Vet Misdiagnosis - Refund?
July 27, 2010 6:33 PM Subscribe
I recently took my cat to an emergency vet over a weekend. I was initially pleased with the care he got, not so much afterwards, and was obviously expecting it to be a little pricey. Well, it certainly was, especially emotionally. (more on that inside) In a fit of emotion/rage I wrote them a letter expressing how upset I was with them and demanding some of my money back. So now... how do I follow up?
I hate to get too into all the details on this, but here goes.
My 4-year-old cat Simon was having some back problems, for the second time in a month. The first time I noticed a problem I took him to his regular vet, who gave him some pain meds and worked well. This time he was back to the symptoms: not eating, not walking, not doing much of anything but staring in judgment from the same corner for about two days. Naturally this was over the weekend so when I watched him get up and walk and almost fall over with every step, I finally decided to take him to the emergency vet. He was clearly in a lot of pain, which the vet found out for sure after he tried to poke around and Simon reacted loudly. He gave me some pain meds, and $375 later I was out the door. The vet advised me that if he didn't get any better the next day I should bring him back and they would admit him overnight.
Sure enough, the next day he didn't get any better. The pain meds weren’t working their same magic so I took Simon back that Sunday night.
When I was given my estimate for that night’s charges, I saw that it was “until 1 pm the next day.” I asked the tech if I could leave Simon until after work at 5, or if it would cost extra. She had no answer for me.
The doctor called me later that evening like he had said he would and told me that Simon’s bloodwork was all normal, nothing had come up in an X-ray, and he probably just had some arthritis. Comforted, I planned on picking Simon up the next day. The doctor said I’d hear from someone the following morning (Monday).
Monday morning I was expecting to hear from someone and didn’t. Finally, around noon, I called and spoke with a different doctor, who informed me that Simon had not improved, an ultrasound would be the next step and he probably had a chronic infection or cancer.
Shocked, I left work early, driving the 45 minutes crying the whole way, paid even MORE money at the vet (bringing my total close to $1000) and took Simon to our regular vet, still in tears because I thought I was taking him to be euthanized.
Imagine my surprise when she told me Simon just needed something stronger for his back pain and was fine. She gave me some steroids and he's now eating more than he ever did before and is completely back to normal. She was also of great comfort to me ("They told me it's possible he has cancer." "Oh, God, no!! That's a little over the top!") and has called at least twice a week since this event.
So I wrote a letter outlining this to the emergency clinic, and expressed my anger and disappointment in a doctor who would so casually suggest a vague "chronic infection" or cancer, especially when blood tests and X-rays revealed nothing. If Simon was a person that could probably be malpractice.
I know it may sound cruel that my first thought was that I'd have to have him put down. I'd already spent $1000 for this "care" that wound up making me cry for 2 hours straight and did him no good at all, and money is just too tight. I love him, obviously, but I couldn't imagine getting into ultrasounds and chemo or whatever else.
So, finally, the point. I've written this letter, I'm sure they've received it by now, and I want to follow up. I really do want/need and feel I deserve some of my money back from this experience. I could be wrong and still feel emotional about it. What do you guys think?
If you agree with me on it, how do I go about pursuing it further? Call and ask if they got my note and what do they think?
Thank you in advance!
I hate to get too into all the details on this, but here goes.
My 4-year-old cat Simon was having some back problems, for the second time in a month. The first time I noticed a problem I took him to his regular vet, who gave him some pain meds and worked well. This time he was back to the symptoms: not eating, not walking, not doing much of anything but staring in judgment from the same corner for about two days. Naturally this was over the weekend so when I watched him get up and walk and almost fall over with every step, I finally decided to take him to the emergency vet. He was clearly in a lot of pain, which the vet found out for sure after he tried to poke around and Simon reacted loudly. He gave me some pain meds, and $375 later I was out the door. The vet advised me that if he didn't get any better the next day I should bring him back and they would admit him overnight.
Sure enough, the next day he didn't get any better. The pain meds weren’t working their same magic so I took Simon back that Sunday night.
When I was given my estimate for that night’s charges, I saw that it was “until 1 pm the next day.” I asked the tech if I could leave Simon until after work at 5, or if it would cost extra. She had no answer for me.
The doctor called me later that evening like he had said he would and told me that Simon’s bloodwork was all normal, nothing had come up in an X-ray, and he probably just had some arthritis. Comforted, I planned on picking Simon up the next day. The doctor said I’d hear from someone the following morning (Monday).
Monday morning I was expecting to hear from someone and didn’t. Finally, around noon, I called and spoke with a different doctor, who informed me that Simon had not improved, an ultrasound would be the next step and he probably had a chronic infection or cancer.
Shocked, I left work early, driving the 45 minutes crying the whole way, paid even MORE money at the vet (bringing my total close to $1000) and took Simon to our regular vet, still in tears because I thought I was taking him to be euthanized.
Imagine my surprise when she told me Simon just needed something stronger for his back pain and was fine. She gave me some steroids and he's now eating more than he ever did before and is completely back to normal. She was also of great comfort to me ("They told me it's possible he has cancer." "Oh, God, no!! That's a little over the top!") and has called at least twice a week since this event.
So I wrote a letter outlining this to the emergency clinic, and expressed my anger and disappointment in a doctor who would so casually suggest a vague "chronic infection" or cancer, especially when blood tests and X-rays revealed nothing. If Simon was a person that could probably be malpractice.
I know it may sound cruel that my first thought was that I'd have to have him put down. I'd already spent $1000 for this "care" that wound up making me cry for 2 hours straight and did him no good at all, and money is just too tight. I love him, obviously, but I couldn't imagine getting into ultrasounds and chemo or whatever else.
So, finally, the point. I've written this letter, I'm sure they've received it by now, and I want to follow up. I really do want/need and feel I deserve some of my money back from this experience. I could be wrong and still feel emotional about it. What do you guys think?
If you agree with me on it, how do I go about pursuing it further? Call and ask if they got my note and what do they think?
Thank you in advance!
Just like with anything else, vet care is, firstly, customer service. You did not get good customer service. For that, you are justifiably angry. Secondly, it is, well, vet care not vet scare.
