How much is too much to spend on a dog's health?
October 24, 2011 5:08 PM   Subscribe

Our dog is ailing -- how does one determine how much to spend on her treatment(s)? More wrinkles to the situation inside...

Here's the situation: Our 7 year old lab-mix has been having issues, stumbling around a bit (ataxia), having trouble with the placement of her feet, and appears to be in a fair amount of pain, walking around hunched over, having accidents in the house. She'll wince/whimper every now and then when she turns her head. She's the sunshine of our lives, always happy, always waggy and wiggly, and kind of a happy dumb (in the best way possible) oaf... however, it appears that the only avenue now is to get her an MRI and almost inevitably, some sort of neck surgery. It appears that the average neck MRI for a dog costs around $1500, and the surgery could be over $4000, excluding any therapy she'll need. She's otherwise healthy, but getting worse daily to where she is stumbling all over the place and losing her appetite (she's on painkillers and anti-inflammatories that are quickly losing their effectiveness).

The problem isn't that we can't afford the surgery -- as with many other things in life, we're blessed to be in a position where we have some money in the bank, but not a whole lot, and it's only there because we've been prudent with our spending -- it's that I can't get enough perspective on the situation to know whether it's a good idea to spend $5000 (or likely more) on a surgery that will also require a significant amount of follow-up and no guaranteed results.

Before anybody judges me as a heartless bastard who can't pony up a few thousand dollars on the the "sunshine" of our lives -- I know she would happily sacrifice herself for us if the situation was reversed... I should note that we (my wife and I) are also suffering the extreme fatigue (physical and emotional) of my wife's (malignant) brain tumor, and the depression/cognitive issues that have come with it (not to mention the dark cloud of significant medical costs for her eventually).

So, that said, does anyone have any advice on how to approach the situation? How much is too much? (I'm sure the more morbid question is easily devined here...)
posted by theplatypus to Pets & Animals (32 answers total) 1 user marked this as a favorite
Your dog's in pain despite painkillers and anti-inflammatories. I do not think you are a heartless bastard. Let her go. It's not about the money, it's about her pain. Also, with your wife's medical issues, you need to give your full attention to helping with her medical needs and keeping yourself healthy and able to assist.
posted by eleslie at 5:14 PM on October 24, 2011 [8 favorites]

You're not a heartless bastard if you don't spend the money. Not at all -- not by a long shot. Just because you literally have the money in the bank doesn't mean you must or even should spend it. And the fact that your wife is dealing with a major medical issue makes it even more important to acknowledge that fact.

Let's face it -- here in the West we have access to very advanced vet care; in other places of the world this wouldn't even be an option. But just because the medical possibilities exist doesn't mean we must always access them.

I am a pet-owner and a pet-lover and there have been times when I've spent a bundle on my "babies," and times when my husband and I have thought long and hard about it and then not spent the money. What your dog wants from you most is your love and kindness and companionship -- not your wallet. So it's totally morally correct and acceptable to say that you'll skip spending the money, and instead make his last days wonderful. Here's a very nice article about making a dying dog's end of life really enjoyable.
posted by BlahLaLa at 5:17 PM on October 24, 2011 [12 favorites]

If your vet is any good, he/she should give you a very candid breakdown of the prognosis and an honest assessment of what you can expect the treatment to do. Put another way, a good vet will not let you spend $5000 or $6500 without being very up front about the likelihood that this will cure her and about how many months/years it will "buy."

My oldest dog passed away several months ago and I never felt I was being misled about exactly what to expect for each stage of treatment. The odds of improvement were explained very clearly to me.

I guess what I'm saying is that I think a good veterinarian's job is to give the perspective that you are seeking with your question here. Mine did, and I was very grateful for it.
posted by jayder at 5:31 PM on October 24, 2011 [7 favorites]

We considered getting pet insurance for our cat when we first got her. It was $20 a month. We decided against it, but we are kind of keeping the cost of the insurance in mind as a ballpark figure for how much is reasonable to spend on medical expenses. After all, that's what the insurance company is betting against.

