Pets, Ethics and Health Care

[Kaylee]

I had to think about this quite seriously yesterday and today as one of my cats, Breamy, had a blocked urinary tract earlier in the week. I took him to the ER (for pets, yes NYC has everything) and just brought him home Thursday night. He immediately had trouble peeing again and also had a fever. Now, his fever is gone, but he is still partially blocked. Perhaps the hospital made a mistake, and he is still blocked from earlier in the week and was never actually completely unblocked. That is a possibility also.

I happen to come across these articles:

What I Wouldn’t Do For My Cat


But Doc! The Dog’s Already Dead!

I know there are a lot of pet lovers in this forum and I’m interested in your opinions. When it comes to giving our pets health care, should we treat them the same way we would our parents, husbands, wives and children? Or is another standard OK? And if another standard is OK, than what is that standard?

I think most people would agree that we should give our pets the basic shots and if they have worms deworm them. The first article linked above mentions a person that spent $25,000 on their dog's vet bills to take care of an infection from a wound (at the top of 2nd page in the article). I think most people would say that if you decided not to spend that much money on your dog's vet bills, esp. if you aren't wealthy, that doesn't make you an evil person! But where does the demarcation line lie?

Mods – I wasn’t sure what forum to put this thread in. If there is a more apt one, pls move it. Thanks.

PS I am taking care of Breamy, so this thread doesn't have to go in a practical real life direction. I just thought it would be useful to have an abstract discussion on what the ethics are in this area. Should only very wealthy people own pets? Would that actually be beneficial to most companion animals?

I'll hold off on my opinions for now, I don't want to prejudice the way this discussion (if any) starts.

 

[pgwenthold]

{Busby} writes that he has had a satisfying 40-year career, "but sadly, I would never enter the profession today, if I had to practice the way things are currently done." He sees too many vets who try to "push as many procedures and services … as the pet owner will tolerate, in order to generate as large a cash return as possible."

I can relate this firsthand. My wife is a vet who got fired for "not making her numbers." See, she was unwilling to order procedures that the animal didn't need and that the clients couldn't afford. Her boss wouldn't accept such behavior. He admitted she was a good doctor, and she was LOVED by her clients and the staff. A lot of her clients called her when they found out just to tell her how mad they were.

Then again, Busby is extreme in the other direction. His dismissal of "wellness exams" is one example. Waiting until an animal is sick is not the best approach to promote a long and healthy life. Just as people go to the doctor for regular checkups when they not sick, it is not unreasonable to do the same for pets, especially if the pets are indeed "beloved family members." Wellness exams do help extend life by finding problems earlier, and improve quality of life by promoting healthier living. If your pet is just an animal to you, then, no, such things don't matter.

 

[Foster Zygote]

Coincidentally, one of my cats, a seven year old male named Schwarz is at the vet right now with the same problem. I took him in on the 7th and they catheterized him and put him on meds. Then last weekend he was acting listless and uncomfortable so I brought him in last Monday to find that he was blocked again. He's scheduled for surgery on Monday which should eliminate any further urinary blockages. The whole thing will be a bit expensive at around $2000, but I've raised him from a kitten and he's very sweet and loving and especially fond of me. He's otherwise perfectly healthy (aside from being a bit on the pudgy side) and I just can't see myself burying him in the garden over two grand when he has many good year left. As to what I would do if it were $20,000... Well, I'm just glad I don't have to deal with that.

 

[UnrepentantSinner]

I have a terrible cunondrum when it comes to my cat(s)... they hate getting into the kitty carrier and hearing their plaintive mews breaks my heart. So I didn't take Hattie or Scar to the vet for a number of years and Hattie died about 2 years ago to this day. Scar does things here and there and has some symptoms/characteristics that concern me, but she still seems perfectly healthy... and yet, two years after Hattie died, I can't bring myself to cram her into a kitty carrier and take her to the vet since she doesn't want to go.

Scarlett is 14 or 15? With children at some point they accept doctors visits, but cats are still in toddler mode for their entire lives.

I miss Hattie despite what a pain in the ass she was and how she terrorized Scarlett... but kitties are kitties and when you pass the decade mark you miss their presence.

 

[Kaylee]

I can relate this firsthand. My wife is a vet who got fired for "not making her numbers." See, she was unwilling to order procedures that the animal didn't need and that the clients couldn't afford. Her boss wouldn't accept such behavior.

