Below are 3 articles written in regards to vet bills. They are very helpful in explaining the what and why of this sometimes confusing part of ownership.
Employing Cost Controls On Your Monthly Veterinarian Bills
By Barry Trinchard
In horse racing, as in any business, costs incurred in your operation should always be examined for their necessity and reasonableness. Veterinary costs incurred in horse racing are expenses that should be examined and questioned in order to operate an efficient stable. The application of sound business practices can help control these costs, and hopefully allow you to reduce their expense.
Understand Your Vet Bills - Then Work to Reduce Them
As in any business, one must have an understanding of costs in order to be able to control them. The key to any owner understanding his veterinary costs is good communication between the owner and his or her trainer. It is important that you, as an owner, understand the veterinary needs of the horses you financially support. Educate yourself about your veterinary statement so that you may begin to understand what treatments are being given to your horse and why.
Understanding your monthly vet bill will help you control it, as you will then be able to discuss with your trainer such ideas as using bute tablets instead of bute injections. Bute tablets, given to your horse through its feed, cost $5.00 per dose, while bute injections, which allow the medication to directly enter your horse's bloodstream, cost $15.00. Is the extra cost of an injection worth the price? Increase your knowledge so that you may decide.
Ask your trainer or veterinarian to explain the components of the veterinary bill. Most trainers and veterinarians encourage owners to learn more about the business, and will be happy to answer your questions. And as the individual writing the monthly check, you are entitled to them.
When you examine the veterinary expenses generated by your racehorses, it is important to know the answers to the following questions:
1) How are my veterinary costs incurred?
Usually, the trainer is the purchasing agent for your horse's veterinarian services, incurring veterinary costs on an owners' behalf. Communicate with your trainer to guide him or her in regard to what veterinary costs you feel should be incurred, and know what costs he or she believes are necessary to keep your horses fit and running to win.
2) Who approves my veterinary charges and justifies their necessity?
In most cases, this task lies with the trainer, as he is in charge of the daily care of your horses. If you believe that your trainer should be solely responsible for purchasing veterinary services, then your trainer should be responsible for accounting to you for these costs, including reviewing and signing all veterinary statements before submitting them to your for payment. This practice incorporates a check and balance system to help control your veterinary costs. If a discrepancy occurs in a bill, or an increase in service costs, the trainer will be able to address such problems in a timely manner with the veterinarian. The trainer should also explain your veterinary costs to you, ideally on a monthly basis.
If your trainer cannot satisfactorily explain the costs you have been billed for, you should feel free to call and ask the veterinarian yourself. It should be noted that one charge an owner will not see listed on a veterinarian's statement is the cost of routine examinations. These examinations, which are requested by your trainer, are done quite regularly without charge to the owner.
3) What do these words appearing on my statement mean?
As in other areas of racing, the words on the vet's statement may not have meaning to you. What are Acepromazine tablets used for? What is Rompun, and why did my horse receive it? What are Sulfamethoxazole and Trimethoprim, and why did my horse need a whole bottle? Do not let the unfamiliarity of the words deter you in your education. Ask!
4) What payment methods are available?
You, as the owner and payer of the veterinary bills, have the ability to inquire about methods of payment. In most businesses, payment terms are negotiable. Always ask your veterinarian if payment terms are available. You may be ale to negotiate terms based on prompt payment, such as a 4% discount if paid by the 10th of the month. Additionally, if you own a number of horses and are generating larger than average veterinarian bills, you may be able to negotiate a volume discount with your veterinarian.
Veterinarian costs are not one of the happier aspects of racehorse ownership. While you may not be able to reduce your monthly vet costs as much as you would like, understanding and applying some basic business principles will work to your advantage.
Veterinary Bills, Explanations
Decoding Your Vet Bill
By Trainer Howard Zucker
One of the least understood factors in the cost of owning a racehorse is your vet bill. Vet expenses are an unwelcome but necessary part of maintaining your racehorse in peak condition.
Hopefully, your horse was raised with few veterinary costs other than routine wormings and vaccinations. Perhaps you had to pay for antibiotics to treat an illness or field injury. If there were no problems during early training at the farm or training center, you paid for routine x-rays to check on knee closure and bone maturity, and if all went well, your steed went off to the track.
Then what happened? All of a sudden you see a seemingly endless list of charges, mostly for unfamiliar medications adding up to a vet bill which averages $100, $200, or upwards of $600 per month. What's going on? Is your horse hurt, dying, or has he become drug dependent from job-related stress? Ask your trainer!
