Is My Vet Ripping Me Off?

[Vanna234]

Ok so here is the story.
I have a 5-6year old cat, shorthair domestic. SHe started sneezing by the end of July so I went to the vet and she told me that she most likely had URI(upper respiratory infection). So they prescribed her Clamavox and after six days of taking it, she started vomiting so they gave her other medication. Azithromycin(antibiotic) and Famciclovir(antiviral). She took the antiviral for 21days and the antibiotic for, I think 2weeks-1week. Anyways I went back to check if she is okay because I heard her voice was scratchy and I thought there was some little congestion left. They listened to her on a stethoscope and said that they wanted to do an x-ray because she did sound a little bit congested. So I had to leave her at the vet for 3hours until they did the xray and then I got a call from them. They told me that she had vomited, the first time it was food with some hairball and the other time it was bile(stomach juice). They said that the vet wanted to do a blood test and also they wanted to give her an anti-nausea shot. So I was like okay. When I got off the phone I googled reasons why cats vomit and saw that they vomit when they are stressed. Also, the xray may make them vomit as well. I went to pick my baby up and I was told that the xrays were fine, they gave me more of the medication that I had used before and said that probably she wasn't on antibiotics long enough for her to clear up. Then they went to tell me that her GGT levels were high(normal 0-14) my cat was at 102. Now they want to do an ultrasound to see why her levels are so high(which by the way costs $365). I mean right now my bill is $430 and I'm not saying that because I'm cheap. I want to also mention that they signed me up for a payment plan since I could not afford the xray and they told me I would get a card in the mail which has $1,000 that I can use for my cat. How come they wanted to do a blood work and all of the sudden now she has high levels of GGT. it sounds fishy to me, she was perfectly fine until they gave her the anti-nausea shot and now she is not eating much. I mean all of the sudden they ordered blood work and now she has high GGT levels and they also want to do an ultrasound? I feel like they WANT my bill to go up to $1,000 so they can make money off me? Doesn't it sound weird? Can vets do that? Can they make up numbers for blood work?

 

[jen]

Well I would want to know why my cats GGT levels are high. You could always ask to see the bloodwork results for proof but if your cat was at 102 when the normal max is 14 that seems serious to me... Sounds like they were looking for one thing and found another. Since cats are very effective at hiding their pain and discomfort, looks at it that you are lucky you caught things early. You could always request to treat the issue to get the GGT level down and see if that works at her recheck, yes more bloodwork, and finish off the antibiotics. Then if things are still bad or if it flairs up again do the ultrasound.

 

[jen]

Oh as for your actual question, is it a vet you have been to before? Vets don't make a lot of money and are vets because they love to care for your pets. Sure there are bad apples out there but most are overworked and underpaid and want to make all the pets healthy and can't. You get some who do bare minimum and then it turns out more serious and the client wonders why the vet didn't push for more. You also get others do throw out everything possible to get to the bottom of things and the client then wonders if they were ripped off. They can't win. Just ask questions, as what the necessary first steps in solving the problem might be, ask what to do first and what can wait, and MAKE SURE you come back for a follow up and don't skip it because the cat "seems fine".

 

[KarenKat]

First of all, welcome to The Cat Site and I hope your kitty feels better. It's been my personal experience that
1. Most vets really mean well and want to help your pet
2. Vets want to run every test possible because they can better treat a pet with more information
3. Vet bills tend to be expensive, and I personally always have sticker shock.

While I don't know the exact situation of what the vet was thinking, I doubt the vet is trying to scam you - maybe someone else can chime in, but even though it's a business I don't think vets make any commission, so there would be no reason to purposefully rake up bills. Based on your story, it's possible that the vet was a little bit test-happy, and that seemed to discover an anomaly in the bloodwork. Of course, it would be illegal to invent blood results. They should be able to provide you with a 1-2 page report of all the things they tested for, the level on your cat and the normal range. And I agree with jen - the range of GGT levels is quite outside the norm. I would ask my vet what that would indicate, and if any of the medication your cat was given or even the URI itself could have contributed to that.

In my opinion, a good vet should provide all possible tests/services, explain why each one would be done, and recommend a path to take. Don't be shy to ask what the service will cost, what the vet is looking to see, and how it may change a treatment plan or diagnosis. I've had vets that didn't necessarily volunteer information, but I was able to dig and ask a lot of questions so I could knowingly decide my course of action. If you don't like your vet, ask for a copy of all records and get a second opinion from another one.

