The featured photo is of Arran and Bill, just a few days ago… As you can see, they love each other very much. Arran is glad to be here with his favorite person. I’m glad we can afford to treat his cancer and keep him comfortable for a little while longer. And I’m grateful that living in Germany allows this outcome for us.

A month ago, I wrote a post about our decision to treat our dog, Arran, for B-cell lymphoma. I was inspired to write that post after reading an article in the Washington Post about the cost of treating major diseases in pets. The article in the WaPo was written by Kim Kavin, whose dog, Blue, was diagnosed with cancer. She decided to pull out all the stops to treat Blue, and it cost a lot of money. Blue initially responded to the treatment, but then suffered a relapse when the cancer came roaring back with a vengeance. Kavin’s piece ran in the paper, and lots of people had negative opinions about it. I felt badly that she was getting so many brutal comments, so I wrote my own post about our decision to treat Arran.

At this writing, Arran has had six chemo treatments. If we hadn’t done these treatments, I feel pretty sure he would have died by now. When we started the chemotherapy on October 13th, he was starting to get sick. He wasn’t eating much, and looked very sad. He spent a lot of time sleeping, and could barely manage a short walk around the block. Now, he eats, sleeps, takes walks, jumps on the furniture, and tears things up. The chemotherapy hasn’t made him feel sick. The only thing I’ve noticed is that he sleeps a bit after he gets Vincristine and/or Endoxan. But he doesn’t have diarrhea or issues with vomiting. He hasn’t lost his fur. He doesn’t even have to take medication every day. And you’d never know he has cancer.

What has his treatment cost us so far? So far, we’ve paid for six weeks of treatment, which consists of weekly IV pushes of Vinistrine, a chemo drug. He takes two Endoxan pills per week– on Thursdays and Saturdays. Every other day, he takes three 5 milligram tablets of Prednisolone. This regime will continue for another two weeks, and then it will change to one that is less extreme. Total cost here in Germany? Still less than 1000 euros. And he feels much better with a great quality of life, while we’ve been able to enjoy his company for a little bit longer. I think he’ll make it to his tenth anniversary with us. That’s all we could have ever hoped for.

A couple of days ago, The Atlantic ran a story titled “How Much Would You Pay to Save Your Cat’s Life?”, by Sarah Zhang. The story was about the veterinary hospitals in the United States that give cats kidney transplants to save their lives. Their owners shell out $15,000 for the surgery, which involves using a donor cat’s kidney, implanting it in an often elderly cat. Many times, the owners end up adopting the donor cats, too, as they are typically young and healthy and in need of a home. As it is for most humans, cats can get by just fine with one kidney. In one case, the prospective donor got adopted anyway, when the cat that needed a kidney passed from heart failure before the surgery could be done.

It was noted in the article that kidney transplants are the only transplant surgeries available to cats. The donors are not killed. Apparently, transplants are not yet available for dogs, because “the canine immune system is unusually reactive, leading to kidney rejection.”

Zhang wrote about a 16 year old cat named Strawberry who got a new kidney. Strawberry’s owner did not want to be identified, as she feared backlash from people about the cost. The surgery alone costs $15,000, but with travel, follow-up care, and other costs, it can end up being twice as expensive. And Strawberry’s owner didn’t want to deal with a bunch of negativity about her choice to spend that money. Zhang writes that she interviewed a dozen cat owners who had opted for the surgery and also wanted to remain anonymous. One person quipped, “I wouldn’t think of saying to somebody, ‘Wow, that’s an expensive car,’  But people seem pretty free to say, ‘Wow, you spent a lot of money on a cat.’ ”

I remember the very negative and judgmental comments on Kavin’s article in the Washington Post. I expected to see similar comments on The Atlantic’s article. Much to my surprise and delight, The Atlantic’s readers seem to be a lot more open-minded. Or, at least they aren’t as full of judgmental bile about what people will spend their money on, as well as the mistaken belief that cancer treatment is always unpleasant and leads to sickness, as it often does in humans. And one person wrote a very astute comment, which I think really highlights why people tend to have strong reactions to other people’s choices to treat illnesses like cancer in their pets. Facebook user Isaac Suárez wrote:

The issue is not “is a cat’s life worth saving.” A cat is a companion, to be loved and cared for. There is no shame in wanting to preserve this bond and prevent unnecessary suffering.

