A suicide crisis among veterinarians | Hacker News Reader

A suicide crisis among veterinarians

bbc.com

334 pointsrntn441 comments

We can talk about other negative aspects of being a vet, but the primary factor is that they know how:

> But that reality of the job can also colour the way veterinarians view human lives – including their own – and for those already experiencing suicidal ideation, it can provide a simple justification: death is preferable to suffering. In a 2021 survey by pharmaceutical company Merck, 12.5% of the veterinarians surveyed said they were "suffering". And nearly half of the respondents were not receiving mental health care.

> "There's an idea that veterinarians work on the belief that it's right to euthanise a hopeless case," says Volk, "and we are seeing ourselves, emotionally, as hopeless cases."

> Death is a routine and repeated part of the job, and while it's never easy to end a life, Volk adds that it is easy to start seeing it as an option to alleviate their own distress. "I have medications in my clinic that are called 'Euthasol', and I euthanise all the time," she says. "Literally like five or six times a night."

> The CDC's 2019 study identified poisoning as the most common cause of death among veterinarians. The primary drug used was pentobarbital, one of the main medications used for animal euthanasia. The study’s authors determined that "training on euthanasia procedures and access to pentobarbital are some of the key factors contributing to the problem of suicide among veterinarians".

What often stops otherwise suicidal folks is that it's not an easy thing to do - suicide attempts usually do not lead to deaths (https://www.mayoclinic.org/medical-professionals/psychiatry-... - 5.4% according to one study, and the denominator here is # of people. not # of attempts). Vets on the other hand are trained to put down animals painlessly and effectively - it's not a surprise that those that have the means to complete suicide and have plenty of experience applying this to other animals then die disproportionately from suicide.

This reminds me of bridge fences being successful at bringing down overall suicide: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2610560/

Yup, suicidal attempts are often impulsive, so any barrier (in this case literally) even if it's relatively easy to get around, reduces suicide rates. Here's another study, this time on firearms:

https://med.stanford.edu/news/all-news/2020/06/handgun-owner...

> The researchers found that people who owned handguns had rates of suicide that were nearly four times higher than people living in the same neighborhood who did not own handguns. The elevated risk was driven by higher rates of suicide by firearm. Handgun owners did not have higher rates of suicide by other methods or higher rates of death generally.

Suicide attempts by firearm are far more likely to complete than most other means, ergo, suicide death rates are higher among those that have firearms.

I think about this a lot with my brother. He took his life in the alleyway behind the gun shop where he just bought the ammo -- I have no idea what his mental state was (estranged from family for many years) but I have to think there was some impulsive decision-making involved.

I'm sorry to hear about your brother :( depression can be very much like torture. Some people can last for a long time before they will do/say anything to make it stop, but without help eventually it will wear you down until you don't value your life anymore and the promise of a "quick, painless end" via gunshot is hard to resist when you are too deep. Add in any kind of extra stress like drug addiction or trauma and it very quickly becomes too much.

I remember reading about how "sticking your head in an oven" was a legitimate suicide method when using coal gas ovens. When people switched to natural gas/electric, the suicide rate dropped drastically:

>The switch from coal gas to natural gas also had one unexpected effect. During the ‘50s and ‘60s, about half of the suicides in Britain were by coal gas. By the ‘70s, when the transition to natural gas was complete, the number of gas suicides had dropped to zero and the overall suicide rate was down a third. Even the suicidal appreciate convenience. If it's too much trouble, as Dorothy Parker said, "You might as well live."[1]

1. https://gizmodo.com/why-have-people-stopped-committing-suici...

For those unfamiliar with Dorothy Parker[0] and/or that punchline, here's the poem, Resumé, that it's from[1]:

Resumé

By Dorothy Parker

Razors pain you;

Rivers are damp;

Acids stain you;

And drugs cause cramp.

Guns aren’t lawful;

Nooses give;

Gas smells awful;

You might as well live.

[0] https://en.wikipedia.org/wiki/Dorothy_Parker

[1] https://www.poetryfoundation.org/poems/44835/resume-56d22415...

Dark comedic thought: if a prerequisite to suicide is to get your affairs in order and leave behind a clean house, suicide would be very low; ugh, too lazy to clean. I'll just live instead.

Dark, comedic, and so true!

Imagine some kafkaesque effort of bureaucracy

Tangent: There’s a lot of societal pressure in A house being clean. Remember the line in Goonies from the mom, “boys, I really want the house clean when they tear it down”?

I always wanted to die clean and pretty

But I'd be too busy on working days

So I am relieved that the turbulence wasn't forecasted

I couldn't have changed anyways

I am relieved that I'd left my room tidy

Goodbye

If you see a friend getting their affairs in order and unexpectedly cleaning house then you should worry.

"Guns aren't lawful", after reading that line I thought she might be British, but it looks like she's American. Were gun laws stricter back then or something?

Yeah the Sullivan Act. Supreme Court struck it down last year.

That could also be explained that everyone who wanted to kill themselves (WW2 veterans) had already done so. Suicides being 1/3 lower in the 70s than the 50's and 60's seems expected.

Coal gas purportedly has much higher levels of carbon monoxide than natural gas, which would be sufficient.

I'm just talking about the connection to the overall suicide rate. Obviously if natural gas doesn't kill you, or as quickly, that method of suicide will go down. But the overall rate can be explained by many other phenomenon.

Yes but there is a much larger effect on gas oven suicides than overall.

Suicide prone population dying out would not cause one type of suicide to reduce in a much quicker rate - as is implied here.

E.g., Sylvia Plath.

Just living without dying is not a good life. If anyone wants to stop suicide they should prevent the root cause that leads to it, not just stop giving a less painful way to do so. It's inhuman and many forced to die horribly because of this. It's always the privileged who decides to make suicide harder.

They think life is always going to be good at after waiting. For many it's not true. Privileged people think just because they themselves have it easier, people who are willing to die just mentally ill and don't know how to enjoy life.

If we are brought to life easily without thinking and no consent, then there should be a way to leave if anyone wants to. Life should not be a one way hell trap, suffering for long time just so that well off people can feel better and not hear about suicide.

Nobody actually does anything to prevent root cause, but it's completely ok for them if people suffer long time without dying. Media will also never show humans whose life is still miserable after not dying. It must be a feel good story.

https://youtu.be/tetwGGL997s?t=149

Thank you! I am not, nor have I ever been suicidal. But the societal view towards it has always felt like tyrannical bullshit.

You’re telling me that if there is nothing left for me in life and I just don’t want to go on anymore that I can’t because society deems it has wrong and selfish (and yet society applauds other selfish acts…)

To be stuck as a slave to your environment and be deprived of your one ultimate freedom is inhumane.

It goes without saying that we should absolutely strive to help those that are suicidal. And a big part of that I imagine is actually providing people a space where they can find a purpose in life rather than being trapped in the endless cycle of trying to escape their debt with low paying and soul destroying jobs.

This makes me wonder more about the idea of legalizing assisted (pain-free) suicide, with the caveat that the process needs a lengthy evaluation time (background check for no coercion, mental evaluation etc).

I wonder if it would have the opposite effect, reducing suicide rate by picking up the people so hopeless they would've just jumped a bridge/bought a gun if the option of peaceful suicide didn't exist.

It sounds like any length process would remove the impulsive component and should suffice.

I think Canada has a popular assisted suicide program. I'm not sure if anyone has done the research to see how it affects suicide rates or methods outside of the program.

They tried this in Europe and it resulted in an interesting scenario where the doctor was killing someone who changed their mind and was telling them to stop.

Vermont passed a law like this in 2013, designed to help those with incurable diseases choose when to pass. Vermont Public Radio recently did a good podcast on it.

https://www.vermontpublic.org/podcast/brave-little-state/202...

That actually gives me some appreciation for some seemingly pointless vertical posts my city put into a bridge near me.

In the Netherlands there is a problem of suicide by train near mental health institutions.

So they placed fences. That left the nearby crossings where there had to be gaps in the fencing. There they placed "anti walk mats", rubber(?) mats with a pointy surface that's hard (but not impossible) to walk on.

And those two together brought down the number of suicides by a lot.

I was lucky enough to own a house next to the vet clinic that ended up being my first dogs final veterinarian. Her sickness was very gradual; a boil grew on her neck and started aspirating blood, she became anemic, and somewhat lethargic. I supplemented her diet as the vet walked me through everything I could possibly do and was willing to afford. She gave me her number to text when weird things happened with the caveat that "the time" was when she wouldn't eat for three days. That day came after her 10th birthday, around Christmas time. I laid there in a room they had prepared and cried a lot with her. When the vet came in she cried as they delivered Euthasol. It was over in seconds and everyone in the room just cried for a while, people slowly left and they told me I could have as much time as I needed.

I cannot imagine doing that six times a day. You're not only having to watch a creature die, a creature whose personality you've observed, one that you've fostered good health in, but you often have to walk the human through delivering something out of this world. Being there with someone or something as they exit this plane is one of the most arduous journeys you can take, imo. I can understand the toll this must take after some time, when you relate to and see yourself in your patients - whether animal or human.

I think one of the worst things about society right now is we don’t share the burden amongst ourselves. The dirty work so to speak is delegated to specialists and our hands stay completely clean. I’m not saying pet owners should euthanize their animals but staying there in the room while the vet did their work probably helped, and the article mentions that owners leaving is part of the problem.

I think there are still a number if people who would euthanize their own animals. But to your point, it seems a large part of society has completely detected from the realities of life. How many know what it takes to grow/process food, or butcher an animal for meat, etc? No, that just comes in a package at the store...

> I think there are still a number if people who would euthanize their own animals.

I would lean towards agreeing with you. Anecdotes aren't data etc etc but my uncle couldn't bring himself to take his dog into a sterile and impersonal vet's office when it was his dog's time, nor could he bring himself to doing the deed himself, so he and my dad worked together to do it. For a stoic old logger, army mechanic, and construction worker, it broke him for a while.

One of my favorite cats has a bad tumor and a 3 month expected life span. I found out a few days ago.

I’m shattered and the thought of having to be in the room or not is just super depressing.

I’ve never lost a pet before or even someone very close to me.

I’m scared for how bad it’s going to hurt

Part of me (most of me) wants to be there to feel the pain in the deepest way and not bitch out. To be there for the last breath

Oh man I feel so bad

Never let your friend die alone.

We all die alone.

Except those of us lucky enough to die in the arms of the one we treasure most in this world.

Keep telling yourself that. It's a solo experience.

[flagged]

You can ask your vet for a home visit. Let them pass in a place that they know is safe and loving.

I did that. I am told it usually goes well.

Mine did not go well. I was a wreck for about two weeks after.

I was wondering about that. I'd hate to make their last hours full of freakout.

I'd most prefer doing the euthanization myself. It feels like something that should be my responsibility.

I fed my pupper the biggest spoonful of peanut butter he’d ever seen, he fell asleep peacefully. When the vet switched to the euthanizing agent, he didn’t move a muscle.

My little parrot died in my hands, and while it was sad, I was (and still am) glad that she didn’t die alone. She’d been ill, and I was about to take her back to the vet to have that final shot, so it was not shocking.

Be there for your friend. It won’t make the hurt go away, and it may even be a bit scary, but it will help your healing process.

I brought a sick cockatiel to the vet. They couldn't take care of him right away so I left. A few hours later I got a call that the bird was in cardiac arrest, and wanted to know if they should intervene. I quickly decided no, he should pass in peace. The household was in a panic for a few moments, then we were distraught. That was the worst phone call I've been on in my life. Its effects have not been fully processed over a year later. That is not how you're supposed to find out your pet passed. I know now not to take a visibly sick bird to the vet as it's already too late. I can only hope that I remember this lesson in the horrible case it happens again.

I’m sorry that you and your family had to experience the loss of your cockatiel that way, and wish the vet had told you to take your little friend home instead.

Regular vets who aren’t avian specialists really can’t do much for pet birds aside from mending injuries; an avian specialist can help you diagnose diet issues before the bird is critically ill, so it might still be worth taking in a bird that seems a bit under the weather to see if it is a diet issue - an awful lot of pet bird problems are diet issues. I took mine to one to have a microchip implanted before exporting her to Germany; not a huge deal with big parrots (they can be injected into the wing), but for small conures, it involves general anesthesia, so I went out of my way to find someone who had a lot of avian experience.

But yes, once a pet bird appears seriously ill, it’s likely too late to do anything other than keep it warm and in a place it feels safe, and let nature take its course.

As far as I know, pretty much all animals, especially prey animals, hide illnesses and injuries, and that is definitely the case for parrots.

Be there.

I have had a cat die unexpectedly (heart failure) and she was in the car on the way to the vet when she died. She held on in the back seat until I was able to pull over and be with her. She was looking for me. You owe it to be there.

Ok I will definitely do it then.

How long did it take to not feel just truly awful? Like I said... Ive never experienced that much grief/pain from loss before. I am scared how bad it will be, or what to expect.

There was a scene in the movie "Don't Look Up" where Leonardo DiCaprio's character talks about losing the family dog. He says, "I've never cried so much before." That was pretty much my experience after losing my first dog. I felt pretty terrible for a day or two, but the grief went down over a week or so. My wife also pushed pretty hard for getting a new puppy, which helped with the "empty house" feeling.

When I lost my cat of 13 years, the first few weeks were terrible. Even just the feeling of emptiness in the house. And everything reminded me of her. For 6 months I could not talk about her without crying. But it's OK to feel this. I would rather feel it than not. It's a reflection of the wonderful companionship we had.

In my experience, the actual death brings a feeling of relief. This has been my experience for both dying pets and family members. It’s hard but it’s a part of life. It’s gonna be alright.

It was my first time losing anyone/anything close to me as well.

I was acutely distressed for a good month and basically non functional for a week or so, which is embarrassing to admit, but this cat was with me through some really dark times when no people were there for me. I was holding her body and just wailing when we got home - I was a 30 something year old woman and I needed my mom to come over to manage what to actually do. There is no shame in the pain - it means you love your kitty.

That makes me feel a lot better... thank you

I would recommend making arrangements for the body beforehand/having someone else around to take care of the immediate 'aftermath', as morbid as that is to think about. You aren't going to be in any shape to handle any logistics and seeing her body without 'her' in it WRECKED me.

Hmm so the vet doesnt deal with that? what do i actually do to make preparations, as theres no pet cemetaries that Im aware of?

Vets usually have information about cremation services. Some vets offer them on site, but some don't - check with your vet. There are also memorial options (urns, paw prints, etc.) that you might want to look through now as kitty is alive, because trying to decide how you want to remember them right after they go is just asking for ugly sobbing. Also figure out your budget because the last thing you want to do is pick something in the throes of grief and be unable to afford it. "I can't even afford to remember them properly" - > More crying.

You will feel awful, it's normal. It sucks a lot. And it's part of loving someone or something that much. I've done it 3 times now.

First time, it was probably a week or two before I stopped getting choked up or crying when I'd come around a corner expecting to see the dog, or hear the jingle of tags and it was just empty space. It was probably a month or so before it started feeling "normal" again, and we had a second dog at the time. She had lived 17 years, and when it was time she was barely able to stand or lay down properly. I still had doubts about whether I was doing the right thing, and even now almost 15 years later, I still feel guilty about the times leading up to then when I lost patience with her and her getting old. That experience was also the one that felt the strangest. Our vet had us do all the paperwork and payments up front so we weren't dealing with it after. It's a very strange feeling knowing you're paying someone money to kill your pet. I held her, told her how good of a girl she was and pet her the entire time. It hurt. We stayed for probably 20 minutes, but at a certain point you know they're just not there anymore and in a weird way you start feeling silly talking to and crying to a thing that isn't your pet anymore.

The second was the worst by far. She'd been steadily getting more aggressive for no reason we could understand for a few years. Our life circumstances at the time didn't really let us devote the time or money it would have taken to correct the problem. Looking back now, we should have given her up to someone or someplace that could do better than we could. One day, she just hauled off and maimed our other dog. In the middle of dealing with getting that dog surgery to preserve what limbs we could, I spent a terrible 2 weeks calling every rescue, shelter and option I could think of to try and find a home for her so we wouldn't have to put her down. In the end, we got nowhere, and we couldn't keep her and take the risk again. She was only 4 years old. It broke me for a solid month and was possibly the second worst thing I've ever had to go through in my life. She was terrified, confused and didn't deserve it and there was nothing we could do different. It's been about 6 years now, and I still sometimes have nightmares about her. About failing her and having to put her down. I can still see and hear her confused cries when it happened. It still hurts, but in this case it's less the loss and more everything that happened around it.

My last one was just this year. He'd survived being mauled by the previous dog, and went on to live to an incredible 17 years, despite losing a leg to that attack at the ripe old age of 11. We'd known it was coming for a while. About 3 years before hand the vet started getting concerned about his kidneys. He wouldn't eat the special diet so the vet figured it was better to just feed him what he would eat and let things run their course. No point in starving him early just to save some kidney function after all. On the day of, I left for work and he was happy and healthy and energetic. I came home and he would not leave me alone until I acknowledged his presence, which was unusual for him. He then went to lay down and refused to move or eat after that. We took him in to the vet and despite having just been to the bathroom 3 times in the last hour or so, he peed about a gallon all over the floor. The vet confirmed what we already suspected, that his kidneys were finally giving up. We weren't ready, but you never really are. Again just sat with him, petting, telling him how good he was. How much we would miss him. Thanking him for his loyalty. It took easily a month again before it started to feel at all normal to not have him around. It's been 6 months. I still miss him a lot. Like all of them, it's a dull ache now mostly. And even though I knew that I made the right decision, there are still days I doubt myself. Where the voice in the back of my head tries to convince me that he wasn't that bad and we should have paid for more testing and some meds and we killed him for nothing because he was fine that morning. But it was the right thing.

