Controlling Your Veterinary Costs
by Rick Arthur DVM

One of the things that distresses owners is high veterinary costs. The well respected Dr. Rick Arthur, currently the medical director for the California Horse Racing Board, wrote the following while still a practicing veterinarian working the Southern California circut. It was originally printed in the February 2006 TIA Newsletter and is still very revelent today.

“Several years ago The Blood-Horse did a survey of owners about the most frustrating aspects of owning racehorses. Number one was poor communication with their trainers and number two was vet bills. I was interviewed for the same article and contended they were really the same issue.

“There is one point almost all owners miss--even very experienced, longtime owners--which I find bewildering; Nothing is done to any horse on the racetrack by a veterinarian without the direct or implicit approval of the trainer. The trainer controls the veterinary costs, not the veterinarian.

“As evidence, I can tell you what every trainer’s veterinary charges will average per horse per month in my practice, and I suspect every veterinarian can do the same. The monthly averages are amazingly constant for every trainer, and those averages range from about $50/month to over $1,000/month per horse, depending on the trainer. What’s the variable? The trainer, not the veterinarian.

“In real dollars almost every routine service available 25 years ago is cheaper today. So why do veterinary medical costs seem so high? There are a number of reasons. Some of the reasons simply mirror the same factors in the human health care field, where costs have risen astronomically in the last few decades.
 
“When I went to work for Dr. Robbins in the mid 70’s, we had the second fiber optic endoscope on the Southern California Thoroughbred circuit. Since that time diagnostic ultrasound, digital radiography, video endoscopy, nuclear scintigraphy, arthroscopic surgery, laser surgery, (and now MRI) and many more technologies have all have been introduced into the racetrack practice.

“All of these technologies are expensive and add significantly to the overall veterinary medical costs. They certainly can improve the quality of veterinary care and, therefore, should be cost effective if used judiciously and properly.

“For example, Tiznow, Johar, and Pleasantly Perfect all had musculoskeletal problems identified with nuclear scintigraphy earlier in the same year that they won their Breeder’s Cup races. The specific diagnoses obtained with nuclear scintigraphy led to specific rehabilitation plans for their successful returns to racing.

"Horse owners should be aware arthroscopic surgery on racehorses at the racetrack is cheaper than the equivalent surgery on your dog.

"Another factor similar to the human medical experience is the introduction in recent years of a number of patented, useful, but expensive medications. During the 1980’s the pharmaceutical industry discovered marketing directly to consumers resulted in higher profits. Any evening, while watching TV, you can see ads for specific drugs to control everything from acid reflux (the same drug as Gastrogard®) to depression.

“The pharmaceutical industries now uses the same strategy to market medication to the equine consumer, the horse owner. You all see the ads for these medications in The Blood-Horse and similar magazines. Examples include Gastrogard®, a treatment for ulcers, and Adequan® and Legend®, both used to treat arthritic problems.

“The third factor is simply increased demand for veterinary services. For the most part, large veterinary bills are not necessarily the cost of individual procedures or treatments but the number of services being performed. This is particularly apparent in claiming horses where the “leave no stone unturned” approach to veterinary care has become the standard operating procedure in many barns. Maidens and high class horses are not immune to this approach.

“Every trainer is afraid the next trainer may find an undiagnosed problem and move a horse up; owners don’t like it either. The competition in claiming races has become severe and veterinary services have become a key consideration.

“The belief becomes seldom is a horse simply too slow or lacking in class. The conclusion is the horse must have a veterinary medical problem which needs to be corrected. This could include injecting joints, using anabolic steroids, any number of perfectly legal medications to address real or perceived problems. Those costs add up quickly.

“Many trainers, especially those with large stables, have a routine program where all horses receive the same set treatment prior to a race. This approach simplifies stable management but can get very expensive. For example, a horse could receive Banamine® (a non steroidal anti inflammatory medication), Roboxin® (a muscle relaxant), and Azium® (a cortisone) the day it’s entered; phenylbutazone (commonly referred to as Bute, another non steroidal anti inflammatory) and a vitamin shot the night before the race; Lasix® and estrogens (anti bleeding medication) the day of the race; and an endoscopic examination after it runs.

“With those alone, an owner could spend $200 to $300 every time the horse competes exclusive of any other treatments prior to entry. How much of all this is really necessary?

“Ironically I am not paid for my most valuable service, examining 10 30 horses every day for lameness or other problems. For whatever reason, owners, trainers, and many veterinarians have the notion that veterinarians are selling products rather than services. The products are a backward way to pay for professional services, an inherently flawed system.

“How does an owner control veterinary costs? Certain costs are hard to control, particularly where serious illnesses or injuries are concerned. Colic, colitis, pleuro pneumonia, or a life threatening fracture can cost thousands of dollars and are unpredictable, just as they are with your pets or family. However, routine veterinary care is very much discretionary. You should let your trainer know what your level of tolerance is--what level of veterinary care you want. Communication with your trainer will make sure that those decisions are made in your best interests and hopefully in the best interests of your horse.

"One point to never forget is that the owner’s interests, the trainer’s interests, and the horse’s interests are not always the same.

“Preventive health care procedures such as vaccinations, deworming, and dental care are always cost-effective. Addressing a specific veterinary medical problem such as a lameness or respiratory problem should almost always be worth the cost. A major error in attempting to control veterinary medical costs is eliminating diagnostic procedures. Remember, without a diagnosis, medicine is poison and surgery is trauma. A properly diagnosed problem can save considerable costs by avoiding unfocused and often unnecessary veterinary medical expenses.

“Finally, an owner needs to communicate with his trainer. If you can’t communicate, you need to change trainers rather than blame your veterinarian. If you don’t trust your veterinarian, shame on you for not making a change.

“Thirty years of experience has taught me that asking a trainer to change veterinarians rarely works; you will probably need to change trainers. Veterinarians work with certain trainers because of personal relationships that go beyond professional talent.”