Reasonable charge for a suture on a dog?

[pob]

Hi gents

I'm really sorry if this breaches some kind of etiquette.

My Labrador cut her leg on glass last week (I presume). She was still moving around fine and it didn't seem to bother her. I ordinarily sort out minor cuts myself but, although this one stopped bleeding quickly and was clean, it looked a bit wider than I was comfortable with and in a high flex area, so I rang the vet asking if they could give it a couple of stitches. (Picture attached.)

They insisted on using a GA to allow them to work on the wound uninterrupted, which seemed reasonable. She didn't need an overnight stay. She's not on any further drugs, just a daily oral painkiller suspension.

Final bill was £743.72 (reduced from £787.36 after I spotted an overcharge for a snap test). That's over twice what it cost to have her speyed!

Does that seem like a reasonable ball-park cost?
Have I misunderstood the complexities and costs of what seems to me, the completely uneducated, a simple procedure?
Or is the new vet at the practice taking the opportunity to bend me over?

 

[finnbear270]

You have had your trews yanked down.

 

[75]

I'm generally the first to defend vets fees but, er, how much?? I'd prob also have taken a trip to the vets for that one but a staple or two maybe?

 

[sh1kar]

Did you go out of hours/emergency?

 

[NP435]

My vet would do that for under 200 USD even if GA was used.

 

[pob]

Did you go out of hours/emergency?

No.

But I did go to their hospital. They have two sites. I might have picked the wrong one.

 

[sh1kar]

Does seem very expensive

 

[KRW]

Wow, I'm out of touch with these things as not had a dog for some 15yrs or more now, but unless you have insurance to cover these instances it looks like you could find yourself well and truly stung by these professional bodies, whereas if you do have insurance its the companies that get stung and and which in turn sees the premiums constantly increase....

 

[sh1kar]

Wow, I'm out of touch with these things as not had a dog for some 15yrs or more now, but unless you have insurance to cover these instances it looks like you could find yourself well and truly stung by these professional bodies, whereas if you do have insurance its the companies that get stung and and which in turn sees the premiums constantly increase....

Which is why I self insure myself and the dogs

 

[Bo Diddley]

Charges like this are also why I come across more people that have gone back to the old skool ways of a final walk in the woods with a .410

 

[KRW]

Which is why I self insure myself and the dogs

Its getting to the point where practically everything we do or partake in will need to be insured against,
What happened to the days when we just went about everyday life and when mishaps occurred we bore the cost which were more of a kick in the pants rather than having to face serious unexpected and extortionate costs and fees.

 

[Bavarianbrit]

Did you manage to get into the car park between the Bentleys and RRs?

 

[Fair Hill]

You'd get a brand new dog for that money.

Seriously, I hope you haven't paid what he asked for.

 

[TringSaint]

That is outrageous.
I know agri vets are not the same thing, but a friend of mine had the vet out to see to one of his cows with a twisted gut.
Cow was opened up whilst standing, gut untwisted and stitched into place and the huge opening re stitched and that all was <£300!!!!
We had 5 ewes out through embryo transfer flushing with the resulting embryos put into 19 miles and the cost of the entire process, including multiple over night stays for the ewes and ram and a full day onsite with 3 vets and all the donor ewes put into full GA, was £3.5k and there were a lot of drugs involved.
Dog and cat vets seem to extract the urine with their charges, especially for things that take 10 mins and require little equipment or medication.

 

[hcm1]

For perspective looking at a wound like that which is a few days old and in a high motion area you would be lucky to just be able to stick a few staples/stitches in it and have a decent chance of success. Generally speaking with older wounds you tend to need to cut out the whole of the "old" wound and create a whole new fresh one which you then stitch up and aim to heal by what is termed First Intention. Now for obvious reasons this requires a general anaesthetic. Did that wound NEED stitching, possibly not but it would definitely have needed some extra care, cleaning and dressing for a while etc. Surgical debridement and closure usually gets it healed more quickly, assuming the surgical repair does not break down, in which case you are back at square one but managing a wound like that to allow second intention healing is perfectly acceptable.

