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Why we help people with veterinary treatment costs

I'm sometimes asked why we spend money helping people with the cost of veterinary treatment; the implication being that we're really just enabling owners to have more money to spend on themselves. Frankly I sometimes feel that way myself when I have conversations with owners who can't manage appointments we've set up for them because they've got holidays booked (what are those? I seem to remember having one sometime in 1982).

Unfortunately the fact that owners ought to have put at least some money aside for emergencies doesn't help an animal who needs a vet now. Most of the people we deal with genuinely don't have £100 available to spend on a visit to the emergency vet late at night, let alone another £200 or so for actual treatment. At the moment this is quite likely to mean that an animal who's been hit by a car may have to wait to see a vet at our clinic the following day as the only alternative to being put to sleep by the emergency vet with no attempt at treatment.

If our clinic wasn't there, the only alternatives would be euthanasia that night or euthanasia the following day, depending on the goodwill and ethics of the closest private vets, which might well start to run dry if it was happening every day.

As well as this, we also have to consider that the RSPCA does eventually prosecute people who neglect their animals by not taking them for veterinary treatment when it's needed. This implies that the owner can access a vet within a reasonable timespan, and for some people the only way that's going to happen is if someone else stumps up the money. When we do that we try to get the owner to pay at least something; there may be more delay than we'd like, and we may not be able to fund more than palliative care or euthanasia. What isn't acceptable is if we do nothing.

Dereliction of duty?

I wasn't planning to blog about the media criticism of the way we have to prioritise need when deciding which animals we can or can't accept for rehoming, but something that happened yesterday annoyed me so much I felt I had to mention it.

At present our branch funds are too low for us to afford to run our animal clinic, care for injured strays and other animals taken in via the inspectors and help owners with the cost of veterinary treatment at private vets. Paying part of the cost at private vets is the least cost-effective way of getting animals treated, so, sadly, we have had to decide that we can only help low-income owners via our clinic. This has open sessions on Tuesday, Thursday and Saturday mornings, and, after an animal has been registered at one of these, our service provider will treat him/her outside normal hours in an emergency provided registration is kept up by annual visits to the clinic for booster vaccinations.

Of course, this leaves the insoluble problem of animals whose owners have absolutely no money and haven't been registered. Vets are supposed to have a professional duty to relieve pain and suffering, so, in theory, it should at least be possible for any owner to have their animal put to sleep rather than live on in misery. Veterinary surgeries are businesses (and have to be), so it's not reasonable to expect them to go beyond this at their own expense, because they'd simply go bust, which would help no-one in the long term.

Anyway, to cut a long story short, yesterday morning I had a phone call from a tearful owner whose pet needed to be put to sleep. The veterinary practice concerned wouldn't see her at all unless someone was prepared to put up some money. In the circumstances, as someone who's not being paid by anyone, it makes me very cross to have talk about "dereliction of duty" when the RSPCA, which is after all a charity, tries to stretch funds so that they cover the cases of most need.

Owners who breed their dogs

Called just before half-past seven this morning by a panicked owner whose Yorkshire terrier bitch had been in labour since the previous evening with no sign of puppies. He'd got absolutely no money — not even the cost of a consultation fee for our clinic, although he had been responsible enough to get her vaccinated and registered with us so we could get her seen by the vets who provide our clinical services as an emergency. I don't know at this stage what happened or whether she and her puppies lived or not.

If she survives, she will be luckier than the poor animal whose eventual fate was described in last week's Mirror:

A family yesterday claimed their dog was put down by a vet because they could not afford a £1,200 operation.

Parents Andrew and Lisa Geddes took Staffordshire bull terrier Coco for treatment as she struggled to give birth to puppies.

The couple claim they were told a consultation would be £39 but after the pet was examined they were informed a caesarian op was needed costing at least £1,240.

It sounds from the article as though the owners were expecting the £39 to cover their pet's treatment and had no realistic idea of what operations cost. They probably were intending to sell her puppies (in itself not wonderful considering how many unwanted Staffies are out there), but I doubt whether they were just cold-bloodedly trying to turn a profit; they probably did love her and were very unhappy that she died; they just didn't expect to have to take any responsibility.

