(MONEY Magazine) – Soaring medical bills. Limited insurance coverage. Expensive care for the aged and critically ill. Sounds like the familiar list of problems being addressed in Washington, D.C., right? Not so fast. Don't expect help from Hillary Rodham Clinton and her husband on these health issues. We're talking about truly beastly things here -- dogs and cats, rabbits and reptiles, even Vietnamese potbellied pigs. These days, virtually anything your doc can do for you, one of the nation's 48,000 vets can do for your pet. You can send kitty for a CAT scan ($300 to $700), dispatch porky pup for liposuction ($350 to $500) and order tranquilizers for your displeased Siamese. Veterinarians prescribe medicated contact lenses for dogs (about $20), barium enemas for birds ($120) and abdominal surgery for reptiles ($500 to $1,200). At Colorado State % University's vet hospital, doctors perform corneal transplants, balloon angioplasty and open-heart surgery on cats and dogs. Owners even order dental work for -- we're not making this up -- pocket pets like gerbils and guinea pigs. "The other day I anesthetized a one-ounce hamster to grind down a malocclusion (bad bite), "Denver veterinary dentist Edward R. Eisner recently said. "It's tight work." The price for elaborate dental procedures ($1,250 for a root canal and crown) can cause people to gnash their own teeth. As with human health care, these veterinary advances have sparked debates at the uneasy intersection of ethics and economics. People who once had no choice but euthanasia for very sick pets can now balance their finances against their animals' lives. So how far and to what expense would you go with treatment for, say, a sick iguana? Put in more graphic terms, while almost any sacrifice is judged acceptable to save a human life, does it make sense to spend thousands of dollars on chemotherapy for a cocker spaniel? The answer from many people is, emphatically, yes. Indeed, Americans shell out $20.3 billion a year on their pets, about half of that on health care, or nearly the same as the entire $10.3 billion budget for the National Institutes of Health. Furthermore, those vet bills have soared. From 1987 to 1991, national expenditures for veterinary services climbed from $5 billion to $7.4 billion -- a 49% jump that's just a, um, whisker less than the runaway 52.1% rise in medical spending for people. Since then, in the slow-growth U.S. economy, spending increases have moderately outpaced the national inflation rate, according to the American Veterinary Medical Association. The Humane Society of the United States estimates that each year pet owners spend around $1,200 on a pooch ($135 for veterinary services) and $600 on a kitty ($85). But that's chickenfeed when your pet rooster has a serious health problem. At Cornell University's vet hospital in Ithaca, N.Y., for example, a Labrador retriever who had lapped up antifreeze ran up a bill of more than $10,000 in 37 days when doctors repaired its kidneys. As animal surgery becomes progressively more elaborate (now available: organ transplants), there is a record need for blood. At the Veterinary Hospital of the University of Pennsylvania, blood transfusions have tripled to 3,003 pints a year since 1990. To help amass that supply, the hospital fitted out a $48,000 animal bloodmobile that solicits donors at dog shows and canine club meetings. (Cat donors, more skittish, give at the hospital since they dislike the cramped, noisy van.) The blood -- 13 types in dogs, three in cats -- is sold at $140 to $180 a pint and used not only for surgery and trauma, but for anemia and hemophilia. These Penn donors receive no money, only food treats -- the equivalent of the doughnuts served to humans. There is even a veterinary group, the American Canine Sports Medicine Association (305-633-2402), that offers advice on diet and training for racing greyhounds, Frisbee exhibitionists, hunters and other athletic pups. Miami vet Ronald Stone, the association's executive secretary, has fielded some rather unusual calls. "I had one owner," Stone says, "who was preparing his dog to swim the English Channel." In some instances, animals get even more advanced care than humans, since leading-edge techniques are perfected on nonhumans. At the Sacramento Animal Medical Group in Carmichael, Calif., for example, surgeons use a five-foot, computer-driven robotic arm, known as Robodoc, in hip-replacement operations. "It can do the drilling more precisely than a human," says internist Ralph Barrett, which means a speedier recovery for the patient and less chance of the new hip jostling out of joint. On the low-tech side, the American Veterinary Medical Association has