In the really old days when Bowser or Tabby or Polly got sick, it was easy. They either got better or they didn't.
Then in more recent old days, there might have been a veterinarian in town who could treat your pet. You either could afford it or you couldn't.
Nowadays, it's much more complicated. Should Fido go to the family-practice vet or to the internist, the surgeon, the dermatologist or the ophthalmologist? You'd take Fido straight to the exotic-animals vet if Fido is a python.
And increasingly nowadays, the word afford does not figure into it.
"Because of the area we're in and the clients we have, we're privileged to treat cases where people want to do everything they can," said Dr. Jeffrey S. Cohen, a veterinary internist in Newport Beach.
"A lot will say, 'My life revolves around this kid' (yes, "kid") or 'The sun rises and sets on my dog.' Most of the time we're treating a pet that's a member of the family. They've invested a lot of time and emotion in what they may see as a child.
"Even if they're not wealthy, cost is no object when it comes to their pet. They may postpone their own doctor's appointments. I'm sure if we charged 10 times what we do, some owners wouldn't care."
This has resulted in pacemaker implants, heart surgery and brain surgery for animals, sometimes performed by medical rather than veterinary doctors. Some veterinary clinics have ultrasonic sound equipment for internal examinations and laser equipment for surgery. Wealthy and not-so-wealthy pet owners have inquired about organ transplants and prosthetic eyes.
That sort of devotion may be good for vets and for pets, but sometimes it can go to extremes.
One woman called a county vet to ask whether she could breast-feed her cockatiel. ("She'd need plastic surgery if she tried it," said the technician who got the call.)
One dog owner, about as upscale as you get in Southern California, told a county vet to disregard cost when it came to treating his sick Great Dane. He said he wouldn't let his sons near his Rolls-Royce for fear they might scratch it but gave his dog free rein in the back seat--where the dog tore the leather upholstery to shreds.
"They are so devoted because the pet enriches their lives so much," Cohen said.
"I can remember a case when I was an intern. I was working in emergency one night, and a lady comes running in with a dog in her arms and her husband with her. She'd left her 6-month-old child alone at home.
"The dog died on the table right then. She said--her husband's standing next to her--'I've lost the only thing that ever mattered to me.' Now you want to worry about something like that."
Maybe, but maybe not, said Dr. Steven Potkin, professor of psychiatry and director of research for the UC Irvine Medical School's department of psychiatry.
"We all have a need for emotional closeness, and sometimes it's easier to be close to a pet than to another person who makes demands and all sorts of other things," Potkin said.
"A pet is adoring and loving and doesn't have divided loyalties and doesn't place demands that the owner can't meet. Essentially, it's a relationship one can control much better.
"It can augment human relationships. The problem is when a person gives undue emphasis to the pet relationship to the exclusion of relationships with other people and the person begins to attribute to pets human emotions, feelings and thoughts."
At one county veterinary clinic, a family brought in their sick bird, and day after day they visited it there. "They literally had prayer meetings and Bible sessions with the bird," said one of the clinic workers. "They'd read, then wait for the bird to read its paragraph. They anointed it with holy oil."
The bird bounced back--and so did the family's check. They had stopped payment. "They told us God had cured the bird, not us," the worker said.
For most veterinary clinics, such extremes are unusual. Dr. Craig E. Griffin, a veterinary dermatologist who practices in Garden Grove, typically treats dogs and cats whose allergies are causing skin problems. He said the owners are dedicated indeed: "My average client is spending $20 a month on drugs and bathing his animal once or twice a week, maybe daily, for the rest of the animal's life."
The willingness to do this seems to be an urban trait, and only in certain urban regions, he said.
"You seem to get this attitude in metropolitan centers. Most of the private practices (in dermatology) are in Southern and Northern California, Boston and New York.
"You can't have a successful practice in most Midwest cities; I know that for a fact. I worked in Missouri, and there's a different attitude toward pets. If you're from a farm background, animals are very important and you develop a bond, but there's still the attitude that they're disposable."