That's why we'll help the little Yorkie, but we will insist that her owner gets her spayed as soon as is compatible with her welfare and that of any surviving puppies and we will insist he pays us for her treatment.

Twenty or thirty years ago the vets who saw the Staffie bitch would probably have allowed her owner to pay by installments — and the owners would probably have actually paid. There's no shame in being poor, and there's no reason why people who aren't well off shouldn't have the fun and companionship that pets bring into our lives. If everyone decides the world owes them a living the system falls apart and it's misery all round.

And another cat

Owner thinks the cat has a chicken bone stuck in his throat. He's never been to any vet before, although, as he's on benefits this is another cat who could have been registered with our clinic and so eligible for out of hours emergency treatment from our veterinary service provider.

Cat's Protection are going to try to get the cat seen by a vet — which is likely to cost them over £100 at this time of night and their funds won't hold out indefinitely either if something similar happens every evening. The added problem is that the owner has no transport and no friends with transport, so getting to a vet is going to be difficult.

And a cat

Feel terribly sorry for the owner, but again it's just such a shame the cats weren't registered at our clinic. The cat's probably been hit by a car and at this time of night just the consultation fee for the 24 hour vet would be over £100 with treatment costs on top of that. I've advised her to phone them in any case in the hope that they may be willing to give some treatment and try for help from the PDSA in the morning.

The out of hours cover offered by our clinic's veterinary services provider would cost less than a third of this. At our current income there is just no way we can fund the £36,5oo p.a. which would be needed to pay for one out of hours consult at private vets every day of the year on top of running our clinic and pet rehoming.

If you live in our branch area and are on benefits (including carer's allowance, working tax credit, attendance allowance) and know you would struggle to pay a private vet PLEASE be proactive about getting your pets registered at our clinic. Provided your pet attends the clinic at least once a year (booster vaccinations should be given yearly in any case), they will be eligible for the clinic's out of hours service. This is not free, but it is much more affordable than the alternatives.

A Gecko...

Again, the vets were very good and agreed they would at least take a look even though the owner claimed to have no money at all to pay them.

I don't think the no money claim bodes well for the poor little beastie as even small reptiles are high maintenance because of their absolute requirement for suitable heating and light, unlike, say, a hamster which can at least survive at room temperature so long as it has food and bedding.

And another dog

This vet was very helpful and is at least prepared to see the dog and possibly give first aid knowing that they're very probably not going to get any payment back from the owner. However they're not going to be able to commit to doing anything seriously expensive.

Dog is now collapsed after being ill for several days and isn't registered with any vet. If ONLY the owner had pulled out all the stops to get him to our clinic this morning. If the private vet's first aid can keep him alive until Thursday we can do our best for him then, but it doesn't sound good.

And another...

Feel worse about this one, as the dog's clearly in a bad way: vomiting and very dull, and it's another 6 hours until our clinic opens. However, it does illustrate why we have to press owners to take more responsibility so our funds can be used to best effect. The dog's registered at a local private vet and was previously on long term medication, but hasn't been seen there for some time. This was presumably because the owners were short of money and just let it lapse and hoped for the best.

They're on benefits, so they could have transferred their registration to our clinic before things got desperate. At this time of day (night) it would cost £150 just for the consult at the 24 hour vet, which just wouldn't be a sensible use of our limited funds.

Welfare assistance at private vets

With great regret Cambridge branch committee have decided there is no realistic alternative to suspending help with the cost of veterinary treatment at private vets for owned animals.

This does not affect branch help with first aid for strays whose owner is not known.

Over the past five years the demand for emergency financial help at private vets has more than quadrupled, and the amounts of money required for each treatment has more than doubled. This is just not sustainable without a gigantic increase in our income, which has not been possible in spite of our best efforts.

Treatment at a private vet is enormously less cost effective than using our branch animal clinic, and most of the time there is no good reason why the animal's owner could not have got their pet registered there. The vets who contract to provide services to our clinic will treat out of hours emergencies provided the individual animal involved has been registered at the clinic previously. Animals can be registered provided that the person who owns them is on a means-tested state benefit (which includes working tax credit, job-seeker's allowance and state pension and carer's allowance, but not child tax credit on its own).

