For love of dog… How much would you pay for your dog? | Dr. Justine Lee
Any dog lovers out there read my book It’s a Dog’s Life… but It’s Your Carpet? In it, you meet the my last pit bull – the best dog ever – JP.
JP was my main squeeze for the past decade plus. JP has been my loyal companion and “Justine-supporter” through many a move, transition, job, residency, and boyfriend. JP is named after Jamaica Plain, an up-and-coming (i.e., ghetto) subdivision of Boston where I used to live (This is on the infamous “other” side of the tracks, where one needs a pit bull to safely walk down the street). Since rescuing him from parvovirus, he’s been a fantastic, well behaved, obedient ambassador for the breed.
When JP was 12 years of age, he acutely seizured one night. As an emergency critical care veterinary specialist, I knew instantly what this meant – something horrible: a stroke, a hypertensive event, or a brain tumor. Having said the words “Your dog has cancer” thousands of times to pet owners in the veterinary emergency room, now it rocked my world to hear it on the “other side” of the table. Unfortunately, a few days later, JP was diagnosed with an aggressive brain tumor (a suspected glioma) based on MRI.
Panic set in. This dog was my main love: above boyfriends, family and friends. The rational, scientific side of Justine fought with the emotionally charged, “pathologically-attached-to-my-dog” Justine. I frantically called fellow colleagues who specialized in veterinary oncology or neurology to figure out what to do. My options:
- Euthanasia: Humanly euthanizing him. Average life span: 0. Cost: $200-$400. Pros: he doesn’t suffer; no seizures or behavioral changes to deal with. Cons: He’s dead, I’m a mess, and I’ve had no time to spend with him.
- Medical management: Putting him on anti-seizure medications and steroids (to reduce the swelling in his brain). Average life span: 1-2 months. Cost: $200-$400. Pros: Cheap. Cons: I’m still dealing with bad seizures; I have to deal with side effects from the medication (e.g., excessive thirst, urination and hunger); and I don’t get that much more time with him.
- Traditional radiation therapy + chemotherapy: Putting him under anesthesia once a day for 21 days for radiation therapy to zap his whole brain (including healthy brain tissue). Average life span: a few months. Cost: A few thou. ($3-$4,000). Pros: I can get it done locally in St. Paul, MN. Cons: High risks of anesthesia, low specificity of radiation.
- Stereotactic radiation therapy (SRT): Putting him under anesthesia once a day for 1-4 days for a specialized radiation therapy that zaps only his tumor – not his whole brain. Average life span: 4-10 months. Cost: $8000-$10,000. Pros: Cutting edge technology where it’ll maximize a good quality of life; specific localized radiation against evil, bad tumor cells. Cons: High risk of anesthesia; expensive – it costs more than my car; and I’d have to drive cross-country for it (as it’s only offered in a few places in the United States).
- Brain surgery: Putting him under anesthesia and have the tumor surgically “debulked” (which is a nice way of saying “melon-scooped” out, as an anonymous veterinary oncologist told me). Cost: Free, thanks to an NIH grant at University of Minnesota. Pros: Cutting edge research; free; done by board-certified specialists. Cons: High risk of anesthesia; risk of having a mentally-impaired dog post-operatively.
So what did I do? I needed to do everything that I could, as long as it didn’t hurt JP or put him through what I deemed to be too much. I wanted my dog – not a mentally impaired dog – and couldn’t handle the risks of JP losing his cognitive function or personality.
So, thanks to a 5-hour energy drink and a mocha, I drove non-stop from St. Paul, MN to Fort Collins, CO to one of the top oncology departments in the world at Colorado State University for stereotactic radiation therapy. Thanks to the support of some excellent counseling staff (part of Animal Cancer Center’s team), I was able to survive the tumultuous, stressful, one week experience…
A few weeks later, once JP was recovered, my friend asked me “What’s the cost-benefit ratio to you?” In other words, how long would JP have to live before it was worth the financial investment for SRT?? Bluntly, I said that if I got an extra six months with JP, I’d be happy. I needed that time with JP to say goodbye, provided it was a good quality life.
So, 13 months later, when I humanely euthanized JP, I crunched the numbers. Between his MRI, CT, blood work, SRT, medications, pet-sitting and dog walking fees, treats, emergency endoscopy (Damn rawhide!), etc., JP cost me $37/day since his initial seizure one year ago.
