For pets' sake
From cataract and brain surgery to hip replacements, pet owners are willing to pay for almost anything to keep their furry friends alive longer. But are we doing more harm than good?
By Joanne Laucius, The Ottawa Citizen March 13, 2010
When four-year-old Abbey needed cruciate ligament surgery, her owners didn't hesitate to spend the $3,000 necessary to keep the yellow Labrador retriever mobile.
About half a year later, Abbey needed the same operation on her other hind leg. Again, David Cullwick and his wife, Derry, both real estate agents, had no qualms about the expense.
That was nine years ago. For the Cullwicks, the surgery was worth every penny. Now 13 and still relatively spry, Abbey has given them so much, says David, who credits her with helping him recover from leukemia.
"Having a dog got me out and got me to appreciate things I didn't appreciate before," he says.
Cruciate ligament surgery is hardly cutting-edge veterinary stuff anymore. And it is only one part of of a growing arsenal of diagnostics, interventions and surgery available for pets.
For those who can afford it, that list includes joint replacement surgery, cataract surgery, allergy testing and treatment, mechanical ventilation, around-the-clock critical care, dialysis, MRI and CT scans, nuclear scans, neurosurgery, laparoscopy and minimally invasive surgery. For pets with cancer, there is surgery, radiation therapy, chemotherapy and pain management.
"Innovations and breakthroughs happen every day. In some cases, you can treat animals better than people," says Dr. Shane Bateman, recently appointed to the Ontario Veterinary College at the University of Guelph to help retool the Doctor of Veterinary Medicine program.
"Vets have to question themselves. We can do it. But should we do it?" says Bateman.
It is possible, for example, to get a kidney transplant for a dog, but at a price: Although the procedure was pioneered at the Ontario Veterinary College in Guelph, transplants are only performed in the U.S. They cost about $20,000 and thousands more for monthly or follow-up veterinary care and anti-rejection drugs, says Bateman, a Canadian who spent more than a decade at Ohio State University's College of Veterinary Medicine.
It is also possible in the U.S. to get a cat kidney transplant. The surgery alone costs about $12,000. Part of the transplant agreement is that the owner also has to adopt the kidney donor, usually a cat from a shelter.
The Ontario Veterinary College already has a pet loss hotline and is planning to hire a social worker for grieving pet owners, as many leading-edge veterinary schools in the U.S. have already done. In Ottawa, a pet loss support group meets on the second Wednesday of every month at the Sandy Hill Community Centre.
Then there are pet pharmaceuticals. Novartis, for example, sells an anti-anxiety drug for dogs called Clomicalm. In the U.S., Eli Lilly produces a drug called Reconcile based on its blockbuster anti-depressant Prozac. It is not yet available in Canada.
When Dr. Dan Rodgers first started practising at the Alta Vista Animal Hospital 33 years ago, there were 10 veterinary practices in Ottawa. Small animal work often consisted of extracting porcupine quills and administering rabies shots. Now, Rodgers estimates there are about 100 veterinary practices in and around Ottawa.
The animal hospital stumbled on a pent-up demand for higher-level veterinary care when it hired its first veterinary surgical specialist.
"Once we started getting specialists on board, we needed 24-hour monitoring. Then we needed an emergency department," says Rodgers. "We keep adding as demand grows."
Alta Vista was the first animal practice in Canada to have an MRI scanner. It has specialists in cardiology who perform angioplasties and implant pacemakers. Specialists at the clinic also perform cataract surgery, dentistry and cancer surgery. There is a soft-tissue specialist and an orthopedic specialist.
Vets at the clinic have done brain surgery on a cat. They replace hips and diagnose diabetes. There is a 24/7 intensive care unit with space for up to 12 pets.
Unlike human medicine, there is no wait time in the veterinary business, says Rodgers.
If an Ottawa owner decides to get a CT scan for a pet -- admittedly a relatively rare necessity because other diagnostics often can do the job more cheaply -- the scan can be scheduled for the next day.
Elena Johnson grew up on a farm where an ill, injured or aggressive dog was likely to be dispatched with a shotgun.
Still, when her cat Phyllis broke her leg after a tumble from a third-storey balcony in Montreal, Johnson didn't hesitate to put the $400 vet bill on her credit card, even though she was unemployed and the bill represented almost twice her share of the monthly rent.
