The Canine Ledger

Vet Bills, Medicines and Decisions: What You're Paying For, and What You Can Ask

Why vet bills rose, how risky anaesthesia is, how pet insurance works, and how to buy medicines safely, with the questions you can ask your vet.

Written by thecanineledger

This page carries no advertising, and nothing on it is for sale.

1. Start where you are

If you are…Start here
Wondering why your vet bills keep going up§2: Why bills went up
Worried about your dog having an anaesthetic§3: Anaesthesia
Thinking about pet insurance§4: Insurance
Paying a lot for ongoing medicines§5: Medicines
Getting ready to ask about a bill or an estimate§6: What you can ask
Wondering how this section works§7: How this section works

In March 2026, the UK’s competition regulator finished a two-and-a-half-year investigation into vet services. It found that “average prices at veterinary businesses across the sector grew by 63%” between January 2016 and December 2023, “compared to a 32% increase in general inflation” (CMA final report summary, 24 March 2026).

While some of that rise paid for better equipment and higher salaries, the inquiry found that these costs “do not justify the full extent of the increases in average prices.” It also found that owners had little information to judge what they were paying for. This section covers the bill, the anaesthetic, the insurance policy and the prescription, and what you can ask about each.

2. Why bills went up

The UK inquiry is the most detailed independent study of vet pricing we found anywhere. It found that large groups now own “the majority (60%) of vet practices in the UK”, and that their practices charged more on average than independents. It also found that owners rarely had the information to compare.

We found no equivalent inquiry in the US or Canada.

→ Why Vet Bills Went Up: What the UK Competition Inquiry Found

3. Anaesthesia

For most dogs, the risk is low. In a UK study of 157,318 dogs given a general anaesthetic or sedation, “there were 159 (0.10%)” deaths related to the anaesthetic within 48 hours (Shoop-Worrall et al., Vet Anaesth Analg 2022). That is about 1 in 1,000. The risk was higher for older dogs, sicker dogs and urgent procedures.

→ How Risky Is Anaesthesia for My Dog?

4. Insurance

This site carries no insurance links or insurance adverts. We explain how policies work so you can read one, not to sell one.

The main thing to understand is what a policy won’t pay for. In the US, a model law written by state insurance regulators defines a preexisting condition, in part, as one where “A veterinarian provided medical advice” before the policy started or during a waiting period (NAIC Pet Insurance Model Act, 2022). In the UK, the Financial Ombudsman Service handles complaints when an insurer turns down a claim.

→ How Pet Insurance Works: Policy Types, Excess, Co-Insurance and Waiting Periods

5. Medicines

If your dog takes a medicine every month, where you buy it matters. The UK inquiry found that “commonly prescribed medicines are typically available at online pharmacies for prices that are 50% to 60% less than those at veterinary practices.”

Buying online is only safe from a legitimate seller. In the US, the FDA warns that a website selling a prescription pet medicine without a vet’s prescription is “breaking the law” (FDA, Be Website A.W.A.R.E.).

→ Buying Your Dog’s Medicines Online, Safely

6. What you can ask

Wherever you live, you can ask:

  • For a written estimate before treatment, and a new one if the plan changes.
  • For an itemised bill, so you can see what each part cost.
  • For a written prescription, so you can buy the medicine elsewhere.
  • What the options are, including a simpler or cheaper one, and what each is likely to achieve.
  • Who owns the practice.

In the UK, many of these are becoming legal requirements. Under an Order made by the competition regulator, practices must publish a price list and, later, give a written estimate when a treatment plan is “reasonably likely to cost £500 or more, including VAT” (CMA guidance for small veterinary businesses, 2026). Large groups must comply sooner than small practices. Most of the rules take effect between December 2026 and September 2027.

Our note: We haven’t researched whether US states or Canadian provinces require written estimates or itemised bills from vets.

7. How this section works

Each article starts from the best independent evidence we could find: regulators’ reports, large studies of practice records, and the law itself. We say when a figure comes from one country.

We don’t recommend insurers, pharmacies or payment plans, and we don’t take money from them. Where a decision is about cost at the end of a dog’s life, we link to our End of life section. → Saying Goodbye: An Evidence-Based Guide to Your Dog’s Final Chapter

Our note: “Better equipment and higher salaries” is our paraphrase of the CMA’s “investments that have led to improvements in quality and increases in salary costs”.

8. What we could not verify

Commonly saidWhat we found
“Vet bills went up because vets are greedy”Too simple. The inquiry found weak competition and poor information, and rejected caps on prices or profits.
“Anaesthesia is too risky for older dogs”No age cut-off in the studies. Age raises the odds; the risk is still low for most dogs.
“Pet insurance is always worth it”No independent cost-benefit study found.
“Online pet medicines are fakes”Not true of registered sellers. The risk is from unregistered ones.

Sources

Always confirm with your vet before acting on anything on this page.