How infuriating.

He admitted she was a good doctor, and she was LOVED by her clients and the staff. A lot of her clients called her when they found out just to tell her how mad they were.

Sounds like a good basis for starting her own practice -- although I'm sure there are many other considerations.

Then again, Busby is extreme in the other direction. His dismissal of "wellness exams" is one example. Waiting until an animal is sick is not the best approach to promote a long and healthy life. Just as people go to the doctor for regular checkups when they not sick, it is not unreasonable to do the same for pets, especially if the pets are indeed "beloved family members." Wellness exams do help extend life by finding problems earlier, and improve quality of life by promoting healthier living.

Agreed. There was a lot I didn't know about cats and I'm still learning. The physical annuals helped for that reason alone.

 

[quixotecoyote]

It's clear cut for me, but I've had to give cats to a shelter before when my roommate couldn't put up with them anymore (for various good reasons), so I know that the experience of losing pets through your own actions is rough but bearable.

Right now I have ferrets and am planning a wedding. If the ferret budget runs up against the wedding budget, the adorable furballs are, sadly, outta luck.

 

[Kaylee]

Coincidentally, one of my cats, a seven year old male named Schwarz is at the vet right now with the same problem. I took him in on the 7th and they catheterized him and put him on meds. Then last weekend he was acting listless and uncomfortable so I brought him in last Monday to find that he was blocked again. He's scheduled for surgery on Monday which should eliminate any further urinary blockages. The whole thing will be a bit expensive at around $2000, but I've raised him from a kitten and he's very sweet and loving and especially fond of me. He's otherwise perfectly healthy (aside from being a bit on the pudgy side) and I just can't see myself burying him in the garden over two grand when he has many good year left. As to what I would do if it were $20,000... Well, I'm just glad I don't have to deal with that.

$2,000 for all the procedures? NYC is more expensive. I took Breamy to a non-profit ER and their est. is about $5,000. They won't do a perineal urethrostomy (the procedure they told me about which makes urinary blockages less likely) until they do at least 3 catheterizations first. To try to steer this back to a general ethical conversation about pets, ethics and health care -- I tried to find out how much other hosptitals and clinics charge but its difficult to find places that are willing to inform people how much they charge in advance.

Is that ethical? It doesn't seem so to me. If someone expects to get paid, shouldn't they tell a potential customer how much they charge so the customer can know if they can afford the services before they commit themselves?

(BTW, from the web, reading about people's experiences, it seems that a perineal urethrostomy alone in NYC, can be as much as $6,000, possibly more.)

Anyway, Breamy's case is a little complicated and perhaps a little unusual. I might open up another thread about that in either the science or community forum. I've gotten snapped at for not sticking to my own OP's topic in other threads , so I think I'll go back to that, for now. (Actually I need a break today from thinking about Breamy's situation. Its been a very stressful week. He's a wonderful cat ... and I'm not having an easy time with this. He seems a little better though, so hopefully he'll get healthy and stay that way at least for a little while.)

But back to talking about the abstract concepts...

In regard to how much I (generic I) should be prepared to spend on a pet's care -- I suppose its fair to take into account what the pet's options would have been if they had not been adopted by me (generic me).

By that standard it seems that a purebred probably shouldn't be adopted by someone unless they have significant amounts of money at their disposal to spend for that pet's healthcare. Because given the supply and demand for purebreds, chances are that someone else would have been willing to adopt that pet who has the resources.

ETA: But than again, there seems to be a lot of purebreeds available from breed rescue groups, although I think most of them are adult dogs.

IMHO, I think its reasonable to have that standard be lower for a pet at a typical kill shelter. Many healthy dogs and cats are destroyed if they are not adopted within a short time frame. So if a cat is adopted by someone who takes good care of them but gets hit with a large, unexpected and rare medical expense that they can't afford -- I don't think it makes them an awful person if they decide that they don't have the resources to pay it. After all, one could argue that the pet got to enjoy X number of months or years before the rare, unusual medical emergency occurred. If that pet had not be adopted, he would have been killed much earlier. So one could argue that if the only people who were legaly able to adopt pets were the ones that had proof of at least $15K in reserve (for argument's sake) for unexpected medical expenses, then more animals would actually be hurt than helped by that custom. Because a lot of people would not have that much money on hand in their bank or other convertible assets and more animals would end up being destroyed instead of adopted because it would be harder to find people financially qualified to adopt them.

