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About once a week, I whip out a special device that plenty of veterinarians resort to — the sliding scale. When pet owners can’t afford veterinary care, sometimes there’s no fancy medical tool that can resurrect a savable pet like a good, old-fashioned freebie.

Although most pet owners have, at one point or another, found themselves in the unenviable position of having to scrimp, scrounge, beg and borrow to pay for their pets’ medical care, some of us have had to forgo treatment entirely or euthanize a pet because we couldn’t afford life-saving treatment.

Truth is, which pets get the necessary care and which don’t is kind of random when it comes down to it. Some pets get great care by virtue of their parents’ outsized pocketbooks, while others suffer second-rate medicine because their owners can’t afford better.

And the least moneyed of all? If they’re fortunate, these pets get granted the luxury of the long sleep, instead of a bitter end rife with pain and distress. Yes, euthanasia can sometimes be the best medicine — even in cases when treatment is affordable but not necessarily recommended.

When Free Vet Care Comes Into Play

I’m here to tell you that it’s not all doom and gloom in some no-cash cases. You may not hear of these situations often, but sometimes veterinarians will choose to treat their patients anyway — for little to no money down.

It happens about once a week per doctor (there are three of us) where I work. In other places, it happens daily, maybe monthly — or perhaps vets will offer a really big gift every few months to one needy patient. For example, the specialty hospital across the street from my practice has come through for me with expensive heart surgery and in serious trauma cases on more than one occasion.

The desire to do good, however, is often offset by the nagging feeling that we can’t offer the same gift to all of the patients who might benefit from our goodwill. In fact, our charity work often seems so random as to induce serious guilt when we give here but decline there.

But that’s life, isn’t it? It’s not always fair. And nowhere does this seem truer than when it comes to deciding who gets free care and who doesn’t.

Nevertheless, there are some soft rules most veterinarians will observe when choosing whom to gift or help out with discount services:

Is this a life-and-death case? If we’re pretty darn sure that we can save a patient’s life by offering a procedure, we’ll be sure to keep a deeply discounted fee in mind.

How treatable is the condition? If it’s a highly treatable situation — for example, a crushed leg amenable to amputation — then we’re way more likely to go for it than, say, if it's cancer, which rarely gets treated for free due to its relatively low long-term treatability.

Are there alternatives to treatment? If there are cheaper options, these are always investigated first. If home care is possible for the condition, we’ll seldom offer to spend our own resources.

How much pain is involved? If this is a condition that will yield chronic pain, we’ll shy away from definitive treatment on our own dime. It’s a personal philosophy thing.

How expensive or specialized is the treatment? If this is going to cost us a lot of money to fix or we need to rely on specialists to help make it happen, we’ll tend to forgo financing the treatment, so we can save up for more readily fixable cases.

Is a long convalescence, with lots of client compliance, part of the process? If a lengthy, potentially tricky recovery is required, most veterinarians may think twice about investing too much of themselves. If we can’t control what happens after a patient leaves our care, we don’t want to be held responsible for a lifetime of continued treatment should a pet owner be incapable of or unwilling to provide the necessary follow-up care.

How long will the animal need to remain in our care? Most vet hospitals have limited room, so this is definitely a factor.

How healthy is the patient to begin with? If we’re talking about a diabetic dog with severe arthritis, spending money to fix a new condition just doesn’t seem rational compared to an otherwise healthy animal who just needs one simple fix.

How old is the patient? Young ones always tug at the heartstrings most. Although the oldies get me, too. And everyone rallies behind the babies. Can you blame us?

Is this a truly needy client? Consider a recent case: The guy who washes my car found a puppy with a fractured femur. I know for a fact that he’s an illegal immigrant with little disposable income. I found a surgeon to fix the pup for free, kept the cutie until he was healed and then gave him back to my car wash guy, who now trades car detailing for services like vaccines. No one wants to be taken advantage of, so knowing for sure that an owner can’t possibly pay means that I’m much more willing to pony up.

Even with this list, there really are no hard-and-fast rules. Since emotion is at the foundation of so many of these cases, it’s impossible to explain the exact calculus behind any of our charitable giving decisions.

One thing that I do know is that we always feel fortunate to be in a position to give, saving an animal in the process — and making a human friend for life, too.

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