Published on March 30, 2014
Page 79 - Issue 1 of 2014 Photo by Dr. Ron Stone, Veterinary Trauma Centre Photo by Dr. Ron Stone, Veterinary Trauma Centre Under the Knife: $urgey for your Four-legged Friend? By Tom Lloyd (USA) Tom Lloyd spent most of the past few decades writing for newspapers and magazines in the mid-Atlantic region. He and his five-year-old rescue Rottweiler have a symbiotic relationship. Tom writes and Ben deals with critics. Choosing your own doctor can be tough. Choosing the right doctor for your pet, however, can be even tougher and if your animal suddenly needs surgery, that selection process can quickly become a nightmare. My dog, Gentle Ben, recently injured his right knee and needed anterior cruciate ligament (ACL) surgery. I started looking for a surgeon right away. I headed to Google for help. I didn’t get any. I did find page after page of tediously long descriptions of every surgical procedure available for Ben’s knee. What I didn’t find was any hard information on pricing. By the time I finished reading, my head probably hurt as much as Ben’s knee, yet I still had no idea what his surgery might cost. Next, I tried the phone and quickly learned the veterinary mantra: “We don’t give quotes over the phone.” So, I got into the car. I drove to seven different vets, paid seven different exam fees and got seven wildly different cost estimates. The first was the worst. It was an emotional bombshell. It was $6,000! There is no nice way to say this. Living on a fixed income, $6,000 was simply out of the question. I realized that if every quote was that high I might have to have my loyal companion put to sleep. Fortunately it turned out there were more affordable options. It took several more days, several more exam fees and several more car trips to find them but in the end, I did. Now, there are essentially three surgical techniques on the menu for dealing with a torn or ruptured ACL. They are the lateral suture stabilization or LSS procedure, the tibial plateau leveling osteotomy or TPLO option, and the tibial tuberosity advancement or TTA operation. The TTA and TPLO procedures both seek to change the geometry of the leg by sawing into the bone and securing a mechanical device under the skin to shift weight from the injured joint to the leg bone. The LSS, meanwhile, seeks to stabilize the injured joint with a monofilament cord. The fur can really start to fly when the relative merits of each procedure are debated, but the more I learned, the more I started to favor the LSS procedure for Ben. There was one simple reason. Ben had torn his left ACL five years earlier and had the LSS procedure then. I’m no Euclid, but I worried that either of the “geometry-changing” surgeries (TPLO or TTA) might have risks above and beyond the drilling, bone sawing and mechanical implants. Changing the geometry of Ben’s right leg, I reasoned, might change the geometry of the whole dog! That is to say, I feared a mechanical rebuild of Ben’s right leg might put too much stress on the monofilament cord in his previously repaired left knee. Not a single vet I spoke with was able to show me it wouldn’t.
Page 80 - Issue 1 of 2014 Still, no matter which way you slice it (pun intended), surgeries of any kind have become something of a cash cow for the veterinary community. The fees for those three-minute examinations of Ben’s knee were pure chump change compared to surgery. Depending on which doctor you choose, prices for an ACL surgery can range anywhere from $1,200 to well over $6,000. In other words, a procedure that takes about 45 minutes to perform, bills at between $1,560 to almost $8,000 an hour. Because of this, veterinary surgical specialists groups have sprung up all across the country that do nothing but ACL procedures all day, every day. Each specialist can, in theory, generate well over $100,000 a week or nearly $5 million a year in revenue for the practice. So, the pressure to funnel you into one surgery or another is high. Just how high a priority your animal’s well-being ranks in such a setting is open to some debate and requires serious research on your part, asking a lot of questions and relying on your own intuition. In my search here in Florida, two vets stood out from the pack: Dr. John Wight at Veterinary Surgery Service and Dr. Ron Stone at Veterinary Trauma Center. Both had experience with large dogs. What’s good for the goose may well be good for the gander, but what’s right for a seven-pound Yorkshire terrier probably isn’t going to translate well to a 110-pound Rottweiler. Both Wight and Stone were willing to go into details and explain the various procedures. Both asked multiple questions about Ben’s history, personality and exercise habits. I felt they cared. Incidentally, they were also the only two vets who did not charge me for their consultations. While those two vets were not the least expensive, they were nowhere near the $6,000 level. They were, however, the only two who made a point of saying their prices were all-inclusive. That is, pain medications, antibiotics, removal of sutures and everything else would be included in the numbers they gave me. That was significant to me. Ben’s former vet was infamous in my eyes for quoting one price and then adding hundreds of dollars for medications and assorted other fees onto the bill. As a retiree, I need to know up front what’s going onto that credit card. In the end, I opted to entrust Ben’s future to Dr. Stone. He had experience. He had an impressive resume. He had excellent online reviews and he had an ace up his sleeve. Call it anthropomorphizing - attributing human characteristics to an animal – but I knew that if I were about to undergo major knee surgery, I would expect to receive post-operative physical therapy. Why shouldn’t Ben? Dr. Stone was the only vet I spoke to who included post-op physical therapy sessions in his quote. Two weeks ago, Ben had his surgery. Today he is already walking well and putting more and more weight on his right leg. His stitches and staples have been removed and he has had his first physical therapy session. Dr. Stone says Ben is now doing so well he may be free to hit the local dog parks in three or four weeks and resume his normal athletic life again. I can’t even begin to put a price on that.
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