And you know what? It was worth it. While my friends and family were appalled by what I spent on JP, I needed it. (This coming from the girl who is too cheap to splurge on Starbucks mochas more than once a week.) All in all, I’m ecstatic I had an extra 365 days to spend with JP. My love for that mutt runs deep, and I’m blessed that I was able to afford it. I’m cognizant that most people aren’t, but where people splurge on cars, plasma screen TVs, and assorted materialistic things, I splurge on pets. (I do drive a 2000 Hyundai, after all). Besides which, $37/day is a hell of a lot cheaper than a daily shrink visit… and JP has provided me a lot of mental health.
To all those pet owners out there struggling with cancer, hang in there. Whatever decision you make is the right one.
To JP: thank you for teaching me more than I could ever learn from a two-legged human: devotion, loyalty, companionship, and most importantly – that success isn’t measured by society, but by the joy of a tail wag.
PS. I found out about another glioma glioblastoma dog brain tumor study going on HERE at Auburn U:
and further information at Texas A&M.
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Thanks for this post. My wife and I recently spent over $7,000 for spinal surgeries for our dachshund suffering from IVDD. He got 8 months of quality life before we lost him after complications from a third surgery. This worked out to a little over $29 a day. We don’t spend a lot on luxuries or entertainment but those 240 days with a happy companion were definitely worth it. Thanks for reminding us that there are others out there who understand spending this much on what many consider “just a dog.”
They are our family members right? In fact, my dog, JP, was closer to me than some family members! 🙂
Best dog ever. Squamous cell carcinoma in the upper sinus which errupted through the top of the skull. $18K out of pocket for 6 months (no insurance). Every day good quality until the very last one. Worth every penny. Our current dog is covered by insurance. I would think long and hard before spending that much out of pocket again. Did I mention she was the very best dog ever?
Wow – we just had surgery for our dog with squamous cell carcinoma in her sinus. Hopefully, they got it all. She has no nose pad now, just an opening, but she’s happy and it’s totally worth it! Her look surprises/scares some people that drive by, but people who ask are very compassionate and happy she’s doing well.
Reading this was pretty much like having someone read my thoughts.
My dog, Ellie, had her first seizure three days after she turned nine years old. As a CVT with years of experience in ECC at a large referral hospital I knew before even signing the MRI consent forms that she had a tumor. I barely hesitated when our neurologist told me it was surgical. She had her surgery a month later and thanks to an awesomely generous study at VHUP she started radiation a few days after her staples were removed.
We got three and a half years together. In those three years we took lots of road trips. She won a contest to star in an episode of Portlandia and we had a sweet cross country trip. We even adopted another elderly dog (with epilepsy) because hey, if you’re medicating one dog, what’s another!
In the end I spent around $10,000 (she also had a scope mishap unrelated to her brain tumor. D’oh!). I never thought to break it down per day but now knowing that her medical care cost me less than $8/day, I can be even more confident I made the right choice.
Ellie was euthanized in November 2014 and I don’t think I waited a day too long or did it a day too soon. I feel lucky to have had just the perfect amount of time.
Thanks for the post.
Man, thanks for sharing. So tough, right? You were in really good hands at VHUP. I know it ends up being a lot of money, but if you are blessed with being able to do advanced care WHILE keeping your dog’s good quality of life going, I think it’s such a blessing. 🙂
Thank you for this article. My beloved Boston was diagnosed with an atypical lymphatic tumor in her vertebral body (all scary words when I first heard them). My husband and I sat so many nights, thinking about what would be best for our baby and our lives. I’m a teacher and he does free lance work…we don’t really have much in the way of funds, but we did have a new-house fund. In the end, we went with an intensive rad treatment and a palatal chemo treatment (plus surgery to remove the tumor compressing her spinal cord and causing paralysis in her hind end). It was expensive…it still is expensive…but we wanted time with our baby more than we wanted a new house. I completely and totally get what you felt and and got many of the same looks…. “You’re speaking WHAT?! on a DOG?!” -nope, I’m spending money on a member of my family…who I have an obligation to. No one knows what her life span will be…her tumor and cancer is really strange…but so far we’ve been on several road trips and we’re making the time count. That’s totally and COMPLETELY worth all the money. Thank you for writing this article. I feel this.
