polyps, steroids, average vet's capabilities

Have about a 10 year old cat. Last vet found an aural polyp that he
thinks is mostly responsible for his chronic sneezing, and mucous. He
also has a swollen nare that is erythematous, firm, round. It's not a
nodule, is smooth and redness increases and decreases with small open
sore that occasionally bleeds or white cell discharge. Have tried some
natural anti-inflammatories, but no luck. Looked for allergies but
cannot find anything obvious. Vet thinks it is esophilic granuloma. I
suspect it could also be beginning SCC.

Many here advertise "full service vet", but really are not judging
from the equipment they have. They do not have x-ray capability, in
house labs, and other things.

Questions please:

How reliably can the average vet/lab determine definitive cause of the
nasal swelling? What is the least invasive method that is reliable?

What questions should I ask to determine if the vet is capable of
properly diagnosing this condition and doing nasal surgery in case the
nare is malignant? Sneezing could also be partly due to some viral
condition, but there is no eye involvment. He occasionally paws
forcefully at his nose as if to try to eliminate some obstruction-it
is swollen such that the breathing is effected, and he reopens the
sore, so it is obviously bothering him.

What is the estimated cost to determine the exact cause of the nostril
problem? If malignant what can I guess will be the cost of surgery.
What clinical tests would find the cause most efficiently?

Last vet wanted to put him on prednisone, and thought an allergic
response might be a factor. I have tried several different foods, some
seem to aggravate his condition, but have found no definite allergic
response to anything. If the nasal problem is malignant what effect
will the prednisone have on the problem-will it accelerate any
possible cancer? His breathing is sometimes worse than other times,
but not so bad that he is mouth breathing. Same for his sneezing-it
comes and goes.

Thanks for any educated answers from people who actually read the post
before replying ;-)

What is the estimated cost to determine the exact cause of the nostril
problem? If malignant what can I guess will be the cost of surgery.
What clinical tests would find the cause most efficiently?

There is no standard estimate for any procedure, especially such as this. It
all depends on the cost to the doctor/hospital. Depends on how much
monitoring equipment they use, how many staff are used for surgeries, what
medications/anesthesia used, what their recovery facilities are, what
pathologies they opt for and where they send them out to, how many doctors
staff the hospital or if it's a specialty center. Overhead comes in many
different forms including medication, facilities, equipment, staff/payroll,
insurance etc. And estimates (also commonly called treatment plans) are
nothing more than guesses. They are not guarantees - just ball park figures.
Surgery could last longer, or shorter, than estimated. Depending on what the
doctor finds, there could be more expense in the medication department, etc.

In short, you get what you pay for. We tell people (and we are mid range
priced, not specialized, but AAHA accredited) that if they are looking for
the cheapest vet and cheapest care, they've come to the wrong place. If
they're looking for the hospital with the best care, educated staff and very
good facilities, then we are where they want to be. In the end, you make the
decision. Don't be afraid to ask to tour the facility. They should have
nothing to hide, unless they are taking care of another client in an area
and need to protect confidentiality.

Ask for an estimate with a low and high end, and don't expect it to be spot
on. For non-elective procedures, it's just not possible to have ESP and
predict everything that could come along.

-Sharon

"Sharon Too" wrote in
:

What is the estimated cost to determine the exact cause of the
nostril problem? If malignant what can I guess will be the cost of
surgery. What clinical tests would find the cause most efficiently?

There is no standard estimate for any procedure, especially such as
this. It all depends on the cost to the doctor/hospital.

edited

Disagree completely. A good experienced clinician CAN tell you the most
cost efficient and best route to take. That is THEIR JOB. Should be easy
for anyone knowledgeable in the field especially given the O.P. has
given a quite specific clinical picture.

If they cannnot do that, look elsewhere. Some of these high price
clinics exist to make money and the often involves taking the scenic
route at patient's expense. They buy their state of the art facilities
and then expect you to pay for them whether you really need them or not.

Disagree completely. A good experienced clinician CAN tell you the most
cost efficient and best route to take. That is THEIR JOB. Should be easy
for anyone knowledgeable in the field especially given the O.P. has
given a quite specific clinical picture.

This wasn't a question about what would a 'cost efficient' be or what the
'best route' is to take. This person wanted to know an estimate for the
surgery. We can't do that from across the web. My point was that an estimate
is just that - and estimate. Any good clinician would NEVER give a set cost
for any non-elective procedure. A ball park figure with a high and low end,
yes. But no one can get it to the penny.

"beenthere" wrote in message
...
"Sharon Too" wrote in
:

What is the estimated cost to determine the exact cause of the
nostril problem? If malignant what can I guess will be the cost of
surgery. What clinical tests would find the cause most efficiently?

There is no standard estimate for any procedure, especially such as
this. It all depends on the cost to the doctor/hospital.

edited

Disagree completely. A good experienced clinician CAN tell you the most
cost efficient and best route to take. That is THEIR JOB. Should be easy
for anyone knowledgeable in the field especially given the O.P. has
given a quite specific clinical picture.

If they cannnot do that, look elsewhere. Some of these high price
clinics exist to make money and the often involves taking the scenic
route at patient's expense. They buy their state of the art facilities
and then expect you to pay for them whether you really need them or not.


Often you don't know until you get in there. Vets aren't omnicient. If you
want a firm price, they can always quote high, and charge you that.