"She brought us a lot of happiness, entertainment, and companionship," says Johnson, who held a fund-raising party that brought in $150 to help pay the vet bill. "Now we see our pets more as part of the family, and so of course we do anything we can to try to keep our pets alive and well. On the farm, the dogs and cats were more like farm animals and we weren't so attached to them."
Dr. Julius Liptak, a native of Australia, trained as a surgical oncologist at the renowned Animal Cancer Center at Colorado State University. The university clinic caters to patients from as far away as Russia and Hong Kong and regularly treats celebrity pets. Some grieving pet owners at the university clinic were so depressed over the loss of a pet, they were put on suicide watch.
In Ottawa, Liptak performs facial surgeries to remove tumours and complicated surgeries that prevent amputations in cancer cases. A few weeks ago, he removed a sarcoma from the toe of a pet rabbit.
Liptak admits that sometimes vets have to "inject some reality" into pet owners. "I will refuse to do some surgeries because it will do more harm than good," he says.
But it's also important for vets not to impose their opinions on what owners should do, he says. "Animals are more of a part of the family, and they are treated as such. They consider their pets differently. They're not disposable."
If pets are family members, its not just in the informal sense. Veterinary malpractice suits are on the rise in the U.S. where some pet owners who believe their pet died wrongfully have tried to change the legal status of pets. California, for example, has drawn the line on pet death liability, arguing that awarding damages for the emotional distress in a pet's human family would open the litigation floodgates.
In Canada, a veterinary practice usually carries malpractice insurance and all employees are covered by it. In most provinces and U.S. states, malpractice only covers the "commercial" value of the animal, and doesn't place a monetary value on the emotional bond the client has with their pet, says Bateman.
There are 14.4 million cats and dogs in Canada. One in three will make a non-routine trip to the vet every year, says Randy Valpy, president and CEO of SecuriCan General Insurance Company, the largest pet insurer in Canada.
Premiums range from $20 to $100 a month depending on the deductible and the coverage, which can be as high as $20,000, with annual limits.
As in the U.S., only about one per cent of Canadian pets are insured -- in the United Kingdom, about 23 per cent of pets are covered. Securican is seeing 25 to 30 per cent growth each year, says Valpy.
Pet owners can spend their insurance money as they see fit, as long as it is within the parameters of their policy. Claims above $10,000 tend to be for cancer therapy. Some owners make claims for palliative care, says Valpy.
Liptak notes there is no difference in the human-animal bond between celebrity clients and those in the working class. In Adelaide, Australia, where he first worked as a vet, he recalls one pet owner who lived in a trailer with few amenities, but was quite happy to drive 700 kilometres to see a veterinary specialist for her dog.
"That bond is there, regardless of who you are," says Liptak, who has two cats. "Yes, they make you happy. But hopefully you make them happy too. To a certain extent, it may be self-indulgent. But people feel they're members of the family, and we treat them as such."
Philadelphia-based Michael Schaffer, author of the 2009 book One Nation Under Dog, was amazed by the devotion people showed their pets as he researched Americans' obsession with them.
"There's things people do now that would have been completely nuts 20 years ago," says Schaffer. "People aren't thinking with their wallets. They're thinking with their hearts."
Schaffer chronicled the case of Ben, a six-year-old beagle diagnosed with bladder cancer. Ben's owners, an empty-nester couple, paid about $10,000 U.S. for surgery to keep Ben's last months as pain-free as possible. The surgery was palliative care, not a cure.
"For some people, getting that extra four months was worth it," says Schaffer.
He believes the changing relationship between owners and their pets boils down to the people.
"They apply human standards to their pets," he says, pointing to trends such as organic food for animals. Pet owners who have embraced organic food believe that their pets, as family members, should have organic food too.
"The choices you make for them are going to reflect your values. People are aware that there's a vast variety of specialists out there for their pets. A hundred years ago, the relationship was more utilitarian. A dog was a tool for guarding a house or herding sheep. Now people keep an animal for its own self."
At one level it's ridiculous that people spend so much on their pets when there are other people in need. But the money people spend on their pets is not money that would otherwise go to charity, says Schaffer.
"It's money that they would have spent on a vacation or a big screen TV. And the joy you get out of it is pretty sweet."
Dr. Julie de Moissac, the president of the Canadian Veterinary Medical Association and self-described "old cow doc," lives in Outlook, an hour from Saskatoon, where she divides her time between caring for small animals and livestock.
She sees examples of the human-animal bond, even among the practical farmers in her rural practice. One ailing farmer requested that his 16-year-old cat be euthansized so the two could be buried in the same casket.