Thank you for this great article. Finally somsbody is willing to spent money on their pet and not be ashamed about it. i am an emgercy vet in Amsterdam, the Netherlands and i deal with these problems every day too. If I spent this money can you fix my pet?? Sometimes but not always…. My own dog is my best friend too. She has had almost every specialist have a look at her. Stong and active now but i worry about every little lump i can detect….
Good for you for making the right decision for you. I wrestled with the same decision for my toy poodle Misha who was 15 at the time,, UF does stereotactic radiation. We were all set to go and two days before Misha’s kidneys failed . My wonderful vet Erin Bendict made a house call and Misha was put to sleep while lying in my arms in my bed with her family surrounding her.
THIS is why I have pet insurance. I carry “catastrophic” level coverage, that doesn’t kick in until I’ve spent $1000 but after that lets me spend up to $10,000. Because the choice for every pet owner shouldn’t have to have worry over costs. It paid for itself when my greyhound got osteosarcoma, and I was able to get her every treatment necessary.
After our almost three year old Lab/Chessie cross was hit by a car, he spent three weeks in the hospital while they tried to save his hind leg. Amputation was followed by a total hip replacement in the other leg, due to damage also caused by the accident. Eight surgeries total, plus extensive physical therapy, came to just about $17,000. Was it worth it? You bet! We wouldn’t’ have had it any other way.
He did not have any health insurance, but you can be sure that we bought major medical for the new pup we got three weeks ago.
My Basset Hound Riley was just diagnosed with Squamous Cell Carcinoma. It has not metastasized. His bloodwork is excellent. The tumor is not tonsillar and the vet has said the tumor is very localized. It is inside of his cheek. It is growing rapidly. It popped up out of nowhere less than 3 weeks ago and I hope to never go on this journey again. I live in Florida and my oncology options are limited. I have one facility which is very close to me but the cost of the radiation they are recommending is 7k plus another 1,700 for a CT plus the 2k I have already spent. He is worth every dime and I am determined to get rid of this tumor however I am absolutely amazed at the lack of oncology doctors in Central Florida. I would at least like to get a second opinion but i cant find one. No wonder this facility charges whatever they want and they get away with it… there have no competition. Its really outrageous to see this happening to so many pet owners.
Unfortunately, that is similar to costs to just about anywhere in the USA, I’m afraid. You can always check with the Florida veterinary school too. Best of luck for your little guy!
My pet insurance bill for multiple cats and dogs is over $900/month. Yes, I’m an idiot. But I need to be able to take care of them if they become ill or injured.
Wowza – that’s a lot! 900 a year or a month? If it’s a month, I’d get price quotes from multiple pet insurance companies. But I’m so glad you’re wise enough to do this as it will save you $$$ in the end!
I’ve had a COMPLETELY different experience from everyone here. People judge us for NOT getting cancer treatment for our dog, but it would cost at least $1,700, we have 3 kids, multiple medical issues, I’m going to grad school and will quit my job soon. We rescued this pupper from certain death from a kill shelter. He would have been dead for over a year had we not adopted him. He’s had a great life (he was a street dog before this) and he’s been spoiled and loved. I feel no guilt whatsoever not paying for his treatment and using that money for our human children instead. Honestly, even if we could afford it, I’d rather donate that money to help other human children who live in hunger and poverty – just a personal preference (I’m a social worker and I see how those kids live – it’s atrocious). I understand that not everyone sees things this way and that some people truly need their dogs for emotional support – no judgment there. But we’ve felt judged from the moment we decided not to treat. Our dogs get enough love and they will die before us – it’s already guaranteed. Personally, I don’t see a reason to prolong their suffering and put them through tests and radiation.
I’m so sorry to hear this! Never any judgement – I always support a pet owners decision and always tell people it’s more important to feed you and your family!
I just read this article and I really appreciated hearing it from someone in the Veterinary field. My dog Coda was just diagnosed with a brain tumor, most likely a Glioma based on the MRI. He is 9yrs old with a heart condition so my options are limited because I would have to travel to get to a place that does the Cyberknife. We have him on palliative care and it’s very difficult watching him change from the fun loving dog he was to having more bad days then good days. It’s been over $6,000 for the diagnoses and emergency treatments with his seizures. The challenge now is when will I know it’s the right time to have him euthanized . This is part of pet ownership, making those tough decisions that makes your heart hurt. Thank you for sharing your story!
