The CBC recently aired an undercover investigation into veterinary medicine.

I have been working in veterinary medicine for 7 years now, though I am not a vet. I spent five years at one clinic, about 8 months at another and I’ve been at my current place for about a year and a half. I’ve worked as a receptionist, veterinary assistant and hospital coordinator. I put in purchase orders for supplies, so I know what that cost is. I deal with clients both over the phone, in reception and in appointments. I work with the animals, holding them for procedures and caring for them while in hospital. What I’m saying is that I’ve worked in many areas of the clinic and have a pretty decent overview of how things work.

I found this report very upsetting and I’m going to try to explain why. And it’s going to take a while, so get comfortable.

CBC seems to have gone into this report with the conclusion predetermined: that clients are spending too much for their veterinary care and – here’s the part I take issue with - that vets are doing this on purpose. It’s a sentiment I’ve seen echoed by many people in the comment sections related to this story and on various sites like Yelp where clinics are reviewed. I’ll freely stipulate that there are some crappy vets who overcharge for things. That’s true of any profession. Dentists, lawyers, mechanics, retail, reporters, any profession you can think of has jerks in it who take advantage of others. Trust me, the good vets dislike the bad ones far more than any of those “barking mad” clients ever could. It makes us all look dishonest and it’s frustrating.

First off, I’ll address a few of my quibbles with the way some information was presented.

Apparently, we’re spending $6 billion more on pet care. This report doesn’t make it clear if that includes food, grooming, boarding etc.? Because hey, those things cost money and have gone up in price too and it’s dishonest to make it look like that’s all vet bills if it isn’t.

There are a bunch of dog owners holding up signs with how much they spent on vet care in… a month? A year? That isn’t clear and it should be. Also, do those owners know what those services would cost for a human? How much is a doctor’s exam? How much is lab work? Are you really “overpaying” for lab work or are you just mad that it costs you any money at all?

A woman with a dog Joey has a sign saying she spent about $650 for her dog. From the prices she held up, it looks like she had one visit, 3 vaccines, a heart worm test and 60 dollars in meds. If that’s for a whole year, this is pretty reasonable for downtown Toronto. HOW MUCH DO YOU THINK OWNING A PET COSTS?!?

A woman with two dogs, Chaos and Mayhem, has a huge bill from seeing an emergency vet. Hey guys, here’s a shocker: emergency is expensive. You don’t know it because it’s Canada, but seeing an ER doctor is more expensive than seeing your GP. Why do you think it’s such a problem for the US that uninsured people use the ER as their primary care? The fact that emergency care is more expensive than a regular veterinary clinic should not surprise you.

Did this reporter seriously tell us that a larger dog has larger bills?!? Is she serious right now? Yes, big dogs have bigger bills - because meds and food go by weight. People who get large breed dogs and then complain about how much these things cost compared to people with small dogs are straight up morons. Don’t blame us that you got a Great Dane and now it’s costing you a ton more money than your friend with a Yorkie – that’s on you and your lack of research.

How their weight expert tests for weight is how every vet does it. I really love that they gloss over the fact that 9 out of 10 vets said their example dog’s weight was fine, but the fact that one whole vet recommended a diet food that the clinic sells is enough to condemn them all. Oh and the expert they consulted also agreed that he could lose some weight. So, it’s not like that 10 th vet was totally wrong, now, is it.

I fail to see how different vets having differing idea on what is causing a dog’s eye issues is a bad thing. Human doctors do this too. Medicine is not an exact science. That’s why second opinions exist. I know amazing vets who will miss a difficult diagnosis that another vet gets, not because they’re scamming money, but because they are human. That doesn’t mean they aren’t trying or don’t care.

Wait, wait, wait, things are cheaper in the US?!? THIS IS UNHEARD OF IN ANY OTHER CATEGORY OF CONSUMER GOODS EVER. Oh wait, except clothing and gas and cigarettes and alcohol and… well, everything.

Now, let’s discuss their three big ways people are being over charged.

First up, vaccinations.

