Tuesday, January 5, 2016

Lab Services. What clients need to know about the internal organs of their vets practice.

Jarrettsville Vet has an obligation to providing exemplary service, medicine and care to all of the many diverse pets who need us. Whether it is a rabies vaccine, a sick pup, a desperately undernourished ill kitten, or a dying patient in need of an emergency exploratory surgery to fix a ruptured spleen. We can do all of these and almost everything in between. Pretty amazing in the whole big scheme of things, isn't it? Where else but your vets office can you get an x-ray, blood work, urinalysis, ultrasound, and surgery at the tips of your fingertips AND within minutes? Your vets office provides veterinary examinations, diagnostics, answers and treatment options all available under one roof and all within minutes.

Me and Ruby

For us to provide this we are dependent on a whole long list of partners to provide the many working parts that keep our veterinary hospital running. Still think that this isn't such a big task? Here's a little peek into my clinics internal organs.

Digital radiography cost to clinic to purchase is $100,000 dollars. This machine allows us to take incredibly detailed human medicine equivalent images in seconds. Digital dental radiography was another $15,000. Ultrasound comes to us at a price tag of $45,000. Cold laser $15,000. Never mind the hundreds of thousands of dollars it takes to train that vet who provides your dog something as simple as a rabies vaccine. The costs of running a hospital that does all of this, with the best staff on the planet, is almost beyond my ability to comprehend.

No veterinary hospital is an island and Jarrettsville Vet is no different. We might be small and seemingly independent from the rest of the world when you bring your dog in for their annual exam and vaccines, but, we rely on a huge array of service providers, manufacturers, distributors, veterinary specialty companies and the representatives from each to accomplish this. Even the smallest and simplest of things at the clinic comes to us with great long tales of history and adventure. For instance, have you ever wondered how that seemingly minuscule rabies vaccine which is so vital to the life and safety of so many pets worldwide found its way into the hands of your vet? Before it was even a product listed in our doctors kit of miracles it took years to perfect and millions of dollars in research to develop. Each little red bottle came from an order we placed a few days ago when our stock got low. From this order the vaccine was shipped out under very tight controlled temperatures from a highly specialized manufacturing plant from our distributors warehouse. Just how important is that tiny red 1 ml of liquid? Well, vaccines are vital life saving elixirs. I can't imagine how many lives that tiny 1 ml of red potion has saved? Many of these we never even know of. We, your local veterinary hospital, deliver magic and miracles every single day.

How does your $16 rabies vaccine help make a practice this big keep running? Well, to do that we have to have practice partners who provide help with the JVC infrastructure and bones that we rest our working organs upon. These guys are our life blood. Those companies who make the vaccine, the big fancy, expensive machines, and the hidden elves who collect the fecals, heartworm tests, CBC's and biopsy samples at 9 pm and have our answer back by 10 am the next day.

And so it goes that every few years I have to decide which of the many veterinary players to choose to partner with to best serve our needs and provide us the support we need to keep functioning. One of  the biggest decisions a practice owner has to make is which company we select to send our blood work, urine, fecal samples, tissue samples, cytology, titers, urinary stones, and other patients samples to. We call these companies our 'lab services providers'. There are two behemoths in the veterinary arena when we talk about lab services. Two, only two. Every 5 years I get the short lived stressful discomforting task of thinking about how to decide between the two rich kids on the block. The lab service companies have other partnerships with every other branch of what a veterinary hospital needs to do all of the multifaceted services your pet might need. They hook  us up with x-ray, ultrasound, staff training, machines, etc. etc.. For a few weeks every 5 years I am courted for my lab services business. I am offered large sums of 'rebate dollars' in the forms of mysterious non-redeemable 'points' to buy the big stuff I would never otherwise be able to afford. Company reps descend  upon us trying to convince me that my practice will be better off if I choose buy (with the use of those funny-money point-dollars) one of their fancy new loaded lab machine Ferarri's. They are pretty, and fast, and able to run multiple samples all at once at the tips of our techs fingers. They mesmerize with flashy lights, bells and whistles.  Who doesn't want a beautiful sleek sports car and some eager flirty guy telling you that they can make it happen just because you are so special to them?  It's not easy to stay focused on your budget and buy that subcompact when you are being wooed with the snazzy sparkling equipment. I do, after all, have to pay for this by passing on the charges to you. I have to guess where the business is going, what price points my clients will tolerate, and how likely it is to break when the clinic cat decides it makes a nice warm napping spot. I don't live in a Ferrari neighborhood, and I don't think my clients want to pay for Ferrari price tagged fecals?

