Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:05/29/2025

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  May 24, 2025, we had an emergency visit with her 12-year-old cat, who was suffering from respiratory distress.Upon arrival, we were told that we would receive an estimate and billing information before any treatment was given, which is also outlined in Pet ER 24/7s own Authorization for ******************** Admittance document. That document clearly states:I understand that payment of the estimated amount is due in full before treatments are administered. This means that I am required to pay the entire estimate cost of my pets treatments before procedures or treatments begin.However, no estimate was ever provided prior to treatment. The veterinarian stated that an X-ray was needed but gave no pricing, and no one discussed costs with us until after all diagnostics were performed and a diagnosis was made. After learning the condition was related to chronic asthma, my auntheartbroken and seeing her cat in distressmade the incredibly difficult decision to proceed w euthanasia.Only at this time, when she was at her lowest and most emotionally vulnerable, were we presented with a bill totaling $877. This was the first time we were shown any cost information. ** wouldnt make any adjustments. The receptionist then added, If you dont pay, you can take the cat and go somewhere else and go through this all over again.This response was not only insensitive and unprofessional, but it also ignored Pet ER 24/7s own stated policies. The estimate form also includes these promises:All efforts will be made to contact me before exceeding the estimate. ( I was in the office)Additional treatments and procedures... will require additional cost estimate and discussing treatment plans and progress status with the doctor.These procedures were not followed. No estimates, no consent to charges, no communicationjust a bill presented after the fact, once the most emotional decision had already been made.

  Business Response

  Date: 06/05/2025

  *** *****: First and foremost, please accept our sincere condolences for the loss of your beloved aunts pet. We understand how difficult such moments can be, and we extend our heartfelt sympathies to your family.
  However, we must address certain aspects of your review with transparency and accuracy. Our records show that during a previous visit, your auntor the individual acting on her behalfinitiated a chargeback after receiving and expressing satisfaction with the full scope of services rendered. Despite this, she returned to Pet ER, which we interpreted as a reflection of her trust in the quality and value of our care.
  As is standard in emergency veterinary services, we provided a detailed cost estimate upfront before any further services were rendered. This is a common and fair practice in medical transactions, giving clients the choice to proceed with full clarity or to decline without incurring charges. Your aunt demanded our stealth and speedy imaging to diagnose her cat's illness which helped her make an informed decision without undue delays and suffering.   Unfortunately, this estimate was met with belligerent back peddling scheme and  confrontational behavior, which disrupted our efforts to focus on your aunts pets care.
  We must be clear: Pet ER cannot continue to provide services to individuals who engage in patterns of post-service charge disputes, as it undermines the sustainability of our clinic, our hard-working staffincluding many who make personal sacrifices to serve our clientsand the many families who rely on our transparency and care during emergencies.
  We offer assistance programs for clients with financial hardship, and we remain committed to providing compassionate support. However, we cannot offer such aid retroactively when a history of chargebacks and disputed payments exists without prior communication or good-faith effort to resolve concerns.
  Once again, we are truly sorry for the loss experienced by your family. Pet ER is proud to continue delivering high-quality, efficient, and compassionate care to our community, just as we did for your aunts pet. We thank you for taking the time to share your perspective and wish you and your family healing and peace.
  

