November 20, 2016

The cost of treating Piri's cancer

Our cancer treatment journey with Piri was a heck of an expensive one.

During our consultation session with our oncologist, she let us know that cost is usually the deciding factor for many families. But she let us know that whether we pursue an all out treatment plan or not, we ultimately knew what was best for Piri. And I feel that this is true for all pet owners. That whether we pursue a multifaceted treatment plan or one that is completely holistic based or one that focuses on keeping the pet comfortable without pursuing any type of treatment, we make these decisions knowing what is best for our animal companions and for us. And in the end, the fact that our pets were so loved carries us through to the last remaining days. 

While our treatment costs were high, we only have about three months left in paying off Piri's vet bills. This is only possible because throughout the year, every month, we didn't let the our vet bill pool grow bigger, and instead we used any extra income we had coming in to pay off our debt. We kept our personal expenses low, we didn't eat out or go out at all (no happy hour, movies, shopping sprees, keeping our grocery bills to $100 or lower per week and cooking all our meals, etc) and while we did treat ourselves here and there (because our well being, happiness and keeping stress levels down was also important), we made use of sales and discounts to keep overall expenses down. 

Sometimes we took on more hours at work during some months - Yangkyu sometimes working well into the night and into the weekend and me taking in more guest dogs where I could, without compromising Piri's care. There were many stressful and long days and nights but ultimately we made it work. I think I can look back now and feel somewhat proud of the fact that we were able to make it work, but I can say that it wasn't a walk in the park either. That it took a lot of patience, sacrifices, controlling stress and believing in each other and really having love carry us forward (I know, it sounds so cheesy!). We were also privileged in a sense where we both had jobs that gave us leeway to pay off vet bills in the thousands. It was stressful, but it wasn't impossible. I think we can say that it can be possible for all families and individuals, but not everyone has the luxury or the privilege, which we must acknowledge and be aware of. 

We also had pet insurance, which helped somewhat. Although, some may disagree. And I know this is going against everything I wrote in this scathing piece about pet insurance. 

At the time, we were denied continuous coverage from our pet insurance for Piri's kidney disease because after a year, it was considered a pre-existing condition. If we had enrolled Piri in something called Continuing Care by the time he was 8, we might have been able to lift that pre-existing condition. But we didn't enroll Piri in insurance until he was 10, which would've made the Continuing Care option too late for us anyway. Fundamentally though, this health insurance operated by the ASPCA did not make sense to me because it would ultimately exclude pets adopted when they were past the age of 8, rendering the insurance useless should they need continuing care well into their golden years (I mean how do you encourage senior pet adoption when you can't come up with more accessible services that help senior pet care when they are ill?).

But the reason we got pet insurance in the first place was that it was an investment for us should there ever come a time when Piri would need unexpected surgery or treatment if he was ill. To be honest, I wasn't expecting anything like cancer or kidney disease. But I figured there might be something in the future. And I was scared that vet bills would be through the roof. And insurance did help. Throughout the years, we were able to claim and get back a portion of the bill (up to 80% with ASPCA insurance). When we first started pet insurance we paid $35 a month (it's more expensive for senior dogs). The fee steadily rose throughout the years and most recently we were paying $70 a month. 

However, after the incident with Piri's kidney disease, we contemplated on whether we should cancel. Other people suggested how they save a little every month so they can have an emergency fund in case their dogs needed to go to the vet. This is a very good and smart thing to do, but when your dog's vet bills range in the thousands and when the sickness is so bad that he goes in every other week, unless your fund already has thousands and thousands of dollars saved (because you started when your dog was a puppy or you are able to put in a lot every month), it wouldn't be all that helpful.

The thing that I found most helpful about pet insurance during this time was that even though his illnesses were eventually considered pre-existing after a year and it doesn't cover holistic care (ours didn't, but other insurance companies might), was that it covered emergency room visits and all the new illnesses that arose from kidney disease and cancer. 

Guys, I could sound incredibly naive, but I did not expect Piri to get of a host of other illnesses that arose from his current medical issues, all of which were new and eligible to be covered under his insurance. Things like urinary tract infection, pancreatitis and pneumonia, which eventually took his life. 

