by CAROLYN KARRH DVM , Feb. 2016
Below are snippets of a good article outlining the differences between low-cost clinics and full-service hospitals. See complete article here.
February 23, 2016 – Originally published on http://www.peacelovepaws.org/#!THE-DIFFERENCE/c1l9s/1
“For Pet Lovers:
I lost a patient this past weekend. I don’t know why and I will likely never know, as the owners of the dog decided not to have a necropsy to find out. They blame me, however. This would not be the first time I’ve been blamed for the death of an animal (nor will it be the last), and though I can’t be certain, there are likely some that I was responsible for, directly or indirectly—-unintentionally, of course. I recall during my senior year of vet school telling a classmate that I was terrified of losing a patient or accidentally killing a pet. A nearby faculty member, typing quietly on her computer, overheard me, and without moving or turning her head, said gently, in a conversational tone, “You will.” …
I don’t want to imply that low-cost facilities provide sub-standard care (though people often assume this)—perhaps there are some, but typically this is not the case. In fact, spay/neuter clinics often have very experienced veterinarians who work quickly in surgery, often lowering many anesthetic risks that might be seen in places where pets are under anesthesia longer. In addition to managing my own non-profit organization for pets of the homeless community, I work in two other places—in a low-cost spay/neuter clinic run by a local shelter, and in a high-end, AAHA accredited, full-service veterinary hospital…
The difference between low-cost clinics and full-service hospitals:
Low-cost clinics do not typically require or offer bloodwork before surgery. One main reason for this is because most young, healthy animals do not have any underlying metabolic issues. But there are always exceptions. If the clinic provides a bloodwork option, your cost will go up. But if you decline the bloodwork or if the clinic doesn’t offer it, if your pet has an underlying medical issue (liver or kidney disease, bleeding disorder, etc.), the vet and staff will not know and the risk for surgical and post-op complications will go up. Or your pet may die. Bloodwork helps your vet and staff know what risks are present, what anesthetic drugs to use and/or whether your pet can even safely have surgery.
Low-cost clinics do not usually place an IV catheter or give intravenous fluids to your pet during surgery. One of the reasons for this is that most high-volume spay/neuter veterinarians are able to perform surgery in a fraction of the time of many others (often less than 5-10 minutes), simply due to experience. But why might an IV catheter and fluids be important? Fluids provide assistance with blood pressure stability and perfusion to organs. If your pet has trouble with blood pressure, decreased perfusion to important organs may cause them to fail, typically not seen for days or weeks after your pet goes home. Most young, healthy animals will not have this problem and typically the surgery is quick, but not always. If your hospital provides this, your cost will go up.
Low-cost clinics have limited staffing and cannot provide constant attention to your pet before, during and after surgery. There are often only one or two veterinary technicians or assistants on staff during a typical surgery day, and they are commonly multi-tasking. The most consistent time we see complications or accidental death is right after surgery, in recovery—this is true for any hospital or clinic. If your pet is not directly monitored by a technician at all times, if they have any difficulty in surgery or recovery, it is possible that a minute or two (or more) may go by without this difficulty being noticed. This is not intentional, of course—it has to do with the number of staff available. If a hospital provides constant nursing care and monitoring for your pet, your cost will go up.
Low-cost clinics do not routinely monitor CO2 levels, ECG, blood pressure and constant body temperature for your pet during surgery. A pulse-oximeter is usually the only monitoring device present, revealing heart rate and oxygen perfusion in the blood, which are important. But other vital signs can be important too. Hypothermia can make recovery long and difficult, ECG readings help determine any heart abnormalities, abnormal CO2 levels can be deadly, and I’ve already explained what low blood pressure can do. Again, the the most common reason for not monitoring these things is that the surgery is often less than 5-10 minutes, so significant changes are unlikely in young, healthy animals. If your hospital provides these other monitoring devices, the equipment costs money and the trained/certified staff member must be paid to be there, use them and know how to manage any complications….so your cost goes up.
Low-cost clinics do not provide a full, comprehensive physical exam and vet consultation for your pet before surgery. Exams are limited due to the number of surgeries that must be performed in a day. You do not have an opportunity to discuss your pet’s health and concerns with a vet before the surgery is performed. There may be an area on your drop-off sheet where you can write your concerns, however you likely never see or meet your veterinarian. If your hospital provides time and an opportunity for a comprehensive exam and discussion with your vet, that’s right, your cost goes up.
Low-cost clinics are not the best option for higher-risk pets: large and giant breed dogs, senior pets, brachycephalic breeds (those with flat/smashed faces), obese, in-heat, pregnant and aggressive dogs and cats, those with a history of medical issues, etc. Low-cost clinics are not typically set up to handle emergencies if they arise or hospitalize animals overnight for additional care if necessary. They lack the proper equipment, training, staffing and time to handle anything outside of a normal, healthy patient surgery and recovery. If your hospital is set up for this, your cost will go up.
So, you see where the costs are cut? …”