Corporate Greed (Part 8): When Wall Street moves into the exam room (#471)

Rick LeCouteur
3 days ago
9 min read

Walk into a clinic in Denver, Toronto or Des Moines and it still feels local.

A hand-written note on the whiteboard, a well-worn coffee mug on the desk, a vet who remembers your dog’s first vaccine.

But follow the ownership trail and that local practice may now be part of a chain backed by global confectionery money, New York private equity funds, or a Luxembourg investment vehicle most clients have never heard of.

As in Europe, this isn’t a simple story of good clinics versus bad clinics.

It’s a story about a caring profession that has been re-imagined as a financial product.

How far has corporatization gone in the US?

US estimates converge on the same rough picture:

25–30% of general practices in the US are now owned by corporate consolidators.

Around 75% of specialty and emergency hospitals are corporate.

Those groups generate more than half of all companion-animal revenue, even though most individual clinics are still technically independent.

In Canada, corporate ownership is smaller by clinic count but growing fast.

A 2023 review in the Canadian Veterinary Journal estimated that corporate veterinary medicine controls more than 20% of hospitals and roughly 40% of veterinarians.

By 2024 the Canadian Competition Bureau was warning that a handful of large consolidators - primarily VetStrategy, VCA Canada, and NVA Canada - own more than 600 clinics between them, in a market where Canadians already spend more than C$9.3 billion a year on vet care.

On paper, independent ownership still looks dominant.

In practice, the center of gravity - money, decision-making, market power - has shifted towards corporate platforms.

The Big Beasts in the North American Pasture

Mars Veterinary Health

The candy company that became the biggest vet owner in the room

The single largest veterinary player in North America is not a private equity fund, but a privately held conglomerate: Mars, Inc.

Through Mars Veterinary Health, Mars now owns:

Banfield Pet Hospital - more than 1,000 primarily first-opinion hospitals, many embedded inside PetSmart stores.

VCA Animal Hospitals - roughly 800 hospitals acquired in 2017 in a US$9.1 billion deal that took VCA private.

BluePearl - a large specialty and emergency network with 100+ hospitals.

Across its brands, Mars now operates over 3,000 clinics worldwide and more than 2,300 clinics in the US/UK alone, using common corporate systems and strategy.

Mars positions this network as a platform for clinical research and a better world for pets.

Critics note that the same corporate family also sells a vast share of the world’s pet food, creating a vertically integrated pet-care empire whose scale gives it enormous influence over the profession.

JAB, NVA and Ethos

Private equity with permanent capital.

National Veterinary Associates (NVA) is one of the largest veterinary consolidators in the world:

>1,500 hospitals worldwide, including community practices, specialty/ER hospitals and pet resorts.

Acquired in 2019 by JAB Investors, the Luxembourg-based investment firm behind many coffee, fast-food and pet-care brands.

In 2022 the US Federal Trade Commission acted for the second time to stop JAB from further consolidating local specialty/ER markets. As a condition of NVA’s US$1.65 billion acquisition of Ethos Veterinary Health, JAB was ordered to divest clinics in multiple metro areas to prevent loss of competition.

By 2023–25 JAB had split its veterinary business into two separately managed units - NVA (community hospitals) and Ethos Veterinary Health (specialty/ER) - with analysts expecting possible stock-market listings in the mid-2020s.

JAB insists it is a permanent capital investor, more like Berkshire Hathaway than a flip-and-exit private equity fund.

But from the clinic floor, it still feels like Wall Street has moved in.

VetCor

A billion-dollar roll-up backed by Oak Hill, Harvest and Cressey.

VetCor started as an early consolidator; today it is one of the biggest community-practice networks in the US:
- Around 700+ hospitals in North America as of 2022, expanding since.
- In 2018, VetCor was recapitalised in a US$1.5 billion transaction led by Oak Hill Capital Partners, alongside Harvest Partners and Cressey & Company, all private equity firms.

The business model is classic PE:
- Buy independent hospitals.
- Tie in founders with rolled equity.
- Centralize back-office functions.
- Grow Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) and refinance or sell at a higher multiple.

VetCor has even acquired smaller consolidators (such as People, Pets & Vets), turning roll-ups into roll-ups of roll-ups.

