Is this vet ok?

I sent a list of questions to a local vet and received this list of answers, I got the questions from a site ( a couple I added myself) But are these appropriate answers?

From one rabbit-lover to another, I completely understand your concerns. Rabbits are sensitive to anesthesia so it's smart to get these questions answered. For the record, I've had both my mini-rex and dwarf lionhead spayed here and both are perfectly happy and healthy. I've answered all of your questions below.

Our spay and neuter surgeries come as packages which means they include all of the following:
Pre-surgical vitals check (to verify that vitals are healthy to receive anesthesia)
Pre-sedation to relax the pet, allowing for a less stressful experience
Pre-medication: your pet will receive both an antibiotic injection and an injection of pain medication prior to the surgery. For rabbits, this is generally all of the pain management they need, so none is sent home.
Gas anesthesia
Surgery - for a spay, both the uterus and ovaries are removed.
Constant vitals monitoring throughout the surgery
Post-anesthetic monitoring to ensure a safe recovery
The cost of this package is $225.00 for a rabbit. What the package does not include are two things which we highly recommend but are not required to perform the surgery: A comprehensive pre-surgical exam ($45) to verify overall health and pre-surgical bloodwork ($85) to verify healthy kidney and liver function. Preferably these things are done several days in advance of the surgery to allow for processing of the blood work.

We have spayed/neutered 14 rabbits in the last 12 months and have had a 100 percent success rate. No bunnies were lost.

We do not require fasting or water withholding prior to surgery for rabbits.

In regards to the anesthetic: We pre-medicate with ketamine and acepromazine in order to relax the pet before anesthesia. The actual anesthetic is an inhaled sevoflurane gas which is also used in human children and is the safest inhaled anesthetic available to us. Also, we have special intubation tubes designed for rabbits which allow us to have good airway accessibility to provide the patient with continuous adequate oxygen and gas anesthesia.

As far as recovery, rabbits wake up and are back to normal within a couple of hours.

Just concerned that they don't think they need to send bunny home with any pain meds. That's not cool in my opinion. Just ask the many forum members on here who got sent home with nothing and then wondered why bunny wasn't eating, moving or pooping enough. Especially with a spay, this is a major surgery to recover from. Bunny needs to be comfortable enough to let the healing process occur. But even for a boy there should be something available for pain. So in my opinion, a bit of a red flag.

This is what another vet sent me

We are excited about your new addition. I sent you an estimate for a rabbit spay, pain medication is included in the price. So far this year we have examined 43 rabbits, this doesn't include rescue or shelter rabbits. I could get you the number of surgeries we did last year but it take a little bit for the report to run because of the volume it needs to review. We have a very good success rate with surgery because we have a detailed anesthesia and recovery protocol. Yes the doctor will remove the uterus and the ovaries. Rabbits are not fasted prior to surgery. We ask you to bring some of their food with you so we can also feed them after surgery. The doctor will select the anesthesia based on each patient's individual needs but the gas anesthesia we use is Sevo.

This vet is farther away. but here is the itemized report I do hate that they charge you for EVERYTHING.

All those things you're seeing individually listed are built into the cost the other veterinarian quoted you (except the critical care and pain meds which would probably be going home with you). It's common for veterinarians to have a packaged price for common surgeries (like spays and neuters) whereas less common procedures would have to be planned out like you're seeing below (often including charges for use of the surgery suite, surgery time, etc.).

Both sound like good options to me. I'd ask the first vet about being sent home with some pain medications to at least have on hand (I would personally want them) and if you don't have critical care already that's also a great thing to have on hand for bun emergencies. I would absolutely recommend an exam before you book your rabbit for a spay and bloodwork is always a good idea but much more important in older animals.

They do a general health check before the spays at the second one. I took my rat there to be spayed. Unfortunately what we thought was a small tumor was 3 cm long and attached to her bladder We couldn't help her and decided not to wake her.

Don't worry I will certainly get pain meds. I always do after surgeries .

My main question is why are the pain meds more than the surgery lol.

I'm not sure what the specific pain medication they're providing is (some drugs are more expensive than others and some take more time to dispense than others), but notice that things that are a part of the surgical package, like sterilizing the instruments and induction, are listed separately. I'm sure if you'd prefer to pay more for your surgery they'd gladly accept it.

I think the high end is if their are complications considering one thing listed is hospitalization.

it just depend(s) in the region of the country that your in ... IMO

my surgeries for the bun(s) that I have ( male n female ) were 187.- for each individual

How does the region I am in make the vet a good choice or not? The cost is really not my concern. I want to choose the best vet for my girl.

I also got a qoute from the vet I took my rats to, $200, But they didn't fill out the questionaire yet

honestly the only reason I included the prices is because I copy pasted lol.

do they have a bun association in your area ( or close to it ) .. ??

or you have looked on the inner web for bun group(s) in the area also .. ??

these people can refer someone

I haven't. I didn't even know there were rabbit groups.

I did however contact a local experienced rescue to ask what vet they use.

So a few things...

