Vet Bills…..Panorama….BBC 1

Our small animal vets are independent and fantastic - both cost and service wise. We're very lucky. they also have an equine branch, which I don't use, but only becaue I've been with my current equine vets forever, they know the horses well and I really like them too.

However, when we had our old man cat PTS, they put a catheter in and needed to sedate him to get it in, before administrating the lethal drug (He'd spent quite a lot of time in the vets in the year before PTS due to eye ulcers and eye removal). Before his eye issues, he'd
always been very good with needles, so I think he found the catheter insertion traumatic and fought it - they took him away from us for this bit, which is something I will always regret allowing. He was incredibly weak and 'ready' due to a large tumour growing in his stomach very quickly. It cost lots of money, and was incredibly upsetting as we felt he didn't know if we were there in his last moments as he was heavily sedated. We took him home to bury him. He was the kindest and most gentle cat and did not deserve an ending with added trauma.

When we had our old lady cat PTS last year, we specifically requested that she didn't have the catheter or sedation and has the drug injected directly. this is how they'd always done it previously and we're happy to do so. Meant we stayed with her the whole time, and she knew we were there. Much better, and also a fair bit cheaper too! she's also buried at home.

I do worry about vet bills, but we have back up just in case... but sometimes even if it's affordable, it feels like a head and heart decision where this amount of money is concerned.

I think one of the biggest issues with vets is that they don't have their prices available to view, and unless it's a big procedure, they rarely discuss cost, that, alongside added extras that just don't make sense. One of my current cats has epilespy that's controlled with a drug called Epiphen... the drug itself is cheap, and the 'dispensing fee' is actually more expensive that the drug. After a battle, a letter and them realising I'd actually had some vet nurse training and wasn't a complete novice, would they give us three months worth, not one month... which is much more sensible!
 
anguscat said:
I just find him rather predictable in his takes on issues. I find him in his bubble/camp and inclined to stay there and argue from it.
Click to expand...

He's the opposite in many ways. He changes his mind through the hour on certain topics, especially since he went through therapy (during lockdown I think). He has a blind spot on the economy (from my point of view) and on anything he thinks is extreme left (Corbyn for example), he's a bit small c conservative so tends to go with current perceived wisdom in terms of the economy (ie capitalist and right of centre compared to the 60s and 70s, struggles to move away from the household budget model).

He has shifted, and does shift, on quite a few things. I would imagine he's further left than you, so it can feel like he doesn't change his opinion as he changes from one type of left of centre opinion to another (broadly). Has Nick Ferrari ever changed his mind within an hour's phone in? I can't listen to him for more than the last 15 minutes, or in clips where he's actually not simply repeating DM headlines, so no idea.

I'm not sure I know any other chat show host who shifts his position as much and seems to enjoy the process. I mean he even calls them "ping pong" topics where he shifts back and forward throughout the hour.
 
Trot_on said:
I think one of the biggest issues with vets is that they don't have their prices available to view, and unless it's a big procedure, they rarely discuss cost, that, alongside added extras that just don't make sense. One of my current cats has epilespy that's controlled with a drug called Epiphen... the drug itself is cheap, and the 'dispensing fee' is actually more expensive that the drug. After a battle, a letter and them realising I'd actually had some vet nurse training and wasn't a complete novice, would they give us three months worth, not one month... which is much more sensible!
Click to expand...
To be fair to your practice, because Epiphen is a Sch 3 Controlled Drug, the new prescribing regulations stipulate prescribing a maximum quantity of 30 days supply at one time.
You can prescribe up to 3 months, but this can only be in truly exceptional circumstances and for a justifiable clinical need. In these cases robust documentation of the reasoning for the exceptional circumstance must be made that will stand up in court. I think you have been very lucky with your practice here because just not being a 'complete novice' is not something that would normally be considered an exceptional circumstance in the eyes of the law.
 
Last edited:
@sbloom maybe I should re-listen to him again. Haven’t for years. Your comments don’t reflect how I recall him. Quite liked a book he wrote a few years ago. I’d like to get some time to read Follow The Money.
 
