Vets Integrity/Care - Changing Vets - what would you do?? Advice urgently needed

zoeshiloh

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www.stowmarketanddistrictridingclub.com
I am posting this on behalf of our YO - she has asked me to pick the brains of people on here as to what they would do.

OK, so the situation is this (will be a long one, sorry)

YO bought a horse just before christmas - he belonged to one of her former liveries, and had been on loan for a couple of years to someone else (kept at their home). She didn't pay much for him at all as he is 16 and the owner needed to sell him (has one young child and pregnant with another, hence reason for loaning him out in first place - loaner off to uni, so wanted to give him back).

Anyway, YO buys him, gets him home and dentist is out a couple of weeks later, so she decides to have his teeth checked. Vet does teeth and says that he needs surgery as he has two cracked molars and they need to be removed. He says it should be fairly simple procedure, but worse case scenario (if sinus infected etc) it would be £1500. YO has insurance, and they agree to pay out, so he is booked in. In mean time another dentist comes to the yard, has a look and says "yes, they are cracked but might never cause a problem, it isn't totally necessary to have them out". Because insurers have already agreed to treatment, YO decides to go ahead anyway.

So, off the horse goes to the vets (at this point I would say that I did not think much of this vet as I've heard bad things about him, not that he is a bad vet, but that he will rack up the bill immensley if he knows the horse is insured. Also he works alone and never asks other vets/professionals opinions on things - I pointed this out to YO but she was happy to go with him). The vet then calls and says he could only remove one tooth, and horse would need to go back in a week later for second tooth to be removed under another sedation. OK, so he goes back the following week, and second tooth is removed. Xrays done, and antibiotics given. Then a couple of weeks after, vet comes out, removes 'plugs' and says one side is infected - gives another course of antibiotics. Another couple of weeks and there is a bad smell coming from the horse's nostril (no puss or discharge). Vet comes back, takes another xray and give more antibiotics. Now, the YO has just received a letter from the insurers to say that they have paid the vet directly for nearly £3000 (he had told her would be half this!). The vet then called YO and said horse will need another operation, sinuses flushed out etc, and even then it might not cure it. This will cost another £2000, which takes her to her limit.

Now, neither of us can see why the bill has already climbed to £3k - he has had two hospital visits, but YO has paid transport and livery whilst there. He has had half a dozen xrays, two sedations and two teeth removed. No dressings, etc - just some antibiotics. She really is not happy, as she was told it would cost £1500 at the most - she understands that things go wrong, but the vet is very funny about what he will actually tell her, and she has not seen an itemised bill at all. I have told her to ask for the itemised bill, but the vet seems reluctant to provide it, as he is dealing with the insurers??

So, I have advised her to get a second opinion. She is worried that the new vets will want more xrays etc, and that the insurers will refuse to pay if she changes. I have said that she should call the insurers and ask them first, technically the xrays belong to her as they have paid for them, so the vet should forward on his notes and xrays to the new vets. We have Rossdales just up the road, and I have tried to explain that they have a huge team of vets, and would be able to tell her whether it is worth continuing or not, and what would be the best course. The current vet seems reluctant to tell her future prognosis etc, which I think is wrong when he is charging her so much money.

The thing is, once the insurance is maxed out, she has decided that the horse will be PTS. He is 16, she paid nearly nothing for him, and doesn't want to pay out of her own pocket, thousands and thousands of pounds for something that might never be put right. I personally feel that with the correct vets this problem could have been sorted out, but she is worried about changing vets, because of the insurance and cost.

So, if you were in this position, what would you do? Has anyone have these problems before, where the teeth have been damaged and then gotten infected etc? She is worried that his jawbone might be infected, and that even if they sort this out, a few months down the line the problem could return.

Please no nasty comments about her thinking of having the horse PTS - I am hoping it wont come to that, I am trying everything to convince her otherwise.
 
Oh dear, what a worry.

You have already stated that the vet is reluctant to provide a breakdown but I think legally he has to, so one of the first things to do would be to obtain that and then run through it carefully. I would think though ( and I'm no expert ) that if there were any major discrepancies in it though the insurers wouldn't have paid out.

I would also be talking to the insurers pretty quickly and asking them whether they are prepared to pay for a secondary opinion form an alternative practice and then I would organise that as a matter of priority. It does seem that the first vet is taking the mick a bit and as the horse hasn't healed it really does need looking at by a vet your YO can trust. I'm sure the insurance company would be fine with a change of vets, I've certainly done it with my dog before during treatment I was claiming for, so that would be my course of action after running everything by the insurance company first. As long as she keeps them informed of everything i can't really see a problem.

I hope it gets sorted soon, good luck.
 
The insurers wouldn't pay out without a breakdown - they need every bl***y cotton wool ball itemised so couldn't she get a copy from them? Otherwise she just has to be firm and press the vet for a copy, legally he can't withold it so if she's prepared to be strong she will be able to get it.

I think the downside with regards to this is that it has been paid without query so she may have a fight on her hands. TBH though I think priority is getting another vet to look at the horse because the bill has been paid & getting a breakdown won't actually get the bill reduced now.
 
Rather than asking him directly she can put her request in writing, keep a copy too. It may be less confrontational, she could even put in a sae to be helpful.
 
That's the thing - she has not seen a breakdown of the bill and he is cagey about suplying one. She is quite a timid person and wont really question authority figures, so wouldn't push him I don't suppose.

He has to - just tell her to ring the practice, ask them to prepare her bill and tell them when she'll be in to collect it.