Thank you so much for writing this. Now I just have to find a hospital in Sweden that will do stereotactic radiosurgery!
This is the home of the Gamma Knife, so it should be possible.
This is the best, most sensitive, comprehensive and comprehensible article on the subject I can find on the internet. Thank you! The one thing I can’t seem to find anywhere — and I realize all dogs and conditions of glioma are different — is:
1) For you, how soon after the radiation did symptoms subside?
2) Did symptoms then steadily, slowly progress over the next 13 months?
3) I realize this is very sensitive, but, for you, what symptoms did you experience that indicated it was the right time to humanely euthanize your pet?
These are the issues I’m struggling to grasp right now. Any response is so much appreciated! Thank you!
Hi Josh,
I’m so sorry to hear about your dog – it’s such a stressful night. I will say that my dog’s radiation symptoms took about 1-2 weeks to resolve. In other words, my dog was really lethargic and quiet for a bit. He wasn’t eating well and just seemed really ‘dull.’ But by the 2nd week, he had dramatically improved and was back to his old self. However, he was blind in one eye and couldn’t hear well (which was from the brain tumor) PRIOR to radiation and this was persistent. The symptoms slowly progressed over a year, and his appetite was worsening and he was walking more wobbly.
For me, I knew the time to euthanize him was when he didn’t want to go for walks anymore. My general guidelines for when to euthanize a beloved family pet are when they 1) act like they are in pain (hiding, whimpering, shaking, tremoring, acting very aloof or very clingy), 2) when they don’t act like they used to as a puppy (happy), and 3) when they stop eating (even with enticement). I hope that helps. Here are two blogs about the “process” of euthanasia, just FYI:
https://drjustinelee.com/euthanasia-pet-dr-justine-lee/
https://drjustinelee.com/let-pet-die-home-dr-justine-lee/
It’s such a hard decision, but definitely worth talking to your veterinarian and a veterinary ONCOLOGIST about all your options. Keep me posted and best of luck. Thoughts for you and your dog. Brain cancer SUCK. Sending you guys well wishes.
Dr. Justine Lee
Thank you for writing this. The neurologist just told us our beloved 6 year old German Shepherd has a brain mass. Meningioma. My first question was can we do Gamma Knife . She’s our girl we love her. She’s part of the family and will get the best care we can obtain.
I’m so sorry to hear this, Kathie – it’s so horrible, isn’t it. 🙁 Please let me know how she does with Gamma Knife (That is SRT).
Justine – I can’t thank you enough for this article. In total serendipity, it was delivered to me at exactly the right time. Reading your words was like reading my own mind. My 10 year old shiba inu/husky mix was diagnosed with nasal cancer last Sunday. 3 months to live without treatment (it has taken over 2 months to diagnose properly), SRT recommended. Luckily, I live in Colorado and have easy access to CSU, and my doctor previously worked there so she was able to tell me all about SRT.
That said, I have been under massive pressure from friends and family to stop spending such an appalling amount of money on my dogs. They even held a family intervention of sorts last year, when I was treating my 2 dogs for various conditions which were very expensive. They ganged up on me and pressured me then to “put them first (over myself) and let them go”. But the dogs are happy and not in pain, so I left that meeting in tears, and refusing to change my perspective. But knowing that I am truly on my own now. My boyfriend even left, saying “your dogs are not your family”.
I was horrified that my family and friends thought I should euthanize my dogs due to finances. Is that how we would treat each other??
As I read your article, I related to every word. Boyfriends, family, friends, not understanding. Me standing my ground and externally strong, but internally feeling so alone. Me driving a ridiculously old car and not buying new clothes or going on trips like all of my friends.
I sat here last night, praying for some sort of sign as to how to move forward. Hoping that I am not completely crazy for moving forward with yet another procedure: SRT for my baby, which may only give her another year and which will drive me back into debt.
But I take strength from you and the people responding to your story. I feel less alone and less crazy. My initial gut feeling was YES I absolutely will do SRT!. I will figure it out. Then over the next few days I started questioning myself. You all brought me back to center. To my true self. To that part of me that aligns with love and doesn’t apologize for it.