It doesn't get easier, but of all the doubts, regrets and nightmares I've had none of them have ever been about being there. All 3 of those dogs were absolutely devoted to us and there through so much hardship. The least I could do at the end was make sure I was there for them, and despite how hard it was I don't regret it for a moment. Being there helped me to. It's hard enough walking into a place with your pet, and walking out without them. I can't imagine how I would deal with walking in and turning them over and then just walking away.

You should think now (and maybe look at) what sort of options for the end care are available from your vet. Ours takes the body afterwards, and you have different options, the cheapest being a group cremation where you get nothing back. Then at least the company our vet uses offers individual services, ranging from just getting a paw or nose print casting back to getting ashes back. It helps to know ahead of time what your options are and what you want to do so you're not trying to decide on what will be a very hard day.

I don't think anyone can prepare you for it. I don't think you're ever going to be ready. It will be normal to hurt in ways you've never thought you could hurt. It will be normal to feel silly about hurting so much over an animal. It will feel like it will never be normal again. Then it will feel guilty when it does start to feel normal. In time, the pain comes in smaller and less frequent waves. Your memories will be dominated by the rest of the time you had with them, and not the worst day. You will inevitably be given a copy of "The Rainbow Bridge". It's schmaltzy and beautiful at the same time, and may or may not be comforting. If nothing else there's comfort in knowing it's something of a ritual to get it, and it reminds you that you are just one of a long line of people who have been brought to some of the highest of highs and the lowest of lows by a ridiculous 4 (or fewer) legged companion.

It is ok to be scared. It is ok to hurt. You won't want to do it, but at least for me I can't imagine not being there, and in the end I don't think you'll regret being there. It will suck a lot at first, and less as time goes on. Whether it's worth going through again is up to you of course, but it's probably worth thinking on the fact that every pet owner before you has done it, and most of them probably went on to own many more pets. I think there's something hopeful and positive in that. Good luck, I'm sorry for what's coming, and I hope the pain fades quickly for you so that you can remember the good times sooner.

Oh man I just googled the rainbow bridge Im not ready to read that yet it hurts too much. Thank you so much for your reply, I know this isn't a long reply but just know I read each word, and it really helped me digest this, somehow knowing other people go through the same thing helps a bit, I'm not sure why

I don't know if this is bad advice or not but maybe take some valerian root or something like it before going in if you're worried about being overwhelmed. This is 100% bro science coming from me, but there are real studies studying the effects of propranolol on patients with PTSD where they purposely trigger the offending memory while on the drug in order to rewire the sensations associated with the memory.

It doesn't have to be traumatizing and you won't be alone.

I'm so sorry about your cat. You have my condolences.

It's going to hurt. Real bad. But you will come through. Life is precious because it is hard, not because it is easy.

Be there for your cat. Let your touch, smell, and sight be what your cat remembers as they pass.

And sit with your grief. I'm getting teary-eyed just typing this as I remember doing the same for my little Abbi, a 14-year old Shih-Tsu mutt I euthanized over a year ago. And that's ok. It's ok to be sad. You will be sad. Cry, let it come out. Ironically, you will feel better than trying to "be strong" or hold it in.

Thank you :( Your words make sense and I appreciate it. I havent really cried much in the last 10 years, maybe 2 times. So it feels very weird. I just started crying in the car while driving thinking of this post, and that is really new to me.

I am very sorry about Abbi

Be there.

My family recently had to put down one of my family's beagles who had been with us for 15 years. She was blind, could barely walk, and was having trouble keeping food down, and we decided it was time for her to go to prevent her from suffering. My father, my sister, and I were in the room all together when the vet put her to sleep, and me and my sister held her until she stopped breathing altogether. It hurt, and I keep crying every time I think about it, but OTOH I am absolutely certain us being there made her feel safe and calm, and made it easier for her to pass in peace. The fact that I was able to be there and say goodbye in her final moments is a memory that, although very painful, I treasure tremendously.

Absolutely, this.

Being that human companion that's there with them to the end is terrible, and I wouldn't do without it. I've done it a few times now over the years, and see it as part of the price I pay for all they give me through our time together.

As a contrast, I was something like 13 when my mom took our dog in for euthanasia, without telling us kids that it was happening. They thought they were sparing us some pain, but I found it devastating. Getting home from school, "where's Buddy?" "Um...."

No, be there. It's always better in the end.

You should be there. It won't be easy, but you will revisit this memory many times in the future. Each time you think about it later, you won't regret being there. You will, however, regret NOT being there. And know that it gets easier.

I remember when a friend of mine had to let go of his dog.

Paraphrasing, he said something like "I've been there since almost birth, commanded and controlled every aspect of his life, but who am I to choose this."

It's a dreadful responsibility, but it is just that -- a responsibility. When the pet goes to their forever home, this is part of forever.

I have personal issues with it being "scheduled", that just tears me up. That at 12pm there will be this life, and 12:01, there won't.

But at the same time, it's on us as caretakers to not let the slow decline turn into a spike of severe suffering. Sudden, crushing pain. Struggles breathing, etc. Crisis may well dictate when the time has arrived, some escalation (like not eating). Sometimes its just "We have an opening on Tuesday".

This is not what we necessarily signed up for, but it's the job.

As the others say, be there, hold them, hold them and let them go. You are their everything. This process is part and parcel to loving them.

Fond farewell as they cross the rainbow bridge.

Sorry about your cat.

Focus on how good of a life you've given your cat. Be there for it when it passes if you can.

My childhood dog had cancer and ended up having a seizure in my arms. Later I buried him myself.

Being there for him and burying him myself gave me a lot of closure and I'm proud I was able to be his friend and give him a good life.

I just did this for my cat Cauchy about 10 days ago. It was brutally difficult. But I was so glad ("glad" seems like a gross word in this context, not sure how to phrase it) I was there with him in his final moments and that he was able to die painlessly in my arms.

My vet had a "back door" entrance for these sorts of things. I took them up on it and I needed that.

I've been there several times, and I know I'll have to do it at least 8 more times before I die. I will always have dogs because "I'm a dog person". I love them. I have two greyhounds on my couch right now. (Always two).

3 years ago I had to have lovely Lily put to sleep because she was 14, had bad arthritis, and years of meds had taken their toll. I was sad but I didn't second guess it at all. I gave her a wonderful home, and I doted on her. The last thing to do "for her" was prevent further suffering.

2 years before that, I did it with Zuni, a wonderful, sensitive, intelligent dog. He had lung cancer. He was only 11, but he was already starting to suffer, and I simply couldn't bare to put him through any more. It's easier to deal with your own pain of loss than to watch him slowly deteriorate and wheeze and suffer more every day. No regrets.

5 years before that (yes, I was unlucky) I had to put Pasha to sleep because she had bone cancer. She was 6. My first dog, as an adult with my own home. That was the first time I ever had to make that decision. I was wracked with guilt and worry that I wasn't finding some other way for her to live. I got second and third opinions, scoured the internet looking for novel treatments. I eventually had her put to sleep because she was in so much pain and the vet said "there is nothing you can do, I've seen this a thousand times". My only regret with Pasha is that, in my fear, I failed to do the one thing that was in my power, for her: prevent suffering. That's my only regret.

When you hit 50 and you're on your Nth dog, you don't so much "just go through the motions and then get another dog" when you're dog dies. That makes it seem cold. It's always painful. But these days I accept that I'm "a dog person", and that I'll always have a space in my heart and on my sofa. There are thousands of dogs that need homes right now. And as sad as I'll be when one of these two muppets gets terminal, I'll do the right thing. Then I'll wait a few weeks, and go straight to the pound. It's not cold and mechanical. It doesn't diminish the love I have for these two idiots, or for Lily, Zuni or Pasha. What I've realized is that the two worst things are:

- their pain

- you worrying about their pain

Honestly, while the moment of death is a terrible thing, it's always peaceful. It's always a release.

Be there.

I was 14 when we had to put our first animal down; my mom, someone I guess you’d describe as hyper-emotional, was a wreck. A year later we had another, thankfully just of old age, but she “couldn’t bear it again” so I was in the vet by myself because I didn’t want my cat to be alone when she passed. It sure sucked doing it alone and feeling like I had to be the grownup, but I’ve never regretted my choice.

If you need to bring a friend to help get you through it, then do. But be there, no matter what. The closure that it offers is invaluable.

I’m so sorry. I hope you both find peace.

I wonder if that's true. You're putting the animal out of its misery in many cases, but for a lot of people in the room you're a key part of one of the worst moments for them. I think of the last one I went though that was unexpected, how many people have to stand in a room and watch two grown adults lay on the floor and truly sob, to see their hearts break. I can't imagine the empathy for the love people feel for animals makes it any easier.

I often think that I would prefer to euthanize my dog myself. He is absolutely terrified of going to the vet (of strangers as well), and having to do it there makes it that much worse. I'm one of only a handful of people he trusts.

That was why we used an at home euthanasia service for our dog. He hated going to the vet and had to go multiple times a week toward the end. We didn't want to have him scared and stressed in his last moments.

Look into at home options if the time comes. We actually found that the cost was not much more than doing it at our vet's office. I think it was $500 at home vs $400 in office. $100 extra to give him the best end possible was the least I could do.

Same, he was mostly bed bound as he had been for months, the vet came to our place. My wife and I were crying like no other, was this the right time, the question was haunting us, still does. He still appeared to like to eat, but he was paralyzed, needed help to poo and pee, even to stand to eat, but he could still sit on lap and seem happy but even that was mitigated by the fact he was on a lot of gabapentin. The moment of euthanasia came and he was asleep throughout the whole thing. Broke our hearts but gave him a painless exit. I will say this though, kids under 10 need not be there. I love and miss you everyday W.

Yea there are services. I assume you can hit a vein based on your username?

Only thing I'd worry about is making sure you have extra drugs and know what to do in case your initial dose doesn't work. It can happen sometimes.

I take care of a lot of feral cats and it's really tough. They die often, due to feline HIV or feline Lukemia.

It sucks. 9 have died since January (3 were kittens). But it's just not practical to put them to sleep. The first one I did but it was 300 bucks.

Idk it does suck.

Oof yeah, this is tough. I have done some fostering of kittens and on the whole I highly recommend it; it's a great way to have kittens in the home without committing to long term adoption, and it helps out shelters that really need the help. But this part of it is tough. Feline lukemia and other terminal illnesses are not uncommon with shelter cats and it sure hurts to lose them.

It's crazy how fast they go down hill. Go from like just fine to holocaust skinny in 2 months. Brutal to watch, especially hard when the kittens die or dissappear. I had 2 tabbies that were born this year. One had a white tipped tail and the other a black tipped. I loved them both but loved black tipped the most.

She would sit in my arms and purr just staring in my eyes. So cute. Then one day it got run over. Not much you can do really.

In a very weird and minor way it gave me insight into why losing a child during pregnancy or very young is so painful. I always thought "What's the big deal? You just have another one".

I mean I wouldn't say that to people but that's just how it seemed to me. But then with the cats some had great personalities or super soft coats and I was so looking forward to petting them and playing with them when they got older. Then they died and there is a bit of a hole.

Obviously this is nothing compared to a human life, but it made more sense now. You have a child and you think about their first day of school, how you will dress them, what their interests are, what special skills they have.

It gave me a lot more insight into what it's like to be a parent and lose a child and how devastating that probably is.

That is a very interesting view point. Existence used to be cohesive, ritualized, we were all close to and part of every aspect of it. Now it's all industrialized, and it's not surprising that it's dehumanizing to people in charge.

My wife thinks that in time of peace we should require kids that turn 18 to spend a year doing some community service. Somewhere far from home.

I so wish our cultures did something like that. I think Denmark has a habit of 18yo kids going away for a year, to live freely with new found majority status.

I was also thinking international community swaps.. people from one country would have opportunities to go, not to their direct neighbours, but one frontier further. To make people know about other countries on the field. The plan would be to have kids all around develop a clearer bond with people far away and avoid dehumanised reflex hatred.

Totally agree. In college I lived in a transfer dorm for a year which was mostly filled with kids who had either transferred from another country or had taken a gap year before college to do something interesting. It was great! The group was full of interesting people and there was dramatically less of the typical dumb college freshmen behavior than usual.

> I think one of the worst things about society right now is we don’t share the burden amongst ourselves

Watched a reddit post about a romanian mother making a fuss about her and her small autistic son being kicked out of an uber because the son threw a tantrum and somewhat dirtied a chair.

I was appaled by the lack of empathy of some of the redditors.

Nobody is entitled to anything, nobody owes anything to anybody, but the sharing/safety net thing is what makes us an advanced species.

Generally speaking, I think it's totally okay to try and align interests. I know people who feel a lot of gratitude to be able to accompany people through hard times, and would never want to call that "dirty work".

" the caveat that "the time" was when she wouldn't eat for three days."

Same as my cat. We were trying to force feed her and eventually she couldn't breathe when she choked on her food.

I'm curious, since you mentioned this, and I've never really understood the alternative to euthanasia.

Your vet said to take the dog in when it wouldn't eat for more than 3 days, and you did.

What would've happened if you didn't take the dog in? If you kept leaving food out for it in case it did eat, but expecting that it probably wouldn't.

I imagine the dog would die on its own, but I have no idea of the time frame or what you could expect in that situation.

Good question. During that time we didn't know exactly what was wrong. I brought her in for the boil, we ran lots of tests, and the only thing we could determine was that she was anemic. If she ate more she was anemic less as long as the wound continued to aspirate. I cleaned it up every night, kept a patch on it, and fed her whatever would make her eat her dog food. That ended up being lots of hot dogs, burgers, and pumpkin puree but it varied by the day. Sometimes she really liked this gut flora powder. If I didn't add this stuff, she plainly just wouldn't eat. By the team she wouldn't eat food with the additives for three days is when I brought her in. At the time I didn't know it, but the cancer she had was sending her into a sort of liver failure.

When she passed away her abdomen relaxed and the vet was able to feel her liver. It was covered in tens of tumors. Without a way to clean her blood her body was expelling the blood. On the day I put her down had I not given her a blood transfusion her tiredness would have shifted towards being weak and achey, probably pretty painful, and she would've been susceptible to severe infection, stroke, or a seizure. After the blood transfusion she would've immediately needed surgery to attempt to remove the largest tumors and chemotherapy to attempt to rid her of the cancer.

The odds of surviving the surgery and chemotherapy were relatively low. I didn't listen to much the vet said as I just kind of zoned out while she explained the options that day. What I do remember is the vet noting that both of those options would result in a lot of pain that she wasn't going to understand and that the odds of survival were very low while the cost was going to be high. In my mind, humans have the privilege of letting a pet leave this world with marginal suffering - a privilege we don't even really extend to ourselves. In the end, I made the choice that I'd want for myself.

You made the right choice and you were a caring pet owner and care giver.

The worst day of my life was a few years ago when I had to put down my greyhound. I will never forget opening the door to the examination room, beside myself in grief bawling my eyes out, and stepping into the waiting room full of horrified people. And then going up to the desk to pay and trying to keep my shit together. I felt so sad and vulnerable it was just awful.

Totally. Putting Jimmy down was the worst day of my life.

Great comment. I've had an interest in suicide prevention for many years and I think you're right on the mark.

I'm in the US military which has a suicide rate much higher than the general population[1], so prevention is a high priority, and hence my interest. A common thread is clearly that military service members are people who are willing to kill, and think differently about killing and death, and often have access to guns (most often personally owned, because they're gun enthusiasts, not because the military issues guns).

[1] My understanding is that after you adjust for demographics, because most service members are young males, the rate actually isn't higher, but the reality is what it is: we lose more people from suicide every year than combat operations.

"think differently about killing and death"

I think this is a huge factor that feel under represented for the population in general. I'd imagine this is part of a factor for the higher farmer suicide rates as well.

> My understanding is that after you adjust for demographics, because most service members are young males, the rate actually isn't higher, but the reality is what it is: we lose more people from suicide every year than combat operations.

Interesting note, I didn't realize this. Apparently, demog-corrected military suicide rate was previously below civilians [1]. In a few recent years this may have reversed, per the graphs on https://chrisfrueh.com/wp-content/uploads/2023/04/Smith-et-a... .

[1] https://scholar.google.com/scholar?cluster=13069467757696393...

Yes, that study is a good find. There are so many fascinating bits of information once you start looking at this topic below the surface.

Another one that I remember learning is that the suicide rate among white troops is much higher than the rate among black troops; I have no idea why.

Also, the rate is actually higher among troops who haven't been to deployed to combat. That might be an age thing (younger people are higher risk, and less likely to have served long enough to see combat). It might also be because troops with intense personal problems get held back from combat deployments so that they can get medical care, make court appearances, etc.