  Customer Answer

  Date: 06/06/2025

  Better Business Bureau
  Re: Complaint ID# ********
  I have reviewed the businesss response to my complaint and have determined that my concerns remain unresolved for the following reasons:
  There was no cost estimate provided prior to services being performed, despite multiple verbal requests. As stated in your own estimate document (#*****), Section 5 reads:
  I understand that payment of the estimated amount is due in full before treatments are administered. This means that I am required to pay the entire estimated cost of my pet's treatments BEFORE procedures or treatments BEGIN.
  This policy was not followed. The estimate was presented after all treatments had already been completed, directly violating your stated procedure and creating a breach of contract under basic contract law principles. For a contract to be enforceable, there must be mutual consent and agreement to its terms before performance. In this case, consent was not obtained until after services were renderedmaking the signature obtained post-treatment arguably invalid and unenforceable.
  I was asked to sign the estimate after the fact and only under duress. At that point, I was told that if I did not sign the document and accept the $877 charge, I would need to take the cat somewhere else and begin this process all over again, which would have further distressed both me and my elderly aunt. This coercive scenario may be considered economic duress, which can invalidate a contract under established legal precedent (see ************ Tug & *********** ** ***************************** ****).
  Additionally:
  When we asked for a cost estimate prior to any imaging or x-raysas we were told would happenwe were never provided one. This omission deprived us of the opportunity to make an informed decision, which is required in both medical and veterinary contexts. Informed consent is a legal and ethical obligation, and failing to provide pricing information beforehand can constitute a violation of consumer rights under state Unfair and Deceptive Acts and Practices (UDAP) laws.
  I was also asked to sign a consent form after all imaging and treatments had already been completed. Again, this violates the legal doctrine of informed consent, which must be obtained before any procedure is carried outnot after the fact.
  After signing, the estimate form appeared to be altered (with an X added through it), and when I requested a copy, I was denied one. This may constitute document tampering and a failure to provide legally entitled documentation, potentially violating state consumer protection laws and record-keeping requirements under veterinary licensing board standards.
  Furthermore, your response includes the following quote:
  Pet ER cannot continue to provide services to individuals who engage in patterns of post-service charge disputes.
  I find this statement inappropriate and irrelevant, as this was my first visit to your facility and the only dispute Ive ever raised. This comment appears retaliatory in nature and is not based in fact. It may also be construed as defamation or an attempt to discredit a legitimate complaint without basis.
  Lastly, your claim that
  We provided a detailed cost estimate upfront before any further services were rendered
  is factually false. The only fee I was informed of prior to any service was the $175 emergency fee. No other pricing was disclosed, discussed, or approved in advance.
  Based on the above, I am unwilling to pay for services I was not informed of or did not consent to in accordance with your own stated procedures. I respectfully request that the business take full responsibility for its failure to follow contract terms, uphold informed consent obligations, and comply with applicable consumer protection standards.

   

  
  **** ***
  
  
  
  
   
  

  Business Response

  Date: 06/09/2025

  ******** ** *** ********* *********
  *** *** ** **** ************ **** ***
  To Whom It May Concern

  
  We begin by expressing our sincere condolences to your aunt ****** ******* and her family on the passing of their pet. Pet ER 24/7 recognizes that medical emergencies are emotional experiences, and we strive to provide both urgent care and compassion during such times. Nonetheless, we must respond to this complaint with clarity, accuracy, and documented support.

  On May 24, 2025, the client ****** *******  presented to our emergency facility with a cat in acute respiratory distress. In such situations, stabilization and immediate assessment often take precedence to prevent suffering or further decompensation. While our standard procedure includes obtaining written and verbal authorization, in emergencies where delays could be detrimental to the patient, initial diagnostics may be initiated in parallel with communication. Nevertheless, our records indicate that informed consent was obtained, and care was delivered in good faith and consistent with veterinary emergency standards.

  Our "Authorization for Treatment & Hospital Admittance" document does state that estimated costs are discussed before treatment begins. However, it also includes provisions for urgent medical judgment and flexibility during time-sensitive presentations. Furthermore, clients are not billed without services being rendered, and any invoice reflects actual diagnostics and treatments performed.
  Contrary to the complainants statement, our medical team discussed the cats condition, diagnostic steps, and prognosis. The decision to proceed with humane euthanasia was not taken lightly and was made after consultation with the owner, who was counseled regarding options and clinical findings. The final invoice reflects fair and customary charges for diagnostics, radiographic imaging, medical consultation, and euthanasia.
  The complainant also references an insensitive statement allegedly made by a staff member. While we take such concerns seriously, we are unable to corroborate this exact phrasing. It is standard for our staff to advise clients that they may seek care elsewhere if they are unwilling to proceed with recommended treatment or financial policies. This is not meant to be insensitive but is a matter of transparency and consent.
  
  1. Signed Estimate and Transparent Consent
  The claim that no estimate or consent was given is objectively refuted by the signed "Authorization for Treatment & Hospital Admittance" form dated May 24, 2025, executed by ****** *******, the patients legal owner. The estimate, totaling $877.00, outlines all servicesincluding examination, imaging, IV catheterization, and euthanasiaand was signed prior to treatment.
  Payment was made in full by ****, and the cardholder receipt was signed by *** *** herself at the time of service. This was not a surprise bill or a post-treatment demand. It was a standard, agreed-upon transaction.
  
