Well, like they say, never say never. Working with my vet today with another one of my dogs who deteriorated over the weekend. She wanted me to go to VES b/c she had gone to a presentation by one of the respiratory specialists there and had discussed the case of my dog. I went. She was fabulous. My dog is getting the best of care. Like I said before, it depends on who you get. This one was a 5; the other one was a 1. But to be fair, all my trips there before, probably at least six times, each vet was a 5. So I'm giving six ratings of five and one rating of one!