When my local bank manager bought  herself a brand new Hummer a few years ago I changed banks. If the vet in my rural little hometown starts driving a Ferrari I expect I will lose a few clients too.

Here's what I think every client should know about how to get the best deal from your vet when it comes to diagnostics;

Know what your vet can offer you in the way of diagnostics before you need them. 

I would also inquire about the prices. 

I think that digital radiology is an important necessity. It allows for superior image quality and it also allows us to refer those images to a specialist. The fees for radiographs at JVC are $100 for the first image, $200 for 4 or more.

I also believe that every dental should have radiographs done with the cleaning. Any and all extractions should be done at the time of the dental procedure. This idea of not placing a pet under general anesthesia and clients being "afraid" to remove compromised teeth is a detriment to your pets health and longevity. I get asked for the price of a dental almost daily. Unfortunately these are (as they should be) on a case by case basis. I know of some clinics who provide a "flat fee" for this. I quite honestly don't know how they do this? Too many mouths are full of disease and mystery until you get in there and probe, x-ray, and assess. There are many a vet who would willingly do an orthopedic surgery over a dental, (present company included). Fees for dentals at JVC range from $200 to over  $700.

Your vet should be able to run a few tests in-house. Emergencies happen daily. When they happen to your pet I think it is fair to expect that your vet can help you.* I consider core in-house labs to be the following;
  1. A full CBC (complete blood count). Our fee $50
  2. Chemistry with electrolytes. Our fee $80
  3. Parvo $40
  4. Lyme $20
  5. FeLV/FIV $35
  6. Urinalysis $30
  7. Fecal $30
I am on a personal mission to educate every pet lover the world over. I believe that a knowledgeable pet parent is a capable guardian. I can't convince every human being to see a pet in the same compassionate manner that many of us do, but, I can provide the tools to empower you to help your pet with the resources available. Join me on Pawbly.com as we inspire and enlighten pet lovers for free.

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Want more pet education? Meet me on Mondays at Meerkat for live streaming from the clinic. Or Twitter @FreePetAdvice.

Want to change the face of pet care forever? Write me a comment here. I am looking for partners who know that we can do better AND save more lives across all socio-economic borders.

*Footnote. If your vet is a small 1-2 doctor practice some of these services are not feasible. JVC has assistance in purchasing equipment and partnerships due to our overhead and volume. It is the same reason Wal-Mart provides $4 prescriptions that cost $15 at JVC.


  1. Interesting look behind the scenes.

    Just one possibly negative(?) general comment... this scenario has happened more than once & I just find it unfair that the owner is not 'kept in the loop' & is later 'accosted' with a much larger bill than was budgeted for.

    When my Dad brings his dog in for a dental cleaning, that is what he expects to pay for (somewhere in the neighbourhood of $300). He is a senior on a limited income, he cannot AFFORD to be surprised by a bill that totals 3 to 4 times what he expects with multiple extractions that he was not informed of (he is available at all times, & usually waiting for his dog in the office!) & therefore did not authorize or agree to pay for.
    He buys the vet recommended food at the clinic that costs triple what store brands cost, as well as the vet recommended water additive for the dog's water. We look at the dog's teeth everyday - no plaque buildup & all teeth look bright & white & feel solid. This has happened to my Dad with his older dog & his young dog alike - surely all these extractions are not necessary when he is doing all he can & all that is advised to care for the dogs & their teeth look great?

    This is NOT a criticism of Jarretsville at all - this is intended only as an devoted owner making a point about what sometimes can be construed as UP-billing.

    I realize that vets want to do all that they feel may be necessary, but does the owner not at least deserve the courtesy of being told in advance that the vet may go ahead & do more than what was agreed to & possibly far more than he can afford?

    1. Hello!
      I don't see this as a negative comment at all. We try very hard to provide a solid estimate for every service that we provide. It an be difficult but we never want to blow the socks off of an unprepared client. If we do blow the estimate we offer assistance on how to budget, or mitigate the difference.