One cat owner's bill tops $25,000
By Mary Battiata
The Washington Post
WASHINGTON — In Maura Hall's suburban kitchen a cat — a stray turned queen of the household — perched on the table. At the counter, Hall drew drops of the immunosuppressant drug cyclosporine out of a tiny bottle with a hypodermic needle and injected it into a capsule. She added an antibiotic for a fungal infection, the steroid prednisolone, and insulin for diabetes.
Lily, a longhaired, gray Maine coon-type, received her new kidney last year, and the medicine is part of her post-transplant regimen. She takes it every 12 hours and will need it on that precise schedule for the rest of her life.
Lily is a good patient. She swallowed her medicines, licked her paw and, with a look of fastidious forbearance, jumped off the table.
"I'll be doing this for the rest of my life, or hers," Hall said cheerfully. The divorced mother of a teenage daughter, Hall has spent more than $25,000 for kidney-transplant surgery and follow-up care at the University of Pennsylvania's veterinary hospital. The transplant itself cost about $8,000. Complications, weekly blood tests at $200 each, and medicines have driven the cost up from there.
But Hall says she has no regrets.
"It's not for everybody," she said. "But to see this cat now — she's fat, she's happy, she's jumping on top of the couches. To me, it doesn't matter whether it's a human life or an animal life."
Still, "you ask yourself: Is this the right thing? Am I interfering with the natural progression of things?"
The decision can be a lightning rod. Hall received hate mail after news of Lily's transplant appeared in local newspapers. For some Americans, the idea of spending tens of thousands of dollars on a cat when so many humans don't get even basic care is, if not incendiary, at least highly objectionable.
Hall also encounters resentment and guilt from pet owners who had to forgo transplant treatment for financial reasons. "I can understand it," she said.
The question of access is "the driving ethical question in veterinary medicine today," said Arthur Caplan, chairman of Penn's department of medical ethics.
"I can assure you that if your cat or dog is hit by a car in a poor neighborhood, you're going to have the choice of euthanasia or hoping that the animal will come around," he said. "In a rich neighborhood, you're going to get a whole recipe of things you might consider doing: orthopedics, the possibility of dialysis, lots of things that would be similar to what happens with human trauma.
"I think that sometimes the economic forces, on the part of the vet, and family guilt, line up to promote treatments with only a remote possibility of success."
Katherine Karamolengos agrees. Her cat, Leo, lived 3 ½ years after surgery in Penn's feline kidney-transplant program, but much of that time was spent battling complications including diabetes, anemia, and liver cancer. The transplant's original estimated cost, $4,000, ballooned to seven times that.
"Faced with similar circumstances, I wouldn't do it again. Absolutely not," Karamolengos said. "I think the public should be educated and know what they're getting into when they consider high-tech and experimental procedures," she said. "Because everything is very expensive, and you don't get a break."
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