I know at the clinic I volunteer at, they won't quote firm prices on
dentals. Why? Because when you get the animal under, and really start poking
around their teeth, you find more have to come out that you would have
thought, or sometimes you find that none have to come out, or sometimes you
find that a massive tooth that looks healthy (but isn't once you get a
*really* close look) has to come out and its going to take a very long time.

So, they are faced with two options:

1. Be wishy washy about the price.
2. Be firm on the price, but quote so that all the 'maybes' are included.
(in which case on average the client would end up paying more).

Dale

It would be nice if someone actually READ my posts and saw that I
asked several important questions, and price was only one of them.
Maybe I need to bring down my language to a layman's level as
apparently there are no veterinarians reading or answering these
groups, nor even technicians, as they cannot answer the medical
questions I posed.


On Mar 21, 4:00 pm, "Dale Atkin" wrote:
"beenthere" wrote in message

...



"Sharon Too" wrote in
:

What is the estimated cost to determine the exact cause of the
nostril problem? If malignant what can I guess will be the cost of
surgery. What clinical tests would find the cause most efficiently?

There is no standard estimate for any procedure, especially such as
this. It all depends on the cost to the doctor/hospital.

edited

Disagree completely. A good experienced clinician CAN tell you the most
cost efficient and best route to take. That is THEIR JOB. Should be easy
for anyone knowledgeable in the field especially given the O.P. has
given a quite specific clinical picture.

If they cannnot do that, look elsewhere. Some of these high price
clinics exist to make money and the often involves taking the scenic
route at patient's expense. They buy their state of the art facilities
and then expect you to pay for them whether you really need them or not.

Often you don't know until you get in there. Vets aren't omnicient. If you
want a firm price, they can always quote high, and charge you that.

I know at the clinic I volunteer at, they won't quote firm prices on
dentals. Why? Because when you get the animal under, and really start poking
around their teeth, you find more have to come out that you would have
thought, or sometimes you find that none have to come out, or sometimes you
find that a massive tooth that looks healthy (but isn't once you get a
*really* close look) has to come out and its going to take a very long time.

So, they are faced with two options:

1. Be wishy washy about the price.
2. Be firm on the price, but quote so that all the 'maybes' are included.
(in which case on average the client would end up paying more).

Dale

It would be nice if someone actually READ my posts and saw that I
asked several important questions, and price was only one of them.
Maybe I need to bring down my language to a layman's level as
apparently there are no veterinarians reading or answering these
groups, nor even technicians, as they cannot answer the medical
questions I posed.

I read everything but only answered where my expertise is as a practice
manager. I'm not qualified to get into the deeper medical issues. Hopefully
others will fill in the blanks.

-Sharon

On Mar 21, 6:54 pm, "Sharon Too"
wrote:
It would be nice if someone actually READ my posts and saw that I



:

I think it is completely unreasonable for someone to post and expect
answers to magically appear. Particularly within the time frame of
only several hours (in this case approximately six hours).

The folks on this board, unfortunately for you, are not here at the
mercy of your whims. We have lives too.

We are not veterinarians and can only answer questions within our own
ranges of "expertise".

Sorry for you if you feel "inconvenienced" to have to read through
several posts to get the answers you are seeking.

Perhaps your best bet would be to contact several veterinarians
offices with your "significant" knowledge of the condition and proceed
to get some opinions from some veterinarians directly. Certainly, that
will take some time and effort on your part, but most likely you will
get the answers you are specifically seeking.

Unfortunately, things are not always as easy as it seems like they
should be sometimes.

There are actually QUITE A NUMBER OF VERY KNOWLEDGEABLE people on this
board who could probably help you... but with your pathetic attitude,
you may not get very far.

How sad for you. Pathetic.

Maybe you should wait to see if you get some response from the
alt.med.veterinary group since you posted your message there too. Or call a
vet's office instead of posting a message on newsgroup if you want "medical"
advice.

S.
wrote in message
...
It would be nice if someone actually READ my posts and saw that I
asked several important questions, and price was only one of them.
Maybe I need to bring down my language to a layman's level as
apparently there are no veterinarians reading or answering these
groups, nor even technicians, as they cannot answer the medical
questions I posed.


On Mar 21, 4:00 pm, "Dale Atkin" wrote:
"beenthere" wrote in message

...



"Sharon Too" wrote in
:

What is the estimated cost to determine the exact cause of the
nostril problem? If malignant what can I guess will be the cost of
surgery. What clinical tests would find the cause most efficiently?

There is no standard estimate for any procedure, especially such as
this. It all depends on the cost to the doctor/hospital.

edited

Disagree completely. A good experienced clinician CAN tell you the most
cost efficient and best route to take. That is THEIR JOB. Should be
easy
for anyone knowledgeable in the field especially given the O.P. has
given a quite specific clinical picture.

If they cannnot do that, look elsewhere. Some of these high price
clinics exist to make money and the often involves taking the scenic
route at patient's expense. They buy their state of the art facilities
and then expect you to pay for them whether you really need them or
not.

Often you don't know until you get in there. Vets aren't omnicient. If
you
want a firm price, they can always quote high, and charge you that.

I know at the clinic I volunteer at, they won't quote firm prices on
dentals. Why? Because when you get the animal under, and really start
poking
around their teeth, you find more have to come out that you would have
thought, or sometimes you find that none have to come out, or sometimes
you
find that a massive tooth that looks healthy (but isn't once you get a
*really* close look) has to come out and its going to take a very long
time.

So, they are faced with two options:

1. Be wishy washy about the price.
2. Be firm on the price, but quote so that all the 'maybes' are included.
(in which case on average the client would end up paying more).

Dale