So over her lifetime that works out to maybe $4000. Which means in your case I would probably pay the cost of the surgery if the vet was able to assure me that it would solve the problem, permanently. But that would be the upper limit I would feel comfortable spending.

Absent other ways of calibrating "reasonableness", I think this is a good one.
posted by lollusc at 5:35 PM on October 24, 2011 [1 favorite]

Unpopular & blunt opinion: put her down, now. It's the most sensible and caring thing to do in your current situation. She's had a good run up until now, but this sounds like a miserably stressful situation for you all, and frankly, the money is better spent on supporting the human that you dearly love.
posted by Betty's Table at 6:09 PM on October 24, 2011 [6 favorites]

You're not heartless. Your dog is in pain. That's all she knows. If you had unlimited resources, you could afford surgery that might give her a few extra years - or it might not. She might still be in pain, and then that money isn't available to help your family, who matter more than your dog (I say that as someone who loves dogs). If painkillers aren't working, she's clearly seriously sick. Seven years is a good life for a lab. The most compassionate thing to do is to give her a painless, peaceful, stress-free death surrounded by the people she loves. It may be the hardest thing you ever have to do, but based on your description I think it will also be the right one. Good luck. You have my sympathy.
posted by Dasein at 6:20 PM on October 24, 2011 [1 favorite]

I agree with Snickerdoodle. Unless it's really clear that this is going to alleviate pain and suffering for the dog, the dog's time has come. Dog's don't understand suffering and recovery well, they just know they hurt. And they don't usually communicate that until it's very bad.

Sadly, I think the dog's time might be here.
posted by kaszeta at 6:24 PM on October 24, 2011 [4 favorites]

Were I in your shoes, I would take the dog for a second opinion. I would find another general vet with a good reputation, or if maybe ask at a vet school if I was close to one.

If two different vets gave me the same diagnosis/prognosis, then I would feel that I had all the necessary info to make a decision.

And I, for one, don't think you're a heartless bastard at all. This is a very tough situation to be in, and you have my sympathies.
posted by SuperSquirrel at 6:26 PM on October 24, 2011 [3 favorites]

You do need to ask how long this surgery would give her, even if it did solve the problem. A 7-year-old lab may only have a year or so left, at best. I would not recommend neck surgery for an octogenerian and I would not think it was a good idea for your lab.
On the other hand, she may have had a stroke. I would get a second opinion, if your vet can't do better than suggesting an MRI (always the last gasp of "I haven' a clue"). When our old dog had similar symptoms (ataxia-like), the vet thought it might be irreversible nerve damage, but later admitted that it seemed to be a minor stroke. The dog managed to pull himself through that one with only minor issues, but he was a determined little animal and just kept trying to walk straight until he succeeded. In the end, though, we had to let him go when he developed arthritis and could not raise his head properly.
If your dog seems to be in pain, it is probably kinder just to let her go. Get a second opinion to make sure, but be prepared to say goodbye. And stay with her until the end - don't let her die in the company of strangers.
posted by Susurration at 6:31 PM on October 24, 2011 [1 favorite]

It appears that the average neck MRI for a dog costs around $1500, and the surgery could be over $4000, excluding any therapy she'll need.

i know this is hard for you, and im sorry.

You could do a few ings here to relieveyour conscience:

1. Put the dog to sleep...its in pain...even with all the treatment, itll still be in pain...for a prolonged time.

2. Take a good portion of that money and do something for:

A. Your community of dogs...donate to spca or soming in memory of the dog.
B. your wife and yourself...for you are facing a loss...and maybe spending money on something for you both will make you feel better.
C. Any good cause. Give them some money in memory of your dog.

Good luck, and im sorry to hear about your dog.
posted by hal_c_on at 6:34 PM on October 24, 2011

I spent the last 3 years spending thousands on a sick dog. Looking back at the stress, time, and money that it cost us - well, having a few more uncomfortable and frequently unhappy times was really not worth it.

