How Much is Too Much

“Did you ever consider the alternative?” the Wall Street Journal reporter asked.

I’d been introduced to him by a neighbor. He was writing an article about the rising cost of veterinary care.

“You mean not getting back surgery,” I replied.
“Or perhaps,” the journalist paused, not sure how to say it.
“Putting Angel down?  That alternative?” I said.
“Well, yes.”
“Never. Would you?”
“I’m more interested in your thinking here,” the journalist said.
“She was our children’s first dog. She’s family. Would you put your mother down?”

My husband and I both grew up with dogs.  And even though we were raising our daughters in the typical, cramped New York City apartment, there was no question we would get a dog. The question was when, but Angel found us. In the middle of winter, our four and five-year-old daughters spied a tri-color Shih Tzu in the window of a pet store.

veterinary care cost
Angel and the Little Girls

While the other puppies chased  their tails or snoozed, oblivious to other dogs falling on top of them, this puppy sat in the middle watching the mayhem.  The clerk said she had been bred to be a show dog but was too big in the hips to compete.  Knowing she hadn’t come from a puppy farm assuaged my concern about plucking her from a pet store window.  When he said she had been born on Christmas, the deal was cinched.  Leaving the pet store, our daughters decided ‘Angel’ was the right name, considering her birthday and apparent disposition.

Our girls dressed her in doll clothes and fed her with baby bottles.  Strangers did double-takes when they pushed her down the street in their old umbrella stroller wearing a string bonnet and onesie.  She marched in their pre-school Halloween parade wearing eponymous halo and wings.  She was as beautiful as she was calm.  Her forelock was blonde tinged with red and brown, her tail fanned in a perfect half-circle, and she carried herself like royalty.

But she was also sickly.  Instead of the usual puppy diarrhea that comes with too many treats, Angel developed hemorrhagic gastritis, requiring emergency room visits, IV’s, antibiotics, overnight stays, and a diet of boiled lamb and rice. And then there was her back.  She wiggled her too wide hips like Marilyn Monroe, an affectation we adored, but the vet said her exaggerated gait was symptomatic of a spine that was “too loose and too long,” and prone to injury. It took a few years, but eventually jumping on and off furniture would bring on an attack.  We knew she was in pain when she hid from the girls. Usually, bed rest, painkillers and a round of steroids brought her around.  But by the time she was five years old, a simple walk around the block could ground her.  And then one morning, seemingly out of nowhere, she began dragging one of her back legs and was incontinent.  She didn’t whine or shake but the look in her eyes made it clear she was as frightened as we were by her incapacity.  By the time we got to the vet, she was full down dog.  Her back legs were splayed behind her and she could not walk.

“She’s ruptured a disc,” he said. “I’m not sure if she’s paralyzed or in too much pain to move. She needs immediate surgery.”

Fortunately, an orthopedic surgeon was available at the nearby animal hospital, but before admitting her, I had to pay.

“That’ll be $8,000,” the admitting clerk said adding a column of numbers. We accept cash, credit cards, or checks.”
“Right now?” I said gulping.
“Or we offer financing or financial aid, if you qualify.”
“What costs $8,000?”
“Surgery, anesthesia, and a normal recovery.”
“What if her recovery isn’t normal?” I asked.  The clerk was patient but detached.  It was clear she answered these questions all day long.
“We refund the days you don’t use.”  I didn’t stop to consider what that really meant and took out my checkbook.
“What if $8,000 isn’t enough?  And we run out of money?”
“Euthanasia is $75.”

I was horrified.  But understood.  Fortunately, we had savings, but in 1999 dollars, $8000 was many months’ mortgage or a half year of babysitters.  We were lucky enough to not have to choose.

Angel recovered, but returned home a more taciturn dog.  It was as if she blamed herself for her injury.  And despite her sedentary lifestyle, illness continued to stalk her.  First, there was Rocky Mountain spotted fever, requiring IV antibiotics and intermittent gastritis brought on by the antibiotics.  Then she punctured her cornea.   She was ten years old by then.

“We can cover eye, keep it clean, and let it heal,” the vet said.
“Will she be able to see?” my husband asked.
“Probably not,” he replied.

We had two other dogs at that point, who were as healthy and able as Angel was not.  But she occupied a soft spot in my husband’s heart, and not just because she was our family’s first pet.  He walked her every morning and night and was usually the first person to notice her ill health.  They had a special bond.  I loved her, too, but saw no reason to repair her eye.  She already had learned to live with physical limitation and was getting older anyway.

“She can still see enough with the other eye, can’t she?” I prompted the vet.
“For now.  She does have cataracts, though.”
“But partial blindness won’t hurt her?” I tried again.
“No. But she might become confused. More withdrawn.”
“Can her eye be fixed?” my husband pressed.
“Probably. And they can remove the cataract at the same time.”
“That’s it, then,” my husband said.

This surgery was less dramatic than the herniated disc repair, but no less expensive.  When complications ensued, requiring additional surgery, I balked.

“She doesn’t need to see,” I argued with my husband.
“Losing your vision is awful.”
“For you. But she’s a dog. She doesn’t read or drive a car. She’ll get by.”
“But she’ll suffer.”
“We have better ways to spend that money.”
“We can’t let her suffer.”

The second surgery was successful.  And the cataract removal made her younger.  She played a little with the other dogs now and snuggled in bed with us at night.

“How much have you spent in total?” the reporter asked.
Adding the amounts in my head, even I was shocked.
“At least $30,000. But that doesn’t include all the trips to the ER. Wow. That’s a lot of money.”
“Do you think you spent too much?”
“Maybe in dollars. But I don’t measure it in dollars.”
“How do you measure it then?”
“We did what was necessary. Like the back surgery.  We had no choice.”
“What about the eye surgery?”
“That made her life better.  My husband was right.  But we also could afford it.  If we didn’t have the money, eye surgery would have been too much.”
“Why?”
“Because there’s a balance.  We love Angel and wouldn’t want to lose her or make her suffer but Angel loves us, too. If she had a vote, I know she wouldn’t have wanted us to go out on a limb financially to save her eye.  She would have made do.”
“Is there anything you won’t pay for then?”
“I won’t pay for chemo or dialysis.”
“Most pet owners say just the opposite.  They say they’ll do anything to save their pet’s life.”
“I won’t make her suffer just to prolong her life.  I wouldn’t want my mother to suffer either.  How much is too much isn’t about dollars.  It’s about quality of life.”

Angel lived another three years after that.  Fortunately, she never required chemo or dialysis and frankly, was healthier the older she got.  One day a few weeks before her 16th birthday, she stopped eating and the next day, she stopped drinking.  By the third day, she was sleeping most of the time.

The vet said Angel knew it was time and we should listen to her.

We did.

Mary Shannon Little is a lawyer, writer, investigator, and the new mother of Lucille Ball Little, a rescue Malarkie (Maltese – Yorkie.) She refuses to befriend or vote for people without pets.