"People are willing to take a terminal dog with cancer and give every possible resource that's available, even if it gets them two weeks," de Moissac says. "That's how strong the human-animal bond is."
Loving animals doesn't make them more important than humans or replace the need to tend to people in need, says veterinarian and internal medicine specialist Dr. Nancy Kay, who often hears from people who criticize those who believe in treating animals as family members when, for example, there is famine in Africa.
"Rather, opening our homes and our hearts to animals makes our own humanity more accessible," says Kay, who is also a veterinary ethics blogger and author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life.
"As a veterinarian, my job is to provide my client with all of the potential pros and cons, risks and benefits of any and all options.
"The bigger dilemma is when a client wishes to go too far on an animal that is suffering and truly cannot be helped. In this situation, it is incumbent upon the veterinarian to step up to the plate as the animal's advocate and try to reason with the client."
Schaffer's dog Murphy, a seven-year-old Saint Bernard, is on Clomicalm. The veterinary version of the human anti-depressant Anafranil is often prescribed for anxious dogs who chew up the couch or leave a mess on the floor when their owners are away.
Schaffer hesitated at first to use it. An anti-depressant for a dog?
"This was one of those things where I thought 'What is wrong with this country?' But we adopted Murphy from a shelter, and he had a hard time adjusting to life in a house."
He figures it's money well-spent. For about a dollar a day, he and his wife no longer clean up Saint Bernard poop.
"We were determined that we would never be crazy dog people," says Schaffer. But his travels in the land of furry babies, GPS devices for dogs and dog walkers who earn $100,000 a year has brought him to the conclusion that there is no such thing as a crazy dog person.
If the time came for expensive measures, Schaffer would treat Murphy like any other member of the household. "I can't imagine saying 'I'd rather go on vacation.' "
Abbey has, in fact, been on vacation with her owners.
The Cullwicks took Abbey to Lake Placid for her first birthday and visited Vermont's Dog Mountain, the home of recently deceased artist Steven Hueck, who built a dog chapel and played host to hundreds of dogs and their people for an annual festival.
"We take her on holidays. We would never put her in a kennel," says David.
He knows Abbey will soon be pushing her life expectancy. The Cullwicks don't plan to go to heroic lengths if she becomes seriously ill.
Says David: "The best-case scenario is that she would fall asleep in her bed and never wake up."
PET POINTERS
Number of cats and dogs in the U.S.: 160 million
Number of cats and dogs in Canada: 14.4 million
In both cases, less than one per cent are covered by pet insurance. In Britain, almost a quarter of cats and dogs are covered. SecuriCan General Insurance Company, estimates about 130,000 pets are covered in Canada.
Proportion of pets that will have a serious illness in its life: Two out of three.
According to SecuriCan, 76 per cent of claims for pets are for illness. About 70 Canadian employers including Harry Rosen, Home Depot and Xerox offer pet insurance for employees through payroll deduction.
Number who graduate annually with a Doctor of Veterinary Medicine from one of Canada's five veterinary colleges: Close to 370. About three-quarters are women.
Cost of pet care: In 2008, the average cat and dog received $154and $335 worth of veterinary services according to information compiled by Ipsos Reid. In 2001, the average household spent $298 on veterinary care and grooming, not including food, toys, or accessories according to Statistics Canada. (Both figures reported by the Canadian Veterinary Medical Association.)
Estimated number of cats and dogs euthanized in Canada each year: 400,000, according to Michael O'Sullivan, chairman and CEO of the Humane Society of Canada. The primary reason for euthanasia, particularly for dogs, is that they are destructive while their owners are away.
Approximately number of CT scans performed monthly at Ottawa's Alta Vista Animal Hospital: 15 to 20
Cost: $650 for the procedure, plus up to $350 for anesthesia, monitoring, recovery and hospitalization.
Approximate number of cataract surgeries, each month: 1 to 4
Cost: between $4,500 and $5,000 for both eyes, including anesthesia, medication and up to 10 follow-up visits.
Approximate number of hip replacements each month: 1 to 2
Cost: about $5,000 including pre-operative appointment, X-rays, anesthesia, medication and pain control.
Number of dogs that would potentially benefit from anti-anxiety medication: Novartis, which markets Clomicalm, says up to 14 per cent of dogs exhibit signs of separation anxiety when left alone. Research at Eli Lilly, which markets Reconcile, suggests that number is closer to 17 per cent of dogs -- representing a potential market of 10.7 million anxious canines in the U.S.
