Last year, my husband got a nice bonus from work. The same week our cat, Leo, ate a penny (yes, ate a penny, in front of our two kids). Turns out that is a very awful thing for a cat to do. He ended up with pancreatitis, mouth infections, ulcers, was in an emergency vet hospital for a week on IV's, all sorts of treatments. And, he pulled through. My kids love that cat--but the treatment? Took the bonus--ALL of it--over $5,000. I joked that the cat ate my new carpeting, which is what I had intended to spend the $5,000.

Yes, we love him and I am glad to have him, but I still think we were crazy to spend that much money on a cat.

One morning I noticed my normally very hungry, very active cat had become immobilized and wouldn't eat so I brought him to the local vet. An xray ($300) revealed a huge sack of fluid crushing his lungs and was diagnosed as probable congestive heart failure. The vet quickly ushered me out the door to a passing taxi so I could bring him to the animal medical center on New York's Upper East Side ($25 with tip). There they rushed him into emergency care at a speed that would be the envy of human hospitals anywhere. About 40 minutes later the very nice Dr. Thompson came out to explain that he actually had an invasive thoracic infection and they had already drained about a litre of puss out of his chest to relieve the pressure on his lungs.

The recommendation was that he go into intensive care ($300/day) where he would stay in an oxygen rich kennel with a chest drain in each lung cavity and interveneously administered antibiotics. Shell shocked by all that had happened, I made the snap decision to go for it. After all, he seemed perfectly healthy the day before so I guess I wasn't ready to write the little bastard off yet.

I took him home 8 days later ($7000 when all blood tests and medications were added in) with instructions to keep him on oral antibiotics for the next 8 weeks ($120).

Well, that was two years ago and he has been perfectly healthy ever since, but I really questioned my sanity for spending all that money on a cat. Then one day my neighbor showed me his $7000 Cartier watch and I stopped feeling guilty.

I have. Animals die. Animals disappear. When I was a child we had eight cats, all living in the barn. I loved them all, but my father made it very clear to me that we could not afford vet visits for them. When they got sick or injured we did our best to make them better, but if we couldn't, we put them out of their misery. It was an awful awful decision to make, but we did it because we had to.

Interestingly, as an adult I had to make the same decision about my father. That really put the whole cat thing into perspective. Animals are not people, and the same rules to not apply.

Unless I skimmed past it, no one has suggested talking to your vet before emergencies arise. (One reader did advise getting a second opinion.) If you already have a vet you trust, ask at the next annual exam, or sooner, his or her philosophy on expensive care. If you're new to an area or to pet ownership -- or you've never much felt comfortable with the doc you use -- investigate prospective vets like you choose a new physician, starting with word-of-mouth of other pet owners, then interviewing the doc.

This just could be asking about cost of the more sophisticated procedures, but it should be more than that: Does your vet share your views about where "too-much" begins, what to do when the care may just be prolonging the animal's suffering etc. A competent vet should be for eager this conversation before it's dire. If the client and clinic agree generally, the client will bring the next pet to the same place for repeat business.

I used to have horses. Nice show horses. Horses that cost more than my car now. (A lot more, sigh.) When you have nice horses you make good friends with a good vet.

Our large animal vets were awesome. They were very practical. They realized that horses were valuable animals but also cost a lot to keep, and they always laid it on the line with absolutely no BS or sentimentality.

Oh, and I had the myriad vet problems too, let me tell you. I had the horse with lymphomas on his penis. I had the horse with a sinus infection so entrenched we had to drill a hole in his head so we could flush it with disinfectant. I went through a colic or two, and had a horse with crazy severe melanomas (almost all gray horses get them, but not this bad). I had a horse who got nerve damage so one side of her head so her face drooped. I attempted to breed that mare, and then had to deal with the ensuing uterine infection. And, of course, one horse or another would go lame from time to time. This was besides all the basic shots and tooth maintenance and regular weenie washes for the boys (yeah, you actually have to do that).

In all these situations, my large animal vets would lay out the options and their costs, the odds as best they saw them, and would objectively await a decision. No pressure. Hey, and they made barn calls.

Small animal vets always seem to treat me like an irrational, irresponsible creature who CANNOT BE TRUSTED TO HANDLE THE TRUTH. I've learned to go to the vet in my relatively poor neighborhood. They have much more of that sense of pragmatism I appreciate.

We veterinarians of the older generation did not hesitate to offer a guilt-free option of euthanasia. In fact, I myself leaned that way when presented with a pet with a chronic, expensive condition or an expensive problem with a poor long term prognosis, especially if the owner's family had needy children. This attitude been supplanted in the current generation by the model of animal physician, for whom only the most current and expensive diagnostics and treatment are even considered. Actually, many of the older therapies that cost less were quite effective.

That being said, in many cases we veterinarians are able to save animals we would have lost in the past. Our incomes remain far below comparable professions, some of which require less training and involve less heartache. Many of our new practitioners have staggering student debt. And I often say to those who complain about their vet bill that the same case management for a human would be many times that amount. I also remind people that they would easily spend that amount on car repair, and would be very glad that they had found a competent mechanic they could trust.

I truly feel terrible that my profession has somehow priced veterinary care out of the reach of the lower income population, but it seems the same thing has happened with human medicine.