Here's a real life example: A few years back I bumped into an acquaintence (lets call her Mary) in an animal hospital's waiting room. I was there to get my other cat vacinated as part of the adoption process prearranged by a pet shelter affiliated with the hospital. Mary was there because her cat had torn through a ripped screen (she didn't realize it was ripped) and escaped to the balcony where he fell off and broke his leg. IIRC, it cost her about $8 or $10K to get it fixed. While she told me this she was pretty shell shocked, not from the vet bill yet, but from the fact that her pet had broken its leg and probably almost died.

I'm about 99.9% sure that Mary couldn't really afford the vet bill. I also know where she got the cat from. She had been pressured to adopt it by another acquaintance of ours (lets call her Sue) who had found an abandoned pregnant cat on the street. She had adopted the cat and now wanted to give away the kittens. Now kittens usually get adopted in pet shelters but I have heard that the city pet shelters make people pay to surrender animals to the shelter. My guess is that Sue didn't want to keep the kittens but she didn't want to pay to drop them off at a shelter either. She was good at twisting arms and Mary doesn't have a strong personality.

After my recent emergency at the hospital with Breamy I learned that this particular hospital doesn't discuss various options and doesn't give you any time to think about it. I suspect that some of their vets could teach used car salesman some excellant high pressure techniques. Frankly, as much as I love animals and wish that they could all be saved, I don't think that is ethical. Particularly since this hospital is known as a non-profit institution and is known to have lower rates they are getting a lot of people from a wide range of financial circumstances. As far as I know, there is no cooling off period for medical expenses like there are for other people in other type of transactions. (Vet care can be a wonderul thing, but it is also a business transaction. As proof, don't pay your vet bill and see what happens. ) I can see how some people could sign themselves into serious debt before they had a chance to think about it. On one hand they are adults and legally responsible for their actions. On the other hand, its an emotional situation and very likely the first time that many of them are in this situation ... and I do think that many are being taken advantage of. Its not reasonable to expect everyone to be in a position to pay $10K or more for emergency care. And I would not be a bit surprised if Mary ended up having to go into bankruptcy or came close to it. If she had been given time to think about it, then she might have made the difficult choice to not save her cat. And that would have been awful, but then again she had him for about 3 years and he was a rescue cat that got to live for 3 years because she was willing to be pressured into adopting him. Does a nice person in Mary's situation deserve to face financial ruin because she was caught in a weak moment? And this affects other people in her family also who are dependent upon her, or at least strongly affected by her decisions.

I think its ethical to make an effort to live within your means. And I think its unethical when people try to use your emotions to defeat that.

So thats where I am now when I think about this whole topic abstractly. I haven't finished thinking about it yet though.

And I'm a little tired and as a result I rambled a lot...

 

[Kaylee]

I have a terrible cunondrum when it comes to my cat(s)... they hate getting into the kitty carrier and hearing their plaintive mews breaks my heart. So I didn't take Hattie or Scar to the vet for a number of years and Hattie died about 2 years ago to this day. Scar does things here and there and has some symptoms/characteristics that concern me, but she still seems perfectly healthy... and yet, two years after Hattie died, I can't bring myself to cram her into a kitty carrier and take her to the vet since she doesn't want to go.

The last time I took my cat Kaylee (I stole my user id from her )to the vet she started hyper ventilating and had ropes of saliva hanging from her mouth. It was not the temperature, it was a beautiful fall day -- she was just simply terrified. For a while there I thought my cat was going to die by checkup.

Scarlett is 14 or 15? With children at some point they accept doctors visits, but cats are still in toddler mode for their entire lives.

I miss Hattie despite what a pain in the ass she was and how she terrorized Scarlett... but kitties are kitties and when you pass the decade mark you miss their presence.

Yeah, I know what you mean. I was surprised how attached I got to my cats. I realized how strongly I was attached the first time something went wrong and I couldn't fix it right away.

 

[Kaylee]

It's clear cut for me, but I've had to give cats to a shelter before when my roommate couldn't put up with them anymore (for various good reasons), so I know that the experience of losing pets through your own actions is rough but bearable.

Right now I have ferrets and am planning a wedding. If the ferret budget runs up against the wedding budget, the adorable furballs are, sadly, outta luck.

Some good examples where people are put first, and I absolutely agree that people should come first. But you know that in some forums you would get a hard time for the second example. I'm not going to give you a hard time though.