Our animal clinic is at 1 Pool Way, Whitehill Road, Cambridge CB5 8NT and it is open on Tuesday, Thursday and Saturday (8.30 am - 10.30 pm). To register an animal you need to bring proof of current benefits and a £7 consultation fee, and the animal must attend to be checked over. Sick or injured animals can be seen for the first time on these days, and they will then be treated as registered. Animals must be brought to the clinic at least once every two years to keep their registration current.

We have not come to this decision lightly, but the only possible alternative would have been to put a strict limit to cover the vet's consultation fee only. This would still strain our funds and it would mean that we would frequently be achieving nothing beyond reimbursing the vet for part of the cost of putting the animal to sleep. The number of animals put to sleep using RSPCA funds is frequently used in campaigns to discourage donations to the RSPCA, so in the interest of our overall ability to help animals it would be preferable to stop help at private vets entirely rather than continue at a low level.

What would you do if your pet needed an £800 operation?

In comparison with the astronomical costs of human surgery, veterinary operations are (almost) a bargain, but they come as a complete shock to many otherwise good owners. Many cats (and some dogs) will sail through life, needing no more than annual boosters and some geriatric care as they age. Sadly this is not something that is guaranteed, and sometimes the owners of quite young animals may be faced with horrible choices if they are unaware of what may happen.

If a cat or dog is hit by a car, treatment costs may quickly reach the thousands, but there are also acute medical conditions which can need treatment that cannot wait. Some of these are completely preventable (pregnancy complications are my particular hate), but some are nobody's fault. It's particularly upsetting if an otherwise healthy animal's life is endangered by a condition that is treatable.

As a branch, we will do our very best for animals whose owners really cannot raise the money needed to save their lives, but we cannot work miracles and we cannot spend money that we don't have. If you are earning, PLEASE make sure you have a credit card with available funds cover the cost of unexpected emergencies, or an insurance arrangement that will pay your vet direct. If you are not earning, don't simply assume that charity funding will be available - often any charity help will go no-where near covering the cost of treatment, particularly if the emergency happens outside normal surgery hours.

Our branch can help some people who are working, but on a very low income, but many charities have tighter restrictions, and in the end it all comes down to our ability to continue raising funds. 2009 was a bad year for this because of the economic downturn and the freeze just before Christmas. If you care about animals, please support our charity shops in 2010 - they are a lifeline for animals in Cambridgeshire, and at the moment it is a lifeline that is close to breaking.

More and more requests for help

The number of requests we're getting for emergency help with veterinary treatment is increasing in a worrying fashion. I've had five calls this weekend, each of them meaning £100 just to get the animal seen by an emergency vet for pain relief. This time last year two or three calls would have been a bad weekend, and it doesn't seem to be slackening off.

A bigger proportion of them now seem to be people who are registered with a private practice and have never needed help in the past, but haven't budgeted for the increased cost of out of hours treatment now that nearly all vets use a dedicated ER cover vet rather than just expecting their staff to get up and deal with emergencies. I've no doubt that it makes out of hours treatment safer if the vet's not single-handed and dizzy with fatigue. However— it's making pet insurance more and more essential and also more essential that owners investigate the small print and make sure their insurer will pay the vet direct if they aren't going to be in a position to pay by credit card and claim the cost back.

From our point of view it's making the cost of veterinary help a more and more concerning part of our outgoings and it's ever more urgent that we increase the income from our shops.

Why subsidised veterinary care is part of our work

Occasionally people complain that we spend lots of money helping people who really ought to have thought whether they could afford pets, or at least whether they could afford to have so many of them. There are several reasons why this service is essential:

• It's much better to help otherwise good and caring owners to keep their pets than to force them to give them up for rehoming—particularly in the case of older animals who would spend a long time in kennels. There is no point spending even more money just to punish the owners.
• If there is no source of help then people may panic and do irrational things. They may abandon animals, or simply hope that the problem will go away if they ignore it. This can sometimes result in extreme suffering, for example if the animal has broken bones.
• A major part of the "law enforcement" side of the RSPCA involves prosecuting owners who didn't seek veterinary treatment for their animals, or who allowed their animals to breed until they had far more than they could look after. If we are to be tough about enforcing owners' "duty to care" we have a corresponding obligation to make it possible for them to care.

