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Old August 20th, 2014, 11:18 AM
GreyDSH GreyDSH is offline
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interpreting vet bill for steroid injections

My cat has had severe allergies / IBD since 2008. If he eats anything other than Hill's Prescription Diet DD cat food (dry, venison and green pea) or if he eats the smallest crumbs of "people food" or bits of grass that get tracked in, he throws up. You have never seen someone vacuum as much as me!

With the D/D cat food and steroid shots, he has been successfully treated since 2008 such that he can typically go 4-6 months between shots and vomits rarely in between. While I know steroids are not good, I'd tried lots of other things, and by far that seems to work the best.

A vet had prescribed a combination of Dexamethasone, Kenalog, and Depo-Medrol. For whatever reason, apparently Kenalog is hard to find, so after I moved, Vetalog was substituted in for that, and that seemed to work about as well. Now I've had trouble finding a veterinarian who stocks Vetalog. I called around and found a new vet who has Kenalog, and my boy got his shots.

When I look at the bill, it says:
Description Qty
DEXAMETHASONE 4MG INJECTION 0.80
KENALOG INJ 1OMG ML 0.20
DEPOMEDROL INJ 20MG/ML 0.50
(the numbers 0.80, 0.20, and 0.50 are in a Qty column for each of the steroid rows)

Would it be correct to assume that he received 4*.8=3.2 mg of Dex, 10*.2=2 mg of Kenalog, and 20*.5=10 mg of Depo? The reason I ask is that the new vet said that he received different amounts of each (some more, some less) that reflect what I told her previous vets gave him, but he isn't doing as well as he has in the past (he vomited yesterday after 3.5 weeks). I don't want to be antagonistic or foolishly non-trusting of the new vet if bills often don't reflect reality or if I don't understand billing issues/math, but it's also hard not to wonder if the vet tech gave a different ratio that is reflected in the billing, or if the new vet means well and gave what she thinks are appropriate amounts and doesn't want me second-guessing her.

Thanks for your thoughts.

PS - While I know I probably seem paranoid, I love my boy very much, and I've had bad experiences before. He previously went to an animal hospital where his regular vet left, and the new vet (probably meaning well) prescribed him prednisolone instead of the injections. He not only didn't do well with that, but when I looked closely at the pills, I realized he had been given prednisone instead of prednisolone even though the bottle had been labeled for prednisolone. When I called them they initially denied that they would do that until I brought the pills and bottle in and showed them, at which point they admitted their mistake. (I know prednisone and prednisolone are very similar, but there are also important differences, and it seems like it is important for patients to know if they are getting something other than what is prescribed and labeled on the bottle. I track his health very closely, and because of his fragility, I want to know exactly what he has been given so that I can proceed accordingly based on what works and doesn't.)
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Old August 20th, 2014, 11:48 AM
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Dog Dancer Dog Dancer is offline
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I would suggest calling the vet and asking for clarification.
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Old August 20th, 2014, 01:37 PM
GreyDSH GreyDSH is offline
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Quote:
Originally Posted by Dog Dancer View Post
I would suggest calling the vet and asking for clarification.
Yeah, that makes sense, , I just didn't want to seem suspicious if someone could say, "Oh, yeah! That happens all the time where the bill says/implies one thing but the doctor says something else - nothing to worry about!"
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Old August 21st, 2014, 06:51 AM
Longblades Longblades is offline
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I agree, call the Vet. There's nothing wrong with asking for an explanation since you are not the medically trained professional. I think one mark of a good Vet or Doctor or car mechanic is their ability to put explanations into layman's terms. A good Vet understands that in the height of the matter you are a bit discombobulated and might need time to digest and learn new material pertaining to your pet's health.
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Old August 30th, 2014, 06:48 AM
GreyDSH GreyDSH is offline
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Thanks for your replies. I emailed the vet and didn't hear anything, but I then had to take my cat in again anyway and so I saw her then. She apologized for not replying and essentially said there are multiple ways of conveying dosages (e.g., mg / ml, mg/kg, total mg given, etc.) and that the receipt is not always useful / accurate in reflecting what was given, regardless. She reiterated that my cat got the agreed upon dosages (which still don't seem to relate at all to what was on the bill). While I suspect most clients don't look that closely at their bill as long as it is not too expensive, this is pretty unfortunate for those of us who like to closely track our pets' health, especially if we have to move.
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allergies, ibd, steroid injections, throw up, vomiting

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