CAG first vet appointment, was I scammed?

[saganismyhero]

Hey guys,

I took Sagan to his first visit since I adopted him at a local exotic vet. He told me there was “white plaque in the back of the mouth that had hardened” and it is below the trachea but not on it?! (Never showed me a picture) He told me I’d need it cultured to see if it was fungal or bacterial, and would start him on antibiotics. I’m absolutely anxious.

The check up, nail trim, and culture with antibiotics cost me $900?!?

Is this normal? And for the life of me I could not find anything online about this particular issue and he told me it could be serious if it’s resistant to antibiotics?

 

[noodles123]

That sounds high, but it depends on where you are. The thing about the white plaque could very well be legit, but was the 900 before or after the swab? How did he determine the need for antibiotics? Did he scope him or something?



You want to go to a certified avian vet if at all possible-- you said this one was exotics, and that is not ideal, although you are smart to question etc-- ****call back and ask for medical terms-- ask him to explain what he thinks this is so that you can look it up yourself, because it doesn't sound like you have enough info** You don't have to tell him why you are asking, but ask for medical terms etc AND an itemized receipt of all of the tests (names included) that lead to your bill. There has to be a name for this plaque-- or at least potential names for it (based on what he thinks it is).


Where are you located (roughly, if you don't mind)?


If he was given antibiotics, what tests was the prescription based upon? Most vets worth their weight will not prescribe antibiotics without at least performing a swab or gram stain first...so if he was prescribing these without having first performed the test, I would be concerned.

For me, a first time vet fee generally runs around $150-200. The swab usually runs 40-150 and the nail trim is between 40-60. Antibiotics can vary, depending on the type, but usually you don't pay for them at the vet. Are you getting the meds filled there or at a pharmacy (because if filling there, you will also pay for those)? IF YOU GET MEDS AT A PHARMACY and they are liquid, make sure that they do not have any flavorings added to them because these also include artificial sweeteners (which can be dangerous).



If you are in a big city, prices can be higher, so it just depends...If he is concerned about aspergillosis, that is a tricky disease that basically requires you to rule out everything else because there is no one diagnostic test that will tell you for sure..You have to do a ton of tests before you can say it is aspergillosis because aspergillosis can look like a bunch of other things and there is not really a definitive test for it alone. I did find this: https://www.tandfonline.com/doi/full/10.1080/03079457.2010.506210

 

[saganismyhero]

He sent the culture in but also gave an antibiotic...he also gave a dose in the office before we left.

Pretty sure the liquid has vanilla flavoring...

I live in north Jersey and I went to the only vet that had availability. All others did not have any appointments for a month.

 

[noodles123]

He sent the culture in but also gave an antibiotic...he also gave a dose in the office before we left.

Pretty sure the liquid has vanilla flavoring...

I live in north Jersey and I went to the only vet that had availability. All others did not have any appointments for a month.

Call and ask all of these questions-- ask if the medicine contains artificial sweeteners, and if so, what kind. Write it down and make sure it's safe for birds.


Ask for an itemized receipt outlining the coat (tell them they can read it to you over the phone if they want and just write it down)


Find out what the vet THINKS it could be and ask the secretary to confirm this with him.

 

[bill_e]

Seems high to me. Do you have a breakdown of the bill?

 

[saganismyhero]

I attached the breakdown.

The vet didn’t give me much else, and they said the suspension is fine? But now I’m worried...

 

[noodles123]

Unfortunately, that looks legit-- although the swabs/cultures seem expensive-- did you ask about the difference between the culture and the sensitivity/aerobic one? I know that is likely talking about aerobic vs anaerobic bacteria, but it's interesting because I'm not familiar with why they would do that if already prescribing meds, but I can see why they would IF trying to rule out other posibilities..did they do anything to test for yeast? I am hoping that initial culture ruled that out and that the second one is just to nail things down further.......Having lived in NYC , I know that a haircut alone (for me) was at least $100 more than it is here. Depending on where you are in NJ, costs are likely also higher. It appears that you filled the prescription there, which also adds to the cost. You can sometimes get a bird script filled at a human pharmacy, but I'm pretty sure insurance doesn't cover it anyway.. Seems like a lot for Baytril, but then again, you are in NJ, so everything is going to be more. I wonder if you drove an hour to a different vet (again, preferably an avian one, and not just exotics) if you could get a better rate in the future-- of course, you will always have those stupid "new patient" intake fees.



The new patient fees always are more, so in the future, it shouldn't be as much because that initial visit always has add-ons (from my experience)


The most annoying thing about this is that they charged separately for supplies etc-- your nail trim wasn't a bad price though.



I have gotten a surprise 500 dollar bill before, not 9....but again, could be location...