You know what was missing from this broadcast in general? The client asking why the vet is recommending what they are recommending. I’ll be honest, I found it weird that 6/10 vets would vaccinate a dog with up to date vaccines. None of the clinics I’ve worked at would do that, so long as the client had proof of vaccination. So yes, that was unnecessary – but why is there no footage of the appointment as a whole? Why do they not show the vet seeing these records and the client asking why they should re-vaccinate? This gets to the heart of my problem with this report: there is absolutely no context offered for any of their findings. The one reason that they show – that most clients won’t come back annually if there are no vaccines due – is absolutely true in my experience. I have done reminders at all my clinics and often have people skip annuals if their pet has no vaccines due (especially with cats). Does that justify over vaccinating? Not to me, but I’m not these vets. Annual checkups are definitely important to your pet’s health and it doesn’t seem to occur to the people behind this report that the vets may be genuinely using the vaccines as a tool to get people in for preventive care (which, as I’ll say again and again, saves clients money in the long run) rather than a money grab. That’s not to say that it isn’t a money grab - it may be. But since this report doesn’t show any of the appointments, there’s no way to know either way. I’d be very curious to see what went on.

Side note about three year rabies: yes, for dogs this is the recommended standard. For cats, it is not. This is not mentioned on this broadcast at all and that’s irresponsible. There is some concern that cats can develop a sarcoma if given the three year vaccines, due to the way they are manufactured. So some vets use vaccines that are formulated differently for that reason, but those vaccines are currently only labelled for one year. Personally, I do three year vaccines on my cats because they hate going to the vet and I know the risk. The vet I currently work for offers both (at the same price) and we have all kinds of clients who opt for the one year after being fully informed about both options. So, the information they gave out is misleading and incorrect because there are one year rabies vaccinations being used for a valid medical reason. Plus, if a client cannot provide information that tells us if the vaccine their pet received was a one or three year, vets will often vaccinate if the vaccine was given over a year ago because rabies is required by law so most vets err on the side of caution. Now, perhaps that information was provided to the vets in this investigation or perhaps the vaccines were under a year old, so perhaps those vaccines were unnecessary. But we don’t know either way because this report doesn’t tell us.

Next up, heartworm testing.

The vets I have worked for will tell people that if they’ve done the preventive correctly, they don’t need a test every year. Keep in mind that lots of clients screw up their preventive treatments. So, did it occur to this reporter that some vets just don’t want to take the chance? No, heartworm is not prevalent here in Ontario, but the risk isn’t zero. Personally, I do tell people that if they keep up with the prevention, the test isn’t needed (and I do say clearly that heartworm is not prevalent here) and so does my boss. However, did you know that both major labs give a discount on comprehensive wellness testing if you do a heartworm test at the same time? So, I’ve heard many vets say that while the heartworm test isn’t necessary, it’s a good idea for someone with an older or at risk animal to take advantage of the discounted wellness test. But why mention that on the report? That might make it look like vets want to do something to save the client money and that’s not what this story is about.

Finally, that super controversial topic: pet food.

Look, if you ask for a food recommendation, we’ll recommend something that we sell because THAT’S WHAT WE’RE FAMILIAR WITH. Do you know how many companies make pet food? Do you know how many new small companies pop up every year? You cannot honestly expect a vet to know every single one of them. No one I’ve worked with has ever judged a client for feeding something from a pet store – a recommendation is optional and you don’t have to take it. They don’t actually bother showing how the client reacted to the recommendation in this piece – did she say she’d rather keep feeding her current diet or something from a pet store? If she didn’t, how was the vet to know she didn’t want it? If she did, what was the vet’s response? If she hard sold her food, yeah, that’s a bit shady. If she said ok, let’s work with that, then what the hell is the issue? Again, we have no idea how that went because we weren’t shown the whole conversation.

