Any cheaper option, Doc?

[JoelleStudent]

I have a question that is a little strange so bear with me. 🙂

We live in one of the poorest counties in our state, and it seems that people here haven’t heard of spaying and neutering their animals!!! So there are a lot of litters of critters. Of course, the county already has enough animals, the pound is full, and people can only afford to feed so many animals. There are plenty of vet clinics around, but people can’t afford the cost of the operation. A friend of mine just payed $300 to get one cat spayed. Yes, there are cheaper clinics, but they are scheduling sometimes 6 months out. If you get a new cat, in 6 months you’ve got kittens. Before covid, we worked with an organization that gave us grant money to help people, but now they are out of funds.

Now I know that vets deserve to be paid well after spending half their life learning about critters and probably taking on debt. But I’m wondering where the expense comes from. Is it because of how valuable the vet’s time is? Or does the operation itself have a lot of costs? I may be wrong and correct me if I am, but from an onlooker it would seem that this is a pretty repeatable surgery? So is there such a thing as “spay/neuter techs” that went to school just to learn spay/neuter? If they spent less time in school than a vet and specialized to just fixing animals, could they offer it more cheaply? Just brainstorming at this point I guess. I’m just a little tired of seeing vet clinics walls covered in “spay and neuter your animals” knowing that the average person can’t afford it, so it’s not really addressing the problem. Curious to hear anyone’s thoughts or solutions. 🙂

• This topic was modified 1 year, 6 months ago by Joelle.
• This topic was modified 1 year, 6 months ago by Joelle.

1 user thanked author for this post.

Angela Krusi

[KimStudent]

Hi Elena, I’m a vet, but not an accountant or business manager, so my numbers won’t include everything and are just rough guestimates.  Here is some basic info on the subject though:

“Consumable costs” = suture material, cutting blade tips, sterile gloves, syringes and needles for administering those meds and drawing blood, IV catheters in many cases, medical tape to hold catheters and endotracheal tubes in place, Elizabethan collar (cone of shame), cleaning products to wash the instruments and the operating room, cleaners for the cage or kennel the pet was in, surgical scrub to sanitize the skin prior to surgery, gauze for absorbing blood during surgery, CO2 absorbent for anesthetic machine:  ~$50-100 per procedure.

“Medication costs” – vary significantly from protocol to protocol and place to place, procedure to procedure, etc.  Bigger animal = higher doses = higher cost.  Many pros and cons to any combination.  In general, the less expensive = the less margin of safety/more side effects and risks.  Injectable sedatives/anesthetics, gas anesthetic, oxygen, anti-emetics, pain medications.  $30-$200

“Smaller reusable equipment costs”, most of these can be re-used many times but like anything, don’t last forever.  Sterile pack wraps and drapes ~$25, endotracheal breathing tubes of many sizes (one of each size needed for small animal practice let’s say roughly $50-$100, breathing bags for gas anesthesia machine ~$30, tubes for anesthesia machine ~$10

“Big equipment costs” – these things hopefully last for several years and will eventually have an ROI, but they are significant up-front costs = surgical instruments ($500-$1500) , autoclave to sterilize the equipment ($3000-$6000), surgical table ($3000-$6000), surgical light ($2000-$3000), gas anesthesia vaporizer machine ($3000-$4000), vital signs monitor ($1000-$3000), In house blood testing equipment (not everyone does pre-anesthetic testing, but it creates a significantly larger margin of safety) (~$30,000), centrifuge for separating blood cells from plasma to run blood chemistries (~$200), again optional, but many practices will use electrocautery or laser equipment to minimize bleeding during surgery and post-surgical pain and inflammation (~$8,000-$15,000).

“Overhead costs” – building, taxes, energy expenses to run everything, computers, printers, and a practice management/medical record software, insurances of several types (property, liability, business, worker’s comp, etc.), oxygen tank contract, biohazardous and sharps materials handling contract – I’m not even going to try to guess at this expense because it’s going to be so different situation to situation.

