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Written by leading veterinarians to provide you with the information you need to care for your pets.

The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.


Veterinary cancer treatments can be expensive. The options I offer to owners are completely elective in nature, and affordability of care is a subject discussed on a daily basis. For many of the different cancer types I treat, the long-term prognosis can be very good, but such fortunate outcomes often come at a costly price, and sometimes the most effective plan is absolutely financially out of reach for owners. The struggle is palpable: owners want to do the best for their pets, yet know the cost of the treatment is beyond their means.


Specialty medicine is a unique aspect of the veterinary profession. We are able to offer pet owners diagnostic and therapeutic options on par with those available to humans, and we work hard to advance our different areas of expertise by developing research projects and clinical trials. I can walk through the hallways of my hospital and pass a young dog with orthopedic disease undergoing a CT scan, an older cat with a brain tumor having an MRI, a ferret having an abdominal ultrasound, endoscopy equipment being used to retrieve a mistakenly ingested toy from the stomach of a puppy, a rabbit receiving radiation therapy, and a geriatric Labrador walking on the underwater treadmill as part of a rehabilitation program for arthritis. The demand for specialty veterinary medicine is high and many educated owners seek referral to a specialist based on their own personal health care experiences.


I rely on the advanced diagnostic tools that are so readily available to me to help achieve a definitive answer as to what is causing a particular pet's illness and to help perform what are known as staging tests for various cancers. Staging refers to examining where in the body the cancer can be found, and many tumor types have a specific staging scheme, which is often found to correlate with prognosis. The results of staging tests will influence treatment recommendations. For example, in cases where tumors are localized to a single anatomical area of the body, I will often recommend a localized form of treatment such as surgery and/or radiation therapy. However, in cases where the cancer is more widespread, I will typically recommend systemic therapy (e.g., chemotherapy or immunotherapy).


These tests are pricey, however, and one of the biggest problems faced by pet owners is that fees for services need to be paid up front, whereas in human medicine, insurance helps to defray the majority of costs of healthcare. Often the price of a particular test or treatment option for an animal is significantly less expensive when compared to the cost of the same test for a human. The increased fee for human healthcare is often buried in insurance claims, so the only demonstrable cost comes in the form of a co-pay. Contrast this with the fact that only about 1% of owners have health insurance for their pets, so the vast majority of pet owners are faced with financing their pet’s cancer care out of their own pockets.


What this means for me as a veterinary oncologist is I need to be aware of not only the ideal plan for treating a particular type of cancer, but also to be able to provide alternative options for owners when that ideal plan is not feasible for them financially. I will always discuss with owners what the ideal plan for testing and treatment would be for their pet’s disease and explain the rationale behind my recommendations, but I need to be cognizant that this may not be realistic for every owner.


For example, sometimes pets will undergo an ultrasound test at their regular veterinarian’s office as part of a diagnostic work-up for chronic vomiting, and the scan will reveal a tumor within an intra-abdominal organ. The animal then has surgery to remove the tumor, and a diagnosis of cancer is confirmed on a biopsy. Owners are typically then referred to see me in order to discuss various treatment options for the tumor. In most cases, I recommend that a repeat post-operative ultrasound be performed fairly soon after surgery to provide a baseline before starting treatment, and that recheck exams be performed every three months or so for at least the first year following the diagnosis.


The initial recheck exam is very important because structures and organs will look differently after surgery when compared to the pre-operative scan. If a portion of the gastrointestinal tract was removed, this can be detected on the scan and that particular region of the tract will appear differently. The scan provides new information from which future comparisons can be made and eliminates the question of "Was this abnormality present after surgery?” that is asked several months down the line when the next scan is performed. If owners cannot afford the post-operative ultrasound, we will postpone this test until later in the treatment plan, with a full understanding that though not ideal, we are still providing the pet with its best chance for survival in the long run.


If cost becomes an issue, there needs to be flexibility in planning on my part, and the ability to present owners with alternatives. As long as full disclosure is met, and we are all aware that the expected outcome for substitute options may not be as good as the initially proposed plan, or in some cases, the outcome is virtually unknown because we are electing for a more "experimental" approach, I am comfortable doing so.


I feel fortunate that the majority of clients I meet are able to afford diagnostic and treatment options for their pets and that together we are able to provide their pets with a great quality of life and truly control their cancer for months to years. I understand that the services I provide are a luxury for many, and not always attainable for every owner. And for cases where the "ideal" plan is out of reach, I am happy to provide substitutes designed to achieve a similar goal. Specialists can work together with primary care veterinarians as well as make sure that pets with cancer can have every opportunity to tackle their disease and live longer, healthier lives. It’s truly an honor to do what I do and I appreciate all the owners who care so deeply for their companions and allow me to be a part of their pet’s cancer care.


Dr. Joanne Intile



Image: P.Fabian / Shutterstock


Comments  2

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  • Options
    11/21/2012 07:06am

    It must be difficult for both owner and doctor when there are options to help the critter, but they are financially out of reach.

    More than once, my vet has indicated that a critter's problem is one of two or three things. Unfortunately, none of those outcomes would be treatable. As a result, there's really no need to put the critter through the stress of testing.