Who is the head of the vet clinic? Is the owner a practicing vet? If so, you definitely have a chance to reason with someone who knows both sides of the business. If you worded your letter to them the way you worded it here, he may listen.
posted by TheBones at 6:46 PM on July 27, 2010 [2 favorites]
Who is the head of the vet clinic? Is the owner a practicing vet? If so, you definitely have a chance to reason with someone who knows both sides of the business. If you worded your letter to them the way you worded it here, he may listen.
posted by TheBones at 6:46 PM on July 27, 2010 [2 favorites]
How long has it been? You don't say. You just say it was "over a weekend," but you pointedly left out what weekend exactly this happened on.
If it was last weekend, obviously it's worth it to wait and see if they're the first to react. They may decide to reimburse you or otherwise try to help you out, out of a sense of fair play and good business sense. However, they may also be heartless bastards about it.
In which case small claims court is probably the next step, if you believe this strongly. Here are the steps you can go through to take someone to small claims court in Michigan; it isn't very difficult, just fill out the correct forms, collect the paperwork, serve them, and show up (although of course it will take some effort.)
That does sound pretty egregious, frankly, although obviously it's up to you how you take it. $1000 is a lot of money to some of us.
posted by koeselitz at 6:51 PM on July 27, 2010 [1 favorite]
If it was last weekend, obviously it's worth it to wait and see if they're the first to react. They may decide to reimburse you or otherwise try to help you out, out of a sense of fair play and good business sense. However, they may also be heartless bastards about it.
In which case small claims court is probably the next step, if you believe this strongly. Here are the steps you can go through to take someone to small claims court in Michigan; it isn't very difficult, just fill out the correct forms, collect the paperwork, serve them, and show up (although of course it will take some effort.)
That does sound pretty egregious, frankly, although obviously it's up to you how you take it. $1000 is a lot of money to some of us.
posted by koeselitz at 6:51 PM on July 27, 2010 [1 favorite]
With apologies to all the vets out there, but, holy shit, vets like to upsell.
It doesn't seem like you will get any money back, but the best thing to do is to a) complain to the Better Business Bureau and b) complain to the local vet college, registrar, or other licensing body.
posted by KokuRyu at 6:53 PM on July 27, 2010 [1 favorite]
It doesn't seem like you will get any money back, but the best thing to do is to a) complain to the Better Business Bureau and b) complain to the local vet college, registrar, or other licensing body.
posted by KokuRyu at 6:53 PM on July 27, 2010 [1 favorite]
Response by poster: koeselitz - Well, it was about two weeks ago that this happened - July 10-11, I guess it would have been? I sent the letter last week so it was only 7-10 days between check-out and letter.
$1000 IS a lot of money, that's why I'm especially livid. I certainly don't have it stuffed in my mattress. Visa is to thank for this.
posted by slyboots421 at 6:56 PM on July 27, 2010
$1000 IS a lot of money, that's why I'm especially livid. I certainly don't have it stuffed in my mattress. Visa is to thank for this.
posted by slyboots421 at 6:56 PM on July 27, 2010
I'll chime in on the "emergency vets exist to prey on you like this" note.
I completely agree with that statement. When my 2 year old male was having a urinary issue (he couldn't pee!), the emergency vet attempted to charge me over $1000 to put him right - just for the night. In the morning, I still would have had to transport him from their facility to his normal vet, who would then need to treat him with a long(er)-term solution. I thought they were kidding me, but they told me the price with deadpan faces and only lowered it when I made it clear that I refused to pay their outrageous prices.
Unfortunately, with emergency vets, that seems to be the only way forcing a price drop works: demand it before the work is done. You know, while you're highly emotional about the idea that your beloved pet is (a) in pain or (b) on the verge of dying if he doesn't get the proper treatment.
TheBones also has a great point. You are justifiably angry and deserve a refund of at least a portion of what you paid. Too bad 'malpractice in vet care' hasn't been codified as a cause of action (although, possibly, you could claim that you'll see an attorney about an intentional infliction of emotional harm action (not likely to work - for more reasons than I really want to go into tonight/here) and scare the vet into some action).
I'm glad Simon is okay.
posted by LOLAttorney2009 at 6:58 PM on July 27, 2010 [1 favorite]
I completely agree with that statement. When my 2 year old male was having a urinary issue (he couldn't pee!), the emergency vet attempted to charge me over $1000 to put him right - just for the night. In the morning, I still would have had to transport him from their facility to his normal vet, who would then need to treat him with a long(er)-term solution. I thought they were kidding me, but they told me the price with deadpan faces and only lowered it when I made it clear that I refused to pay their outrageous prices.
Unfortunately, with emergency vets, that seems to be the only way forcing a price drop works: demand it before the work is done. You know, while you're highly emotional about the idea that your beloved pet is (a) in pain or (b) on the verge of dying if he doesn't get the proper treatment.
TheBones also has a great point. You are justifiably angry and deserve a refund of at least a portion of what you paid. Too bad 'malpractice in vet care' hasn't been codified as a cause of action (although, possibly, you could claim that you'll see an attorney about an intentional infliction of emotional harm action (not likely to work - for more reasons than I really want to go into tonight/here) and scare the vet into some action).
I'm glad Simon is okay.
posted by LOLAttorney2009 at 6:58 PM on July 27, 2010 [1 favorite]
If all else fails, this is the kind of thing that could be sold easily to a local paper/publication as a human interest-sympathy sort of story.
posted by mannequito at 7:01 PM on July 27, 2010
posted by mannequito at 7:01 PM on July 27, 2010
LOLAttorney2009: “Too bad 'malpractice in vet care' hasn't been codified as a cause of action...”
Er – it has. Not under that heading; no court in the US would take this level of case as a "malpractice" suit or anything like that. But there are clearly recourses.
In Michigan, for example, anything under $3000 is required to be filed as a small claims court claim. And in Michigan (as in most states) it's set up so that you don't even need a lawyer to make a claim in small claims court; all you have to do is fill out the forms, have the vet served, and show up. If you feel like you've been ripped off (and I think it's clear that you have) and if the amount that you've been ripped off for is less than $3000, then small claims court is the way to go.
