Call three emergency clinics in your metro at 2 a.m. tonight. There's a decent chance you're calling the same owner three times.
Brakke Consulting, the veterinary industry's longtime data shop, estimated in 2023 that corporate groups own about 30 percent of general practices in the US. Its estimate for specialty and emergency hospitals: roughly 75 to 80 percent, a number AAHA's Trends magazine has cited in its own reporting on the trend. That gap didn't open this year. It's been there for at least a decade.
A caveat worth stating up front: there is no government census of veterinary practice ownership. Brakke's numbers, and the AAHA reporting built on them, are industry estimates compiled from deal tracking and market surveys, not a regulatory filing. Treat the 75 percent figure as a well-informed estimate, not a hard count.
The Timeline Nobody Advertises
The corporate roll-up of veterinary medicine didn't start with private equity. It started with VCA.
Founded in 1986 by Robert Antin, Arthur Antin, and Neil Tauber, VCA bought its first independent animal hospital in 1987 and spent the next three decades doing the same thing over and over, per company history compiled by Encyclopedia.com and VCA's own materials. By the time Mars, Incorporated bought VCA for $9.1 billion in September 2017, per Mars's own announcement, VCA's network already leaned heavily specialty and referral, not just general practice.
The American Veterinary Medical Association's JAVMA News ran the numbers in December 2018: corporations owned about 10 percent of general companion-animal practices at that point, but 40 to 50 percent of referral (specialty) practices. General practice roll-ups were still a side business. Specialty was already half-corporate.
By the time Wall Street headlines caught up, with JAB Holding buying Compassion-First Pet Hospitals for $1.2 billion in February 2019 (a 41-hospital network spanning specialty, emergency, and general practice, per deal records) and general-practice consolidation accelerating through 2020 and 2021, specialty and ER had already had a 30-year head start.
Why Specialty Went First
Three structural reasons, not conspiracy.
Capital. A CT scanner, a linear accelerator for oncology, an ICU running three doctors around the clock: none of that is a $40,000 remodel. It's a multi-million-dollar buildout that favors an owner with a balance sheet, not a solo DVM with a practice loan. General practice can run lean on a stethoscope and an ultrasound. Specialty and ER can't.
Referral, not relationship. Your GP client picked you. They know your name, maybe your kids' names. The specialty or ER visit is different: the client got referred there, or drove there in a panic at midnight, and they are not shopping on brand loyalty to a particular doctor. That makes a specialty hospital far easier to sell without the owner worrying the client base walks out the door with the founder. Brakke Consulting has made this exact point in industry presentations on why specialty consolidated faster: less relationship risk in a sale.
Margin. Emergency and specialty medicine bills out at higher case value per visit, with less price comparison from a client whose dog is actively bleeding. Higher case acuity plus lower price sensitivity is the explicit thesis several PE-backed platforms, including the emergency-focused Ethos Veterinary Health and Mars's own BluePearl, were built on.
The FTC Already Flagged It
Regulators noticed the specialty concentration before most vets did. When Mars sought to acquire VCA in 2017, the Federal Trade Commission required Mars to divest 12 clinics, all providing specialty or emergency services, across markets including Kansas City, Chicago, Seattle, Portland, and Washington DC, per the FTC's August 2017 press release. The FTC's complaint said the deal, as originally structured, would have substantially lessened competition for specialty and emergency veterinary services in 10 US localities by eliminating head-to-head competition between Mars's and VCA's specialists in those markets.
That's a federal antitrust finding specific to specialty and emergency medicine, not general practice. The FTC didn't ask Mars to divest a single general-practice GP clinic in that deal. It went straight at the ER and specialty overlap, because that's where the local market concentration already lived.
What This Means at Your Console
If you're an associate or owner referring out to oncology, cardiology, surgery, or the local ER, you are very likely dealing with one of a small number of corporate umbrellas in your market: Mars Veterinary Health (VCA, BluePearl, Banfield), NVA (JAB Holding, which also owns Ethos and Compassion-First), or a regional consolidator like MedVet or PetVet Care Centers (backed by KKR). That's not a value judgment. It's a fact worth knowing before your next referral conversation or contract negotiation, because it changes who actually holds the upper hand in that relationship, and it means "shopping around" for a specialty referral in your metro may mean picking between two or three logos with the same parent company, not competing options.
The one thing worth doing this week: pull up who owns the specialty and ER hospitals you refer to most. It's usually one Google search away, and it tells you more about your negotiating position, and your patients' actual options at 2 a.m. than any amount of guessing.
Sources: AAHA Trends, "Corporate consolidation and the rise of private equity"; AVMA JAVMA News, "The corporatization of veterinary medicine" (Dec. 1, 2018); Federal Trade Commission, "FTC Requires Mars to Divest 12 Veterinary Clinics as a Condition of Acquiring Pet Care Company VCA Inc." (Aug. 30, 2017); Mars, Incorporated, VCA acquisition announcements (2017); Mergr deal record, JAB Holding Company acquisition of Compassion-First Pet Hospitals (Feb. 25, 2019).