The follow up care, I'd imagine, only gets more expensive and more work for you.

If you go back in my posting history you can see some great answers on doggy life.

But first I'd get a second opinion from an IMS.
posted by k8t at 6:41 PM on October 24, 2011 [2 favorites]

There are so many dogs that need a good home, are healthy and the resources you might spend on this one animal could help so many. That is the view we take on it with our dogs and cat. We did spend about 3000 on our puppy to fix luxating patellas (bad kneecaps), but that was on a 9 month old terrier, with a good prognosis and almost certain 100% recovery (all turned out true). At about the same time we put down a 12 year old sheltie with ailing health and probably only being able to prolong her pain for our comfort. Not a good deal at all. Take a fraction of the resources you would spend on an uncertain future for your ailing animal and give a good home to some young dog that needs it, will benefit from it and will help you fill the void in your life. I even like getting a new animal when the old one is getting near the end so they can interact a little and maybe carry forward some of the old animal, and that way it isn't a replacement, but an addition to our life. It is tough spot to be in, but it is a hard old world all the way around. Good luck.
posted by bartonlong at 6:48 PM on October 24, 2011 [1 favorite]

Get a second opinion. Then,

Will this dog be the comfort your wife needs over the next months? Will the surgery provide relief from pain so that your dog can be there for your wife?

If yes to both, I'd consider it.

Otherwise, let her go without living through more suffering.
posted by freshwater at 6:52 PM on October 24, 2011 [2 favorites]

If you want, get a second opinion.

But, my belief is this: if you choose to put the dog down, she will not know what you did. She won't be walking around anymore, but she won't be doing it in pain. And dogs are stoics; if they are expressing their pain it is very serious.

I am haunted by the decisions I didn't make when I should have in similar situations. Get the second opinion to be sure that there's not a pill or insignificant change you can make to resolve this situation, and if there's not let your dog go.

It's not heartless to not consider surgery. Canine spinal surgery is not the sort of thing where you get it done and then everything is okay; you would be asking for an extraordinary effort from yourselves and your dog to recover from that.
posted by Lyn Never at 7:07 PM on October 24, 2011 [2 favorites]

I'm so sorry for you, your wife, and your dog. What a horrible situation to be in. Plenty of folks have already given you answers that can quite reasonably justify a decision to euthanize your dog now. I respect that and would not disagree that this is an option that could be appropriate here. However, if a voice of (some degree of) dissent is useful, I would also suggest that you talk to your vet so you can take into consideration the likelihood that neck surgery could largely or completely cure your dog of her current pain, and weigh that alongside the emotional ramifications of losing your dog right now.

Obviously you and your wife are already dealing with an enormous amount of stress and emotional pain due to her own medical issues. Losing a dog you are both very attached to seems like a hideous blow right now - I lost my first dog about a year ago and am still hurting from that. IF your vet feels that surgery is highly likely to help your dog regain a positive quality of life and normal lifespan (and if you trust your vet's assessment), then maybe tests and surgery would be money well spent. At the very least, I hope you wouldn't feel wasteful if you spent your money this way (fwiw, my dog was a lab mix who lived to be 14, and 10-13 years is an average lifespan for a Lab - I certainly wouldn't assume that a 7-year old only has a year or so left).

Again, all of this is of course dependent on your dog's prognosis if she were to get the surgery, along with your assessment of the emotional strain that losing her would entail for you and your wife. I don't think you're heartless if you decide to euthanize her now, but so long as the surgery were likely to be successful (with, of course, minimal pain/stress for your dog), neither would I think you were foolish or wasteful if you chose to pursue surgery.
posted by DingoMutt at 7:35 PM on October 24, 2011