  2. Coercion Claim Is Without Basis
  Pet ER 24/7 does not coerce clients. The suggestion that emotional duress invalidates consent is legally tenuous in this case, as the client was explicitly offered the option to decline treatment and leave without financial obligation. Voluntary payment and signed authorization, following full disclosure, do not meet the legal threshold for coercion.
  
  3. Repeated Engagement Followed by Dispute
  We also highlight a concerning pattern: the complainant or her representative has previously sought and received services from Pet ER, only to initiate a post-service chargeback despite no documented dissatisfaction at the time. This practice of engaging, consenting, receiving services, and then disputing charges retroactively is disruptive and unsustainable in the animal emergency medical care model.
  
  4. Transactional Party and Scope of Consent
  The transaction in question was between ****** ******* and Pet ER 24/7, with *** *** electing to assume financial responsibility. If *** *** objected to the estimate or terms, she could have declined to pay, and no services would have been rendered. The act of paymentpreceded by a written, signed agreementconstitutes informed and voluntary consent.
  
  5. Document Alteration as Evidence of Dispute Mindset
  The signed estimate shows that the client attempted to strike through key binding clauses before signinga behavior that demonstrates a deliberate effort to undermine standard contractual language. These clauses exist to protect both parties and ensure mutual understanding. We cannot disregard our own legal and operational clauses simply because a client chooses to unilaterally nullify them before signing. This conduct reflects belligerence and a lack of good-faith participation in a clear, documented transaction.
  
  6. BBBs Limitations in Jurisdiction and Legal Interpretation
  Respectfully, we must also point out that the Better Business Bureau does not hold jurisdiction to adjudicate commercial transactions or to evaluate complex legal defenses such as coercion, contractual alteration, or third-party financial assumption. These are matters of civil law and case precedentareas which fall beyond the BBBs charter as a voluntary consumer mediation body. The complainants invocation of legal concepts such as coercion or contractual invalidity, while noted, are not within the BBB's scope to interpret, nor are they factually supported by the record in this case.
  
  To summarize:
  A signed estimate and consent were provided prior to treatment;
  Payment was made voluntarily and matched the estimate exactly;
  The complainant was never obligated to proceed and had the option to decline services;
  The Better Business Bureau does not have the authority to rule on legal matters or override contractual agreements supported by evidence.
  We remain committed to providing transparent, ethical, and high-quality veterinary care to the community. We believe this matter was handled professionally and in full accordance with our protocols and the terms agreed to by the client.

  
  Sincerely,
  

  Pet ER 

  Customer Answer

  Date: 06/13/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  
  Nevertheless, our records indicate that informed consent was obtained - FALSE -CONSENT OBTAINED AFTER EXECUTING CARE
  1. Signed Estimate and Transparent Consent
  The claim that no estimate or consent was given is objectively refuted by the signed "Authorization for Treatment & Hospital Admittance" form dated May 24, 2025, executed by Usulla *******, the patients legal owner. The estimate, totaling $877.00, outlines all servicesincluding examination, imaging, IV catheterization, and euthanasiaand was signed prior to treatment. - THIS IS FALSE - 

  
  offered the option to decline treatment and leave without financial obligation - FALSE - TREATMENT WAS ALREADY ADMINISTERED 
  We also highlight a concerning pattern: the complainant or her representative has previously sought and received services from Pet ER, only to initiate a post-service chargeback despite no documented dissatisfaction at the time. - FALSE AGAIN - I NEVER WENT TO THIS ESTABLISHMENT BEFORE - SLANDEROUS LIES
  she could have declined to pay, and no services would have been rendered - FALSE - SERVICES WERE ALREADY RENDERED - I WAS TOLD THE BILL WOULD BE SENT TO MY AUNT WHO DOESNT HAVE FINANCIAL MEANS
  The signed estimate shows that the client attempted to strike through key binding clauses before signinga behavior that demonstrates a deliberate effort to undermine standard contractual language. - FALSE - YOUR WORKER MARKED THE DOCUMENT WITH AN X - YOUR ESTABLISHMENT STRIKE THROUGH THE CONTRACT!!  NOT ME 
  To summarize:
  A signed estimate and consent were provided prior to treatment; - FALSE - ONLY AFTER TREATMENT
  Payment was made voluntarily and matched the estimate exactly; - FALSE - BEING TOLD MY DISTRESSED AUNT WOULD HAVE TO START THIS PROCESS SOMEWHERE ELSE (AND STILL BE RESPONSIBLE FOR TREATMENT LEADING UP TO EUTHENASIA) WAS NOT MADE VOLUNTARILY 
  The complainant was never obligated to proceed and had the option to decline services; - NEVER HAD OPPORTUNITY TO DECLINE UNTIL AFTER SERVICES RENDERED 
  Please proceed with the BBB giving ***** a negative rating. I am willing to pay for $175 fee that was disclosed from the beginning. If they do not want to settle, I will follow up in civil court as suggested.
  