And even if the vet wants to settle and not let it get that far, serving him papers is often the best way to convince him to pay attention and work to resolve this with you. And it's a hell of a lot more efficient than complaining to whoever'll listen.
posted by koeselitz at 7:09 PM on July 27, 2010
Er – it has. Not under that heading; no court in the US would take this level of case as a "malpractice" suit or anything like that. But there are clearly recourses.
In Michigan, for example, anything under $3000 is required to be filed as a small claims court claim. And in Michigan (as in most states) it's set up so that you don't even need a lawyer to make a claim in small claims court; all you have to do is fill out the forms, have the vet served, and show up. If you feel like you've been ripped off (and I think it's clear that you have) and if the amount that you've been ripped off for is less than $3000, then small claims court is the way to go.
And even if the vet wants to settle and not let it get that far, serving him papers is often the best way to convince him to pay attention and work to resolve this with you. And it's a hell of a lot more efficient than complaining to whoever'll listen.
posted by koeselitz at 7:09 PM on July 27, 2010
Best answer: I would have lost my ever-living mind if some leech of an emergency vet told me my cat hand cancer, and then my very reasonable regular vet told me that was the craziest thing possible. You are justifiably angry and upset.
If they won't deal with you properly, which I would think is refunding some if not all of your fees, then you have every right and possibly an obligation to report their conduct to any professional societies that might be interested (American Veterinary Medical Association, Better Business Bureau) and to take your story to a local paper. Times are hard, and I don't think any business wants to be in the news for preying on worried pet owners. And, as koeselitz points out, Small Claims Court is definitely an option you should pursue.
Good luck. People like this need to be weeded out.
posted by Medieval Maven at 7:12 PM on July 27, 2010 [1 favorite]
If they won't deal with you properly, which I would think is refunding some if not all of your fees, then you have every right and possibly an obligation to report their conduct to any professional societies that might be interested (American Veterinary Medical Association, Better Business Bureau) and to take your story to a local paper. Times are hard, and I don't think any business wants to be in the news for preying on worried pet owners. And, as koeselitz points out, Small Claims Court is definitely an option you should pursue.
Good luck. People like this need to be weeded out.
posted by Medieval Maven at 7:12 PM on July 27, 2010 [1 favorite]
I've written my sister, an emergency vet, for her opinion on the matter. Once I get it, I'll drop a note.
posted by Atreides at 7:16 PM on July 27, 2010 [2 favorites]
posted by Atreides at 7:16 PM on July 27, 2010 [2 favorites]
I just want to chime in that I have had some really positive experiences with emergency vet clinics, so I disagree that they exist *entirely* to scare you into upsells. I've even had them tell me "don't come, you can take care of this at home," with instructions.
I got results when I was a really unhappy with a small company by looking up the company info and writing a clear letter to the company president. I laid out my complaints and exactly what it would take to make me happy (and specified a dollar amount). This got me a lot farther than I had previously gotten, calling their general info line and getting brushed off. I received a weasel-worded letter saying essentially, "I'm sorry you had that experience, and we don't take responsibility for the incident, but out of a sense of good neighborliness, here, have this check." It took a couple of weeks.
If you're really unhappy with a veterinarian's professional behavior, you can complain to the state association that oversees licenses. If you *don't*--and no one else has bothered to--then there's no record of what this vet is doing, no way for future clients or even employers to know what he's done.
posted by galadriel at 7:18 PM on July 27, 2010 [3 favorites]
I got results when I was a really unhappy with a small company by looking up the company info and writing a clear letter to the company president. I laid out my complaints and exactly what it would take to make me happy (and specified a dollar amount). This got me a lot farther than I had previously gotten, calling their general info line and getting brushed off. I received a weasel-worded letter saying essentially, "I'm sorry you had that experience, and we don't take responsibility for the incident, but out of a sense of good neighborliness, here, have this check." It took a couple of weeks.
If you're really unhappy with a veterinarian's professional behavior, you can complain to the state association that oversees licenses. If you *don't*--and no one else has bothered to--then there's no record of what this vet is doing, no way for future clients or even employers to know what he's done.
posted by galadriel at 7:18 PM on July 27, 2010 [3 favorites]
I had a really bad story with an emergency vet, and my regular vet was so angry, she called the clinic and, in the tech's words, "ripped them a new one." I did get a refund of several hundred dollars after that.
posted by MexicanYenta at 7:21 PM on July 27, 2010 [1 favorite]
posted by MexicanYenta at 7:21 PM on July 27, 2010 [1 favorite]
I'm not saying that it's right or wrong, but this is how it is: a lot of emergency vet clinics are emergency only. That is, they don't have a regular clientele to support the cost of the building or running the business, paying salaries, etc. That is why emergency anything is expensive. That doesn't give them the right to scare you or act unprofessionally, but it seems that a lot of people feel that veterinarians should be providing their services for free or next to nothing for everybody. The vets are not out there "preying" on you or always trying to upsell. They are trying to make a living and do the best for your pet. Medical care isn't free. It has to be subsidized by someone.
As for the vet telling you it could be cancer: not likely, but four year-old cats usually don't have arthritis. A chronic infection is a reasonable guess, too. The way he presented it was probably not the best. So he gets an 'F' in bedside manner.
Here's something else to consider (I'll be the devil's advocate). I took my dog in to see her vet for back pain, etc. He did the quickie "steroids will make it better" routine, but I knew something was wrong. And by his answers to my questions, I knew it was out of his league and his ego prevented him from admitting it. I went to another vet who was willing to refer me to a specialist, and after a $5000 spinal surgery things have improved. There are different levels of competence in veterinarians, just as in human doctors. (this is in no way saying that your vet is incompetent. She may be right, but it is also possible that she's wrong). You don't know that Simon is out of the woods yet. If you do decide to follow up, you will get far better results being calm, polite, and composed, rather than ranting and demanding.
posted by bolognius maximus at 7:48 PM on July 27, 2010 [6 favorites]
As for the vet telling you it could be cancer: not likely, but four year-old cats usually don't have arthritis. A chronic infection is a reasonable guess, too. The way he presented it was probably not the best. So he gets an 'F' in bedside manner.