Gamebird said:
To be fair to your practice, because Epiphen is a Sch 3 Controlled Drug, the new prescribing regulations stipulate prescribing a maximum quantity of 30 days supply at one time.
You can prescribe up to 3 months, but this can only be in truly exceptional circumstances and for a justifiable clinical need. In these cases robust documentation of the reasoning for the exceptional circumstance must be made. I think you have been very lucky with your practice here because just not being a 'complete novice' is not something that would normally be considered an exceptional circumstance in the eyes of the law.
Click to expand...
Just to follow in from Gamebird’s post, all of which is correct, I would like to point out that this is a LAW. If a vet is found to not have the robust clinical reasoning documented in the notes, then they can be reprimanded legally, including prison time, and will be struck off, thus unable to practice their profession again. ‘Because it saves a dispensing fee’ is absolutely not an appropriate reason, cost is also not a justifiable reason to go ‘off cascade’ with medicines, we legally can’t just use a human one because it’s cheaper, or tell you to buy a human one on the hush hush, because, yep, jail time.
Dispensing fees are a bundled together fee added to medications supplied by a practice that reflects the cost to the practice of ordering, stocking, appropriate storage which includes refrigeration, appropriate dispensing vessels for each medication, the cost of labelling the drugs including printing, the cost of countersigning the drugs, delivery, paying staff to manage the pharmacy, paying staff to dispense the medications stocked in the pharmacy etc, dispensing fees are perfectly reasonable to charge, it costs a lot of money to hold stock and medication accounts, and fulfil criteria to be allowed to stock and supply them in the first place. Oh but online pharmacies do all that and are cheaper I hear you cry. Yeah, because they only employ one vet to check (maybe two or a job share), and they have a huge warehouse with insane buying power that practices JUST DO NOT HAVE AS WE CANT STORE THAT AMOUNT. I have said it many times before, but a lot of folk just like to have the same old arguments in their head and trot it out for the ‘big vet scandal’ discussions, online pharmacies sell their drugs cheaper to owners than we can buy it in WHOLESALE. So obviously, we cannot compete, and obviously, our costs will inevitably be higher to us as a business, and therefore higher to consumers
 
Redders said:
Just to follow in from Gamebird’s post, all of which is correct, I would like to point out that this is a LAW. If a vet is found to not have the robust clinical reasoning documented in the notes, then they can be reprimanded legally, including prison time, and will be struck off, thus unable to practice their profession again. ‘Because it saves a dispensing fee’ is absolutely not an appropriate reason, cost is also not a justifiable reason to go ‘off cascade’ with medicines, we legally can’t just use a human one because it’s cheaper, or tell you to buy a human one on the hush hush, because, yep, jail time.
Dispensing fees are a bundled together fee added to medications supplied by a practice that reflects the cost to the practice of ordering, stocking, appropriate storage which includes refrigeration, appropriate dispensing vessels for each medication, the cost of labelling the drugs including printing, the cost of countersigning the drugs, delivery, paying staff to manage the pharmacy, paying staff to dispense the medications stocked in the pharmacy etc, dispensing fees are perfectly reasonable to charge, it costs a lot of money to hold stock and medication accounts, and fulfil criteria to be allowed to stock and supply them in the first place. Oh but online pharmacies do all that and are cheaper I hear you cry. Yeah, because they only employ one vet to check (maybe two or a job share), and they have a huge warehouse with insane buying power that practices JUST DO NOT HAVE AS WE CANT STORE THAT AMOUNT. I have said it many times before, but a lot of folk just like to have the same old arguments in their head and trot it out for the ‘big vet scandal’ discussions, online pharmacies sell their drugs cheaper to owners than we can buy it in WHOLESALE. So obviously, we cannot compete, and obviously, our costs will inevitably be higher to us as a business, and therefore higher to consumers
Click to expand...
I understand all the points you are making but client's simply cannot afford to buy from vets so have to buy online. My cat for example is on thyronorm. It is around £47 online and vet charges me £120 for the same quantity. What am I expected to do.
 
I was trying to steer clear of this thread for my blood pressure, not saying all of you are a problem for me on the thread, but that the argument is exhausting. I will say though, that by far and away, the biggest amount of complaints/expressions of displeasure from owners, are because they want top tier treatment, but only want to pay bottom tier prices (caveat not everyone but, my days, enough for it to be the most common treatment plan discussion I have). Example:
Me -
I suspect xyz is wrong with pet, my recommendations are A, B or C. By choosing B or C, these are the trade offs, the things we may miss, side effects etc, but pet still has reasonable chance of resolution.
Owner -
A then please.
Me- ok the costs are 1234
Owner-
WHAT? Why so much?
Me -
Because of A, for this reason, B for this test, C because this drug causes this issue and the more expensive one doesn’t, D because we ideally need to know bla bla or such and such may occur. Options B and C cost this much respectively
Owner -
But I want A
Me -
Ok then, shall we go ahead?
Owner -
But I don’t want to pay that!! It’s ridiculous!
Me -
Ok then we go for option B, middle of the road?
Owner -
But you said without that test that we wouldn’t know xyz and I want to know xyz, and that the drug might not be as good
Me -
This is true, but I also said there is a reasonable chance of resolution with option B and C
Owner -
I don’t want reasonable chance, I want the test and the other drug
Me -
Ok, well then, that is option A
Owner -
But why is it so expensive???!!
Me -
………… and rinse and repeat.
 
