Which serves clients better, a £200K CT scanner or better nursing care?

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Clive Ansell — Wed, 13 May 2026 11:38:02 GMT

[quote userid="12930" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248865#248865"]That's a new one to me! [/quote]

It is not uncommon now, I've done many locums in practices with no permanent vets. Sometimes no RVN's either. I did a one week locum about 4 years ago, where the only permanent staff member was a receptionist, that really was a sh1tshow.

In this case, it is a corporate owned 5 branch 6 vet group (Used to be 7 branches and 12 vets prior to corporate streamlining and efficiency savings) . There are 2 employed vets across the 5 branches, about to reduce to one in July because of retirement. The other 4 vets, soon to be 5, are locums. RVN's have been reduced to an absolute minimum through 2 waves of redundancies, so if a single RVN is off sick or on annual leave, we're left snookered if a locum RVN cannot be found in time, which is more often than not.

They are between permanent vets, but seem unable to recruit or retain staff, been like this since covid. 2 vets that started as permanents over the last 12 months lasted 1 month and 3 months before they bailed. There is a practice manager across all 5 branches who is very efficient.

They seem on top of ordering and admin etc, not sure how and by whom, but that side of things seems very well run, always fully and properly stocked. Different story with broach dates on injectables and and recording controlled drugs, many locums I'm sorry to say don't bother.

PSS, yes, and I assume they still are (Waste of time that is)

[quote userid="12930" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248865#248865"]I have the utmost respect for locums - got to be the most challenging role for a vet by miles.[/quote]

Thank you.

It can be challenging, but we have the advantage that we can easily quit if things are or get too bad.

When I became a locum in 2001, it was very different. Almost all of my work then was 1 and 2 week blocks covering for colleagues on holiday. Now it has become more common to stand in for permanent vets because of retention and recruitment problems. I think a being a stand in for a permanent role works less well, really as a locum we are there to plug a gap or fill a hole on a temporary basis, and it is unlikely, with the best will in the world, that most locums will have their heart 100% in it as a permanent staff member would

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Beats — Tue, 12 May 2026 21:02:46 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248863#248863"]this clinic has no permanent vets[/quote]

That's a new one to me! I've done locum for holiday cover back in the day when I was the only vet until the married couple returned, but not having a permanent vet to actually hire me and to hand back to at the end of my time - I'm not sure I would feel comfortable with that.

Surely there must be a permanent vet to be ordering medicines and all that sort of thing - I can't imagine a locum taking that level of charge and responsibility? Is there a permanent vet you are filling in for on temp basis, or genuinely "between" permanent vets with no one running the clinic beyond yourself?

Is it in the RCVS Practice Standards Scheme? I'm assuming that would be impossible? I have a hard enough time staying on top of the PSS as it is.

I have the utmost respect for locums - got to be the most challenging role for a vet by miles.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Clive Ansell — Tue, 12 May 2026 14:24:47 GMT

[quote userid="6765" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248859#248859"]Even if a diagnosis is achieved the plan would be weight loss and analgesia! If dissatisfied with that then go elsewhere.[/quote]

That is my take on it exactly.

Whatever condition is found, indeed if anything is found, basic advice of weight loss and analgesia remains the same

I also agree with the "if you don't like it, the door is over there" approach.

Very difficult, intense, demanding clients though.

Very aggressive dog, no hands on exam possible. if any surgery is indicated, no hands on post op monitoring or care possible without sedation. Referred about 2 years ago for BOAS assessment, but turned away by referral clinic as too aggressive to be able to treat.

[quote userid="6765" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248859#248859"]I appreciate that you have little influence as a locum.[/quote]

True, but this clinic has no permanent vets or RVN's and gets given locum(s) of the day. That is one of the problems of this case; many different vets giving different and conflicting opinions and options, nobody has got a handle on it and taken full charge of it really

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Alistair Graham-Evans — Mon, 11 May 2026 21:15:47 GMT

Owners need a reality check and to adjust expectations.

Even if a diagnosis is achieved the plan would be weight loss and analgesia! If dissatisfied with that then go elsewhere.

Our price for GA ( iv Propofol) and 4 Xrays in Australia is equivalent of £350. I think some owners may have justified anger in some fees? These particular owners are obviously delusional though.

