Simba stopped chasing his squeaky toys. He wouldn’t run after the tennis ball or play our evening game of hide-and-seek.
These were the first signs that our nearly 14-year-old shih tzu-Yorkie mix’s health was failing. The decline came fast.
Late last year, during a routine checkup, the vet detected a heart murmur in Simba and recommended a cardiac ultrasound.
“How much will that cost?” I asked my husband, who had taken Simba to his appointment.
“Does it matter?” he said. “How much are you willing to spend to keep him alive?”
My husband said the scan and assessment could be about $1,000.
In an attempt to inject levity into a heartbreaking situation, I said, “Well, Simba’s had a wonderful life with us.”
“You’re joking, right?” my husband asked, genuinely concerned.
I love our 11-pound Shorkie, even when he tests my patience. We have an ongoing family bet about how long any new toy will last: His hunting instincts drive him to find and destroy its squeakiness. We constantly search for indestructible toys and once thought we had found one. It lasted a whole two days.
On walks by our neighborhood pond, we occasionally let him off his leash. This freedom rarely lasts long. He’ll bolt at any deer or squirrel he spots, and no amount of calling or scolding will stop the chase.
Despite my affection for Simba, I did debate internally how far we should go to extend his life — and at what cost. We opted not to purchase pet insurance years ago. The policies my husband and I reviewed didn’t cover wellness exams, vaccines or dental cleanings. They also wouldn’t cover preexisting conditions. For us, there were so many fine-print conditions and exclusions that we were concerned pet insurance wouldn’t pay off in the end.
Now, facing steep vet bills, I was worried about our little guy and our budget.
What if the specialist recommended an expensive heart surgery?
We have the savings for a big bill, but at almost 14, Simba is already at the average life expectancy for his small breed. I’ve gone back and forth about whether it’s cruel to take that into account.
Paying for an animal’s treatment is a difficult choice, made even harder when you’re making life-and-death decisions for a companion who can’t tell you what they want. Where do you draw the line between comfortable end-of-life care and costly medical interventions?
The decision to treat a pet is especially difficult for families already struggling financially. Higher prices for gas, groceries and utilities make it hard to justify spending their savings on their pet’s vet bills.
A 2025 poll by Gallup and PetSmart Charities of pet owners found that more than half of them — 52 percent — have declined recommended veterinary care or skipped a visit entirely, often citing financial concerns.
Lower-income households earning $60,000 or less struggle most with basic affordability, while higher earners are more likely to forgo treatments they don’t consider worth the cost. A third of pet owners earning $90,000 or more have skipped care because it was too expensive.
A second Gallup and PetSmart Charities poll of veterinariansreleased in early 2026 found that nearly all veterinarians — 94 percent — said their clients’ budgets sometimes or often prevent them from following through with recommended treatment.
Then there are owners who go into debt for their pets. In a 2024 LendingTree survey of nearly 2,000 Americans, 37 percent of pet owners reported doing this. In most cases, it was due to a medical emergency.
When a co-worker heard about Simba, she reached out with her own story about facing a health crisis affecting her 9-year-old rescue dog. The border collie-Great Pyrenees mix, Gracie, needed emergency abdominal surgery to remove a mass.
“Where do I draw the line both on what I’m willing to put her through to give her a chance and on what I can afford?” she asked.
Without knowing whether her pet insurance, which cost her about $1,600 annually, would reimburse her, she put the $10,000 bill on a credit card. Thankfully, her plan covered 80 percent of the surgery’s cost.
Years ago, I faced a similar choice with my first pet, Gizmo, a Yorkshire terrier and poodle mix. I adopted him from a pet rescue group just after I graduated from college, when he was about a year old. From the start, I knew he had a heart condition. The vet said that with surgery he could live a long life. As a young adult just starting my career, I didn’t have much in savings. As I recall, the surgery cost a few thousand dollars. I didn’t want to go into debt, so I worked out a no-interest payment plan with the vet. In the end, he lived to be 13 years old.
We took Simba to see the specialist late last year. A few months later, in April, he became lethargic and began coughing constantly. After several more visits and X-rays, his condition had worsened. He has chronic heart disease that has progressed to congestive heart failure. He’s now on a regimen of cardiac medications.
Some days Simba is like his healthier self, dropping his yellow tennis ball at my feet, ready to play fetch. Even then, he can only manage a round or two of the game. Other days, he’s listless and just wants to curl up at my feet.
My husband and I are fortunate to have a financial cushion that allows us to give Simba the best care possible. But we care about his comfort, too: We’ve agreed not to pursue extraordinary measures at the expense of his quality of life.
Here’s what I can say if you find yourself in the situation we are in now.
If you decide to pay for care with a credit card, make a plan to pay off that debt. Get help from a nonprofit credit counselor who can help you work the new expense into your budget. You can find a counselor through the National Foundation for Credit Counseling at nfcc.org or by calling 844-865-2828.
If you have a hard-stop spending limit for whatever reason, it doesn’t mean you love your pet any less than someone who is willing to take on significant debt. Choosing not to pursue aggressive, high-cost interventions for a pet can be a humane decision that prevents prolonged medical trauma and suffering.
If you have a healthy pet, start saving now before a crisis hits. You can self-insure or purchase a pet insurance policy, but be sure to shop around and read every plan’s fine print.
I’ve spent much of my career advising people to live within their means and avoid unmanageable debt. Yet I know how hard it is to focus only on the numbers when your pet is the one suffering. Watching Simba snooze contentedly in the sun, I know that keeping him comfortable is worth every dollar we’ve spent.
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