 should they not be good.

I have since been told of a localish vet to me that will advise you with regard to that.

Adrian

[apache]

1. Or they have an X-ray specialist who simply takes X-rays for hips as mine did, no corners cut and top quality X-rays. Don't forget most vets will be amateur radiologists and not do many for hip scores.

 

2. as it's something most vets do very little of and where you are best asking people who breed regularly for reconendations

1. Hip x-rays are easy to do. Really quite easy. What is not easy is getting a dog to lie still on its back whilst it's knees are rotated firmly inwards and legs pulled out backwards without anyone holding the dog. Holding the dog is not acceptable in this day and age, with the known dangers from radiation. You cannot take x-rays of a young bouncy dog without any sedation or anaesthetic without holding it. I promise you that.

 

2. Vets do these all the time.

 

Good that you got good scores Dave, I've just had mine done and that including a removal of a benign tumour with lab tests for that came in at around £500.

But what I must say is that you would hope most vets/radiologists would be able to look at the xrays and tell you if it was worth sending them to the BVA first, as that would save you another £100 should they not be good.

I have since been told of a localish vet to me that will advise you with regard to that.

Adrian

That's against the spirit of the scheme and something responsible vets shout not do. It defeats the concept of the scheme and the apparent improvement of hip scores over time if every dog scored is not submitted!

 

All you guys are showing with your examples is bad practice and whether you like it or not you are reinforcing my point about the mass variation in standards and ethics.

[al4x]

1. Hip x-rays are easy to do. Really quite easy. What is not easy is getting a dog to lie still on its back whilst it's knees are rotated firmly inwards and legs pulled out backwards without anyone holding the dog. Holding the dog is not acceptable in this day and age, with the known dangers from radiation. You cannot take x-rays of a young bouncy dog without any sedation or anaesthetic without holding it. I promise you that.

 

2. Vets do these all the time.

 

That's against the spirit of the scheme and something responsible vets shout not do. It defeats the concept of the scheme and the apparent improvement of hip scores over time if every dog scored is not submitted!

 

All you guys are showing with your examples is bad practice and whether you like it or not you are reinforcing my point about the mass variation in standards and ethics.

Not without sedation but there is sedation and then there is the need for a full on general. I can assure you apache that mine wouldn't be easy and wouldn't be held if she was uncomfortable, and you also wouldn't get the quality of X-rays that we got. It may not be that hard but the better the X-rays the easier they are to score. Dorian that not submitting poor ones is where the whole system falls down. What's also surprising is what people are saying they are charged for the bva to do the score, it's £57 for hips and &103 for hips and elbows that's a fixed amount unless marked up by your vet. That one dog if you can get together with others and do 5 then there are discounts available. Mine was x rayed in a morning with 5 others all done vet cost was vastly reduce hence the whole lot being just over £100 including scoring. That was 3 years ago though and the friend that took her did have to go to Southampton but that is a small price for a decent job done without a general

Edited July 19, 2014 by al4x

[sambu13]

Cost of anaesthetics vary depending on the drugs used and the facilities. For example depending on the drugs I have available I could use (at cost price to me) anywhere between about £2 and £50 in drugs depending on the protocol I chose. As a general rule the more modern the drugs the more they cost.

 

A decent monitor for the dog under anaesthetic may cost £6000. An anaesthetic machine is £1000. etc etc. It also depends what they do - some vets will do the hip x-rays under a heavy IV sedation that can be reversed (and that always is cheaper, in terms of drug cost).

 

The standards once you hand your dog over and they take it out the back vary a huge amount. That is my point. You cannot judge from the smart waiting room.

 

You CANNOT provide top quality care for rock bottom prices. It is not possible. Someone doing the same procedure for half the money is cutting corners somewhere.

 

How would you suggest customers make the most informed choice possible? i appreciate that the whole picture will ever be know but an indication would certainly help us choose a vet. when we were getting our GSP spayed we faced some almost hostile reactions to questioning about IVs and monitoring etc.

[apache]

 

How would you suggest customers make the most informed choice possible? i appreciate that the whole picture will ever be know but an indication would certainly help us choose a vet. when we were getting our GSP spayed we faced some almost hostile reactions to questioning about IVs and monitoring etc.

Ask questions. If the vet is hostile and doesn't want to answer them ask yourself why!

 

Personally we'd always happily talk to people about these things.

[apache]

without a general

There seems to be a unsubstantiated belief that a sedative is somehow safer for the dog than a full anaesthetic. The evidence does not support that. It's safer for the dog to be under an anaesthetic with a tube secured in place protecting the airway, breathing oxygen and being monitored.

 

To do hips under a sedation (and I sometimes do, depending on the dog!) requires a high dose given into the vein.

 

I suspect the preference is down to the fact a sedative costs less.