officially acknowledged acupuncture as a curative tool, unlike the American Medical Association, which doesn't sanction the technique for humans. It's working too. Veterinary acupuncturists have been notably successful in treating lameness, arthritis and other chronic conditions that limit an animal's mobility. More than half of all U.S. households have pets, many of them regarded as full family members. It is this emotional tie that creates the tough financial and ethical choices. Consider the dilemma of the Whitmans -- Tom, 41; Jill, 34; and their four-year-old daughter Elizabeth. In December 1992 they returned to their Albany, Ore. home from a vacation in Maui to find Herb, their eight- year-old cat, suffering from chronic renal failure. The only cure for the usually fatal malady was a kidney transplant and lifetime medication. Ultimate cost: about $16,000. The Whitmans, whose annual income is about $70,000, made that commitment, and veterinarian Robert Rooks, owner of the All Care Clinic in Fountain Valley, Calif., accepted Herb as a transplant candidate. Two months later, the fortunate feline returned home with a functioning kidney and a bill for $6,000. Twice-daily doses of cyclosporine capsules (to prevent tissue rejection) and regular blood tests currently cost the Whitmans about $2,500 a year. Next year, when testing is reduced, annual expenses will become $2,000 for as long as the kidney lasts -- an estimated three to five years, says Rooks. But the Whitmans aren't complaining. Tom, Jill and Elizabeth together agreed to forgo fancy vacations for a few years to meet the expense. "This drew us together tremendously," says Jill. "It's made us more of a family." Some of the Whitmans' friends, however, think they're nuts. Yet there's nothing inherently wrong with spending on animals, argues James F. Wilson III, who teaches veterinary ethics at the University of CaliforniaPDavis and at Penn. "People spend $50,000 on travel, cars or diamond rings, and no one bats an eye -- or says they should have given that money to the poor," he says. "Just because some human needs are unmet doesn't mean we should deny pets the care that's available today." Adds Herb-the-cat's doctor, Rooks: "Every person has an indulgence. But very few indulgences give things back. Pets do." While the expense can be considerable, medical treatment for the modern pet is, in fact, a bargain compared with identical procedures in humans. A double hip replacement costs $16,000 for you, but only $1,500 to $6,000 for your German shepherd. Why the gap? First, the average doctor of veterinary medicine earns $63,466 a year, compared with $177,400 for an M.D. Also, the money comes right out of the owner's pocket; insurers pay more than 75% of human health- care costs but less than 1% of veterinary care (see "Pet Insurance Worth the Price" on page 156). "Hillary Rodham Clinton could learn a lot by coming here," says Barry Stupine, director of Penn's vet hospital. "Economics has always driven animal medicine because there is no Blue Cross, and there's a limit to what most families can pay. Doctors think twice before ordering extra tests. In human medicine, you don't have those constraints." Additionally, vets can practice certain economies that M.D.s cannot. For example, animal doctors will reuse catheters and recycle pacemakers from humans into dogs. But even with these cost savings, some vets wonder whether medical breakthroughs are outstripping pet owners' ability to pay for them. It's one thing to use money earmarked for a Hawaiian getaway to cover Rover's bills -- but quite another to deplete your kid's college fund. And even if the money is readily available, you should not reflexively lay it out. Susan Phillips Cohen, director of counseling at New York City's Animal Medical Center, regularly advises owners on treatment options, including euthanasia. She recommends that you "calculate all the costs -- not just money but time, energy and emotions. No dog or cat should have the power to ruin life for the other family members." To help you make decisions about how much to spend on your pet, here is an overview of what your money can buy today: Basics for Bowser. Most puppy and kitten owners agree to the need for vaccinations and annual exams. But vets say that your rabbit should get an annual physical too, as should your iguana, ferret and finch. The cost of a routine physical is about $35 (see the table comparing medical prices for dogs, cats and humans at right). These and other prices quoted here will vary by location (higher in cities, lower in rural areas) and the size of the veterinary practice (smaller is often cheaper). Dental treatment has become increasingly important in