Here's something else to consider (I'll be the devil's advocate). I took my dog in to see her vet for back pain, etc. He did the quickie "steroids will make it better" routine, but I knew something was wrong. And by his answers to my questions, I knew it was out of his league and his ego prevented him from admitting it. I went to another vet who was willing to refer me to a specialist, and after a $5000 spinal surgery things have improved. There are different levels of competence in veterinarians, just as in human doctors. (this is in no way saying that your vet is incompetent. She may be right, but it is also possible that she's wrong). You don't know that Simon is out of the woods yet. If you do decide to follow up, you will get far better results being calm, polite, and composed, rather than ranting and demanding.
posted by bolognius maximus at 7:48 PM on July 27, 2010 [6 favorites]
I'm so sorry this happened to you, although I'm glad Simon is better. You might be able to get a partial refund from this clinic if you keep at them, promising to tell your story to their customers and potential customers. If I were you I'd write an accurate and detailed review of my experience with this clinic on in Royal Oak's Yelp page. If they don't have a listing, add one. You may be able to use your honest review, and its potential revision, as some leverage to work out a compromise with this organization--especially if they're small enough that your negative review "makes a dent."
...In any event, If I were taking my pet to a new clinic, I'd want to read an honest review like yours before I did.
In my view (and this is not legal advice), litigation--even small claims court-- is seldom worth the time and trouble and it's not nearly the panacea many non-lawyers seem to think it is.
posted by applemeat at 7:56 PM on July 27, 2010 [1 favorite]
...In any event, If I were taking my pet to a new clinic, I'd want to read an honest review like yours before I did.
In my view (and this is not legal advice), litigation--even small claims court-- is seldom worth the time and trouble and it's not nearly the panacea many non-lawyers seem to think it is.
posted by applemeat at 7:56 PM on July 27, 2010 [1 favorite]
You should ask for copies of the xrays and lab work they charged you.
posted by rhizome at 8:44 PM on July 27, 2010 [2 favorites]
posted by rhizome at 8:44 PM on July 27, 2010 [2 favorites]
Emergency vets are good for one thing and one thing only: immediate traumatic injuries that are quickly and easily identifiable. Dog gets hit by a car? Cat breaks a leg? Sure, go to the emergency vet. But mood changes? Appetite loss? Digestive problems? Don't waste your money. They will bleed you fucking dry.
posted by Civil_Disobedient at 8:49 PM on July 27, 2010 [2 favorites]
posted by Civil_Disobedient at 8:49 PM on July 27, 2010 [2 favorites]
Very sorry to say that my experience with an ER vet was also characterized by an overblown and unnecessarily scary diagnosis.
(Was told the cat was "in heart failure" due to a serious respiratory infection -- he made it sound like she was going to die. She was fine in a couple of days. The ER doc never did manage to truly diagnose her; my regular vet and I pieced together a feasible explanation afterward.)
posted by desuetude at 9:45 PM on July 27, 2010
(Was told the cat was "in heart failure" due to a serious respiratory infection -- he made it sound like she was going to die. She was fine in a couple of days. The ER doc never did manage to truly diagnose her; my regular vet and I pieced together a feasible explanation afterward.)
posted by desuetude at 9:45 PM on July 27, 2010
Best answer: Glad to hear Simon is doing better. Hi Simon!
Some suggestions if you want to pursue this:
1 :: Decide what you want. What's more important to you: money or an apology? If it's money, and it sounds like it is, decide how much you think is fair. If you have an itemised bill, break it down and work out exactly what you're asking for a refund on. Going in with a specific amount is better than just saying you want some money back.
2 :: Decide your angle. Why should the clinic refund you? "I believe I was deliberately frightened into authorising more tests than were reasonable given the situation, and would like a refund on those tests", for example. Simply being unhappy with the service after the fact probably isn't enough.
3 :: Call and ask to speak to the clinic manager. Explain you wrote a letter about a week ago and that you're calling to follow up. Briefly state what happened, the money you're asking for, and why. Use open-ended language like, "Is there anything you can do about this?"
4 :: Stay calm. I know it's difficult, but you're likely to get further if you're polite and rational. Don't make threats or say you're never going back there -- once you acknowledge they've lost you as a client, they have less incentive to make peace with you.
These techniques have worked for me in similar situations, but unfortunately there's no guarantees. Good luck!
posted by Georgina at 1:56 AM on July 28, 2010
Some suggestions if you want to pursue this:
1 :: Decide what you want. What's more important to you: money or an apology? If it's money, and it sounds like it is, decide how much you think is fair. If you have an itemised bill, break it down and work out exactly what you're asking for a refund on. Going in with a specific amount is better than just saying you want some money back.
2 :: Decide your angle. Why should the clinic refund you? "I believe I was deliberately frightened into authorising more tests than were reasonable given the situation, and would like a refund on those tests", for example. Simply being unhappy with the service after the fact probably isn't enough.
3 :: Call and ask to speak to the clinic manager. Explain you wrote a letter about a week ago and that you're calling to follow up. Briefly state what happened, the money you're asking for, and why. Use open-ended language like, "Is there anything you can do about this?"
4 :: Stay calm. I know it's difficult, but you're likely to get further if you're polite and rational. Don't make threats or say you're never going back there -- once you acknowledge they've lost you as a client, they have less incentive to make peace with you.
These techniques have worked for me in similar situations, but unfortunately there's no guarantees. Good luck!
posted by Georgina at 1:56 AM on July 28, 2010
Best answer: If all else fails, this is the kind of thing that could be sold easily to a local paper/publication as a human interest-sympathy sort of story.
This. You should make them aware of the fact that you WILL be telling EVERYONE you know about not only the terrible diagnosis, but also that they charged you one thousand dollars to lie to you about your beloved pet having cancer. Go to the local news station if you have to. This kind of negative publicity is absolutely terrifying to any business, especially one that is built on deception like this. They will likely return some or all of your money to quell the bad reputation they'll be getting, especially if it's all over the news.