Hey, know why Hills is in every clinic? Because it’s one of only four companies that make veterinary lines of food (those are Hills, Medical/Royal Canin, Iams and Purina). Veterinary food needs to go through way more testing than pet store food does since most of it is made for specific conditions. There are a billion news stories and articles on pet food and labeling, so I won’t get into it here, but suffice to say, the food in pet stores is not controversy free either. Any client who has told a vet I’ve worked for that they’d rather feed homemade or pet store food has been told that this is fine (for a healthy pet, that is. If the animal has a condition that requires a prescription diet, then the client is advised that it’s better to feed something formulated for that condition and why). I’ve seen vets recommend their weight loss food, be told the owner wants to use pet store food, and then calculate out for the owner how much to feed of their preferred diet. I also know vets that will recommend good cook books for people who want to make their own pet food.

Do you know why a lot of vets recommend that Metabolic diet? Pets are obese and it’s a problem. Look, we can let you keep your dog fat and and make tons of money off their orthopedic problems later on. And when your fat cat gets diabetes, we can take your money then too. We recommend weight loss because it’s better for your pet. Now, why this food? It works on its own. Client compliance with weight loss programs is often terrible. I see fat dog after fat cat come in year after year and nothing has changed no matter how many times we tell them their pet is unhealthy.

Weight loss takes effort. Most common issue? Multiple pets. If you want to have a successful weight loss program, you have to measure your pet’s food and stick to it. So, people with multiple pets always say “I can’t possibly feed them separately!” Bullshit. I live in a one bedroom apartment and when my cat got to be 3 pounds over weight, she went on a diet. I have two other cats, so I trained them to eat in different rooms (bedroom, living room, hallway). So, when a person with a whole house tells me it’s impossible to separate their cats, I know they’re just lazy. It took me a couple of weeks of train my cats where their individual food spots are, but in the long run it’s been great. The point is, from what I’ve read, Hills developed this food to help with compliance. Yep, it sure is expensive. Over the course of their lifetime, so is an unhealthy, overweight pet. So, I guess you can take your pick on what you want to spend your money on.

Now I want to address some of the reactions I’ve seen. The reporter has been fielding a lot of questions on her Twitter feed and her general response to any complaints, especially “why didn’t you cover this” is “I was only focusing on things owners are overcharged for”. Lovely way to not take any responsibility for the blow back. I don’t see comments from viewers regarding vaccines, heartworm and food. I see “my pet was sick and the vet charged me for test x and y and z! They are horrible and don’t want to save Fluffy, they just want money!”

So let’s address that.

I think there are a couple of things that lead to vets recommending a lot of testing. Part of it is that some vets do honestly think that the expensive option is the best medicine. A previous clinic I’ve worked at makes everyone do a fecal test and deworming at their annual exams. It makes the annual exam more expensive and, from my experience at other clinics, it’s not necessary, especially for an indoor cat. But I heard them talk about it and they weren’t discussing the money, but the medicine. They felt it was the best practice. They aren’t wrong, they just weren’t considering that not everyone can afford best practice. That’s not malicious, that’s trying to advocate for their patients.

Another example is dental xrays or pre op blood work. At some clinics, these aren’t presented to clients as optional because the vets genuinely feel that it’s better medicine. Dental xrays are great, but expensive. An xray may show that a tooth is healthy and can be salvaged despite appearances. The alternative is that the vet takes out any teeth that are looking rotten. Most vets do this as the xrays make dentals cost prohibitive for a lot of clients. Rotting teeth can lead to systemic infection when bacteria from the mouth travel through infected gums into the bloodstream, so for a lot of vets, a dental without xrays is better than no dental. Neither option is right or wrong – as a doctor, they have to recommend to you what they believe in and both sides have a good point. Those who promote the xrays believe that they are doing the best, safest medicine and those who don’t feel that animals with dental disease need the treatment and that making the cost too high will prevent owners from getting it done.

