A few months ago, I was sitting with a friend at a veterinary conference in Las Vegas. The first thing he said when he arrived was, “Do you know how much this costs?” He shook a Starbucks cup and a protein bar at me. “I do not,” I responded. “Well,” he explained, “today it costs $16.84, but yesterday it cost only $9.20.” It turns out my friend had purchased the same drink and protein bar from the same barista at the same shop and gotten two wildly different prices. When he asked, the barista confirmed the price difference.
“Yesterday was Sunday, so the prices were lower because that’s when the locals are at the casino,” she told him. “Today is Monday, and the only people coming in are businesspeople for conferences, so the prices are higher.”
I asked my friend how he felt about it. “As a coffee drinker, I’m furious,” he said. “As a capitalist, I love it.”
This, my friends, is where capitalism is today. We are at the point where prices change based on whether coffee shops think you have an expense account. Does anyone feel shame anymore for separating people from as much of their money as possible? If you can get more dollars from someone, should you always do it?
I shook my head. At the tables around us, private equity investors talked excitedly about the opportunities they saw in “the veterinary space.” I couldn’t help but feel a deep sense of unease about the challenges some of us will face in the future if we want veterinary care to be highly accessible. The path of commerce appears to be going in the opposite direction from the path of affordable care.
According to Veterinary Hospital Managers Association data, price increases in veterinary medicine have been the main driver of practice revenue growth since late 2022. At the same time, April 2025 data showed a consistent decline in patient visits and active patient counts. Our profession has also seen a significant increase in the average time between visits. The patterns don’t bode well for pets, as a population, getting needed medical care.
The Price of Doing What’s Right
A few days after the conference, I was back in the clinic. I was about to examine a patient, a senior cat with a history of significant weight loss and inappetence, when the technician stopped me. “Just so you know,” she said, “if they decide to put this cat to sleep, I don’t want to be involved.”
I was confused because I hadn’t set foot in the room yet and didn’t know euthanasia was being considered. Also, it seemed possible that humane euthanasia would be something everyone might ultimately agree was needed, given the presenting complaint.
“Why do you feel that way?” I responded.
“This cat just needs diagnostics,” she said. “I think we have to do them to see if it’s something we can treat.”
I wrestled with the technician’s words. I understand the feeling that we have a moral obligation to advocate for our patients, but at the same time, people sometimes don’t have the resources to extend a pet’s life. Thinking about my friend’s experience at Starbucks and the steadily increasing cost of veterinary care, I was certain that we, as veterinary professionals, will be caught more and more often between the rising cost of care and a deep desire to make sure pets get the best life possible.
As caregivers, how do we look pet owners in the eye and tell them they must do what is required to extend an animal’s life as we continually raise our prices? As I walked into the room, I had no idea.
Precious Bonds Must Be Extended, Right?
Later that night, as I cooked dinner at home, my thoughts shifted back and forth between the cat that needed diagnostics and an issue I struggle with personally. My oldest daughter is a high school junior, and we had spent the previous week touring colleges. I am unsure how I will handle having one less person at the dinner table.
I’ve always known my children will leave home, but that realization feels theoretical at this point. My kids will move out, I’ll lose the ability to drive myself safely, and the sun will expand to consume the Earth. You know those things will happen, but not soon.
Seeing a college tour guide who looked like a child show my daughter a dorm room made everything about her leaving home feel incredibly real. Also, somewhere along the way, my daughter casually mentioned that next Christmas will probably be the last one with us while she is living at home.
Suddenly, I was reeling. The only reason I got a Facebook account was to share pictures of my baby girl. I took cooking classes just to have something to do with her. I spent an entire year of evenings riding shotgun so she could practice driving and be safe enough to transport herself and her sister. I am the person she comes and talks to when she feels overwhelmed or doesn’t know what else to do. She is a presence in my home and life. I can’t imagine her not being there. How can she move away?
My heart desperately wants to pause the flow of time because I can’t stand for this chapter of my life to end. Unfortunately, it’s going to. The pain of a concluded chapter is one of the unavoidable realities of life, and battling it only worsens our suffering.
As I made toast for my daughter — she refuses to eat rice — I realized how my struggles in the clinic and at home are related. Just as our time raising children will pass, so will our time with pets. Sad endings are inevitable and painful, but to consider the transitions as “bad” is to misunderstand the essence of life itself. The problem is that we, as humans, are not good at letting go.
