Avian Medicine: Why is it so expensive?

It was early afternoon, that wonderful quiet lull that sometimes happens in a normal day of a busy veterinary practice. I had just finished my lunch, and was sitting at the front desk. When the phone rang, I answered. "My daughter’s parakeet has been acting funny for awhile, and she thinks it ‘s sick. I got some of that bird medicine from the feed store and I’ve been putting it in his water, but now he’s on the bottom of the cage. I asked my husband’s sister-in-law’s neighbor what I should do -- she has a parrot -- and she suggested I call the new bird store in town, that maybe since they sell only birds, they would have better medicine. So I called them and they said I should call your hospital right away, ‘cause you people treat birds and would be able to tell me what I should do. My daughter’s only eight and she’s going to be very upset if it dies….." As an aside, she added, "I didn’t know that vets treated birds." (Like, why would they do such a thing?) Unfortunately, this sad tale was a very familiar one. I wondered briefly just what the odds were that this poor little bird would even live long enough to make it to the hospital. So I explained how dangerously sick the budgie sounded, and told her she should bring the little guy in NOW. And because I’d learned from long experience, I also explained how expensive an office visit was for birds. "WHAT!?!?! That’s ridiculous! This is only a ten dollar parakeet!" she cried.

What A Horrible Thing To Say….
In the years that I worked as an avian technician, I cannot count how many times I heard that line, and I cannot verbalize how depressed it has always made me feel. With those words, the person on the phone has told me volumes -- that she does not value this tiny life at all, that it is a disposable pet, as it were. She also told me that little bird wasn’t tame (at least to her), and wasn’t an important member of her family (at least to her). I thought about the fabulous budgies I have known over the years, and I felt very, very bad for that little bird. I also felt bad for that eight year old, and wondered what she would have said if she’d been asked how much her budgie was worth. And once again, I pondered the fact that I’d never heard a dog owner say their dog was only a mutt from the pound. I tried to be patient as I explained that the exam fee isn’t based on the value of the animal -- it is based on the value of the avian veterinarian’s time. After all, veterinarians don’t charge more to see a show dog than they do to examine a mutt. And it takes just as much time and expertise to treat a budgie than it does to treat a hyacinth macaw. The explanation was lost on her. Muttering something about how she could buy several keets for that price, she hung up the phone. Angry and disheartened, I went back to my nursing duties, caring for animals that obviously did have value to their owners.

Time = $$$
Yes, avian medicine is much more expensive than dog and cat medicine. Why is that? There are several reasons, which I will explain, but the main one is TIME. Simple arithmetic explains a great deal. For example, small animal vets generally see four appointments in an hour, and I’ve even seen some that would see as many as six. Here in the greater Philadelphia area, the good small animal hospitals charge about $30 per visit for a dog or cat. At that rate, a busy vet can bring in about $120-180 per hour—not counting flea spray and heartworm preventatives. However, if a vet sees birds instead of dogs and cats, the timing changes dramatically. From my experience, good avian veterinary hospitals schedule bird appointments every 30 minutes. So if the bird vets want to bring in the same income as a dog and cat vet, they have to charge 2-3 times as much. However, the best bird vets around here only charge $35-45 for an avian exam. Consequently, they are only bringing in $70-90 per hour, so they are actually losing money when they chose to work with birds.

It's A Dog Eat Dog World
This situation is exemplified by the experience of one of the avian vets in my area who was between hospitals. To service her client base, she rented exam room space in a dog and cat hospital, paying a percentage of the money she brought in each day. However, that business relationship ended abruptly when the hospital owner got the same offer from a small animal vet, and the avian vet found herself without a place to work. When asked why he chose to replace a well-known avian veterinarian with a dog and cat vet, the hospital owner stated bluntly, "A dog and cat vet makes more money." (This is strange, isn't it, if you consider that an avian veterinarian is a specialist. Specialists are supposed to make more money than people that are NOT specialists, right?)

Teaching Takes Time
So why does an avian exam take so long? If all the avian vets had to do was a physical exam on the patient and a test or two, then the length of their office visits would be much more reasonable. However, when it comes to knowledge, most new bird-owning clients are throwbacks to the Stone Age. Even a New Bird Check-up takes a while because the process of education takes time -- and that's with a supposedly healthy bird. As a rule, the first thing new bird owners need to learn about is diet. After all, in this rich and over-fed country, malnutrition is still the underlying cause of approximately 85-90% of the medical problems that avian vets see in caged birds. STILL. Amazing, isn’t? After all this time, most people still feed seed and grapes and an occasional piece of apple. (But actually, that
isn’t surprising when you consider that most Americans feed a primarily junk diet to themselves and their kids, too.) Then, after the avian vets have explained the importance of a good diet, they have to teach the new bird owner how to get their little seed junkie to eat better foods, or better yet, how to convert them to a manufactured diet.

On To The Next Subject
Once they’re through discussing all that, they can start on the subjects of proper management, safe caging and bar width, good cage locations, broad spectrum lighting, varied perches for foot health, proper and safe toys. And while they’re at it, they need to warn these people about non-stick cookware, toxic houseplants, ceiling fans, aerosol sprays, other pets, small children, etc., etc., etc.. One of the avian vets in my area has asked me to work with him on the development of a behavioral pamphlet to give new clients—he’s a great believer in setting proper controls, but found when he also tried to explain nurturing dominance, that his office visits lengthened to an hour!