Thrive Pet Healthcare

Pathway, Morgan Stanley and TSG

Thrive Pet Healthcare (formerly Pathway Vet Alliance) illustrates the private equity carousel clearly:
- Originally backed by Morgan Stanley Capital Partners.
- Majority stake acquired by TSG Consumer Partners in 2020.
- Grown to 400+ hospitals across the US, spanning general practice, specialty practice, and ER.
- Credit analysts explicitly frame the company’s risk profile in PE terms: finite holding periods, high leverage, and a focus on maximizing shareholder returns.

By 2024, S&P was warning that Thrive expected to burn US$80–90 million of cash in 2024, highlighting how aggressive expansion can leave even big vet chains financially stretched.

PetVet Care Centers

KKR’s veterinary platform

PetVet Care Centers has been another major consolidator in specialty and general practice care:
- KKR, one of the world’s largest private equity firms, acquired PetVet in 2017 from Ontario Teachers’ Pension Plan and L Catterton.
- PetVet now runs 450+ hospitals across the US, financed with significant unitranche loans and other debt facilities.
In the competitive landscape, KKR’s PetVet is routinely listed alongside Mars’ networks, EQT’s IVC Evidensia and the new Shore/Silver Lake platform as one of the largest vet chains in North America.

Mission Pet Health

Southern Veterinary Partners + Mission Veterinary Partners under Shore and Silver Lake.

The newest giant is Mission Pet Health, the product of a late-2024 merger between:
- Southern Veterinary Partners (SVP) – 420+ practices, and
- Mission Veterinary Partners (MVP) – 330+ practices.
Backed by Shore Capital Partners, and recapitalized with US$4 billion of fresh equity from Silver Lake, the combined group now operates over 750 facilities, valued at around US$8.6 billion.

Shore presents Mission Pet Health as a vet-owned, partner-friendly network. But structurally it is a classic private equity roll-up with billions of new equity and debt raised specifically to acquire more clinics.

Canada: VetStrategy

VCA Canada and NVA Canada

In Canada, three consolidators dominate:
- VetStrategy – 360+ hospitals nationwide; initially majority-owned by Berkshire Partners (Boston-based private equity); merged in 2021 with EQT-owned IVC Evidensia, linking Canadian clinics directly to European PE capital.
- VCA Canada – part of Mars Veterinary Health.
- NVA Canada – the Canadian arm of JAB-owned NVA.
Investigative reporting has highlighted how VetStrategy’s branding is often invisible at clinic level; journalists had to ask directly to discover that apparently independent clinics were part of a national chain.
Canadian commentators and regulators are now openly asking whether this hidden consolidation is linked to annual price increases of ~8% or more and reduced local competition.

Why Wall Street loves vet clinics

Put yourself in the shoes of a fund manager reading an investment memo:

Pet ownership is high and emotionally anchored; people cut back on themselves before they cut back on their animals.
The industry is fragmented; no single clinic has pricing power - but a chain of 500–3,000 clinics does.
Revenue is recurring: vaccines, preventives, dentals, chronic disease management.
Higher-end diagnostics and surgery create opportunities for fee increases well above inflation.

Valuation guides aimed at practice sellers routinely talk about double-digit EBITDA multiples for clinics that join consolidator platforms.

No wonder private-equity and corporate investors have poured billions into the sector. The question is what happens to prices, clinical culture, and access when this logic dominates.

What happens to prices and care?

There is no single master dataset, but the pattern across US and Canadian evidence is disturbingly consistent.

US Bureau of Labor Statistics data show veterinary-service prices rising roughly 60% since 2015, well ahead of general inflation. Global analyses attribute much of this surge to corporate consolidation and private equity’s entry into the sector.
A 2025 AAHA Trends review notes that corporate consolidators now likely capture over half of companion-animal market share, and that their clinics are typically larger and higher priced than independents.
Watchdog groups like the Private Equity Stakeholder Project have warned that veterinary roll-ups reduce local competition and can push prices higher while pressuring clinicians to prioritize revenue.
In Canada, the Competition Bureau has launched a public education campaign named Pets, vets and meds that explicitly links consolidation, opaque ownership and rising costs, and calls for more competition and better price transparency.

Investigative journalism and documentaries in both countries feature the same stories:

Clients shocked by high-pressure upselling and unexpectedly large bills.
Staff describing moral distress when corporate KPIs collide with what they believe is best for the animal.
Independent vets struggling to compete with chains that own multiple clinics in the same city and can out-advertise them.

