"Thirteen!"

"Lily is no longer available."

"Fifteen!"

"Jenny is no longer available." My second choice, gone.

"Eighteen!"

Eighteen was the number handed to me by the employee managing the waitlist at the door. I freeze, my heart starts racing, I can feel my armpits start to sweat. This is it. I raise my hand to get the attention of the shelter employee, she waves me over and leads me to an overflow room that had been set up for meeting the puppies. I stand there for what feels like an eternity until the employee returns carrying a 10-week old ball of fluff in her arms. It's Jeno, she's still available, and if I would like to adopt her she's mine...

I didn't grow up thinking that my relationship to animals would define so much of my personal and professional life. My career in the veterinary software services industry began in 2013, when I started working for a startup called Vet's First Choice. We were building an e-commerce platform to modernize the process of prescribing and shipping medications and special diet pet foods to pet owners. The company was founded by Benjamin Shaw; his father David Shaw founded what is now one of the largest veterinary diagnostics companies in the world (and my current employer), IDEXX Laboratories, in 1983. There were many Vet's First Choice employees that had previously worked at IDEXX. It was a small world, and it was focused on pets and pet parents. Everyone I worked with had pets; dogs, cats, horses (but we're not supposed to call them pets), hamsters, lizards, snakes, even a hedgehog.

It had been a decade since I lived in a household with dogs. Most of the apartments I lived in didn't allow pets of any kind or did not allow dogs specifically (I never really was a cat person). So I got my fix at the office, we had Office Dogs. It is just what it sounds like. Any day of the week, you can bring your dog into the office and they have the run of the place. Paris and Apollo became some of my favorite four legged colleagues. Paris was a ten year old Yellow Lab that must've been crossbred with a garbage disposal. She had the figure of an overstuffed ottoman, and her appetite was insatiable. Apollo was a three year old Black Lab mix with the sweetest face, and he was a shameless beggar. He would show up at your desk promptly at lunch time, pout his lips, and let out the most pitiful whimper. This would continue until he got your attention and a little taste of whatever it was that you were eating. As much as I loved seeing the Office Dogs every day and getting to know their quirks, I knew they would go home with their owners at the end of the day, and I would go home to an empty apartment.

Two years later at age 28, I finally found myself financially stable enough and living somewhere that allowed dogs. It was a one-bedroom apartment on Washington Avenue in Portland's East End. I had been checking the adoption websites diligently for months at this point. Seeing dogs and puppies of all ages get listed with a "Ready for Adoption" status and almost immediately their status changing to "Adopted". They were already on their way to forever homes. I was hesitating, taking too long to decide if I was ready. Adopting a dog is a major decision, to put a finer point on it, it's a major financial decision. You're committing to caring for an animal for the rest of its life, at least a decade and probably more (Montoya et al.). Can I really afford to own a dog? I had 6 months of my own living expenses covered by savings. I didn't really know what 6 months of dog expenses would be. There's food, grooming, routine veterinary care, but what about an emergency trip to the vet?

I decided to throw caution to the wind when a litter of 8 puppies was listed on the Greater Androscoggin Humane Society adoption page. They were all given “J” names. Jeno and Jenny were two of the most adorable dogs I had ever seen. They took after their mother, a petite Lab mix with a short blonde coat and what appeared to be the ears of a beagle.

On March 20, 2015 I drove from Portland to Lewiston. At around 10:00am I arrived in the parking lot outside the Humane Society and strangely there wasn't a line at the door. The rule was the line could begin forming as early as 8:00am, but the doors would not open until 11:00am. Adoptions were handled on a first come first served basis, so your place in line mattered a lot if you had a particular puppy preference. Overnight lows had dipped into the single digits, it was unseasonably cold, and I thought maybe that was keeping people at home. In reality, I had grossly underestimated the popularity of the litters available that day. I walked up to the front door to take my place at the head of the line with the kind of confidence that only ignorance can give you.

Eighteen was the number I was handed by the employee managing the waitlist at the door after giving her my name and my first and second choice puppies' names. The woman at the door put my name on the list and handed me a number. There were seventeen other people on the list ahead of me and twenty-four puppies total available for adoption that day. There were twenty-four puppies total available that day. I started to do the mental math, seventeen people ahead of me, eight puppies from the "J" litter, 100% of them are adorable, only a fool would pass one of them up. There is zero chance I will be taking either of them home. Why stand here in the freezing cold if I won't even get a chance to meet either of them? I had a choice to make, stand here for however long it takes to see this process through or tuck tail and return home wondering what might have been. Did I want to be the kind of person that embraces the uncertainty of life and all its joys, or someone that runs from it? So I stayed. For the hope that I would get to experience the joy of raising a dog and for the hope that I could provide her with what she needed to live a full and healthy life. After an hour of watching the line at the door get shorter and shorter in front of me, I was finally able to took my first steps inside the building. The scene was organized chaos. Numbers, names, and availability being called out over the dull roar of conversations between family members deciding if they've found the one.