And The Vet Hasn't Even Examined The Bird, Yet….
Now, everything I’ve explained so far completely ignores the unfortunate fact that the "average" bird owner only seeks veterinary assistance when (s)he recognizes there is a problem. And by the time uneducated bird owners finally understand there is a problem, that means the bird is really in trouble -- like that poor budgie I talked about at the beginning of this article. So avian veterinarians also have to explain about birds masking the signs of disease, that "looking fine" doesn’t mean a bird IS fine, etc. etc. etc.. As I explained in another article [PET BIRD REPORT Issue #26, "Why Your Bird Needs An Avian Vet & How To Tell If You REALLY Have One…"], a proper physical exam doesn’t provide sufficient information regarding the health of a bird, no matter how good it looks. Diagnostic testing has to be done to rule out the possibility of latent or asymptomatic disease, which is something regular small animal vets don't really have to worry about. After all, when a dog is sick, it LOOKS sick.

Sick Bird Syndrome" Not only does a sick dog look sick, but the symptoms it shows generally gives the vet a good guess as to what's making it sick. Birds are different on this count, too. Birds that are sick with totally different diseases can display the same generic set of symptoms. Avian vets fondly call that group of symptoms Sick Bird Syndrome, or SBS. A bird with SBS is too quiet, fluffed, sleeps more than normal, eats less than normal, ETC., ETC., ETC.. So what might be the symptoms of a terminal cancer in a bird? SBS. How about psittacosis? SBS. What about liver disease? SBS. Get the point? This lovely birdie trick has many times led to the following phone conversation: Bird Owner: "My parrot is fluffed up and quiet. What is wrong with him?" Avian Vet: "He's sick." Owner: "I know that, but what is wrong with him?" Avian Vet: "I don't know, other than he is sick. To find out why he is sick, I would have to be see him and run some tests." Owner: "That's crazy, you should be able to tell me more than that. You're just trying to rip me off." CLICK.

STILL More Money…
So bird vets have to do more testing than dog and cat vets. And these tests done on birds are often MORE expensive than the equivalent test done on a dog or cat. But why is that? Again, because birds are different from mammals. Not only is the handling of the patient different, the collection, handling and running of the samples themselves is often different, too. Trust me on this -- working with birds in vet medicine is considerably more difficult than working with dogs and cats -- physically as well as psychologically (and that's a future article by itself). Avian samples are usually sent to special labs, again because they are different. For example, being experienced doing lab work with mammalian blood samples does NOT mean one is also competent to deal with avian blood. Because of this, many avian vets use labs that specialize in exotic animals -- and special labs are generally more expensive than regular labs. The avian vets in my area send bird samples (be they blood, cultures, pathology, etc.) to labs as far away as Florida, Texas or California. This means the transportation of the samples is different, too. Instead of a messenger stopping by daily to pick up samples to be transported a few miles to a local lab -- which is the situation for the dog and cat hospitals in this area -- the avian veterinary staff has to package samples to be sent hundreds of miles. And since disease can move much faster in a sick bird than a sick mammal, those samples often need to go FAST. Blood samples, for example, are usually sent Overnight Air. Therefore, MORE money. Lastly, one vet commented to me that even the phone calls with lab results take longer when the patient is a bird. He said he
can call 10 dog and cat owners about test results in a few minutes, but the same number of calls to bird owners will take several hours. You know how we birdie-types can be, right? We always have "one more quick question…," but it isn't the question that takes time, it's the answer!

And If The Bird IS Sick…
If the bird is sick enough to need medicating while the vet awaits lab results, but not sick enough to hospitalize, then the avian vet or staff has to teach the owner how to safely medicate their pet. And needless to say, it takes longer to properly teach someone how to restrain and medicate a bird (either by mouth or by injection), than it takes to teach them to pop a pill into a dog. Suffice it to say, this process tacks another 20+ minutes to an already long office visit. Most bird owners report that a visit with a sick bird lasted over an hour. So the next time you take your feathered friend to your avian vet -- and that should be once a year, whether it looks sick or not -- try not to shriek at the receptionist about the size of the bill. (That's a cheap shot, anyway -- the bill isn't the receptionist's fault!) From my experience, vets will spend as much of your money as you the owner say they can spend. If you tell them your finances are limited (and hey, Ed McMahon didn't come to my house, either), then they will do what they can to keep expenses down. If you say nothing about money but agree to all the tests the vet recommends, (s)he will assume money is not a problem. After all, you didn't bring it up, right? According to the numbers, veterinarians are the lowest paid professionals in this country -- if you don't believe me, look it up. I have worked with a lot of vets over the years, and they are NOT rich people! And statistically speaking, the avian vets would be making more money if they canned the bird stuff, and stuck to dogs and cats.

But we don't want them to do that, do we?

Liz Wilson, Certified Veterinary Technician, has been assisting pet bird owners with parrot behavior problems for over a decade through lectures, phone consultations, and house calls in the Greater Philadelphia area.

She can be reached at (215) 946-5964 9AM - 9PM M-F
Website: http://www.upatsix.com/liz