paddy555 said:
I understand all the points you are making but client's simply cannot afford to buy from vets so have to buy online. My cat for example is on thyronorm. It is around £47 online and vet charges me £120 for the same quantity. What am I expected to do.
Click to expand...
Oh I don’t mind people buying online! It makes sense to do so, and I write so many online prescriptions daily I lose count, I offer them to all clients where waiting a few days to order and deliver is appropriate.
The issue I have is people claiming the vets are terrible profiteers for charging so much more than pet drugs online, for example. ‘My vet sold me tablets that cost £43, but I bought them from online for £22. Vets are disgusting’

It’s ill informed and mean. And it doesn’t matter how well you inform these owners of the reasons, they still forget and call you disgusting, in it for money, don’t care bla freaking bla.

This isn’t aimed at you paddy555, and I completely agree with buying online if it suits and works out cheaper, but the same companies that own the big corporates, also own the main pharmacies. Animed = CVS; pet drugs online = IVC; vetuk = vetpartners; viovet = pinnacle pet group (not a vet practice owner but pet insurance and services)
So when owners state to me that they will just take their drug business to pet drugs online because they don’t charge our ridiculous prices and they will vote with their feet and we won’t get their money….. the company they don’t like because they are a greedy corporate, will still get their money anyway.
this is one of the points I wish the CMA actually investigated, and would actually remedy, this is something that actually corners a huge part of the market to corporates
 
Nice to see you back, Redders :)
I think you guys have it much tougher in the UK with your regulations, not being able to go off label etc than we do over here which sounds super stressful.
Re the euthanasia and the catheter- I would NEVER do a euthanasia without putting a catheter in. If that drug goes extra vascular it really hurts. Much worse than having a catheter placed (esp with the local anaesthetic sprays etc we have now)..
 
paddy555 said:
I understand all the points you are making but client's simply cannot afford to buy from vets so have to buy online. My cat for example is on thyronorm. It is around £47 online and vet charges me £120 for the same quantity. What am I expected to do.
Click to expand...
Ditto what Redders said - absolutely get a prescription and buy online. No one would expect anyone to spend nearly 3 times the price. Vets are totally happy with that.

BUT (and again, this may well not be you, but it is an awfullot of people, as this week has demonstrated) don't also yell that the £120 is disgraceful profiteering on the part of the vets. Take a minute to understand the many reasons the cost is so much higher, that we can't even purchase the drugs ourselves for £47, and the £120 does not represent pure greed on the part of the vets.
 
KEK said:
Nice to see you back, Redders :)
I think you guys have it much tougher in the UK with your regulations, not being able to go off label etc than we do over here which sounds super stressful.
Re the euthanasia and the catheter- I would NEVER do a euthanasia without putting a catheter in. If that drug goes extra vascular it really hurts. Much worse than having a catheter placed (esp with the local anaesthetic sprays etc we have now)..
Click to expand...

I would never give euthanasia solution off the needle either in an alert animal
It stings intravascular never mind extra vascular.

However, I rarely place catheters for euthanasias and my IM sedation puts the pet under a surgical level of anaesthesia before an intrarenal injection of euthanasia solution. This let's the owner cuddle the pet to sleep and they keep the front end for petting/loving on while I carry out the procedure. Easier and kinder in home.
 
druid said:
I would never give euthanasia solution off the needle either in an alert animal
It stings intravascular never mind extra vascular.

However, I rarely place catheters for euthanasias and my IM sedation puts the pet under a surgical level of anaesthesia before an intrarenal injection of euthanasia solution. This let's the owner cuddle the pet to sleep and they keep the front end for petting/loving on while I carry out the procedure. Easier and kinder in home.
Click to expand...
This is how my vets do it.
 
Gamebird said:
To be fair to your practice, because Epiphen is a Sch 3 Controlled Drug, the new prescribing regulations stipulate prescribing a maximum quantity of 30 days supply at one time.
You can prescribe up to 3 months, but this can only be in truly exceptional circumstances and for a justifiable clinical need. In these cases robust documentation of the reasoning for the exceptional circumstance must be made that will stand up in court. I think you have been very lucky with your practice here because just not being a 'complete novice' is not something that would normally be considered an exceptional circumstance in the eyes of the law.
Click to expand...
This is really interesting thank you - the vet who prescribed just said it was on a case by case basis and she was comfortable than I wouldn't overdose my cat! It's also a much better explanation as to why they couldn't prescribe more than 30 days previously. Thank you :)
 
Mynstrel said:
Does anybody else wonder if some of this has come about because of the way some pet parents (yes that phrase is used for a reason) think these days ie "fluffy must live forever regardless of the cost" and some companies are just cashing in on that?
Click to expand...
It's more to do with the massive advances in medical technology and treatment options, which come at an equally massive cost - and people naturally wanting what's best for their pets - as well as a rise in pet ownership without an equal rise in the understanding of the costs involved - and the corporates saw a way to become involved.
 