But... I would like to see some of the people we help recognise that our funds are not a bottomless pit. Many of them do take on more animals from a genuine desire to rescue them, but it does put more and more strain on us.

Emergency treatment costs

I've taken four requests for help today on the branch emergency contact number. Three of these related to animals who were already registered at our clinic, which means that they are eligible to be seen by the vets who provide our subsidised out of hours cover. The fourth was a dog who'd never been seen at our clinic, so had to go to a commercial vet.

I keep banging on about registering with our clinic before an emergency happens if you are on a very low income (defined as being in receipt of state benefits, including working tax credit). The costs involved in getting these four animals treated show just why this is such an issue for us.

Two of the registered dogs had gastric problems, involving the owners in a £30 out of hours surcharge, plus the cost of drugs. One had a nasty wound which required surgery, at an all in cost to the owner of £200 (a struggle if you are on benefit, but not impossible).

The dog who went to the commercial vet had a similar wound which cost us £200 simply to get him seen and given antibiotics and pain relief and will probably cost another £200 (which the owner will be expected to pay) when he goes to the next available session at our own clinic.

If the commercial vet had stitched the wound we would be looking at about another £600, which simply is not a realistic proposition for us to pay.

It's all very well to say: "In that case, you ought to be running a subsidised out of hours service that will treat animals who haven't been pre-registered," because that would cost money we don't have, just as much as providing unlimited help via private vets does. (Because our service provider would charge us more for an unrestricted service).

Simple arithmetic demonstrates what I mean. The RSPCA overall gets roughly a million calls each year, which are either dealt with centrally or forwarded to the relevant branch. The National RSPCA's income is roughly £100 million and the combined branch income no more than another £50 million, making around £150 million available each year for everything we do.

Divide that £150 million by a million and you get an average of £150 available to deal with each call and you can see why we need to keep praying that a reasonable percentage of them won't need anything more than some advice.

Waiting their turn at the clinic on Saturday

Very busy Saturday (which was why Nicola ended up waiting so long with Neville.) The pic shows Izzy the lurcher, back in for a re-check of the surgery on her neck. She's lucky to be alive as her jugular vein was punctured when another dog attacked her (hence dramatic pink bandages round her throat). Nice to see her looking so well now.

More dog accidents

Caution about leaving children and dogs together works both ways. Very young children don't know their own strength relative to small puppies and they can very easily drop them because they're not as co-ordinated as an older child or adult.

Last night's staffie puppy with difficulty breathing turned out to have several broken ribs, probably because he'd either been dropped or helped onto something like a high table and then fallen off. Staffies often don't react to pain by squealing the way other breeds might, and this one's owners only realised there was a problem because the little fellow was gasping for breath because half of his lungs wasn't working any longer.

This sort of thing is also why rats and hamsters aren't really suitable for very young children. Being dropped can badly hurt or kill them, and they will bit really hard if little hands clutch them too tight. Adult cats who like children are probably the best bet with toddlers as they're robust enough not to get hurt (and fast and strong enough to get away from an excessively enthusiastic child).

Puppies and dummies

This happens more often than you might think. Also here, here and here. The victims are usually puppies, presumably because larger dogs are either more cautious about what they swallow or more likely to pass something relatively small and soft through their intestines without getting a blockage. 

Unfortunately if the puppy does get an obstruction as a result of swallowing a baby's dummy or a bottle's rubber teat it will die if not operated on as an emergency and the operation is likely to be very expensive.

Another one this morning; a Jack Russell terrier. The puppy's too ill to wait for the clinic session tomorrow and isn't eligible for our clinic's emergency cover because he's not registered. Even with our maximum level of help the owner's now got a bill of £500 to cover. She may get some help from the Blue Cross and has now filled in a form to register with the PDSA (I don't know whether they might help retrospectively). 

Can a vet refuse treatment because an owner has no money?

Yes, and No. The RCVS (Royal College of Veterinary Surgeons) which sets standards for vets in the UK states:

17. A veterinary surgeon or a lay member of staff accepting telephone calls must not refuse veterinary attention because the caller is unable to make immediate payment for the treatment. Arrangements for payment should be discussed at an early stage, but immediate first aid and pain relief should not be delayed while financial arrangements are agreed.

18. The RCVS is aware that it may be appropriate to advise euthanasia to relieve suffering, if the owner is unable to afford the fees and is ineligible for charitable treatment.

