Medical advances for pets come at price
Pets are benefiting from advances in veterinary medicine that have accelerated in the past two to three years, raising the hopes of pet owners and tough new questions about extending or saving an animal's life, and how much to spend in doing so.
The New York Times
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Two years ago, Mike Otworth's 10-year-old chow, Tina, was diagnosed with lymphoma. The prospects were grim. Lymphoma, a cancer of the lymph nodes, can be put into remission through chemotherapy, but tumors almost inevitably reappear within a year, and death quickly follows.
Otworth seized on a new option. After a veterinarian near his home in Indialantic, Fla., administered chemotherapy to Tina, he drove her to North Carolina State University in Raleigh, N.C., where she became one of the first dogs to receive a bone-marrow transplant at its college of veterinary medicine.
Using equipment donated by the Mayo Clinic, the doctor who established the college's Canine Bone Marrow Transplant Unit in March 2009, Steven Suter, harvested healthy stem cells from Tina's blood and introduced them into her marrow, after radiating it to eliminate cancerous cells. After two weeks of treatment and a $15,000 bill, Tina returned to Florida, unsteady on her feet but cancer-free.
Older pets such as Tina are benefiting from advances in veterinary medicine that have accelerated in the past two to three years, raising the hopes of pet owners and tough new questions about extending or saving an animal's life, and how much to spend in doing so.
A long list of cancers, urinary-tract disorders, kidney ailments, joint failures and canine dementia can be diagnosed and treated, with the prospect of a cure or greatly improved health, thanks to the latest imaging technology, better drugs, new surgical techniques and holistic approaches such as acupuncture and herbal medicine.
"What's new is the sheer number of approaches to treat problems that, not too long ago, would have meant the end of the line," said Dr. Julie Meadows, a specialist in feline-geriatric medicine at the veterinary medical teaching hospital at the University of California, Davis.
The Animal Medical Center in New York, which performed 34 stent procedures on dogs and cats in 2005, usually to open passages in the bladder or kidney, created a clinic about two years ago to accommodate rising demand for minimally invasive surgery. Last year, it performed 630 stent procedures.
Suter, at North Carolina State, has done bone-marrow transplants on 65 dogs, with 10 more on the waiting list. Many veterinarians offer hospice care, too, mapping out a treatment plan that lets a pet spend the remainder of its life at home, its pain eased through palliative care.
Treatment like this comes at a price, monetary and emotional. Improved veterinary care for all pets has boosted consumer spending in this area to $13.4 billion in 2011 from $9.2 billion in 2006, according to the American Pet Products Association.
Pet insurance rarely comes to the rescue, because fewer than 3 percent of Americans carry it, according to the American Animal Hospital Association. Those who do can expect reimbursement, according to their level of coverage, from a few hundred dollars to several thousand dollars, but bills for the most advanced forms of treatment outpace even the most comprehensive plans.
Otworth paid about $25,000, total, for Tina's treatment. He also wrestled with whether to go ahead with late-life treatment: Will the pet suffer unduly? Will treatment give it a good quality of life, or merely extend it?
"I wondered if I was doing this for selfish reasons," he said.
Some pet owners decide on treatment and then, after writing the checks, have sobering second thoughts. The prospect of a $6,000 bill for orthopedic surgery can force even the most ardent animal lover to ask, "Precisely how much do I love my dog?"
Patti and Dave Halberslaben of Madison, Wis., recently spent $10,000 to treat their 12-year Maltese-poodle mix, Chip, for an inoperable brain tumor. Much of that cost went toward three courses of radiation at the University of Wisconsin, where 118 dogs and cats have been treated in the past year using a highly accurate image-guided radiation machine called Tomotherapy.
"We did not hesitate to do it, but in the future, I'm not sure we can handle a bill like that," Patti Halberslaben said.
Life extension for a cat or dog can be relatively short, and old age can bring a variety of ills. Although Otworth's dog, Tina, was cured of lymphoma, she developed liver cancer about nine months after returning home and soon died.
The most rapid advances in veterinary medicine have taken place in the treatment of cancer, propelled by the latest diagnostic technology such as CT scanners and MRI machines. With precise imaging, veterinarians can deliver more concentrated doses of radiation to tumors whose location and dimensions were mostly guesswork just a few years ago.
Precise imaging also has made it possible to treat a variety of ills with minimally invasive surgery so owners can take their pets home within 24 hours.
Dr. Allyson Berent, director of interventional endoscopy at the Animal Medical Center in Manhattan, recently treated Simba, a 17-year-old cat who had developed a benign tumor in the urethra, making it impossible to urinate.
A mesh tube, or stent, inserted into the urethra opened the passageway. The cat, which had been in acute distress, went home in a matter of hours. "Traditionally, the animal would have been euthanized," Berent said. "This used to be major, major surgery."