"Hey guys, we're not so evil! We gave her her money back! Please put down the pitchforks!"
posted by Captain Cardanthian! at 4:17 AM on July 28, 2010
This. You should make them aware of the fact that you WILL be telling EVERYONE you know about not only the terrible diagnosis, but also that they charged you one thousand dollars to lie to you about your beloved pet having cancer. Go to the local news station if you have to. This kind of negative publicity is absolutely terrifying to any business, especially one that is built on deception like this. They will likely return some or all of your money to quell the bad reputation they'll be getting, especially if it's all over the news.
"Hey guys, we're not so evil! We gave her her money back! Please put down the pitchforks!"
posted by Captain Cardanthian! at 4:17 AM on July 28, 2010
Response by poster: Thank you everyone for the great advice! I hadn't even thought of taking this public. I appreciate all the insight and will embark upon my crusade immediately!
posted by slyboots421 at 4:44 AM on July 28, 2010
posted by slyboots421 at 4:44 AM on July 28, 2010
I hadn't even thought of taking this public.
Consumerist.com might be a good resource for this. I'm pretty sure I've seen vet/pet related stuff there before.
Also, adorable kitteh pictures are always a bonus.
Also also, maybe for future reference, you can ask your regular, trustworthy vet for an emergency vet recommendation?
posted by elizardbits at 5:13 AM on July 28, 2010
Consumerist.com might be a good resource for this. I'm pretty sure I've seen vet/pet related stuff there before.
Also, adorable kitteh pictures are always a bonus.
Also also, maybe for future reference, you can ask your regular, trustworthy vet for an emergency vet recommendation?
posted by elizardbits at 5:13 AM on July 28, 2010
I'm not a vet, but I've had lots of sick animals and thus way more experience with vets than I'd wish for. I know you've already marked best answers, but I can't believe only bolognius maximus has chimed in with a differing opinion--which is the crux of the matter here.
Young cats do not have back pain for no reason. For a vet to offhandedly suggest some startling possible reasons for the pain may have been hamhanded, but you shouldn't ignore the possibilities.
ER vet practices are usually staffed by vets who did (optional) residencies in a specialty such as cardiology, oncology, neurology, general trauma, etc. They have much deeper knowledge in specific areas than vets who have normal practices, who are general practitioners that went into practice straight out of vet school. ER vets/specialty vets chose to go into an area of medicine where they get to see more interesting (i.e., sicker) cases. The ER vet you dealt with may or may not have been using that narrow focus when suggesting possible reasons for Simon's back pain.
I'm concerned that you seem to be ok with steroids taking care of Simon's symptoms, but you don't seem to be still seeking the cause of the pain. If he'd pulled a muscle or had some other temporary injury, a month might be on the long side for that to stick around. Debilitating pain lasting this long in a young cat absolutely warrants some speculation and exploration--and some of the possibilities include, yes, some scary and awful things. You're responsible for Simon's life, and that includes entertaining the remote possibility that he has something scary and awful.
When my 8 year old dog had a limp that wouldn't go away, I expected to have a conversation with the specialty vet about arthritis or dysplasia. I was in tears within 2 minutes of the exam because he started using the word osteosarcoma. We didn't get the test results back for 2 days. Unfortunately my beloved dog did indeed have bone cancer. But if I'd been told he hadn't, and I'd been offended at the mere suggestion that he might have it, and I'd asked for a partial refund because they were so wrong, and I considered contacting local media about something so personally awful for me but actually quite mundane that happens every day... Well, I'd hope my friends would kindly and quickly let me know how irrational my thinking was.
I suggest if Simon's pain doesn't improve when he's done with the course of steroids that your regular vet refer you to a specialist. Which kind would be up to him/her, but if it were my cat, I'd start with a neurologist or orthopedist. Good luck.
posted by ImproviseOrDie at 5:36 AM on July 28, 2010 [1 favorite]
Young cats do not have back pain for no reason. For a vet to offhandedly suggest some startling possible reasons for the pain may have been hamhanded, but you shouldn't ignore the possibilities.
ER vet practices are usually staffed by vets who did (optional) residencies in a specialty such as cardiology, oncology, neurology, general trauma, etc. They have much deeper knowledge in specific areas than vets who have normal practices, who are general practitioners that went into practice straight out of vet school. ER vets/specialty vets chose to go into an area of medicine where they get to see more interesting (i.e., sicker) cases. The ER vet you dealt with may or may not have been using that narrow focus when suggesting possible reasons for Simon's back pain.
I'm concerned that you seem to be ok with steroids taking care of Simon's symptoms, but you don't seem to be still seeking the cause of the pain. If he'd pulled a muscle or had some other temporary injury, a month might be on the long side for that to stick around. Debilitating pain lasting this long in a young cat absolutely warrants some speculation and exploration--and some of the possibilities include, yes, some scary and awful things. You're responsible for Simon's life, and that includes entertaining the remote possibility that he has something scary and awful.
When my 8 year old dog had a limp that wouldn't go away, I expected to have a conversation with the specialty vet about arthritis or dysplasia. I was in tears within 2 minutes of the exam because he started using the word osteosarcoma. We didn't get the test results back for 2 days. Unfortunately my beloved dog did indeed have bone cancer. But if I'd been told he hadn't, and I'd been offended at the mere suggestion that he might have it, and I'd asked for a partial refund because they were so wrong, and I considered contacting local media about something so personally awful for me but actually quite mundane that happens every day... Well, I'd hope my friends would kindly and quickly let me know how irrational my thinking was.
I suggest if Simon's pain doesn't improve when he's done with the course of steroids that your regular vet refer you to a specialist. Which kind would be up to him/her, but if it were my cat, I'd start with a neurologist or orthopedist. Good luck.
posted by ImproviseOrDie at 5:36 AM on July 28, 2010 [1 favorite]
Response by poster: ImproviseOrDie - I certainly appreciate your opposing viewpoint. My regular vet thinks, and I tend to agree with her, that Simon fell and hurt his back, it's not a chronic ache.
He is very clumsy and slips on/off the counters he jumps onto, he's just not that coordinated. Also working "against" him is that he's very small - he's only about 5.5 pounds. So any type of injury or trauma is more likely to cause him pain because he doesn't have as much cushion.