  

  **** ***
  
  
  
  
   
  

• Initial Complaint

  Date:03/18/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Procedure date: 9/26/2023 Only received an estimate bill and was told would be on low side of estimate. Staff member at front desk said I will be capped at $4,000. She said I could save a little bit of money if the doctor does not send out for additional X-ray review at 3rd party lab. She mentioned a patient just before me was able to reduce her bill by $85 by requesting no additional X-ray review. Paid $4,000 in full Never received an itemized bill. Was told computer not printing. Requested email copy and never received I received a surprise bill for $58 in one month and spoke with staff. The doctor refused to speak with me. One month later I was sent to collections. I called collection agency and explained the circumstances. She advised this $58 did not get reported to credit bureau.She allowed me to setup payment plan for $5 per month but I would have to call each month because this is not technically considered a payment plan and I will not receive a bill every month. 3/15/24 Paid $5. Balance $53 In conclusion, this entire transaction is unethical and feels like a scam. I do not feel I should pay the $58 but trying to protect my 766 credit score. I have had perfect credit for over 20+ years. This man is a con and a fraud and should have his medical license revoked.

  Business Response

  Date: 03/23/2024

  Dear Better Business Bureau, 

  Pet ER 24/7 LLC, our team of inquisitive pet urgent care personnel and myself responded, evaluated and performed a life saving surgery to save ******* life. Our office extended a cost estimate to *************************** ranging from $3,389.00- $4,059.00 to cover the cost of pre-op care, surgery and post op ICU care, capped to a maximum $4,059.00 including to cover complications. This cost is far below industry standards in the region, and in this particular area of small animal emergency, which is also  enshrined in our added value of surgery services to our business model, so we may attract client base to use our services in the future that are not necessarily surgery.  ***** did very well and made a remarkable recovery, we are happy to hear ***** is alive and well. Because our surgery cost is capped, our office discounted significant amount of funds that we normally allocate at a cost to monitor recovery utilizing monitoring devices or unforeseen injections that we determine needed, notwithstanding ICU personnel time tied up to a critical patient in recovery mode. Because ***** required oral medication to continue recovery at home and prevent infection and pain, our office invoiced the higher end of the estimate, rightly so, and discounted all cost above that end. We also completed status rechecks and incisional staple removal during the recovery phase at no cost to ***************************. To that end, Pet ER 24/7 LLC, our inquisitive urgent care personnel and myself would like to congratulate ***** for being with us today. ***** is no exception, our office lives great life stories daily, and as such our office earned a prestigious name and characterization on the part of civilized communities we serve, unlike the name calling and characterization *************************** champions. *************************** is welcome to join in with our civilized communities and pay funds she owes to our office;  or in the alternative our civilized communities we serve have a name and a characterization for actions on the part of *************************** that seeks to  brake the rules and deny our office funds she owes. To that extent, our office will continue to ascertain our rights in securing the funds she owes to Pet ER 24/7 LLC. *************************** will not be welcome to enter our office again, our business culture and friendly work environment does  not tolerate belligerent, bully and toxic conduct our office and unsuspecting personnel have experienced on her part as a result of the experience before us. Once again, Pet ER 24/7 LLC would like to thank Better Business Bureau for bringing this matter to our attention, and we continue to congratulate ***** for being with us today. 

