Large vet's bill - advice please

Sooz00

Hi all - I wonder if anyone has any advice regarding a large vet's bill I have. It's very large (just under £4,000) and although there were complications during the operation (removal of lymph node), at no time did anyone tell me it was amounting to anything close to £4,000. The procedure had been estimated at £2000 inclusive of VAT and hospitalisation so this is a 100% increase compared to the estimate.

Can anyone advise where I stand and offer any advice?

WolfSong2000

get them to give you a breakdown of costs...often vets inflate the fees because they assume that the insurance will be covering the bill. My mother asked for a breakdown after being charged over £300 for a few stitches for a dog...bill came down dramatically when vet was forced to itemise it...may or may not help, but got to be worth a shot!

Sooz00

Thanks Wolfsong. I already have a breakdown and it is scary to say the least. I am not sure what to do. I don't feel it fair that they can just present me with a bill that is double the estimate. I have used the practice before and usually they will call if a bill starts to go way over, so whilst I thought this would be over, I had no reason to think it would be double. They made me feel guilty for even questioning it. I don't know what to do... I have always paid everything without question before, even if the bill is more than I'd been estimated. Every other time though, it's only been £100 or £200 out but this is just short of £2000 over! It's in a different league....:eek:

What' worse is that I'm not even convinced my boy is well enough to be home.:(

Elle7

Have you asked why it is so much over the estimate, and why you weren't asked? I'd ask for a meeting with the practise manager.

As for your dog, either take him back, or ask another vet for a second opinion. This is a big operation, so if he isn't right, he needs to be somewhere he can be very carefully monitored.

I presume he isn't insured? Have you checked to see if the PDSA can help you?

Sooz00

Hi Elle,

I have emailed my general vet with the discharge note and asked him to give me a call back regarding my concerns about my boy... He is not wanting to eat and I am worried he will become dehydrated. I syringe fed him this morning and did the same at lunch. It was a big op, yes. I will see what my general vet thinks.

It is so much over the estimate because of 'complications'. The surgery was scheduled to be an abdominal exploratory surgery. We had agreed that if it was operable (i.e. not attached to blood vessels etc.) then they would remove it. If not, they would try and debulk it to try and make it more chemo sensitive as he has handled his chemo well apart from this one resistant mass. When they opened him up, they saw it was vascularised and attached to 'the pylorus/proximal duodenum, the epiplon and the body of the pancreas' (took that from the discharge note). It also says 'Some major physiologic blood vessels were adherent to the mass and had to be ligated'. They didn't contact me at that point. They decided that despite the risks (which were high), they would attempt a complete resection which obviously caused complications, loss of lots of blood, etc.

I have already spoken to one of the clinicians involved and they have said the bill is correct and stands. They made me feel more guilty for even questioning it by saying that they should have told me but their priority at the time was to save my boy. I feel quite hurt and let down by that on top of everything else. They say they can't foresee complications like this but the bill is accurate. They corrected it by about £50 in my favour because they charged me for blood used in a transfusion that my other related pet actually donated. This was only after they rang me to tell me they thought they were going to lose him on the table due to complications and blood less. At that point I suggested the transfusion.

He is insured but this bill leaves us no cover left for any follow up. We already know follow up is required and will be ongoing as prior to removal of the mass, the biopsy confirmed large cell lymphoma. If I had known the operation would be this expensive, I don't think I would have put him through it, if I couldn't afford the aftercare. It wouldn't make sense or be fair to my boy. I'm not eligible for PDSA but I don't think they would pay toward this anyway.

I think I need to have a conversation with the MD. The office staff were not very helpful yesterday because the clinicians do the bills themselves. I wondered if there are any rules about things like this, estimates being way under and no-one advising. Previously, they had always advised if something was going to go over estimate so you can make informed choices so although I suspected my bill may be more due to the complications, I had no reason to suspect it would be significantly more, certainly not double!

puddy

im sorry but with a story like that, what else did you expect them to do? they could have killed your pet if they had taken time out to try and get hold of you, so they carried on to save him

its annoying but if it were me, i would put it on credit and put it down to having pets. its something we're all at risk of. my pets are not insured so i know its credit card if anything bad happened to them (as it has in the past, resulting in rather large debt)

Sooz00

puddy wrote: »

im sorry but with a story like that, what else did you expect them to do? they could have killed your pet if they had taken time out to try and get hold of you, so they carried on to save him

its annoying but if it were me, i would put it on credit and put it down to having pets. its something we're all at risk of. my pets are not insured so i know its credit card if anything bad happened to them (as it has in the past, resulting in rather large debt)

Thank Puddy. I understand what you are trying to say but at the time of opening up, and just looking, they could immediately see there would be complications but they did not call and seek consent in the light that the bill would no doubt be considerably higher. At that point, there would have been an option to close, wait a week as we had discussed and then change chemo protocols or try radiation if that is what I wanted to do and it would maintain my boy's quality of life.

The thing is, that didn't happen. They decided without me, to go ahead despite the increased risks. They did not allow me to make the decision. I don't think I would have opted for surgery for this disease which is a systematic cancer, I am pretty sure I would have wanted to try the other avenue.

Once they had made the decision without me and things went down hill, that is when they did call me (whilst he was on the table) to tell me to prepare that there was a high chance he would not make it through the operation or the following hours.

I hope that clarifies...

puddy

i understand, but i think you're being unrealistic. you have an open animal on the table in front of you and you see theres problems. is your first thought as a vet to prepare the owner for a large bill? or is it to carry out your work and protect the animals health?

what would your response be if they delayed, thought about informing you of the bill and treatment and because of their delay further complications set in, or problems from going under too many times and being opened up too many times caused further complications?

quite rightly in that situation you would be saying they were negligent.

Sooz00

puddy wrote: »

i understand, but i think you're being unrealistic. you have an open animal on the table in front of you and you see theres problems. is your first thought as a vet to prepare the owner for a large bill? or is it to carry out your work and protect the animals health?

what would your response be if they delayed, thought about informing you of the bill and treatment and because of their delay further complications set in, or problems from going under too many times and being opened up too many times caused further complications?

quite rightly in that situation you would be saying they were negligent.

I do understand what you are saying but at the time they should have called, there were no complications. They hadn't touched the blood vessels or done anything else aside from open him up. It was proceeding that caused the complications.

When they realised the complications, they DID call and tell me they had cut blood vessels, pancreas etc and that I may lose him. Maybe I am not explaining it well...

puddy

Sooz00 wrote: »

I do understand what you are saying but at the time they should have called, there were no complications. They hadn't touched the blood vessels or done anything else aside from open him up. It was proceeding that caused the complications.

When they realised the complications, they DID call and tell me they had cut blood vessels, pancreas etc and that I may lose him. Maybe I am not explaining it well...

no, im talking about possible complications that can arise from going under anaesthetic too many times or being opened up too many times. its not like going to the dentist, any operation has a risk of death and complications. once under and opened, they were obliged to continue with what they saw

pinetree

Hi this is a difficult situation whilst we all want the best for our pets your bill does seem a lot. Without being insensitive( I hope) did they give a prognosis for your dogs future as that can sometimes have an effect on the bill, also as an observation an op is an op I dont know why they were giving details blood vessels etc it sounds to me that they were trying to justify the fees. These are just a couple of points i wanted to say, if they do not give you any reductions I would ask to pay in say monthly instalments to help

hope your dog is ok