 

[Laurasea]

Yes parrots can have plaques. There are dome very scary, and some easy to fix issues that show that . More common snd easy to treat is yeast overgrowth. But it would take anti fungal not antibiotics , but dome can be bacterial...if its an avsin vet you have to ho with what they say..

I think the culture was on the high end, close to double what I have paid. But can depend on how many tests they included with the culture. But yes I pay near thst when I have a vet visit with a sick bird.

I suggest adding yogurt with live culture, like acidophilus, and no artificial sweetners. Yogurt is safe, helps balance flora , important since he is on antibiotics, but I feed a little routinely.

 

[bill_e]

Yep, I agree that given your location all of that seems reasonable. The exam for $112 in Northern NJ seems reasonably marked up for your location verses the $75 my vet in the sticks of NH charges. Nail trim from my CAV is $20 vs the the 31.75 charged you. The patient processing fee seems like the fee car dealers charge for "documentation", gouging in my opinion. Hopefully that is only a first visit fee.

The lab fees seem reasonable based on what I've been experiencing for blood work and culturing for my dog these past 6 months....who knew culturing was so expensive.

Most vets up here set their rates based on the population of clients and what they can reasonably charge. I know the wages and cost of living in northern Jersey is higher that where I live so hence the markup.

My daughter is a Vet hospital administrator who has had experience with the growing wave of management corporations buying and running practices and as a matter of fact her practice was just bought out by one. Independent vets are growing scarce and along with them the flexibility of the practice to do the right thing based on the client's means. That processing fee is likely the result of such management. With a managed vet there is a schedule of treatment set by the corporation which the vets aren't supposed to deviate from and which results in the loss of flexibility that I talked about earlier.

But all in all, if it was my vet it might be $100 or so cheaper but I don't think that you were taken.

 

[bill_e]

I suggest adding yogurt with live culture, like acidophilus, and no artificial sweetners. Yogurt is safe, helps balance flora , important since he is on antibiotics, but I feed a little routinely.

Laura, please tell me more about yogurt and if it should be fed regularly to a non-symptomatic bird.

Thanks
Bill

 

[noodles123]

I suggest adding yogurt with live culture, like acidophilus, and no artificial sweetners. Yogurt is safe, helps balance flora , important since he is on antibiotics, but I feed a little routinely.

Laura, please tell me more about yogurt and if it should be fed regularly to a non-symptomatic bird.

Thanks
Bill

I know Laura has had luck with this, and it's probably fine to try, but I will say that there is mixed research about this. I give my bird powdered Benebac, but my CAV told me that there was very little evidence that this actually worked (I still give it....) The thing is, each parrot species has its own specific digestive flora, so my vet's reasoning for discounting Benebac for parrots, is that it is marketed towards parrots and reptiles, but he says that in order for the flora to be a true match, it has to be cultured from a bird of the same species/sub-species. He said they have a very promising GCC conure culture in development (nationally, not at his office) but that the others are very broad (too broad).. I keep giving it anyway (because he said it's safe, just not very helpful lol--- I am not sold on its inefficacy, but his science seems sound...nevertheless, experience (for me) seems to indicate a certain level of success)...so I DO believe in probiotics to some extent--I keep giving them to mine.


I know lots of people give plain yogurt to their birds, and if it seems to work, go for it. My concern is always lactose-intolerance in parrots. Despite what my vet has said, I DO believe that Benebac seems to help my parrot resist infection, but it may be placebo. If you can afford Benebac powder (available on Amazon) I am more inclined to suggest that than plain yogurt. I am NOT DISCOUNTING LAURASEA'S INPUT!!! I just feel like it may be less likely to contain irritants...I am not telling you not to try yogurt-- you can, but the whole dairy intolerance (coupled with human strains) makes me inclined to choose something more specific for parrots (even if my vet is shaking his head at me).


If a tub of yogurt costs $4, you can get some very shelf-stable bene-bac for under 20 and it lasts for a much longer period of time.

 

[bill_e]

Thanks noodles123,

I'm asking for knowledge and just looking for data, I'm a believer in "if it ain't broke..."

I have a great memory and will file Laura's, and your answers for later use if the need ever arises.

 

[noodles123]

Thanks noodles123,

I'm asking for knowledge and just looking for data, I'm a believer in "if it ain't broke..."

I have a great memory and will file Laura's, and your answers for later use if the need ever arises.

Again, I know this has worked for her and she has a great track-record, so I am not trying to dismiss it-- I just don't understand why it would work...but at the same time, according to my vet, Benebac shouldn't be very significant, but I feel that it has been, so...just do what you will lol!