  All the Best to ***** and Family

   

  ** ******* * *** ** **** ***

  Customer Answer

  Date: 03/25/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  Dear better business bureau,

  In review of Pet ER's response its clear they didn't take the time to read my complaint, but rather deciding this is an opportunity to ****et their brand and services! Nothing in my complaint was belligerent or hostile and at no point did I attempt to bully anyone or place. In truth Pet ER's response is a passive aggressive attempt to indirectly call me hostile & belligerent while trying to discredit me personally. As a consumer we are all entitled to provide fair and honest assessment on service rendered or goods received to keep other consumers informed. We can not allow for businesses to respond in this manner, claim victim and take advantage of consumers, especially as costs continue to rise. The facts of this situation remain unchanged, I was provided an estimate capped at $4,000.00 not $4,059.00, we paid that 100%, leaving $0 balance, a few days after picking ***** up I received a call stating due to internal administrative issues they mis quoted me and requested an additional $59.00. Perhaps I should be happy they didn't increase the cap by $500.00 All services noted in Pet ER's response was included in our capped estimate, nothing was added! To be nickeled and dimed after paying $4,000.00 for ******* care is poor business practices turning a positive experience into a poor one. This situation appears un ethical, Pet ER could make a decent amount of money if every patient is asked to pay $25, $50 or even $100 more than their "caped estimate", playing on emotional strings of pet owner.

  Our family lives local, were involved locally and value relationships, it's sad to see that a small business would destroy a relationship with a patient over $59.00, especially knowing we paid our balance in full prior to surgery. Pet ER really missed the customer service **** as well! As noted above we will pay $5.00 a month to collections, based on Pet ER's business practices they will need the money more than we do.

  [Your Answer Here]

   

   

   

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

  
  Sincerely,
  
  ***************************
  
  
  
  
   
  

• Initial Complaint

  Date:12/19/2023

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I dont have enough characters to tell the entire problem. Ive uploaded it in the following section. Problem one charged for services not rendered $2600 10/19/23 this one Id agree to an adjustment Problem two charged for services not agreed to $397 12/12/23 this should fully be refunded

  Business Response

  Date: 01/02/2024

  Good morning

  Thank you for the opportunity to respond to ********************** complaint: 

  I will address specific statements ****************** outlined, I will also outline elements in our records to help both rebut and flesh out many of ********************** assertions. I will also draw inferences with merits to help explain Pet ER's processes which *** help both ****************** and your Agency address the complaint. 

   

  1) I,  and our office do not engage in conversation involving another Veterinarians performance or assessment,that which rise to breach of the States bylaws and code of ethics. In the case of ******, I communicated to ****************** that I detected large amounts of free and septic peritoneal fluids (within the belly) which were not present from reading the ultrasound reports of a study completed earlier that day and by competent sources. This, I made it clear to ****************** concludes that fluids had critically escalated within hours from when ****** had been seen, and so did sepsis. This also testifies to the progression of the disease process (acute abdomen), NOT the performance of another Veterinarian or assessment thereof.  

  
  2) We had moved all our resources to save Boomer including blood product transfusion to curb the escalating sepsis, thanks to our offices lean and tactical diagnostics early in the process. ****** passed despite, and we moved to issue a partial refund of the cost that would have covered extended *** stay and additional monitoring, testing and therapies, because Boomer passed and did not stay in our *** much longer.
  Our *** stay billing is 24 hours at a time once we move the resources to keep a critical patient in the **** we moved all the resources and staffing to save Boomer and the 24 *** stay fee stands. Once the resources are moved to save a patient, they remain by the patients side until the fee renews 24 hours later. Those resources remain the same for the duration of 24 hours,and their cost cannot be undone once deployed, because they are a cost to our business and operations.  

  
  3) ****************** returned to use our services several weeks after ****** passed in our care to fatal septic abdomen, she returned  without raising any questions or issues about the care of ******* fees or refunds, which would suggest she was satisfied.
  ******************  clearly **** similarities this time around to her passing Boomer weeks earlier,  because in her words she was paranoid. I and our office have no control over her decision to refuse treatments. She refused treatments and did so unhindered.