I understand how you took my saying that I was upset with such a casual suggestion of a deadly disease. I honestly expected more responses like yours.
My main problem with this emergency clinic was that I had to call them despite their saying I'd hear something the following morning. And then a doctor I'd never met got on the phone and said she went over Simon's results with the overnight doctor and that they had concluded it had to be one or the other. Despite the fact that every test was normal. So if I hadn't called, they may have kept him until I could get there, charged me even MORE money, and then been able to recommend expensive tests and probably another overnight visit. Probably doubling my tab.
He didn't eat during the night he stayed there, to which my regular vet said, of course he wouldn't, he's unhappy and not home and he's not going to eat in a vet's office. At the emergency clinic they had me come back to get him out of the cage because he wasn't "havin it" with the techs. As soon as I walked back he got up and walked out of the cage. They assumed his "moodiness" to be something much worse.
I've had the same thoughts - something *must* be really wrong here. But it's been two weeks and he's the same as ever. Better, even, because his appetite is immense now!
So, I appreciate your opinion. But he doesn't appear to be in pain anymore and since he's had two "episodes" like this I certainly am on high alert.
posted by slyboots421 at 5:51 AM on July 28, 2010
He is very clumsy and slips on/off the counters he jumps onto, he's just not that coordinated. Also working "against" him is that he's very small - he's only about 5.5 pounds. So any type of injury or trauma is more likely to cause him pain because he doesn't have as much cushion.
I understand how you took my saying that I was upset with such a casual suggestion of a deadly disease. I honestly expected more responses like yours.
My main problem with this emergency clinic was that I had to call them despite their saying I'd hear something the following morning. And then a doctor I'd never met got on the phone and said she went over Simon's results with the overnight doctor and that they had concluded it had to be one or the other. Despite the fact that every test was normal. So if I hadn't called, they may have kept him until I could get there, charged me even MORE money, and then been able to recommend expensive tests and probably another overnight visit. Probably doubling my tab.
He didn't eat during the night he stayed there, to which my regular vet said, of course he wouldn't, he's unhappy and not home and he's not going to eat in a vet's office. At the emergency clinic they had me come back to get him out of the cage because he wasn't "havin it" with the techs. As soon as I walked back he got up and walked out of the cage. They assumed his "moodiness" to be something much worse.
I've had the same thoughts - something *must* be really wrong here. But it's been two weeks and he's the same as ever. Better, even, because his appetite is immense now!
So, I appreciate your opinion. But he doesn't appear to be in pain anymore and since he's had two "episodes" like this I certainly am on high alert.
posted by slyboots421 at 5:51 AM on July 28, 2010
In the future, if you're looking for an emergency vet, I recommend you find one that's owned by a group of veterinarians who themselves own regular animal clinics. My mother was a partner in such a group, and she was fairly committed to ensuring client satisfaction because she hoped to retain or add them as regular clients. That's in contrast to standard emergency hospitals, which don't expect to see an animal more than once or twice in its lifetime (and can thus get away with crazy prices).
posted by acidic at 6:57 AM on July 28, 2010
posted by acidic at 6:57 AM on July 28, 2010
Wow, Simon's really small for an adult.
I hear you. Emergency vet care is expensive. And diagnosis can be just as much an art form as a science.
My main problem with this emergency clinic was that I had to call them despite their saying I'd hear something the following morning. And then a doctor I'd never met got on the phone and said she went over Simon's results with the overnight doctor and that they had concluded it had to be one or the other. Despite the fact that every test was normal.
So you called them before they called you. I don't see that as very much to be angry about, but I'm one of those people who'll wait maybe one hour and then call--if I wait at all. Just like in human healthcare, you have to be your own advocate. i.e., You don't have to wait to make that call. You don't have to be shy about needing information.
And by the time you did talk to someone shifts had changed and you had to talk to another doctor. And your original post said this doctor said he probably had a chronic infection or cancer--which are reasonable avenues to explore in a young cat with long lasting back pain that hinders movement. Unless they said "your cat has cancer" or "your cat has a chronic infection," he was not misdiagnosed as your title indicates. Many types/stages of cancer wouldn't show up in blood tests and would require further testing. Osteosarcoma (bone cancer), for example, requires as definitive diagnosis punching a hole into the bone to take a core sample for a biopsy.
All of this sounds like perfectly reasonable behavior to me, actually. I don't see any cause for a refund, and if you were my friend I'd counsel you against waging a battle against this ER practice. The bedside manner sounds clumsy; it wouldn't hurt to speak to the practice manager about that. But I respectfully suggest that the roller coaster of emotions you experienced--at being told cancer was a possibility--coupled with the high cost of ER care is what's got you upset enough to be looking for someone to take it out on.
posted by ImproviseOrDie at 7:05 AM on July 28, 2010
I hear you. Emergency vet care is expensive. And diagnosis can be just as much an art form as a science.
My main problem with this emergency clinic was that I had to call them despite their saying I'd hear something the following morning. And then a doctor I'd never met got on the phone and said she went over Simon's results with the overnight doctor and that they had concluded it had to be one or the other. Despite the fact that every test was normal.
So you called them before they called you. I don't see that as very much to be angry about, but I'm one of those people who'll wait maybe one hour and then call--if I wait at all. Just like in human healthcare, you have to be your own advocate. i.e., You don't have to wait to make that call. You don't have to be shy about needing information.
And by the time you did talk to someone shifts had changed and you had to talk to another doctor. And your original post said this doctor said he probably had a chronic infection or cancer--which are reasonable avenues to explore in a young cat with long lasting back pain that hinders movement. Unless they said "your cat has cancer" or "your cat has a chronic infection," he was not misdiagnosed as your title indicates. Many types/stages of cancer wouldn't show up in blood tests and would require further testing. Osteosarcoma (bone cancer), for example, requires as definitive diagnosis punching a hole into the bone to take a core sample for a biopsy.
