On Dolittler (Fully Vetted's former incarnation), I used to offer you a series of posts designed to demystify the expenses associated with keeping your pet healthy -- particularly with respect to veterinary products and procedures. Since I really don't know why I stopped writing about this crucial topic, it's probably time to reprise it.

This time, it's all about injectable drugs and why they cost what they do. It's a subject I find especially fascinating since it's an area most consumers of veterinary services tend to ignore. Yet when it comes to identifying how a big bill got that way, the savvy invoice scanners among you (especially those whose pets are plus-sized) will often make a quick discovery: The danged injectable drugs nearly double the bill!

Now, it's not always so obvious as that. Nor are injectables disproportionately expensive to the same tune in every hospital. But vet medicine is clearly headed into this pricier-drug landscape, one in which drugs and products comprise more of your pet's expenses than the veterinary services themselves.

Yes, this truism was brought to you by a pharmaceutical company near you. Their goal? To create drugs and products that improve your pets' health so effectively you'll not want to let them go without. Their game? To price these products carefully so that they can: a) at the very least recoup their investment, and b) make the product as profitable as possible.

Makes sense. Trouble is, sometimes the drugs are priced so high that veterinarians feel they can't hardly charge for anything except the service connected to administering the drug. After all, there is no fee attached to coming up with the right diagnosis and there's only so much we can charge for an office call, regardless of how much time we spend with your pet. Drugs, especially those of the injectable variety, are often how we manage to make up the difference.

Why the injectables? Because the dispensable drugs (pills and such) are different. We can't rightly mark these up too much seeing as: 1) pets often need them on a chronic basis, 2) competition abounds, online and elsewhere, and 3) we're finally starting to get used to losing the the in-house pharmacy as a profit center.

But with the injectables we see things differently. We feel comfortable pricing them higher because we can file this procedure under "service," which indeed it is. How an injection is administered, I'm sure you'll agree, is an important aspect of care.

For example, when a veterinarian draws up a drug with one needle and then replaces it with a fresh, sharper needle to help minimize any discomfort, that's not only a kindness, but a valuable aspect of the service that distinguishes it from other practitioners' versions. Warming the drug, anatomic placement, drug storage, and clinical skill all play into this as well.

Still, does that justify the sometimes 1,000 percent markup I've seen on some invoices? Um … probably not. But it all depends on a hospital's overall pricing strategy. Because if the office visit is only $30, it matters less that the injectable drugs are priced at a 500 percent markup. (So you know, this is a common approach: low prices on the items clients price-shop for and high prices on those they'd never think to ask about.)

Then there's this to consider: Small animals and large animals get different-sized doses, of course. Some hospitals price injectable drugs strictly according to the size of the animal, so that a Rottweiler will incur about ten times more of an expense than a cat. Some hospitals will be more lenient on the Rottweiler and less so on the small cat or pocket-dog, charging more of a one-size-fits-all fee.

The last issue to consider is this one: Does your pet really need that injection? Hmmm … not always. Sometimes it is just an invoice padder, seeing as we know we can charge more for injectables. But then, if you suspect your veterinarian of padding the bill, you're probably not still going there, right?

Dr. Patty Khuly

Pic of the day: "moneybags" by boxchain