There has been a lot of press and debate lately about the high costs of veterinary medicine. Being in New York, I’m thinking of several NY Times articles.
On the front page on April 5th, there was the article “New Treatments to Save a Pet, but Questions About the Costs.”
This article highlighted the advances in veterinary medicine and the associated high costs, including bone marrow transplants for dogs with lymphoma at NC State, urinary stents for blocked kidneys or bladders, and radiation therapy for brain tumors. These procedures can cost $10,000 to $15,000, and total bills may exceed $25,000 for all medical care. There are also advances in diagnostic tests such as CT scanners and MRI imaging. These tests (including anesthesia) can cost $1,000-2,000.
There were over 300 comments posted by readers before the paper closed comments. Clearly, this article generates a lot of interest and many opinions.
These debates appear from time to time. Last September a client of mine shared his experience with his dog Newman, who had tumors in his lung and brain, in the NY Times Well blog. Chemotherapy was less grueling for dogs that for humans, he wrote.
In the comments on his post, debate erupted when a human doctor commented:
“Awful and wasteful when there are so many *humans* unable to afford chemotherapy. The entire pet industry, for which we spend something like 11+ BILLION dollars in the US is sick when we have 44 million uninsured humans and hungry children in poverty. Priorities.”
The ethics debate continued on April 9th in Room for Debate: One Sick Dog, One Steep Bill
So what do I think?
I don’t believe people should feel guilty about spending money on their pets, nor do I believe it is unethical to spend money (a lot or a little) on pets. You can spend your money on whatever you choose. If a Guardian wants to pay $15,000 for treatment of their pet’s cancer, it is their choice. Spending that money is no less ethical than the purchase of a new car, a new computer, or a dream vacation. We all have a choice.
I am not suggesting treating a dog is a good choice if the pet’s bill interferes with one’s ability to pay bills, to feed the children, or to support the family.
But choosing to treat your pet does not deny money for human health care, as some seem to argue in these comments. If we spend less money on pets, is that money somehow going to support human healthcare? Our society just doesn’t work that way.
I agree that adequate health care for all humans should be a priority, but I don’t understand the argument that we should spend less on our pets in order to achieve better human health care. It is not that simple.
So yes it bothers me to read that that treating our pets is “deplorable” when poor people do not have health insurance or adequate medical treatment, and that treating animals indicates moral decline of our society. I guess it bothers me because treating pets is personal for me. And it is also personal for each Guardian and each pet.
As a vet, I am obligated both ethically and legally to provide all available treatment options to the pet Guardian. This will range from aggressive and often expensive options, alternative protocols, palliative plans, no treatment, and in some cases, euthanasia. I cannot make assumptions about what one can afford or is willing to spend. One’s background, upbringing, religion, past experience with pets or family or one’s own health may all play a part in the decision making. The decision will be very different for each Guardian.
How would you feel if you were willing and able to pay for a treatment for your pet, but it was not offered to you because the vet assumed you would not or could not pay for treatment? The decision to treat is a balance between quality of life, the benefits of extending it, the cost of treatment, and the Guardian’s financial situation. Vets cannot decide what to offer nor make that decision for you.
These are such difficult decisions, and there is no one-size-fits all solution. For example, I know of Guardians who were upset that they were advised to euthanize because their dog’s cancer was not treatable. They were never even given the option to treat. The lack of options was upsetting to them.
And yet, my job as a vet is to tell you that NOT treating is always an option, too. While some Guardians are upset when I mention not treating, others tell me they wish their own vet had encouraged them to at least consider euthanasia, rather than to continue aggressive treatment.
I am often asked what I would do about a dog’s diagnosis, if this were my dog. It’s almost impossible to answer this question. It’s not a decision that a vet can, or should, make for you. The best I can do is to provide medical information, my expertise, guidance, and support. I have to give you everything I know, so that you can make the decision. Client empowerment is an important part of my practice, and an important part of why I chose to join Dr. Dressler in co-authoring the second edition of The Dog Cancer Survival Guide. It’s an extremely empowering book.
So these articles will continue to appear from time to time, and the debate about ethics, costs, and treating sick pets will continue. Part of my frustration is that these articles often leave out the alternative, less expensive options, many of which are FREE and are covered at length in our book. They paint my work and your life as a Guardian into little boxes, rather than acknowledging how complicated treating cancer is.
It does not have to be all or nothing when treating your pet. I recommend you seek a second opinion and hear ALL the options. And I hope people can remember what is right for you and your pet is not necessarily right for the next Guardian and her pet. When someone else makes a decision about how to treat, it does not reflect on anyone else. Everyone makes their own choices for their own reasons.
If you are dealing with dog cancer, get The Dog Cancer Survival Guide for a much more empowering experience. You can find out all the options and get actual reassurance that treating according to what you feel is best is not only OK, but one of your major responsibilities as a dog owner. If you’re not in charge, who is?
Sue Ettinger, DVM. Dip. ACVIM (Oncology). Dr. Sue is a boarded veterinary medical cancer specialist. As a Diplomate of the American College of Veterinary Internal Medicine (Oncology), she is one of approximately 400 board-certified veterinary specialists in medical oncology in North America. She is a book author, radio co-host, and an advocate of early cancer detection and raising cancer awareness. Along with Dr. Demian Dressler, Dr. Sue is the co-author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity.