The same considerations can be applied to human medicine. If the results of a test (particularly an expensive or invasive one) will not change the treatment plan, is it worth doing at all?
Note that this is likely the reason that some screening tests are not recommended for very old people or others with short remaining life expectancy, where the thing being screened for would not kill the person sooner than s/he is likely to die anyway. E.g. no point in colon, breast, or prostate cancer screening for someone who just turned 100.
Sometimes a behavior or sign could be a symptom of either a relatively treatable disorder or a hard-to-treat disorder… Eliminating one or the other can be useful, for example if the treatment in the first situation is sufficiently rigorous that you wouldn’t want to use it for the second situation. There was a small chance my dog’s limp was caused by a fungal infection. I would have strongly considered having him treated for that. The cancer (which he has) is a very different situation.
Our girl was dx’d with neck cancer while at an appt for teeth cleaning and extraction. We stopped the teeth cleaning and instead the vet tried to extract the tumor (same cost). It was wrapped around her carotid, windpipe and other structures. Vet said we could go to the oncologist a d do chemo/radiation, but said her feeling was that we’d wind up in the same place. There was an anti-inflammatory drug that cost $32, which helped with the swelling. It bought us three months of her being fairly comfortable, until she started to struggle with breathing when lying down. At that point we knew it was time. Our vet came to the house for euthanasia, but charged us the same rate as doing it in the office.
Our new puppy is a sweetheart, but chews all kinds of things she shouldn’t. We’re working on that!
We figure about $1000/year for dog expenses including food, equipment and vet. Glad we are able to do this; our dogs have been really important for my well being as I deal with illnesses.
@CountingDown - We figured about $1000 as well, but that it’d be spread out over the year. The $1700 hit all at once was a surprise. Our dogs are really important for my well being as well. When we rescued the newest one, the “adoption” fee was more than we’d ever spent before, as she was still very young and the demand is higher. The additional set of shots and spay fee once she got older was more than we expected. I did not expect to also have to pay for a new coffee table which she chewed the corners off - but we got one second hand at the Habitat for Humanity store for only $60.
Even so, DH reminded me that its cheaper than therapy, and cheaper than hiring a divorce attorney…
My dogs are good for my wellbeing also, although spending 9 of the last 10 months as a caregiver to a dog with cancer has been stressful. At least I feel needed.
Our vet has not generally tried to push expensive treatments on us, and has been very sensitive to the “will this test provide treatment options?” issue. But the office has definitely been ramping up the number and frequency of vaccinations and tests they recommend/require, and of course the heartworm and tick medicines cost a lot.
I am still upset, however, with what happened at the end of our previous dog’s life. She was 14+, had had some never-precisely-diagnosed chronic illness for several years, with periodic seizures, and had been visibly declining for a number of months. I came home one afternoon to find her in the middle of a profound seizure – completely nonresponsive and barely breathing, in a puddle of pee and poop, in a place she never would have lain down on her own. I called the vet, and the technician I spoke to essentially refused to let me bring her in to be euthanized. She insisted I should take her to a veterinary emergency facility to see if she could be revived. I wrapped her in a towel, and drove 8 miles to the nearest such facility, a horrible, soulless doc-in-a-box where I had never been (vs. the 1.2 miles to our neighborhood vet). When I got there, and carried her in, the tech there said, “Is that dog alive?” and then started giving her oxygen. A few minutes later, the vet came in and said, “You can’t possibly want me to revive this dog.” She didn’t have enough blood pressure to euthanize her with a normal injection into a vein. He had to put a needle directly into her heart, something that took him several tries. I got charged about $700 more than my vet would have charged, even after they discounted the bill. Plus they never gave me the towel back.
We have a new dog, but I am still thinking of leaving our vet (after 25 years) because of not letting me bring my dog there.
We have an English lab. As a 9 week old puppy he ate some lava rocks from the backyard. Had emergency surgery to remove them. Few weeks later he ate half of the plastic floor of his crate. Another surgery. We ended up getting dog health insurance for him. Turns out it came in handy a few more times. He chewed a cone after getting neutered and a shard got in his eye. He had eye surgery to remove the shard and fix his eyelid. Now as a big boy 4 year old he’s calm and just relaxes around the house. But the puppy days made us frequent fliers at the vets office.
I dress poorly when going to the vet (or to see any wedding vendor, but that’s a different story!) You are more likely to be offered less expensive treatment options if you don’t look well off.
About 6 years ago, one of our cats developed hyperthyroidism. We were offered three options: a special cat food, thyroid medication and frequent blood tests for the rest of his life, or radiation treatment and a one week hospital stay. The food was a no go, the medication and vet visits over a lifetime were the most expensive option and did not guarantee success, so we opted for the radiation. It cost $1900.
The amazing thing is that at the end of the week, when we were told about the onerous discharge procedures, we asked if there was another option. The discharge instructions included isolating the cat and wearing gloves and a mask to scoop his dedicated cat box until his poo was no longer radioactive. There were further instructions regarding the disposal of the waste. We were very concerned about our ability to handle this situation safely since we had another cat and my husband is a cancer survivor. The hospital kept the cat free of charge for another two weeks.
