Puppy in vet's office

Q. I told my vet his costs for a simple spay were outrageous, and he told me he won’t “cut corners on good medicine.” What does that mean? And shouldn’t veterinarians discount spays because it’s the right thing to do?

A. There are two parts to your question — and two parts to my answer. One part is medicine, and one part is business. I’ll start with the medicine.

A “spay” may be common, but it is major abdominal surgery. Doing a spay as a “no-frills” procedure to help reduce the populations of unwanted pets may make sense as “herd” medicine — but depending on how it's done it can be riskier and more painful for an individual animal. Making something potentially riskier and more painful for your pet just doesn’t feel right to your veterinarian, and can you blame him?

Modern surgical protocols — the “good medicine” your veterinarian is talking about — may include a presurgical blood screen to make sure the internal organs can safely metabolize the anesthetics, an IV catheter to give warm fluids and provide a path if emergency drugs are needed, injectable and inhalation anesthetics that are the newest and safest options, and monitoring of anesthesia that’s wide and deep (pulse, respiration, blood pressure, tidal CO2, capillary refill) by a dedicated anesthesia tech. These protocols also require keeping the animal on a heated pad with pain medications before, during and after the procedure. Pain medications aren’t just about kindness, by the way: The stress produced by pain slows the healing process.

Now I suppose it’s possible to offer all this at the rock-bottom cost many people expect to pay for a spay, but it’s not possible for your veterinarian to do so routinely without losing money. And here’s where the business part of my answer comes in.

Your veterinarian lives in the same world you do and is well aware of what it costs to make mortgage or rent payments, keep clothes on the children, keep the car repaired and, yes, take care of pets, because we vets all have them, too. Those veterinarians who own practices — and a lot of younger ones can’t (burdened by educational debt) — are dealing with the same costs all businesses have: employee salaries and benefits, insurance, taxes, loans on the property and equipment, inventory and much more.

Almost all clients want the most modern care for their pets, and they want it at 1970s prices. That just can't happen. And though every veterinarian I have ever known donates more in goods and services than most pet owners can possibly imagine, that can’t be the way to do business every day. If it is, there won’t be a business for long.

Do I believe veterinarians should perform spays for less than they cost to do because it’s “the right thing to do”? No, I don’t, and that’s coming from a person whose own accountant sometimes begs me to give a little less to charity. I believe it’s up to each veterinarian — each person, actually — to choose how much and when to give. It’s not my decision to make for another person, nor is it yours.

Low-cost, free and even “pay to spay” programs exist throughout the nation, many of them supported by the volunteer work of veterinarians. Though I support your veterinarian for the decisions he is making, I also support you in finding such a program if you honestly cannot afford to use your own veterinarian to spay your pet.

What I do not encourage you to do, however, is switch vets over this matter. You may disagree with your veterinarian on this issue, but by insisting on the best care he can provide your pet, he has shown himself to be a strong advocate for your pet’s health.