All of this sounds like perfectly reasonable behavior to me, actually. I don't see any cause for a refund, and if you were my friend I'd counsel you against waging a battle against this ER practice. The bedside manner sounds clumsy; it wouldn't hurt to speak to the practice manager about that. But I respectfully suggest that the roller coaster of emotions you experienced--at being told cancer was a possibility--coupled with the high cost of ER care is what's got you upset enough to be looking for someone to take it out on.
posted by ImproviseOrDie at 7:05 AM on July 28, 2010
Response by poster: I hate to keep splitting hairs, but I need to further explain the calling-in-the-morning point because I realize how it makes me seem a little unhinged.
The estimate I got was "until 1pm the next day." I gave it the morning to hear back, and then called at noon. I signed him out just before 1:00, when I assume the clock would have re-set to start charging again. That's what bothers me - they didn't tell me if more time would cost more money, and then didn't alert me that he was ready to be picked up.
I had to squeeze my way into the regular vet, who was in surgery all morning, and I could have arranged it better if I knew he would need further care immediately. The last I heard he was fine and I could bring him home the next day. So all of those things would have been nice to know a little sooner.
I know you're probably right and it's more a personal thing than an actual "this definitively was wrong." It was my first (and hopefully last) experience with an emergency vet so like I said, I knew it'd be pricey, I just didn't realize it would be $1000, and didn't know I'd get a sucker-punch of a conclusion: "We'd like to do an ultrasound and more testing." As if I'd have them do it, at $1000 a round? No thanks.
posted by slyboots421 at 7:32 AM on July 28, 2010
The estimate I got was "until 1pm the next day." I gave it the morning to hear back, and then called at noon. I signed him out just before 1:00, when I assume the clock would have re-set to start charging again. That's what bothers me - they didn't tell me if more time would cost more money, and then didn't alert me that he was ready to be picked up.
I had to squeeze my way into the regular vet, who was in surgery all morning, and I could have arranged it better if I knew he would need further care immediately. The last I heard he was fine and I could bring him home the next day. So all of those things would have been nice to know a little sooner.
I know you're probably right and it's more a personal thing than an actual "this definitively was wrong." It was my first (and hopefully last) experience with an emergency vet so like I said, I knew it'd be pricey, I just didn't realize it would be $1000, and didn't know I'd get a sucker-punch of a conclusion: "We'd like to do an ultrasound and more testing." As if I'd have them do it, at $1000 a round? No thanks.
posted by slyboots421 at 7:32 AM on July 28, 2010
"We'd like to do an ultrasound and more testing."
I hesitated writing this because I genuinely don't want to scare you, just give you another anecdote that might help you make decisions after Simon is finished with his steroids.
I went into debt having my six-year-old cat at an ER vet for a week trying to determine what was wrong with him. For six months prior, he'd been given three steroid injections that left him happy and ravenously hungry and seemingly healthy only to regress once the affects of the steroid wore off. Steroids work great in cats, but they can disguise serious, ongoing problems. My cat eventually was diagnosed with pancreatic cancer by ultrasound--the tumor never showed up on x-rays. It's been a few years, so I can't quite recall whether or not the steroids were disguising his cancer on the x-rays or if the x-rays just don't show that kind of tumor.
An ultrasound might seem expensive now, especially after all the tests the ER vet ran, but it may also help you determine what's happening with Simon. Although, I would wait until the effects of the steroid course are finished before thinking about it.
posted by gladly at 7:48 AM on July 28, 2010 [1 favorite]
I hesitated writing this because I genuinely don't want to scare you, just give you another anecdote that might help you make decisions after Simon is finished with his steroids.
I went into debt having my six-year-old cat at an ER vet for a week trying to determine what was wrong with him. For six months prior, he'd been given three steroid injections that left him happy and ravenously hungry and seemingly healthy only to regress once the affects of the steroid wore off. Steroids work great in cats, but they can disguise serious, ongoing problems. My cat eventually was diagnosed with pancreatic cancer by ultrasound--the tumor never showed up on x-rays. It's been a few years, so I can't quite recall whether or not the steroids were disguising his cancer on the x-rays or if the x-rays just don't show that kind of tumor.
An ultrasound might seem expensive now, especially after all the tests the ER vet ran, but it may also help you determine what's happening with Simon. Although, I would wait until the effects of the steroid course are finished before thinking about it.
posted by gladly at 7:48 AM on July 28, 2010 [1 favorite]
I'm wondering if your cat has very slight brain damage -- when I volunteered at the SPCA, I occasionally saw clumsy, staggering, or klutzy cats and kittens. The staff told us that sometimes cats get mild brain damage at birth, almost like cerebral palsy -- some can have a useless leg, or just be really uncoordinated.
If Simon isn't in any apparent pain, that might be something to consider asking your vet about.
posted by vickyverky at 12:36 PM on July 28, 2010
If Simon isn't in any apparent pain, that might be something to consider asking your vet about.
posted by vickyverky at 12:36 PM on July 28, 2010
Here's the response I got from my sister. She was a bit testy after seeing some of the earlier comments slamming her profession, so take the anger stuff with a grain of salt.
-------
1. Steroids are a band-aid and are highly out of favor with the up to date community for treating ill defined, undiagnosed pain.Of course the cat is eating better, he's had steroids. Whether or not it's helping the pain (which studies have shown they really don't) he's gonna eat BECAUSE HE GOT STEROIDS. Steroids are NOT a pain medication!!! They are an anti-inflammatory drug so you are only potentially masking the true problem
2. If the male cat is that small and that clumsy...I would suspect an underlying birth defect...neurological and or musculoskeletal and possibly an immune system problem
(which could include cancer though much less likely).
3. Expensive. Yes, sometime we get expensive b/c we have to do full workups on critical animals. We have no long term history to refer to like the rDVM. We are starting from scratch in most cases. We don't bill b/c we have people walk out and we never see them again and in a lot of cases, we are staffed 24 hours a day which is more expensive to run than a day practice. I would like to see her bill from a human ER if she went in with these symptoms and got the same workup!! Plus, she didn't HAVE to agree to all the diagnostics if she didn't want to. They could have done it step by step.
