When my shih tsu developed a hyphema (blood filling the eye by the lens) I was horrified to think she would lose her eye. I was referred her from vca mesa. Within 15 minutes she was seen, I had an estimate for meds, surgery, and after care. I fortunately did not need to call after hours, but that is an option. The cost for surgery and all care exceeded 2000 dollars, so it's fair to say that one needs to either have a high limit credit card, good credit, or a lot of cash to pay for care here. They don't accept insurance, you'll need to pay first and seek reimbursement later (my experience). I'm glad we came here, my shih tsu is back to normal.