March 4, 2016

A client said to me today: “My brother had his dog spayed at the Humane Society and it was only $100. Why is your clinic so much more expensive? Cost is an issue for us and if all things are equal, we would rather have our dog spayed there, too.” Sigh. All things aren’t equal when comparing surgical services between an SPCA or Humane Society and your own veterinary hospital. There are some very major differences between the two; a spay isn’t just a spay. It’s not an apple to apple comparison, by any means.

Before discussing why surgery is more expensive at your local veterinary hospital, I should make an enormous disclaimer. I’m wildly in favor of SPCAs, rescues and shelters. I regularly volunteer my surgical skills to perform spays and neuters at one of our area SPCAs, and am thrilled to donate my time for pets in need. Our family has only owned rescued dogs and cats, and given the massive pet overpopulation problems in America, shelters provide an essential service in housing and re-homing unwanted cats and dogs. They also offer an essential service in providing low-cost spay, neuter, vaccine and basic medical services for impoverished dog owners. Shelters, however, are funded by donations and government grants; thus, they are much more limited than vet clinics in terms of medical and surgical equipment and their ability to provide diagnostic testing and treatment for sick pets. Shelters do the absolute best they can with their limited resources, but they cannot provide the same level of comprehensive, dedicated care as private veterinary hospitals.

What are the essential differences between a shelter surgery and a surgery performed at your veterinarian’s hospital?

1.) Shelters do not perform pre-operative bloodwork, which can identify undetected pre-existing illnesses that may make a pet more of a risk for anesthesia. Additionally, pets having surgery at shelters do not undergo a pre-anesthetic physical exam (which is a standard of care in most veterinary hospitals); this pre-op exam may identify serious anesthetic risk factors such as an irregular heart beat.

2.) Animals undergoing surgery at shelters do not have intravenous catheters placed. This makes it very difficult to provide emergency drugs in the event of a cardiac or respiratory arrest under anesthesia. While very rare, arrests under anesthesia can be reversed successfully in many cases; however, without existing IV access and necessary CPR drugs, the likelihood for successful resuscitation is much lower. Through IV catheters, most anesthetized patients at veterinary hospitals receive intravenous fluids during surgery; this helps maintain adequate blood pressure, protecting the kidneys and other organs while anesthetized. Shelters simply do not have the funding to provide catheters and fluid therapy for their surgical patients.

3.) Veterinary hospitals provide extensive anesthetic monitoring for anesthetized patients, and most have a dedicated anesthetic technician who monitors the patient’s vital signs during surgery. It is a standard of care in veterinary practice for anesthetized patients to have blood pressure, pulse oxygenation, electrocardiogram and body temperature monitoring before, during and after surgery. Most shelters do not have any of this monitoring equipment available; thus, patients having life-threatening anesthetic complications may not be identified and treated appropriately.

4.) Shelters often do not have the resources to provide pain management for painful surgical procedures such as spays, neuters and dental extractions. The medical term for a spay is an ovariohysterectomy, where an abdominal incision is made allowing surgical excision of both ovaries and uterus. As the recipient of a c-section surgery when my son was born, I can say emphatically that this type of surgery HURTS (and it also cost $30,000, so a dog spay is an absolute bargain even at the most pricey animal hospital!) Analgesia before, during and after surgery is a standard of care in veterinary medicine, as it absolutely should be. Unfortunately, due to restricted funding, many shelters offer very limited pain control for surgical cases.

5.) Your veterinarian and veterinary staff are available to thoroughly discuss your pet’s post-surgical management, answer questions you may have about the procedure and recovery, as well as diagnose and treat any surgical complications. Most veterinary hospitals schedule courtesy post-surgical follow up and suture removal appointments, to ensure your pet is recovering well. Shelters simply do not have the time or resources to devote to individual pet owners, even if questions or complications arise.

6.) Finally, it is imperative to remember that, unlike shelters, your veterinary hospital does not receive major tax deductions, donations, grants or state funding to pay the electric bill, the mortgage, the malpractice insurance, the medical suppliers, the salaries for experienced and devoted nursing staff, the lease on the $100,000 radiograph machine needed for x-rays to diagnose your dog’s pneumonia and the thousands of other expenses associated with running a veterinary hospital.

Your veterinarian is there when your pet is sick, to return calls when you have questions or concerns, to stay late when Fido ate a box of chocolate and needs immediate medical care, to talk you through how to housebreak your new puppy, and to help you say goodbye to your beloved, sick older pet. Shelters do not and cannot ofter these services. To be frank, income lost to shelters for routine services like vaccinations, annual examinations and spay/neuter surgery negatively impacts your veterinary hospital’s ability to be there when you need them. When your pet has a complication from the $100 dental procedure performed at the shelter, it’s your regular veterinarian (and not the SPCA) who will pick up the pieces and provide Fido with the care he needs to get back on track.