Saturday, September 01, 2012

A Massive Veterinary Bill for an Upset Stomach

Mountain is the poster child for a ball of energy and so when I found her in her crate Wednesday morning, having vomited up all her food and looking poorly, it was very unusual.

I took her outside and she drank a lot of water.  A good sign, and I left her in the yard all day Wednesday to take some sun and relax, skipping her feeding.

That night, Mountain was still not eating and did not seem interested in water.  I crated her overnight, and when I let her out Thursday morning, she was still not interested in eating and took only a single sip of water.  Not good.

I took her inside and crated her for the day.  That night, she was still not interested in eating, and took only a single sip of water. 

The next day, Friday morning, I took her to the vet at 7:30 AM.  A dog that will not drink is not a good thing, and I was worried.  They said they wanted to keep her overnight.  The next morning they called and said I could pick her up at 2 pm.

I picked her up Saturday at 2 pm, and the bill presented to me was for $921.75.

It seemed she only had an upset stomach.  Here's the bill for that little diagnosis:

  • Physical Exam - $68.25
  • Radiography 1st film - $107.75
  • Radiography Additional Films - $66.25
  • IV Catheter Placement - $76.00
  • Intravenous Fluids (1 qty) - $60.50
  • Hospitalization Canine 0-20 lbs) - $53.25
  • Health Profile Cbc - $144.50
  • Famotidine Injection - $33.00
  • Cerenia < 15 pounds - $32.00
  • Fecal Cytology - $29.25
  • Fecal and Giardia Elisa - $41.75
  • Recheck Exam - $39.50
  • Cerenia < 15 pounds - $32.00
  • Famotidine Injection - $33.00
  • Intrevenous Fluids (1 qty) - $60.50
  • Partial Hosp. dof 0-20 -- $44.25
  • TOTAL:  $921.75

The instructions I was given as I was leaving:  A printed sheet for a "Bland diet for Vomiting and Diarrhea": 
  • No food for 24 hours to let the gastrointestinal tract to rest.
  • Imodium A-D or generic lopramide HCI (available at Target for less than $2) at the rate of 1 tablet per 50 pounds or 1/2 teaspoon  per 15 pounds, three times daily.
  • Pepcid AC (also generic over the counter available at Target for under $2) can be given once daily for vomiting, not eating, or stomach gurgling (< 10 pounds 2.5 mg, 11-25 lbs 5 mgs, 25-50 pounds 10 mg, 50-11 pounds 10 mg)
  • A bland diet should be fed to your pet for three days after fasting.  Make food from 2 parts cooked rice to one part skinless chicken, turkey or lean hamburger.
Yeah, right.  Anyone wonder why I do not go to vets with bills like this?

For the record, Famotidine is just an antacid, and you can order 170 tablets for less that $12 without prescription from Amazon.  I was charged $66 for two tablets.

Cerenia is just an antivomiting medication not very different from dramamine, which is over the counter at a cost of 50 cents a dose.  Cerenia cost $8 for four tabs from Drs Foster and Smith.  I was charged $64 for two pills.

Intrevenous fluids is simply a bag of lactated ringers solution, which costs less than $6.  I was charged $60.50 per unit (not including the catheter placement which was another $76.00).

And yes, I am in the market for a new vet.


Unknown said...

You have my sympathy. I'm much of the same mind as you re vets - only when absolutely necessary. But my experience with my dog's last upset stomach was wrenching. After two days of home treatment by me we reluctantly went to the vet and $1800 later I came home with a cured dog and a peach pit which I sterilized and painted gold. I hung it from a satin cord and it is quite a nice bit of jewelry.


Viatecio said...

Did they not even give you an estimate of services to be performed? That's just insane, those prices are amazing! That's slightly less than my total bill for a pancreatitis case that required around-the-clock care over the weekend and IV drugs infused through fluids.

Are prices like that normal in your area?

I know there's the whole "Would you search for a pediatrician by price-checking" thing, but there's a certain line of quality care that should intersect with decent prices, especially since people pay out-of-pocket.

jb said...

An acquintance recently thought her dog accidently swallowed one of her child's ADHD meds. She took the dog in where they gave it hydrogen peroxide and charcoal. $500 to a gal who struggles to make $13/hr.