Here are some numbers.

Total cost for Piri's cancer treatment journey, which includes a visit with the cardiologist to see if he can be a candidate to go under surgery to remove his lump (in January), the actual surgery to remove the suspicious lump and three teeth (in March), his second lump removal surgery (in August), two biopsies, two fine needle aspirates, numerous oncology visits, chemo refills, vaccine shots, medication refills and holistic treatments came to a total of $13,936.42* (from January to October 2016). Of the $13,936.42, insurance was able to pay for $3,217.86. We also received unsolicited financial assistance from a couple of our friends and also a super generous DogVacay client totaling $550. Our overall out of pocket treatment cost for Piri was $10,168.56. And as I mentioned before, we have about 3 more months to pay everything off. 

Further breakdown is as follows: 

Just oncology visits alone was $7,067.74 (this includes medications, vaccine shots, etc.).
Palladia (his checmo) at 10mg was $74.40 (tablets which covers 2 weeks of treatement)
Melanoma vaccine shot was $661.73 per shot (Piri received the four initial shots and died before the 6 month boosters were due)
Oncology recheck visits were $115 per visit 
There were also other blood panels that needed to be done, oral exams to check regrowth, fine needle aspirates, sedation costs, etc. Because when you go through chemo and decide to get the melanoma vaccine, you don't go in for oncology visits to just get those treatments. It means you have to get regular blood panels and other tests done to see if your pet's organs are functioning properly to continue with treatment. 

While being treated for cancer, Piri was rushed to the ER twice for urinary tract infection and pneumonia. The total to treat illnesses that arose out of his cancer (whether it was directly related or because his body was too weak to fight them off) was $3,275.56. Insurance covered $1,911.33.

Piri's end of life cost was $315. Insurance covered $211.26.

Total hospital bills for Piri's cancer and new illnesses that occurred after his cancer diagnosis and end of life costs was $17,526.98. Of this, insurance coverage was $5,340.45. Our overall out of pocket payment was $11,636.53 (this total includes the $550 we received from friends). This doesn't reflect his ongoing treatment for kidney disease (Enacard - $13.20 for 30 tablets - for his blood pressure related to his kidney disease and also sub-q fluids, which he got every other day. Needles, two bags and two lines cost $125.34. 1 bag and 1 line was good for three sub-q fluid sessions). 

Some people may still look at the numbers and say that pet insurance isn't really worth it. For us, ultimately in the end, it was. Any type of financial support for us was helpful.

If we were to take away anything from our experience it's this: 

1. Choose a good pet health insurance plan and really know what they are offering. I think I read somewhere that only 2% of American pet owners have pet insurance. The lowest compared to other countries (it was on a Trupanion pet insurance pamphlet, I believe). I thought that was staggeringly low. I am not in any way advocating for pet insurance in this post, but when we look at the full picture, we think it was more helpful than not (including the fact that it helped pay for 1 year's worth of kidney disease treatment). The thing is, we knew why we wanted pet insurance, but didn't fully understand what we were signing up for. There are very good pet insurance companies out there and if you do your research and ask pointed questions (what is actually covered, will illnesses that arise in the future be considered pre-existing once the plan renews after one year, etc.) you can find one that will benefit your pet immensely.

2. If insurance still isn't something for you, then create a fund where you save every month for an unexpected illness or surgery (not a regular visit or a low grade treatment). Sometimes it's really hard to figure out how you can breakdown your salary even further to find ways to save monthly for your pet (trust me - there was a point in my young life when I was making $24,000, $26,000, $28,000 working as a community organizer and then $30,000 a year and with rent in Queens, NY, paying into my insurance, taxes, basic living expenses, there wasn't much left to do anything else), but if you can, you won't regret it. 

3. Ask for help. For us, we had several people who were willing to help pay for Piri's medical bills. We never started a gofundme or indigogo page because as I said before, while it was stressful, it wasn't impossible for us. I didn't want money that could potential help another dog go towards something we would be able to manage. But I can tell you that I have contributed to other people's call for help in paying for their pet's medical bills even while I was going through paying for Piri's medical bills (going through it myself, I understand their struggle and I want to help any way I can. I know that any amount truly goes a long way). There are many people out there willing to help if you ask. But please pay it forward, when you are able to, to another person who may be in need of some financial support.

