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Shakti

Vets Fees With No Warning?

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I really detest this kind of "do you want fries with that" up-selling on medical stuff. As others have already said, if it is crucial, then it should be included...if it is not included, it isn't crucial in my book. I certainly don't worry about pre-GA bloods for surgery on young healthy dogs. If it was an older dog, or one that has some health problems already, I might consider it (though certainly not at $240! :laugh: ). Ditto the fluids. It's OK for me because I have been around for a while and know my own mind; I am more than happy to say "no". I do worry that newer or less confident owners will be pressured by a kind of emotional blackmail into these overpriced extras that are not necessary.

I don't worry about pre-GA bloods either but I understand that I take that risk upon myself.

There is no question in my mind that speys of any age wake up a lot better with operative/postoperative fluids. It is still a very invasive surgery.

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Niques   

The vets should do to the dog what needs to be done. I, as a lay dog owner, have no idea what is required (or not) during surgery nor the impact of refusing the offered "sides". And if they are going to offer "extra" things it should be done at time of booking so owners are able to do a little research.

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The vets should do to the dog what needs to be done. I, as a lay dog owner, have no idea what is required (or not) during surgery nor the impact of refusing the offered "sides". And if they are going to offer "extra" things it should be done at time of booking so owners are able to do a little research.

Well they do what "needs to be done" but in my case I was told things like the extras would make the dog more comfortable....that sort of thing, so you feel like a bad owner if you deny it.

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The vets should do to the dog what needs to be done. I, as a lay dog owner, have no idea what is required (or not) during surgery nor the impact of refusing the offered "sides". And if they are going to offer "extra" things it should be done at time of booking so owners are able to do a little research.

Well they do what "needs to be done" but in my case I was told things like the extras would make the dog more comfortable....that sort of thing, so you feel like a bad owner if you deny it.

It's up to you if you want to feel good or bad, not the vet!

I understand why they offer these things as extras and it usually comes down to budget so it's actually good they DO offer them and not quote a price that includes everything and have everyone balk at the cost of medical treatment for pets.

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When my animals go under for surgery or even a dental, they all go on IV fluids. For me, there's no question about it. But those prices do seem expensive.

I think that it's sometimes hard for vets to win. If they offer things like fluids and pre-anaesthetic blood screening to clients as extras, they're accused of up-selling. But if they include them as standard, they're then going to be charging more than the competition & going to end up losing clients to the cheaper practice down the road.

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fifi   

All our speys are put on IV fluids, its included in our spey price.

and OMG, I thought Thio was long gone !!! thankfully I have not seen it in many years :-)

we offer in house bloods in an older or higher risk patient, and really recommend a full blood profile in aged and high risk patients - and discuss when they make the appointment.

fifi

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When my animals go under for surgery or even a dental, they all go on IV fluids. For me, there's no question about it. But those prices do seem expensive.

I think that it's sometimes hard for vets to win. If they offer things like fluids and pre-anaesthetic blood screening to clients as extras, they're accused of up-selling. But if they include them as standard, they're then going to be charging more than the competition & going to end up losing clients to the cheaper practice down the road.

Fair enough, but I think the issue is also just as much the way some vets seem to have told some of us as we drop the pet off (last minute), rather than provide the options before hand so it can be discussed, considered and budgeted for.

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When my animals go under for surgery or even a dental, they all go on IV fluids. For me, there's no question about it. But those prices do seem expensive.

I think that it's sometimes hard for vets to win. If they offer things like fluids and pre-anaesthetic blood screening to clients as extras, they're accused of up-selling. But if they include them as standard, they're then going to be charging more than the competition & going to end up losing clients to the cheaper practice down the road.

Fair enough, but I think the issue is also just as much the way some vets seem to have told some of us as we drop the pet off (last minute), rather than provide the options before hand so it can be discussed, considered and budgeted for.

Yes, that seems fair. Perhaps suggest it to them? They may be totally unaware that clients are finding it upsetting to get hit with these additional options at the last minute.

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TBH I wish I'd been offered bloods at the time of desexing with my boy it would have shown up a serious liver condition and saved a lot of money and heartache, however I agree that you were ambushed and they should have alerted you to the options prior to booking. The prices seem excessive to me too, when my dog was finally diagnosed he had full blood work (not just pre anesthetic) and it was $160.

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Propofol and Alfaxan is actually quite pricey. We use opioids with most pre-meds too.

Agree that they are more expensive, but on average it only adds maybe $6 - $10 to the overall bill.

None of the following is directed at you S & T just a frustration I have.

Seems really ironic that vets show concern about pre GA bloods (and charge the client) but then proceed to induct the GA with Thio. Great in its day, but I shake my head at vets who still use Thio over Propofol and Alfaxan.

If vets asked the majority of dog owners would they like half-a-century old technology or the safest technology available for a few extra dollars I know what most would pick.

The most common reasons for using Thio is that it's cheap and it keeps the dog down longer (great, body is struggling to metabolise it).

Im still :laugh: at the $440 the OP was quoted

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stormie   
Propofol and Alfaxan is actually quite pricey. We use opioids with most pre-meds too.

Seems really ironic that vets show concern about pre GA bloods (and charge the client) but then proceed to induct the GA with Thio. Great in its day, but I shake my head at vets who still use Thio over Propofol and Alfaxan.