animal medicine. By age four, roughly 75% of dogs and cats develop periodontal disease, with some bone or tooth loss. The major cause is plaque, and at four to six months, when their adult teeth come in (42 for dogs, 30 for cats), it's time to start fighting it. Plaque attackers, such as commercial chew strips ($4 to $10, depending on size), may do the job for large dogs like retrievers. But to reduce the risk of periodontal disease for cats and tiny dog breeds like Pomeranians, which have precious little bone to lose, vets suggest you clean the teeth daily with one of the many animal toothbrushes on the market. You'll also need a special pet toothpaste since the foaming ingredient in yours will upset Fifi's stomach. A favorite flavor: poultry. (Cost for both: under $10.) Colin E. Harvey, dentistry professor at Penn, recommends that you supplement your home care with a professional dental cleaning ($115) once a year. But now brace yourself: You may want to improve Fluffy's smile. Denver's Edward R. Eisner handles about 25 orthodontic cases a year ($600 to $1,200 apiece) that require metal appliances. The devices, used when the teeth are so badly misaligned that they damage gum tissue or impair chewing, are worn for two weeks to four months. (The owner must change the elastic bands once a week.) Root-canal therapy ($450 to $650 without a crown) is also fairly common $ for dogs and cats who break a tooth, but you won't really be a dreadful person -- and we won't tell -- if you decide to have it pulled instead for about $160 to $240, including X-rays and anesthesia. Even doggies get the blues. If your pet has serious behavioral problems, like howling all day when you're gone or attacking children or other animals, this could be a life-threatening condition, since antisocial behavior is a major reason that house pets are euthanized. There's hope, however, in the form of animal psychiatrists and psychologists ($50 to $100 an hour; $20 for a phone consultation) who offer effective therapy, sometimes combined with drugs. Yes, pets take the same Prozac and Valium that we do (at about the same $71 and $20, respectively, for 30 pills) and a clutch of other antidepressant and antianxiety pills. The medications are typically effective in curbing depression (evidenced by loss of appetite or unwillingness to play, for instance), relieving phobias (fear of thunderstorms, say) and obsessive-compulsive disorders -- incessantly chasing or chewing the tail, for example -- which occur in both dogs and cats. Valium is helpful for high-strung felines who won't use their litter boxes -- but don't give a Dhuman's prescription to an animal; seek professional guidance. Eye, ear, nose and goat. Celebs of the animal world -- show animals and performers -- must often endure cosmetic treatment, some of it benign, some not. Example: Bullterrier and other puppies with a fatal show flaw -- nose leather of mottled pink and black instead of the desired ebony -- have on occasion had their noses tattooed (about $200) to solid black by owners ambitious for blue ribbons. Other surgical procedures are more sensible, however. Hereditary cataracts are common in more than half a dozen dog breeds, including poodles, spaniels, terriers and retrievers, and canines of all kinds tend to have some degree of haziness in their vision after the age of six. Cataract surgery ($800 to $1,500) restores their vision about 90% of the time. Among purebred dogs, deafness is a common genetic problem afflicting at least 45 breeds, including 30% of newborn Dalmatians. Hearing loss also occurs in other dogs as they age. Typically, the older animals compensate with their remaining senses, but a few owners opt for a canine hearing aid (about $370, including vet fees). The amplifying device is housed in a small canister attached to the animal's collar. A plastic tube runs up the neck and plugs into the ear. The aid was developed in 1990 by A. Edward Marshall, veterinary anatomy professor at Auburn University (205-844-6741), and audiologist Curtis R. Smith. (They accept orders only from vets.) Some experts say the expense is unnecessary, though. Says George Strain, professor of neuroscience at Louisiana State's vet school: "In a protected environment, such as a fenced-in yard, olderdogs get along fine with reduced hearing." When pets lose the use of their hind limbs because of an accident or a spinal ailment, some owners make laudable attempts to keep them mobile -- often with the help of a K-9 Cart. This custom-made device props the hind legs on wheels while the animal propels itself with the front limbs. Dogs and cats are the primary users, but the conveyance also has been prescribed for goats, rabbits, sheep