Congratulations on your wedding! You mean you have time to post here and plan a wedding also? Wow!

 

[JoeEllison]

I'm rather intimately familiar with this sort of ethical dilemma, for reasons that are too unfortunate for me to go into. I will say this: animals are NOT people. We love them and welcome them into our homes, our families, and our hearts, but they are still not people. There's a quality of life issue involved... and, frankly, there's a veterinary insurance plan available. If your ethics require the very best care, then they should also require the minimum monthly expenditure.

The quality of life issue is trickier. If I lose a leg, it only affects those situations in life which absolutely require a fully-functional leg, of which there are very few. The rest of my life goes on with the relatively minimum inconvenience of a permanent limp and/or a cane or crutches. Even in a case of more severe injuries, a relatively full life is possible. Look no further than the "Murderball" documentary. For animals, however, it isn't that simple. Could a cat or dog really be happy after a serious illness or injury? Maybe, maybe not... and it needs to be addressed when choosing a treatment.

I used to keep pet rats. When they get the mycoplasma, it is pretty much a matter of time before they die, and plenty of suffering before they do, and a decreased quality of life throughout. And, yes, it can get damned expensive. What's worse is to spend that kind of money for a few weeks or months of health before the inevitable relapse.

Forget it. My wallet can't bear it, and neither can my heart.

 

[godofpie]

Right now I have ferrets and am planning a wedding.

OOh! A ferret wedding! Can I come? What do you give a ferret on its wedding day, cedar shavings?

 

[godofpie]

I think its ethical to make an effort to live within your means. And I think its unethical when people try to use your emotions to defeat that.

So thats where I am now when I think about this whole topic abstractly. I haven't finished thinking about it yet though.

And I'm a little tired and as a result I rambled a lot...

Everything changes if you have a kid. For many years it was just me and the dog and I would do whatever it took to take care of him. Now that I have a daughter, she is the priority in my life and I would not go to the same lengths for my dog as I have in the past.

 

[Kaylee]

I'm rather intimately familiar with this sort of ethical dilemma, for reasons that are too unfortunate for me to go into.

<snip>

I used to keep pet rats. When they get the mycoplasma, it is pretty much a matter of time before they die, and plenty of suffering before they do, and a decreased quality of life throughout. And, yes, it can get damned expensive. What's worse is to spend that kind of money for a few weeks or months of health before the inevitable relapse.

Forget it. My wallet can't bear it, and neither can my heart.

I'm sorry you had to go through this sad experience. I hope you don't mind this question -- do you feel that you were pressured by a vet or by anyone else to provide more medical care to your rats than you thought was appropriate?

 

[Kaylee]

OOh! A ferret wedding! Can I come? What do you give a ferret on its wedding day, cedar shavings?

Everything changes if you have a kid. For many years it was just me and the dog and I would do whatever it took to take care of him. Now that I have a daughter, she is the priority in my life and I would not go to the same lengths for my dog as I have in the past.

That makes a lot of sense.

Even though I don't have kids, I do have other responsibilities and I know its important to prioritize.

 

[JoeEllison]

I'm sorry you had to go through this sad experience. I hope you don't mind this question -- do you feel that you were pressured by a vet or by anyone else to provide more medical care to your rats than you thought was appropriate?

No. I have a very good vet, who is sensitive to the emotional issue of pet health, but who also understands the serious financial costs involved, and has always been good enough to state the costs up front, as well as the best and worst possible outcomes of any medical treatment. He let me know up front that treating my rats would only provide short-term relief, and didn't try to pressure me into accepting expensive treatments without letting me know how ineffective they would be.

 

[Kaylee]

He sounds like a great vet!

 

[quixotecoyote]

Some good examples where people are put first, and I absolutely agree that people should come first. But you know that in some forums you would get a hard time for the second example. I'm not going to give you a hard time though.

Congratulations on your wedding! You mean you have time to post here and plan a wedding also? Wow!

Thanks!

About the second example. I'd be given a hard time in other forums, but unless those other forums consist entirely of vegetarians, I'd give some hard times too.

The only reason my mini-weasels are my tenants rather than teriyaki strips is that they fell on the same arbitrary cultural side as dogs and cats rather than pigs and cows. Given that in some cultures pigs are pets and cows are sacred, anyone that demands human-level consideration for cats, dogs, and ferrets while eating pork chops and hamburgers can be safely ignored.