On that note, the upward trend over the past 20 years is likely, partially explained by demographic shifts too. When we had a draft up until the 1970s, the military got a broad cross section of society. Then through the early 2000s, the military was able to be quite selective, only taking people with high school diplomas and few personal problems. Starting around 2005, with both Afghanistan and especially Iraq raging, and a fairly low unemployment rate in the US, the military had to start scraping the bottom of the barrel, bringing in more people with criminal histories who didn't finish high school and had other life problems.

getting into the infantry, at least in the US military, is non-trivial. entire generations have now grown up on Halo and Modern Warfare 2, and there are no shortages of wanna be trigger pullers. Meanwhile something like 1 in 11 troopers in the Army are combat arms -- you need a lot of logistics, mechanical, etc. bodies. Closer to 1 in 7 in the Marines, but still the majority aren't combat arms.

might be a different story in UKR, where they're grinding through troops and everyone is looking to be in the rear w/ the gear.

but that selection bias is definitely geared towards motivated combat troopers. meanwhile some kid from Missouri joins up thinking he's gonna get out of his shit town and learn computers or something but then spends 18 hours a day filtering water and fuel at a remote base in Germany for 4 years.

> Another one that I remember learning is that the suicide rate among white troops is much higher than the rate among black troops; I have no idea why.

depressed middle class white kid realizes he could have worked at Target while going to community college, and is now isolated doing a job he hates and can't quite for 3+ years. black kid is happy he doesn't have to go back to a worse situation.

also heard a statistic that hispanic recruits are more likely to make it though basic training and AIT / A-schools. hispanic paradox, military edition?

It seems like one of the main issues is that vets have super easy access to a quick and painless death, as well as extreme familiarity with it. Just like having access to a gun makes you more likely to suicide. In general people with more access are more likely to commit suicide when they feel that way. Not trying to undermine that they also feel extra depressed due to the job though. I've seen a few of my pets be euthanize and it was torture.

> What often stops otherwise suicidal folks is that it's not an easy thing to do

Assuming you are acting in good faith - please give this a minute of thought.

The link you provided giving the 5.4% number - did you fail to read on to see what happened afterwards? To 81.8% of them within one year, explained in the very same paragraph?

Do you see how that 81.8% figure undermines your argument?

The 81.8% is out of the 5.4%. (In fact, it is out of a subpopulation of the 5.4%--it is the rate at which, given that the person died by suicide, but survived the first attempt, died within the subsequent year).

From the study:

> During the study period, 81/1,490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year.

Ok I've had to double check to see where we've gone wrong.

5.4% is the number of people who died by suicide out of the studied sample. It is not the number of suicide attempts resulting in death, as implied by the original parent.

It is actually 59.3% success on first attempt, and of those who failed on first try, 81.8% succeed in subsequent attempts within a year.

> Ok I've had to double check to see where we've gone wrong.

It's okay to admit you're wrong without these sort of "include everyone else involved" type of statements.

I think you're still a bit confused. 81.8% refers to, out of the population which _both_ failed in their first suicide attempt, _and also_ eventually (within the study observation window, i.e. 3-25 years) dies of suicide, the proportion who die within year 1 rather than years 2-25. In fact, the study authors point out that they found follow-up attempts _less_ likely to succeed compared to the initial attempt:

> Of the cohort, 3.2% (48/1,490) died on index attempt, whereas only 2.3% (33/1,442) of index attempt survivors went on to kill themselves. This drop in the suicide rate for survivors compared with those dead on index attempt held true for both men and women (males: from 6.7% to 4.8%; women: from 1.2% to 0.9%).

Thanks, I am no longer confused.

> What often stops otherwise suicidal folks is that it's not an easy thing to do

Is the take away from this that if all people knew how to kill themselves efficiently, the suicide rates in general population would be as high as they are among vets? It's pretty grim to think that the only thing that's stopping many people from killings themselves is that they don't know how...

I think it depends on how 'easy' it is. If it was as simple as pushing a button and you knew it was instant and painless I can imagine many times in my life I would have pressed that button - and I'm sure a lot of people might do it in moments of great distress, when thoughts of the future aren't there. I think the issue isn't the "know how" as you mentioned, it's more the difficulty and uncertainty (of pain and success). Working in a place that has the tools and you know how to use them reduces so many barriers to entry so to speak.

There's a case study [1] from the UK when they phased out "coal gas" which contained carbon monoxide, and which many people were using to painlessly kill themselves via their ovens (Silvia Plathe being the most famous to do so). The conclusion was that removing this method of suicide did decrease the suicide rates over that time period.

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC478945/

Just putting paracetamol in small blister packs lowered the rate of overdose in the UK:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

I wouldn't be surprised.

I had an gf who was bipolar and suffering from PTSD and was on meds for those conditions and also due to previous suicide attempts.

I remember one conversation after we had broken up when she told me how depressed she had been and I said, "well at least you haven't offed yourself."

She smiled a bit and said, "I tried to kill myself three times in the last two months. I guess I'm not very good at it."

Answering the begged question: twenty+ years later and last time I checked she was still alive and well.

> > "There's an idea that veterinarians work on the belief that it's right to euthanise a hopeless case," says Volk, "and we are seeing ourselves, emotionally, as hopeless cases."

Fuck me that is dark.

The realization that to some pet, you're merely a fallible god, but one who can often offer little but death in an alien place, filled with the scent of sick, dying, and/or terrified other animals. Why am I here? Did I do something wrong? And your face is the last one they see. Run through that a thousand times per year and, unless you have monastic levels of detachment, you might end up feeling as if you were little more than the keen whistling edge of a scythe which never quite dried.

I'm not sure what a poet is doing on a tech forum, but glad to have you here. I'm gonna go be sad and reflect on life now.

This was beautifully written. Thank you.

Now this is beautifully sad

> keen whistling edge of a scythe which never quite dried

Forgive me if I steal this quote.

> Fuck me that is dark.

I mean we all die eventually. It’s just a matter of when and how much joy and suffering will we encounter on the way. If you look at it as an optimization problem, dying early can be the better scenario.

Frankly there are fates worse than death. To suffer for years before dying is just messed up. I hope that when I go it will be relatively quick. I can only hope it will be relatively painless but I think I will only be able to get that in a hospital setting.

You can be saved from fates worst than death. You're not forced to be saved from fates worse than death.

But you can be.

Faith is a failing concept in the West when people 'give up' to a predicted outcome.

Xylacin syringe into the brainstem.. Nothing comes back from that.

I think you are using the wrong statistics to make your point. The key point here is the there is a suicide difference between males and females. And vets are overwhelmingly male (90%).

Women attempt suicide a lot more and those statistics you used are skewing your conclusion. Men (vets or not) use guns and are more successful.

You're wildly off the mark here. From the study quoted:

> In 2017, over 60% of 110,531 US veterinarians were female, and in 2016, approximately 80% of students enrolled at US veterinary medical colleges were female.

> The PMRs for suicide for all veterinarian decedents (2.1 and 3.5 for males and females, respectively), those in clinical positions (2.2 and 3.4 for males and females, respectively), and those in nonclinical positions (1.8 and 5.0 for males and females, respectively) were significantly higher than for the general US population.

So no, this has nothing to do with vets being disproportionately male (which isn't the case to begin with).

lol, have an upvote!

I think this is a dangerous way to approach the problem. Regardless of whether or not the assertion that the "primary factor is they know how", the underlying cause is distress and hopelessness.

I'm frustrated a bit by how discussions of suicide — with vets as well as others — tends to focus on making the means less available, as if it just solves the problem. That's a solution for society, to wash their hands of addressing the underling problems, and not a solution for the person suffering.

Veterinarians should be in a position where they don't want to commit suicide, regardless of whether they have the means.

It doesn't need to be either/or. Both aspects are important. If I or someone in my household were experiencing suicidal ideation, I'd remove firearms, for example, from the house while also trying to addressing the underlying causes.

Sure, but at this point you're no longer talking about why vets are dying from suicide at a higher rate. We don't know if vets tend to deal with more "distress and hopelessness" than the general population.

> And nearly half of the respondents were not receiving mental health care.

Mental health care is rarely affordable or accessible even in countries with socialized health care systems. I guess that explains the rise of tele mental health sessions via apps, but who would trust them? Privacy is already a big issue, and it’s even more important when it comes to mental health care

are vets not well-paid? (vet services' cost has risen a lot more than human healthcare's, so there's clearly a strong demand, thus a big consumer group willing to pay them)

are they consuming mental health services more/less compared to general population or compared to their zip code?

It ranges, but it tracks with developer pay.

I work in a veterinary school, and it's remarkable to see how worn down veterinarians are compared to my colleagues in "people medicine" (and my comparison group are infectious disease folks - they're not exactly a cheerful group).

To be honest, at this point, between how hard it is to get into vet school, the debt load, and how you're signing up for crushing compassion fatigue your whole life, and a career of hoping someone will pay for a procedure to save their pet's life while being braced for "I guess we should put them down..." every day, I wouldn't tell someone I cared for to become a vet.

> hoping someone will pay for a procedure to save their pet's life while being braced for "I guess we should put them down..."

I'm sorry, but vet costs are completely out of whack with reality these days. The truth of the matter is that most people cannot justify spending thousands of dollars on a pet, no matter how much they are loved, and that DOES NOT make them bad or unfit owners. The story quoted $10k to remove a skewer a puppy swallowed, and then pressured the owner give the pup up when they couldn't afford that. Can you not see how that would be viewed as insanely predatory? For profit companies should not be involved in human or animal medicine. Once that cash cow is gone maybe vet school prices will come down to earth.

Absolutely. Any time we have a routine visit, e.g. shots and a checkup, it costs us about $300. I can't remember a single vet visit we had that was less than $100, and we haven't had an emergency visit in years. I have no idea how most people afford it, I assume they just don't take their pets to the vet.

Vet costs vary wildly across different regions.

I just took my cat in for an emergency (little idiot ate plastic and we had to see if she had a block in her when she was continuing to vomit blood) and got her examined, a shot of anti-nausea medication, imaging of her gi tract, and some bland food to take home (which had to be special as she's allergic to chicken protein) for $215. I thought that was pretty damn reasonable honestly.

Private equity is taking over vet clinics. In areas where they have the market locked, they raise prices

I just did the same with a dog maybe a week ago. It was a little over $600. I'm in the exurbs of Chicago.

I'm in mid-MI, so I'm not even that far away. Crazy how prices vary.

So one of the things that comes up a lot is that it's not actually that correlated with cost.

Most vets I know (I also work for a state school, not a for profit company) are very sympathetic toward very large and expensive bills, and have always been up front about cost in a way that human medicine is not. There's also a myriad of ways they try to reduce bills when they can.

The toll is from folks who aren't spending much smaller amounts of money on life saving procedures.

The absolute amount of money is irrelevant, it matters what percentage of a person's disposable income it is.

$10k is nothing if you making half a million dollars a year and have $200k in credit with no balance, because your disposable income is probably $400-450k/yr.

$200 is a ruinous amount of money if you make minimum wage and take the bus to work because your disposable income is very likely negative.

Yeah, well if someone can't swing $200 they probably shouldn't own a pet.

one's financial situation may change very rapidly, and humans have an innate need for companionship and comfort.

> Yeah, well if someone can't swing $200 they probably shouldn't own a pet.

I'm not sure poor people not adopting pets would meaningfully change the rate at which pets are born. It just results in fewer pets being adopted.

Particularly true if shelters fix pets before putting them up for adoption.

Most animals that have been bred as pets over 1000s of years are no longer permitted to live without a human caretaker.

If they can't swing $200 for a life-saving procedure for a pet, I'd still advise them to adopt a pet to provide it a home for the window of time when the animal could happily live without any vet services.

A no-cost (or low-cost) adoption is often a life-saving procedure for an owner-less pet.

What gives you the impression these are adoptions?

Just an availability heuristic.

I grew up poor, by US standards at least, and everyone around me either adopted their pets from shelters or found them as strays on the street. All my pets have been either strays or from a shelter.

The only exception I can think of from my childhood were fish, I think those almost always came from a pet store, but fish tanks were very uncommon.

Even my Axolotl was a rescue, it was given to me in a Tupperware container full of pond water after its previous owner was unable to take care of it.

If you have anything that would suggest it’s common for people who can’t afford $200 in vet services to buy their pets from breeders, I’m open to learning.

That's an extremely easy thing to say from a place of privilege, and of course there is some truth to it. On the other hand, how many chronically broke and miserable people out there are only hanging on for love of a pet (perhaps the only consistent source of love and meaning in their adult or entire lives)? I'll bet its a lot. But fuck them, they're poor so I guess they should either tough it out alone or die.

Sorry to be so harsh about it, but your comment lacks basic empathy so I figured I'd give you a little dose of same.

Back when I was broke I owned a cat. There were literally times in my life that the only reason that I didn't paint the ceiling with my brains was because I was worried what would happen to that cat.

I'd love to have a pet too, but I don't have the conditions for that (including financial conditions), so I don't. Even though I'd love to. But having a pet is responsibility, which includes financial responsibility. So yes, you shouldn't have a right to have a pet, when you can't afford it. That it may even be controversial is bewildering to me. Animals aren't things which exist for your pleasure.

Pets are companions who you steward because you're the name on the lease and the one with the bank account. Like all living things, they're usually healthy without intervention as long as their basic needs are met. If you can fulfill that stewardship 100% of the time for 5 or 10 or 20 years, but then can't pull things together in some exceptional case at the end, that's not a failing. That's just one of those sad things that happens in life.

As long as you can afford basic care for a pet, then you can have a pet.

food, water, bedding, the ability to keep it safe, vaccines(they're pretty cheap mostly and often done by animal shelters for free--neutering too).

There are so many pets in shelters who could live good happy lives but no one is there to adopt them.

Better a pet to live with an owner who cant afford their chemo when theyre 14 years old than to be euthanized at 2 years old.

Who are you proposing should carry the cost then? Society?

Well decades before people didn't graduate with hundreds of thousands in debt. If you follow that chain and look at the colleges which have been replacing highly paid professors with adjunct professors paid little more per hour than people who make french fries its not professors sucking up those costs. It looks more like trying hard to minimize money paid to professors while charging what the market will bear wherein the price the market will bear is inherently distorted by huge piles of government money available that people are in turned obliged to borrow in order to break into their desired profession.

As with everything else we are currently screwing up we could do well to look at what smarter countries are doing.

Smarter countries are providing pet care for people who can't afford it? Which country do you mean exactly?

Smarter countries make education affordable instead of a government sponsored bonanza for the financial class leading to greater supply of vets who haven't had to front load their life with 200-400k in debt to reach the starting line of their profession. This leads to more supply per capita in theory and in fact.

Having enough supply means that when fuzzball junior has a health problem you don't have to choose between going into hock for $500-$1000 for an emergency vet, paying rent, or waiting a month for your regular vet who is also obliged to bill at a level that will pay costs, and repay their lender plus interest.

This is to say that actual cost of service is even worse than it looks due to the necessity of relying on emergency vets to plug massive hole in supply. This encourages individual practices to price discriminate by offering the same services on an emergency basis for much more which further decreases the already scarce vet hours for non-emergency situations.

All of this makes perfect sense from a market perspective but none of it was normal 20 years ago here nor in most of the world so its not fate its a scrape we have gotten ourselves into.

All that you are describing matches Sweden quite well. Still, my niece who lives there (and only barely counts as middle class, working at a burger joint in Stockholm) regularly rants about that she doesn't have the money to get care for her dog. Maybe she should just not have a dog.

Will say: In theory it sounds great what you are saying, and for many other areas of life it really is great (I've heard lots of storries from her indicating that it's basically paradise), but that doesn't take away from that people don't understand that having a pet is not a human right but a huge responsibility and a luxury that one needs to understand the consequences of having. Instead of crying for daddy/the government when things inevitably come around that were not in the rosy picture when that puppy looked at you.

> Instead of crying for daddy/the government

This is a weird way to say work together to lay the groundwork for a more functional society. Accountability and recognition that are society is ridiculously poorly constructed are complementary not contradictory. It's humorous that you use as an anecdote your "barely middle class" niece and her complaints devoid of context whereas someone working at a burger joint here might not be able to afford to live inside. Over here she would probably either work a second job or her and her pup would live in her car.

The biggest first step towards sanity would be no longer issuing government backed loans for 400k, making pricing requirements and capacity goals based on prior performance to qualify for one thin dime. They might find the will to fire some of the useless expensive staff that aren't actually teaching kids. do a lot of the basic crap inexpensively online, and kick sports to the curb.

Currently we live in a completely broken market that is literally cause by the distortion of uncle Sam's unlimited funds on the educational market with no concurrent regulation to keep it from blowing everything up. The result of a minority of rich fuckers crying to big daddy government.

> > Instead of crying for daddy/the government

> This is a weird way to say work together to lay the groundwork for a more functional society.

I see where you are coming from. You don't need to convince me that the U.S. society with its bizarre incentives is deeply broken. I'm all for strong societal support.

But you also need to realize that offloading lots of responsibility to the government (and thereby the rest of society) has real drawbacks. Sadly many people either take advantage of it (in a bad way) or are just so careless that it just leads to overall worse outcomes. That needs to be acknowledged if you want to discuss fundamental rules for a more functional society. We can't ignore those effects.

