Veterinary Vexations: The right place at the right time

The quandary: My patients frequent emergency clinics for minor problems such as hot spots and torn dewclaws. Conversely, cats with dyspnea and dogs with heat stroke come through my general practice door too often. Why these venue mismatches? And how can I help my clients make better choices?

Photo: Ivanko80/Adobe Stock

Answers and solutions: For tiers of care, the offerings in the veterinary field have never been so vast. Not too long ago, the owner had one choice for their pet—their local general practitioner. These veterinarians were likely available 24-7, either in person or by phone after hours, and for anything from eyes to kidneys, topical treatment to emergency surgery. But today, the choices are jumbled.

“The options for triaging pets include general practice visits, urgent care visits during off-hours, emergency services, or telemedicine,” Michael Bailey, DVM, DACVR, president of the American Veterinary Medical Association (AVMA), said. When pets become sick or injured, he continued, clients are often uncertain where to seek care.

Erik Zager, DVM, DACVECC, head of emergency and critical care at Philadelphia Animal Specialty and Emergency in Pennsylvania, estimates that 20% to 25% of the cases that cross his threshold are not true emergencies and are better suited for their regular veterinarian. “They thought they saw a tick on their dog. Or their cat has been losing weight for 8 months,” he explained.

Urgent care centers are a nice step-down between emergency and general practice. They are for owners to use when the problem is now, and their own vet is unavailable. They also scratch the itch of I don’t think it’s serious, but let’s make sure.

Zager said his emergency cases are frequently referred by nearby urgent cares. He estimates that he sees more second-hand cases from urgent cares or general practices that should have come directly to the emergency department than vice versa.

The pet owner’s first stop is not always the ideal one because most pet owners don’t have the medical background to triage their own pets, said Lenore Bacek, vice president of clinical affairs at Blue Pearl Specialty and Emergency Pet Hospital.

“I’m sure a lot of owners are confused between what an urgent care [facility] would do vs an emergency [team] vs their regular veterinarian,” she said. “But I would rather someone err on the side of caution and go to [the] emergency [department].”

Many owners are doing just this. According to Mordor Intelligence, the veterinary emergency care market is set to hit $20 billion for 2025, with North America taking the lead.¹

Many factors are at play.¹ Millennials and Gen Z populations drive pet adoptions and pursue emergency intervention more readily than their predecessors. Also, pet insurance penetration has grown recently, enabling owners to seek costly emergency and specialty care.

The AVMA lists 13 actual emergencies that warrant immediate veterinary care or consultation. These include seizures, fractures, eye injuries, breathing difficulty, and toxin exposure.² Owners generally seem to have received the “memo.”

Investigators have found that accidental ingestions (toxins or foreign bodies) represent nearly one-third of the veterinary emergency care market last year, with respiratory distress cases on the rise.¹ 

For emergencies, must owners properly call the play? Zager said sometimes “emergency” is in the eye of the beholder. “My most experienced [emergency] doctor used to roll her eyes at every ear infection that came in, until her own dog got an ear infection that couldn’t wait until the morning,” he said.

Zager also said he thinks owners who are not “married” to a particular veterinarian in their usual hospital are more likely to head off to the emergency practice. “Sometimes they come into our emergency hospital because they want to hear better news than what they got from their regular vet,” he added.

Aime Berman, VMD, medical director at Dutton Road Veterinary Clinic in Philadelphia, Pennsylvania, said these second opinions, whether the problem is big or small, suggest a lack of trust between the client and their regular veterinarian.

But not always. Berman pointed out cases such as the suspectedintestinal foreign body that everyone is afraid to cut. The client cannot afford the recommended ultrasound to confirm the diagnosis and instead goes to an emergency care provider for a second opinion.

Nationwide Pet Insurance, which covers more than a million pets in the US, has identified 3 different pet owner personas based on how they select veterinary care. The first persona, explained Nationwide’s chief veterinary officer Emily Tincher, DVM, is care focused and prioritizes their pet’s health. They trust their own veterinarian but will go elsewhere if necessary.

The second is cost focused. Less likely to have a regular veterinarian, these owners access care when necessary and are unwilling or unable to pay a lot. The third persona is focused on convenience. These clients are busy and navigate care in ways that work for them.

So whether an owner overshoots or undershoots in their venue selection has much to do with their personality characteristics. “I think many people go to specialists for certain things that maybe a general practitioner can handle,” Berman said.

There are a few problems with this. First, emergency care is expensive. According to the pet health educational resource organization Preventive Vet, emergency care exams for dogs run from $96 to $236 and are slightly lower for cats.³ Emergency treatment for gastroenteritis and pancreatitis, which usually can be addressed at a regular clinic, can run into the thousands.

Anita McMillen, owner of Braden Run Animal Hospital in Waynesburg, Pennsylvania, recalls one of her patients, a 6-lb Yorkshire terrier, that ate some chewing gum. The animal’s owner rushed her to the local emergency practice, where her 4-day stay yielded some eyebrow-raising numbers: 8 veterinarians, 4 catheter changes, and an $8000 bill.

Speaking from her clinical experience, Tincher noted, “As you escalate up the level of care, the cost and the waiting times go up…. If I’ve got a hemoabdomen and a hit-by-car case, it might be hard for me to remember that the ear infection that’s here feels like an emergency to that owner.”

This is stressful for everyone and strains resources. Mary Jane McNamee, JD, VMD, co-owner of Apple Creek Veterinary Hospital in Lebanon, Pennsylvania, said her local emergency department has started to triage cases and send home those that are not true emergencies. “I appreciate that they are trying to break the cycle,” she said, “but really they have to focus their resources on those cases that are truly emergent.”

Nationwide’s Vet Helpline, a teletriage program offering 24-7 video consults with veterinary professionals, steers pet families to the right level of care when problems arise. This improves outcomes while balancing costs and other concerns, Tincher explained.

Human medicine has long embraced the concept of right care at the right time at the right place, which, Tincher explained, veterinary practices of all types can promote to their clientele in various ways. These include online billboards, TikTok videos, instructional voice mail messages, lobby art, and good verbal communication with owners.

“By providing clear, proactive guidance,” AVMA’s Bailey said, “the veterinary health team can improve efficiency; reduce stress for clients, pets, and staff; and ensure timely, appropriate care for their pets.”

References

1. Mordor Intelligence. Veterinary emergency care market size and share analysis-growth trends and forecasts (2025-2030). Accessed September 10, 2025. 2024. https://www.mordorintelligence.com/industry-reports/veterinary-emergency-care-market#:~:text=Veterinary%20Emergency%20Care%20Market%20Analysis,triage%20times%2C%20improving%20clinical%20outcomes
2. 13 animal emergencies that require immediate veterinary consultation and/or care. American Veterinary Medical Association. Accessed September 10, 2025. https://www.avma.org/resources/pet-owners/emergencycare/13-animal-emergencies-require-immediate-veterinary-consultation-andor-care
3. Pet emergency statistics and veterinary costs. Preventive Vet. Accessed September 10, 2025. https://www.preventivevet.com/pet-emergency-statistics