I actually wonder if the acidity or PH of the yogurt might even play a role in its efficacy for her, but I am not sure, as I do not use it

 

[Laurasea]

I'll have to find my sources. But it is on the parrot safe foods. It totally helped Ta dsh when she had a yeast overgrowth issue. Ellen D recommended it at the time. I just read a few days ago an article on the benefits of acidophilus in parrots.
And many breeders add to their hand feeding formula.
Lastly lol, I read the label on the birds probiotic powder you can buy, same culture as in yogurt. Same thing for benny bac.
I'm a big believer in the fresh, that's why I use yogurt, over the powdered stuff sold at pet stores.. ok off to Google

 

[Laurasea]

Will start putting info here
https://www.beautyofbirds.com/Lactobacillus.htm

 

[noodles123]

I'll have to find my sources. But it is on the parrot safe foods. It totally helped Ta dsh when she had a yeast overgrowth issue. Ellen D recommended it at the time. I just read a few days ago an article on the benefits of acidophilus in parrots.
And many breeders add to their hand feeding formula.
Lastly lol, I read the label on the birds probiotic powder you can buy, same culture as in yogurt. Same thing for benny bac.
I'm a big believer in the fresh, that's why I use yogurt, over the powdered stuff sold at pet stores.. ok off to Google

Lol! Love it-- again, I have no issue with trying it. I just know that my CAV thinks I am silly for continuing with Benebac, but then again, like I said, it DOES seem to work for me.


I know that in lactose intolerant humans that yogurt can be somewhat easier to digest (same with hard cheeses, like parmesan--and no, I am NOTTTTT SAYING to give parmesan to parrots lol!) but I am sure that there is some legitimacy to this-- just not sure it relates entirely to the cultures, as human and parrot probiotics are vastly different (from what I understand)...but it doesn't hurt to try, as long as you aren't seeing any negative side effects.




Here is a link that discusses the variety of intestinal flora in parrots: https://link.springer.com/article/10.1007/s13199-019-00613-7


At the end, the study states:


"
Potential effects of Lactobacillus on the gut microbiomes of parrots

Lactobacillus might benefit hosts by protecting the hosts against potential invasions by pernicious bacteria and promoting the absorption of protein, monosaccharides, calcium and magnesium (Hemarajata and Versalovic 2013; Valeriano et al. 2017). Lactobacillus has become the most common probiotic in commercial feed (Bai et al. 2013; Phuoc and Jamikorn 2017). Adding Lactobacillus into basic animal diets has become popular (De Angelis et al. 2006). A commercial feed with Lactobacillus was used in the zoo, but we did not see evidence that it could effectively withhold maleficent bacteria (such as Staphylococcus, Helicobacter, and Escherichia Shigella) in parrots (Figs. 6 & 7). Indeed, we found that Lactobacillus might significantly lessen the richness and diversity of gut microbiomes in parrots (Figs. 6 & 7); however, we did not characterize the effects on physiological activities of hosts. Therefore, more research is needed to clarify the influence of Lactobacillus on the gut microbiomes of parrots, which will offer guidance for adjusting parrot diets."

 

[Laurasea]

From the parrot magazine.
BTW o only feed a teaspoon, about every other week. I haven't had issues. I see pro and no articles out there..... I just trust EllenD, and it made a huge difference in my sick parrit Ta-dah who had a yeast overgrowth. So for me I am a believer.
Parrots Magazine.
" Plain, unflavored yogurt is the best type to feed your birds. Select a yogurt without any sugar, colorings or flavorings added. Avoid those containing starches, gelatins or tapioca. Your yogurt should be naturally thickened from the fermentation process."

 

[noodles123]

From the parrot magazine.
BTW o only feed a teaspoon, about every other week. I haven't had issues. I see pro and no articles out there..... I just trust EllenD, and it made a huge difference in my sick parrit Ta-dah who had a yeast overgrowth. So for me I am a believer.
Parrots Magazine.

I think that probiotics (as they are currently known) must be a lot like believing in God lol. I believe, so I give them, but there's limited poof (although I believe I have seen a big difference in mine since giving Benebac). That is why I said what I said- when it comes to plain yogurt, I worry about the RBST hormones and lactose, but in humans, it does seem that lactose impacts are reduced when yogurt is consumed (vs other dairy products). It is all confusing, but I am not saying you are wrong- I just don't know! lol Clearly we both believe in probiotics, despite limited research, which is why I say it probably doesn't hurt- I just wish I knew more.

 

[bill_e]

Didn't mean to start anything, just looking for a little education on the subject....thanks!

 

[Laurasea]

Noodles, I think you suggested this to me as well as EllenD a couple of years ago when Tadah was sick!!@@@

Birds are so different than us. But gut flora is hugely important in many creatures, play a role in immunity, permeability, Inflammation...do much.

I have autoimmune cascade of several conditions. One is gi , I get prescribed probiotics......
Anyway we are hijacking this thread.. lol