Doctors, vets, professionals now know that they can charge ridiculous sums to many of their clients. They are counting the same level of cooperation/ignorance that are also reflected in our own personal medical care decisions... e.g. Say "yes" to whatever the MD tells you without any questions.

I learned years ago to put my vets on notice that I must approve treatment and cost est. prior to administration. It seems to work when they know that they have an engaged and educated consumer.

Seahorse said...

There's the bill-padding you're always talking about. The radiographs are ALWAYS a hideous rip-off. Yes, at times you need them, but they cost a couple of bucks. If they didn't have significant fudge-factor in there, why would the second x-ray be so "discounted"?

Did that nice old vet who helped when Sailor went down in the field retire?


Seahorse said...

This got me thinking about the time my male JRT was in a similar condition and I took him into our local "country" vet's office. I pulled the bill out, dated 1/19/2012.

Breakdown: Office visit: $39.00
Radiograph II: $85.00
IV fluids: $15.00
Metronidazole 250 mg: $5.00
Fortiflora box of 30: $35.00

Total: $179.00

This total included having an outside radiologist review his x-rays to be certain he had not ingested a foreign body.

Same vet did my boy's neuter, double cryptorchid, for $185.00, even though he said it was a lot more involved than he'd thought. Because he'd promised to do it for under $200.00 he kept his promise.

The "city" vet in my town would have charged at least triple for each visit. Fair vets do exist.


boct said...

Perhaps they read your blog and you are 'red-flagged' and they are spiteful as in 'we'll fix your dog and we'll fix you up as well for blasphemy of our imperial ways'.

Perhaps the name of the vet's office should be known..damn it all for this open billing latitude of some in the industry.

I have had variable billings with my vet depending on the examining vet at the time. Usually new vets to an office seem to be eager for up selling and 'diming'.

I'm surprised their take out lunch wasn't included in your bill.

Viatecio said...

RE Rads, you're not just paying for the picture. You're paying for the techs/assistants to take them, the doctor to look at them...

...and the equipment to take them and, if necessary, develop them.

I'm not defending the high cost by any means, and yes I feel that they are way overpriced. But once a clinic goes digital, the only reason price might change, if at all (and usually upward) is because you're helping pay for new equipment, new computer programs and rewiring so the rooms can have monitors now.

With all that said though, rads themselves are quite inexpensive. Bill-padding, oh you bet.

PBurns said...

boct -- No, they do not even know me. I take my dogs in for neuter/spay and rabies and once for teeth cleaning. They simply do not see me. This vet seems to have changed management a few years ago, and I notice that the vet who dealth with Mountain claims expertise on "homeopathy." Yes, that's right. Run screaming. Junk billing and junk science. I could scream, and I will send a letter, but life is too short to wrestle with the devil. I am simply ditching this vet and going to find another.

Garnet said...

Yeah, a vet with expertise in homeopathy is going to rip you off. Any vet that tries to sell me what's basically water for high prices won't get my business a second time.

Karen said...

They always f**k you at drive thru!! Damn.

I went to an emergency vets on a long weekend because I thought that my dog had bloat. $700 later I was told that my dog *might* have had heat stroke.

If you are looking for a new vet, try this site.

badgerhse said...

Yep, you're paying for the staff, the vet's over 100,000 in student loans....try comparing it to human medical care costs...the education and equipment is not dissimilar....going to vet school is a lousy financial investment, plumbers make more, AND you get to listen to garbage about price gauging vets. good thing the animals make it worth it. If the education and skill isn't worth it to you, treat at home, you can buy anything on the Internet it seems. Can't hit a vein for an injection or IV cath? Cant read a fecal? Found out an X-ray machine requires a bunch of regulation and expensive equipment? Maybe the skills are worth something after all.

PBurns said...

Actually badgerhse, almost everything I was billed for would have been illegal as bill padding or rejected as price-gouging if done in human medicine. If you think $925 is the cost of treating an upset stomach, you are mistaken, ditto if you think overnight hospitalization is the norm for anything short of massive bleeding, or that insurance (private or Medicare) allows charging $60 for 10 cents pills. The parallels you make between human medicine and animal medicine are mostly fictional. Not only do veterinarians not have to pay medical malapractice claims (if they kill your dog, too bad for you!), but they are also not covered by most consumer fraud laws or the False Claims Act. As a result, vets feel free to price-gouge, up code, bill pad, and in fact the entire industry is built on that.