I appreciate that you have little influence as a locum.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Clive Ansell — Sun, 10 May 2026 09:50:20 GMT

[quote userid="3169" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248851#248851"]HOW THE HELL DO YOU GET to £2000 for any number of radiographs taken in a vet practice? [/quote]

Practice involved charges about £500 for GA, x-ray set up and up to 3 images. Additional images about £100 each.

[quote userid="3169" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248851#248851"]It's simply not proportional to either the work involved or the direct expenses incurred. [/quote]

That's decided by management and coporate overlords, I as a lowly clinician have no say whatsoever.

However; it is not as simple as it seems.

Very difficult and aggressive dog that has to be preloaded with Gabapentin and Trazodone to inject it with Domitor. without which any form of examination is impossible. Obese >40Kg Bulldog cross thing (XL Bully?) with terrible BOAS, so high GA risk as no pre op assessment or close post op monitoring is possible. Owners unable to control or place a muzzle. Many colleagues have already refused to see it. History of vague lamenesses shifting between limbs, but no hands on examination is possible, so any investigation is going to just be a fishing exercise at best and may not even yield any answers at all.

Owners are just as difficult. Complainers if things don't go to plan and want instant black and white answers and a quick magic wand fix. As per, they want Supervet and pay for Yorkshire vet.

I think the estimate for radiography was suitably upscaled to edge towards referral or going elsewhere.

After speaking with a referral colleague who has agreed to a consultation, his advice was (depending upon the outcome of the consultation of course) that CT would probably be more appropriate and more cost effective in this case.

[quote userid="12930" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248850#248850"]A weekly visit and weigh in with advice and no imaging may have been even better though for fraction of cost?[/quote]

That was my initial advice; dramatic weight loss and nsaid's as needed. Dog continues to gain weight despite advice. All the younger colleagues want to rush in for full body, all limbs and spine, radiographs (Although none of them want to do it themselves given the dogs temperament)

Also raw fed and not on a balanced diet, so concerned may be nutritional, in part at least?

Owners are demanding answers though as "we keep coming back with the same thing and just get given Metacam, and have to pay" Hence, I've been looking at different options including referral.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Michael Woodhouse — Sun, 10 May 2026 01:34:24 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248841#248841"]A referral level orthopaedic consultation and all limb CT scanning will work out cheaper (c£1800) and give superior imaging and better value than in house radiograph of all limbs(c>£2000)[/quote]

HOW THE HELL DO YOU GET to £2000 for any number of radiographs taken in a vet practice?

Fundamentally the x-ray machine is digital so has virtually the same ongoing costs whether you use it or not - we are not using up film and chemicals.

I'd be very confident that a nurse and a student could collect a complete set of leg rads in 30 mins, allowing for some repeats. I can be in my office doing something else once the propofol in the vein and tube down the throat, pop down at the end and check I'm happy and don't want anything repeating or extra views. I'll do it for £500 and throw you chest and abdomen in for free.

This is where I start thinking maybe vets ARE profiteering and just seeing what the hell they can get away with. It's simply not proportional to either the work involved or the direct expenses incurred.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Beats — Sat, 09 May 2026 19:32:53 GMT

A weekly visit and weigh in with advice and no imaging may have been even better though for fraction of cost?

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Clive Ansell — Sat, 09 May 2026 11:32:14 GMT

[quote userid="8663" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248780#248780"]It is worth it clinically if used for the right cases. I’ve a whole lecture on this but I’d use the example of investigating a chronic cough. Set of X-rays under ga might cost £600 but is less sensitive than a chest ct. The ct might cost 1000-2500 but gives a definitive answer much more often. Another example would be numeral intercondylar incomplete ossification. Ct is much more sensitive than X-rays so represents excellent value[/quote]

I agree.

I have been involved with a case this week, an obese Bulldog with a history of different lamenesses seen by many different vets, where suspicions of hip and elbow dysplasia, carpal deformities and developmental abnormalities have been mentioned.