She can also get a copy from her insurers.
 
OK, so where would she stand with insurers with regards to getting another opinion? I am happy to take the horse to Rossdales for her, and I think they would be the best people to see. Would she be legally entitled to have the xrays that the first vet took? If her insurers (petplan) have paid for them, surely they belong to her/the insurers?
 
Definitely push for an itemised bill. My insurance co. pay my vets direct, but I still have a break down of each bill from my vets and it is itemised right down to every pair of surgical gloves used for Be's IRAP injections. I've had 3 serious lots of treatment for my horse on my insurance, and yet have not maxed out on any of my claims so I'd be amazed if she has done purely on dental work.
 
Would she be legally entitled to have the xrays that the first vet took? If her insurers (petplan) have paid for them, surely they belong to her/the insurers?

Absolutely! Her horse, they're paid for, her vet couldn't possibly claim otherwise.
 
Personally I would get heavy with the vets and insist on a breakdown of the bill, copies of all the xrays and a copy of the report sent to the insurers. If they won't provide I would go direct to insurers and tell them you are worried about the horses treatment and the bills, they should be able to give you at least the bill breakdown and the report.

FWIW we have a horse on our yard that has gone through what would sound to be a more extensive situation than yours, and involved GA, tooth removal, massive jaw bone infection needing to be scraped away, a few nights hospitalised, and a good month post op with 4-5 check up with lots of antibiotics. his horse is now as good as new, back in work and looking well. I can ask them how much that cost them if you want?
 
I'd be inclined to phone the Royal College of Veterinary Surgeons (RCVS) - they're the regulatory body for the vets and would be able to tell you where you stand re getting an itemised bill / ownership of x-rays etc.

What a horrible position for the owner to be in. My vets won't do a procedure of any kind without giving a very accurate cost and ensuring the owner is happy with it. If follow up procedure is needed they will let me know what my bill is standing at etc etc so I never get a horrible surprise.
 
If you can work it out in the end, please let your Insurers know your suspicions about the Vet- They can and will keep an eye on him in future and it may come back and bite him on his wotsit. Best of luck for the poor old chap, maybe it would be worth getting your dentist to have a quick look with a gag on to see if anything has been "accidentally" left in?
 
If you have private health insurance and your insurance company pays for the procedure you legally own the xrays and they have to keep them for so long in case you want to claim them. I'd assume with xrays for a horse it would be the same thing.
 
Definitely push for an itemised bill. My insurance co. pay my vets direct, but I still have a break down of each bill from my vets and it is itemised right down to every pair of surgical gloves used for Be's IRAP injections. I've had 3 serious lots of treatment for my horse on my insurance, and yet have not maxed out on any of my claims so I'd be amazed if she has done purely on dental work.

Sorry Puppy this made me laugh!! My vet got in trouble for not charging me for the gloves, so from then on everything was charged! Personally I think they should charge x for a procedure and any gloves etc they use should be included!!
 
Right, I have good experience of this and unfortunately it was from who you are planning on taking the horse to.

Firstly, call the insurance company, tell them you are not happy with the vet you are using and would they be happy with a second opinion, they might even recommend you a vet. Once they say yes you need to speak to the 'new' vets tell them the situation, the previous vet info and they should be able to contact the rubbish vet. Also put in writing to the previous practice that you are very unhappy that you have not had an itemised bill you would like this sent to you or ready for you to pick up by x, you are also very unhappy with situation - double the job, double the price and a very unhelpful vet and you are seeking a second opinion. X practice will be contacting them in due course for the horses medical history with works up to date and that you are happy for them to pass these details on.

With regards to the xrays unfortunately they are 'owned' by the vet practice, not even the insurance company!! They are well within their rights to ask you to pay for the copies and they could get difficult with you. Now if you are taking the horse to say Rossdales or Newmarket Equine Clinic (better) or even AHT hopefully the vet will not want to lose face with any of these big practices and will email them over free of charge, however when I was asking I was going to be charged several hundred for mine to be sent over.

The vet has to give you the breakdown of what he has done to your horse as you are the owner!!

I had this situation a few years ago with a very well known hospital, my horse had every test under the sun bar MRI for everything that wasn't a major issue. He had gone in with hind limb lameness due to falling over on the lunge and damaging his stifles. They checked his neck, his back and his feet and there was apparently nothing wrong with his back legs. After 3 claims were raised and paid for by the insurance company the horse was crippled, the vet made out that there was nothing wrong with him and told me to just get on with him. He wasn't prepared to get off his high horse and come and see the horse and also told me under no circumstance should the horse be pts, and he didn't want me getting it done and telling people he recommended it.

I was so upset that I called my insurance company (NFU) and told them the situation, they were so lovely and said that this vet was very well known for being like that!! They recommended a few other vets in the area and I told them who I wanted to use and they said it was all fine. Within reason they would pay for similar or same tests if the tests before weren't conclusive, so a fresh xray etc would be permitted.

Had a new vet out who even stopped me walking him in hand - I had told her the issues he had, had and the treatment, said nothing about a fall on the lunge or stifle problems. She organised me to get him in the next day as he was so bad. Straight away they diagnosed stifles! So another claim, we tried everything with arthroscopy and treatment but he was pts 6 months later. Due to changing vets i was 'banned' from using the previous vets, they said they didn't want my custom anymore - not that I would have ever taken a horse back there again!!

So fight for the second opinion and make sure you go for one that isn't going to spend the rest of the money in a morning! Good luck to you and your friend.
 
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