When do you let go? My oldest dog will be fourteen years old in a few months. She's a cranky, slightly bitter Pom with an attitude. I adore her. On Christmas night, Katie(the dog) grew lethargic and collapsed. One Veterinary Emergency Room visit later and we are home with a bag of pills and a bill for three hundred dollars.

The frightening diagnosis is congestive heart failure. The following morning, I take her to my regular vet who gives her a larger collection of pills. By 1am on the morning of the 27th , I'm back at the emergency room. Katie can't breath. Fluid is in the sac around her heart and it is suffocating her. I take her to a specialist, he puts her on a salt free diet, Digoxin, Lasik, and a heart rhythm pill.

The total bill is nearing seven hundred dollars.

Katie coughs half the night. I'm averaging almost three straight hours of sleep each night. I'm utterly exhausted. I wonder if putting her to sleep would be kinder for both of us. Yet, none of the vets will agree or disagree with me. I feel like the vets think that I should keep trying, that I'm giving up too easily. Yet they, in turn, inform me that she might have a year. A whole year of endless coughing, of strangling in her own juices. Great. Yet, not a single one of them recommended euthanasia.

The decision is all mine it seems. Katie's breathing is often labored and her usual endless energy is gone. The last vet added a narcotic cough suppressant to her array of medications. She gets four medications about three to four times a day. She sleeps most of the time when she isn't coughing.

The finally total on the bill is just over nine hundred and twenty three dollars.

The Human Society of the United States estimates that 63% of homes contain at least one or more dogs and that an average person spends about $220.00 dollars on health care for their pet each year. This is average cost is if your pet is relatively healthy. If your animal has a chronic illness or significant health issue, the expense starts to snowball rather quickly.

Americans love their dogs. Most of us buy high-designer foods, fancy dog beds, and worry about our dog's emotion and physical health. My three dogs get their teeth cleaned, get regular check ups, and the one had a visit to a canine optimologist. Don't laugh...my male dog has early onset glaucoma.

As you may guess, I adore my dogs.

Yet even as a die-hard dog lover, I have to ask when enough is enough. My Katie is an elderly dog. She's had a good, full life. Most of the time now, she's exhausted or drugged out of her mind. She doesn't even get excited when I bring home take-out.

Fifteen years ago, there wouldn't have been any choices for a dog with Katie's heart problems at her age. I would have been told to either take her home and try to keep her comfortable until she passed or put her down. With modern advances in canine medicine, now I'm given option after option, drug after drug, until I'm nearly broke and the dog is still miserable.

Veterinarians seem hesitant to bring up putting Katie to sleep. But isn't it in Katie's best interest to end her pain and let her move on? What is the point of dragging her inevitable death out over several months with her strung out on narcotics so I can save' her life?

Plus, as crude as it sounds, money is an issue. I've already spent nearly 1,000 dollars on her care in less than a month. I am a single woman with a low income job. This is a tremendous amount of money to me. I have two other dogs to support. I am horrified that money is part of my decision but I have to eat, pay the mortgage and it isn't like I can get doggie hospice care.

As a dog lover, don't I have the obligation to say enough is enough for both of us?

Veterinary medicine continues to become more advanced, offering cancer treatments, heart surgeries, and even insulin shots. But as a dog owner, I'm overjoyed and horrified by all the options. Just because a dog's life can be extended, it doesn't mean it should. One must always take in to account the quality of life you are offering your beloved furry friend. I think vets should really consider that sometimes with a dog's age and condition, a quiet death truly is the kindest thing.

As for Katie, our time together is growing short. I am letting those that love her say good-bye this weekend. Soon, I'll help her leave her pain behind. I'll cry the whole time but whether or not the vet agrees, I think it is in her best interest.

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