  
  4) I,  and our office operate within the urgent critical care area of Veterinary medicine. I am independently liable to the patients assessment I draw,  and therefore investigate and treat based on my findings and review at the time I evaluate an incoming emergency or critical patient. I don't make findings or treatments based or ******************** wish or what her Vet told her. We cooperate openly and fully with the ********************* primary Veterinarians however are not available most of the time during our assessment, and out critical diagnostics and therapies therefore are not guided by what her Vet had told her, furthermore I and our office do not apply therapies based on therapeutic plans ****************** had drawn or suggested.In this case, I and our office was notified of her in coming ill pet and that his blood glucose was high. We immediately checked his Blood glucose which was critically high just under 800, a fast scan was also completed to make sure we detect other comorbidities which *** hinder our ability to control blood glucose levels and the complications that come with it. This was our experience with Boomer weeks earlier when were  able to detect fatal sepsis and large amount of free peritoneal fluid along with pancreas that had shaped up into a mass. I and our office obtained permission to check blood glucose and a fast scan and ****************** did not object. I returned to the exam room and sat on the table with ****************** and her Partner and engaged in face to face conversation to brief her with the findings and the course of action including *** stay, and insulin slow drip and other necessary therapies to address the findings. I informed ****************** that based on the fast ultrasound scan,******** had shaped up into a mass structure (****************** has those images and our records indicate that she clicked on the link to review then and successfully); this *** render Blood glucose control difficult, unless the proper sampling is completed to understand and characterize the nature of pancreatic shape.  **************************** and **** similarities with her passing pet from weeks earlier and concluded that her pet had cancer and in her words had a gigantic mass. ****************** and her Partner voiced disagreements over the course of action after I discussed *** stay and therapies, and I yielded to their privacy to discuss that matter.They had left our office and suggested to our front desk that they would be coming back to humanely euthanize the patient.
  ******************** statement are both vague and lack specificity,because in medical terms, our clinical judgment and assessment is much more complex and land itself to specific clinical assessments and guidelines. Diabetic Ketoacidosis (in human medicine referred to as crashing diabetic) is not a beginning,  it is a serious complication of diabetes as we understand it- in any event we did not deny ****************** treating it at our ***. Our hospital does not make findings and treatment plans at the owner's wish or their primary Veterinarian- we are independently liable and devise plans as such, albeit in close cooperation with the primary Veterinarian. In any event we did not depart from the gold standard treatment of complicated diabetes neither denied treatments to ******************** pet.

  
  5) Our records indicate that ***************** checked in and out within just over an hour (this time was allocated to both rush patient into the *** for initial screening, making findings and one on one discussions, along with ******************** private discussion with her Partner in the exam room when I yielded to their privacy). ****************** awaited less than 20 min because I was in the middle of completing an ultrasound on another urgent patient, our nurses can testify to this. ****************** was at liberty to depart  to an alternate hospital if she felt she waited for hours and worried about her pet. We rushed him into the *** and checked his blood glucose and a fast scan because we decided he was urgent and needed immediate attention.

  
  6) Our staffing structure is outside the scope of ******************** jurisdiction. ******************** assessment of our staffing and hours of operations would be grossly arbitrary if she was able to make that assessment because in her words she wants to shut down the place. Nevertheless every time ******************  came with her pet,  our office was available to address their emergency because we are open 24/7. There are multiple other emergency hospitals she is at liberty to go to. Our office was fully operational as always when she came in and I was assessing other emergencies, I did not have to arrive from anywhere else except from the *** area to meet ******************.  

  
  7) Our emergency exam or a distressed patient involves points of critical care especially in acute abdomen based on our experience with her previous pet where we detected catastrophic lesions that led to his death. A fast scan is always part of our points of critical care so we *** understand more about the critical elements of illness and make sure we don't miss sources of distress. I informed her of the scan and blood glucose and she did not object to it; the patient was discharged against medical advise and with no objection on her part. She also requested the images be sent to her vet.

  
  8) Our reports we disclosed to the primary Veterinarian indicate that she **** similarities with her previous pet. She said she was paranoid. Our ultrasound captures detected altered soft tissues in shape and echogenicity over pancreas consistent with mass effect. This is a narrow definition and require sampling to characterize the nature of altered soft tissues/mass over pancreas. Our reports do not suggest a gigantic mass or cancer.

  
  10) We hold ourselves by high standards of empathy and compassion, and we do not tolerate posture or body language that is either vexatious or offensive to vulnerable pet owners who are in the process of understanding their pet's illness. Therefore I was not prepared to laugh at her comments about genetics, neither suggested that, in ******************** words, her pet will die a horrible death. Our records indicated that she **** similarities with her previous pet who succumbed to his illness, and she was in conflict with her partner about the course of action. I made it clear that I am here to address this emergency, I suggested that blood glucose *** be difficult to control because of the appearance of pancreas on ultrasound which *** suggest a lesion.

  
  11) The dynamics of our urgent pet care requires that pet owners review with the primary Veterinarian, it is a working relationship that we ****** and as such all pets we treat manage to undergo a review and a second opinion by their primary Veterinarian when they leave our office. I, and our office do not take issue with her pet undergoing treatment at her primary Veterinarian, and welcome the opportunity to do so if owners seek to do so at our office. In this case, we were not able to treat ******************** pet because ****************** refused to leave her pet in our ***; and did not deny her treatments.

