Claire Kirsch and her dog at home in Vassar, Mich. Brittany Greeson for The New York Times

The new pet care

By Katie Thomas

I’m an investigative reporter with a focus on the intersection of money and health care. I have a dog named Gerald.

Pets these days are just like us. They get birthday cakes, day care and rubber boots to wear in the snow. Their health care is becoming more human, too — for better and for worse.

Decades ago, animal care was relatively rudimentary. Veterinarians usually owned their own clinics, and the options to treat a sick or injured pet were limited. Today, animal hospitals are equipped with expensive magnetic resonance imaging machines, round-the-clock critical care units and teams of specialists in cancer, cardiology and neurology. For pets and the people who love them, the advances are welcome.

But as animals’ health care has changed to more closely resemble our own, it has also taken on some of the problems of the human system, including the biggest one: cost. The price of veterinary care has soared more than 60 percent over the past decade, outpacing inflation. Private equity firms have snapped up hundreds of independent clinics, in a trend reminiscent of corporate roll-ups of doctors’ offices. Veterinarians around the country told me that they worry this is changing the way that they practice, as they face growing pressure to push costly treatments and order more tests.

The changed landscape means that even as veterinarians can do more for dogs and cats than ever before, pet owners face sometimes heartbreaking decisions about whether they can afford the care. (Read more in our story on the topic.)

Changes in the industry

About one-quarter of primary care clinics and three-quarters of specialty clinics are owned by corporations, according to Brakke Consulting, which focuses on the animal health industry. Sometimes, the corporate ownership is not obvious: Many private equity firms do not change the name of the vet clinic when they take it over.

Most veterinarians are paid, at least in part, based on how much money they bring into a practice, whether that is by ordering tests, selling prescription dog food or performing procedures. One veterinarian said she quit her job after she was told her “cost per client” was too low; another said she was told she needed to see 21 animals a day, about a half-dozen more than her current workload.

Retired veterinarian David Roos and his dog, Chester. Mike Kai Chen for The New York Times

Other veterinarians said the pressure had no influence on the care they provided. In interviews, they said they bore the brunt of pet owners’ complaints, even when they have little to do with setting prices. Veterinarians make far less money than doctors for humans, and are also often in debt from years of education. Prices have gone up partly because of the rising cost of drugs, vaccines and other supplies, as well as worker salaries in a tight labor market.

One veterinarian I interviewed, Dr. Pam Nichols of South Jordan, Utah, has seen the transformation firsthand. When she was starting out in the 1990s, she said she used to sneak dachshunds into the human hospital where her father was a radiologist to give them M.R.I. scans. If the dog needed surgery, the bill would be about $2,000. Now, she said, a similar dog might get an M.R.I. and a CT scan, and will probably be operated on by a specialist who is assisted by several nurses. The cost could reach $10,000.

Tough choices for owners

Veterinary care differs from human health care in one big way: Most pet owners pay out of their own pocket — and in full — before leaving the vet’s office. While pet insurance is available, only a small percentage of pet owners have it.

A generation ago, pet owners with a seriously ill animal may have had little choice but to opt for euthanasia if they wanted to relieve their pet’s suffering. Now, they must choose between extending the animal’s life and going into what can be debilitating debt, or letting an animal die. I spoke to some pet owners who were still paying off credit card debt years after their animals had died. And animal welfare groups said owners frequently relinquished their pets to shelters because they couldn’t afford veterinary bills.

For many people, though, the sacrifices are worth it. That was the case for Claire Kirsch, who was earning less than $10 an hour as a veterinary technician in Georgia when her own dog, Roscoe, and her horse, Gambit, each had medical emergencies, resulting in bills that totaled more than $13,000. The animals would have died if she had not opted for the additional care. She took a higher-paying job, maxed out a credit card and tapped into her husband’s retirement account to pay off the debt.

“I knew I would never be able to forgive myself if we didn’t try,” she said.

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