When it comes to pre op blood work, some clinics require it for any animal having sedation and some only require it for animals over 7 or 8 (therefore considered senior). I have had discussions about it and the vets at those clinics that require the lab work honestly don’t know how other vets sedate animals of any age without doing it. They don’t say “because they could make an extra $100!” they say “because it’s so much safer.” Other vets will present it as option for young animals to keep costs down because they are comfortable with the risk. But it is still a risk to skip blood work and they always offer it to clients no matter what. Especially because if something happens to your pet while under ansesthetic, you are going to blame the vet. Can you honestly fault vets for wanting to be as cautious as they can?

Which brings me to another point – you have no idea what that vet has experienced in their career. All it takes is one bad outcome and one screaming client to make a vet decide to proceed more cautiously in a similar situation next time. Vets are humans with feelings and, surprise, they feel awful when animals don’t recover as they hoped they would.

Also, I think some vets, especially (but not only) newer grads, get caught up in what the “textbook” treatment is and forget that they have to work with their client and their client’s budget. For instance, some newer grads aren’t experienced enough to know what alternatives they can offer or what diagnoses they can rule out without testing. That’s not a slam on new vets and I think people should still see them – we were all new at our jobs at one point and some of the new grads I’ve worked with have turned out to be amazing vets. I only bring it up for some perspective on why a vet may recommend a lot of diagnostic testing for your pet. They may honestly feel, for a variety of reasons, that it’s the best course of action medically, not financially. That view of things is totally ignored in this broadcast and it’s horribly unfair.

Finally, what really upset me about this report is that it totally removes all onus from the client to advocate for their pet.

I’ll stipulate up front that the majority of my clients are lovely, especially at my current clinic. But part of this job is dealing with awful people. See, because the majority of vets and clinic staff are there because they love animals, it’s hard to watch crappy owners do crappy things to their pets. People always say that they don’t know how I can work at a vet clinic because it must be so hard to watch animals be put to sleep. I always have to say that while that’s sad, it’s not at all the hardest part of my job. Dealing with bad owners is far, far worse.

What makes a bad client isn’t a lack of money – it’s attitude. I’ve had amazing clients who didn’t have two cents to rub together and horrific clients who drove up in brand new BMWs. We don’t judge owners based on their ability to pay – we judge them based on their attitude to their pet.

Here’s a story from a previous clinic to illustrate what I mean.

A couple came in with their 8 year old cat. The cat has been vomiting for a few days, but is otherwise fine. The vet recommends some blood work that costs about $150. The response? “Is that necessary? I mean, isn’t she just going to die anyway?” These people were wearing designer sunglasses that cost about $300. Money wasn’t their issue – their pet just wasn’t a priority for them. And in that case, basic blood work is pretty standard practice and the cat was no where near terminal. This is the kind of person – and I get them all the time – who just can’t understand why anything for their pet has to cost them money. They expect a vet to spend hours discussing their pet’s condition on the phone so that they can avoid a consult fee. They never consider that they are taking up the vet’s time or if they do, they’re pretty sure that despite having paid nothing, they’re entitled to it. Note: I’m not talking about follow up calls after an appointment, I’m talking about people calling up and saying “My dog has the following symptoms – what can I do because I don’t want to bring them in.”

To all those self important clients who keep having negative vet experiences, I’d like to point you to this quote from Raylan Givins: “If you run into an asshole in the morning, you ran into an asshole. If you run into assholes all day, maybe you’re the asshole.”

Oh, remember that “vaccines make people come in for annual check ups” rationale we heard on the show? One day, I got a call from a woman with a 16 year old cat who was quite ill. “Can I call your previous clinic for records?” I ask. “No, she hasn’t seen a vet since she was a kitten.” So that woman didn’t take her cat in to see a doctor for 15 years because in her completely uneducated opinion, her cat was fine. Her cat was euthanized at that appointment because she was too sick and in pain to help. Do you know what would have prevented that? Hint: it’s called “preventive care” for a reason. This is especially important for cats – who were totally ignored by the CBC, by the way – because as solitary hunters, they’ve evolved to mask illness and pain as a survival mechanism. So, maybe for some vets, giving extra vaccines is worth it to avoid situations like that. I’m not saying that’s the right approach (in fact, I don’t think that it is), but I am asking you to consider that it’s not necessarily over-vaccinating for money.

