New York: People and their pets often end up resembling each other, but image-obsessed Americans are taking that age-old relationship a step further, treating their four-legged friends to everything from spa facials to testicle implants.

In a nation of surgically enhanced human breasts, teeth and skin, perhaps it was just a matter of time before the beauty stakes were raised for pooches and cats.

One end of the spectrum features dogs like Hops, a Maltese terrier who recently was given a blueberry facial, followed by a blow dry, and tooth brushing with chicken-flavoured paste, at Manhattan's Downtown Doghouse spa.

Groomer Ani Corless described this as the new normal for lapdogs.

"These are man-made breeds and they require maintenance," she said.

Mid-facial, Hops ejected a tiny puddle of vomit, but otherwise did seem to enjoy the attention. More extreme — and painful — makeovers are also gaining ground.

New York Republican lawmaker Nicole Malliotakis says animals are subjected to tattoos, earrings, nose rings, chin rings, tummy tucks, even facelifts.

Owner of two Chihuahuas called Peanut and Olympia, Malliotakis has proposed a law to ban cosmetic alterations to pets in New York state, calling this "a form of animal cruelty".

But Gregg Miller, founder of a company called Neuticles, says Malliotakis is "nuts" and exaggerating the problem.

Nuts might be a favourite word for Miller, whose company outside Kansas City leads the world in manufacturing fake animal testicles.

Created from the same silicone used to enlarge women's breasts, Neuticles fill the space left when a pet is neutered.

"We've Neuticled well over 500,000 pets in the United States and all over the world — dogs, cats, horses bulls, monkeys, rats, water buffalo," Miller said.

Prices range between $119 (Dh437) for the XSmall pair and $599 for the XXLarge.