I spent twelve years working for a good vet who explained things in SoCal, and four years as manager for a financial pet-assistance non-profit. I'll give a few tips about working with clinics (and this includes emergency vets, too). I've also been the customer of several vets (four in this local area).
The two largest operations are Banfield (900 clinics) and Veterinary Centers of America (called VCA) with 800+ clinics. Banfield is owned by the Mars, Inc. (the candy and dog food company), and Mars is just now in the process of buying VCA.
These two operations were probably the first ones to sign up for these referral services. Neither of them seem to have a very good reputation, locally, or here:
VCA: https://www.complaintsboard.com/bycompany/vca-animal-hospital-a43075.html
Banfield: https://www.consumeraffairs.com/pets/banfield.html
Pet Clinics can run the gamut of very good to very bad, and a lot of in-between. Living on the road, it's going to be hard to know the reputation of the one closest to you. If you tend to stay in certain areas, ask the locals what they think, before you need a veterinarian. This isn't 100%, but it can help. Luck does figure into things... both good and bad. The worst vet I ever went to was on a recommendation.
The first thing to remember is that animal doctors aren't gods, just like the people doctors aren't. They don't own you, they don't own your pet, and they aren't paying your bill. LEARN TO THINK FOR YOURSELF. And don't feel funny or intimidated for asking questions. If the vet tries to obviously intimidate you, your radar should go into full alert. If this isn't an emergency, is there another clinic around?
The two mega-corporations listed above may have some good doctors, but they are operated by the company, and the company's prime objective is Profit. Without question, they will want to make as much money off you as they can. If you say 'do everything', and then can't pay for it, many places will confiscate your pet, hold it for a few days, and if you still can't come up with the balance, they will dispose of the pet one way or another (euthanesia, send it to a shelter, or an employee, friend or other client may be allowed to adopt it). No amount of whining, crying or threats will change it. They know that if you don't have the money to pay the bill, you won't have the money to hire a lawyer.
If this confiscation disaster should come to pass, find out where the
several most-local shelters are and keep an eye on them. They may not send it to the most-local place because they know that's where you might think to look. Think no vet would be that vindictive? Think again.
With a more serious health problem, you can ask what needs to be done, and if they give you a pretty long list of 'needs', ask them to divide that list into which things are necessary and which are less crucial. If the doctor says that all of the work is critical, that just isn't very likely, unless the pet is critical, in which case it may be 'all or dead'. Trust your instincts.
My personal vet is pretty good. He probably has some reasonably good idea what is wrong after getting a temperature and basic exam, and he divides his suggestions between what would be best and what would be 'nice'. Everything doesn't need to be done at once, in most cases. If my dog has stopped eating and is dehydrated, it is likely an internal problem (he would have seen an obvious external injury), so he would probably advise drawing blood and sending it the lab for analysis, and maybe also getting a urine sample and testing that (sometimes in-house). These are pretty basic, and they can often get to the crux of the problem faster than anything else. Depending, they may give some meds. If they try to sell you a bunch of meds, ask why for each one, and then ask which one or two are most important. A lot of meds before a diagnosis tends to be a waste of your money.
If a limp or other pain has been going on for more than a few days, he probably needs some x-rays; sometimes, they need to sedate them for x-rays, sometimes not. If your old Lab is very easygoing, ask if they could skip the sedation; the criteria here might be that they have to put him in an awkward/painful position, which needs sedation, no matter what (hips are something that fit into this exception).
If your cat is semi-feral, or your dog isn't used to strangers (growls or bites), ask if you could be with him while they draw blood, collect urine, or sedate for x-rays, just to touch and talk to him, to keep him calm. If the pet gets all wound up and fearful, none of it may get done. If you need to, INSIST. Some technicians get a little flustered with the client being there.
Some male cats create crystals in their urinary system, and those crystals will create a blockage in a narrow part of the urethra just before the urine leaves the body. The onset is rapid. They will stop eating, and often yowl in pain. This is not a meow, this is a YOWL. Stop what you're doing and gently feel his lower abdomen with your fingertips - DO NOT SQUEEZE. If you can feel a hard lump about the size of a lemon or so, or even larger, he's blocked and needs immediate vet care.
THIS IS AN EMERGENCY. If you try to let it go until morning,
He.
Will.
Be.
Dead.
In agony. That's fact, not opinion -- their
system goes toxic very fast, and shuts down. And there is nothing you can do, yourself
*. The basic needs: Office call + anesthesia + clearing the blockage. A vet can tell what's wrong in 3 seconds. He doesn't need a painkiller or bloodwork or other fiddly things that just run up the bill. Once he's unblocked, they will probably recommend fluids, and that's a good thing, to flush out the waste that's been backing up.
Help prevent this with decent food. My vet: "You can pay for decent food, or you can pay me to try to fix the problems that cheap foods create, but you ARE going to pay". Here is a non-profit rating for cat food (doesn't include all brands):
http://www.petfoodratings.org/dry-cat-food/friskies/ There are other ones, too. Pet food ingredients change often, which is why you'll find differences.
* ABSOLUTELY
DO NOT let your husband, boyfriend, son or passing stranger attempt to squeeze the bladder 'to force the blockage out' -- this will result in a ruptured bladder.
Massive trauma, caused by being hit by a car, getting shot, maimed by larger animal, etc, obviously needs immediate care. Try to move him as little as possible -- if you've got a piece of plywood or something, line it up with his spine, grasp his scruff at the back of his neck and over his hips, and pull him onto the board. Cover to help prevent more shock. Don't try to give anything by mouth. Get him to a vet. If possible, have someone else drive, and you stay with him to keep him quiet.
And I will keep my fingers, toes and eyes crossed that none of you will ever need this information.