In these situations it is useful to consider the concept of "Theatre Time" i.e. the cost of operating a fully equipped surgical suite. Now this would generally consist of a dedicated (heated) room housing a specialist table, surgical lighting, gaseous anaesthesia machine, multiparameter anaesthetic monitoring machine, sterile surgical kits and equipment, emergency resuscitation equipment, a fully trained surgeon and often a fully trained nurse to monitor the anaesthesia. There will be a group of support staff waiting to receive the patient in recovery and monitor until awake and then disinfect the housing and betting between each patient in addition to turning around the surgical room for the next procedure, washing and sterilising the instruments used, cleaning all the surfaces, probes and machines used etc etc.

In short, in some scenarios it doesn't necessarily matter what procedure takes place in a theatre, the costs to run the theatre are the same and it has to pay for itself and maintain itself.

Now, I could have likely stitched that wound on the tailgate of a pickup with some sedation a bit of iodine, a leatherman and a pack of suture material BUT the chance of complications would be much much higher, I would have had to prescribe antibiotics which we are trying to avoid using as much as possible, there would have been no monitoring equipment available to check the quality of the sedation, no heating and no nurse monitoring the anaesthesia. Therefore the safety of the patient would be compromised but it would likely have cost you 30 quid and a beer. BUT what would your feelings be should the wound break down again, or become infected with potential progression to a cellulitis and even involve the joint? Now these latter scenarios are highly unlikely but not impossible. When an animal is presented to us we are duty bound (and personally aim to) provide the very best care with the lowest risks of complications that we can.

Now without being privy to the invoice of works done it is hard to understand where the final costs came about but my immediate reaction is that it is indeed bloody steep! However as I alluded to earlier top notch facilities cost a lot of money to establish and also maintain, sometimes it does come down to how high a standard of care you want your animal to have and how high a risk of complications you are willing to accept.

Do I feel that a comparable job could have been done for significantly less, yes I do. Unfortunately it is a free market like a lot of things. I would always urge people to get an estimate for treatments and discuss any fees ahead of time. Not that that helps you at all and I hope the dog heals up ok.

 

[hcm1]

I would add that if anyone has any questions about why things are done a certain way or what the reasons may be feel free to message me, sometimes the profession doesn't explain as fully as we maybe could and in times of stress, often people forget to ask questions that they would otherwise want to.

 

[Bowland blades]

You where not paying the vet you where paying the venture capitalists that own the practice ( along with most others ) . There needs to be a change - a big one ! People will literally not be keeping animals or will be going back to treating themselves at home

 

[ashray]

good afternoon ,our vet charges over £700 for a general anaesthetic and £165 to put four stithes in a cut if it needs any more than 4 stiches is an extra £10 per stitch. the vet surgery is named LARKMEAD and is part of a very large vet group. they are not the best vets but charge the most money.

 

[pob]

I would add that if anyone has any questions about why things are done a certain way or what the reasons may be feel free to message me, sometimes the profession doesn't explain as fully as we maybe could and in times of stress, often people forget to ask questions that they would otherwise want to.

Thanks all for your comments, especially such a comprehensive view from hcm1.

The wound did get "Surgical debridement", though that term was not used. It wasn't an old wound, nor obviously infected and we hadn't yet given it a chance to heal on its own; but it didn't look likely to me, so I decided to not take the chance and opted for the treatment with the best chance of a cleaner, faster recovery.

I'm not sure that saying we should have discussed fees is helpful though. I have no knowledge to challenge with, and just had to trust the vet that the £600 -800 estimate for treatment was accurate, applicable and reasonable.

It was only when I checked my records later that I was surprised to find that the same practice speyed her 18 months ago for only £345. I'd forgotten that. I assume that the theatre costs for both ops should be comparable, if not more for the speying?

The invoice is very detailed, down to every scalpel blade, swab, glove and apron. But the one line "1 X Suture wound £636.57" seems to do most of the heavy lifting.

 

[pob]

good afternoon ,our vet charges over £700 for a general anaesthetic and £165 to put four stithes in a cut if it needs any more than 4 stiches is an extra £10 per stitch. the vet surgery is named LARKMEAD and is part of a very large vet group. they are not the best vets but charge the most money.

I seem to share your pain......so, this isn't unprecedented then.