man with catAdvances in veterinary medicine and pets’ status as family members in many households mean people are willing to go to great lengths to treat illnesses in their animals and prolong their lives, but some observers say the trends raise important and tough questions about resources and the difficulty many people have with facing end-of-life issues — for their pets and themselves. “Death is part of the cycle of life, and we have to accept that,” said veterinarian Phillip Nelson, dean of the College of Veterinary
Medicine at Western University of Health Sciences. The New York Times (tiered subscription model) (3/25)

I COULDN’T begin to add up the number of times my husband and I have had the Talk. We know illness and death are two of life’s certainties. And we’ve taken care of the issue when it comes to ourselves. We’ve signed medical directives saying we want no extraordinary measures taken to extend our lives if we become incapacitated to the point that we’re a burden, emotionally and financially, to our families.

 But when it comes to our pets, the Talk never resolves anything.

Luckily our two 14-year-old cats, 8-year-old Border collie and 3-year-old Labrador retriever are all in fairly good health. We haven’t had to make decisions about whether to spend thousands of dollars, possibly tens of thousands, to save or extend their lives. But those decisions are coming, and despite our efforts to have the Talk, we have no idea what we’ll be willing to do to keep them around as long as possible.

That so many more technological advances are available now than there were 10 years ago means pet owners have more ethical and financial choices to make. “In the last 30 years there’s been an increase in specialty veterinary medicine,” said our veterinarian, Dr. Woody Walker of La Cañada Pet Clinic, north of Los Angeles. “And the technology is amazing. Whatever we can do in people, we can do in pets.”

Pet owners, who represent 68 percent of United States households, spent a collective $53 billion on pets last year, according to the American Pet Products Association. That’s for everything from medicines and operations to toys and food.

No one has a figure for how much people spend on end-of-life care for their pets. But it’s safe to assume that the number mirrors ours; for humans, 90 percent of medical spending occurs in the last 10 percent of life. The choices involved in keeping pets alive can be as numerous, expensive and emotionally thorny as they are with people.

Lisa Sobieri of Greenwich, Conn., knows the choices all too well. The 49-year-old married mother of two lost two dogs to kidney disease in the last three years. The first, Kiefer, an American Eskimo, died just before turning 15, only after the family had spent several thousand dollars on chemotherapy for bladder cancer and then other drugs to keep him comfortable as his kidneys failed.

“I guess when you go into it you don’t really know how much you’re going to spend,” she said. “So it keeps kind of adding up, and you don’t really know. We were thinking, O.K., there is a limit, but when it’s $500 here or $1,000 there, you don’t really see it adding up that fast.”

After Kiefer died, the family got Perry, a 6-month-old golden retriever. When Ms. Sobieri took the dog to the vet to have him neutered, a routine blood test showed Perry had a genetic kidney disease. “I actually didn’t believe them,” she recalled. “I said, ‘No, you’re looking at my other dog’s file by mistake.’ ” Unfortunately, they weren’t. The vet sent Ms. Sobieri to a veterinary oncologist who said Perry probably would not live more than three years.

“I was thinking, Well, we’re such great dog owners that we’re going to defy that, give him all the medications and diet, experimental treatments, and he’s going to live longer,” Ms. Sobieri said. The family decided against a kidney transplant, which would have cost a minimum of $25,000 just for the operation, an amount she said would have taken money away from the children’s college fund. There was also no guarantee it would work. But they still spent, by Ms. Sobieri’s estimates, tens of thousands of dollars to keep Perry comfortable for the duration of his life, with pet insurance picking up the rest.

Many pet owners struggle with whether to buy pet insurance, because it has a mixed track record. Consumer Reports, in its August 2011 issue, said the insurance was “rarely worth the price.” Pre-existing conditions are usually excluded from coverage; routine care, like annual checkups, is sometimes not included in plans; and premiums can rise significantly as the pet ages.

The Sobieris, though, said their insurance, provided by Embrace, was invaluable and made their decision-making just a little easier. Still, Ms. Sobieri said, “We did some pretty good damage on the credit card toward the end.”

The puppy lived only an additional 18 months. And Ms. Sobieri said she now wondered if the money would have been better spent as a contribution to research to find a cure for the disease, even though they cherished the extra year and a half they had with Perry.

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