  
  12) ****************** did not oppose the services we rendered,  and paid without objection and suggested to our front desk they will return to humanely euthanize patient. Furthermore ****************** requested the imaging we completed and helped us make findings which our office forwarded to her and the primary Veterinarian. A reasonable customer or a service provider would conclude that one could not request copies of imaging for review without approving of their completion and the cost of the service. Had ****************** informed us that she had objections to taking blood glucose and a fast scan, we would not be applying such fees, similarly we would not be in a position to disclose findings and imaging if she did not pay for the services. Instead, ****************** accepted the services and obtained the imaging, then went on to suggest that she did not approve of those services and therefore she did not have to pay for it.   

  
  13) Blood glucose and fast ultrasound cans are standard vetting for critical patients to make sure we are aware of critical underlying lesions that *** hinder our ability to treat effectively, this was no doubt our experience with ******************** other pet. I informed ****************** of both blood glucose and fast scan and discussed the treatment and the scan findings. She did not authorize the treatment after we discussed patient's status in great length and she began discussing humane euthanasia with her spouse at which time I yielded to their privacy. They left our office with an invoice and unopposed.She then requested imaging we completed and billed which we provided in a timely fashion.
  ****************** did not authorize further treatments after I discussed blood glucose,  the scan findings and icu stay and treatments. Therefore there was not need to form an icu stay and treatments cost.

  
  14) I and our office do not corroborate our findings with parties rendering opinion outside the scope of their expertise. If a practicing veterinarian rendered an opinion, we do not have reports to examine. Our findings were reviewed by a boarded Radiologist at our own cost and made findings consistent with altered soft tissues in shape and echogenicity over the pancreas regions which opens the door for sampling whether needle aspirate or biopsy to characterize the soft tissue changes. Our findings were specific and guarded and in conflict with ******************** assertions that we told her there was gigantic mass. If the parties she consulted with such as a certified ultrasound technician were not able to substantiate the findings we made, it is likely that making such findings were outside the scope of their expertise.

  
  15) Our notes and ultrasound captures were forwarded promptly,upon request and in accordance with our standard procedure and the requirements of the board of veterinary medicine;  in a full disclosure fashion. Our imaging is forwarded in a DICOM fashion, our records also indicated that ****************** opened the imaging link successfully. Our records also indicate that ****************** requested another send attempt by email and I once again attached the images and sent them shortly after, along with her other pet's images she requested from our review weeks earlier.

  
  16) I responded to ******************** request to call her and discuss the findings. She said she didn't think I know how to read ultrasounds, because in her view there is a ****** review she read that suggested that. She added that she consulted with an ultrasound tech and she did not confirm to her my findings. I advised her that my findings and assessment of the case are not guided by a ****** review or an outsider to the scope of expertise, I instead bring a higher standard to address her concerns about her ill pet, but she is welcome to seek expert opinion to review the imaging so I *** respond. I added that she is also welcome to file a complaint with the board of veterinary medicine and a Court of Law so she *** bring expert evidence, and so I *** be able to respond and dispute my findings in a fact finding forum. Such a resolution in my view to redress her concerns do not rise to the threshold of rage or irate conduct on my part, instead it was made in the context of fairness, in a non arbitrary fashion to protect both ******************** and her pets interests.

  
  17) Our diagnostics and treatment plans are guided by both our urgent and critical care services model vested in early detection such as fast ultrasound scans that we employ both routinely and early on. This had allowed us to detect fatal lesions few weeks earlier on her other pet. This time around was no exception, and I detected both critically high blood glucose and highly altered soft tissues in shape and echogenicity over pancreas sufficient enough to raise concerns. Nonetheless our records indicate that I discussed treatment plans and *** stay with slow drip insulin therapy and other necessary therapies;I cautioned ****************** that blood glucose *** prove difficult to control based on the ultrasound findings, so this remained a discovery process. ****************** was not denied treatments as such, she instead **** fantasized conclusions outside the scope of her expertise and **** similarities with her earlier deceased pet, so she began discussing humane euthanasia with her Partner and left our office. I am happy to hear that her pet did respond well to insulin therapy, had I had the opportunity to oversee his treatment in our ***, one would reasonably reach similar outcome, albeit a cautionary one given the ultrasound findings. Although we cooperate fully with ******************** vet, our urgent care diagnostics and treatment plans are not guided by her and her vet's wish, but guided by our assessment of the patient upon evaluation. In other word, and to the extent of our clinical liabilities, we do not yield to therapeutics imperatives or owner's requests,  such as my vet would like you to do such and such. Instead our diagnostic tactics and treatment strategies therefore are guided by the immediate clinical imperatives before us, and we remain liable to our own clinical decisions and outcomes throughout, unhindered by a third party or non expert opinion.
  