The only thing I see that this doctor did wrong (without being able to see his bedside manner) was that no one called her in the morning. Now, it could have been that other emergencies were coming in and time got away from him/her OR the overnight doc didn't tell the day doc that they needed to call. Definitely a mix up and should not have happened. She wouldn't have been charged the $1000 again if she picked up her cat later, that was to include all of the diagnostics which had already been done. She would likely have been charged boarding/icu and for any medications the cat was receiving.
When this happens again, and I think it probably will based on the history, I hope her rDVM is open to give her the magic steroid injection to mask the real problem b/c if I was that ER I would never see her again!
---------
There's a scoop from another emergency vet. As an aside about my sister, she definitely didn't get into this niche of the vet profession to make money. She did it because she absolutely loves animals. After hurricane Katrina, she volunteered to go down to Louisiana to help with the abandoned pets and animals. Prior to that, when a hurricane wiped out the veterinary school on St. George's, she helped to arrange for some of those vet students to come and attend her vet school. After graduating from Vet school, she took on this job when it meant lousy hours and bad days that consisted of having to put down numerous pets. Last Christmas was the first time I got to see her at Christmas dinner because previously she had to work the Christmas day shift. So there's a brief history behind the person responding and also perhaps an example of the type of background that you might encounter with other emergency vets.
posted by Atreides at 8:01 PM on July 29, 2010
-------
1. Steroids are a band-aid and are highly out of favor with the up to date community for treating ill defined, undiagnosed pain.Of course the cat is eating better, he's had steroids. Whether or not it's helping the pain (which studies have shown they really don't) he's gonna eat BECAUSE HE GOT STEROIDS. Steroids are NOT a pain medication!!! They are an anti-inflammatory drug so you are only potentially masking the true problem
2. If the male cat is that small and that clumsy...I would suspect an underlying birth defect...neurological and or musculoskeletal and possibly an immune system problem
(which could include cancer though much less likely).
3. Expensive. Yes, sometime we get expensive b/c we have to do full workups on critical animals. We have no long term history to refer to like the rDVM. We are starting from scratch in most cases. We don't bill b/c we have people walk out and we never see them again and in a lot of cases, we are staffed 24 hours a day which is more expensive to run than a day practice. I would like to see her bill from a human ER if she went in with these symptoms and got the same workup!! Plus, she didn't HAVE to agree to all the diagnostics if she didn't want to. They could have done it step by step.
The only thing I see that this doctor did wrong (without being able to see his bedside manner) was that no one called her in the morning. Now, it could have been that other emergencies were coming in and time got away from him/her OR the overnight doc didn't tell the day doc that they needed to call. Definitely a mix up and should not have happened. She wouldn't have been charged the $1000 again if she picked up her cat later, that was to include all of the diagnostics which had already been done. She would likely have been charged boarding/icu and for any medications the cat was receiving.
When this happens again, and I think it probably will based on the history, I hope her rDVM is open to give her the magic steroid injection to mask the real problem b/c if I was that ER I would never see her again!
---------
There's a scoop from another emergency vet. As an aside about my sister, she definitely didn't get into this niche of the vet profession to make money. She did it because she absolutely loves animals. After hurricane Katrina, she volunteered to go down to Louisiana to help with the abandoned pets and animals. Prior to that, when a hurricane wiped out the veterinary school on St. George's, she helped to arrange for some of those vet students to come and attend her vet school. After graduating from Vet school, she took on this job when it meant lousy hours and bad days that consisted of having to put down numerous pets. Last Christmas was the first time I got to see her at Christmas dinner because previously she had to work the Christmas day shift. So there's a brief history behind the person responding and also perhaps an example of the type of background that you might encounter with other emergency vets.
posted by Atreides at 8:01 PM on July 29, 2010
Response by poster: Wow, I'm glad I had a boulder of salt for that response...! I appreciate you getting a further scoop from your sister, Atreides.
Just for the record and then I'll stop beating this dead horse (bad expression for this particular post) - I was angry and emotional because I spent more money at the ER vet than I spent on myself this past week going to three different medical appointments for myself (without insurance). I was upset because I wish I had just waited to see his rDVM on that Monday instead of going over the weekend. I understand why it costs more - more overhead, less consistent patients, etc. The thing that upset me the most was the confidence with which the day doc told me that my cat probably had cancer or a chronic infection. It put me into a tailspin and I wish that part had been avoided.
Birth defects are not something that my regular vet, who has been seeing Simon his whole life, has ever mentioned to me as a possibility but he's due for his shots this month so I'll be sure to ask her about that.
posted by slyboots421 at 5:28 AM on August 2, 2010
Just for the record and then I'll stop beating this dead horse (bad expression for this particular post) - I was angry and emotional because I spent more money at the ER vet than I spent on myself this past week going to three different medical appointments for myself (without insurance). I was upset because I wish I had just waited to see his rDVM on that Monday instead of going over the weekend. I understand why it costs more - more overhead, less consistent patients, etc. The thing that upset me the most was the confidence with which the day doc told me that my cat probably had cancer or a chronic infection. It put me into a tailspin and I wish that part had been avoided.
Birth defects are not something that my regular vet, who has been seeing Simon his whole life, has ever mentioned to me as a possibility but he's due for his shots this month so I'll be sure to ask her about that.
posted by slyboots421 at 5:28 AM on August 2, 2010
Response by poster: Also he's been done with the steroids for almost 2 weeks and is still crazy-hungry and happy. Don't know if that's all part of the "magic" of steroids, but he's seemed like himself again for a while.
posted by slyboots421 at 5:29 AM on August 2, 2010
posted by slyboots421 at 5:29 AM on August 2, 2010
It's understandable given the stresses and costs involved. Regardless, and I'm sure my sister agrees, we just hope the best for your little guy!
posted by Atreides at 10:53 AM on August 3, 2010
posted by Atreides at 10:53 AM on August 3, 2010
This thread is closed to new comments.
The best thing you can do is steer everyone you know away from them; but remember, emergency vets exist to prey on you like this, it isn't just you that this has happened to. No one will walk away from a high price when their pet is in pain.
Good luck, and I'm glad to hear Simon is doing better! (Also, what about obligatory kitty pics?)
posted by InsanePenguin at 6:44 PM on July 27, 2010