Tuesday, April 12, 2011

Cost v. Outcome

So! As I mentioned, while we were at the vet's the other night, we discussed The Runt's heart murmur. The vet would like to do an ultrasound in the fall to determine the extent of the problem, and possibly put him on heart medication, which is not cheap. And I'm kind of conflicted about the whole thing, especially since LOTS of cats live long, healthy lives with heart murmurs and without medication.

I guess it boils down to two conflicting things:

He. is. a. CAT.

He is my cat.

Let's say The Runt, I don't know, fell out of a tree. And broke his leg. And I rushed him to the vet, and she said, "We can fix him! It's a pretty bad break, so he will need surgery and pins and plates and recuperation time, but we can fix him! And it will cost $5,000."

Would I spend the five grand? Of course.

NOW, let's say that The Runt has a congenital health condition. Say, a HEART MURMUR. *cough* That he was diagnosed with as a kitten, and that has not gotten any worse as he ages. And NOW the vet says, "We can fix him! We can put him on heart meds, which usually help, although even WITH the meds, there is still a possibility that he could keel over from a heart attack. And for five years on the meds, it will cost $5,000.00".

Would I spend the five grand? Let me think about that one.

Five grand for meds that may or may not prevent a heart attack, for a condition that he may very well live his entire life with, without suffering any adverse effects, without being on the meds. Oh, and if he lives as long as Rocky did, that would be a total of sixteen grand, over his lifetime.

Okay, now I can hear what you're thinking - "What if it was your kid?" And all I can say to that is, but he's NOT my kid. He's a CAT. And like it or not, there is a difference.

Okay, so now I can hear you saying, "Well, if it was medicine for YOU, you'd spend the money, right?" And to that I say ... maybe? I know a LOT of people who go without prescribed medications, either because they can't afford them or they don't like the side effects or they don't agree with the diagnosis or whatever, so who's to say if I would take the meds myself? I'm not in that position.

All I know is, in this situation at least, I need to weigh cost versus outcome. Do I love The Runt? Absolutely. Am I ready to spend a bunch of money on medication that may or may not help, that may or may not be necessary? Let me think about that a little more.

Am I a bad pet owner? I don't know.


~~Silk said...

Accidents are one thing. Birth defects are another. You can't use the same criteria to decide.

The Runt is a child of Nature. It would not be wrong to leave it up to Nature. Remember that in any case, Runt is living a longer and healthier life with you than if he were wild.

Anonymous said...

Of course you are not a bad owner. He has been fine without the meds--is his risk increasing as he gets older? I realize there is no gurantee, but it doesn't sound like putting him on the meds decreases the odds of a problem? Also, meds have side-effects. Are there cheaper but just as effective meds? I would recommend a second opinion. Also, Chris Bern, DVM, at http://avetsguidetolife.blogspot.com/ has answered my questions before. You might try him?
Good luck.

Badass Nature Girl said...

Difficult spot to be in, and I agree with Silks point of view. You have to make the decision that is best for you and your cats and I'd be thinking along the same lines that you are.

rockygrace said...

~~Silk, that's it - it's a birth defect. It's not like he's an old cat with heart disease. I'm not sure how effective meds are with a birth defect.

The vet's main concern seems to be the risk of putting him under anes - anesth - oh, hell, knocking him out, for a teeth cleaning or something, as evidently that's risky with heart murmurs. But (a) it's a level 2 murmur, which is mild, and (b) he's already BEEN knocked out, when he was neutered, and he came through fine.

Anonymous, thanks for the advice! I don't know if the risk increases as he ages - the murmur's been steady at level 2 since he was a kitten. (He's almost 3 years old now.) Sounds like I really need to talk to his vet some more. His previous vet didn't seem to think the murmur was a big deal, which is part of why I'm confused now. (Ha! And if you want to get REALLY confused, google "heart murmur in cats". Holy macaroni!

And BNG, it IS difficult! And the last thing I want to do, is come across as a cat murderer or something.

And if there's anybody out there muttering under their breath, "But you ARE a cat murderer, if you deny him treatment!", please, speak up! I'm interested in all sides, here.

bridgett said...

Nope, I sort of go with the "not seeing the urgency" school on this one. He's not in pain, it's not a condition that degenerates without meds, it's not a quality of life issue, and...yeah, Runt's a cat.

I think maybe you're getting a touch of the upsell, letting you know about expensive therapies because you seem like the kind of person who might be willing to front that kind of cash.

rockygrace said...

So I look like a patsy, do I, bridgett? Yeah, I probably do. :)

the queen said...

I re-read this, of course, after the Runts passing, and it still holds true. You did the right thing.

rockygrace said...

Queen, I just keep telling myself that *I* didn't kill The Runt, the heart murmur did.

Thanks for your supportive comment - I thought I was really gonna get put through the wringer, considering how it turned out.

It's still hard.