Vet Fees (surgery Extras) - Blood Tests And Iv Fluids (optional)

[westiemum]

This situation puts vets in between a rock and a hard place.

If bloods and fluids are not done and not offered - a general opinion / expectation is that vets would do what is needed and they are better / more experienced because they do this.

If bloods and fluids are offered but not compulsory - the vets are only offering to make more money.

If bloods and fluids are compulsory - it increases the cost of surgery, vets are accused of hiking costs up and frequently, and frequently a decision is made on cost comparison alone regardless of the standard of care.

In my hands, IV fluids are not negotiable, nor is pain relief. It's either just included in the cost (such as for desexing) or is a standard part of the estimate. If there is a good reason not to do IV fluids (very short IV only procedure etc) then they won't be run, but an IV catheter gets placed routinely.

Pre-anaesthetic bloods are not negotiable for many unstable and/or elderly patients, strongly recommended for patients 7 years and older and optional but recommended as the best option for routine surgeries in other patients. It's all based on the relative risk of having a problem, sometimes I might say bloods are not essential but this is by no means indicating they would not be useful and you can bet that I will discuss why they are run and note that they have been declined. If the blood test is what stands between having a procedure done or not, then I'll work around it. Our patients don't talk and often owners are not acutely aware of their pet's health, I don't have xray fingers and sometimes I leave my crystal ball at home. Sometimes we need more information to make the best decision. I see my role as an advocate for the patient, I provide advice based on my knowledge and experience. I present available options, owners make decisions about which of those fit with their needs and budget.

This

All my dogs get blood tests at least once a year - particularly as two out of the three are now elderly - I figure it's good preventative medicine and an opportunity to nip any looming problems in the bud. And if it happens to be prior to surgery then that's fine. But if they've had a recent blood test before surgery then I don't bother. But as for IV and pain relief - always - and I always ask\make sure I go home with adequate pain relief as well.

Edited January 7, 2012 by westiemum

[juice]

So out of interest, when bloods are taken, are they tested for just anything and everything?

And how expensive are they generally? I have never had any bloods done with my lot, never been offered, perhaps its something to think about.

[jrm88]

So out of interest, when bloods are taken, are they tested for just anything and everything?

And how expensive are they generally? I have never had any bloods done with my lot, never been offered, perhaps its something to think about.

There are different blood profiles, different clinics will do different profiles.

We do a pre anaesthetic blood profile which includes;

electrolytes (sodium, chloride, potassium)

biochemistry (creatinine, urea, alkp, alp, tp, glucose)

haematology (hematocrit, hemoglobin, mchc, white blood cells, granulocytes, platelets, reticulocytes, not sure if ive missed some)

This gives us info on electrolytes, kidneys, liver, glucose (diabetes in particular, but also can be raised with stress in cats), infection, inflammation, anaemia, etc.

It is a great idea to get bloods done when 'healthy' so you have baseline values to work off in the future, as well as it may show up some abnormalities (but hopefully not!)

Costs will vary depending on suburb, overheads, etc, but this is $88 at my clinic.

Edited January 7, 2012 by jrm88

[westiemum]

Hi Juice - maybe Rappie or one of the vet nurses can confirm but I run a comprehensive one which goes out to the lab and it costs $80 or so from memory. Macs last blood test in July came back 'perfect ' - and I can't tell you how pleased my marvellous vet and I were - as not only was I sure Mac was well and not brewing anything but obviously I was doing something right in my care for him too.

I know they cost money - but I figure it's cheaper to do a test and treat anything as early as possible than to wait for clinical signs and then have an expensive battle for me and a painful debilitating one for Mac on my hands... anyway just how I see it.

Edited January 7, 2012 by westiemum

[Rappie]

Depends on the purpose of testing.

The 'routine' pre-anaesthetic blood test covers basic liver and kidney values, blood glucose, total protein, electrolytes and packed cell volume. It's a screen for any major problems that would affect an some aspect of an anaesthetic - liver disease affects drug choice, kidney disease affects the hydration status, choice of drugs and tolerance of anaesthetic effects , abnormal protein levels can indicate dehydration, inflammation or blood loss, and the packed cell volume if low indicates anaemia (and can be used to monitor blood loss). If run in house, this is usually $60-80. Even just a packed cell volume, total protein and electrolytes can tell you a lot.

For some cases I will send off a full profile, for a couple of reasons:

- they include full biochemistry and haematology

- we might do a routine general screen for underlying problems (two major labs refer to these are a "Total Annual Health Profile" or a "Wellness Profile")

- we might have a suspicion of a disease that will not show up on a preGA such as infection, or abnormalities with red or white blood cell levels

- we have done an in house test and found some abnormalities and need to get more information

These range from $150 - 300 depending on which specific test is run - some include interpretation by a pathologist, some include thyroid or pancreatitis tests etc.

I rarely send off blood just to see what is there - usually have a good reason in mind, even if I suspect the result will be normal (such as running blood work on a patient that has had a seizure - metabolic disturbance are uncommon causes, but if they are present and significant enough to cause a seizure it's important to find them quickly).

[Jumabaar]

This situation puts vets in between a rock and a hard place.

If bloods and fluids are not done and not offered - a general opinion / expectation is that vets would do what is needed and they are better / more experienced because they do this.

If bloods and fluids are offered but not compulsory - the vets are only offering to make more money.

If bloods and fluids are compulsory - it increases the cost of surgery, vets are accused of hiking costs up and frequently, and frequently a decision is made on cost comparison alone regardless of the standard of care.

In my hands, IV fluids are not negotiable, nor is pain relief. It's either just included in the cost (such as for desexing) or is a standard part of the estimate. If there is a good reason not to do IV fluids (very short IV only procedure etc) then they won't be run, but an IV catheter gets placed routinely.

Pre-anaesthetic bloods are not negotiable for many unstable and/or elderly patients, strongly recommended for patients 7 years and older and optional but recommended as the best option for routine surgeries in other patients. It's all based on the relative risk of having a problem, sometimes I might say bloods are not essential but this is by no means indicating they would not be useful and you can bet that I will discuss why they are run and note that they have been declined. If the blood test is what stands between having a procedure done or not, then I'll work around it. Our patients don't talk and often owners are not acutely aware of their pet's health, I don't have xray fingers and sometimes I leave my crystal ball at home. Sometimes we need more information to make the best decision. I see my role as an advocate for the patient, I provide advice based on my knowledge and experience. I present available options, owners make decisions about which of those fit with their needs and budget.

This is what I think happens- and its not always the case!!

I think as time passes fluids will become standard practice, and pain relief already should be!!

[Dame Aussie]

This situation puts vets in between a rock and a hard place.

If bloods and fluids are not done and not offered - a general opinion / expectation is that vets would do what is needed and they are better / more experienced because they do this.

If bloods and fluids are offered but not compulsory - the vets are only offering to make more money.

If bloods and fluids are compulsory - it increases the cost of surgery, vets are accused of hiking costs up and frequently, and frequently a decision is made on cost comparison alone regardless of the standard of care.

In my hands, IV fluids are not negotiable, nor is pain relief. It's either just included in the cost (such as for desexing) or is a standard part of the estimate. If there is a good reason not to do IV fluids (very short IV only procedure etc) then they won't be run, but an IV catheter gets placed routinely.

Pre-anaesthetic bloods are not negotiable for many unstable and/or elderly patients, strongly recommended for patients 7 years and older and optional but recommended as the best option for routine surgeries in other patients. It's all based on the relative risk of having a problem, sometimes I might say bloods are not essential but this is by no means indicating they would not be useful and you can bet that I will discuss why they are run and note that they have been declined. If the blood test is what stands between having a procedure done or not, then I'll work around it. Our patients don't talk and often owners are not acutely aware of their pet's health, I don't have xray fingers and sometimes I leave my crystal ball at home. Sometimes we need more information to make the best decision. I see my role as an advocate for the patient, I provide advice based on my knowledge and experience. I present available options, owners make decisions about which of those fit with their needs and budget.

This is what I think happens- and its not always the case!!

I think as time passes fluids will become standard practice, and pain relief already should be!!

Totally agree.

When I was nursing the general opinion was that they were offered as an extra because the cheaper price without them would encourage people to have surgery done, when they maybe would not have with the whole price.

Guess they figure it's better for the dog to get the care it needs without fluids/blood, than not get it at all because "it's too expensive."

[Rileys mum]

Just wondering, if someone opted to have fluids and bloods done. and the bloods comes back fine, Im guessing the fluids would still be given?

Is there an option of 'give fluids if indicated necessary by bloods' ? what is the benefit of fluids in a dog with normal range bloods that is physically able to rehydrate itself post op? For short routine surgeries such as desexing etc that had no complications, what benefit is there?

Im talking about fluids more so than bloods. i think bloods are necessary but i was interested in fluids being given if bloods are fine (most post have been discussing blood results indicating the use of fluids which is why Im interested in fluid use if bloods are ok :-)

Edited January 7, 2012 by Rileys mum

[jrm88]

Just wondering, if someone opted to have fluids and bloods done. and the bloods comes back fine, Im guessing the fluids would still be given?

Is there an option of 'give fluids if indicated necessary by bloods' ? what is the benefit of fluids in a dog with normal range bloods that is physically able to rehydrate itself post op? For short routine surgeries such as desexing etc that had no complications, what benefit is there?

Im talking about fluids more so than bloods. i think bloods are necessary but i was interested in fluids being given if bloods are fine (most post have been discussing blood results indicating the use of fluids which is why Im interested in fluid use if bloods are ok :-)

Fluids help:

maintain blood pressure/can increase blood pressure if it drops (isoflurane, main inhalant anaesthetic used can drop blood pressure)which in turn supports the kidneys and other organs by increasing blood flow/oxygen availability

often help an animal recover quicker and better

blood pressure is the main thing I worry about during a surgical procedure, speys in particular, can be a long surgery if there are complications (which you cant tell there will be until your in there!)

[coogie]

I wouldn't get our two routine bloods every year, if they appeared healthy & fit I would possibly go every other year (although this has never happened so far as they have needed some treatment each year)!

I don't however understand why you would opt not to have bloods done if they are going under anaesthetic - knowing that not having the bloods and fluids could potentially have an adverse impact on the outcome/recovery. To me having pre op bloods is about preparation for any invasive procedure where they need an anaesthetic - I know people throw around the phrase "routine surgery" but to me any surgical procedure must carry risks and I would like to know they are minimised beforehand where ever possible,rather than being treated reactively if something goes wrong. Our vet recommends them and so we go with their recommendation, we may be plain lucky but I don't get the feeling our vet is out to make money with "extras" . I think trust in your vet is possibly the key?

[WoofnHoof]

My dog appeared to be healthy. She was just a fussy eater. However it turned out that she has a serious liver condition and the chances were very high that she would have died if she had gone under a general anesthetic.

From now on I will always get the bloods done on my dogs. If nothing else it is a good health check.

Yep if my boy had had pre op bloods done (it wasn't offered at the time and I didn't know about it) it would have shown up the liver issue much earlier and saved him getting very very sick later on.