4. Research other options like programs and funds for families to help pay for vet costs and life saving treatments. 

5. Take care of your dog. I said this in my last post but there are a lot of things I would do differently with Piri if I had known what I know now with his food, supplements, maintaining better teeth and gums, not over vaccinating and using harsh chemicals to prevent ticks and fleas, etc. And perhaps even if I did everything "right", he would've still ended up with cancer. But it would leave out a lot of what ifs. We are so in tune with healthy living and eating for ourselves and there is no reason why it shouldn't extend to our pets as well. Ultimately, we can avoid a lot of trips to the vet if we pay attention to overall health and well being by changing how they eat and keeping up a healthy daily life style.

I am not sure if this post was at all helpful. I am not sure if I was trying to show you how costly treatment is or different ways you can pay for treatments. In the end, it is perhaps more just our personal story and take aways from it. 

November is almost over. Thanksgiving cannot be this week already, but it is. I still hope to get a few more posts in regarding Piri's cancer journey and it may well flow into the month of December. 

I hope you'll continue to stick around and read them. 

Thank you.

*We were denied coverage for Piri's cardiology visit because they claimed that it was pre-existing according to previous notes from our primary vet where she suspected Piri was having a mild heart murmur (we fought this and said that he was never officially diagnosed util we saw a cardiologist but it was not enough). Also, because the oncology visits were so expensive, we had already reach the limit of coverage by May and were no longer qualified for future claims within the same insurance period. I feel we could've been covered for more but such limitations prevented it. 

November is Pet Cancer Awareness month. I decided to write a few posts throughout the month of November to share Piri's cancer journey. Thank you for following along. 


  1. Thank you Jane for sharing.

    If not already written in your old posts, can you please share with us about the food experiece & what you would have done differently?

    I also believe that food is one of the major factors contibuting to our dogs' health. Although our dogs considering living a long life (my Tango left me at 16) but they were sufferring from those illness that may be a result of what they ate. (Mine got pancreatitis, & spleen tumor)

    By the way, I hope you feeling more comfortable each day. Take care

    Tik & Tango ❤️

  2. Jane, those of us who are able to say yes to these expenses are lucky. I understand your financial struggles well as 2 years ago my service dog Boomer was struck by a truck and his medical costs in the course of 3 months cost us a bit over 14k. That doesn't include his injections of medication for his hips he needs weekly, ongoing physical therapy, water therapy, heat therapy, massage therapy, and Laser therapy, or his anti-inflammatory/pain meds. We use embrace insurance and are lucky that beyond our chosen deductible we received a reimbursement of 90% of our illness coats. We will never again have any of our animals uninsured. I'm glad that you and kyu were willing and able to make whatever he needed happen for your Piri. You are such a sweet family and remind me so much of my fiance and myself with our dogs. Love, the @boomerlovin family

  3. Rule number two is so incredibly important and it's always a good reminder for people. The animal is dependent on you and trusting that you'll make the best decisions for its well-being

  4. Oh yes! Vet bills definitely add up! I don't think people consider that enough before getting a pet! Besides just regular vet visits/meds add up over the year... and his is most recent eye/cancer lump removal plus meds and the oncologist visits, we're just over $2000! Then throw in car issues, literally the worst timing ever! Our savings account dwindled fast! We always try to put a little money aside for Bosco but with 1 main income, it's tough sometimes. I never thought of pet insurance when he was younger, but now I wish we would have had it... definitely something to consider if we ever got another pup!

  5. I think you highlight really important points about pet care. I didn't even think of doing more holistic flea/tick control, although unfortunately at the moment there is only one option for ticks, here in Australia :( About 6 months ago we also started a fund for our cats which we aptly named the "kitty". We also have them started on a dental biscuits and their teeth got great reviews last check up from the vet, I'll have to ask next time about gum maintenance though! So many things to think of as a pet owner but I think you have to try your best because little lives are dependent on you and they bring so much joy.


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