Have you considered the PDSA ?

I'm answering this because there are folk on here who will be aware that I am a retired vet. However 9yrs is long enough for there to be changes in techniques and medications that affect statistical outcomes on a proven diagnosis. For an unproven diagnosis my answer is likely to be that i can't/won't give advice without having examined the patient myself, accessed it's history and discussd it with the previous attending vet (no longer possible).
Any advice will be based on what I might have done 9yrs ago. If you accept all that then by all means PM.

pgk

If the practice is in a huge shiny building and equipped with things like MRI scanners ask how come they can afford these?

Plus, if they have all this equipment there's a big incentive to make sure it is used in order to pay for it.

When our dog had cancer, the first vet diagnosed it as 90% likely.

The SO wanted a second opinion which ended up costing all the insurance and more and was no more definitive (except it ruled out lots of things I had eliminated by common sense like a bone stuck in her throat) the main result was that all the extra tests just meant it took longer for the poor animal to get the palliative treatment she needed by two to three weeks.

There are very few private vet practices with an MRI.. tend to be the reserve of referral practices and universities and the animal health trust all of which can and do command high fees but in fairness somewhat because they aren't knocking out a profit on the easy bread and butter income of neuters and vaccines and counter sales. And because of the amount of time spent in research and keeping at the pinnacle of knowledge.

I did indeed consider buyng an MRI – the options being either a second hand artic unit with associated costs of maintenance or more sensibly (but a little limiting) one of the smaller units based on permenant magnets. They were knocking about at a mere £300K puls some building works for shielding 9yrs ago. Quite time intensive in veterinary usage since you can;t ask the patient to lie still for the duration involved and with the magnetic fields involved anaesthetic supply has to be outside the cage with no monitoring attached to the pateint… so you have to keep stopping and going in to check on it unless it's a 'quickie' where you can get away with a single injectable dose of something. the actual running costs become a few bob in the meter

There are some paradoxes to the ownership of such equipment. Referral places tend to be dealing with the dramatic cases and relative low throughput which leaves a hole for the use of such a machine to discriminate on simpler stuff that is often poorely handled in General practice or diagnosed more invasively than necessary. A simple example being a knee scan to separate out the cruciate cases with damaged cartilage where the knee will need to be opened up from the ones where it can be fixed without invading the joint as opposed the the common practice of invading it for a visual.

I figured that 5 or 6 simple cases (my own and neighbouring practices) per day and we'ld be charging less than £300 a time (about a quarter of what was being charged elsewhere) and definately in the area of benefit to the patient rather than just a money mill. And a new fun toy to play with.

I'd found out the same when I was one of the first to invest in direct digital radiography (as opposed to digital storage film). they were so quick to do that we could charge less than almost anyone else, do them whenever they might help and take extra views to remove doubts and generally end up with no higher fee than the guys plodding their way through a case slowly. Having fancy kit doesn't mean you have to charge more if you manage it efficiently.

As for a cancer case- it depends where the cancer is and what sort it may be. I was very much into ultrasound guided biopsy work but few other vets in general practice would be game to do those on livers or kidneys (never lost a patient doing them either albeit a couple of close calls and necesary transfusions over the years). There were many practices that weren't prepared to get involved with chemotherapies due to the staff health and safety aspects and waste disposals but we would always give an honest statistic on outcomes and leave that to owner choice and have a go – gave some patients a quality life extension.

But the game was changing.. fewer youngsters prepared to get stuck in in general practice, fear of litigation, a measure of cowardice and easier availability of dumping to referral and sticking to the simple things – and not being prepared to deal with longer stay in-patients and night care.

pgk

No Vets come cheap, even over here.