and even opossums with posterior paralysis, according to an officer of the Berwyn, Pa. K-9 Cart Co., which sells about 1,000 devices a year at $175 to $310. New Age treatment. When conventional procedures don't work, increasingly owners -- and vets -- are turning to alternative therapies. "I'll use antibiotics or Chinese herbs, whichever works better," says Patterson, N.Y. veterinarian Allen Schoen, a Cornell graduate. His holistic medical techniques include acupuncture and chiropractic treatment. One recent success was Patrick, an arthritic golden retriever with extreme weakness in the hind legs. After two months of acupuncture and diet supplements, Patrick was able once again to leap into his owner's Jeep. Cost of treatment: about $400. Some people share alternative therapies with their pets. Shiatsu massage therapist Pamela Hannay of Flanders, N.J. treats Arlene Hubner and Hubner's black Lab, Hannibal, for a combined fee of $75 a session. Hannibal suffers from hip dysplasia (a genetic condition in which the ligaments loosen and the thighbone begins to work free from the hip socket), as well as a related spine disorder. He gets 30 minutes of massage; his owner gets an hour. Hubner, who lives in Glen Ridge, N.J., has also enrolled Hannibal in a doggy playgroup that takes regular romps in a local wildlife preserve ($75 a week) -- an excellent way to keep his spirits up and his muscles toned, thereby slowing the degeneration in his hips. Hubner administers powdered yucca and other diet supplements ($3 to $5 a day), which she believes relieve his back and leg pain -- though traditional vets might disagree. "I want him to have a good quality of life," Hubner says, "just as I would want for a child."

To locate the most appropriate caregiver for your pet, ask veterinary societies, breeders and groomers for referrals. You also can get leads from the American Animal Hospital Association (800-252-2242), which imposes rigorous standards on its 2,500 member clinics and hospitals. As you compile a list of candidates, ask a local animal rights attorney for names of practitioners he or she has heard complaints about. The Animal Legal Defense Fund (415-459-0885) maintains a directory of some 750 attorneys and law students nationwide with a particular interest in animal cases. Next, make an exploratory visit to the clinic. If it passes the initial test for cleanliness and friendliness, find out about fees, emergency services and availability of specialists. About 7% of the nation's veterinarians are board-certified in one of 26 specialties such as dermatology, oncology and ophthalmology. A specialist's treatment may cost 20% more than a general practitioner's, but often it can prolong your animal's life. Of course, given today's medical magic, your pet could live longer than you do. But once again, you now have an option that rivals human care: Tuffy can spend his sunset years in a pet retirement home. Under the auspices of Texas A&M University, the Stevenson Companion Animal Life Care Center, which opened a year ago, provides lifelong accommodations with all the creature comforts -- if you can pay the tab. To enroll a pet, you must bequeath $25,000 to A&M's veterinary college. The interest your investment earns is used to meet the animal's needs; when it dies, the income will go to the veterinary college, supporting a program of your choosing that advances veterinary education or animal health. So far about 10 owners have enrolled their pets, though none of the favored four-footers is yet in residence. Can AARP be far behind? Of course, we mean the American Association for Retired Pets.

BOX: PET INSURANCE WORTH THE PRICE

Less than 2% of cats and dogs are covered by medical insurance, according to animal health industry surveys. But if you would never give up on your pet and you fear crippling vet bills, you should consider a policy. There are two major offerings. Fireman's Fund Insurance (800-528-4961) markets its Medipet policies in all 50 states. Veterinary Pet Insurance (VPI; 800-872-7387) sells in 39 states. Annual premiums range from $49 to $219, with some policies paying as much as $3,000 per injury or illness. Fireman's Fund gets an A rating from A.M. Best.And VPI, underwritten by National Casualty, gets an A+ rating from Best.

CHART: NOT AVAILABLE CREDIT: NO CREDIT CAPTION: COMPARING MUFFIN'S BILLS WITH YOURS MONEY's survey of veterinarians throughout the country determined that, generally, pet health care is a bargain compared with costs for humans. And beyond that, vets in rural areas charge up to 40% less than those in cities. Also, routine services may cost only half as much at a small clinic as at an elaborately equipped hospital.