    I can't even imagine how much Winston Alexander's 2 1/2 year battle with lymphocytic lymphoma cost. His Leukeran pills were pretty expensive. They put him into remission for awhile, so it was worth it.

  • Dealing w/cost vs. care
    05/20/2015 10:27pm

    Thank you, Dr. Joanne Intile, for this thoughtful and sensitive post about cancer treatment for pets. Although I noticed that it was written in Nov. 2012, it just showed up in my Twitter feed this evening, and it is as timely as ever.

    Fortunately you recognize the difficult dilemma that many pet owners are in. Knowing there is a treatment option, yet not being able to afford it, is tough. More than tough - for some, including myself, it would be excruciatingly painful.

    My concerns about the cost of veterinary care in general - not just specialty or emergency care - led to my partner and I launching a business that is dedicated to the mission of ending euthanasia and owner surrender due to cost constraints.

    We developed our business model, VetBilling.com, to give both vets and owners a more flexible payment option. VetBilling.com enables payment of a costly bill over time, in installment payments that are set up as automatic withdrawals.

    The inception of this idea resulted from my own experience needing emergency care for my dog several years ago. At that time, I was going through a difficult divorce and I was only working part-time. Facing a $4000 emergency vet bill after my 8 year old schnauzer was treated for an acute bout of pancreatitis, I had no idea what to do. At the time it was suggested I apply for Care Credit. Given my situation, I did not qualify.

    I ended up putting the entire bill on the one credit card I had. I maxed it out and spent the next 5 years paying it off, at 21% interest. I remember thinking at the time that I certainly could have afforded to make payments, but because Care Credit "said" I was a poor credit risk - or at least not good enough to qualify for their financing - the emergency hospital had no choice but to decline my offer to make payments. I understood that it was a business decision, and that other pet owners had taken advantage of such arrangements and skipped out on their bill.

    That being said, I knew I was a responsible and reliable pet owner; I knew I could and would make the payments because I loved my dog; and most important, I was deeply grateful to the ER staff for saving her life, so I certainly wanted to be able to pay them. But of course, as a business, the ER couldn't simply "take my word for it." I remember feeling stuck, frustrated, and hamstrung by the fact that a computer algorithm somewhere decided I was ineligible for credit.

    By the way, I am part of that minority of pet owners who has pet insurance. I became a policyholder back when pet insurance was first offered, and there was only one company handling pet insurance - VPI.

    Unfortunately, as you mentioned in your article, pet insurance doesn't allow for a reasonable co-pay at the time of service. Payment in full up front is still due the veterinarian, and very often, coming up with several thousand dollars is difficult, if not impossible. It certainly helps, though, to receive a reimbursement check, even if one has to wait several weeks for it.

    While I can't honestly say that my insurance has ever covered the advertised 90% of the bill - there is a benefit schedule that has maximum allowances for a number of diagnostic and treatment protocols - I will continue to be a policyholder, and I strongly advise pet owners to purchase pet insurance. Unfortunately, most monthly premiums hover around $40 for basic plans, which is not easily affordable for many people. However, I am pleased to see that some insurance companies now offer "catastrophic care" policies, which have a very low monthly premium, and would not cover routine care. These types of policies are helpful to many pet owners -- the elderly on a fixed income, the pet owner who was just laid off work, the family with four children who lives paycheck to paycheck.

    These are the same people that VetBilling.com seeks to help. In the year and a half since we launched the business, we've managed to keep quite a few people and their pets together. Our first payment plan customer enrolled in a 3 month plan when she couldn't pay the full cost of her Cocker Spaniel's emergency surgery for pyometra. She is in her 60s, is on disability, and her check comes once a month. Her dog is her primary companion and source of emotional support, so she couldn't fathom having her euthanized.

    Despite being enrolled in a 3 month plan, this woman paid off the remainder of her balance in 2 weeks. She just needed 2 payments - that is all - but she had been turned away by one emergency clinic because she didn't qualify for Care Credit and couldn't afford to pay more than 50% of the estimated cost at the time of treatment. Fortunately, she was referred to one of our client practices - in fact one of the early adopters of our payment plan service - and her dog was saved.

    I have a picture of her and her dog in my office, to remind myself on the tough days (when I know we can't save every pet nor help every owner) that our services ARE needed, and that we ARE making a difference.

    In the realm of cancer care, I honestly don't know if an installment payment plan model would be feasible. On one hand, since the course of treatment can be lengthy, it seems reasonable to me that pet owners could make payments concurrently with treatment (similar to what orthodontists often do.) On the other hand, some specialty veterinarians may feel that the potential for financial loss is even greater for them because care is expensive. That is a valid point as well.

    Navigating the cost vs. care issue requires sensitivity and understanding of the financial limitations that many pet owners have, but who yet love their pet as much as wealthier owners do. It is a delicate balancing act for veterinarians, who must walk a very fine line in developing a treatment plan that offers the best prognosis and is at the same time affordable for the pet owner.

    I truly hope that VetBilling.com can play a role in overcoming the cost barrier to care, in a way that supports both pet owners and veterinarians.

    Once again, thank you for such a sensitively written article. It is absolutely the best response to the issue of cost vs. care that I have ever read.


    Suzanne Cannon

Meet The Vets