 

[1CatOverTheLine]

Ok so here is the story.
I have a 5-6year old cat, shorthair domestic. SHe started sneezing by the end of July so I went to the vet and she told me that she most likely had URI(upper respiratory infection). So they prescribed her Clamavox and after six days of taking it, she started vomiting so they gave her other medication. Azithromycin(antibiotic) and Famciclovir(antiviral). She took the antiviral for 21days and the antibiotic for, I think 2weeks-1week. Anyways I went back to check if she is okay because I heard her voice was scratchy and I thought there was some little congestion left. They listened to her on a stethoscope and said that they wanted to do an x-ray because she did sound a little bit congested. So I had to leave her at the vet for 3hours until they did the xray and then I got a call from them. They told me that she had vomited, the first time it was food with some hairball and the other time it was bile(stomach juice). They said that the vet wanted to do a blood test and also they wanted to give her an anti-nausea shot. So I was like okay. When I got off the phone I googled reasons why cats vomit and saw that they vomit when they are stressed. Also, the xray may make them vomit as well. I went to pick my baby up and I was told that the xrays were fine, they gave me more of the medication that I had used before and said that probably she wasn't on antibiotics long enough for her to clear up. Then they went to tell me that her GGT levels were high(normal 0-14) my cat was at 102. Now they want to do an ultrasound to see why her levels are so high(which by the way costs $365). I mean right now my bill is $430 and I'm not saying that because I'm cheap. I want to also mention that they signed me up for a payment plan since I could not afford the xray and they told me I would get a card in the mail which has $1,000 that I can use for my cat. How come they wanted to do a blood work and all of the sudden now she has high levels of GGT. it sounds fishy to me, she was perfectly fine until they gave her the anti-nausea shot and now she is not eating much. I mean all of the sudden they ordered blood work and now she has high GGT levels and they also want to do an ultrasound? I feel like they WANT my bill to go up to $1,000 so they can make money off me? Doesn't it sound weird? Can vets do that? Can they make up numbers for blood work?

V Vanna234 - First, welcome to TCS.

I'd have to say that "making up numbers for blood work," would be as rare as it would be unethical.

A Gamma-Glutamyl Transferase level of this calibre would certainly make any veterinarian explore the possibility of inflammatory bile duct disease, and probably order an ultrasound with an eye toward finding any possible neoplasms.

Is there a veterinarian whom you trust, who'd examine her, and run a GGT at the same time? Second opinions seldom do any harm.
.

 

[Vanna234]

Well I would want to know why my cats GGT levels are high. You could always ask to see the bloodwork results for proof but if your cat was at 102 when the normal max is 14 that seems serious to me... Sounds like they were looking for one thing and found another. Since cats are very effective at hiding their pain and discomfort, looks at it that you are lucky you caught things early. You could always request to treat the issue to get the GGT level down and see if that works at her recheck, yes more bloodwork, and finish off the antibiotics. Then if things are still bad or if it flairs up again do the ultrasound.

So can I ask for medication that helps on lowering the GGT level? Do you think they would give it to me? They did give me a copy of the blood work though.

 

[mikameek]

I have to say, I have a cat who has chronically high GGT and liver enzyme levels (ALP, ALT, AST) and hers have never been as high as the 100s. She has gall bladder sludge which means her biliary system isn't working properly and her highest GGT reading was 47. Mika is currently on medication (and will likely be for the rest of her life) for her GGT levels so yes, I would say that you can ask for medication. See what the vet suggests to give her for that.

 

[Vanna234]

Oh as for your actual question, is it a vet you have been to before? Vets don't make a lot of money and are vets because they love to care for your pets. Sure there are bad apples out there but most are overworked and underpaid and want to make all the pets healthy and can't. You get some who do bare minimum and then it turns out more serious and the client wonders why the vet didn't push for more. You also get others do throw out everything possible to get to the bottom of things and the client then wonders if they were ripped off. They can't win. Just ask questions, as what the necessary first steps in solving the problem might be, ask what to do first and what can wait, and MAKE SURE you come back for a follow up and don't skip it because the cat "seems fine".

That was my second time going to the vet. The first time I went for the URI.

 

[jen]

Well from the little understanding I have it makes sense that she was in the clinic, she vomitted a couple times, they wanted to run bloodwork and good thing bc they saw her GGT level was off, which could mean she may have inflammatory bile duct disease which they would want to confirm with an ultrasound before treating.

So either they vet doesn't do the ultrasound and treats what they SUSPECT is the bile duct issue and low and behold they are wrong and now you have spent money on unneeded meds and didn't treat the actual issue, or they do the ultrasound to find out for sure and treat accordingly.

I don't know what treatment for bile duct disease is but I imagine they would want to know for sure. Perhaps the anti-nausea medication was the start on making her feel better until more was known and you decided what to do.

Ultimately this is your cat and the vet can't do anything you don't approve. But they also don't necessarily have to dispense medications based on a wild guess.

 

[jen]

Sorry I tend to ramble on a bit. I think you are getting better advice from others with more experience then me

 

[mikameek]

Also, I wanted to throw out there, I only added my own experience with the numbers to suggest that something is clearly off if your cat is reading in the 100s. That is VERY alarming! I would suggest to get a second opinion if you don't feel comfortable with this vet. If her numbers are really that high, you need to find out why!