A referral level orthopaedic consultation and all limb CT scanning will work out cheaper (c£1800) and give superior imaging and better value than in house radiograph of all limbs(c>£2000)

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Dinu Catilina — Mon, 27 Apr 2026 14:41:45 GMT

[quote userid="12930" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248782#248782"]Anyone tried proximal ulnar osteotomy for HIF? [/quote]

I did not, not brave enough. Have you listened to the BVOA podcast on elbows?

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Anthony Dennison — Mon, 27 Apr 2026 12:37:55 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248797#248797"]Apparently there have been some advances in the tech meaning these are less of an issue now.[/quote]

I imagine so, like I said ours is about a decade old!

RE: Which serves clients better, a £200K CT scanner or better nursing care?

David Mills — Mon, 27 Apr 2026 09:32:20 GMT

[quote userid="8663" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248779#248779"]

It isn’t. It’s limited to

small patients or small parts. Ok for heads and limbs. Not ok for chest or abdomen of medium or large dogs

[/quote]

[quote userid="11308" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248795#248795"]We have an older version of one of these, had it about 10 years now. It is good for elbows and skulls, bony changes, soft tissue is ok but due to the time it takes to take the images it's hard to get anything other than venous phase when it comes to using contrast.[/quote]

Apparently there have been some advances in the tech meaning these are less of an issue now.

(I'm not involved in the specifics, just what the boss said).

It would make sense that the conical ones would improve with time and therefore have wider applications and eventually replace the traditional ones (just like MRI machines have come on from losing 3 hours of your life for a spine).

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Anthony Dennison — Mon, 27 Apr 2026 07:51:01 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248722#248722"]Interestingly the new conical CT scanners from China are about 60k cost price now - believe there is a UK distributor. Space requirements less (not even a single garage required), quicker processing and may well increase accessibility. [/quote]

We have an older version of one of these, had it about 10 years now. It is good for elbows and skulls, bony changes, soft tissue is ok but due to the time it takes to take the images it's hard to get anything other than venous phase when it comes to using contrast.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Vet2Vet — Sun, 26 Apr 2026 12:19:07 GMT

I find personally the tele reporting type scenario much less useful , as you say , still does not refine differential diagnosis and as you say much less likely to be currently clinical and therefore less likely to keep in mind that the referring vet was trying to answer clinical questions .

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Beats — Sat, 25 Apr 2026 18:30:34 GMT

Anyone tried proximal ulnar osteotomy for HIF?

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Alasdair Hotston Moore — Sat, 25 Apr 2026 17:55:55 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248763#248763"]I wonder whether most would think it has been worth it, that the clinical benefits of CT outweigh the rising cost of care to clients[/quote]

It is worth it clinically if used for the right cases. I’ve a whole lecture on this but I’d use the example of investigating a chronic cough. Set of X-rays under ga might cost £600 but is less sensitive than a chest ct. The ct might cost 1000-2500 but gives a definitive answer much more often. Another example would be numeral intercondylar incomplete ossification. Ct is much more sensitive than X-rays so represents excellent value
but of course this only works as a good investment in a clinic that sees enough cases where ct is important.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Alasdair Hotston Moore — Sat, 25 Apr 2026 17:51:28 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248763#248763"]conical CT scanner is as good as any other[/quote]

It isn’t. It’s limited to

small patients or small parts. Ok for heads and limbs. Not ok for chest or abdomen of medium or large dogs. So a cheaper investment but fewer clinical uses. Tends to be used for heads and orthopaedic work

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Arlo Guthrie — Fri, 24 Apr 2026 10:20:41 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248746#248746"]If we are to continue to offer a high, and increasing, standard of veterinary medicine,[/quote]

And that's the million dollar question, innit. Should that be a given? I mean, on the one hand, nobody wants to stand in the way of progress, but on the other, there must surely be a rational limit to treatment (have we not already reached it?)

Crikey, I'm not really up on my CT scanner terminology, but if a conical CT scanner is as good as any other, that surely is a game changer.

