LOS ANGELES — When a vet told Nancy Gates that her dog Arabella had heart problems, needed surgery and it would cost $500, she had no choice but to put her pet down.
"It was pretty straightforward because I had four young children to feed. The vet said surgery was my only option. I did not want my dog to suffer," she said.
Gates, 41, of Cotati, about 50 miles north of San Francisco, made that decision 11 years ago but said nothing has changed. She still couldn't afford high-priced health care for her current pets, an 11-year-old cat, Cocoa, and an 9-year-old golden retriever Sadie. And Gates isn't alone.
Money is a consideration for the majority of people when dealing with the cost of health care for animals, according to an AP-Petside.com poll conducted by GfK Roper Public Affairs & Media.
While most pet owners, 62 percent, would likely get vet care if the bill was $500, the percentage drops below half when the cost hits $1,000. The number drops to 35 percent if the cost is $2,000 and to 22 percent if it reaches $5,000.
Only at the $500 level are dog owners (74 percent) more likely than cat owners (46 percent) to say they would likely seek treatment. In the higher price ranges, the two are about equally likely to seek vet care.
"Grief gets complicated when we can't do everything we would have liked to do for our animal," said veterinarian Jane Shaw, director of the Argus Institute in the College of Veterinary Medicine & Biomedical Sciences at Colorado State University in Fort Collins, Colo.
That's especially true in hard economic times, when spending money you don't have on an animal can have a lasting impact on children, the mortgage, grocery bills, heating bills.
"Euthanasia is always sad but when finances have to be considered, when you feel there is a possibility you didn't or couldn't do the right thing, you feel guilty," Shaw said. "We are at a point where we are talking about basic life needs or survival needs."
Terry Cornwell, 55, of Newport, Ore., has had to put down a couple of pets, but none was harder than a dog that was diagnosed with cancer.
"My income decides a lot of my expenses," she said.
So far, her current year-old cocker mix, Buddy, and her 8-year-old cat, Boo Kitty, have had few health problems. Cornwell would do everything she could, but if a vet told her surgery was her only option and she had to have the money up front, "I would be done. There would be nothing I could do about it."
Cornwell does worry, though. So do one in five pet owners who said they fret a lot about being unable to afford seeing a vet. Dog owners are more likely to worry than cat owners, and women and low-income people are among the biggest worriers.
"If they start getting into expensive vet bills, there's nothing I can do. I have no options. If you are talking about something like serious cancer, you're putting the animal through a whole lot of stuff that's iffy anyhow and it's not fair to them," she said.
About one in four people, or 27 percent, said pet insurance is a good way to save money on vet bills, though that's five times the number who actually carry insurance on their pets.
Diego Negrete, 26, of Austin, Texas, has insurance on his 4-year-old fox terrier, Roxy, and his 2-year-old cat, Charley, but he's in the minority. Ninety-five percent of those polled said they didn't have insurance.
"It's a nice cushion to have," he said of the policy that covers all yearly shots and checkups for about half what they would normally cost. It also pays for part of the costs of different problems, he said, although he didn't know all the details.
But Negrete doesn't fear vet bills. "I'm not worried at all because the insurance would cover part of it and I am financially capable of covering whatever it costs," he said.
However, if you are looking upward of $5,000, "something must be seriously wrong," Negrete said. He would have to look at how much the animal would suffer through the problem, and how the recovery could go. And he would want some assurance the pet would have a good life later.
Negrete had a 14-year-old dog who'd had a hernia removed twice. When it grew back a third time, "he was old and about done and he was in pain, so we put him down," he said.
Meg Fowler, 63, of Port St. Lucy, Fla., is a retired insurance agent, "so I know the risks."
If something catastrophic happened to leave her 10-year-old cockapoo, Jasmine, in a lot of pain, "We would have to put her down," Fowler said. "It would be much more humane. Jasmine is a huge part of our lives and we adore her. But she is a dog. It is hard to remember that, as much as I believe she has a soul."
Before Jasmine, there was Max, another cockapoo. When he was 15, he got a brain tumor. Their vet helped them come to grips with a decision that no insurance could have cushioned — euthanasia.
For Fowler and her husband of 43 years, "It was the hardest day of our lives. We had no choice in that situation. There was no lifesaving surgery and the dog was way over his life span. It was a difficult decision, but it had to be done and we did it," she said.
When quality of life has diminished and there is severe pain and suffering, the time has come to start making decisions, Shaw said.
In the final hours, it helps some people to share one last special time with an animal — a trip through a fast food drive-thru for a hamburger, a bath, a dish of homemade ice cream — something familiar to the pet, she said.
Some will take a hair clipping or clay pawprint to help build a bridge and foster the grief process. Others will arrange for euthanasia to happen at home so the pet can be surrounded by every member of the family, including other animals, Shaw said.
But nothing will completely ease the ache, she said, because guilt is part of the cost of caring deeply.
The poll was conducted April 7-12, 2010, and involved landline and cell phone interviews with 1,112 pet owners nationwide. It has a margin of sampling error of plus or minus 3.3 percentage points.
Associated Press Polling Director Trevor Tompson, AP News Survey Specialist Dennis Junius and AP Writer Alan Fram contributed to this report from Washington.