Yes, I am possibly a pathologically, crazy dog lady. Those of you who love your babies get it. Tonight, I feel empowered and understood.
Deepest Thanks,
Cathy
Awh, Cathy, my heart truly goes out to you. It is the hardest decision ever, but I will say, I really needed the time with my dog that I got with him – and he handled SRT really well. 🙂 Thinking and praying for you and your pup. You are in good hands with CSU. Keep me posted!
Will do! Thanks for bringing kindness and light to a tough situation. I so appreciate you.
My love, my girl, a red lab pit mix has spindle cell cancer on her side. I’m kicking myself for listening to a vet 2 years ago who put us on a watch and wait based on inconclusive aspirate. I did not realize he had no clue as a general vet that an inconclusive aspirate necessitated a biopsy. I had asked for one and he dissuaded me to eliminate anesthesia risks. I was left with wait and watch and no fixed schedule..at that time I was a victim of gross negligence on the part of of an orthopedic surgeon, fully thrombosed due to a genetic mutation…I was out if it..I should have questioned and not just accepted his direction.
So then this year it grew suddenly and was fixed. He said “now it’s cancer”. It was before and his gross oversight could take my dog from me.
She had a surgery without clean margins with a grade 2 spindle cell cancer.. I am devastated..
I thought treatment would be high side 5-7 k…I’ve already spent 2600 on surgery, oncology appointment, x-ray and ultrasound..my dog came out clean everywhere else on the diagnostics and I was whooping it up over that yesterday..now I’m overwhelmed again. The oncology vet says with radiation this type of cancer has a 95% survival rate at 5 years. ( I hope I didn’t mishear)
Am so angry at the original vet. I will lodge a complaint with the board if veterinarians and write him a letter. I’d love to sue him. He had no business talking me out of a biopsy on an inconclusive aspirate..none.
My sister and brother are telling me not to treat…they have cited longevity statistics for labs and pit bulls..( my girl Banjo is 8 1/2 and I always thought I’d have her until she was 15 or older. I take very good care of her..
So on Monday I have an appointment at Sage in Campbell, Ca to see a radiation tech and to get a CT scan..I’m 2600 in and for stereotactic radiation I’m looking at 13k..
My dog is the love of my life and I will not feel bad about helping her. I feel sick we’re here. It was so preventable.
This is the most accurate, relatable, helpful post on what has to be the most difficult situation I’ve ever been in, and I’ve experienced a little more than average loss so far in life. I know dog love and loss is different for everyone, but I was amazed at how amazingly similar my concerns and considerations are to yours. Thank you!!!
Hi, I’m sorry about your loss.
I’m in the process of deciding what’s best for my toy poodle. He is 12 and diagnosed with meningioma on right front brain. 2cm x 2cm x 1cm in size. I want to ask you as why you chose to do Stereotactic radiation therapy rather than resection surgery followed with fractionated radiation?
I’m torn deciding what’s best for survival length post surgery and invasiveness. I don’t like that resection has long recovery time and the 20 days of fractionated radiation and anesthesiais brutal.
f you don’t mind me asking should traditional resection surgery be an option would you have opted for it?
Why did you choose Colorado State University? Thank.
Hi, I’m sorry about your loss.
I’m in the process of deciding what’s best for my toy poodle. He is 12 and diagnosed with meningioma on right front brain. 2cm x 2cm x 1cm in size. I want to ask you as why you chose to do Stereotactic radiation therapy rather than resection surgery followed with fractionated radiation?
I’m torn deciding what’s best for survival length post surgery and invasiveness. I don’t like that resection has long recovery time and the 20 days of fractionated radiation and anesthesiais brutal.
f you don’t mind me asking should traditional resection surgery be an option would you have opted for it?
Why did you choose Colorado State University? Thank.
CSU is most well know for SRT – I didn’t want to do 20 + days of RT.
If prognosis is showing surgical resection with fractionated radiation has 2 years plus more survival length and SRS/SRT is only 16 months or 18 plus months. Which option would be better? Thanks.
In my situation, I live in Toronto, Petcure Oncology in New Jersey is much closer to me than CSU. It is a very difficult decision. Many thanks again.
There’s one in Yonkers, NY too.