Can I ask why? I did a training day with Colin Dunlop recently on Advanced Anaesthesia and he happily uses Thio. My Boss went to a continuing education night held by Colin and an Anaesthetist from USA who also happily used it (and actually I believe preferred it).

Both of them teach that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

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Pippa   
Can I ask why? I did a training day with Colin Dunlop recently on Advanced Anaesthesia and he happily uses Thio. My Boss went to a continuing education night held by Colin and an Anaesthetist from USA who also happily used it (and actually I believe preferred it).

Both of them teach that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

Thiopentone is a barbituate that's use results in a very slow recovery time, and it's also very outdated and if accidentally given external to the vein it can cause tissue necrosis. Propofol has a very fast recovery time. Thio has not been routinely used in hospitals for a good fifteen years.

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Pippa   
that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

The best anaesthetic is actually one that is given by someone who is knowledgeable with the latest drugs and techniques. Anaesthesia is becoming safer and more minimalist every day in humans.

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fifi   

Thanks Pippa, beat me to it.

Thio is also a very signifcant danger to sighthounds because it's a barbituate and the amount given according to weight is far too much for sighthound to metabolise.

In the past we did see some horrific tissue necrosis with thio. As well as very scary prolonged recoveries.

I had to take one of my wolfhounds to a locum a couple of years ago and nearly died when I saw him draw up thio :-o of course he wasn't allowed near my dog with it.

I'm genuinely shocked that some vets still use it.

fifi

efs

Edited by fifi

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Drumbeat   
he should also undergo a thorough blood test which would ensure that the absolutely right anaesthetic for him could be administered correctly as it would reveal info about his kidney and liver etc.

and then charge you the extra few dollars for Alfaxan over Thio.

That all seems soooo expensive an extra $440 for pre GA bloods and fluids. How old is your dog?

I had the pre-anaesthetic blood profile done on our girl and it was $55 - are you sure the $240 wasn't for bloods and the op??

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stormie   
Can I ask why? I did a training day with Colin Dunlop recently on Advanced Anaesthesia and he happily uses Thio. My Boss went to a continuing education night held by Colin and an Anaesthetist from USA who also happily used it (and actually I believe preferred it).

Both of them teach that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

Thiopentone is a barbituate that's use results in a very slow recovery time, and it's also very outdated and if accidentally given external to the vein it can cause tissue necrosis. Propofol has a very fast recovery time. Thio has not been routinely used in hospitals for a good fifteen years.

I know what it is and know about the side effects. But Propofol has side effects too. And I know for a fact Thio is still used in one of the top Specialist Hospitals by a Specialist in Veterinary Anaesthesia so I wouldn't say its not routinely used.

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Can I ask why? I did a training day with Colin Dunlop recently on Advanced Anaesthesia and he happily uses Thio. My Boss went to a continuing education night held by Colin and an Anaesthetist from USA who also happily used it (and actually I believe preferred it).

Both of them teach that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

Thiopentone is a barbituate that's use results in a very slow recovery time, and it's also very outdated and if accidentally given external to the vein it can cause tissue necrosis. Propofol has a very fast recovery time. Thio has not been routinely used in hospitals for a good fifteen years.

Actually the premed affects the recovery time, the induction affects the quality of recovery

Those prices the op was quoted sound extravagant To me and I work in an expensive area!

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Pippa   
I know what it is and know about the side effects. But Propofol has side effects too. And I know for a fact Thio is still used in one of the top Specialist Hospitals by a Specialist in Veterinary Anaesthesia so I wouldn't say its not routinely used.

Human hospitals, not veterinary hospitals. Sorry you asked why Thio is not preferred and I answered.

What side effects have you seen with Propofol?

Fifi, I am also shocked to hear it is still used in veterinary work. There is no need.

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Can I ask why? I did a training day with Colin Dunlop recently on Advanced Anaesthesia and he happily uses Thio. My Boss went to a continuing education night held by Colin and an Anaesthetist from USA who also happily used it (and actually I believe preferred it).

Both of them teach that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

Thiopentone is a barbituate that's use results in a very slow recovery time, and it's also very outdated and if accidentally given external to the vein it can cause tissue necrosis. Propofol has a very fast recovery time. Thio has not been routinely used in hospitals for a good fifteen years.

I know what it is and know about the side effects. But Propofol has side effects too. And I know for a fact Thio is still used in one of the top Specialist Hospitals by a Specialist in Veterinary Anaesthesia so I wouldn't say its not routinely used.

If you work with an awesome Vet you never get tissue necrosis, prolonged recovery or anaesthetic deaths due to Thio. :laugh:

I've had a crash anaesthetic with Propofol and I can tell you it's nasty. Sorry to quote you in as well Stormie but I agree it's fine if the Vet is very comfortable using it.

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whippets   
that there's no such thing as a bad anaesthetic, only a bad anaesthetist. They agreed that the best anaesthetic is the one that the anaesthetist is most familiar with. Obviously there are times when a different drug may be preferred, but I'm speaking for routine surgery in healthy animals.

The best anaesthetic is actually one that is given by someone who is knowledgeable with the latest drugs and techniques. Anaesthesia is becoming safer and more minimalist every day in humans.

IF you own a sighthound don't let a vet get anywhere near your dog with any kind of barbituate.

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