Study finds many after-hours small-animal visits aren’t truly urgent
Bottom line
A new retrospective study from a private small-animal practice in Berlin analyzed 4,579 after-hours visits in dogs and cats during 2021 and found that not every case presenting as an emergency was truly urgent. Using a structured triage approach, the authors reported that lower-acuity, “green” cases were a major driver of caseload, especially during morning hours, with presentations per hour roughly doubling between 9 a.m. and 11 a.m. The paper, published in Veterinary Sciences by Leoni Wizenty and Marcus G. Doherr, adds practice-level data to a broader German debate about after-hours access, staffing pressure, and how emergency services are being used. (mdpi.com)
Why it matters: For veterinary professionals, the study reinforces a familiar operational problem: after-hours demand includes a meaningful share of cases that may be stable enough to wait, even as true emergencies still require immediate capacity. That matters in Germany, where after-hours care has become more strained amid clinic closures, staffing shortages, and formal emergency-service obligations, while the 2022 veterinary fee schedule also allows higher emergency billing and a €50 emergency-service fee. Together, those pressures make triage systems, client communication, and referral workflows more important for protecting team bandwidth and reserving overnight resources for the sickest patients. (mdpi.com)
What to watch: Expect more attention on structured triage, public education for pet parents about what constitutes a true emergency, and whether private practices or regional systems in Germany adopt new after-hours models to reduce overload. (vetline.de)
Key facts
- Study type
- Retrospective descriptive study
- Setting
- Private small-animal practice in Berlin, Germany
- Sample size
- 4,579 after-hours visits
- Species
- Dogs and cats
- Study period
- 2021
- Main finding
- Not every after-hours case was truly urgent
- Triage finding
- Lower-acuity, "green" cases drove much of the caseload
- Peak timing
- Presentations per hour roughly doubled between 9 a.m. and 11 a.m.
- Publication
- Veterinary Sciences
- Authors
- Leoni Wizenty and Marcus G. Doherr
A new study in Veterinary Sciences puts numbers behind a challenge many small-animal teams already know well: the after-hours caseload is not made up solely of life-threatening emergencies. Reviewing 4,579 dog and cat visits from a private practice in Berlin during legally defined after-hours periods in 2021, the authors found that lower-acuity presentations accounted for a substantial share of visits and heavily shaped peak caseload patterns. In particular, the paper notes that “green” triage cases drove a marked surge in presentations between 9 a.m. and 11 a.m. (mdpi.com)
That finding lands in a veterinary system already under pressure. In Germany, emergency-service coverage has been a recurring profession-wide concern, tied to clinic attrition, workforce shortages, working-time constraints, and uneven distribution of after-hours burden between clinics and private practices. Industry discussion in recent years has focused on how to preserve access while avoiding burnout, especially for solo and small practices that may be asked to shoulder more emergency duty. (vetline.de)
The study itself was designed as a descriptive review of medical records from 3,189 dog visits and 1,390 cat visits over the 2021 calendar year. According to the paper summary, each visit was treated as a separate case so the authors could evaluate overall emergency caseload rather than follow individual patients longitudinally. The stated goal was to distinguish and quantify true emergencies versus non-emergency presentations, while also characterizing presenting complaints, diagnostics, and treatments in a real-world private-practice setting. (mdpi.com)
That practical framing matters because triage has become more central to small-animal emergency medicine, not just in referral hospitals, but across first-opinion practice. A recent review on basic triage in dogs and cats notes that all small-animal practitioners need to be able to triage and stabilize common emergency cases, and that many emergency presentations do not necessarily require emergent referral if they can be appropriately assessed and stabilized first. In other words, the Berlin data fit a broader clinical reality: urgency and presentation time aren’t always the same thing. (pubmed.ncbi.nlm.nih.gov)
The paper also intersects with the economics of after-hours care in Germany. Under the current veterinary fee schedule, services provided at night, on weekends, or on holidays within emergency service can be billed at higher rates, and veterinarians may charge a €50 emergency-service fee once per case. Those rules were introduced nationally in 2022 and were intended, in part, to reflect the higher cost and staffing burden of emergency coverage. While this study used 2021 visit data, before the updated fee schedule took effect, its findings help explain why policymakers and practices alike have focused on differentiating true emergencies from lower-acuity demand. (gesetze-im-internet.de)
Outside the paper, commentary from the German profession suggests the operational tension is bigger than one practice. Vetline reported concerns from private practitioners that the emergency-care burden has grown alongside rising client expectations, and that overnight cases often fall into two difficult groups: patients too intensive for a typical practice to manage, or patients stable enough that care could reasonably wait until the next day. That’s not a direct validation of the study’s numbers, but it does align with the authors’ central point that after-hours demand is clinically mixed, and that not every presentation requires the same level of emergency response. (vetline.de)
Why it matters: For veterinary professionals, this study offers evidence to support more disciplined triage, clearer communication with pet parents, and possibly more formalized routing of lower-acuity cases. In practices where overnight capacity, staffing, and morale are already stretched, the ability to separate immediately life-threatening cases from deferrable complaints can affect patient safety, wait times, and team sustainability. It also has implications for fee discussions: when emergency surcharges are legally supported, practices may need to do even more to explain why after-hours care is priced differently, and why some cases may be better managed during regular hours. (mdpi.com)
What to watch: The next step is whether studies like this lead to broader adoption of structured triage tools, digital pre-visit screening, or regional after-hours models in Germany, as the profession continues looking for ways to protect emergency access without overwhelming the practices still providing it. (petsvetcheck.de)