Rather, the judgement comes from the fact that some have $15k to burn on pet care while the vast majority of people don’t. I know many people who’d happily pay the price to help a friend; I know very few who have the money to do so.

Sadly, a cat with kidney failure is just one of innumerable occasions where the stark class divide of our country manifests. Instead of talking about “are cats worth the price” we should be asking “why is the price so high” and “why do some people have the freedom to make this choice when the vast majority don’t?” As with many topics covered by Atlantic, the question is misframed and a valuable opportunity to address a visceral and important issue is sidestepped.

Another Facebook user liked Isaac’s comment, and responded thusly:

Brilliant and eloquent response! Its heartbreaking that so many must choose to have their beloved pet euthanized because the treatment cannot be afforded or people take on a hideous amount if debt in order to save their pet. Either way, there is a great deal of needless pain.

I also really related to Isaac’s comment, especially as an American who lives in a country where healthcare and veterinary treatments are much more reasonably priced than they are in the United States. If Bill and I were living in the United States, Arran’s treatment would no doubt cost a whole lot more. It would probably be undertaken at a high speed referral center, rather than at our local vet’s office. And we would be paying much more for his medications, as well as every single thing that would be done for him. We love Arran very much, but we’re practical people. He’s already an old guy. I can’t see us spending many thousands of dollars to keep him going. But in Germany, we can easily afford the treatment, and it makes him feel better. So he gets this comfort care at the end of his life, which will allow him more time with us, and give the vet more valuable experience treating lymphoma. It’s a win-win.

Many Americans resent how some people can afford to provide such advanced care for a pet, while human beings are going without care because they can’t afford it. And yet, so many people continue to vote for the same leaders, who do nothing about this problem. The United States is among the richest countries in the world, yet so many Americans lack the ability to pay for their own healthcare, let alone that of their pet’s. But a lot of us would never bat an eye at buying the latest iPad or tennis shoes. We don’t roll our eyes when a neighbor takes a trip to Hawaii or buys a Tesla. A pet can give a family intangible things that an iPad or a Tesla never can. Why should anyone be ashamed to spend money on their best friends? And why should anyone feel the need to judge someone negatively for making that choice? It’s not as if that person who can afford the advanced veterinary treatment for their dog or cat is going to be paying for their neighbor’s treatment.

I am probably not one of those people who would opt for a kitty kidney transplant, especially on a cat who is 16 years old. But now that I’ve experienced giving a dog chemo, I might opt to do it again for another dog… if I think the dog is well enough to be treated and wants to fight. I would probably pay a fair amount for that option, even if I’m living in the United States, where it will undoubtedly cost a lot more. Here in Germany, it’s a no brainer to give chemo a chance, although not all dogs respond the way Arran has. The response depends a lot on the animal and the type of disease. In Arran’s case, he is resilient, and he has a type of lymphoma that responds to treatment. We have the money. Why not treat it? What makes it any different than treating him for heartworms or diabetes or any other disease that people don’t think twice about treating in their pets? And if someone else has the ability and the desire to pay for advanced treatment for their cat, who am I to judge them? I’m not involved in the aftermath of that decision, and it’s really none of my business.

Anyway… I found Sarah Zhang’s article thought provoking on many levels, especially since we’re dealing with a pet who has cancer now. Arran is our fourth dog to get cancer, but he’s the first one we’ve been able to do anything for… and it really does feel good to do something. I can see, every day, that Arran is glad to be here. No, it’s not fun for him to get intravenous medications every week, but that’s only for about a half an hour. In a couple of weeks, he’ll be getting the IV meds less frequently. We’ll see how long he can make it before it’s time to let him go. I’m just glad we have the luxury of being able to prepare for the end, and enjoying every minute with our beloved Arran. If we weren’t in Germany, I’m not sure we’d have that. This shouldn’t be something that other people judge us negatively for doing, simply because our healthcare system is so fucked up and prices for humans and animals needing medical care are so ridiculously high. It seems to me that Americans ought to be demanding lower healthcare costs. I know that’s the way I’m going to be voting from now on.