 

[FeralHearts]

Any chance any of the meds the cat was given, or on previously was / is a corticosteroid? That can produce high GGT. Something to ask the vet - or if you know from what the cat might currently be taking??

Like Karencat - I also suffer from sticker shock every time. Vet's here are normally not cheap. I've been fortunate enough this last year to find two good ones that were very reasonably priced. My one kitty , Charlie had to have an ultra sound once for his heart- that alone was a $600.00 bill. His blood work (baseline testing etc) and shots the one year, over $500.00. (This is Canadian I'm speaking in so 450.00 U.S and 380.00.)

Vets I find much less expensive in many states compared to Canada - California being higher from what I've seen.

That all being said, some vets are better than others - like anyone else. They also have different experiences and methods.

Charlies original vet for example - is no longer his vet. Nice people but always distracted. I never felt he was getting the right care. I gave them plenty of chances - I should have switched sooner as his new vet - she is amazing. The final straw came when they were so distracted they couldn't tell me if they gave him a rabies shot ... that he wasn't even due for!

I have to say - all the vets I've met over the years, there were only two who I questioned their judgement and skills. (I've had a lot of dogs over the years.)

So don't be afraid to ask for copies of her records and take her to another vet if you are worried or believe that she isn't getting the right care. When in doubt, second opinion is worth thinking about. (As others have said.) :-)

Also - don't be afraid to ask questions. Write a list, ask them to explain things so that you're comfortable. You might find them very open to the discussion.

 

[Vanna234]

Any chance any of the meds the cat was given, or on previously was / is a corticosteroid? That can produce high GGT. Something to ask the vet - or if you know from what the cat might currently be taking??

Like Karencat - I also suffer from sticker shock every time. Vet's here are normally not cheap. I've been fortune to find two good ones that were very reasonably priced. My one kitty , Charlie had to have an ultra sound once for his heart- that alone was a $600.00 bill. His blood work (baseline testing etc) and shots the one year, over $500.00. (This is Canadian I'm speaking in so 450.00 U.S and 380.00.)

Vets I find much less expensive in many states compared to Canada - California being higher from what I've seen.

That all being said, some vets are better than others - like anyone else. They also have different experiences and methods.

Charlies original vet for example - is no longer his vet. Nice people but always distracted. I never felt he was getting the right care. I gave them plenty of chances - I should have switched sooner as his new vet - she is amazing. The final straw came when they were so distracted they couldn't tell me if they gave him a rabies shot ... that he wasn't even due for!

I have to say - all the vets I've met over the years, there were only two who I questioned their judgement and skills. (I've had a lot of dogs over the years.)

So don't be afraid to ask for copies of her records and take her to another vet if you are worried or believe that she isn't getting the right care. When in doubt, second opinion is worth thinking about. (As others have said.) :-)

Also - don't be afraid to ask questions. Write a list, ask them to explain things so that you're comfortable. You might find them very open to the discussion.

Thanks for your reply. I did read online that one of the medications does cause high levels of GGT but I will be calling them tomorrow to ask!

 

[FeralHearts]

Thanks for your reply. I did read online that one of the medications does cause high levels of GGT but I will be calling them tomorrow to ask!

:-) It's scary when we don't know what's going on. Costs are high and we don't understand what they are doing or why. That adds to the stress of being afraid for your baby. So ask, ask, ask.

Write things down, anything you can remember leading up to her feeling poorly and since. This will help them - and it will help you as well. Memories can get all jumbled together with stress. This way - when your memory is "off" it doesn't matter, you write down times and dates and what was going on - it will help. Along with questions too. Probably a million of them right now but by morning - you might forget - even if you think right now "Nope, I'll remember". I once thought that too. ;-) I was wrong. lol

 

[FeralHearts]

P.S in saying that about the corticosteroid - good to talk to the vet about it. As that is really, really, high.

So keep in mind it may only be a contributing factor to what else is going on. I'm not a vet, so I can only pose a question for you to ask them, and maybe areas to explore that might trigger someone to look other places or new ideas?

Let us know how it goes please. You'll be in our thoughts! sending out some good vibes your way. I know many people here will be doing the same. They're a great bunch.

 

[Timmer]

I would get a second opinion if you can.

I think a $430 vet bill for everything they have done sounds reasonable and actually not that much. Not only do they take the xray but a radiologist has to read it. My vet always takes a look first but the films are always sent to a radiologist. If that all includes the blood work, that's pretty good.

I don't think they are ripping you off BUT I do think that it is a long time for a cat to be on an antibiotic and I'm surprised at that. I think my vet would have first thought that sneezing was feline herpes unless there were other symptoms. I think your vet finding the high GGT levels is a fluke. I don't know anything about GGT levels or what that even means but from what I see here, it's serious.