"Eighteen!"

Holding that little puppy for the first time triggered a flood of emotions that I didn't quite know how to process. She had the sweetest face, the most expressive eyebrows, and this long looping curl of a tail. I was infatuated, she was the most perfect dog I had ever seen. That puppy breath was just, ugh, *chef’'s kiss*. I did not even want to think about somebody else taking her home. I would take a bullet for this little dog. They will pry her from my cold dead hands. Then the anxiety starteds to take over. I had grown up with dogs all my life, but this one would be my sole responsibility.

"What do I feed her?"

"How do I train her?"

"Will she get along with other dogs?"

"Will I be a good pet parent?"

"What if something happens to her?"

"What am I going to do when she's gone?"

Those last two questions are the ones that most pet parents, myself included, never stop asking themselves. As quickly as we develop a deep and loving bond with our animals, we begin to wrestle with the anxiety of how to care for them and provide them with the best chances of living a long and healthy life.

"Financial Fragility" was used as a metric in a 2020 study of pet owners to measure the confidence level of pet owners being able to cover an unexpected $2,000 expense. What this study shows is that while access to care is not a problem, unexpected cost is. Across all income levels, only 46.4% of pet owners responded as being "Very Confident" in covering that unexpected cost. It's not until you reach an annual income level of $85,000 or higher do you see a majority of pet owners saying they are "Very Confident" in being able to cover that expense (King et al.).

What I would come to know later is that Dulcinea, formerly known as Jeno, had been passed over by two other families ahead of me that day. She was not the model of health at 10 weeks of age. She was born with a heart murmur. The heart murmur I was told would prevent her adoption from being finalized until she was cleared by a veterinarian. She had an upper respiratory tract infection that would need a course of antibiotics, and she would need to stay at the shelter until it was complete. While I was driving back to Lewiston to pick her up after she finished her antibiotics, I received a phone call from the shelter. Some of the puppies in another litter had shown symptoms of parvovirus, and she would need to be held in quarantine for an additional 10 days. It was turning into quite the process.

It started to make sense as to why those other families might have decided to pass on a puppy that was not in perfect health. It could have meant a financial burden that they were not fully prepared to, or fully confident they could, handle. A 2018 study looked at barriers to accessing veterinary care, cost was the largest and most consistently cited factor in not seeking or receiving care. That trend is consistent across preventative, sick, and emergency care (AVCC). So it raises the question, is the trick to helping your pet live a longer and healthier life just a matter of spending more money? Regrettably, I believe the answer is yes.

Let's look at a very specific example. Gastric dilatation-volvulus (GDV) is a condition that combines sudden onset, high treatment cost, and two very distinct outcomes. It can affect any breed of dog, but occurs most commonly in large and giant breeds of dogs. Some breeds are at much higher risk of developing the condition like Great Danes, but other factors like chest shape, diet, and family history can increase the risk regardless of breed (Piras). GDV "results in rapid distension of the stomach causing compression of the major abdominal blood vessels, impeding the return of venous blood to the heart, compromising cardiac output and leading to circulatory shock" (Boller, Manuel, et al.). A study on GDV survivability was done at an emergency clinic in Australia. The study focused on non-referral cases, as they were testing the impact of pet health insurance on euthanasia rates, and referral cases would have likely already been informed of the cost of the treatment (Boller, Manuel, et al.). The two very distinct outcomes I mentioned earlier? Those would be life or death.

The outcomes for patients without health insurance were not good. Just 53% of the uninsured dogs that presented with GDV survived to hospital discharge. Compared that to 80% of insured dogs surviving to hospital discharge. The euthanasia rate for uninsured dogs was 37% and just 10% for insured dogs. In the simplest terms, lack of insurance meant a dog was 7 times more likely to be euthanized prior to surgery (Boller, Manuel, et al.). That's pretty shocking, and underscores just how much influence money has on whether an animal lives or dies.

How many dogs might this condition actually affect? Let’s look at one of the breeds that has a rate of incidence available. The Labrador Retriever ranked number one in AKC registrations from 1991-2022 (Reisen). A total of 137,867 were registered in 2005, one of the last years the AKC published counts alongside rankings. A conservative estimate of the total population over ten years would be roughly 1.37 million AKC registered Labrador Retrievers (137,867 x 10). A 1994 study of GDV in dogs found that the incidence rate of GDV for Labrador Retrievers in the ideal weight range was 1.2% over a 10 year period. If 1.2% are affected by this condition, that’s 16,500 per decade, or 1,650 Labs per year on average. That is also likely undercounting the total population since it doesn’t account for growth. In 2005 labs accounted for 15% of all registrations (AKC). A 2025 report estimates that 2,165,181 puppies are born in both licensed and unlicensed breeding facilities annually (“Puppy Mills: Facts and Figures”). If we assume that 15% of those were Labs, the estimate would be closer to 3,800 today.