I weighed in on this up thread, but to address your specific situation. It sounds like your vet has little idea what is wrong with your dog. She has lived seven good years with a family who has loved her and whom she loves. I would question whether arduous medical treatment with an uncertain outcome is the most humane course of action; a dog does not understand why it's in pain after a serious surgery. It doesn't know that it's "on the road to recovery" or look forward to "the light at the end of the tunnel." All it knows is that it's in pain. So even if there's a decent prognosis after surgery, I would question whether the suffering needed to get well is really a humane thing to subject a dog to. Perhaps your vet can alleviate these worries. But without more information, it seems like an futile endeavor where you might spend enormous sums to prolong the dog's suffering.
posted by jayder at 7:38 PM on October 24, 2011

Of course you're not a heartless bastard, but my understanding is that dogs with back problems are pretty much all about MRIs and surgery. Sorry. :(
posted by rhizome at 8:01 PM on October 24, 2011

I recently attended a presentation on canine acupuncture, which isn't appropriate treatment for all ailments but it might be worth asking about. I'm told the cost of acupuncture treatment is comparable to the price of medications. Just an idea.

And I like the suggestion of getting a second opinion. Another vet might be able to list additional options.

Whatever you decide, it's clear that you love your dog and your dog loves you -- this situation is so difficult for you because you are NOT heartless.
posted by Boogiechild at 8:08 PM on October 24, 2011

I want to add something slightly more poetical or esoteric -- your earlier question mentions the fact that your wife's condition is terminal. Maybe the dog is going to heaven first to be there when she gets there. Just something to consider, and my apologies if it offends.
posted by BlahLaLa at 8:16 PM on October 24, 2011

Sent you a PM.
posted by bolognius maximus at 8:45 PM on October 24, 2011

To me the question is whether the probability the problem is a fixable one or not, and I would use a decision tree something like this:

If the vet is telling you that this looks probably like cancer (or some other very lethal entity), then I'd say there's no point in getting an MRI or surgery, because I would not put a dog through cancer treatment (no offense to those who do, but for you it sounds like you are not that type either).

If the vet is saying this may be a problem that would be curable with a spine surgery (like a bone impinging on a nerve or something), then I think that both might be worth it. That's a qualified might. I don't know about dogs but a large percentage of people who have spine surgery still go on to have chronic debility even if the surgery is just for a bone/disc issue.

If the vet has no idea what's wrong, but thinks it is definitely possible this is a curable problem, then I would get the MRI first, then decide whether or not the surgery is worthwhile based on what the MRI shows. This would give the additional information needed to make a decision that you won't regret, although I think doing neither one in this scenario is also acceptable, if it's something that would keep you awake at night, it sounds like you've got enough on your plate otherwise that you don't need anything else to add to your 'keeping me up at night' list.

good luck to you, wife, and dog, and I'm sorry for this difficulty situation.
posted by treehorn+bunny at 9:10 PM on October 24, 2011

I might check into getting pet insurance before getting a definite prognosis. I use PetCare. It's $14/mo and once saved me from having to shell out several thousand dollars for my dog's surgery after he was run over. Ask your vet if s/he would be willing to label your dog's illness as a non-pre-existing condition, find out which specific tests are necessary, and call the insurance to see which of those tests are covered. That's honestly the only alternative I can imagine.

I'm so sorry you're going through this. Lots of luck to you and your wife. Your dog is lucky to have someone as caring as you are.
posted by pineappleheart at 9:22 PM on October 24, 2011 [1 favorite]

I've owned really sick pets and spent some money. However, the situation you describe doesn't sound commiserate with anything I experienced because the diagnosis at this point seems indefinite.

In your shoes, I would def get a second opinion. I like pineappleheart's suggestion in these circumstances. I might consider the MRI expense after the second (or third) GOOD opinion.

And then I would make the best choice possible.

FWIW, the expensive care we got our ill pet didn't help in the end.

That's a big consideration: If I put my pet through this treatment, will it work.