Dr. Darien Nelson, an animal ophthalmologist in Garden Grove, said she has encountered owners who insisted on inappropriately extreme measures. One insisted on eye surgery for an Old English sheepdog that continually bumped into furniture when it only needed the hair trimmed from in front of its eyes. Another wanted an artificial eye made for a dog so the animal wouldn't "look funny." ("Much too expensive," Nelson said.)
But Nelson added that she doesn't mind the occasional eccentrics because "I don't like the opposite end, where people come in too late to do anything or don't come in at all."
Cohen said a lot of the decisions made in an animal clinic are personal, not medical. He said a cat at his clinic was 17 years old, very old for a cat, and needed risky abdominal surgery. The owner had decided to go ahead despite the chances of failure.
"The people want to take a chance to buy their cat some more time. The woman's in the process of having a cabin built in the mountains, and they're naming the place after the cat: Chalet Simone. They're engraving it on the ceiling beams."
The death of the cat would be traumatic for the people, he said, and that is not unusual at all. "More and more people are getting counseling when they lose a pet," Cohen said. "The depth of feeling people have for another being doesn't seem to have much to do with the species."
Thus, much of a veterinarian's time is spent dealing with the pet owner, not with the pet. And while the pets are almost always "a pleasure to work with," sometimes the owners are difficult, Cohen said. "They can be a rational person, but they're dealing with something that's an intrinsic part of their life that's falling apart in front of them," he said.
By consensus of the veterinary profession, people are at their most difficult with the vet who specializes in exotic pets.
Dr. Richard Woerpel, who practices in Fountain Valley and has specialized in "companion exotic animals" for 10 years, said: "In vet school, we're warned more than once that when you deal with exotic pets, you will be dealing with more exotic personalities. I don't mean that disrespectfully."
Woerpel has treated a three-toed sloth brought in by a magician. He treated the Australian Olympic team's mascot, a wallaby, after it had stayed up all night at a consular party and woke up with an upset stomach. He treated a pet iguana, which was made a present to him in lieu of paying the bill.
And snakes. The emblem of the medical profession is the caduceus, the staff around which two snakes entwine, but "some people are so phobic about snakes we don't have a snake in our logo," Woerpel said.
"We get some big ones--90-pound Burmese pythons, big suckers. You don't want to work on them alone. I had one lift one of my assistants right off the floor."
Some of his clients "are simply nuts about reptiles" and care for them passionately. On the other hand, some have the snake "only as an extension of his ego, if you know what I mean. They don't take care of it well. Its primary purpose is to attract attention. God knows what they do with it."
Some know hardly anything about their snakes. "One guy found a rat in his garage and remembered his neighbor had a snake, a boa constrictor. This was a big snake. He took the rat to the guy as food for the snake, and the guy said, 'Yeah, put it in.'
"This was a streetwise rat, and he chewed hell out of that snake. He chewed eight inches off of it. People are always amazed when this happens," Woerpel said.
An animal health technician who has worked extensively with exotic animals in the county said she is convinced that most of these owners are "filling a different kind of void" than is the average pet owner. The exotic pets "are to frighten or impress people, or whatever."
For some, "it's a status symbol, something to hold up and say, 'Look what I have and you don't. Look how much I spent.' They haven't come to realize that these are living, breathing things."
She said many who have spent $3,000 on an exotic pet have refused to pay a $200 vet bill. She said one woman, unwilling to pay for having her parakeet's nasal passages flushed, asked whether she could hold the bird under the kitchen faucet and turn the water on and off quickly. "She got angry when I told her the bird would drown."
She said doctors are understandably reluctant to talk about some aspects of the exotic-pet business. For example, she said, she heard a commotion one day, glanced through a door and saw one of the vets running down the hall, pursued by a 4-foot iguana.
"None of them will admit it ever happened," she said.