I again was never suggesting societal support for veterinary care. I was suggesting we fix our broken educational system. You mention that offloading responsibility to the government has real drawbacks. We are already experiencing those drawbacks. Again empowering people to borrow hundreds of thousands of dollars of uncle sams money distorts the educational market and massive debt beyond what is profitable is hurting our supply of vets which is directly bearing on the cost of service.

If food could only be purchased with food stamps and there was societal pressure to offer more and more money indefinitely even if for all the best reasons one would soon find that a can of corn cost $12. Any complaints about regulating grocery stores in such a broken market entirely miss the point. There was never a functional market in that instance to protect. We should either stop pouring in billions or we should put stipulations on performance and price. Doing nothing until the can of corn is $15 doesn't seem tenable.

I could see an argument for that. If society is already paying high costs in order to prevent poor mental health and loneliness, pet ownership may be a cheaper solution in some situations than letting people fall into worse conditions that require time off work, pills and therapists.

A cost-benefit analysis could try make a reasonable argument for subsidized animal welfare.

Anyone who has to say ‘from a place of priviledge’ over a comment like that is just being an asshole. Which is what you’re doing.

If you can’t afford to take basic care of a pet, don’t get one. Period.

Life is already harsh enough to not add more misery to it for someone else.

Many "pets" are just farm animals. Nobody will fork out day wage to save some cat, that is catching mice at barn.

Unclear to me why this is being downvoted.

Caring for a pet has a cost. The obvious cost is its nutrition, but its health costs must be accounted for as well in the decision to acquire a pet. No matter if you pay a lot for the pet or get it for free, now you have full responsibility for this life. It lives in your captivity, so it's your responsibility to ensure it's being cared for. This is not nature, it can't just live on its own and take care of itself as it would do in nature. It's essentially your prisoner, even if it's rare to see anybody understand that, so you need to provide to its needs. Including health needs. And that incurs a cost. Not _if_ it's needed, it's _when_ it's needed. If you can't "swing" that, then your decision to own a pet was an unbelievably irresponsible one.

The hate shouldn't go towards the vet charging that money for treatment, but towards this irresponsible pet-owner-who-shouldn't-be-one. It's irresponsible mainly towards the pet, but even towards the vet, as the original article demonstrates quite well.

Perhaps it's downvoted because its facile and ill considered. Its locked into a tiny figure because the parent poster threw it out but in actuality vet emergencies are now mostly $1000-$2500 which exceeds what 57% of households can afford and pets can live 20 years.

https://fortune.com/recommends/banking/57-percent-of-america...

Ordinary responsible people are going to find themselves deciding what care they can provide for their pet both because of financial challenges personal and societal that weren't evident when they got the pet and because its getting expensive as fuck.

To be fair the price of education is limiting our supply of vets drastically to the point where every vet is booked to hell and back and can't see your animal on an emergency basis whereas the emergency vet is $500 to walk in the door and frequently $1000-$2500 wherein "emergency" is herein defined as something your animal needs to be seen this week for not next month.

Telling people you need to be middle class in America today to have a pet seems fairly inadequate.

Most americans cant afford to miss one paycheck. Should most americans not own a pet?

You seem to think people are going to cower in fear at giving the socially unacceptable(to a specific kind of person) answer here.

Yes obviously people should not buy things they can't afford. If that means you can't have a pet or a 90k pickup truck, or the shoes you want or whatever then so be it.

Totally bizarre that you see this as some sort of gotcha to phrase it this way

>$10k is nothing if you making half a million dollars a year and have $200k in credit with no balance, because your disposable income is probably $400-450k/yr.

You must mean half a million after taxes.

People have no clue how much tax cuts out at higher income rates.

And food, mortgage or rent, utilities, …

Man, this thread is a mess

There are a lot of people on this very site making 500k+ pre-tax. You're going to be taking home 300ish after taxes in that case, and it's not entirely unreasonable to "only" have 150ish for savings/investments/disposable income after your housing and living costs are taken out of that

If someone has $12k+ to spend per month and won't spend $10k to save their pet's life, they're an asshole IMO

I agree that people complaining about the higher tax brackets are oblivious at best, but I'll add that there's no income test to post here. I feel like I do OK (especially given that I have a job that doesn't require the sale of my soul), but it's far from 500K lol.

You should go get that money, dude. Life's too short to waste it all working

Pick a FAANG you don't feel too bad about, hit the LeetCode hard for a few months, then go work there for 5 years. You can save up $750k+, which is enough to leave Silicon Valley and eke out a barebones retirement somewhere in the real world (~$30k/year at a 4% safe withdrawal rate)

> hit the LeetCode hard for a few months, then go work there for 5 years

lmao

> $10k is nothing if you making half a million dollars a year and have $200k in credit with no balance, because your disposable income is probably $400-450k/yr.

There is no way someone making $500k a year has $400k of disposable income. Taxes will most likely be $120k; and other expenses will take up a sizeable about of that income.

More likely that person will have $100k or less of truly "disposable" income. That $10k vet bill comes out of the budget for a high-end car, or out of the vacation budget, or a landscaping project gets delayed until next year.

This, BTW, is why people who "have money" either buy pet insurance, or put the pet down. Many people who "have money" only have it because they are very careful about what they spend it on.

That is where some of the frustration does indeed emerge - one vivid example involved refusing a $500 procedure from someone driving a brand new Tesla.

>and then pressured the owner give the pup up when they couldn't afford that

My wife is a vet and I hear about this often.

From the vet's perspective, if the owner gives up the puppy then they don't have to put the puppy down. Putting down a puppy is heart-wrenching.

You can't give out free medical care, she regularly gives as many discounts as she's allowed to give away, even some she's not supposed to, especially for cases like that. But in the end, the choice is A: put the puppy down or B: do the procedure for free but then the owner has to give up the animal.

When presented that choice it's obvious you should try and convince the owner not to put the animal down.

Why is it like that though? Like what are the economics of performing the procedure that it's possible for it to be free if the owner gives it up? Does someone different ultimately foot the bill?

The new owner pays for it.

How does that work, though? Is there a constellation of dog-seeking people hovering around veterinary offices that only want dogs that cost $10k and have recently had major surgery? People who are willing to donate $10k to save a dog's life but consider it very important that the current owner no longer have the dog anymore for some reason?

$10k means very different things to people of different socioeconomic statuses, but the new owner took a rinsing to keep this dog alive - german shepherd puppies from almost all breeders cost less than $5k.

Likely the vet simply knew someone with deep enough pockets who loves dogs and was willing to take one for a well above market fee. It doesn't seem unethical to me that person only wants to save dogs they own.

For a well-bred GSD, probably. Waits for puppies can be years, and cost thousands anyway. Paying a bit more in vet bills instead probably seems reasonable to the right owner.

This is going to change how I view yuppies who tell me they rescued their dog. Was the dog really owned by abusive people before they bought it? Or was the dog owned by a family that loved it but couldn't afford a $10k procedure? Is there a tactful way to ask?

I wish I didn't know such arrangements are happening.

Based on my experience with vets, a large percentage of the time it ends up living with the vet.

Every single one I know has a small menagerie of broken animals.

I can't see it as anything other than emotional extortion. It's not like the animal shelter is paying for that care. It's being written off, and the reason it's being written off is they make so much from the owners that do pay they can afford to do so.

From a microeconomic perspective (which is also my own), I agree completely. I am trying to consider the macroeconomic perspective as well though, which quickly spirals into bankruptcy if they just start doing treatment for free for people who can't/won't pay for it. Unless/until we make it easier and cheaper for people to go to vet school, they have to make money.

It is NOT being written off. It is being paid for.

It wouldn’t make any sense otherwise. It would be a lose lose for an animal shelter to receive this deeply fragile animal and the vet to do this expensive surgery for free.

Who do you think is paying $10k for this pup?

The people who get the pup. That is how it works. It’s not going to a shelter.

You can do this a few times, and sometimes they do actually just do the procedure for free and the owner gets to keep the animal. But it does not scale. As soon as it becomes a rule then it becomes abused. One thing you realize quickly when running a clinic that deals with the public is any rule/policy that can be abused, WILL be abused. People try all kinds of tricks to not pay for their bills. And the clinic has to fight a constant battle with Yelp reviews as well, which greatly affect their business. If someone gets free treatment for one animal but not another they will destroy the business with Yelp reviews.

You get a wide range of clients at a vet clinic, some people are very nice and deal honestly, but there are a ton of people out there, I would say they are "less than savory" characters who recklessly adopt a lot of pets (like 5 dogs, 5 cats, and no money to pay for any bills) and will abuse these policies all day.

In the case the article mentioned, yes. The vet found someone willing to adopt the puppy and foot the bill for the heroic intervention.

Who are these people who want a puppy but instead of getting one for $60 at a shelter just wait for the chance to pay $10k to take one from its owner?

At my wife’s clinic they have shelters that pay for the procedure on condition of taking the animal.

Like there is a shelter in the city that will pay for medical bill and take the dog.

I do sort of see the logic. Part of responsible pet ownership is being able to keep your animal alive and healthy, if you don’t have the resources to do that then you maybe aren’t ready to be a pet owner. They make insurance to cover this exact thing, called pet insurance. If you can’t afford to have pet insurance and you can’t afford to pay for the medical bills then you can’t afford to have a pet. There are other people who will provide the care that the animal needs, but at that point they will become the owner.

I understand that this sounds heartless WRT the owner, I didn’t make these rules this is just how it works at my wife’s clinic and that’s the justification I have heard from the shelter and the company that owns the clinic.

> You can't give out free medical care

Is this asserting a legal or professional requirement? Or rather a "rule of business"?

It's a basic rule of economics. Veterinarians need to eat too.

It is a rule for f business. If vets operated on a 'pay if you want basis' they would all go out of business overnight - tragedy of the commons and all that.

Why does the owner have to give up animal in that case? If its to prevent people from casually claiming they are unable to pay for treatment then why is putting that animal down for want of treatment something that they do?

Not trying to hold you accountable for the practice of course, but it seems like you might know

> …do the procedure for free but then the owner has to give up the animal.

Why go through the trouble of rehoming the pet when it already has a home that loves it..?

Yeah it seems sort of like a punishment for being to poor to pay for the expensive vet care.

> The truth of the matter is that most people cannot justify spending thousands of dollars on a pet, no matter how much they are loved, and that DOES NOT make them bad or unfit owners.

I'd argue not having the means to deal with emergency situations would make someone unfit to own a pet.

I get that circumstances can change and costs increase, but I also feel too many people assume a pet doesn't cost much or isn't much of a comitment.

You're right that the costs are crazy, and not taking it into account when deciding to take or keep a pet is irresponsible.

Or we accept that sometimes pets die and that if the operation costs 10000 then fit owner can still decide for the pet to die.

That goes for fish, dogs or tarantulas.

We're back to the article situation though, the with owners being bitter and unsupportive and the vets in depression and suicidal.

We already have a crisis of homeless/stray animals out there. I can't imagine how much worse it would get if we only allowed the 1% of the population with $10,000 or more to spare in case the pet needs surgery to own pets. Also suicides will go up. Pets are an important source of companionship and oxytocin/closeness for people who live alone.

This is a good point. Perhaps the direction should be more about subsiding pet care cost and moving towards fonancial support as part of the humans' medical insurance ?

Basically pet ownership would require either 10k on the side or registration and justification to get proper insurance.

Personally, like it has in the human medical world, I think pet insurance is increasing vet costs too. Used one clinic for years and they had reasonable (if slightly high due to being a 24 hour facility) costs. On year they suddenly start advertising pet insurance, and "for some reason" every service "covered" by the insurance went up in price.

Medical insurance distorts the market by disconnecting the payer from the costs. It will do the same in veterinary medicine if it hasn't already.

I agree that people shouldn't adopt a pet unless they have stable finances which are enough to pay for pet insurance and/or unexpected vet bills.

Sometimes people's finances change though, and then (assuming it wasn't serious money mismanagement) I think it's cruel to say they should give up their pet.

Pet insurance should be front-loaded, so you have to pay a lot the first few months, but if you stop paying you get to keep the insurance at least for a while.

I had insurance for years and it did me no good, they refused to cover a single dollar of expenses even though I had the best most comprehensive policy I could find. This has been my experience with insurance in general. Even in cases where you read the fine print and have all your paperwork in order, they just deny all claims period. Collecting on insurance requires being ready to go to court.

Pet insurance is basically the opposite. Most people get it when their pet is young and the premiums for young pets are reasonable and low. Then, as the pet ages, the premiums go up and up.

And once you have any vet record of anything other than a routine wellness check, you're basically locked into your policy because if you try and switch providers, you'll run into pre-existing condition limitations, which are quite difficult to understand or predict. This is also difficult because not only will your insurance go up simply for your pet getting older, the pet insurance companies are constantly going through rate changes, as they adjust risk profiles for breeds or adjust to vet care inflation. Depending on what state you live in, these rate adjustments could be completely uncapped.

Even if you don't switch, many insurance providers won't write new policies for pets over certain age thresholds.

So every pet owner without at least $10k set aside for pet emergency care is a bad owner. That describes 99% of pet owners.

I agree people should plan for more pet-related costs than they do, but, as technology progresses, there doesn't seem to be a ceiling on the amount you _could_ spend to save a pet.

In my case, we have always taken in rescue animals. So the choice is between leaving the pet at shelter or a life in a good home with some limited options when it comes to end-of-life care. I think the latter option is more humane.

There are pretty decent pet insurance policies responsible pet owners could purchase and pay a monthly premium on. I've used it for my past two dogs and it has been painless and easy to use when I needed to.

So it isn't a big $10K+ or bust argument. But the sad fact of the matter is very few pet owners assume ownership while planning for the potential bad days and the extra financial burden and responsibility that they should feel when they take on pet ownership.

I come at it from the angle that taking in a horse will costs you inordinate amounts of money upfront, and people are generally ok with it, and won't be crying to get a poney when they're already struggling to pay a mortgage.

If in practice owning a dog or cat will also cost 10k at times, it's only reasonable to take the same approach and consider owning a them as a pretty high luxury, until the costs effectively come down.

Or every pet owner gets to your level of dedication and will assist their pet and the vet when tough times come and hard decisions need to be made. I personally wouldn't have the guts so I'll stick with my goldfishes.

Compared to animals in the wild, or animals we raise for food, our pets have it pretty good, even if we have to put them to sleep rather than pay an expensive vet bill. A painless death at the vet seems like nothing comparatively.

For pets, "means to deal with emergency situations" includes euthanasia if the procedures required for a cure are too expensive.

There doesn't exist a duty to spend unreasonably large quantities of resources on saving any particular animal's life, so not being able to afford that doesn't make someone unfit to own a pet. If a pet has cancer, it's okay to perform a complex surgery that could save it, but it's also okay to let it die.

That’s nuts. My dog is awesome, but I’m not dropping $10k on the guy.

Animals aren’t humans. We do the best we can.

Also, as for "Once that cash cow is gone maybe vet school prices will come down to earth." - the source of the rising cost is a combination of two things, neither one of which has anything to do with small animal medicine:

1) The loss of industry support for large animal vets

2) The loss of state funding for veterinary schools, which has put pressure on the one remaining dial available to those schools, which is tuition. This is a systemic problem that extends way beyond vet schools, but is particularly obvious there

What caused #1?

Also, regulatory and insurance capture.

If anyone could perform veterinary medicine out of their garage, I imagine costs would come down significantly.

> Can you not see how that would be viewed as insanely predatory?

I assume you must be an expert in the cost structure of operating a veterinary practice in that location, at that time, in order to determine a predatory and non predatory price.

If you are not, I am not sure how you can make any claim about the prices.

>For profit companies should not be involved in human or animal medicine.

What kind of quality of life do you think veterinarians and doctors deserve? Should they be able to buy a Mercedes? C Class or S Class? Should they be able to buy a home in the better school district? How many square feet?

These questions are relevant for determining the predatori-ness of the doctors’ prices. Even more relevant is whether or not you want the top caliber people spending years studying one of the most complex machines. Or they could go study how to deliver ads to people.

I wholeheartedly disagree. After seeing the prices of basics like saline in hospitals, I'm not surprised to learn of inflated prices obfuscated from the general public.

That one is obvious due to us knowing the hospitals sell to the government and insurers for much less.

As far as I am aware, this does not apply to a veterinary business. The article also says it was $10k for emergency services at a vet hospital, including the aftercare.

What are the labor costs of having highly qualified people, presumably in low supply, on call to provide these services? What are the costs of supplies like medicine, and malpractice insurance (if that applies)?

The vets that I've been too (minus a non-profit clinic I went to once) absolutely charge outrageous amounts for saline and other things. It's a hard business, so like most time-of-use sales points they take advantage and charge for the convenience. I'm not making a value judgment, just pointing out that it definitely is something they do.

What is definitely something they do? Asking for higher prices in high demand low supply scenarios? That is something (effectively) everyone does.

It is how the world works. It is the mechanism which the markets use to signal more supply of something is needed (or less demand).

If you want me to study advanced biology for 10+ years and then have me work at odd hours of the day and night to be ready to perform surgery, you need to pay up, or reduce the other options I have for earning money which give me a higher quality of life.

