Intussusception in 5 month old kitten

Re: Intussusception in 5 month old kitten

Claire McConnell — Sun, 11 Sep 2011 20:18:57 GMT

I did scan i but wasnt very confident in what I was seeing to be honest. My scanning skills are poor and our scanner isnt great either!

Re: Intussusception in 5 month old kitten

Sarah Keir — Thu, 08 Sep 2011 18:50:17 GMT

Hi,

I work in the South-East and would estimate £800-1000 for this case.

Did you scan the kitten? Post ex lap the air in the abdomen would be problematic.

Sarah

Re: Intussusception in 5 month old kitten

Amanda Nicholls — Thu, 08 Sep 2011 18:27:43 GMT

[quote user="nikki"]

[quote user="newgradvet"]

Thanks for everones advise. Kitten has been discharged after producing two solid bowl movements and eating well with no nausea or vomitting.

Out of interest in average how much would a similar procedure cost at other practices? I am not a practice manager or owner so will not be hiking up our fees in response. I am simply interested as a number of people have commented our fees to be quite reasonable.

So how much would an exam, 1 x radiograph, IV drip, GA and enterectomy with appropriate medication cost in other practices?

[/quote]

exam: £33

xray: conscious is about £75, under GA first plate is £50

IVFT: approx £90

cat GA: £130

cat enterectomy: £325 with suture material and drugs on top

so somewhere around £800 in total hence my reaction to the bill. I have nothing to do with our charges, they are what they are and we are competitive in our locality but I'm aware they're probably top end.

Glad to hear the kitten is doing well :)

[/quote]

well done with the kitten, makes it all worthwhile.

My charges would be similar to Nikki - maybe she is in the south east as well?

inc VAT: cons £34; GA £140, IV fluids £78, x-ray £66 or scan £84, surgery £450 (includes all materials + drugs), hosp £42 per 24 hrs minimum depending on level of care, i-STAT if on fluids >24hrs £48.

I would definitely estimate £1000 to be safe.

As an aside, I refer almost all my orthopaedic cases, the minimum cost for fracture repairs in cats and kittens seems to be about £1500 with an experienced cert holder in this area so I wouldn't say £1000 for the above is excessive and £450 sounds quite cheap to me!

Re: Intussusception in 5 month old kitten

nikki — Wed, 07 Sep 2011 23:24:22 GMT

[quote user="newgradvet"]

Thanks for everones advise. Kitten has been discharged after producing two solid bowl movements and eating well with no nausea or vomitting.

So how much would an exam, 1 x radiograph, IV drip, GA and enterectomy with appropriate medication cost in other practices?

[/quote]

exam: £33

xray: conscious is about £75, under GA first plate is £50

IVFT: approx £90

cat GA: £130

cat enterectomy: £325 with suture material and drugs on top

Glad to hear the kitten is doing well :)

Re: Intussusception in 5 month old kitten

Mark Hedberg — Wed, 07 Sep 2011 19:59:36 GMT

Sorry nikki! Didn't mean to come on over strong. I've been thinking too much - bad for the brains, that! I'm not trying to be any sort of thought police and i apologize for reading too much into your comment. Mea culpa!

Re: Intussusception in 5 month old kitten

Claire McConnell — Wed, 07 Sep 2011 15:24:58 GMT

Thanks for everones advise. Kitten has been discharged after producing two solid bowl movements and eating well with no nausea or vomitting.

So how much would an exam, 1 x radiograph, IV drip, GA and enterectomy with appropriate medication cost in other practices?

Re: Intussusception in 5 month old kitten

nikki — Mon, 05 Sep 2011 22:46:35 GMT

thank-you. comment was purely meant to mean that. i dont have £450 hanging around - it's a lot of money to me, let alone I'm sure most of my clients. purely meant that it sounded a good price for a lot of work. followed hopefully by a useful suggestion that ultrasound would be the way forward - cheap and normally conclusive.

Re: Intussusception in 5 month old kitten

James Laidlaw — Mon, 05 Sep 2011 21:44:15 GMT

And how's the kitten?

Re: Intussusception in 5 month old kitten

James Laidlaw — Mon, 05 Sep 2011 21:44:03 GMT

Before we get too carried away, I think the point was that a bill of £450 while hard on a lot of peoples' pockets, is in fact perfectly reasonable and quite cheap considering the kitten has had a consultation, x-rays, ex-lap and surgery to correct an intussusception alongside any medications it may have already had.

At least I think that's what the bargainous comment was meaning. Not that everyone had £450 to hand.

Re: Intussusception in 5 month old kitten

shanley barber — Mon, 05 Sep 2011 21:33:51 GMT

I agree. I am the first to question my conveyancers' charges! I think many clients are purely thinking of the £450 hole that our bill will create in their already-stretched finances; they aren't all accusing us of extortion! It's our guilt that makes us assume that they are.