I like the first vets more detailed explanation of what is used better, such as the anesthesia used and that the rabbit is intubated. I had a rabbit nearly die during a failed neuter, due to his narrow airway passages restricting his airway while he was sedated. A year later he was successfully neutered with no complications, due to the vet intubating him. So that is definitely a requirement for me, but I would only want an experienced vet doing it. Not sure that 14 rabbits done in a year, qualifies as a lot of experience though. And definitely don't like the vet not sending home pain meds. It's common practice for good rabbit vets to send home pain medication, as rabbits in pain won't eat. I would have definite concerns with a vet that doesn't understand this basic concept in rabbits. Besides, how would you and I like to have a hysterectomy and not be sent home with pain medication. Not nice in my opinion.

I like that the second vet sends home pain meds and may have more experience with rabbits, though they don't state a number and success rate for surgery. What I don't like is that they don't mention intubation or the meds used for sedation. Also the cost of pain medication seems excessive. If they are giving a metacam injection that may be why, and you could request that be knocked off and only to be sent home with oral metacam, which should be less than $40 for several days worth. A metacam injection would be unnecessary in my opinion, when giving oral metacam works just fine, plus it's excessively expensive for just one injection. It's possible they may be including some of the anesthesia meds under the pain med charge, which is something I would ask them to clarify what exactly the charge for pain meds includes.

The hospitalization charge I assume would be if there are any issues and they need to keep the rabbit overnight. I personally like to bring my rabbit home same day, as I like to be the one to monitor them. The only reason I would agree that overnight monitoring would be appropriate, is if an owner wasn't comfortable monitoring the rabbits recovery, keeping it warm, and making sure it starts eating, or if there were complications. It would also only be appropriate if there was a vet tech there with the rabbit, throughout the night, otherwise what would be the point.

If the second vet also included intubation in the cost of the spay, then I would probably go with them as opposed to the first vet, as it seems to me they are more experienced with rabbits. Despite the high charge for pain meds, if the cost includes intubation, then their overall price is still good. One other thing to consider is having blood work done. If your rabbit has any health concerns and/or is older, then it's something that I would want done.

You asked some good questions. With how difficult it is to really find an experienced rabbit vet, this is exactly how you go about doing it. Research what good rabbit vets do in particular situations, then question the vets you are interested in using to make sure their answers match up.

Itemized lists are normal, as this is how vets come up with the cost of the surgery. I actually want an itemized list so I know exactly what I'm being charged for and so I can discuss any charge that I feel is incorrect or unnecessary.

http://www.medirabbit.com/EN/Surgery/Anesthesia/Anes_main/anes_main_en.htm
http://www.veterinarypartner.com/Content.plx?A=671
http://www.bio.miami.edu/hare/opcare.html

both of the vets I found are listed on the house rabbit societies list recommended by keepers.

I have no problem with the itemized list ... But being charged for EVERYTHING ( equipment sterilization for example) seems excessive.

I have also contacted a few more vets and found out that I am getting a male, So I asked a few questions, Both do closed neuters, and both will send me home with medication ( though one is on request).

My normal vet the one i have used for rat spays and surgeries ... Just told me to call when I emailed the list.

Trust me, being charged for everything is relatively normal. There are many charges on my itemized list that aren't on the one you received, such as suture material, surgical prep, surgical pack, operating room, post anesthesia monitoring, but the overall cost is comparable. You have to remember that everything they do and use has a cost. Equipment sterilization requires a machine and manpower to do it. A pulse oximeter requires specific equipment and a tech to monitor. For some of the charges listed they also will be including multiple things in the charge listed. It's the overall charge you need to look at. If the overall charge includes take home pain meds, intubation, as well as all surgical related procedures and equipment needed, then the price is comparable to what I have paid for the same thing at my rabbit savvy vet. It's just the individual vet that decides how to list the charges. I can guarantee that my vet sterilized the equipment even though there was no listed charge for it, and I can guarantee that both of those vets will be using suture material even though they don't itemize the charge.

For neuters, pre scrotal neuters seem to be the best in my opinion, due to lack of post surgical issues and recovery.

Ok I am gonna sound dumb for a minute. Whats a pre scrotal neuter?

A scrotal neuter is where they make incisions in each scrotal sac to remove the testicles. A pre scrotal neuter is where they make the incision just above the scrotal sacs at the base of the belly, to remove the testicles. Scrotal neuters have the additional complication of causing inflammation of the scrotal sacs, which may lead to the rabbit chewing at the incisions due to the pain and irritation. A pre scrotal neuter won't cause this type of inflammation and may minimize chances of the rabbit chewing at the area(though not a certainty). Just my preference though, based on experience with my own rabbits and others experiences.

Here's more specific info on the different techniques.
http://wildpro.twycrosszoo.org/S/00...s/Indiv_TechniquesRabbit/CastrationRabbit.htm
http://veterinarycalendar.dvm360.co...techniques-proceedings?id=&pageID=1&sk=&date=

These vets do scrotal neuters, Hopefully they just leave the incisions alone and painkillers are enough, that was always the case with my rats but rats and rabbits are very different.

I finally got to call the vet the local rabbit rescue recommended. I did not actually get to speak to a vet but they do see rabbits regularly, the neuter is $72, and they have not lost any as far as she knows.

I know it's vague but I have phone anxiety and the other answers were via email.

Wow $72 is a bargain. I've contacted 3 vets about spaying my 2 male bunnies and none will do it for less than $230 each.