Again, I'm not making a value judgment (as rationalizations from both perspectives can be made, and a person's opinion will depend on their perspective), just saying that "charg[ing] outrageous amounts for saline and other things" is definitely something they do. In a free market system they're allowed to charge whatever they want, and the consumer is allowed to take it or leave it. But explicitly stating the practice is a fair thing to do.

Non predatory thing then is to help the owner to put the pet down painlessly and quickly for reasonable price. Without guilting the owner into 10000 operation.

I do not see any evidence of guilting.

> The incident involved a four-month-old German Shepherd puppy who'd swallowed a skewer and needed emergency surgery life-saving surgery. The cost of the complicated procedure and after care was close to $10,000 – more than the owner could afford. As a last resort, to avoid euthanasia, the clinic offered her the option to surrender the puppy to a new owner who could cover the cost.

What is a reasonable price? Unless someone is familiar with pricing from multiple vendors for some period of time, how could one know a reasonable price?

Is a million dollars a reasonable price? The point I make is that you might not be able to tell a reasonable price, per se. But you can generally tell an unreasonable price. It's some x-rays, animal quality anesthesia/meds, and labor. It's hard to see how this reasonably adds up to $10,000.

Were time not an issue, they could probably take a trip to Mexico, get the operation done for maybe a few hundred dollars, and come back home, all for much less money than the vet was asking. And the reason I think that's particularly relevant is that it's not like the underlying costs really change. That clinic in Mexico is probably importing those drugs and machines from the exact same places. So developing world costs tend to give you a 'raw materials' cost, where all that's left is labor + profit.

> Is a million dollars a reasonable price?

If you can’t find someone else to sell to you for less, then yes. Barring broken markets such as due to regulatory capture, etc.

> The point I make is that you might not be able to tell a reasonable price, per se.

>But you can generally tell an unreasonable price.

These strike me as conflicting statements, otherwise I don’t know what per se means.

https://news.ycombinator.com/item?id=37846041

> And the reason I think that's particularly relevant is that it's not like the underlying costs really change.

>So developing world costs tend to give you a 'raw materials' cost, where all that's left is labor + profit.

Why are labor costs not underlying costs? How about liability insurance? Real estate?

Markets can break not only on the supply side, but also on the demand side. When consumers become unaware or uninterested in the baseline cost of what they're purchasing (or in econobabble - when the price elasticity of demand approaches zero), you end up with grossly inefficient markets because companies lose any incentive to meaningfully compete on price.

The point of looking at 'raw materials' cost is that if the costs on top of said raw materials becomes more than the cost of doing business elsewhere (such as in a different country), then one would be wise to do just that. This is the whole reason things like medical tourism exists.

It's not like other countries are getting their machines, medicines, and so on for that much less. It's just they're able to reduce the cost of everything on top of raw materials to the point that one can afford to take a 'holiday' half way around the world, get their issue fixed, and make it back all for less, often vastly less, than it'd cost to do stateside.

I have to imagine that a skewer in the squishy parts could result in a wide range of potential injuries. Maybe the specific injury here was just an “x-ray and pliers” kind of job as you suggest, but suppose this particular skewer skewered one or more organs, or resulted in some kind of awful hemorrhage or something. I could just as easily imagine the sort of injury that would require intricate surgeries and a lengthy hospital recovery, implying the round-the-clock attention of a number of specialized humans with mouths to feed and other career prospects (including patching up human animals instead!).

Euthanasia might be the only humane option in an x-ray-and-pliers outfit not staffed and equipped to perform such an heroic sort of intervention in the timeframe it would take to succeed.

One thing that does stand out to me is the extreme shortage of people willing to become veterinarians, even at these prices. It seems like regardless of the pricing on the retail end, capable young people considering modern veterinary life are sizing up the entire financial, emotional, educational, and lifestyle bargain and not finding the payoff to be worth it.

That said, I am sympathetic to the idea that modern veterinary practice has strayed too far from the way it’s done in lesser-resourced settings. Maybe it is more appropriate to set aside advanced and expensive medical techniques in favor of more cheaply-educated practitioners, more conventional business hours, simpler tools and supplies, more frequent recourse to euthanasia, and so on.

The blessing and the curse of modern medicine, no? It’s bad enough to have to face death when it feels inevitable, when “all that can be done to save them” is relatively simple and well-understood. Knowing that the same situation might be survivable under different circumstances—with more money, or in a place with the right practitioner, or if we’d just had this particular exotic antivenom in stock, or if the line had been shorter that night, or if we could hire some bioengineers and a lab to custom-tailor a treatment to puppy’s genes… the same death then comes with a lingering feeling of guilt over the possibility that more could have been done.

You're creating a false dichotomy. Animals swallowing things, being hit by vehicles, attacked by other animals, jumping from 8 story buildings (and living), and so on all cause similar groups of internal injuries - often life threatening. Yes it requires expertise and work to treat them - that's exactly what the job of a vet is. It's not like you go to a vet in the developing world with a puppy suffering severe internal injuries, from whatever reason, and they just shrug and ask if you want to euthanize.

Quite the opposite I expect you'd see dramatically less euthanasia in the developing world (though a quick search unsurprisingly turned up very little in the way of data). But I think the logic should be clear enough. Pets make everybody's lives better and more enjoyable, but very few people could afford to even think about dropping $10,000 on a puppy. Those prices are just a fast-track to mass euthanasia and depressed vets.

> It's some x-rays, animal quality anesthesia/meds, and labor. It's hard to see how this reasonably adds up to $10,000.

You should open a vet office then. Sounds like you’re well equipped to undercut competition and still make a hefty profit!

Or maybe you’re just making things up. Because we’re talking about an emergency open and close surgery to remove what’s probably a long sharp object with puncturing of the stomach. On a small animal. On immediate short notice (cancel everything else!). It’s going to be difficult with multiple doctors. And it’s going to require a lot of post surgery care.

My partner and I have a number of animals and volunteered at a shelter for many years pre-pandemic. We worked with vets and vet techs and are roughly aware of the associated costs.

$10,000 feels high at first glance but consider the size of the skewer compared to a small animal. There is likely damage done to other areas including major internal hemorrhaging which is not super straight-forward to track down completely (even in humans). If the skewer was single-use bamboo (which I suspect given how much wood will retain food smell and how puppies love destroying garbage cans), the puppy would have likely chewed on it a bit causing splintered mess internally.

This would result in a multi-hour procedure with at least 2 surgical staff (surgeon and tech) and anesthesiologist (due to the complicated nature of this, we can’t have the animal regurgitating as well as active life support monitoring). In addition to the standard tools, they would be using X-rays, dyes, internal (dissolvable) sutures, etc. Internal organs would be mended, stomach fluid would need to be removed from the abdominal cavity, and there would be at least 12 hours of monitoring post op.

Expensive, yes, but I don’t think it’s that unreasonable unfortunately.

I think your guess here is pretty much spot on.

TFA links another article explaining the $10,000 bill is a combination of $3,000 of completed tests the original owner had already paid, the surgical procedure, and aftercare costs.

TBH, the only part of that which sounds high is the $3k for pretests. But I don't know what all had to be done, so I'm just guessing.

How much of that 10K would be Mercedes money ?

It goes without saying that a vet should have higher than average income considering the length and cost of study and responsibility etc. Not at all trying to say that they're greedy.

Not sure why this goes without saying.

More training. More required expertise. More investment - opportunity cost, schooling, etc. The mental/emotional burden.

Because in the US, higher education is largely a personal investment against future earnings, and vets have longer and more expensive education requirements that most jobs, so they need to have higher salaries to justify the initial investment and to incentivize people to pursue that career path.

* FTC acts against private equity firm's acquisition of veterinary clinics[0]

* Private equity is buying everything from vet offices to tech conglomerates [1]

I'm not opposed to people making money and having a comfortable life, but the fact that private equity is capitalizing on vet clinics is telling.

[0] https://news.ycombinator.com/item?id=31728350

[1] https://news.ycombinator.com/item?id=36313967

Private equity companies frequently purchase struggling businesses, not prosperous ones

Maybe, a local monopoly could be a cause for concern. But is the barrier to start a veterinary practice so high as to grant them a permanent monopoly?

In this specific case being discussed, it does seem the vet business was acquired by a PE company a few years ago:

https://www.mainebiz.biz/article/portland-animal-health-star...

Note that the vet doctors themselves may have ownership in the company itself.

The other option is that advanced surgeries for animals are so costly, and the proportion of people who have the ability to pay so low, that there does not exist sufficient demand for a new vet to want to open a new hospital. In short, pet owners simply cannot afford all the pet healthcare they want.

> I assume you must be an expert in the cost structure of operating a veterinary practice in that location, at that time, in order to determine a predatory and non predatory price.

You don't have to be an expert when you can compare vet prices in US and in other parts of the world. And unlike human healthcare, vet is not subsidized anywhere, so the comparison is fair.

With the price tag of 10K$ I'd say it would be worth to take a flight to Mexico, other LatAm countires, or even Eastern Europe to pay tenth of the price for the same operation.

Comparing prices in different locales makes no sense, especially in an un-arbitrage able scenario like time sensitive emergency surgery.

What if tort costs are higher in one country than another, requiring higher insurance premiums? Real estate is more valuable, resulting in higher rents/mortgages? Labor costs higher due to more stringent labor laws/less supply of labor. The list goes on and on.

I considered this for my pet's medical care. I did some things at a very expensive private equity owned bay area vet clinic, and other things at a much cheaper location quite a drive away. The bay area clinic wanted 4x as much for a relatively routine procedure. But they also had new and more advanced imaging equipment and monitoring equipment, and veterinary surgeons with fancier degrees and specializations.

Frankly, if a vet can, as a matter of practice, afford to do procedures probono but only if the owner surrenders their pet, it means they are making an absolutely staggering profit from those who are emotionally extorted to pay. That is predatory.

I miss the days when vets got into the business to run small practices for a reasonable profit and middle class lifestyle. Few of them wanted mercedes money . It's kind of gross to think modern vet medicine is making vast sums off of pet owner's worst days.

Surrenders their pet to someone who can pay

You sound like you don't personally know many vets, you don't know what it was like to operate a vet practice back in the day, and you don't know what they drive.

I do, and going on about this (incorrectly) on an article about a veterinarian suicide crisis is unseemly. This isn't about you. If vets are so greedy and amoral, why are they committing suicide, for all the reasons listed in the article, at 4-8 times the rate of the general population?

You might find it interesting and beneficial to learn more about this topic firsthand. Vet practices, shelters, and vet schools often operate in coordination and are always looking for volunteers and donations. You may find more understanding and empathy with more exposure to the people this area.

You think you should dictate the price of someone else’s labor, and that is less predatory or somehow better than someone being able to price their own labor?

I can't 'dictate' anything. I just think that healthcare, for both humans and animals isn't the place for a 'the price is whatever the market will bear' mentality. That mentality assumes the participation of cool, rational actors. People making healthcare decisions for their family or pets do not fit that criteria. I feel it's immoral to use the love one feels for their pets to extract as much as possible from the owner.

I understand you probably feel differently. Frankly you and I will probably not ever agree on this topic as we have different world views.

Me myself? Absolutely not.

But yes, labor should have some means to be controlled for price, so that people cannot be underpaid or overpaid (as many are).

What is the formula for determining underpaid and overpaid?

The formula is what the master says you get paid.

"Tell me how to create a perfect society right now, otherwise you cannot critique this one."

You proposed implementing price controls to “appropriately” allocate society’s resources.

Unless you have specifics, what value does your proposal have? It is trivial to wish for world peace.

Did I wake up in another world where this is a legislative body? We're all just posting our opinions. Just because you don't like mine doesn't put a higher burden of effort on me to post.

I'm sure no amount of specifics would convince you that's a good idea, just as no amount of your specifics would probably convince me otherwise. And that's fine.

I am under no obligation to provide you "value" in my posts.

"Hey, you can't afford to care for your pet. I'm willing to spend several thousand dollars of my own money, but there's likely more care in the future, and I'd like to ensure the animal then lives with somebody who can afford any future care"

"You predatory monster!"

Do you think even for a moment through what you're saying, or is this just reflexive on your end?

Also, in what world is a median annual income of $100k, for a job with expensive and long training, "mercedes money"? If you have actual evidence of most vets making "vast sums", maybe it'd a good time to share that.

If you are referring to the story in the article then I believe you misunderstood. The vet didn't perform the procedure pro bono; the owners gave the pet up to someone who was able to pay for the procedure.

I don’t know a single vet that drives a Mercedes. I know a lot who drove beat up trucks and have a mountain of debt.

> no matter how much they are loved

I don't buy it. If their kid needed a couple thousand dollars to live, a lot more people would be able to scrounge it up. If they can't do the same for their pet, maybe they actually do love their pet less ... and that's OK.

> If their kid needed a couple thousand dollars to live, a lot more people would be able to scrounge it up.

While I agree that many (most) people would make it work if it were for a child, I wouldn't use the insanity of the US's human healthcare bills to justify anything. It's also insane and a travesty that you can walk into your hospital and walk out with multi-thousand dollar charges you cannot pay. Both can be terrible and unjustifiable.

Emotional attachment does not mean that human is not able to do rational decision. No matter how deep I love my dog, I do not have the same responsibility toward him then toward my child.

Your child is very likely to outlive you. In fact, to some, this is a major reason to have children.

On the other hand, your pet will die in your lifetime, unless you are very old or die unexpectedly. So most people are probably prepared for this emotionally on some level.

There are a lot of people who wouldn't spend a couple thousand dollars to save their own lives, let alone their kids. People get hit with thousands of dollars for their kid because once it gets bad enough, the system takes over and stick you with the bill. If people got a choice, they would not always choose their child. I can guarantee you this. We can see this where parents do get a choice: dental and vision care. There are a lot of kids suffering and going without because of a few hundred dollars.

Replacement cost is less on a pet.

Yes of course! Remember most of us have dead animal remains in our fridges. Ethics is a complicated subject!

I have yet to see evidence that it's out of whack. Vets are are doctors, have to employ staff, and have training, processes and tools analogous to human medicine.

There's no vet industrial complex, so no administrative/insurance/legal parasitic overhead like in human medicine (in the US).

>There's no vet industrial complex, so no administrative/insurance/legal parasitic overhead like in human medicine (in the US).

You obviously haven't seen where private equity has been buying up private vet practices

No, but costs are artificially higher than they need to be because the government restricts who can go into business by requiring advanced degrees, and the schools that provide those degrees make a lot of money doing so. It's certainly not an industrial complex anywhere near that of people medicine, but it's definitely out of whack thanks to regulatory burdens.

I personally agree with the government that you should probably have an advanced degree before being allowed to cut into or administer drugs to a living creature.

I'm by no means advocating a YOLO approach of no requirements, but there's definitely unnecessary bloat in the requirements. Just looking at the incentives, the people who make the rules benefit financially from making those rules as arduous and all-encompassing as they can get away with, and in order to become a rule maker you have to be fully in the system, so it's a positive feedback loop. The same mechanism can be seen with licensing rules on haircutters and stylists.

Why? The effect of that is that it becomes too expensive to treat that living creature, so it gets euthanized instead. Or just let the creature suffer until it dies on its own.

I would rather euthpanize my dog than subject it to quack vets.

And you think everyone should have to make that choice? And that e.g. 4 years for an undergraduate degree isn't enough to become proficient in treating cats (at least for the stuff that's worth treating)?

This thread has become casually dismissive and insulting to the actual work that vets do.

Techs (for states that require technician certification, it's a two year degree) do a lot of the work with pets. There's often more than one technician per doctor. That reduces costs. Doctors are still needed because, unsurprisingly, cases can have a lot of nuance that requires significant training to see.

That's fine if people want the best care for their pet, but not everyone is going to care about getting that level of service. I've taken in multiple strays over the years that found their way to me. Shelters where I lived were already overcrowded. The counterfactual was likely that they get hit by a car or caught by the city and euthanized.

I'm sympathetic toward animals, but there's a lot of them that are lucky to have anyone take them in at all, and a lot that aren't that lucky. If someone wants to get an animal some level of care without there being someone with a postgraduate degree to supervise (instead of no care), that sounds like a good thing. They could always be referred to a more qualified vet if needed.

Doctors are not need or wanted by everyone. I would go to an unlicensed vet for cheaper 10/10 times.

For the routine tasks, eg flea medication or bloodwork, a vet isn't helpful. For difficult tasks like surgery, a vet is too expensive.

I'd rather use a quack in every case.

The good news is that nobody would force you to. They could go to quack veterinarians and you could go to certified ones.

I would question that second assertion; given the rise of pet insurance, private equity buying up clinics, and the increases in cost of veterinary care entirely out of line with inflation, my suspicion is that we're in fact in the early stages of the buildout of a vet industrial complex.

Seems like the usual suspects have realized that there's a ton of money to be extracted by the veterinary industry and we're seeing the direct (hey, our CFO did some analysis and we can raise prices 500% and only impact sales 20%!) and indirect (hey, since there's a lot of money in this industry now, we've developed a new veterinary surgical instrument that improves outcomes 10% for only 20x the cost!) effects of that process.

And in this case, veterinarians are caught in the middle since they don't have a powerful cartel to protect them like human doctors; they end up with all of the stress and none of the profits.

