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Wednesday, May 1, 2013

Increasing Pet Care Costs & Expectations

I received a great question from Jennifer....

Do you think that the cost of owning a pet has increased over the years (more than just the general increase in the cost of living) as more advanced, sophisticated, and expensive treatments become available?  My cat has chronic kidney disease, and I am dreading that one day my vet might suggest a transplant, and I will have to make a conscious decision to NOT spend $10,000 to keep my cat alive.  I know that's a extreme example .... I know that a pet owner who can't pay $50 for shots or for basic treatment shouldn't own a pet if they can't afford it - but what if they can't pay $1000, or $5000, for a treatment that didn't even exist 10 or 20 years ago?  10 or 20 years ago, when no treatment existed, it would be acceptable to have your pet put to sleep.  Now that a condition can be treated, but at great expense, is the bar being raised so that the expectation of what a responsible owner should pay includes more and more expensive treatments?

I certainly think there is validity to the idea that the costs of owning a pet have increased.  It may not be as much as many people think, but it does seem to be going up.  The question is "why"?  And I don't think it's just because newer and better treatments are more expensive.

Go back 100 years and veterinary medicine was focused on livestock, not dogs and cats.  These animals were seen as companions, but not as much as family members, at least not to most people.  Vets would often see a client's dog or cat while they were at the farm looking at the horses and cows.  Fast forward to 2013 and the focus has shifted.  Now most vets end up in companion animal medicine to the point that there is a growing crisis finding veterinary care for livestock.  At the same time dogs and cats have come into the houses and become not just companions but family members.  I believe that this switch in the mindset of the owner is more responsible for increased care costs than simply better medicine.  The clients are the ones expecting better care and the veterinarians are working to provide that level of diagnostics and treatment.

Let's go back about 50 years.  Parvo virus didn't exist yet.  Heartworm disease wasn't a highly recognized concern and there were no preventatives.  Effective flea and tick medications didn't really exist.  Pet food manufacturing were dominated by just a few companies and brands.  Vets didn't have access to in-clinic blood analyzers.  Even x-ray equipment wasn't wide-spread.  We as a profession simply didn't have as much to offer our clients and patients, so treatment was often limited and based on good guesswork rather than a battery of tests.

Now look at today.  We have significantly reduced the number of distemper and parvo cases because of vaccinations.  We have several different options for heartworm, flea, and tick prevention.  There are dozens upon dozens of companies making pet foods, often with multiple brands within a single company.   Most vets can now run a full blood chemistry and blood cell analysis in around 30 minutes.  Not only do we have x-ray equipment as a standard of practice, but the profession is rapidly moving to digital radiography.  Even ultrasound is becoming more and more common in a general practice.  We have a far greater ability to quickly and accurately diagnose a problem than we did in the middle of the 20th century, and safer, more effective options for treatment.  Clients also want better quality food for their pets and are willing to pay premium prices.

Better care doesn't come without some increased costs.  It costs a vet money to have the diagnostic equipment and better medications are usually not cheap.  But this isn't something that the vets are forcing on clients.  These are things that clients now expect and look for.

Obviously if you're reading this blog you have an interest in pets.  Let's say we have Dr. A who doesn't stock heartworm or flea prevention, only gives rabies vaccines, doesn't have x-ray equipment, rarely runs blood tests and when he does he sends it out with the results coming back in a day or two.  He's friendly and cheap, but relies more on educated guesses than anything else.  Dr. B has a modern facility with digital x-ray machines, blood analyzers, two different kinds of heartworm prevention in stock, a full spectrum of vaccines, and a pharmacy full of medications.  He's nice but his office visits cost more than Dr. A.  You have a dog that has been lethargic for three days, won't eat, and is vomiting at least once daily.  Which of these two vets would you want to take your vet to?  What level of care do you want for your own pets? 

There are many clients who still can't afford high costs.  Most of my clients wouldn't be able to afford $2000+ in care, and it can even be difficult to get some to spend $200 for simple tests.  But clients expect to at least be offered these things, and in fact if you don't do so it could be considered malpractice.  Does that sound ridiculous?  Those kinds of lawsuits and board investigations happen and the vets often lose because not giving clients these options is below the standard of care.

