Cat and possible thyroid problems/removal

simontheiceman

OK:
1. oral meds for thyroid disease - great if you can get them in and I have plenty of clients who use these long term.
2. Surgery - gold standard - highly recommended - you can do bilateral surgery (both sides) in one go but you need a surgeon who is capable of preserving the parathyroids (I do these on a regular basis and have only ever had one serious post operative complication). Essentially, if you stuff the parathyroid function then the body calcium level drops dangerously low and the hear cant cope and will stop working (not good).
This CAN happen with staged-bilateral removal; for instance if you remove the left thyroid and all the parathyroid tissue and then do the same on the right at a later date you will create the exact same circumstances.
I would not entrust any thyroid surgery to anyone who is not capable of preserving parathyroid function and I would make darn certain that any surgeon I was using for a unilateral procedure was perfectly happy to go ahead and do it bilaterally, cos if they're not, then they don't know what they are doing.
I have clocked up well over 500 thyroid procedures (I stopped counting ages ago) and unless you do nuclear imaging prior to the procedure you cannot know whether it is uni or bi lateral. No practice in this country has nuclear imaging capability, the hospitals do. therefore you have to judge the surgery as you find it on the day and I counsel all owners about the perils and pitfalls prior to surgery. If I do a bilateral removal then the patient is monitored for calcium levels in hospital for 48hours and if all is OK then they go home. Managing low calcium levels is very hard and fraught.

Radioiodine - should be the best treatment but...expensive, and the cat has to be away from home for some weeks until they stop glowing in the dark. No client of mine has ever wanted it and I have offered it to all of them.

simontheiceman

Forgot:

Costs - about 250-300 for surgery so similar to Q above - this hasn't changed in my hands for a few years now. I am in North of UK so not perhaps indicative of prices in the country as a whole.

Hearne_Household

Wig wrote: »

Does anyone know the cost of a blood test to test for thyroid and/or renal problems?

QUOTE]

My cat had a blood test for thyroid (and general screening) two days ago. The cost (including a worming tablet and the consultation) was £101!

simontheiceman

Hearne_Household wrote: »

Wig wrote: »

Does anyone know the cost of a blood test to test for thyroid and/or renal problems?

QUOTE]

My cat had a blood test for thyroid (and general screening) two days ago. The cost (including a worming tablet and the consultation) was £101!

Why the exclamation mark? Does this mean you are not pleased with the cost? Could it mean that you actually think its so cheap that you cant understand why it wasn't more?

I have a lab to test blood samples. The machinery in it was the best part of £40,000 and the building itself (to house the lab); well, cost the best part of £1M. My staff costs are best part of £300K per annum. Please tell me why you think £101 is not good value for all that information.

For information I thought it was quite cheap: - full profile and thyroid test would be £90, consultation £19 and worming £2 - all plus VAT (but it is not my problem that you have to pay that). Any potential perceived lack of value for money is purely because whoever did the work for you did not do enough to explain the full value of what you had.

Wig

Hearne_Household wrote:

My cat had a blood test for thyroid (and general screening) two days ago. The cost (including a worming tablet and the consultation) was £101!

That is cheaper than mine was,

£27 consultation - no more than 15 mins, just checked heart rate, and felt the throat, and the belly etc.
£30 thyroid T4 (out-sourced)
£61 General blood Ghp (in-house)
£15 urine (in-house)
All incl VAT.

To Simon,
I don't mind having to pay as long as the costs are made clear to me upfront, so I can consent to the charges. As it happened, we were told during initial consultation that the cost would be £91 and that we should come back after the bank holiday weekend to have the blood taken. We asked if that would increase the the £91, answer "no" so we agreed, we left and paid for the work done so far (the consultation) which we were taking to be included in the £91, expecting to pay a balance of £64 on our return.

On our 2nd visit, a different vet, took the bloods and when he came back into the room, in chit chat I asked if a urine test would be good, he replied "yes...." and that he had tried to get a sample out of the cat but the bladder was empty, implying to us that a urine test was all part and parcel of the full screening that we were paying £91 for. Not wanting to miss out on the urine test I suggested that I could collect a sample at home and bring it in (knowing that our cat will use her tray even when it is clean empty - no cat-litter- thus easy to collect a sample). He was not very communicative on the subject (he was entering data on the computer at the time). When he finished we asked again if they had some sample pots and how and when should I bring it in, he said the reception could give a sample pot on our way out. At no point did he mention any extra cost for urine. And like I said, we thought it was included as he already said he tried to take some for testing.

As we left, we expected to pay the balance of £67, but she asked for £91. There followed some debate about what we had been told before, (and a rather clueless receptionist who couldn't understand the concept of "all-inclusive £91" We clarified with the 2nd vet that the blood tests/Ghp alone is worth £91 and we concluded that it was just that the 1st vet had not made the costs crystal clear to us. and we paid up.