"given the rise of pet insurance, private equity buying up clinics, and the increases in cost of veterinary care entirely out of line with inflation, my suspicion is that we're in fact in the early stages of the buildout of a vet industrial complex. "

In the last few years have seen several times how things go when private equity buys a dental or vet practice (or even plumbing) . The workers there are suddenly under a quota to make money, have less time but more stress, costs to the customer go up. The only beneficiaries are the private equity company. Everybody else loses big time.

It is worth adding the drug companies and their lobbying groups to that list.

As much as I wish that were true, it isn't really true. There is definitely a complex of businesses behind veterinarian offices with the intent of driving up prices.

We have pet medical insurance. It’s about $30/month per pet.

If you can’t afford medical costs for your pet then your pet will die if something bad happens.

Likewise if you take some magical fairy “society owes me taking care of my pet” then you’re going to be as disappointed as if you walk into a Chanel store and demand a free purse.

Pets are a luxury, not a fucking right. It’s not anyone’s job to keep it alive if you can’t afford insurance or costs.

Check what that insurance actually covers and do the math on it, especially over time (and even factor in current interest rates) and considering total coverage along with deductibles. You might think that you're covered, but in reality you aren't.

I couldn't find any insurance that made better sense than just putting $30/mo into a money market account at 5.25%. The way the policies are written, they clearly are there to make money on people who are buying piece of mind comfort over looking at the reality of the costs.

It has worked out positively for us so far, but yes, even with insurance it doesn’t cover everything. My point was not “buy insurance”. My point was “pets are an expensive luxury”. Pets. Plenty of farmers with working animals, and you won’t find them here complaining, because they aren’t under any illusions.

In my specific situation, I would have paid less money with insurance for just the diagnostics, not counting any procedures. (For a 16 year old cat.) Definitely do the math, but emergencies and diseases of old age can become extremely expensive. You may end up never needing it, but if you do, it can really reduce your costs. Personally I now prefer to pay out the $30/month and be covered for costs exceeding that, than to maybe get to keep the $30/month in the end.

How much profit do you think is being made in that $10k skewer removal?

probably a significant amount, otherwise private equity wouldn't be buying veterinary practices all around the nation. I know that the service I receive at a veterinary clinic I used to go to has become worse, a number of vets quit and were replaced with new younger ones, and the price increases have drastically outpaced inflation. all after the original partners sold to private equity.

I don’t really know what the answer should be. I somewhat arbitrarily chose a vet, found the group they are a Bart of, and looked up their accounts up to autumn 2022:

  Turnover 987 =
    Goods sold 96
  + services 776
  + ‘health club’ 113

I didn’t look into the health club thing. I think it’s a subscription and it probably includes regular checkups, vaccines, and maybe some other random things.

  Staff costs 442 (50% of turnover)
  Lease payments 37
  
  Profit 69.3 (~7% of turnover)

I’m not very good at reading financial statements and I didn’t try to dig through all the costs. There are things like buying new equipment as well as things needed for each operation. The group spent 118m on buying up other practices, but I don’t know how much leverage they had. If we take those numbers in a conservative “what if they were trying not to profit” scenario where they have no leverage, that’s 177 in “profit” out of 987 in income, or about $1800 if you assign it proportionally to a $10k skewer removal (or $700 if the acquisitions are counted as free).

I don’t know how those numbers look to you. To me, they don’t seem insane and I’m not sure the difference would matter much — I doubt the person unwilling to pay 10k would be willing to pay 8.2k. Also, I would guess that sort of surgery to be lower margin than routine things, though maybe competition drives it the other way.

I've found most veterinary care and meds to be very affordable. Major surgeries or specialized equipment (for large animals like horses) can be expensive.

Yeah, the schools are going to be expensive just as colleges are. Similar to med school, you're looking at high costs of educators, equipment, etc.

They also cut costs when they can. Metronidazole for colitis as an example - it’s not the standard of care for humans, but vets use it all the time because it’s wildly cheaper (cents vs $100s for vancomycin or $1000 for Fidaxomicin)

Even when it's the same meds, it's usually cheaper for the animal form (especially antibiotics).

That puppy example is special. In many cases (most?) the fact that a pet needs more than $10k it is likely too much to put the pet through. No way I would give a dog chemotherapy for cancer for example

That's not a reasonable thing to say. "Giving chemotherapy" is almost as general as saying "giving medicine". A young dog with a treatable cancer is not going to cost anything near $10k and should get many good years of life. Some cancers (eg, mast cell) have glorified Benadryl as "chemo".

Just put in the effort to find a good vet, build a relationship, and trust them give you good advice.

I'm not saying this to you, but this has been a terrible post on HN to read, the worst of the community is on display. Lots of confidently wrong people that are very quick to see the worst in others.

> but vet costs are completely out of whack with reality these days.

This industry, like so many others, has become a target for venture capital and consolidation. It's very quickly on it's way to becoming monopolized. Which makes headlines like this to me very interesting, because I assume they're designed to push people out of the profession and practice ownership and just sell it out to a firm when they come knocking.

> For profit companies should not be involved in human or animal medicine.

What is self ownership but an attempt to earn a profit? The issue isn't attempting to earn, the issue is the attempt to fully monopolize the market. I wish people saw through this more often.

This is a very un-empathetic take towards people who spent many years in school, work very hard, and earn relatively little money for their trouble.

What do you expect surgery to cost?

It's not like it was 1/10th the cost a while back and has suddenly became exploited by Big Veterinary or something. It was always expensive and you just wouldn't even ask unless you were especially wealthy or were unusually willing to sacrifice.

What's changed (perhaps for the better) is the sense that pets are worth the sacrifice. If you're younger or from a more wealthy background, you may not have a good intuition how much more accepted it was that pets (and people) simply don't get all the care that they might. The idea that intense medical intervention is a right for people, let alone animals, is actually pretty new.

Vets are NOT being predatory just because their work continues to be expensive.

The last vet surgery I paid for was in Indonesia and it was like 100x. There isn't some law of physics that makes it cost that.

Do you know how much it costs to maintain and operate an imagining (MRI, X-Ray, etc.) machine? Do you know how much it costs to maintain staff (doctors, techs, office assistants, etc.)

As someone that used to think the same way as you, and then got to see other side of the business (my wife is a Veterinarian who runs an urgent care facility) —— it’s easy to think the way you do without seeing the costs incurred on the other side.

Shouldn’t we as a society front the cost for the services ? I guess, socializing pet care is going to be a far step behind socializing human medicine and that is still a hot topic.

There is enough wealth created in our economy to cover these costs, and more, but heaven forbid a company not make more profit this year than last.

Absolutely not, no. I can think of no basis to demand that non-pet owners pay taxes to subsidize pet owners.

What a silly idea. There is nowhere near enough money in the economy to cover these kinds of costs for pets.

Every dollar in the economy is only 70k/person and the government already takes 28k/person.

Why would I ever want to pay exorbitant prices for your pet. I don't even want to do it for mine.

Ridiculous entitled view. At minimum, vets have to do undergrad + four years of vet school. If you find a board certified vet, they will have gone through 1-2 years of internships, and another 2-3 years of a residency, plus board exams. Technicians in many US states have to at least have an AA degree, but the competition is such that many have Bachelors these days. I know of a few that even have Masters.

And a lot of drugs are re-purposed from human medicine. Syringes, IVs, antibiotics. The manufacturers are not giving vets a discount just because it's being used in a rabbit. You just never see those prices for yourself because insurance hides it. The vets have to pass it on to you because their business is not a charity.

If you don't want top quality care for your pet and you don't value the skill and knowledge of a trained professional, there's plenty of bargain basement vets that are willing to cut corners.

There are some items like medications and IV fluids rebranded for veterinary use. I assume it lowers the cost but don’t know for certain.

Here’s prior discussion of VC firms buying up veterinary practices, and installing new management to squeeze out more value: https://news.ycombinator.com/item?id=36313967

Many of the hard costs in veterinary medicine are exactly the same as human doctors. Rent is rent, stitches are stitches. Most of the supply chain is the same. So when they open a bag of saline, put in a line, gown up, open a pack of sutures, etc. those costs are exactly the same as a human doctor. Their ultrasound machine comes from the same factory as the one one at your obgyn. Equipping a surgical suite is an expensive thing.

Medical doctors have a higher suicide rate

That doesn't seem to be accurate, do you have a source?

https://www.sciencedirect.com/science/article/pii/S016517812... shows in 3.3 that not only is the veterinarian rate more than 2x that of physicians, but the upper end of the 95% CI for physicians is below the lower end of the 95% CI for veterinarians. It doesn't appear to be anywhere close.

This study is about Austria and includes data going pretty far back.

That being said I can’t find conclusive data elsewhere. Most research doesn’t narrow down to jobs neatly. I’ve found number suggesting suicide rates of 200-400% that of the general pop which is in the same ballpark above and blow. So ymmv.

I don't see any reason why the suicide rate among physicians and/or veterinarians would be wildly different in Austria than any other country, or globally. Even if there was, it'd have to very different to have it eliminate the 2x difference and on top of that actually make physician rates higher than veterinarians by any statistically relevant amount.

Income, cost of living, patient expectations, healthcare culture, debt of schooling, etc.

Idk anything about Austria in these regards either way. But as I said, cursory searches for doctor specific stats put it in the same ballpark as those cited for vets.

When I volunteered to walk dogs for a shelter I learned they offered training and support to deal with compassion fatigue. I appreciated that.

My spouse and I had our dog euthanized last year because we did the calculations/justifications and the costs and risks of surgery (likely cancer and organ failure, per the ultrasound) didn't justify keeping our family member alive for perhaps a few more months. The experience changed my perspective about pet ownership/stewardship in general: unless I really need an animal companion or a working animal (e.g. herding), I will never own another pet. I find it a luxury I can do without. I've had three dogs die in my lap now, and that's enough.

Visiting his grave in the back pasture on walks with my young daughter has opened up regular conversations about death, though, which I see as an upside. She was there wfor the funeral and touched his cold ear before we buried him. She asks a lot of questions and often wants the story of our dead dog's later life and eventual death, and after some consideration and kind words to the memory of our dog (I add no religious spin, just that his "spark of life" is gone and his body is being digested by other living beings underground, a fate for myself which I am absolutely fine with), because it feels good to say these kind words even though I am not under the illusion he's listening, we carry on walking.

I'm interested in your thoughts on this:

>The experience changed my perspective about pet ownership/stewardship in general: unless I really need an animal companion or a working animal (e.g. herding), I will never own another pet. I find it a luxury I can do without. I've had three dogs die in my lap now, and that's enough.

I understand not wanting to put yourself through the pain of loss, and have felt that too. Sometimes I don't want a pet because I feel the good times aren't worth the pain of parting. However, you went on to call it a luxury, which confused me. Is that because you will have to pay for the luxury, or because the animal will?

I've never had a pet I thought had a bad life, and it sounds like you were a good owner, so I don't get what the downside is.

My daughter wants more than anything to be a vet. Has talked about it for years. Reading more and more anecdotes and research about what it’s like being a veterinarian, I’m scared to continue encouraging her. We have a particularly medically-needy dog, and have spent $10k on procedures and vet visits over the past few years, and she’s really comfortable and familiar with being at the vet office.

In my position, would you encourage your child to chase their dream? Or would you be comfortable telling them every few weeks until they gave up that you don’t think they should be a vet? I’m asking in earnest because I’m torn with my desire to be encouraging and positive and tell her to chase a dream, with my desire not to set her up for misery or potentially suicide.

> In my position, would you encourage your child to chase their dream? Or would you be comfortable telling them every few weeks until they gave up that you don’t think they should be a vet?

Can't you do both? Let her know about the serious downsides (perhaps don't "repeat every few weeks until she gives up") and if she chooses it anyway, encourage her. This is her decision to make, not yours. She will be responsible for the consequences, not you.

She’s 8. She’s not responsible for much of anything. She’s not mentaly capable of being responsible for making future career decisions. If she said she wanted to be an authoritarian dictator, I’d crush that dream fast. But she wants to help animals. And being someone that she looks up to, it doesn’t take much for me to crush a dream. So do I start crushing that dream now (her wanting to be a vet comes up weekly, so either I would ignore it or have to keep reiterating my position), and ruin any chance of her becoming a vet, or do I let her invest years into it before telling her I think her career choice is a bad idea?

At 8 years old I'm not sure what the downside is to waiting a bit. It's not like she's accruing vet school debt right now.

Late reply, but:

> She’s 8. She’s not mentaly capable of being responsible for making future career decisions.

She's 8, she doesn't have to make future career decisions yet. When the time comes, it's her decision to make.

I really don't understand why anyone would become a vet. I love animals as much as the next person, which is why i don't understand why one would volunteer for this life.

When having the cat put down, my first thought was for the cat and my personal sadness. My second thought was, wait, you folks do this for a living?

Imagine if they were compensated much more and therefore could take on a lighter case load. It's such a sad reality how the people who do important jobs in society are squeezed to the point of breaking, while so much wealth is hoarded so by few.

Imagine if vet care was twice as expensive.

It's just a fact that ppl don't want to admit that raising pets is a luxury. The cost of the healthcare is high and when the economy downturn comes like now, this kind of cost would be the first to be reduced.There is just not much money in this business

Cry me a river. My cats' physical costs $300. The vet is in the room for 20min. When I had to put down one of them (literally had to, there was no other options) it ended up being close to $1000.

Maybe don't charge insane amounts if having to put down a pet makes you suicidal.

My wife is a vet.

One big issue is that most people don’t have pet insurance. But they do have medical insurance. As a consequence they are completely surprised by the out-of-pocket costs of medical procedures.

Hip surgery (to pick something at random) is hip surgery, even if it’s for a dog. It still costs thousands of dollars. But a significant portion of the population expects to pay what they would pay for insurance-covered human surgery, eg a couple hundred dollars at most. And when they see the bill they accuse the vet of “only being in it for the money” if they won’t significantly discount the price.

Meanwhile, the vet is paying back $150,000 in student loans, same as a human doctor, but only making a third of the pay.

Also, not sure how common it is, but an extended friend of mine was a vet tech. She quit due to the emotional toll of seeing animal abuse. Specifically sexual abuse. Apparently they had very limited tools to actually deal with the problem and instead had to give the dogs back to the abusers. That was not an emotional burden that she could continue with.

Not something I would have thought vets would have to deal with.

I used to work with a guy who developed photos in a lab in the 90s. He saw far too much stuff along those lines.

I looked into pet insurance. The best cover I could find would have cost me £250/year, and would only cover up to £7500.

It cost me £7000 for my cat to spend 2 days in "ICU", nothing surgical, though they did do a _cat scan_ and put him on oxygen.

I found the cost of insurance ludicrous given how expensive the vet was and how little the insurance would cover. Granted ICU is expensive, I would still expect there to be an option which would wouldn't cap out at such a low figure.

For such a measly cover, I would prefer to self-insure.

Exactly this! People think they are spending $25/month and getting full coverage in case something happens, but the reality is that if you have a fairly healthy pet, you're just better off self-insuring and putting that money into an interest bearing account instead.

The insurance companies have done all the math and are counting on you making an emotional decision.

I self-insured my previous cat. About a year after she passed of cancer, when I felt I was ready for another pet, I did the math for insurance. I would have paid a lot less with the insurance plan I found. So my new cats have insurance.

The costs for my previous cat were heavily skewed to the end of life period. But if there is ever an an accident or other emergency situation during their youth, the insurance would work out even more favorably. If I never end up having to use it, all the better.

You can't get insurance for an end of life cat. The comparison doesn't work against a young healthy pet. If you never have to use it, you've just wasted a bunch of money.

Don't think you can outsmart rooms full of people who are doing the math against much larger volumes of input data.

My comparison is to a young healthy pet who reaches end of life, as pets tend to do. I did the math, including interest on self-insurance savings and deductibles and co-pays. In my circumstance, insurance would have saved me thousands of dollars. Of course, I might not have needed it. Or it might have saved me $20,000. It's risk management. Pay a medium amount to hedge against the possibly having to pay an exorbitant amount.

No $25/mo insurance is going to pay out $20k, they all have maximum caps.

That's also 800 months of payments and your cat isn't going to live to 66 years old.

My insurance policy does not have any maximums. Your second sentence is nonsensical.

Which insurance is it?

  20000/25=800
  800/12=66

I have mentioned it elsewhere in the thread, so I feel slightly uncomfortable mentioning it repeatedly because I don't want be a walking advertisement, but it's Trupanion.

Definitely not an advertisement. For me with my dog there is no $25/mo plan. The lowest it goes is $60.95/mo, with a $1000 deductible.

Trupanion covers 90% after the deductible. A $3k bill would still require me to pay $1300 ($1700 savings), which I could have just saved myself by stocking some money away. $1700/$61=28 months. I've had my dog for more than 28 months and haven't had any $3k bills.

Of course, if my dog has a $20k bill, it makes more sense, but the chances of that are pretty low given how I know my dog. It becomes an emotional decision, which is my point and what they are counting on.

250/year is not a lot. thats 20/month which is the cost of a netflix subscription these days.

No indeed, but the insurance caps out at £7000, which is not an amount I need to insure myself for.

Insurance must on average cost more than it pays out. When it comes to pets, there is less competition, less transparency on cover and less competition on veterinary costs.