Not Good at Goodbyes
I like to imagine life as a river, and we’re all being swept down the rapids. As we careen along the waterway, we have an innate desire to build ourselves a raft. We grab onto careers, locations, possessions and other people in an attempt to keep them with us and create security, stability and a sense of control in our lives.
Again and again, we build our rafts, only to have them torn apart by life’s rapids. Every time the river destroys our raft, we experience the inevitable loss, change and disappointment that comes from being alive in a world defined by impermanence.
No one wants their raft to fall apart. We want certainty in our lives. We want to find and create good things and hold onto them until someone eventually pulls us out of the river. Unfortunately, my daughter is about to be separated from my raft. My wife and I will cling to each other and our youngest child and watch our oldest daughter drift off on her own raft.
The experience won’t be pleasant, but it needs to happen. In time, I will think much more about how wonderful our time living together was and much less about the sadness of my daughter’s departure. I will accept it as the way of the world and find new things to drag onto my raft. Those people, places and things will never replace what it was like to have my daughter in the kitchen every evening, but they will be wonderful in their own way.
All this is important because we, as veterinary professionals, need to believe that losing a raft is painful but not bad. In veterinary medicine, rafts always come apart because pet lives are undeniably short. Beloved companions departing our world much sooner than their owners wish is the natural way of life. The good news is that an endless number of pets will enter the river, and they all deserve a wonderful raft to call home. That is what we must focus on.
How Do We Fulfill Our Moral Obligations When Resources Are Limited?
When we look at pets, we must understand that our purpose isn’t to hold our clients’ rafts together at all costs. Our purpose is to make the time the raft exists as good as it can be for the pet and the person. We can educate clients about their options without making them feel ashamed. We can advocate for veterinary care that will provide pets with the best possible quality of life. We cannot, however, feel like failures when pet owners cannot or choose not to pursue medical intervention.
Here is an important idea to hold onto as we discuss accessible veterinary care: We can’t create resources when none exist. If clients don’t have the means to pursue treatment and we do not have the means to make that treatment happen, we cannot perceive the situation as a moral failure. As prices rise and advanced care options become unreachable for some clients, we must do what we can to support them while accepting that palliative care and humane euthanasia are not immoral options.
I know my attitude feels disappointing, but if we expect veterinary professionals to be ethically responsible for extending lives as long as humanly possible, we will live in a moral crisis. The ways we can extend life and the cost of those therapies are rapidly increasing, while our clients’ ability and willingness to pay for veterinary care seem to have plateaued.
Doing What We Can And Feeling OK About It
Back in the exam room, I examined the cat that was losing weight. I had no idea what was making him so ill other than constipation. The owners could afford blood work but said they couldn’t pay for anything more. When the results came back, my heart sank. The blood work looked normal. I went back and told the owners.
Ultimately, we decided to try a few things. We whipped up a warm water enema, talked about home nutrition and started empiric treatment. I had no idea if any of it would work. The owners said the next step would be euthanasia if the cat’s health didn’t improve.
It all makes me sad, but I don’t think the approach to the cat’s care was wrong or even “bad.” The cat has had a good life, which won’t change if his time with us ends in the coming days. We, as veterinary professionals, must believe that.
Prices will continue to rise, and pets will continue to get sick. We must focus on providing the best life possible for patients rather than the longest life. We must remember that good things in life come to an end. While the end is sad, it has to happen. A good pet life is one full of love from beginning to end. It has little to do with how long the ride on the raft is.
DID YOU KNOW?
The American Society for the Prevention of Cruelty to Animals operates the RAFT program, also known as the Regional Advocacy Field Team. Volunteers join grassroots efforts to pass animal protection laws. Learn more at bit.ly/4lE6LWm.
BE A BETTER LEADER
Dr. Andy Roark has partnered with VetFolio to release the Uncharted Leadership Essentials Certificate. The program provides training appropriate for anyone who leads or manages others. The topics covered include setting a team’s vision and values, building trust, achieving team buy-in, delivering feedback, understanding communication styles, setting priorities, delegating effectively and managing time. Learn more at bit.ly/Uncharted-VetFolio.