The post-Thanksgiving weekend is perhaps the busiest in pet emergency rooms all over the U.S. It's no surprise, then, that the retail store version of Black Friday should also apply to most animal emergency facilities. The holiday season is when we finally start to show profits for the year. Which, of course, means you're probably spending a lot at these places.

The reason for the ER's enhanced traffic this time of year should be plain: Regular veterinary hospitals are closed. People are home with their pets to watch them get sick. And pets, like their owners, eat excessive amounts of rich foods their GI tracts are less accustomed to than their owners'. Read: diarrhea and vomiting, maybe even pancreatitis (this syndrome is otherwise known as "garbage gut").

Less obvious is the reason these places are so expensive. Most of my clients who've been forced to go to these places in my absence are not very happy about it. Though they're almost uniformly satisfied with my favorite ER's care, they're less than pleased with the bill.

Double the price? Triple? Seriously?

Having run a veterinary emergency facility in one of my past lives, I happen to have a pretty good grasp on why this might be. Not that every ER is worth the up charge (I've met some serious losers in my day), but the ones who do great work in your vet's absence absolutely deserve their premium charge. Consider these six qualities:

1. The hours!

Few people really like working evening, overnight, and weekend hours. It's just not fun. And the older you get, as I have had occasion to learn, the harder it is to do a good job at 3 a.m. The pay has really got to be good enough so that staff can make good money working only three overnight shifts a week. Any more than that and staff tends to be over-tired. Since payroll is the biggest expense at any animal hospital, you can see how the premium the ER staff requires would translate directly into more expensive care.

2. Reliable presence after hours

The hospital shouldn't be an on-off kind of a facility. It should be professional and reliable. And that means staffing it fully on a permanent basis. A veterinarian 365 days a year. Technicians and kennel staff to match the on-off demand for after-hours vet care. That's expensive!

3. Full 24/7 availability

This is no mere after-hours place (though some of those can be great, too). My favorite places don't make my owners show up at 7 a.m. to transfer their pets back to their regular vets. The continuity of care is a valuable thing.

4. Highly trained staff

Not just trained staff but licensed and certified staff. Certified technicians mean your pets get extra-high quality care, worth every penny in the event of a serious emergency.

5. Close relationship with regular veterinarians

If your emergency hospital maintains a close relationship with your regular veterinarian so that continuity of care and your pet’s long-term best interests take precedence over the kind of short-term thinking that sometimes holds sway with one-time-only patients. Keeping close ties with the regular veterinarian means better record-keeping, extra phone calls and more staff time. It's worth the premium.

6. Higher quality equipment and services

Because ER facilities often have to tackle the biggest and baddest emergencies other hospitals can't handle, high-tech equipment and it's equivalent know-how is required. Everything from oxygen cages and infusion pumps, access to specialists and emergency radiology consults, all require, and deserve, a higher price tag for these services -- even when you're only showing up at midnight because your cat won't stop scratching herself.

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So should these six qualities of a vet ER translate into double and triple the price? You make the call.

Dr. Patty Khuly

Pic of the day: "elliot" by Andrew Ciscel