Bob went back to the vet today for another blood test (CBC) and urinalysis. He doesn't like the car ride any better despite having taken as many of them in the last month than he has in all the time we've had him. Also, he's already wise to the trick I used last time to lure him into his carrier with treats — no dice this time!

The amount of bacteria in his urine has lessened, suggesting that the antibiotic has done some good, but Dr F reports finding more blood cells in the urine than is healthy. He has a new theory that Bob's trouble might be due to a kidney stone. If this is the case, and there's otherwise no damage to either kidney, the stone (or the affected kidney) could be removed and the problem resolved. However, Bob's ailment still might be a congenitally-defective kidney, kidney disease, or a tumor.

The consensus from Dr F and Dr S is to get an ultrasound to nail down the exact cause of the trouble. However, this would cost between $800 and $2,000. I'm now faced with a dilemma decorated with big dollar signs.

An ultrasound test would be just the first step in a possibly long series of expenses — surgery, recovery, more treatment, who knows what else. At what point does this become, as they say in people medicine, "heroic measures" for an animal whose life expectancy has likely already been shortened?

I called hubby to relay the news, and he was stunned at the ultrasound cost. "We could adopt 20 cats for that," he said, referring to the $100 we paid to adopt Bob. It's a harsh but realistic perspective. Everything dies sometime. But what an awful prospect to be the one who controls another life. I can hardly hold back the tears thinking about it.

Bob seems quite normal aside from his weight (he's still around nine pounds), and doesn't seem to be in any discomfort, much less in pain. He tears around the house when the evening wildies come upon him, and the rest of the time he snoozes on a warm blanket, or seeks out a warm lap. It seems mad to think of putting him down now. But how could it be ethical to neglect an expensive procedure until he did begin to suffer? I have a much greater understanding of people like these who have to give up or put down pets they can no longer afford to keep.

We could afford the ultrasound. But should we start down this road? Dr F says he'll have a better idea how quickly we have to decide once he sees the blood test results tomorrow. Hubby (who, to be fair, is really paying for all this) is coming with me to the vet after work to get the facts firsthand. We'll have a lot to talk about this evening.

Post-visit update: It's so good to have two vets to discuss Bob's case with. Hubby and I talked with Dr S, who said she believed the clues so far pointed to a congenital defect. Based on the painfulness of kidney stones in humans, she thought this wasn't as likely, since Bob shows no signs of pain even when palpated. This suggests that an ultrasound isn't as necessary, since nothing much can be done for congenital defects. Also, it turns out that ultrasound tests aren't as expensive as Dr F quoted; Dr S thought they were more like $300 — still pricey, but more reasonable if absolutely necessary.

The telling factor will still be the blood-test results tomorrow. Hopefully, his BUN and creatinine levels will be the same or lower, which would indicate that the new diet is easing the load on the kidneys. I was startled to learn that these indicators don't show up until kidney function is at least 75% depleted. Yikes. However, the kidneys have a small amount of regenerative function, so fingers crossed all around.

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This post is part of a series. Past entries can be found on BethW's page at KC Pets.