With solid vet opinions in hand, you can make this choice with a peaceful heart.

posted by jbenben at 10:35 PM on October 24, 2011

Anecdotal experience: my husband and I spent about $5000 on radiation treatment for a dearly-loved ferret with cancer a number of years ago. We bought him about 18 extra months of life (for a creature with a 7-year lifespan) and he was, as far as we could tell, not miserable during the treatment. In your shoes I would seek a second opinion, and if the prognosis is still expensive surgery that requires significant follow-up with no certain return, I would let her go.

I hope a second opinion brings you better news, and wish the best for you and your wife as well.
posted by immlass at 11:04 PM on October 24, 2011

Nthing that the prognosis is the huge question.

My sister and brother-in-law spent about that much money on medical care for a dog when the prognosis was good (and things worked out very well). My brother-in-law said, "I would miss the dog more than I would miss the money."

That aside, at the risk of being indelicate, perhaps it would be appropriate to be deferential to your wife's wishes?
posted by ambient2 at 12:58 AM on October 25, 2011

I work in the veterinary profession and recently dealt with a case similar to yours in which the owners elected euthanasia for their ataxic sight-hound. We couldn't give them a definite prognosis without an MRI, although the vet (a very experienced orthopedic specialist) had a good idea of what was likely to be wrong with the dog and thought he was saveable. The owners decided not to proceed with testing because treatment would have included significant hospitalization for the dog and they felt this would leave him too distressed.

Rather than focusing on the money or how many years the vet promises she will live, I think you should consider your dog's future quality of life. Others have mentioned this already, but here are some questions that may help you make your choice: what will the follow up treatment entail and will it need to go on for the remainder of her life? How long is she likely to be anaesthetized during the initial operation and may she need repeat surgery? How long will full recovery take and will she need to be confined post-op? Will she need to spend more than a few days away from home over the course of her recovery? Does she tolerate injections, poking and prodding, and tablets well or do those things stress her out?

While there are lots of amazing drugs and treatments available, sometimes the kindest, most loving choice is euthanasia. Take some time to think about what the next few weeks, months and years are likely to be like for your lab and go from there.
posted by wigsnatcher at 12:27 PM on October 25, 2011 [1 favorite]

You are not a bad person for putting your dog down. You were dealt a very rough hand and have to make difficult decisions. Peace to you and your family.
posted by kamikazegopher at 6:40 PM on October 25, 2011

Response by poster: I'm not sure if anyone will ever come back to check this post, but I thought I'd bring some closure to this... We put her down today. She had been getting progressively worse -- four vets and a veterinary neurologist later, the only road left was further diagnostics and likely surgery for a spinal issue or even tumor(s). We braced for the inevitable a few weeks off, but she collapsed this morning and had a seizure, ending with a terrible, mournful howl and we decided that although we weren't ready to let her go, it was time. She was no longer the happy, bouncy dog we grew to love, and was clearly embarrassed and frustrated by her limitations -- she could barely make it outside to go to the bathroom, and even lost interest in most food. We just didn't want to put her through more tests, surgery, possibly radiation/chemo, when it was apparent that she'd never be close to 100% again, and couldn't even communicate to her that all of the poking and prodding was for her sake.

I stayed home with her all day, made a hamburger for her, and just loved her. I know, all of this seems overboard for a dog, but she's probably as close to a kid I'll ever have, given my circumstances. I'll miss her.
posted by theplatypus at 9:35 PM on November 1, 2011

I'm so sorry. But I think you made the right decision. Take care of yourself.
posted by lollusc at 4:57 PM on November 2, 2011

That's not overboard at all -- it sounds like you did precisely the right thing given your circumstances. It would be wonderful for all pets to have such loving, thoughtful owners.
posted by BlahLaLa at 5:36 PM on November 2, 2011

My heart goes out to you, it is one of the hardest things to do in life, but it is a selfless act of love for a dear friend. Ancient wolves and man made a bargain long ago to keep each other safe and watch over each others young and face life together. This too is part of the bargain.
posted by bartonlong at 6:17 PM on November 2, 2011

You did the right thing, letting her go so responsibly and lovingly. So sorry for your loss.
posted by immlass at 9:30 PM on November 2, 2011

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