It's never as easy as yes or no

The vet called as I was pulling into the parking lot after lunch. I was going to be, not just on time, but early back to class, but instead I sat in the car and talked to the vet for twenty minutes, and they started class without me.

The doctor said that Sam did, indeed, have blood in his urine, but no protein and not many white cells in his urinalysis--which means it's probably a bladder infection, not a kidney infection. But he also said that there's no way to know for sure without running some more tests, including:

(cue cash register sound effects)

1) More bloodwork, for about $80; and/or,
2) Urine culture, for about $80.

He said that 95% of dogs, presenting with the symptoms Sam has, turn out to have bladder infections and not kidney problems. But on the other hand, most of those dogs are not on immunosuppressants, which can result in more serious infections.

The treatments for kidney vs. bladder problems are similar: bladder infection means ten days of antibiotics. Kidney infection means four to six weeks of antibiotics. I asked if, supposing Sam was not better at the end of the ten days, we could run additional tests and put him back on antibiotics for his kidney. The doctor said that he could prescribe an antibiotic that would work for either bladder or kidney infections.

That's what we decided to do, although of course now there's a risk that his kidney could be damaged in the intervening time between courses of antibiotics, but it'll only be a few days at most.

The vet also suggested that I could collect a urine sample from Sam (there's a lovely picture for you) three or four days after he finishes the antibiotics, and take it in so they can test again for bacteria--the lack of which would show that it had been a bladder infection, as suspected.

I feel mostly okay about deciding to treat for a bladder infection and not do more tests yet. I asked the vet if he thought I was being negligent by not testing for kidney problems right away, and he said "no!".

When I arrived to pick Sam up at the clinic this afternoon, I was faced with the second choice of the day:

(cue cash register sounds again)

1) Antibiotics that will probably work fine, although resistant strains of E.coli might not be killed (and we don't even know if he has E.coli), at $22 for a ten-day course; or,
2) Antibiotics that are more likely to kill E.coli, at $112 for a ten-day course.

After much discussion, I chose the first option, and paid for his exam and antibiotics (kah-ching). The technician told me that Sam should be much better in two or three days, and if he's not I should bring him back in for the other antibiotics--or for the kidney tests. If the first treatment doesn't work, I'm only out $22, and Sam won't be in any danger. So that's what we did.

Sam is currently sound asleep on the floor with his legs stretched out. He's had a big day, although he didn't seem too traumatized when they brought him out to go home. I was afraid he'd think I had abandoned him; but he was much more interested in whatever was in a cage that a lady brought in, than in the fact that his person had arrived to take him home. I also heard the two technicians giving him treats in the back room first, saying how sweet he was and fussing over him.

No one at the clinic tried to make me feel guilty at all for choosing the options I did today, but of course I still feel it. My emotional reaction is to spend whatever it takes to make sure that my dog is okay; but I know that rationally, I can't afford every treatment option, and maybe I shouldn't spend thousands of dollars on my dog, however much I love him. He's not my child; I am not his mother. My responsibility is to see that he is properly fed and housed, that he has somewhere to relieve himself, and to make sure he is not suffering. I also throw in a few belly rubs for free. In return, he provides companionship and affection and general enrichment of my life. But he's not a person, however much he has a personality.

It's a tricky issue. I read a recent article in the New Yorker about people spending money on their pets, and thinking of them as family--because many people see their animals much more than they see their actual relatives, and feel more bonded to their feline or canine companions than to any other human. One example in the story was, of course, Leona Helmsley leaving all her money to her dog, Trouble. Whatever you think of that, and not doubting that she loved her dog very much, I have to wonder if all those millions could be put to better use somewhere else--say, supporting a local animal shelter, or even a local homeless shelter.

So even though I love my dog--and I really do--I also have to remember that he's still a dog. He's happy to sleep on the couch and pee in the yard and go for a walk. I think he has a pretty good life here. I hope he agrees.