Fears about the affordability of veterinary care are very real, especially for people on fixed incomes, like Patti Schiendelman. “At this point I don’t have a cat because I’m now disabled and poor, and I can’t afford to take care of one properly,” she says, adding wistfully that she wishes she could have a feline companion again.

Schiendelman is right to be concerned about what she describes as the “unexpected vet things.” These high bills may be the result of aging and end of life, injuries for boisterous young pets, or freak accidents.

It’s not improbable that pet guardians will face at least one catastrophically high emergency vet bill. Few things leave us feeling more helpless than standing over an exam table with a sick or injured animal, listening to a vet list off a series of lifesaving interventions.

Add the mental stress of calculating the amount of money left in the bank and the process can feel inhumane: to think our pet’s life should be based on what we can afford, rather than what we want to do. Yet those who might rush to condemn people for not trying everything might want to reconsider.

According to the American Veterinary Medical Association, pet guardians spent an average of less than $100 on veterinary care for cats annually as of 2011 (the latest year for which numbers are available) and roughly twice that on dogs. However, researchers elsewhere suggest that these numbers are quite low.

Veterinary students at the University of Pennsylvania, for example, estimate that the average lifetime cost of owning a dog can be around $23,000 — including food, veterinary care, supplies, licensing, and incidentals. But that doesn’t include everything, like trainings.

According to pet insurer Pet Plan’s data, in addition to average costs, one in three animals requires emergency veterinary care every year for procedures that can rapidly climb into the thousands.