  
  I thank you immensely for the opportunity to respond to ******************** complaint, I look forward to working closely with you to resolve any additional or pending issues.
  
  
  
  If you have any questions, please do not hesitate to contact me.
  
  Thank you again,
  
  Yours sincerely
  
  *******

  Customer Answer

  Date: 01/02/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because

  He completely made up most parts of the situation in his response. He did not obtain permission to conduct a scan fast or otherwise which is why we left the room asking where our dog was. The vet tech entered the room with us and asked if she could bring our dog back for a blood glucose check. That is all that we were asked. In our previous visit permission was obtained for everything. So that is a complete lie. In that he had a mass and that treatment would be difficult and ultimately unsuccessful and the best course of action would be to put him down did not lend confidence to leaving my dog there for treatment. He didnt specifically say he would deny treatment but why would anyone leave their pet there after that statement. I told th woman at the desk I shouldnt have to pay for the scan to which she responded well it was done so you have to pay it. At this point we were upset and I wanted to get the heck out of there and get my dog somewhere else so I paid it and left knowing that I would revisit that later regardless. 

  I trusted him and believed him.  Thats why I went back after my first dogs passing in his care.  I was a little taken back with the fact that he charged us the original amount quoted to us for treatment $2600 when he only had him for an hour but he was very convincing after he passed. The next day he even said I will issue a refund of some because I only had him a short time. They did refund $300 which I assume was the cost of the two day overnight stay from looking at the quote which I thought should be been more but again his explanation on why he passed seemed plausible and convincing. He even stated that he called and talked to the vet that treated him for a few days prior. I called, he did not. I really only started to have major doubts when he came into the room after doing the unauthorized scan and claimed that this one also had a mass. Just in my mind the odds of two 5 year old dogs that are not genetically related having almost identical ( rare Im learning) issues in the span of a month seemed rather high and suspicious to us. I said as much to him that night to which he laughed and made a joke about all the Queens dogs being related.  I didnt get it and I wasnt in a joking mood. At that point I had my mind made up that I was getting a second opinion.  There was no difference of opinion between my husband and I. I was just trying to tell my husband as he was asking questions to stop so we could leave.  I guess he took that as a difference of opinion. Thankfully I did take our dog somewhere else. I paid to have another scan taken by a certified ultrasound tech. It was read by them, the head radiologist, and 3 vets at the treating practice and they couldnt figure out what he was looking at. They saw no mass of any kind, which led to them asking for the images from Pet/ER. They hospitalized the dog for two days for ketoacidosis treated with fluids and insulin and he was fine, just as the first vet suggested.  Just went today in fact for a fructosamine test and hes completely regulated and has never been better so I think thats the best proof of my complaint. It all started with him deciding to do a scan without asking. The previous dog admittedly was in worse shape when we brought him in. There he solely relied on bloodwork and scans from the previous vet to come up with his treatment plan. In his words that night no scan of him was even taken until after he passed. 
  Everyone ( me and two vets) did ask for the images from the scans and he did send something and while we did click on the files they cannot be viewed. I honestly dont even care about that anymore. The time has passed. I wouldnt know what I was looking at and the new vets took their own scans and treated him successfully. I care about the fact that he took an already difficult situation and made it ten times worse. 
  The part about me being paranoid referenced me watching this dog like a hawk because I felt guilty that I mustve missed something with my dog that passed. I only found out that this dog was diabetic by chance because he was acting completely normal which also led me to reject ******* to put him down. 
  The ****** review I referenced only to point out that someone else had almost this same exact situation at his clinic a few months prior. 
  The bottom line is that his response almost in its entirety is completely fabricated. Now in asking about Pet/ER after the fact from two separate veterinary practices all they would say is that theyve heard some odd things and its not a place that theyd recommend. ****** learned. 

   

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