Correlation is not causation. Not every price rise is corporate greed. Wages, equipment and drugs have all become more expensive. But:

When the steepest price increases coincide with the fastest period of private equity driven consolidation, it is difficult to pretend there is no connection.

Regulators are awake, but not yet fully alert

United States

FTC and the roll-up problem.

The Federal Trade Commission has twice intervened against JAB’s acquisitions, forcing divestitures and issuing a final order to curb its roll-up of specialty/ER clinics.
The FTC and Department of Justice have also asked for public comment on serial acquisitions and roll-up strategies, with advocacy groups urging them to scrutinize veterinary chains more aggressively.

Yet most practice acquisitions are small enough to fall below traditional reporting thresholds, meaning the bulk of consolidation happens out of the public eye.

A growing coalition of policy groups has responded with proposals like the Save Our Pets Act, model state legislation that would strengthen bans on non-veterinarian ownership and close loopholes used by management-services organizations (MSOs).

Whether state legislatures will adopt such measures remains to be seen.

Canada

Competition Bureau and public pressure.
- Canada’s Competition Bureau has gone further rhetorically than many US agencies, publishing plain-language guidance on how consolidation and lack of transparency affect pet owners, and identifying the top three corporate vet owners by name.
- Consumer petitions and media investigations have specifically targeted VetStrategy/IVC and other chains, demanding:
  - Clear disclosure of corporate ownership.
  - Scrutiny of potential price gouging and abuse of market dominance.
  - Easier access to written prescriptions so clients can use external pharmacies.

For now, though, the basic direction of travel remains unchanged: more deals, bigger chains, and deeper capital pools.

Is this just “corporate greed”?

As with Europe and Australia, it’s important to avoid caricature.

There are corporate hospitals in North America that:

Invest heavily in equipment, staff training and research.
Subsidize charity work or low-cost clinics.
Offer structured career paths and benefits that small practices struggle to match.

And there are independents that are under-resourced, under-regulated and frankly unsafe.

The problem is not the existence of big groups per se. It is the motives and structures behind them:

PE investors are obliged to maximize returns over a finite time horizon.
Debt-fueled roll-ups must keep acquiring and growing to justify their valuations.
When a clinic becomes a unit in a fund model, success is measured mostly in EBITDA and exit multiples, not in the long, quiet outcomes that actually matter to animals and their owners.

At that point, corporate greed is less a moral failing of individual people and more a property of the system we’ve allowed to form around veterinary medicine.

What a better North American model might look like

If North America wants veterinary medicine to remain a profession rather than just a pipeline for financial extraction, a few principles seem obvious:

Radical transparency
- Ownership disclosure: every clinic should clearly identify its ultimate beneficial owner (private equity fund, conglomerate, pension fund, or genuine partnership) on its website, invoices and premises.
- Price transparency: standardized, comparable fee schedules for common services and medicines, so clients can see how corporate chains price against independents
Real professional control, not token structures
- Strengthen and enforce corporate practice of veterinary medicine laws so that MSOs and financing vehicles cannot effectively control clinical decisions while hiding behind nominal vet ownership.
- Professional bodies should articulate minimum standards for clinical autonomy regardless of ownership.
Smarter antitrust and merger review
- Treat serial acquisitions as a single strategy, not thousands of unrelated small deals.
- Allow regulators to call in mergers based on local concentration (how many clinics in a city end up under one owner), not just national revenue thresholds.
Space and support for independents
- Encourage employee-owned, cooperative, and non-profit models that let vets share scale without ceding control to distant investors.
- Ensure independents have fair access to diagnostics, CPD and drug purchasing, rather than being quietly squeezed out by vertically integrated chains.

Closing the loop

Across this corporate greed blog series, the pattern is depressingly familiar:

A fragmented, trusted profession.
A boom in pet numbers and expectations.
An influx of capital looking for safe, high-margin returns.
Rapid consolidation, opaque ownership and rising prices.

North America is now deep into this cycle.

What happens next is not inevitable.

The profession, regulators and pet owners still have choices:

Insist on transparency,
Resist market structures that treat care as just another roll-up opportunity, and
Support clinics - of any ownership model - that put animals, staff and communities ahead of quarterly targets.