All these factors combined make it unattractive to me, as I have enough income to self-insure beyond the low cover pet insurance provides.

What's a good pet insurance carrier/plan, that's not just a straight up scam that just cover's the yearly stuff and some select things? Legit asking because with two super active GSD's I'd sign up in a heart beat if I found one.

In the US, Canada, and Australia, it's Trupanion. It doesn't cover routine wellness costs (exams, shots, teeth cleanings). But it covers virtually everything else at 90% with a $250 deductible. No annual limits or lifetime limits. For my cats it costs $30 per month (each).

That's way better than anything I've seen. I get a 79.50$/mo quote with a $1000 deductible from Trupanion for my 2yr old dog. Which is why we've never picked it up.

The $250 deductible version is a crazy $184.55/mo.

I'm not really familiar with how much dogs cost, but it seems like large dogs just cost a lot. I just did a quote for a small 2 year old dog (Maltipoo), and got $55/month. A 2 year old cat is $38/month. (I enrolled my cats as kittens.) I expect breed in general to be a much bigger factor with dogs than cats. Veterinary costs also vary significantly based on location.

This is true. If you're an experienced cat owner in good financial health, indoor cats are generally not worth insuring.

For dogs, it ranges wildly from "not worth it at all" to "mandatory" depending on the breed, and which breeds you should purchase insurance for is pretty trivial to find information for online. In general, bulldogs and large dogs are generally worth getting insurance for, as long as you get it when they're still puppies.

> But a significant portion of the population expects to pay what they would pay for insurance-covered human surgery, eg a couple hundred dollars at most.

Time travelled from the 1990s, or one of the few who’s never had normal middle-class health insurance in the last decade.

I haven’t had a plan that wouldn’t put us into at least high-four-figures if anyone gets actually-sick, since the ‘00s. Not even the best-available plans to me at any time (which I’ve noticed tend to make little or no economic sense, if you run the numbers) would keep it in the hundreds. Mid-thousands at best (and the higher premium just makes it break-even anyway)

[EDIT] Example: a recent tonsillectomy cost us $2,500 or so. We have middling-leaning-good insurance. It's not some ultra-high-deductible thing. Everything went great, no complications, out of the hospital like an hour after waking from surgery. I don't know how people who make median wages afford kids, with medical & housing costs the way they are. A specialist copay for a 30 minute routine check-up visit (fucking prescription med control rules are a cash-cow for doctors, what a joke) of which ten minutes was with a doctor, was $95 out of pocket the other day, for which we received nothing we actually needed aside from checking a bureaucratic box. Surgery of any kind being in the hundreds is fantasy-land from where I sit. Usually I'm shocked at how cheap veterinarian bills are without insurance. They're usually much cheaper than the same thing on a human with insurance.

For some reason, a certain part of humanity thinks that vets should be doing the work just out of kindness, eg free or nearly free. Minor surgery on your dog still requires anesthesia, x-rays, IV fluids, scalpels, etc etc, and those are usually exactly the same supplies as for human surgery. They cost the same.

Also bear in mind that the nature of veterinary practice is different from eg a surgical practice. If you need surgery, you don’t go to “the local surgeon”. You get referred to a hospital or a specialty surgical practice. Ever seen a Yelp review for a heart surgeon? Neither have I.

But if your dog needs surgery, you go to the little vet practice down the street. The vets in that practice are generally exactly the same people you bring your dog to for their shots. They aren’t protected by a layer of administration and lawyers. They get Yelp reviews all the time — very, very bad ones. Death threats. Because they had the temerity to tell a patient that a cardiac bypass on Benji was going to cost $10,000, and the family couldn’t afford it so Benji died.

Vets are in your community in a way that surgeons aren’t. That exposes them to direct abuse to a far greater degree than surgeons.

My wife knows a vet who was sued because an owner claimed that the rabies vaccine “gave the cat autism”. Really.

The cost of preserving life, human or otherwise, has skyrocketed. When I was a kid, it cost $25 for a vet visit and something like $100 for a minor surgical procedure. Adjusted for inflation those are probably about the same today, the difference being there were no major surgical procedures available for pets. Also, the vet did not carry $150k in student loan debt.

A decade ago I had a kitten with heart arrhythmia. The vet suggested we go to a cat cardiologist. To me that seemed insane, it was going to be $1000 just to get inspected. The cat is alive and well today with no cardiologist visit.

What is the value of the kitten’s life when it was a rescue and there are thousands more to pick from if it passed?The reality is that creating life is cheap and plentiful on planet earth. The resources to preserve life are not. If you are privileged you can afford to pay for your pet’s care. That is a sentimental choice for most people, not a practical one. The equation is different for human life, but only by degree. Insurance is only going to do so much, there is a real cost to medical treatment.

> Adjusted for inflation those are probably about the same today, the difference being there were no major surgical procedures available for pets. Also, the vet did not carry $150k in student loan debt.

Yeah, I remember it being "the dog has cancer? That sucks, let's give them some cheap drugs to keep them comfortable as it gets worse, and plan to put them down when that stops working." Not "let's do chemo". Dog-surgery or otherwise expensive human-like care for pets was like a Beverly Hills rich person thing for celebrities with risible relationships with their pets, not something normal people did. You'd maybe get a broken leg or whatever dealt with, but that was about it, and even that kind of thing would be a lot lower-tech than these days.

This. Vets probably got into the job hoping to care for animals in the best possible way. But economics prevents that.

I've always been very conservative in treating my animals. Mostly due to costs, but also because modern vets offer a lot of questionable treatment options. I've had dogs with cancer where I was offered tens of thousands in care that would have had marginal success and would have extended suffering for the animal. Same thing with my 20+ year old dog with kidney disease and cataracts. I'm not going to take resources away from my human child to add months to my dogs life, regardless of how much I adore my dog.

And the cost of everything of the surgery - IVs, antibiotics, catheters, testing reagents, syringes, needles, are usually the same items used in human medicine. Vets don't get a discount on this.

You just don't see that a bag of saline solution is $100 if you go into surgery because your insurance pays it. Meanwhile, the vet has to pass the $100 to you.

Just paid $30k for a variety of tests and a surgery for my dog.

I have insurance, but the yearly coverage limit is $5500.

Some insurance claims to have no limits, but then turns around and denies many claims.

I’m just glad I could afford the surgery and medications to keep my dog out of pain and help him have a few more happy years.

I grew up on a farm. We lost a couple sheep. We had at least 3 different dogs over the time I lived there. We had a swarm of cats that came and went. We had a baby goat that died from tetanus, that was rough to watch. At least most of the chickens that died were because we butchered them.

Animals die. It sucks, but way less than a human dying.

Maybe life would be easier for vets if their customers had a more temporal view of their animals.

I also grew up “country”, descending from a long line of rednecks.

I think growing up around livestock and farm-pets (cats belong in the barn and are basically disposable…) leads to a super-different relationship with animals from what city folk have. Being around, and dealing, a lot more death. Doesn’t hit one as hard as people who didn’t have that experience.

> Doesn’t hit one as hard as people who didn’t have that experience.

Can't say I agree with that statement--it still hurts hard when animals you've raised for a very long time die. However, I pretty much concur with the rest.

Animals are not small people--they are animals.

If they are a young animal with good recovery and lots of lifespan ahead, sure, I'll spend money. Broken bones. Natch. Swallowed something stupid. No problem. Got in a fight and need to be put back together? Sure.

Once you start talking more advanced things like cancer. It becomes a "maybe". How many good years will that animal have after the treatment?

And I'm sorry, but I'm not going to spend a lot of money at the end of an animal's natural lifespan. It's only going to make a very marginal improvement in the amount of time you're going to get. And, the animal is likely to be miserable, to boot. Better to spend the last 3 months letting your dog do what it enjoys rather than to have it last 9 months of misery.

We are mortal. Pets are mortal. C'est la vie.

Yeah, I didn’t mean to suggest that country-sorts necessarily become totally numb to animal deaths of all kinds, and certainly not that they aren’t bothered by animal suffering, just that their ability to cope with it seems to be far better-developed, generally. There’s a difference of attitudes & culture, and simply having more exposure to animal death probably plays a role. Doesn’t mean they’re not sad when their favorite hound dies, or whatever, or don’t feel bad for a calf caught in barbed wire.

When I was young, the first profession I said I wanted to be was a Vet. I was obsessed with it. I loved all animals, but dogs the most. Still do.

Over the years of having my own pets at some point I realized I would be dealing with animals in their worst condition. Sick, injured, and suffering. I knew I would be bonding with animals I would rarely see and maybe even be responsible for putting them to sleep when the time came. I knew I definitely did not want to be a vet.

I know a few vets, and I know they have that same love for animals. I don’t know how they do it.

> When I was young, the first profession I said I wanted to be was a Vet. I was obsessed with it. I loved all animals, but dogs the most.

Same with my 10 year old. We had a nice "what do you want to be when you grow up" conversation in the car the other day and of course she decided she'd be a veterinarian because she loves animals. I don't want to be Mr. Negative Dad or discourage anything, but we had a "let's think about that for a minute" talk and she figured out the unpleasant side of the idea pretty quickly.

I have four young girls who all talk about wanting to be veterinarians when they grow up. They're young enough that I don't put much stock in that yet. I already had some sense that being a veterinarian has a lot of downsides, but reading this thread is really making me hope that they change their own minds in a few years. Like you said, I don't want to be the one to discourage them.

You're also often dealing with people at their worst. I know of two vet clinics in my area have had to put up signs warning that they will not tolerate abuse and berating at their staff, obvious signs of intoxication, etc. How many businesses have to do this?

One of the first things my wife was told in vet school was, "Most of you are here because you want to deal with animals and not people. In reality, if you are not good with dealing with people, you are not going to make it in this field."

This article hit me pretty hard. But I really wish we could find a better term than 'mental health crisis'. I think it's a polite form of victim blaming.

At what point are we just gonna admit that we've built a crap world and we oughta have an honest conversation about fixing it?

People spend too much time staring into their phones, consuming simple carbohydrates, and being sedentary. The world is better than it's ever been. We just don't take good care of ourselves.

What are you talking about?

Peace in Europe is shattered. The former President of the United States has been indicted multiple times on dozens of felony charges. R&D on the killer bipedal robots + assassination drones + AI from your favorite sci-fi movies is nearing completion. Full Nineteen Eighty-Four-style surveillance totalitarianism has been rolled out in occupied China and is at the pilot stage in most western countries.

According to the SlaveVoyages project, almost 13 million people were captured and sold as slaves between the 15th and 19th centuries:

https://www.slavevoyages.org/assessment/estimates

Today, 50 million people live in slavery, according to the Walk Free Foundation:

https://www.walkfree.org/global-slavery-index/findings/globa...

Are they spending "too much time staring into their phones, consuming simple carbohydrates, and being sedentary"? The "world is better than it's ever been" for those 50 million slaves? They're just not taking "good care" of themselves?

Can you find any chocolate bars that aren't made from cocoa beans harvested by child slaves in west Africa? (Only ones I've found: https://manoachocolate.com)

Are you saying U.S. police officers extrajudicially executing more Americans in 2019 than mass shooters murdered is "better than it's ever been"?

https://en.wikipedia.org/wiki/Lists_of_killings_by_law_enfor...

https://en.wikipedia.org/wiki/List_of_mass_shootings_in_the_...

The Bank of England reporting that real wage growth in the 2010s was back to the slowest since the 19th century, and Britons just need to "take good care of" themselves?

https://web.archive.org/web/20161206225850/http://www.bankof...

What's better than it's ever been? TV dramas?

I could address each of these points and show how you've taken a narrow, specific stance to focus on the negative things in the world. I could point to hundreds of instances that show your view doesn't accurately represent the current state of the world or accurately place it in the context of history. It doesn't accurately account for the scale of historic cruelty, violence, famine, war, oppression, etc.

Steven Pinker wrote a whole book dedicated to the topic and I've asked ChatGPT to give us the Clifs Notes:

Historical Rates of Homicide: Using historical records, Pinker demonstrates that the rates of homicide in prehistoric tribes and ancient civilizations were much higher than in modern societies. For example, he cites studies of prehistoric grave sites where a significant percentage of skeletons show signs of violent death.

Decline of Violent Punishments: In medieval Europe, punishments like drawing and quartering, burning at the stake, and public disembowelment were commonplace. These have been abolished in modern times in favor of more humane treatments. Wars and Battle Deaths: Despite the two World Wars, the rate of deaths in interstate wars has declined since the mid-20th century. Pinker highlights the long stretches of peace between major powers and the decline in the number of genocides post-World War II.

Slavery and Torture: Practices such as slavery, once accepted and widespread, have been abolished in most of the world. Similarly, the use of torture has seen a significant decline, especially in Western societies.

Treatment of Minority Groups: Pinker discusses improvements in the rights and treatment of women, racial minorities, children, and LGBTQ+ individuals over the past centuries. Acts like domestic violence and hate crimes, which might once have been ignored or condoned, are now prosecuted.

Animal Rights: There’s been a growing concern for the well-being of animals, leading to changes in hunting practices, animal farming, and entertainment. Child-rearing Practices: Physical punishment of children, once seen as standard, has declined in many parts of the world. Many societies now view it as unnecessary or even harmful.

Data from Non-state Societies: Pinker contrasts the rates of violent death in non-state societies (like hunter-gatherer tribes) with state societies, noting that non-state societies often have higher rates of violent death.

Comparative Data: Pinker compares different periods and cultures, illustrating that Enlightenment-era Europe was less violent than medieval Europe, and that the 20th century, despite its wars, was less violent in terms of individual risk of death than previous centuries.

Haha, yeah, I read the book too, no bland autogenerated pap with zero citations necessary. It clouded my worldview and made me complacent and content with my privilege in the early 2010s. The other usual citation here is Hans Rosling.

Think any of the 50 million slaves have had the chance to read the erudite works of Steven Pinker?

You haven't addressed any of my points, haven't pointed to a single instance of inaccuracy in anything I cited, and haven't provided a shred of (parochial-sounding) "historical context."

Here's a book recommendation for you: https://en.wikipedia.org/wiki/On_Bullshit

Here is what's being counted as slavery from your source: Forms of modern slavery include slavery by "ownership" ("chattel" slavery), government conscription (forced military service or government labor), forced prison labor, forced migrant labor, debt bondage (slavery until debts are paid), sexual slavery, forced marriage/child marriage, child labor, and forced begging. With the definition of modern slavery in mind, we can now move on to examining the statistics.

Your 13,000,000 slave number is only chattel slavery. You're comparing apples and oranges to better make your point.

Chattel slavery was legal between the 15th and 19th century, so slaves were uniquely accounted for accurately during that time. Now that slavery is officially illegal (unless the government has a good enough excuse), instead of legal, accounted for chattel slaves you get the de facto / black market / "technically-not-slavery" categories you describe and the job of estimating counts becomes more difficult.

Sure, "modern" slavery is more akin to historical/ancient slavery (i.e. ostensibly based on punishment, debt, or civil status), and yes 19th century Southern American slavery was particularly brutal, with cotton becoming the world's top cash crop on the economics of the cotton gin + slave labor.

But my point wasn't how many slaves there were between the 15th and 19th century, use any number you like, we all have some sense of how bad things were. My point was that there are tens of millions people living in slave-like conditions right now, while your point seems to be something like, "but it's modern slavery!"

Interesting. Sounds like the HN rules need a new clause, "No accusing other commenters of writing comments using LLMs".

Accuse? The commenter said they "asked ChatGPT to give us the Clifs [sic] Notes."

Only commenting on the chocolate, because I don't know much about the rest. There are probably hundreds/thousands of other brands that sell organic chocolate.

I checked the chocolate bars I buy in Germany - 1&2: FairTrade, 3: Rainforest Alliance, 4: organic, "fair trade" without label. Many chocolate bars have the country name on it where the beans grew, for example "Edelbitter Perú 78%". I am pretty sure you can find dozens of similar ones in the US.

Fair point, didn't find many ethical options last I checked but should have revisited, now seeing e.g. https://www.slavefreechocolate.org/ethical-chocolate-compani...

Should have just pointed to the apparent failure of the Harkin–Engel Protocol, introduced in 2001, and Supreme Court victory for Nestle and Cargill in 2021 (https://www.cnbc.com/2021/06/17/supreme-court-rules-in-favor...)

My parents and grandparents experienced life from the 1920s to 1950s in Europe. Things were much worse then and much crazier.

Not saying we shouldn’t improve or that we should go back to the “good old days”. But in western countries life has been pretty good the last 70 years compared to before. But my pessimistic/realistic side tells me that we will screw this up and either turn into some dystopia with a few rich people and many poor people or we will just start another world war.

Something like two or three billion people have been lifted out of abject poverty in the last thirty years.

Global violent deaths are a fraction of what they were 50 years ago.

The world is making huge progress; you’d never know it from the evening news, however.

PS: The site you link classifies (correctly, in my view) conscription as slavery. I think if you’re going to compare then to now in terms of slavery, you should include conscription numbers in your historical figures too.

Once the Silent Generation and Boomers no longer hold most of the power.

This is a nice idea, except it's also completely false. Every generation before this one has thought the same and for most of history they haven't exactly been right.

Wrong. No previous generations have held onto power as long. We had the first Boomer President in 1993, now here we are thirty years later with the first Silent Generation President.