Me, I think they're all just animals. Some I'd rather keep around for entertainment and companionship than eat, but I don't see any fundamental difference.

 

[supercorgi]

It all depends on the individual situation - your financial resources, the medical problem, the age and general health of the pet, and your attachment to the pet.

I'm going through this right now with my cat Major. He's 14 years old and has developed a tumor in his mouth. The vet did a biopsy and it's cancerous. She said it's not the worse type of cancer but it is agressive and will grow quickly. She's a great vet and detailed my options.

She said that the most aggressive treatment, if money was no issue, would be to have Major's head cat scanned to see if the tumor had invaded his jaw and then depending what they found they could try to remove the tumor. If it was into his jaw, they'd have to remove part of his jaw, and she honestly said that cat's do not tolerate that very well - dog's do ok with that but not cats. I figured that I would at least have him cat scanned to see what the extent of the problem was but when she told me that the cat scan alone would cost $1500 - I really had to do some serious soul searching.

I love all my pets - they are my kids. But I'm out of work, Major is 14 (not super old for a cat but still elderly), if the tumor extends into his jaw there's really not much they can do and surgery would run into many, many thousands of dollars plus pain for the cat.

I decided not to go through with that. Right now, Major doesn't seem in any pain, he's still bright-eyed and active, comes for petting, meows for food. The only problem right now is that he can't eat very well. I've scoured the grocery store for things he can eat just to make sure that he's still getting the basic nutrition. I'll keep him as healthy and as happy as I can but when it becomes too difficult for him, and when he starts to have pain, I'll let him go.

I'm crying as I write this because I know it's inevitable, but in the end I think it's the best thing for both of us. Before I take him for that final visit to the vet, I'll take him outside, let him eat grass (this is the thing that makes him happier than anything), and then say good bye. I wish I could euthenize him at home because then he wouldn't have to have that scary trip to the vet and he could go out of the world when he's happy and content. I wonder if there are any vets that still make house calls?

Oh Major, I'm going to miss you - you're my big, fluff butt, my flirty cat.

P.S. I am happy today because I've finally found a food that he likes and seems to get down OK. He's eaten almost a whole can of Fancy Feast today and is acting perkier!

 

[Gevaudan]

Re: Handicapped animals. It's one of those case by case things.

Some animals with handicaps actually seem to have a better quality of life than humans with similar handicaps. I'm thinking specifically of my sister's dog Bonnie, who was born without eyes (a problem that didn't become apparent until she was several weeks old). Bonnie not only got around perfectly well, my sister trained her in obidience, cart and weight pulling, and she visited people in nursing homes and hospitals. Bonnie passed away a few years ago, and now my sister (who's a vet tech) has a blind cat who's able to catch flies. Three-legged animals also seem to get around quite well, as long as you make sure their weight is kept down.

In some cases, however, the handicap is clearly hurting the animal. I'mk thinking of the dogs I see in wheelchairs who have no movement in their hind legs whatsoever. Diseases like epilepsy and diabetes can be controlled, like with humans, but sometimes the cost to the owner can be extreme. Pets are NOT people, of course, but they are our creations - cat and dogs have evolved alongside us. We have the responsibility of stewardship.

I had to go through this last year when my dog was diagnosed with a very fast growing cancer of the spleen. Her health collapsed very quickly, and it was obvious she wouldn't survive long. After a week of hand-feeding her (only to have her throw everything right back up) she suffered a seizure and was clearly mentally not all the way there any more. I'd hand raised this dog from a newborn and making the choice to have her euthenized was the hardest thing I've ever done. I could have paid a lot of money to have her on fluids and at the vets, but I think it was better for her to be at home, with me, and to pass while I was holding her too.

 

[supercorgi]

Right now I have ferrets and am planning a wedding. If the ferret budget runs up against the wedding budget, the adorable furballs are, sadly, outta luck.

I used to have ferrets - in fact I had 4 at one point. I will not have another ferret. Not because they're not wonderful pets, I really, really love ferrets, but because they don't live long enough. All 4 of mine died around 4 years old from some weird diseases. Ferrets are prone to cancer. One of them had to have her tail amputated when she was 2 because of a growth. I loved each of those crazy furballs but I get so messed up when a pet dies that I just couldn't go through that so frequently. So I miss they're chucking, their mischief, and their crazy ferret dances, but I need to spare my heart.