Good communication between owner and trainer, resulting in a thorough explanation of the vet's bill, can keep a healthy business relationship alive and well. A smart trainer informs owners of veterinary work being done on a regular basis, either week-by-week or whenever progress reports are regularly given. Such updates avoid the shock at month's end when the bill arrives. It is also a good idea for trainers to personally check and approve all items on a vet's bill before it is sent to the owner. Such practice eliminates one potential trouble of charges mistakenly applied to your bill. It is also useful for the trainer to add a brief note of explanation for exceptionally large charges as to the procedure employed, why it was necessary, and what medication was used.
Some trainers, myself included, use preventative therapies such as electromagnetic therapy, massage, chiropractic adjustments, ultrasound, and ice. Such therapeutic remedies may also work to reduce your monthly vet statement, and keep your horse at its athletic peak.
Is It Better to Administer Medication Orally or Via Injection?
There are basically two ways of administering medication to horses, either orally or by injection. On California racetracks, only a licensed veterinarian can legally give an injection, so any injection will require a veterinary fee. "Injectables" may be given subcutaneously, intramuscularly, or intra-articularly (directly into a joint).
There are a number of ways to administer drugs and medications orally. It may be done by drench (dissolving the medication and squirting it into the horse's mouth with a syringe), or by paste (many common wormers and anti-inflammatories are sold in this form). Some can simply be added to the feed, either as powder or pulverized pills. Oral administration can be done by your trainer, and is thus usually cheaper than injections.
For example, 25 oral doses of Bute cost about the same as one injection. Why then would you want to use an injectable, if the same medication is available orally?
An injection is preferable - sometimes necessary - when a horse needs immediate relief from severe pain. Medication is given in an injectable form before a race to ensure that the horse receives the full dose, and does not leave a part of the dose uneaten in its feed tub. Additionally, some trainers prefer injections because they eliminate the risk of the wrong horse receiving a medication mistakenly placed in its feed tub.
Of course, as in every other aspect of racehorse training, opinions vary. Different trainers and different veterinarians use different approaches to using an injectable vs. and oral dose. Many owners trust their trainers to make these decisions. If an owner is interested in or concerned about how his or her horse is being "vetted," have a conversation with your trainer and/or veterinarian.
With regards to your overall vet costs, don't be afraid to discuss them with your trainer and/or veterinarian. Good communication makes good business, and will enhance your ownership experience.
Howard Zucker has been a licensed trainer for 19 years, during which time he has developed 1993 California Bred Juvenile Champion, Moscow Changes. He has a B.A. from City College of New York, majoring in Finance with a minor in Biology.
Veterinary Bills, Explanations (2)
Understanding Veterinary Bills
By Dr. Rick Arthur, D.V.M.
Ongoing communication with your trainer and your veterinarian can avoid surprises when the vet bill arrives.
No one likes surprises when a bill arrives, and racehorse owners are no exception. Veterinary bills are often the biggest surprise a horse owner receives. Several years ago The Blood-Horse magazine published an article on the most frustrating aspects of owning a racehorse. Trainer communication topped the list, followed by veterinary bills. When I was interviewed for that article, I contended these were really the same problem.
Veterinary bills vary from horse to horse, trainer to trainer, and veterinarian to veterinarian. Some owners prefer to leave everything to their trainers, whereas others expect a phone call on even the most routine treatments. The owner and trainer need to reach a comfort level that fits their goals and relationship.
The California Horse Racing Board recognizes that the trainer has direct responsibility to care for the horse and that the trainer can incur expenses on an owner's behalf to maintain the horse's health and welfare. The trainer orders the services; the owner pays the bill. Implicit in that relationship is the trust you must have in your trainer to control costs. Your veterinarian does nothing to your horse without the direct or implicit consent of your trainer. This is a critical fact all racehorse owners need to understand.
Paying for Services, Not Product
A major misconception regarding racetrack veterinary services is that the racehorse owner is paying for products rather than services. State and federal law requires that the veterinarian have a defined client/patient relationship. That relationship requires that the veterinarian use his/her professional knowledge before administering any medications. Even if the trainer requests a specific treatment, the veterinarian is professionally responsible for that treatment. The veterinarian cannot abdicate that responsibility to the trainer, or even the owner.
Historically at the racetrack, veterinarians do not charge for the most important professional service they provide-the routine, sometimes day-to-day examinations of your horse. Those examinations can take the bulk of a veterinarian's time, especially in the mornings. Veterinarians receive compensation for these examinations by charges for the other services they provide, such as phenylbutazone, Lasix(r), vitamins, dewormings, vaccinations, etc. While this presents an inherent conflict of interest, for the most part, it works well.