We had a beagle/spaniel mix. We got her from the rescue place when she was 3. She started slowing down and stairs got difficult for her when she was 10-11, nothing major.
All of a sudden one Sunday afternoon when she was 13 she started having seizures and foaming at the mouth.
We took her to the emergency vet who ran about $500 of tests. The vet came and told us the diagnosis (I forget what it was) and the treatments would cost thousands. I asked if it would make the dogs life easier and longer. The answer was maybe, maybe not, we don’t know til we try the treatment.
I asked the doctor what she would do if it was her dog. She immediately said she would put it down, so that is what we did. I found it kind of funny though that was not one of the original options.
Now that immunotherapy cancer treatments are becoming available for veterinary use the costs are going to continue to escalate.
We’re currently dealing with digital (toe) melanoma with our 10.5 yr Golden. Biopsy surgery & histology-$900; toe amputation, ultrasound, X-rays, further histology-$2500. We visited with an oncologist who mentioned the availability of a melanoma vaccine, DNA that encodes a human version of a protein in melanoma cells. The dog makes antibodies to the human protein which should also attack the tumors. I was surprised to learn that this vaccine was licensed with no controlled clinical trial data. Approval is through the USDA, not the FDA, and criteria are lax. Cost of the vaccine series- +$3500.
We’re going to say no, make a donation to the shelter, and perhaps rent a beach house for a weekend while our old girl is still feeling good. In some ways a cancer diagnosis makes saying goodbye easier. I’m not sure we would know where to draw the line for infirmities of old age.
I follow the blog of a psychiatrist at UCLA and he wrote this piece about end of life decisions: http://ow.ly/KJ9M30kirEl
@Massmomm - one of my coworkers had to relocate half-way the country to get to a new job… she foolishly decided that it would be good to have that procedure done before moving… talk about driving from Seattle to Chicago with a howling radioactive cat and a box of radioactive cat crap in the car!!!
The only treatment that seemed to offer a real chance of stopping growth of my Aussie’s tumor was a radiation protocol that would have required 20 “doses” of radiation, all under general anesthesia, at a cost of at least $8,500. I was actually kind of relieved that it was so expensive because that made it easier to decide to not have her or me endure the arduous treatment.
I don’t think the euthanasia took place too soon, but I admit that I struggled over the decision of when to do it, especially because, to the untrained eyes of people who weren’t with her all the time, my Aussie looked good until the end.
My sister did the radiation procedure (drove 2 hours each way for the drop off and pick up) for a fairly elderly cat and it worked well. She did do the litter box isolation and scooping and it was difficult with other animals, but she is good with extreme pet things. She got another couple years with the big Maine Coon cat.
Our sweet almost 20 year old cat was out to sleep in December. She had a cancerous growth on her hind quarter.
I can’t tell you how wonderful our vet was. Everyone in the office knew this kitty…and some had known her for a long time.
They advised us well on what to do for our sweet kitty, and never suggested any over the top treatments. But they did offer suggestions to keep her comfortable.
It is not just vet school that is expensive. The drugs and equipment are expensive. They aren’'t subsidized by the large drug companies and partially paid for by insurance companies. They have to rent space, pay employees, pay insurance, buy expensive equipment, everything they use costs money. They can’t pay nothing. Yes the larger companies can do it cheaper because they can buy in bulk. Your local vet can’t. They are not trying to gauge you. Vet school is as expensive as medical school, sometimes more, with less scholarships and MUCH lower salaries once they have finished. It is 4 years of college and 4 years of medical school, plus specializations. Just think a little about that. Vets also have an extremely high rate of suicide. MANY owners yell at them about the cost of procedures and they are honestly making very little profit. They are frustrated they can’t treat pets that can be saved because the owners can’t afford it. They offer the treatment they think is best. It doesn’t mean the owner has to do it. They would be doing the wrong thing if they didn’t offer treatment options even if they are expensive. Next time before you get mad a a vet think about how much each item costs them. They have to pay for anesthesia and someone to give it, they have to pay for bandages, gloves, operating tables, etc, etc. Yes they are pets but a lot of the medicines cost the same. Some medicines are even harder to get because when there are shortages the people get them first and the vets pay more!
I challenged my vet on the frequency of the diphtheria vaccine. His response was “well for a smaller dog like yours I can certainly go three years vs two.” Thank you Mr. Vet
@rosered, our sweet girl was outside walking around the yard when the vet arrived for the euthanasia. She was good when she could stand, though she could no longer handle a walk around the neighborhood; it was when she tried to lay down that the tumor would compress her windpipe and make it difficult to breathe. Otherwise, she was a perfectly healthy 14 old dog without any other medical problems. Just a bad tumor in a bad place.
Re: vets “upselling”…Goskid #1 fell in love with a 23 lb. adult rescue kitty, who had obviously had endured life on the streets. Kitty’s ears were scarred, ragged and he had a chunk taken out of his lower eye lid. Our vet said “No problem, I can fix with a little plastic surgery and he’ll look like new!”
Um…no, believe me, if anyone in the family would be getting plastic surgery, the cat was not going to be the first one.