After this "debate" on misinformed prices had occured and we had got home, we discussed the possibility that they might also charge us extra for the urine test, for 2 possible reasons

1) When handing over the sample pot, the receptionist might not know that we had already paid for the £91 series of tests, we should therefore mention/ask:
"Is it not included in the £91?"

2) It is subject to an extra charge anyway, the vet having failed to make this clear.

We took the sample down and there was an extra charge of £15, and it apparently was not included in the £91 when we queried this.

It turned out that all the bloods were clear, but the urine showed up an infection, which is to be treated with antibiotics, (NOROCLAV 50mg x2 7days) with a follow up urine test. I already have had the foresight to ask for another sample tube so as to avoid taking the cat in again just for them to inject her to get a sample that we can easily obtain ourselves. It would seem a waste of money to pay for a visit to obtain a 2nd sample & before we even know if the infection has cleared up or is ongoing.

All of this ineffective communication, on their part, has left us feeling that perhaps there are better (possibly cheaper) vets out there, and who may also have a "no dogs" policy which would be better for our cat aswell.

Had the vets explained ALL the costs in detail, there would be no hard feelings from us. I would suggest any vet reading this should take note and provide all customers with a print-out of expected costs for the expected treatments, including the initial consultation fee of "day 1". I also think as far as possible a vet practice should provide free printed "practice price list" detailing all their charges. These should be on the reception desk with a sign saying "please take one". I believe it should be mandatory like it is for pubs to detail their prices, at the bar, under the Licensing Acts.

BTW, Simon, does it sound right that a urinalis is not included in the Ghp? As a complete layman on these things I have no clue, but do still wonder if the 2nd vet was intending to include one in the £91.

Also not been told to give the noroclav with food or not or doesn't matter?

Oh and the cat still has a croaky voice (for 2 weeks now) and has just about stopped meowing as a result. She eats well, but occasionally tries to vomit. However this cat has a history of vomiting, but had almost stopped doing it for about 2 years now. So can't really base much indication on the vomiting, except that her throat sounds quite bad (different to ever before) when she is trying to vomit recently.

simontheiceman

Wig wrote: »

T
All of this ineffective communication, on their part, has left us feeling that perhaps there are better (possibly cheaper) vets out there, and who may also have a "no dogs" policy which would be better for our cat aswell.

[COLOR="rgb(72, 209, 204)"]Find one with a "cat waiting area" - quite a few do these days (I included one in my latest extension)[/COLOR]

Had the vets explained ALL the costs in detail, there would be no hard feelings from us. I would suggest any vet reading this should take note and provide all customers with a print-out of expected costs for the expected treatments, including the initial consultation fee of "day 1". I also think as far as possible a vet practice should provide free printed "practice price list" detailing all their charges. These should be on the reception desk with a sign saying "please take one". I believe it should be mandatory like it is for pubs to detail their prices, at the bar, under the Licensing Acts.

[COLOR="rgb(72, 209, 204)"]Clarity and communication - get these right and you can charge what you like (within reason). Charge a ton and be unhelpfully vague and clients notice (you did).I have a price list on the wall and provide written estimates for most procedures. [/COLOR]

BTW, Simon, does it sound right that a urinalis is not included in the Ghp? As a complete layman on these things I have no clue, but do still wonder if the 2nd vet was intending to include one in the £91.

[COLOR="rgb(72, 209, 204)"]Urinalysis is not usually included in GHP but in my case is no more than £8 unless microscopy is included when it becomes £22 (quite a bit more work you see)[/COLOR]

Also not been told to give the noroclav with food or not or doesn't matter?

Give Noroclav as and when you can - with or without food is(in my opinion) irrelevant.

Some interesting points in the above, essentially what most progressive vets have been doing for some time. Be careful what you wish for though; the american model is gradually taking shape in the UK and we may see costs like theirs too...

Wig

simontheiceman wrote: »

but in my case is no more than £8 unless microscopy is included when it becomes £22 (quite a bit more work you see)

The urinalisis reciept says a refractometer test for an adittional £7, so appears to be an enhanced test.

Thanks for the feedback.

simontheiceman

Wig wrote: »

The urinalisis reciept says a refractometer test for an adittional £7, so appears to be an enhanced test.

Thanks for the feedback.

Without wishing to create too much discord; refractometer testing is included in my basic urinalysis. It takes seconds but is very useful information.

Wig

Simon,
Would it be fair to say, I should ask for only the basic £8 urinalisis without the refractometry for the follow up analysis after the 7 day Noroclav treatment?

simontheiceman

Wig wrote: »

Simon,
Would it be fair to say, I should ask for only the basic £8 urinalisis without the refractometry for the follow up analysis after the 7 day Noroclav treatment?

If its a follow up after a course of antibiotics for an infection then I would expect that the refractometer test would be superfluous and I would not need it, especially if you have to pay an extra £7. All the information required should be available from the dipstick test.