Leadership of the Missionary Generation (born 1860-82) did extend into the 1930s and '40s, but they, you know, enacted the New Deal, created Social Security, and led the global war against fascism.

Boomers often talk about the sacrifices of their parents' generation. No one has ever said that the Boomers ever sacrificed anything.

This is a very US-centric take that falls apart the moment you look at the rest of the world.

Agreed, e.g. Britain has already had four Gen X PMs.

And which country faired better in the ensuing years?

> At what point are we just gonna admit that we've built a crap world and we oughta have an honest conversation about fixing it?

When we start admitting the problem is fundamental to human nature, meaning we start pointing the finger at ourselves instead of only at other people. Until then, this cycle will only continue.

Not sure if you're implying that having a "crap world" is inherent to human nature, but I disagree. We live in a society that forces the majority of people to labor tirelessly for low wages. In our society, money is power, and one can't shoulder the blame for a dysfunctional society that they (for all intents and purposes) don't have a say in.

I guess what I'm trying to say is that the mental health crisis is a societal problem, not a personal one. With roots in low wages, high hours, world instability, a loss of community/spirituality, and other factors that simply are not controllable by the average Joe.

It is not fundamental to human nature to be in unfathomable amounts of debt.

Debt is fueled by greed, which human nature is prone to.

'Human nature' is whatever people want it to be for the purpose of argument. It's a thought-terminating cliche. There isn't one single personality type, although there is some evidence to suggest that there are 4 or 5 basic ones.

https://www.science.org/doi/10.1126/sciadv.1600451

Greed is part of human nature, sure, but so is empathy and selflessness and a sense of justice. We certainly didn't need to build a society that rewards people for giving into one of their most selfish and cruel impulses.

Indeed. Suicide rates in the US reached an all-time high last year:

https://www.nbcnews.com/health/mental-health/cdc-data-finds-...

I didn't really see the article itself as victim blaming, but I agree that the way suicide is framed often does just that, and there's a bit of that covered in the piece. Not a collective effort by professional groups to address the stressors identified, but a focus on the mental state of the vets, as if it's all in their head and a "mental hygenic" issue.

This approach seems pretty par for the course now: mental wellness is a focus in professional groups, HR, whatever, but it's seen as something like exercise, where whatever happens is caused by the person's own head, and the stressors are just part of normal life, not something to be fixed or changed.

Sometimes I've felt like society gets way off course, and huge systemic gaps that develop, between reality and the schemas in people's minds about what's going on. There are usually segments of society that end up picking up the slack, depending on the worst parts of society's distortions, and in this case it feels like vets are one of those groups.

I'm compassionate towards the problem, but I don't really understand the doctor analogy.

A doctor doesn't demand that a full battery of blood-tests is ran to determine whether or not I have FIV before he/she stitches together a small flesh wound or before he palpates my skin for tumors; a vet has no problem with creating artificial barriers to care by their own doing as long as it produces additional transaction profit -- now doctors and insurance and medical care might be backwards in the United States, but I haven't been refused medical treatment simply by saying "No, I don't think an HIV test is going to help you set my broken arm, so I won't do it, please set my broken limb.", but this is routine type of behavior around vets and animals, and I speak from years upon years of depressing personal and community service revolving around dogs and cats.

Frankly speaking, if my career enforced that kind of behavior and left me to my own devices to extort potential customers in a time of dire need with their dying pets as hostage/collateral, i'd probably edge towards suicide, too. I don't have a solution, but it feels like an unfair profession even as a spectator looking in, so their grief and anger doesn't come as a surprise to me -- the professionals are as much victims of the 'routine' as are the marks.

I think that MDs are insulated from this issue a bit more-so by their standardized (and pretty regulated) ethical and philosophical guarantees towards medical compassion and care; not knowing what vets are required to do within that regards, it seems lacking given the broad levels of quality of vet care you can find by calling a dozen local numbers -- maybe it helps that MD patients receive the 'hard decisions' usually from their insurance people.

Koshi's story is horrible. A bad cat owner who literally lets cats loose into the wild (Littering basically) sued her.

https://www.bbc.com/worklife/article/20231010-the-acute-suic...

She committed suicide after bullying and people villifying her, and the POS plaintiff Jurmark (who litters cats in the wild) got the cat back.

I imagine vets go into the business because they like animals. Hard if you bond with every patient. Not sure how to get out of that particular catch-22.

Or doesn't get along with humans too well. Which can be a sign of underliyng depression.

Many people are pretty mean, so it's also a sign of a dis-functioning society that causes a lot of underlying depression.

I know that it's a tough and often thankless job. People don't understand the real cost of pet care.

Euthanasia is difficult, especially with pets. Pets are very much like children. I make it a point when calling on a veterinarian for end-of-life care for my pets and my family's pets to talk with them and thank them afterward. It is absolutely hard for anyone in the room when a beloved pet is euthanized. That's a heavy burden for a vet to carry day after day, and it's crucial that they are reminded that they are doing the pet and the family a kindness. Intellectually, I'm sure they realize this. But, it's a brutal emotional situation, and I think it's important that they are shown gratitude for taking that on.

The business fundamentals and the emotional reality seem to be inherently at odds. I'll bet that this is a leading indicator for what's gonna happen in people medicine.

> leading indicator for what's gonna happen in people medicine.

It's been happening for a long time now: https://www.nytimes.com/2023/06/15/magazine/doctors-moral-cr...

I'm not really an animal person and I briefly dated a vet once and it always used to crack me up how when she was telling a story she would refer to the animals as patients. Like I get it, animals are sentient, have emotions, are intelligent, have ways of communicating etc. But there is still something inherently funny about this to me, like a sketch show where you're zoomed in on what you assume are two doctors in white coats with scrubs and stethoscopes talking about a problematic patient and then the camera cuts to the wide shot and you realise the doctors are actually vets and the trouble causing patient is actually a mischievous dog.

Anyway, I bring this up, one because it's funny but two because it highlights how emotionally tough the job is for vets - most people can easily empathise with how hard a surgeon or doctors job must be but can struggle more when it comes to vets. But to these guys these animals are their patients and they feel the same level of responsibility to them that doctors do to humans. It's got to be tough when you have to put so many of them down week after week after week.

I think its normal to be able to empathize with vets. I don't think I'd really want to be around someone who doesn't empathize with dealing with wounded and dying animals.

In reply to your other comment that was flagged:

Well, the reason why the Holy Grail killer rabbit is funny is precisely because a rabbit could never jump onto a man's neck and nibble his head off. If killer rabbits were actually a serious yet somehow obscure danger, maybe you'd find it initially funny, but you'd find it much less funny once you've found out many people are losing loved one to the buck-toothed menace. If you hear two people in white robes talking about how they lost a patient to cancer earlier today and how devastated the family was, and you laugh when you find out they're talking about a cat, what does that make you?

It always makes me chuckle a little bit too, mostly when I see entries for 'species' in the FHIR specification (FHIR is a health care data specification)

https://www.hl7.org/fhir/patient.html

Couldn't this just be what a community with a healthy view of death might look like? Vets see death every day and see it as a valid option to when life doesn't really work anymore. Am I the only one that doesn't see this as much as a problem for Vets as for the rest of us?

There is a number of policy solutions that the government can act on today that would directly help address this problem.

At the core of this is a crisis of animal welfare which is related to the spiking cost of housing and poor economic conditions.

No one has money for pet insurance and people are unable to move into apartments that allow pets, which results in abandoned animals and vets becoming animal executioners.

Some jurisdictions (Eg. Ontario) do not allow landlords to ban pets. More should do this. It would limit the explosion of feral and abandoned animals.

Finally vetcare is too expensive and we need subsidized public animal healthcare.

Another option would be to mandate pet insurance but I see a host of implementation problems with this.

Unfortunately there's still much lower hanging fruit to pick for those looking to subsidize animal welfare than pet healthcare

Farm animals far outnumber pets with far worse conditions:

https://animalcharityevaluators.org/donation-advice/why-farm...

the medical professions in general suffer under the cult of compassion, its not surprising that they have too much put on their shoulders. they're not being treated like people but are the parts of our societies that are forced to be the most compassionate to anyone else.

pet insurance man... get it... for $80 a month I have a $250 deductible, 90% reimbursement and unlimited annual coverage. Not to mention they cover EVERYTHING including hereditary conditions.

I hope I never have to use it. my buddy came home to his dog having his back legs paralyzed. No idea what happened. Did he jump off the bed or get hurt playing with the other dogs? Anyway, surgery was going to be 20K with a 90% chance of the dog walking again OR he can take steroids' and nerve medicine and hopefully regain the ability to walk within 10 weeks OR put the dog down. He couldn't afford the surgery so they went the medicine route. Luckily the dog can wiggle his toes right now at the 2 week mark, we will have to wait to see if he can walk.

Point being... if he had pet insurance the entire thing would have been $2250, a no brainer in my book so putting the dog down is off the table. At that point you just have to decide whether you want to do the operation or do a round of medicine. you have a lot better opinions.

Paying for insurance sucks... You pay every month and you might use it a couple of times in your life, but when you do need to use it, you are so glad that it is there.

Who do you use?

Pet's Best

https://www.petsbest.com/

"When I graduated in 2012, my personal student loan debt was at about $289,000. Despite a decade of payments, the total has increased because of interest, and right now it's at $460,000."

That alone is stressful, which in no way suggests other points being made here are unimportant.

I spent decades suicidal. After some health stuff improved, I'm mostly not anymore.

So I can't help but wonder if exposure to animal diseases might be a factor.

I wonder how different it is for vets who mostly deal with livestock or horses. The article briefly mentions sometimes having to slaughter a whole herd because of a disease outbreak, but I assume the clients are at least easier to deal with as they don’t treat the animals like pets (for horses I guess there’s a bit of a mix but at least people who treat horses as pets will probably have more money they are willing to spend).

(edits to fix grammar) Having been the son of a veterinarian, I'll provide my perspective:

* Veterinarians get into their career because of their love of animals and wanting to take care of them. Working with their owners can be a positive or negative.

* They are limited by what information they can get out of their patients. Example, A dog not wagging its tail could be due to it being scared or internal pain. Dogs instinctually hide pain and will usually cry when they are by themselves. Owners do their best sharing what they know and the vet has to balance what they see, with what they hear from owners, and their experience.

* Modern vet triage relies on medical testing, especially imaging tech. 30 years ago, the vet had simple blood tests, reviewed blood samples under a microscope, XRays on film. They now have access to move advanced lab work, MRIs, etc, digital XRays They have to pay for that equipment as well as their student loans. This equipment is made by the same companies as human medical gear. It's not cheap.

* There is little money in small animal clinics. Increasing the volume of clients improves the cost to client, however no one wants to go to a vet that is rushing them in and out. Like all things, some vets have started corporations to buy up small practices and scaling out.

* There is even less money in large animal care. Vets understand they are impacting the livelyhood of their clients. Many times they have to travel to the client, can be badly injured, and/or may be working on these animals with little help.

* There is more money in specialization, this in turn reduces general practitioners. The same principles in human medicine can apply to animal medicine.

* Vet practices are being controlled more and more by for-profit corporations. This brings some efficiencies but may or may not be passed to the owners. Most vets do not want to run a practice.

* Owners want the same healthcare outcomes for their pets as themselves. This can contradict with their ability to pay. Very few people consider how expensive that puppy or kitten will be towards the end of their life. Would requiring everyone to take a class and sign an 'expected lifetime' worksheet help with this? No, it wouldn't but it would be nice if owners better understood what they were getting into.

* Pets are considered property by the state. Owners think of them as family. They do not have the same rights as people. Vets and their staff have to deal with difference.

* It's not surprising some veterinarians utilize euthanasia solution when commiting suicide. Human doctors utilize whatever pain meds they have access to and would use euthanasia solution if given access to it. Making it harder for vets to use the solution would only get in the way of doing their job. There is room for improvement here (whether its consoling, changes in regulations, etc).

* Owners under stress are not enjoyable to work with. The vet staff didn't create the situation the owner is in and has to comfort both the owner and the animal. Some owners can be downright terrible. This was one of the reasons I didn't follow in my parents footsteps.

see also Lund, "Talkin' Veterinarian Blues", https://www.youtube.com/watch?v=JChwFoCxVC8

I was listening to an interview program several months ago about suicide in veterinarians and they spent quite a bit of time talking — not all of the time, or even most of the time, but more than I thought — about takeovers of vet clinics by private equity firms. Basically they were saying that older veterinarians will get an offer from a private equity firm, sell the practice to them, and then retire early, and the stress on the remaining practitioners would go up.

It seems like this pattern might not apply everywhere (or might), that the problems are broader than the US.

That can get annoying having people guilt trip you into saving their pet but not wanting to pay you the money.

I honestly think veterinarians should just be a luxury for richer people who want to spend extravagant amounts on healthcare for their pets.

If you’re a common person, and your pet gets some illness, then that’s it: you need to expect your pet’s death if they aren’t able to recover naturally or cheap treatments and pills don’t work.

Pet surgeries should not be some routine thing that should be expected to be affordable for everyone.

I know someone who spent close to $10k on her dogs cancer treatment, on top of being broke and in debt already. End result was as expected, the dog died anyway and she is now poorer. Worse, she ended up getting a new dog anyway to keep digging into a financial hole.

Pets man, they are worse than kids. Like toddlers that never grow up.

I have a pretty great life relative to the vast majority of Americans, I’ve been wildly fortunate in some key ways, and even one year of the same bullshit wage-fixing tech economy that like 80% of hackers have had coupled to some bereavement and other stuff that lots of people deal with (and not with the benefit of an expensive shrink like I have), which is still lightyears better than most Americans deal with always has me crystal clear that if I wasn’t sure this was going to improve (and by virtue of some of those blessings it’s all but guaranteed to) I’d kill myself today, it would be the rational move. Navy SEALs don’t demonstrate in training the kind of mental toughness that poor (meaning most) Americans demonstrate year-in-year-out.

Yeah lot vet suicides? How about among veterinarians, people in communities with a lot of fentanyl running around, people in communities with a lot of firearms lying around, people in the military, pretty much fucking anyone with the means who isn’t both of crazy rich and top-decile socially integrated in the scraps of community that haven’t yet been buried by social desertification (whatever your thoughts on the necessity of lockdown, there’s little dispute that it hit the “public space” about as hard as anything can).

We do a pretty good job of making suicide extremely risky, extremely painful, or both to prevent people doing it, which is probably a good thing depending on one’s exact ethics, but people like veterinarians create a natural experiment in whether that’s a mechanism preventing some avoidable tragedies here and there or a dam holding back the deluge.

You can debate the exact numbers and playing games with the stats is a huge industry so footnoting is just begging to have a nerd dick ruler thread, but whether it’s “what subset of the top quartile will ever, ever be financially secure by any definition” or “what subset of the two bottom quartiles will ever have sex” or “MTBF on watching some prick fail upwards in every conceivable field such that it’s happening right next to you and getting called capitalism”, or how long it’s been since some politician (or their kid, or their kid’s spouse) smoothly pivoted from some broad-daylight felony to barking about UFOs on C-Span: truckloads of suicide and mass shootings (~4/day FYI) is exactly what you would expect. The offensive lie that cheap consumer electronics dragging the averages all over the place means anyone “has it better” is icing on the cake. Yeah, a computer used to cost more than an airplane and now costs nothing. Yay.

5 years ago online dating (which is already a piss-poor substitute and regrettable necessity) kicked out a good enough match that I was engaged for a few years. Today (and I know how to do the science on the creatives) anyone who has ever seen a take-no-prisoners conversion funnel takes one look and says “top of funnel for OnlyFans, OF-style social, or some escort ad, got it”.

And this is all eminently fixable: merely enforcing the laws we already have on the books against big corporate cartels, politicians, and the donor class would get you like 60% of the way there. You’d need to like, mandate benefits for part-time workers and it would be 75%.

Suicide prevention is a noble cause right up to the point where it has effectively become the walls around a forced-labor camp.

> showed male veterinarians are twice as likely... than the general population to die by suicide

This may come as a bit cynical, but gender on its own has bigger correlation for suicide, than being veterinarian! 80% of suicide victims are males. That gives 3x higher rate over general population.

It would be nice, if all people who cry here over veterinarians, could give some sympathy to men as well!

Reminds me of a recent HN "article" where a daughter was writing in length about how her dad's suicide destroyed her life.

"Desperate man commits suicide, daughter most affected."

It took me too long to realize it said veterinarians and not veterans , the comments made no sense to me

> One of the most common criticisms veterinarians receive is that they're greedy. Doctors and staff are often asked to give discounts or waive fees, and owners can get upset when the answer is no.

Clearly, we need universal pet health care.

I know you're joking, but it wouldn't hurt to have a nationwide nonprofit pet insurance offering.

That'd be literally putting out fire of exorbitant vet costs with taxpayers money gasoline.

I never said 'government funded', just non profit

Sorry, I mistakenly implied government participation from "nationwide nonprofit".

Are the people who profess to be animal lovers eat meat? There's a certain hypocrisy in caring for pets and disregarding the animals we kill by the billions for our palates, and cruelly [1].

[1] https://www.theguardian.com/environment/2023/may/02/sufferin...

P.S. I am not disparaging the suffering of veterinarians.

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