Redders said:
Oh I don’t mind people buying online! It makes sense to do so, and I write so many online prescriptions daily I lose count, I offer them to all clients where waiting a few days to order and deliver is appropriate.
The issue I have is people claiming the vets are terrible profiteers for charging so much more than pet drugs online, for example. ‘My vet sold me tablets that cost £43, but I bought them from online for £22. Vets are disgusting’

It’s ill informed and mean. And it doesn’t matter how well you inform these owners of the reasons, they still forget and call you disgusting, in it for money, don’t care bla freaking bla.

This isn’t aimed at you paddy555, and I completely agree with buying online if it suits and works out cheaper, but the same companies that own the big corporates, also own the main pharmacies. Animed = CVS; pet drugs online = IVC; vetuk = vetpartners; viovet = pinnacle pet group (not a vet practice owner but pet insurance and services)
So when owners state to me that they will just take their drug business to pet drugs online because they don’t charge our ridiculous prices and they will vote with their feet and we won’t get their money….. the company they don’t like because they are a greedy corporate, will still get their money anyway.
this is one of the points I wish the CMA actually investigated, and would actually remedy, this is something that actually corners a huge part of the market to corporates
Click to expand...
That explains something, I'd always wondered why the corporates couldn't buy in enough bulk to reduce the prices to the customer, but you've explained that nicely - they do but mark up anyway unless you go to their alter ego.
 
Landcruiser said:
It's more to do with the massive advances in medical technology and treatment options, which come at an equally massive cost - and people naturally wanting what's best for their pets - as well as a rise in pet ownership without an equal rise in the understanding of the costs involved - and the corporates saw a way to become involved.
Click to expand...
Totally agree, but what's best for them isn't always about them staying with us. What's the phrase, just because we can, doesn't mean we should?

I'm just not sure some people fully think through what they're going to put their pet through and how long the treatment goes on compared to how much quality life they're actually going to gain afterwards, then consider who they're actually doing it for, the pet or the human. I know on here the trend is quality of life first but I think some clutch at the straws offered and like you say some vets see the opportunity.
 
Trot_on said:
This is really interesting thank you - the vet who prescribed just said it was on a case by case basis and she was comfortable than I wouldn't overdose my cat! It's also a much better explanation as to why they couldn't prescribe more than 30 days previously. Thank you :)
Click to expand...

I think the Supervet has a bit to answer for. I can't watch it, too much I disagree with.
 
Well my Jack Russell was in today had his biopsy done, good news is that my vet said the lumps were very fatty and he is a little more optimistic but obviously we now have a week to 10 days to wait for the results….
Said dog (who has never ever had an “accident” in the house we have had him since he was 10 weeks he’s now 9) came out of the vets took me over to one of their bushes and did the longest ever wee I have seen….!!
Arrived home and did zoomies round garden…..he has staples not stitches….happy dog, very happy mum…
Plus the bill was half what I was dreading…..
 
Gamebird said:
Take a minute to understand the many reasons the cost is so much higher, that we can't even purchase the drugs ourselves for £47, and the £120 does not represent pure greed on the part of the vets.
Click to expand...

I was chatting to my vet about this last week when he came out for vaccinations and wrote me a prescription.

I know you know this but for those who don't.


He is tied to purchasing from the official vet suppliers who charge far more. Online companies go direct to the manufacturers and negotiate deals. He is not allowed to shop around and buy cheaper and then sell it to me cheaper.

He is happy to provide a prescription and put the maximum we can squeeze onto one 6 month prescription.
 
criso said:
I was chatting to my vet about this last week when he came out for vaccinations and wrote me a prescription.

I know you know this but for those who don't.


He is tied to purchasing from the official vet suppliers who charge far more. Online companies go direct to the manufacturers and negotiate deals. He is not allowed to shop around and buy cheaper and then sell it to me cheaper.

He is happy to provide a prescription and put the maximum we can squeeze onto one 6 month prescription.
Click to expand...


My horse vets, quite a large indep. practice.