Another example: a cat stops eating (which I’ve seen happen too many times to even have a specific case to bring up). If you bring them in after a couple of days when they aren’t themselves, but aren’t lethargic, you’ll pay for an exam, blood work and probably some meds. Did you know that if a cat doesn’t eat for 48 hours, they start having serious liver issues? So, if you wait for two weeks until they are too sick to get up, they not only need an exam, blood work and meds, they also need to be hospitalized. They need IV fluids. In extreme cases, they may need surgery to put in a feeding tube. That is not on the vet – that is on the client. If the client wanted to avoid most of those charges, they should have come in sooner.

To me, that’s the dangerous thing about a report like this – it perpetuates the idea that most vets are only after money, so more people will wait to treat their pets.

Let’s look at the flip side of client “sticker shock”. I’ve seen owners freak out and tell vets they have no money to help their blocked cat or dog with a foreign body or other such emergencies. So the vet tries to sort out something with discounts and payment plans, then they are told that they’re heartless and don’t care about animals because they won’t do it for free. For some people, it doesn’t matter what discount you give - they think that they’re entitled to our charity and if they don’t get it, we don’t love animals, only money. It’s emotional blackmail and it hurts because in that moment, it’s pretty clear that we care more about their pet than they do. And it happens a lot.

But here’s the worst story I have, just to help you understand what we deal with emotionally. A family came in with a perfectly healthy 12 year old cat. The only issue? She was urinating outside the litter box. And why were they there? To euthanize her. Not because it would be expensive to run tests – they didn’t even ask about that. It’s likely she had something medically wrong that could be fixed with some simple meds, but no, she wasn’t worth the effort. I sat holding that cat for an hour while two different vets pleaded with these people to try any of the options, no matter how cheap or simple. We finally offered to take the cat and rehome her since they didn’t want her any more. We were informed “No! She’s our cat, no one else can have her. We want her put down.“ Honestly, I’m tearing up now, 5 years later, just thinking about it because that cat was lovely and didn’t deserve the treatment she got. Those vets advocated for her as hard as they could and in the end, we were the only ones who cared for her.

That’s the kind of thing we deal with. That’s the kind of thing I’ve personally dealt with. Then we have to sit through insulting, biased reports like this and suffer the slings and arrows of clients who think they’ve been wronged and this proves it. You want to be pissed that some vets charge extra fees? We’re pissed that assholes like that have animals and we have to deal with them, not just physically, but emotionally. Google compassion fatigue if you want to learn more about it.

We see the neglected pets. The animals with urine scalding because their owners don’t clean them. The animals so badly matted that they can’t defecate anymore because their owners were too lazy to brush them or too cheap to pay for grooming. The animals who are so skinny from untreated hyperthyroidism that you can see their bones. The animals whose teeth are falling out because no one bothered to check why their pet’s breath is all of a sudden smelly. The animals with horrible orthopedic problems because they’re too fat to function. And then we get yelled at for suggesting lab work. For suggesting hospitalization. For suggesting xrays. For suggesting medication. For suggesting weight loss. Why? Because reports like this give the impression that all of those things are merely money grabs and certain people believe that. They’re the people who believe that they are entitled to a simple, cheap solution to every medical problem and totally abdicate any responsibility they have for their animal’s condition or care.

Look, I’m not saying that there aren’t vets out there who charge more than they should and I genuinely think that’s terrible. I think it does a disservice to the profession, I think it damages client trust and I’d love to see them out of business. However, I while think it’s important for pet owners to be aware of what their pet does and doesn’t need, but I also think that the manner in which this report was presented was not only one sided, but misleading. That’s not good for vets, pet owners or, most importantly, pets.

If you’ve read this far, thanks. I know that was pretty long - I’m a bit wordy when I’m upset. Clinic staff don’t get paid much at all – we do this job because we love animals and, for the most part, we love their owners. At least, that’s why I do it. So, I guess I had a bit of an emotional response to this story. Thanks for listening.