Re: Intussusception in 5 month old kitten

bob lehner — Mon, 05 Sep 2011 15:32:40 GMT

[quote user="nikki"]a bill of £450 sounds bargainous! [/quote]

[quote user="Mark Hedberg"]Dunno, that's nearly 25% of some people's salary. Half, if you're on a minimum wage. Still sure it's a bargain? I get the usual arguments about gold standards and i know gut surgery isn't cheap, but treating £450 as anything less than a large sum of money is a trifle insensitive, isn't it?[/quote]

I agree with Mark. If I wasn't in the business, I'm pretty sure I would not consider a bill for £450 for a new kitten to be inconsequential.

I'm always intrigued by the recurrent theme on this forum that vets don't charge enough and that our charges are really so cheap as compared to garages, plumbers etc, let alone the other professions.

Most of us probably see our fees as totally fair and reasonable, and representing incredible value for money and are surprised and disappointed when the punters don't agree.

On the other hand, when we get a bill from someone else it is frequently perceived as outrageous, extortionate and a rip-off.

Re: Intussusception in 5 month old kitten

Laurence Webb — Mon, 05 Sep 2011 13:02:50 GMT

I'd second ultrasound if you have it available - a transverse view should show concentric rings, and far too many of them (3 layers of gut, 1 inside the other). There's no significant cost in doing the ultrasound, apart from gel so it would be up to your practice's owners to determine how much to charge for skill and time.

Re: Intussusception in 5 month old kitten

Mark Hedberg — Sun, 04 Sep 2011 23:17:05 GMT

None taken, just been doing a cpd self study, and one of the things i learned was how much the average vet bill was, and compared it with the average wages in uk in different sectors. Was a bit of an eye opener, and i realize i've been a bit easygoing about it myself! .:)

Re: Intussusception in 5 month old kitten

nikki — Sun, 04 Sep 2011 22:21:03 GMT

didn't mean to be insensitive - just mentally comparing it to how much same surgery would have cost at our practice. been a long week - no offence intended.

Re: Intussusception in 5 month old kitten

Mark Hedberg — Sun, 04 Sep 2011 21:35:42 GMT

Dunno, that's nearly 25% of some people's salary. Half, if you're on a minimum wage. Still sure it's a bargain? I get the usual arguments about gold standards and i know gut surgery isn't cheap, but treating £450 as anything less than a large sum of money is a trifle insensitive, isn't it?

Re: Intussusception in 5 month old kitten

nikki — Sun, 04 Sep 2011 20:21:31 GMT

a bill of £450 sounds bargainous! I'd be utilising my favourite piece of imaging - the ultrasound - intussussceptions look cool on scans!

Re: Intussusception in 5 month old kitten

Claire McConnell — Sun, 04 Sep 2011 19:21:33 GMT

Thanks for your prompt response.

THe kiten has this evening eaten a couple of mouthfull sof ad so going to monitor its response for now and see how the next 24hrs pan out.

WOuld love to do further diagnostics but owners i feel are reluctant at this stage due to finances. Uninsured and already have a bill of about £450!

Fingers crossed

Thanks for your opinion and hopefully get some more soon.

WIll keep you updated

Claire

Re: Intussusception in 5 month old kitten

Evelyn Barbour-Hill — Sun, 04 Sep 2011 19:03:25 GMT

[quote user="newgradvet"]

Yesterday I radiographed a 5mo old kitten with a 3 days history of v+ and anorexia and lethargy after plapating a sausages shaped lump in her abdomen.

There was gas present in the stomach and a small amount in the. This was followed by an ex lap.

An intussusception was eaisly found an an end to end anastomosis carried out after an enterectomy of necrotic intestinal tissue. GA was stable and cat was on IV fluids for 24 hours however inadvertantly the IV catheter dislodged overnight.

Today cat was bright, and not dehydrated however not willing to eat or drink alone. He shows interest in food but will not eat.

On very gentle (following enterectomy) palpation of abdomen today I can now feel a new abdominal mass and the cat is showing signs of nausea.

Is this in your view likely to be post operative swelling/adhesions? Or could there be a second intussusception so soon after surgery.

I was confident during surgery I coud find no other areas of diseased intestines and needless to say the cat is on antibiotics.

ANy views welcomed.

Claire

[/quote]

Well done so far! Well done.

I suppose this is dodging the question, but you are doing the palpation, not us, so we can't really say what you are feeling. It could very well be post-op reactions, but it possibly could be fresh intusussception. I expect someone with more of an intestinal surgery specialism will be along soon to give us a better assessment of the likelihood.

Could you do a bit more imaging maybe? Perhaps with some water-soluble (in case of gut leakage) contrast? It sounds as if you have time.