“Staffing costs” – Registered vet tech ~$20/hr + benefits, veterinary assistant ~$10-15/hr + benefits, veterinarian $45/hr + benefits.  In general you need a combination of at least two of these working with an animal at any given time during the procedure and the veterinarian’s time is already minimized to increase efficiency.  Not to mention the reception staff that spends time scheduling the appointment and greeting the owner or the management staff doing the ordering, payroll, hiring, advertising, etc.  Some estimated times:  5-10min to greet you in the morning, have paperwork signed, take the pet to the kennel area where they will wait to be prepped for surgery.  5-10 minutes to draw blood, process it. 10-15 min to set up the anesthetic machine, surgical suite, review bloodwork results, calculate and draw up medications.  5min to place IV and induce anesthesia, place endotracheal tube hook up gas anesthesia and monitoring equipment. 5min to shave and sterilize the surgical field.  10 – 45min of surgical time depending on the procedure and the surgeon (neutering is a significantly more simple and faster procedure than spaying).  5-10 minutes to call owner post-op and write up surgical notes. ~20-45 min to monitor patient post-op while they recover from anesthesia.  10min to discharge patient when they’re picked back up.  5-10 min to clean the instruments and endotracheal tube, re-pack them, and start the autoclave sterilizer. 5-10 minutes to do the laundry from the procedure and fold or re-use it.  5-10 min to clean the surgical table, floors, vacuum up the hair, etc.  5 min to clean the cage or run the animal vacates.  Again, most of the time per animal is actually already spent by assistants and vet techs, so eliminating the cost of the veterinarian themselves in lieu of a spay and neuter licensed tech wouldn’t actually cut that much of the cost at all.   Where that may help is in being able to get more animals in and through surgery to reduce those 6 month wait times you referred to, and as an added benefit it would give licensed technicians another level of professional development to strive for should they want to.  At the moment, I believe most if not all state veterinary licensing boards do not allow anyone on staff except a licensed veterinarian to diagnose, prescribe or do surgery with the exceptions of suturing lacerations and in some states doing cat neuters.

Creating more “low cost” spay and neuter focused clinics could also increase access.  They are a great option for many situations, but all vets can’t offer those prices, and it’s not because we’re making a lot of money off of each procedure.  These spay/neuter clinic options mostly do not have an entire full-service practice to run and all of the overhead that creates.  Most “regular” vets don’t have someone in the operating room all day, so the ROI on all of that equipment above takes longer than if that’s all you’re doing in a day.   Many of those services are often subsidized by government or non-profit programs, and many of those clinics are often able to keep their costs lower because they use less expensive medications with a lower margin of safety (most of the time these are fine for young and otherwise healthy animals, this isn’t necessarily a wrong thing to do), they often don’t place IV catheters (which are very helpful when a patient’s blood pressure is dropping or they need “rescue” medications, but they aren’t 100% necessary as long as you’re willing to accept a bit of increased risk), they may not run or even be able to run pre-anesthetic bloodwork to make sure there’s not an invisible-from-the-outside problem that could cause the body to process anesthetics differently than expected, and many don’t have the capabilities of dealing with many emergency or post-operative complication situations.  The vast majority of spay and neuter surgeries at all licensed clinics go very well and without issue no matter what end of the spectrum the practice may be on in regards to cost and risk mitigation.  Some people understand and accept a level of slightly increased risk of complication for a service that costs less.  Others want the “top of the line” safest thing they can get and are willing to pay for it.  For that, I’m grateful there are options in a lot of places, but I do wish there were more.  And after all this rambling on the subject, unfortunately I don’t have any great solutions.

1 user thanked author for this post.

Angela Krusi

[JoelleStudentTopic Author]

Kim, this is so helpful! So if I understand correctly, you are saying that much of the cost comes from the expenses with operating whether it is the materials and equipment that are used once and discarded or even the upfront costs in larger pieces of equipments. Plus you have the overhead of the business and staff for it to run smoothly. This all makes sense to me now. I can see how the actual time the vet spends doing the surgery is quite a minimal part of the cost. So that leaves us with few options for people who can’t afford it except for other people personally or organizations to help pay the bill.

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