I had 3 on prascend, got a script, bought online.

started to run out so asked for another script (which they give for 6 mths) Head horse vet told me I could now go onto pergoquinn if I wanted. No script needed, I buy directly from the vet and just ring and they will post it.

So no script cost any longer and pergoquin is a few pence a tablet cheaper than online prascend.

being aware as to how much vets charge for prascend directly from them I asked how.

was told they had joined up purchasing with other independents so they had large bulk buying power and could therefore negotiate the price. (presumably directly with the manufactures)
 
paddy555 said:
My horse vets, quite a large indep. practice.

I had 3 on prascend, got a script, bought online.

started to run out so asked for another script (which they give for 6 mths) Head horse vet told me I could now go onto pergoquinn if I wanted. No script needed, I buy directly from the vet and just ring and they will post it.

So no script cost any longer and pergoquin is a few pence a tablet cheaper than online prascend.

being aware as to how much vets charge for prascend directly from them I asked how.

was told they had joined up purchasing with other independents so they had large bulk buying power and could therefore negotiate the price. (presumably directly with the manufactures)
Click to expand...

I'm part of a buying group - my cost price is still often similar to the UK online pharmacy prices on about half the stock. It definitely helps but it doesn't give the buying power these huge places have.
 
Just on the euthanasia conversation.

My first dog was done without sedation. She had just been for her last walk and was done stood up, tail wagging and scoffing a chocolate bar. It was super quick and I found it a more positive experience. Furthermore, there were none of the gasps etc after she had gone which I am led to believe is linked to the sedation?

In contrast, my second dog was given sedation. She didn't seem to be affected by it whatsoever and we were still stood waiting for it to work some ten minutes later. She eventually led down, but I don't think it was because of the sedative. She was a poorly girl and had just had enough of being stood up. She gasped a lot after she had gone. It felt like a long process. Standing around in the room waiting for my dog to be considered sleepy enough to be PTS just added to the trauma for me.

The latter seems to be the norm now. Im sure there must be solid justification for that now being the gold standard.
 
There is no gasping/agonal breathing with the meds I use. They are not linked to sedation, just to the brain shutting down and the heart stopping, how quickly the meds are given and how good the circulation is. I give an IM/SubQ injection, dog is happily sitting up and can eat treats etc. Slowly gets drowsy over about 5mins and is snoring peacefully by the time I give the second injection which stops the brain/heart.

The issue with off the needle is that if the dogs moves, the euthanasia solution is quite painful and it's quite viscous so injecting it is difficult already (this is a bigger issue in horses with more concentrated solutions). If you place a catheter it means restraint, often clipping, taping etc all of which can be worrying for the pet.

If I do use a catheter it's a butterfly extension set in a lateral saphenous (vein in hind leg) so again owners aren't in the procedure zone.
 
criso said:
I was chatting to my vet about this last week when he came out for vaccinations and wrote me a prescription.

I know you know this but for those who don't.


He is tied to purchasing from the official vet suppliers who charge far more. Online companies go direct to the manufacturers and negotiate deals. He is not allowed to shop around and buy cheaper and then sell it to me cheaper.

He is happy to provide a prescription and put the maximum we can squeeze onto one 6 month prescription.
Click to expand...
My Horse vet said the same thing, She told me to get a prescription and get medication cheaper online (she charges me £12 for the prescription!) I said at the time if i did that was i not sort of doing her out of business as such and she replied no it was the fact she was tied to having to buy from more expensive suppliers that was doing her over.
 
Jenko109 said:
Just on the euthanasia conversation.



In contrast, my second dog was given sedation. She didn't seem to be affected by it whatsoever and we were still stood waiting for it to work some ten minutes later. She eventually led down, but I don't think it was because of the sedative. She was a poorly girl and had just had enough of being stood up. She gasped a lot after she had gone. It felt like a long process. Standing around in the room waiting for my dog to be considered sleepy enough to be PTS just added to the trauma for me.

The latter seems to be the norm now. Im sure there must be solid justification for that now being the gold standard.
Click to expand...
mine was done that way in the way Druid describes in para 1. He certainly wasn't going to help in anyway letting the vet get into a vein and it would have caused enormous stress so she simply walked behind him whilst I held him and put the injection into the scruff. We were at home which was easier and had a coffee for 10 mins whilst he went to sleep. That was very peaceful and calm, Just laid down and slept. By then he was totally out of it. I didn't stay with him as he was very attached to me and no way did I want him to even begin to think of waking up or stressing in any way even though he seemed gone already. Vet and nurse went in with him and it was all very calm.

i can imagine having to sit in the waiting room would be so stressful. I'm sorry you had that experience.
 
You must log in or register to reply here.
Top