General vet expense question

[The Quahog]

I would agree that outcome probabllities are a major, presumably the major concern.
(In general here I am speaking of the very large bills that rapidly accrue at specialists. This is more about how I would advise a client when dealing with those situations than in talking about doctor-client realtions in my own practice.)

For something like a pyometra, that when you are done the animal is cured, its over, there will be no further difficulties, then considerable expense even at the cost of some hardship is not unreasonable.
For something like a very expensive round of surgery/chemo for a malignancy, I would like my clients to have a pretty good idea of percentage survival expected after 6 months and after one year.
For something like a diabetic with concurrent Cushing's and renal failure, I might advise against repeated expensive critical care emergency visits, as we pretty well know it will not end well.

I have seen young couples lose the ability to purchase a house because they spent $8000 on a pet where the chance of a successful outcome was not good. In such cases I'm not shy about telling the client I do not approve, even if it causes some difficulty with the speciaist.
So its really difficult to suggest a figure, or a percantage of income etc. There are many factors.
It's all well and good to talk about 'You shouldn't have a pet if you can't afford ith' when talking about $400. Not so much when you are talking about $6000, and you have a child preparing for college. -Dr. Mac

[Jaynie]

I'm surely not financially well-off - I survive on Social Security Disability payments. I have a wonderful vet who is very frank about what an animal's chances are, and considers quality of life the utmost concern. He'll tell you what he would do as if it were his own dog. (Plus, he has herding breed dogs himself.)

When Neechee and I lived with my parents a few years ago, Neechee had a stroke. He was 16 years old, and I was so afraid it would be the end of him. But the way he looked at me, and the way he responded to my voice convinced me that it was worth anything I had to pay to get him treatment. With a week of 24/7 TLC, steroids, petting, and watchful waiting, he actually recovered, though he was a little more fragile afterwards. It cost what was for me a great deal of money - $300. Luckily, my mom paid for it, because she said Neechee was the only thing keeping me alive at that point. (Looking back, I guess I really was that sick.)

A year later, I awoke early one morning, and Neechee was wailing pitifully. Soon after, he had a seizure, and we rushed to the vet ER. I held him tight all the way, and knew the end was near even before the ER vet told me. Somehow, he let me know. I don't know how, but he did.

I would say, after experiencing this, that I approach vet care for each of my critters on a case-by-case basis. For example, when my Border Collie Max was 7 months old, he got a "de-gloving" injury on his left front leg. It was pretty serious (he fell off a very tall wood pile while playing). Since he was bought especially to become an obedience/herding competitor, and I loved the goofy little guy to death, he had a specialist from the University of Georgia veterinary school to do the surgery and manage his after-care. It wasn't expensive, because the vet used Max's case as a case study for his classes, but the travel almost killed me - it was a drive of about 120 miles each way, plus an overnight hotel stay once a week for about six weeks.

I probably wouldn't have done this if I hadn't had my first Border Collie die due to an overdose of barbituate-based anesthesia about a year prior to this. She had been brought in to the Atlanta Humane Society for a low-cost spay. Apparently, the vet was unaware that dogs with a low percentage of body fat should never be given barbituates because of the risk of overdose. (This is true of greyhounds, italian greyhounds, whippets, border collies, and a couple other breeds.)

[maddiesmom]

Our beloved Miss Maddie was just, yesterday, diagnoised with an abcess on her kidneys which is cancerous. When we picked her up from the Vets office she bounded out of there like a puppy (she's 12). Ate a good dinner and breakfast this morning. Prior to the vet visit she wouldn't touch food. Will we spend money on more emergency vet visits, no. What we will do is monitor her quality of life and when she stops eating again we will tearfully send her to the Rainbow Bridge. Will this be hard, yes I cry now just thinking about it but my DH and I have decided we will not put her through what we did with our Miss Ellie, who had Cushing Disease. I know this is long-winded but the point I am trying to make is I don't think you can put a money limit; each illness is unique. The important thing is the quality of life.