If you do not have confidence in the integrity of your veterinarian or your trainer's ability to supervise your veterinary expenditures, you need to find another veterinarian. You should be aware that this may require you to find another trainer as well.
Everyone feels professional fees are too high. This is true whether you are discussing attorneys, doctors, accountants, or any other professionals. Veterinarians average eight years of university education and are on-call 24 hours a day, seven days a week. The veterinary care provided at the racetrack is actually very efficient. If you paid your medical bills directly rather than through a third party, such as your insurance company, this would be obvious.
Why Are Costs So High?
In real dollars almost every routine veterinary service available 25 years ago is less expensive 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 healthcare field, where costs have also risen astronomically in the last few decades.
When I went to work for Dr. Jack Robbins in the mid-1970s, we had the second fiberoptic endoscope on the Southern California Thoroughbred circuit. Since that time, diagnostic ultrasound, computed radiography, video-endoscopy, nuclear scintigraphy, arthroscopic surgery, laser surgery, and many more technologies have all been introduced into the racetrack practice. All of these technologies are expensive and add to the overall veterinary medical costs.
However, these technologies can improve the quality of veterinary care and, therefore, should be cost-effective. For example, Tiznow, Johar, and Pleasantly Perfect all had musculoskeletal problems identified with nuclear scintigraphy earlier in the same year that they won their Breeders' Cup races. Nuclear scintigraphy provided a precise diagnosis and allowed us to develop a specific rehabilitation plan for their successful recoveries.
Another factor paralleling the human medical experience is the introduction in recent years of a number of patented and useful, but expensive medications. During the 1980s, the pharmaceutical industry discovered that 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 in Gastrogard(r)) to depression.
Pharmaceutical companies began to use the same strategy to market medication to the equine consumer, the horse owner. Examples include Gastrogard, a treatment for ulcers, and Adequan(r) and Legend(r), both used to treat arthritic problems. From a study at the Southern California Equine Foundation at Santa Anita and Hollywood Park, we were able to identify gastric ulcers in 84% of all racehorses we examined. However, not 84% of all horses need Gastrogard. Yet some owners specifically ask veterinarians to put their horses on the medication even when it may not be necessary.
The third factor is simply greatly 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 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 with claiming horses has become severe, and veterinary services have become a key consideration. Seldom is the attitude that a horse is simply too slow or lacks class. Instead, the horse must have a veterinary medical problem that needs correction. This could include injecting joints, using anabolic steroids or any number of perfectly legal medications to address real or perceived problems. Those costs add up quickly.
Take the example that permeates the racetrack of a decade-old procedure for a dorsally displaced soft palate (also known as flipping his palate or swallowing his tongue). One successful claiming trainer has been doing the procedure on a number of claims this past year, and recently a large stable from back East came on the scene and does the procedure on every horse the stable claims. Other trainers are already beginning to follow suit. Many horses displace their soft palates and the surgery is relatively innocuous, so there is little harm. But the owners will pay the bill.
Many trainers have a routine program where all horses receive the same treatment prior to a race. This approach simplifies stable management but can get very expensive. For example, a horse could receive Banamine(r) (a non-steroidal anti-inflammatory medication), Robaxin(r) (a muscle relaxant), and Azium(r) (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.
Controlling 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. Surgery can also be expensive, but you should be interested to know that arthroscopic surgery on your racehorse is usually less expensive than arthroscopic surgery on your pet dog. However, routine veterinary care is very much discretionary.
Preventive health care 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. To put this in perspective, the cost of an X-ray of an ankle or knee is about the same as one day of training. Knowing the condition of your horse will also allow you and your trainer to make better racing management decisions.
What medications are necessary? The answer really depends on your horse, but unless your horse has a specific illness or injury, probably very few. When John Henry was Horse of the Year, his veterinary bill for the year totaled less than $1,000. While Gastrogard, Adequan, and Legend are usually beneficial at one level or another, that is not to say they are necessary or always cost-effective. These are very expensive medications and should only be used with a specific purpose. There should always be a reason to use any medication.
If you have questions you should first ask your trainer. The trainer is your agent and may have a simple, understandable explanation. But if you are not satisfied, your veterinarian should be available for consultation. You should expect a professional relationship with your veterinarian as you would with your doctor, lawyer, accountant, or any other professional providing you services.
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 interest and hopefully in the best interest of your horse.
Dr. Rick Arthur has been a practicing veterinarian on Southern California racetracks for more than 27 years. He is a past president of the Southern California Equine Foundation and the American Association of Equine Practitioners and is a vice president and director of the Oak Tree Racing Association.