19. The RCVS has no power to set the fees that a practice charges.

Basically, this means that a vet shouldn't refuse to relieve an animal's suffering in an emergency situation BUT they are under no obligation to provide expensive life-saving treatment if there is no likelihood that they (or their employer) will be paid.

In the old days, when most vets were self-employed, many of them would do what they could for an animal and hope the owner would eventually settle up. It is much more difficult for a young vet who may not have a job next day if he costs his employer money. Add in the crippling levels of student debt which most young vets will have after qualifying and you'll see that they are in an enormously difficult situation if a client turns up with a dog who really needs £800 worth of investigations and treatment but has no money at all.

One of these turned up at 3 am this Sunday morning. The client's dog had collapsed and was pale and shocked. They weren't registered with our clinic, so they had to go to a private vet. Because of the time factor they'd run up a bill of about £130 simply by virtue of walking through the door. They'd got no money at all, and at this point the vet phoned me. Sadly there's just no way we could cover £800 for investigations that might well just reveal treatment would be futile. I offered to cover £200 in the hope that symptomatic treatment might do some good — basically this would mean starting some supportive fluids and antibiotics, but about an hour later they phoned to say the owners had decided the best thing was to put the dog to sleep.

Traffic to our main website

 If you came to this page searching for a PDSA clinic near Cambridge, please read the information about using the Cambridge RSPCA Animal Clinic. There is no PDSA clinic locally, but the RSPCA clinic is available to help pet owners on low income.

The list of keywords which brought readers to our main website's page with our policy on help with veterinary treatment costs tell an interesting story. Here's the list in full. (I think the first one really wants the University of Pennsylvania Vet School, but can't spell it.) 

The search "why do people give up their pets to the rspca or pdsa" confirms my belief that the average animal-loving member of the public has really very limited knowledge about animal charities—in this case, not enough to know that the PDSA is a purely veterinary charity.

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Owners who genuinely can't afford a vet's fees

The vetnurse has a post about a dog who was probably dumped because the owner didn't take him to a vet in time and then got frightened to take him because by that time his tumour looked so dreadful (warning - graphic photos). 

There is help out there BUT:

• You need to be realistic that charities probably won't be able to fund very expensive treatment and euthanasia to prevent more suffering may be the only option.
• It may be quite difficult to locate a source of help — particularly for someone who is elderly or confused.

The PDSA (People's Dispensary for Sick Animals) operates in all of the UK and offers long-term help for owners on housing benefit or council tax benefit. There is quite a complicated registration procedure and it's designed to allow pet owners who know they would have problems paying for treatment to register for help before something happens. The PDSA uses a mix of its own clinics and help via private vets. They can be contacted by phoning 0800 731 2502.

The Blue Cross accepts a wider range of state benefits (or proof of very low income) and most of its help is provided via private vets, although it also has some clinics of its own in Grimsby and London.  The Blue Cross can be contacted by phoning 0300 123 9933.

The RSPCA accepts  means tested state benefits as proof of eligibility. It's more geared towards dealing with sudden emergency situations than the other two, although it's possible to register pets for long-term help where a clinic or hospital exists. Where help is provided at private vets it's generally expected that this will be a one-off to resolve an immediate welfare problem. All RSPCA branches are expected to provide at least the cost of a standard veterinary consult fee and either pain relief or euthanasia in an emergency situation where an owner is on benefits/pension as part of their Minimum Animal Welfare Standards. All of England and Wales is covered, but not Scotland or Ulster.

If your local RSPCA has a clinic or animal hospital this will be listed in Yellow Pages under "Animal Welfare". Unfortunately if the branch does not have a clinic and relies on providing help via private vets, it may not be easy to contact the person who is responsible for running the assistance scheme. They may have a number listed in Yellow Pages, but generally the best way to find the current number is to contact the National Control Centre on 0300 1234 999 and follow the voice menu prompts. This may defeat an elderly or confused person.

Most vets will be in day to day contact with welfare charities, and they will not mind being asked for advice on getting help, although they won't be happy to be expected to give a discount on their services — they have bills to pay at the end of the day too. If they do offer a discount or allow payment in instalments it is important that they are thanked for it.