[quote userid="8663" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248754#248754"]The problem I’ve seen is that everyone wants one and thinks they can make money from it. [/quote]

Alasdair Hotston Moore which makes it sound like the decision to buy these things has been more commercially driven than necessarily from a clinical need? Equipping practices with a £200,000 piece of kit is inherently inflationary, so I wonder whether most would think it has been worth it, that the clinical benefits of CT outweigh the rising cost of care to clients. Complicated of course by the way that costs decrease over time, so what was £200K this year might be only £60K next, so perhaps that high price is just for the early adopters.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Ben Walker — Thu, 23 Apr 2026 10:05:24 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248718#248718"]Can you give me some examples of large capital investments that bring staffing requirements down (I'm trying to think what they might be in veterinary practice).[/quote]

Sure. Moving from film radiographs to a digital system is what I had in mind. We invest heavily in plant but our business isn’t really clinical practice.

If a practice is over-capacity for their radiography equipment then I reckon there would be examples where investing in CT instead of additional DR/CR equipment would be the economic choice. That may not be the typical case for practices considering CT though.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Evelyn Barbour-Hill — Thu, 23 Apr 2026 09:18:10 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248751#248751"]Anything from your car, phone, pen, dental equipment will have Chinese parts. All probably produced in suboptimal conditions. [/quote]

I'm well aware of that. It doesn't detract from my point.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Alasdair Hotston Moore — Thu, 23 Apr 2026 09:03:12 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care"] £200K CT scanner is the best way to serve clients and make money[/quote]

The problem I’ve seen is that everyone wants one and thinks they can make money from it. But that ship has sailed. So many out there that the case load is too thinly spread. Then the fee for the scan goes up and fewer cases are scanned and we circle a drain of underuse

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Alasdair Hotston Moore — Thu, 23 Apr 2026 08:58:34 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248722#248722"]h CT is its lack of sensitivity. Interpretation normally comes back as a list of differentials[/quote]

Mmm. Thats poor reporting or poor use of the report. Not a lack of sensitivity. Arguably it’s more a case of over sensitivity. But I think the first: reporting radiologists using telemedicine are remote from clinical reality and risk adverse

RE: Which serves clients better, a £200K CT scanner or better nursing care?

David Mills — Wed, 22 Apr 2026 17:49:35 GMT

Anything from your car, phone, pen, dental equipment will have Chinese parts. All probably produced in suboptimal conditions.

"Made in Britain" or "Made in Italy" etc just means either a part has been screwed into another one or the last button added to a designer bag in that country, nothing more.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Evelyn Barbour-Hill — Wed, 22 Apr 2026 16:20:50 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31349/which-serves-clients-better-a-200k-ct-scanner-or-better-nursing-care/248722#248722"]CT scanners from China are about 60k cost price now[/quote]

If you want to patronise China and buy goods possibly made by slave labour, fine.

There are reasons why the Chinese version of anything is spectacularly cheaper, and you have to consider what those reasons might be.

Not preachin', just sayin'.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Clive Ansell — Wed, 22 Apr 2026 15:12:33 GMT

I've mixed feelings:

If we are to continue to offer a high, and increasing, standard of veterinary medicine, then advanced imaging such a CT and MRI scanning will need to become widespread and an essential part of our tool kit. It comes at a price and has to be paid for though.

We can still do a lot with very little in many cases, without advanced imaging and diagnostics, based on good history taking and thorough clinical examination, but of course there are limitations. Most clients I see day to day, it would be well outside of their price range.

I sometimes think CT and MRI scanning are overused, and have seen cases where the scan makes no difference whatsoever to the outcome, end stage neoplasia cases mainly. Maybe there is pressure to use the scanners once they are owned to pay for them? I don't know.

That said, I have had owners demand it where I don't think it is needed. I had a recent case of a young Labrador that had had a few very minor seizures, and based on age, breed, history, exam I made a working diagnosis of idiopathic epilepsy. Snooty, neurotic owner demanded a referral and brain scan. A specialist appointment, CT scan, and £3500 bill later, a report came through with a diagnosis of "probably idiopathic epilepsy"

In two larger groups I work for, they both have CT scanners at their main hospitals. The price of it is coming down, or rather not increasing, and the difference between CT and standard radiography is reducing. A GA and set of standard radiographs can easily be £700-£800, and CT starts about £1250.

RE: Which serves clients better, a £200K CT scanner or better nursing care?

Dinu Catilina — Wed, 22 Apr 2026 08:27:04 GMT

Yes, CT is not a magical device to bring an end to all doubts.

David Mills Apologies for the laziness but do you know the company name? Thank you