 

[1CatOverTheLine]

I don't know anything about GGT levels or what that even means but from what I see here, it's serious.

Timmer - GGT is an enzyme that acts as a binder, which - although there's not yet any hard scientific evidence - is generally thought to be the chief detoxifier in liver function, by binding toxins to tripeptides for elimination from the body.

The GGT test, in part, evaluates the reason(s) for an elevated alkaline phosphatase (ALP) level to give the physician or veterinarian a better idea of where to look - toward the organs (liver and/or bile duct disease) when high, or toward the bones, when low (because only the ALP will be elevated with osteoporosis), however, as noted here:

GGT

"GGT concentrations in serum may also be elevated in response to many drugs and toxins."

The primary problem with using the two together may be seen here:

ALP (Alkaline Phosphatase) Isoenzyme | Medical Tests | UCSF Benioff Children's Hospital

since ALP can likewise be elevated by certain medications, including antibiotics, bacteriostatics, corticosteroids, anti-inflammatories, et al.

In this case, we have a patient - a Domestic Shorthair - with a 21 day history of antibiotic prescription, in addition to a maropitant citrate injection, and a veterinarian who seems immune to the idea that the cat's GGT concentration might very well be induced by the medication stream.

Not to poke fun at Hippocrates, but, "when we hurry, things get blurry; when we wait, we see things straight."
.

 

[Vanna234]

Timmer - GGT is an enzyme that acts as a binder, which - although there's not yet any hard scientific evidence - is generally thought to be the chief detoxifier in liver function, by binding toxins to tripeptides for elimination from the body.

The GGT test, in part, evaluates the reason(s) for an elevated alkaline phosphatase (ALP) level to give the physician or veterinarian a better idea of where to look - toward the organs (liver and/or bile duct disease) when high, or toward the bones, when low (because only the ALP will be elevated with osteoporosis), however, as noted here:

GGT

"GGT concentrations in serum may also be elevated in response to many drugs and toxins."

The primary problem with using the two together may be seen here:

ALP (Alkaline Phosphatase) Isoenzyme | Medical Tests | UCSF Benioff Children's Hospital

since ALP can likewise be elevated by certain medications, including antibiotics, bacteriostatics, corticosteroids, anti-inflammatories, et al.

In this case, we have a patient - a Domestic Shorthair - with a 21 day history of antibiotic prescription, in addition to a maropitant citrate injection, and a veterinarian who seems immune to the idea that the cat's GGT concentration might very well be induced by the medication stream.

Not to poke fun at Hippocrates, but, "when we hurry, things get blurry; when we wait, we see things straight."
.

You know, I was wondering the same thing. If the antibiotics raised her GGT because it was a possibility, however the doctor said that since she threw up bile they need to do an xray and a pancreatic test(i really don’t remember the test’s name). Anyways THANK YOU SO MUCH for all the information, I really really appreciate it.

 

[PushPurrCatPaws]

Besides causing a lot of gastric issues, Azithromycin can sometimes cause higher liver readings &C, with higher GGT being one of them. If the blood test was done after your kitty had been on that antibiotic for 7-14 days, the higher GGT reading might be from that. But other things in the blood work should give vet(s) more information. (I am not a vet, and I have no real idea or training... consulting a vet you trust is always the best option.) You should get copies of that blood work (you paid for it after all), and I'd recommend getting a 2nd opinion, if you are suspicious of or just nervous with the current vet. Your cat needs to get to a point of eating well and eating daily, or more liver issues could occur. That's what's important right now. But with the 2nd opinion vet, see what they think about waiting to see what another round of blood work shows after that antibiotic is fully out of the system and the cat has been regularly eating. If the GGT and other indicators are still weird with another blood panel with a different vet (if you go to another vet or even just have the current vet test again in a week or two), then if I were the pet owner, I'd think an ultrasound might have more information.

By the way, I don't know for sure but I think it could take a lot of, and a longterm usage of, corticosteroids to raise a healthy cat's GGT (e.g. cause such a drastic effect in those readings for a healthy cat). My cat has been on corticosteroids for 2 years, albeit a small dose, and her GGT is just "1" on a scale of "0 - 6 U/L" at her last blood work. Her ALT, AST and ALP were all on the lower side of normal ranges as well. I get her blood work done every 6-8 months, to make sure she is healthy and on track and not having any health issues caused by the steroids.

But remember that one factor in a blood chem panel always works in concert with what a lot of the other factors are also telling the vet.

 

[1CatOverTheLine]

pancreatic test(i really don’t remember the test’s name).

V Vanna234 - The test is an fPLI (Feline Pancreatic Lipase Immunoreactivity test).
.