The patient lies under the heat lamp, limp and lifeless but for the slow up and down of his chest under a baby-blue blanket his owners brought him earlier that day. His eyes are closed and I detect a faint shiver to his head when I look closely. It’s clear he’s on a mission to survive, though I somehow doubt his chances.

Yesterday he was a perfectly normal eleven month-old black Lab pup. Today he’s in a drug-induced, near-comatose state at the specialists' hospital.

Remy was hit by a car last night. His bladder was ruptured, several ribs and his pelvis were broken and his chest had filled up with blood. Though he was lucky to live nearby, he barely survived the five-minute delay in transport. As it stands, his prospects for recovery are unpromising.

Nonetheless, Remy underwent lengthy surgery, received two transfusions and now has chest tubes in place along with two IV catheters and intranasal oxygen to support his delicate state. Drugs to treat the wounds, shock and trauma of it all are dripping steadily. If it weren’t for the heavy infusion of opiates also being squeezed into his fluid line I might have been the first to suggest he be euthanized.

His owners are adamant that every possible attempt be made to save his life. They will no more back down from his treatment than they’d turn down the same for any of their children. As long as there’s any hope of survival, Remy will be cared for here.

But that’s easier said than done. Despite the family’s laudable determination and ready cash on hand, there’s another issue to consider. Namely, when does treatment—albeit with the best of intentions—become a cruel test of clinical skills and medical might at the expense of a feeling, if cognitively limited, being?

Barbaro’s story is one such case where the limits of medicine were pushed to extremes never before seen in the annals of equine medicine. Laminitis like his equals euthanasia for the vast majority of horses—typically at the recommendation of equine practitioners on humanitarian grounds. In fact, its treatment is seldom seen outside of tertiary care facilities like the one at my alma mater’s New Bolton Center.

Many have argued that Barbaro was sacrificed to the gods of scientific research and the sentimentality of one very wealthy family. Less charitable folk suggest that gullibility and ego also affected the Jacksons, while greed and free PR fueled Penn’s wanton disregard for Barbaro’s eight months of unendurable pain.

We speak so much on the subject of pain and suffering here that it seems odd I’ve neglected to post on this point before now. There’s a lot to be discussed here at this fuzzy line between what’s right and fair and what’s abusive and cruel. When it comes to medical treatment of animals beyond a certain point, things get morally murky, indeed.

So what is it exactly that troubles me? It’s not the issue of where society’s money is best spent (since no one’s complaining when the fiftieth Hummer rolls off the local lot that month). People should be free to spend their hard won dollars wherever they please. Rather, I worry that big money means more pain and suffering for those who can’t possibly render an opinion on the subject.

Children, geriatrics and other humans in the same spot? They’ve got a system that’s designed to implement safeguards for their degree of suffering (whether it works or not is another issue altogether and way beyond this blogger’s ability to opine knowledgeably on). But pets? It’s a free-for-all. Every clinician, institution and owner is free to decide what’s best.

Barbaro? His doc didn’t think he was suffering too badly. “He eats. He stands. He’s a brave one, that Barbaro.” But who knows? Maybe with a little more luck he’d have been the first to survive a double-laminitis on top of his degree of bony disrepair. And maybe, just maybe, the treatments his owners paid for have already begun to pave the way for a whole generation of laminitis survivors. Again, who knows?

Remy? He’s in an opiate daze—which makes it unlikely he feels much. It also makes it less likely he’ll survive should his recovery plateau for days at this point. But it’s the kind of compassionate care I wouldn’t want any animal to go without, regardless of a different treatment’s bearing on future sufferers.

Pain is pain. And there’s only so much of it our animals should be made to endure—even if a whole lifetime of play, happiness and familial love is at stake.