I don't see this trend changing.  In fact, I see the burden on the client to increase because of the changing perception of society regarding animals.  In most states animals are still considered a special form of property, meaning that owners can't sue for pain and suffering any more than they could for the loss of their couch or car.  There is growing pressure throughout the US to recognize pets differently, as living companions rather than an unliving object.  I've blogged about that in the past and won't revisit the debate at this time.  One of the unintended consequences of changing the laws to allow for pain and suffering of pets is the increased cost to the clients.  To avoid lawsuits and malpractice charges vets are going to want to run more and more tests, even for simple problems.  That means that a veterinary bill will be higher due to more testing.  Conversely, clients are going to have a greater burden to actually do these tests.  If a vet can be sued for the pain and suffering of their patient and client, then the client can equally be held responsible for the pain and suffering of their own pet.  I can absolutely forsee a time when a client faces charges because they wouldn't pay for the dog's broken leg to be surgically repaired or the dog contracted parvo because they didn't do the proper vaccines.  If parents can be criminally charged for medical neglect to their children, they can also be charged for similar situations with their pets.

The bottom line is that it costs several hundred dollars per year to give proper, basic care to your pet (vaccines, heartworm and flea prevention, food, etc.).  If your pet gets sick you can expect at least $200-500 in tests and treatment.  If you cannot afford these costs, I do not think that you should own a pet.  If you have a pet then you should have money set aside for these purposes.


4 comments:

  1. I think this is a major challenge as a veterinary student.

    For a lot of (small animal) vet students and vets, we tend to be the type who would pull out all the stops to scrape together enough to pay for a major treatment. I do think there can be an undercurrent of judgement toward people who can't OR won't pay for any given treatment. Everyone seems to draw their own lines (not doing a surgery is ok, but not treating diabetes is not. Or not doing a surgery on an old sick dog is okay, but not doing a surgery for a young animal is not. Etc.)

    The reality is that what every client interprets affordability differently. For one client, the choice might be between rent and surgery. For another client, the choice might be between a new ipad and surgery. You never know - they just say they can't afford it.

    When I grew up, we had outdoor cats. We named them and enjoyed them and got them spayed, but if they got sick they were SOL. One had kittens before being spayed, and she had some sort of horrible dystocia. My dad tried to pull the kitten out by himself, causing it considerable trauma, before he caved to his panicking pre-teen and called the vet.

    This type of thing makes me shudder now -- my cats get designer food and pet insurance -- but my dad is/was not a bad person. It was just such a different world and a different way of thinking about pets.

    As vets in training I think its critical to continue to challenge ourselves to remember that any one person's notion (vet or not) of the value of a pet is different than someone else's. As a vet, I STRONGLY believe that we have a responsibility to provide the care the clients want, no matter what we would do personally for the animal if it was our pet. I hope to be able to provide a wide range of care, from educated guesswork to advanced diagnostics, depending on the need of the client, without judgment. I just hope they understand that guesswork is not equal to an MRI, and I will always do my best.

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  2. Excellent analysis, LeAnne! I agree 100%.

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  3. Another excellent blog post Chris that explains the perceived rising costs in a logical, succinct manner. It also explains the continuing dilemma that vets face every day. I wish all pet owners could read this & I think their conversations with their vet could be quite different. I'll definitely be sharing this with the Vetanswers community :)

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  4. excellent - it so does come down to not only the owners ability to afford but also the value the owner places upon their own pet. Just yesterday I had an owner, who was more than capable of affording treatment, tell me the cost of the medication for her pet was a rort! The treament worked and she admitted if she took the dog off the anti-inflammatories it was quite evident, but she still felt the cost was a rort. Even when given the cheaper option it was still a rort. Further to this the dog actually has another major issue that requires attention, but the owner refuses too. It is not that she cannot afford it, she just does not wish too .......
    And then at the other end of the scale I have had clients tell me that have maxed out their credit cards or loaned money to pay for treatment.
    Really great blog!

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