I'm happy to report that Dulcinea has lived a long and mostly healthy life, she grew out of her heart murmur by 14 weeks. She recovered from her respiratory infection without any long term consequences. But she has had her fair share of emergency vet visits over the last 10 years. She has a fondness for bees, but she is allergic to them, and so eating them is not recommended. That has resulted in at least 3 emergency trips to the vet for intravenous Benadryl and steroids. The first time she went to an actual emergency vet, which cost around $500. The second time out of an abundance of caution we went to the emergency vet again, another $500. The third time our regular vet just said to bring her in to see them, and saved us about $200. She loves the outdoors, but the years of hiking and zoomies had taken their toll on her knees.

In June of 2023, she tore her left CCL (similar to human ACL), so we headed to the emergency vet. CCL tears are very common injuries with a 2009 estimate by the Journal of the American Veterinary Medical Association estimating that about one million CCL surgeries are performed per year (AP). The cost for surgical repair? $7,000. The alternative would have been that she would never regain full use of that leg. Additional cartilage damage and scar tissue would accumulate over time, further reducing her mobility. She would not be able to hike or zoom again. After consulting with her longtime veterinarian, as a professional and then as a friend, I went ahead and scheduled the surgery.

In September of 2023 after 8 weeks of recovery and clearance to return to normal activity, she tore her right CCL zooming around the yard. Another $7,000 and another 8 weeks of recovery. $14,000 worth of surgeries in just 4 months. Even as someone who works in the veterinary industry, has had animals all his life, and loved Dulcinea to death, I would be lying if I said the thought of euthanasia hadn't crossed my mind for a millisecond or two. But that was never really a serious thought because Dulcinea has had pet insurance since she was 10 months old. The decision never was a financial one, it was about maximizing her quality of life. The 20% co-insurance meant my final out of pocket cost was just $3,000. Totaling up the monthly premiums paid over 8 years, the insurance had more than paid for itself. The average monthly premium over the first 8 years of her life was $55/month, $5,280 in total. Even if those two surgeries were the only claims I ever made under that policy, my net savings would be $5,720 in out of pocket costs.

Owner-reported financial limitations are commonly observed in emergency veterinary clinics (McCobb, Emily, et al.). While some clinics have the ability to adjust prices or offer reduced cost services, many do not (McCobb, Emily, et al.). What makes matters worse is that many emergency veterinarians observe patients coming into their emergency clinics for treatment for issues that could have been prevented or more cost effectively addressed with regular visits to a non-emergency clinic (McCobb, Emily, et al.).

Is this an advertisement paid for by Big Pet Health Insurance? No. Is this a cautionary tale about the true cost of dog ownership and how to ensure your dog gets the most out of the years they're by your side? Emphatically, yes.

An ounce of prevention is worth a pound of cure, and staying on top of routine preventative care can keep your dog out of the emergency clinic. Seek out programs and resources in your community if you are having difficulty paying for regular care or vaccinations. Local shelters host spay/neuter, vaccination, and basic wellness clinics year round. The Greater Androscoggin Humane Society in Lewiston hosts reduced cost wellness clinics every month January through November, it’s an affordable way to get caught up on vaccines and get a free basic wellness exam (https://gahumane.org/what-we-do/community-outreach/). The Animal Refuge League of Greater Portland also hosts reduced fee spay/neuter clinics for students, individuals receiving public assistance, and low-income households (https://arlgp.org/resources/animal-health-and-wellness/). The Maine Animal Health Alliance (with the unfortunate initialism MAHA), offers reduced fee spay and neuter services as well as non-urgent illness and wellness care to the general public (https://maineanimalhealth.org/). If you’re in a financial position to do so, consider donating to groups like The Maine Animal Health Alliance, they are a registered 501(c)(3) non-profit organization and donations are tax deductible. Finally, if you are thinking about getting a puppy, get a quote for a pet health insurance policy. It is the cheapest when you enroll them as a puppy, and while it may not cover everything, it can certainly take the sting (hah) out of emergency vet visits.

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Boller, Manuel, et al. "The Effect of Pet Insurance on Presurgical Euthanasia of Dogs With Gastric Dilatation-Volvulus: A Novel Approach to Quantifying Economic Euthanasia in Veterinary Emergency Medicine" Frontiers in Veterinary Science, 2020, https://doi.org/10.3389/fvets.2020.590615

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