washingtonpost.com
Pets, Vets and Debts
Owners Face Higher Bills, More Medical Options and Tough Decisions About How Much Is Too Much

By Joe Heim
Washington Post Staff Writer
Sunday, April 27, 2008

In the bad-luck lottery for pet care, Jennifer Freeman hit the jackpot. Over seven bank-account-draining months two years ago, the D.C. resident's four cats came down with several ailments: urethra blockages, gum disease, constipation (hey, it happens). Before she knew it, Freeman, 31, had forked over more than $11,000 for surgeries and veterinary fees, was buying bottled water and prescription pet food for her feline charges and was wondering just how much more she could take.

"On my end, the cash register was just spinning," Freeman says. "Half of my take-home pay was going to pay vet bills." Upon receiving yet another $1,000 bill for a series of tests and procedures, a sobbing Freeman told her veterinarian that the next time one of her cats got sick, he should put it to sleep, because she couldn't afford it.

"The vet seemed a little stunned," says Freeman, whose cats are alive and mostly well. "I think he didn't think that money was a big consideration for me."

Money, it turns out, is becoming a bigger consideration for almost everyone when it comes to pets. Americans spend an enormous sum on health care for their dogs, cats, birds, fish, ferrets, gerbils, lizards, potbelly pigs and other assorted pets: more than $24.5 billion in 2006 alone, according to the American Veterinary Medical Association. (If you're into comparing vast amounts of money, that's greater than the gross domestic product of more than half of the world's countries.) Though care for all pets is included in the figure, the nation's 81.7 million cats and 72 million dogs account for the majority of vet fees.

A generation or two ago, visits to the vet were limited to getting rabies shots and treating the occasional broken leg or bite wound. These days pet owners are offered an alphabet of treatments, from acupuncture, aromatherapy, behavior counseling and chemotherapy to prescription drugs, root canals, surgery and X-rays. Spot, heal thyself, is not an option.

And with veterinarians providing ever more medical solutions for all creatures great and small, owners find themselves having to choose between paying hefty bills and performing the moral and emotional calculus that leads them to decide to put down their pet. Many are finding it increasingly hard to make that choice.

"The human-animal bond has grown so much that people are often willing to spend the money instead of making the very difficult decision to euthanize the animal," says David Kirkpatrick, spokesman for the veterinary association.

Yet although pet owners welcome medical advances that may add months or even years to their animal's life, the associated costs often leave them feeling as if they are being asked to play God.

"There are so many options for people that it can create angst and guilt," says Anne Sweeney, 44, a pet owner who lives in Mount Airy with her husband and three children. "If there's a treatment out there, you feel like you have to do it."

Sweeney speaks from experience. Ally, the family's greyhound, died in 2006 after treatment for a bout with bone cancer that included drugs for pain control, a course of radiation and the eventual amputation of one of her legs. Ally lived for 2 1/2 years from the disease's diagnosis, and Sweeney doesn't regret the steps the family took to keep her alive and control her pain or the approximately $5,000 they incurred in health-care fees. But now a cancerous tumor has been removed from Coach, another of the family's dogs, and Sweeney isn't sure she would take the same treatment path this time if it becomes the only option. The financial implications of doing so certainly would factor into the decision.

"I'm a dog freak. I cry every time I see a commercial showing dogs in the pound," she says. "But I also know my limits. I do think you can go overboard."

The quandary for owners has grown as families have begun to see animals as integral members, says Lorri Greene, a San Diego-based psychologist and the co-author of "Saying Good-Bye to the Pet You Love" (New Harbinger Publications, 2002). And choosing to euthanize a pet can be especially traumatic for owners. "If they are thinking of it [the pet] as a child, it becomes a very difficult decision," she says.

In recent months, as the economy has teetered and money has tightened, Greene says she has seen "more and more owners who are feeling guilt" about what they can or can't afford for their pets and "a lot more people who are reluctant to throw extra money around."

Liz and Nick Chandler of Leesburg fell hard for Sadie, the shepherd-Lab mix they rescued seven years ago. But Sadie was also "a money pit from the very beginning," says Liz Chandler, 64. The dog suffered from separation anxiety and had to be taken to a pet day care that started at $300 a month and eventually climbed to $500. There was also obedience training and treatment for heartworms and Lyme disease.

"The bills came in a flash every time she had a little crisis," Chandler says.

In December, Sadie became sick. She was diagnosed with cardiac cancer, and the illness progressed quickly. So did the bills. Overnight hospital stays, ultrasound and blood tests: $2,400; fluid drained from chest and overnight monitoring: $1,100; platelet count check, antibiotics, herbs to jump-start her immune system: $800; ultrasound and fluid analysis: $735.

Cha-ching. Cha-ching. Cha-ching. Cha-ching.

As satisfied as the Chandlers were that Sadie was receiving excellent care, it didn't lessen the financial impact. "It cost a fortune. But we were worried about her and didn't want to think about the money," Chandler says. "This was our child to us." Six weeks of expensive treatment, and Sadie's outlook had only worsened. The couple ultimately decided to euthanize their beloved pet.

The next time the Chandlers adopt a rescue dog (and, yes, they say they want another one), they will take a closer look at potential medical problems and will investigate whether pet insurance is worthwhile.

Veterinarians say that they are offering more options (including treatments previously available only to humans) because pet owners are demanding better care and want more, even if it adds to the cost.

"Consumers are able to seek out the level of care they are comfortable with," says Peter Glassman, a veterinarian and director of the Friendship Hospital for Animals in Tenleytown. "If a pet owner really wants human-level care . . . then it follows that they are going to have to pay for it."

Glassman says that vets have a responsibility to explain choices and treatment options to pet owners but that it's not always possible for them to predict the result of treatments or how much additional care will be required.

"It's not like taking a car in and changing the muffler," he says. But, he adds, pet owners who can spend more on their pets are likely to get better results. "For those who can take advantage of it, the value is there," Glassman says.

Not all of the nation's 83,730 veterinarians, however, think that spending more and more is the answer. Nor are they all pleased with the direction their field is heading in or comfortable with the explosion in pet health-care costs. Perhaps none is more outspoken than James. L Busby, the author of "How to Afford Veterinary Care Without Mortgaging the Kids" (Busby International, 2005) and a Minnesota veterinarian.

"The trouble is that many veterinarians don't give you all of your options, only the most expensive ones," he says. "And they shame you if you don't want to pay for them. They say, 'Don't you want what's best for your dog?' "

Busby insists that vets are over-vaccinating, overtreating and overcharging for their services. He rails against what he says are unnecessary vaccines for Lyme disease and takes vets to task for advocating the maximum care in all instances. He is not exactly Mr. Popularity among his colleagues.

"I'm a lone dog," he says. "I've had three or four vets say good things about me, and the rest of them throw rocks. If I wasn't 68 years old and didn't give a damn, I'd be in a tough spot."

Busby recognizes that most owners don't have enough information about their pets to know when to accept a vet's recommendation and when to challenge it. His book and Web site ( http://www.oldcountryvet.com), he says, give owners "the knowledge to say no to their veterinarians. People have got to say no."

Ultimately, individuals have to sort through the ethical, emotional and economic dimensions of owning pets to determine how much to spend on them -- and when the cost is simply too great.

"The embarrassing answer is that if I had to do it again, I would probably continue to pay," Jennifer Freeman says about treatment for her four cats. "I accepted responsibility for these cats, and some of those responsibilities aren't pleasant. Now, do I have any plans of getting more cats? Absolutely not."

View all comments that have been posted about this article.

© 2008 The Washington Post Company