Why do spaying prices vary-

Let's get right to the question of the week. 

Q:  Why does the price of a spay vary so much between veterinary practices-

A:  A "spay" is the lay term for an ovariohysterectomy.  This surgery involves an abdominal incision and removal of the uterus and both ovaries.  For most veterinarians, this surgery is fairly routine.  For most pets, it is the single most invasive procedure they will ever undergo. 

The question of price is a complicated one.  Because of the complexity and individuality of fee setting among veterinarians, it is not necessarily the case that you "get what you pay for."  Some offices may provide superior service for low fees as a community service.  Others may cut corners yet charge a premium to maximize profit.  A wise pet owner would never choose a veterinarian based solely on price.

When comparing the price of a surgical procedure between practices, pet owners should be sure they know what services are included for the quoted fees.  Here are some helpful questions to ask:

Does the surgical fee include pre-anesthetic blood tests or other diagnostic screenings-  Most veterinarians recognize the importance of such testing.  However, many do not include them in the surgical fee.  The morning of surgery, pet owners are frequently asked to authorize the additional service and fee or sign a waiver indicating they decline the recommended care.
What type of anesthesia is used-  I have seen veterinary practices that simply use a single injection of a 20-year-old immobilizing tranquilizer to perform this major surgery. 

Most veterinarians consider this cruel and unsafe.  Although this type of anesthesia is cheap, it does not offer any significant pain control and has a high rate of complications.  Other practices use safe, modern anesthetics and pain control medications nearly identical to those used in human pediatric hospitals.

Is a breathing tube used to supply oxygen to my pet-  What type of surgical monitors will be used-  What kind of body temperature support is used-  I have been in practices that use none of the above.  I have seen burns caused by electric heating pads used under an anesthetized pet.  The best practices always use a breathing tube, extensive computerized monitors, and either water or air circulating body heating systems.  Obviously, these things all cost money.  Does the lower cost spay package include them-  You should ask.

Does the quoted fee include an IV catheter and IV fluids during the procedure-  Is the fluid administered at a constant rate using an electric pump like in human hospitals-  These steps are essential to maintaining proper blood pressure, facilitating metabolism of the anesthetic drugs, and allowing the fastest possible care if complications develop.  Is there an additional fee for these important precautions-  Are they even available-
Does the surgeon wear a surgical cap, mask, and sterile gown-  Is a separate sterile drape and surgery pack used for each patient-  Is the suture from a multi-use reel or are individual sterilized suture packs used-  Is the surgery room utilized for storage, grooming, or other non-sterile uses-  Believe it or not, I have personally witnessed all of these corners being cut.

The best practices would never compromise sterility.  By the way, an injection of penicillin after the procedure is not an adequate or appropriate way to compensate for poor sterile technique.

How long does the pet stay in the hospital-  Who stays with your pet while she is waking up, and for how long-  What home pain medications are used-  Are they included in the fee-  Can you reach the doctor if there are post-operative questions or an emergency-  Some practices keep pets overnight, heavily medicated to prevent unnecessary pain.  Some provide 24-hour access to the doctor after the procedure.  Surprisingly, many practices send patients home the same day, without pain medication, and without phone access to the veterinarian until the next morning. 

One of the saddest midnight pages I have ever received was from a frantic pet owner who could not reach her regular veterinarian.  The dog had been spayed earlier in the day.  In response to her inadequately controlled pain, the dog had chewed completely through the incision. 

The dog's intestines were literally dragging on the ground and the veterinarian's answering machine coldly instructed the owner to drive an hour to an emergency clinic.  I don't know if this woman saved money by choosing this veterinarian for the surgery, but I bet she wouldn't do it again.

Dr. Watts is a companion animal general practitioner and owner of Clevengers Corner Veterinary Care. He can be reached through ClevengersCorner.com or by calling 428-1000.