Our Golden taught himself medical alerts. My wife broke her ankle when he was 6 months old, and the little glue puppy who followed me when I gave her meds started to let her know ahead of time that she would need meds, and even proactively bring her pill bottles.
Some refinement let him proactively stop mom from overdoing it, so he's been instrumental in her recovery and PT.
Then like six months ago he started giving me pain alerts from no where when I was feeling ok. But invariably, every time he did, 30-60 minutes later I would get a headache. So now I just listen to him and my bad headaches have dropped to almost zero, because I'll take some coffee and NSAIDs when he alerts.
He also broadly gets the concept of "pills make people feel better in a little bit". He'll stop alerting for about 20 minutes if you take pills (or pantomime taking pills because you're busy or something). Then if you faked him out he'll alert again in 20-30 minutes lol.
He's one of the smartest dogs I've ever met in the "cause and effect generalizes to X" sort of way. (He also is super confident and pretty sure that the world is made of sunshine, rainbows, and friends so is conversely really dumb in risk assessment, like will fall off the bed because he's sure he'll be caught kind of way)
I'm almost there.
I also live in the Bay Area. My rent is locally cheap but nationally very high. My wife has a chronic illness and an unrelated acute issue that recently required surgery. She can barely work. Until this most recent surgery I was keeping ahead, but expenses are up and income is down and that's not true anymore.
I have good health insurance but there's a lot more to medical costs than just doctors, and to partially manage her daily quality of life it's not weird to cook her three different dinners and she can only stomach one. This explodes our meal budget.
We're childfree but one of our dogs recently also got diagnosed with chronic illness. They are our kids, full stop.
Shit happens. Don't be a dick about it.