By Sophia Yin, DVM, MS September 24, 2009
In these difficult times, it can be challenging to care for your pet and to know when you’re getting the most appropriate care. In fact one pet owner once wrote to me for advise regarding what to expect from her vet. “Dr. Yin, she says, ” I no longer trust veterinarians to practice ethical medicine. Three years ago, our newly-purchased guinea pig showed signs of mite infestation. A vet specializing in exotic animals put her on a two-shot course of ivermectin. After the second shot a week after the first, she went into convulsions. There was an emergency room visit with follow-up at the vet’s office. She recovered but a month later the mites returned. I brought her to a different vet who treated her with flea powder, a much less invasive approach. This cured her.”
She went on to explain another case. “We also had a male cat with terrible “blood crystals” which caused severe urinary problems. Medications didn’t help and neither did surgery. It was a stressful time as I was due to give birth. Our poor cat was no longer the playful, affectionate companion we loved. I brought him to the vet for assistance and he insisted on giving heart medications. I tried this and he didn’t improve. We had to have the cat put down the day I came home from the hospital.”
These situations gave the owner a bad taste. And made her wonder: What should pet owners expect from veterinarians? How do we know what the standard of care should be?
These are good questions and they also remind me of something a veterinarian colleague once said, “Instead of giving us all of those classes and a diploma at graduation, they should have just given us a crystal ball and a magic wand. Clients would be happier.”
But we graduated with neither which is why veterinarians can’t predict the future any better than the Wall Street experts can predict the stocks, bookies can predict exact Superbowl outcomes, and the every-day individual can predict what will go wrong the next time he upgrades the operating system on his man-made PC.
Even when your veterinarian follows a diagnostic and treatment plan devised by God himself, which for mite infestations in guinea pigs currently involves a 1-4 shot course of ivermectin at 1-2 week intervals, patients may respond poorly. What’s more, cures are only temporary if the inciting causes, such as mites on neighboring guinea pigs, aren’t stamped out too.
The problem is that fixing an ailing pet is not like fixing a car or TV or someone’s bathroom sink. It’s more like solving a mystery and trapping the source. When looking for the culprit, detectives don’t just ask which one test is the sure-fire solution. Instead the answer requires a pain-staking search for multiple pieces of the puzzle. A mold of a suspicious footprint, a search for telltale stains, analysis of DNA, interviews with anyone remotely involved. Gather the right pieces and the picture takes shape, but the process takes time and skill and different detective teams may come to the solution through different steps.
Similarly, to diagnose your pet’s problem, a thorough physical examination plus the owner’s detailed account are an important start and may do the job. But many cases also require multiple tests. Each test can reveal something different but the puzzle’s picture is revealed only when all the pieces come together.
This can add up quickly. As pet owners ourselves, we veterinarians know. We often perform the ultimate work-ups and treatments on our own pets with ideal or less than ideal results. For me to the tune of $1500 for my cattledog several years back and for one of my classmates $4000.00 for her 14 year old Rhodesian Ridgeback. And my family’s aged Scottie involved diagnostics for lymphosarcoma, and a splenectomy which cost us for about $2000.00 even with my huge veterinary discount. The surgery and chemotherapy provided the dog with 3 good months, followed by remission and then euthanasia. It was a short remission but well worth it for us.
A cat with urinary tract disease would put any veterinarian on red alert. It could get better on its own but it could also mean a long recurring problem that might involve surgery without being completely resolved. And if all else failed or even before, we might also choose to treat less pressing or obvious problems such as a heart condition or the stressful environmental situation going on at home in the hopes that that’s what’s throwing the cat’s system over the edge.
While you may not be able to afford all the tests or treatments it’s your veterinarian’s job to offer you the Gold Standard in care and work down from there rather than to judge your financial situation or the strength of your bond with your pet and offer you less. When vets make assumptions about what owners can afford Kitty may get short-changed. When owners continuously complain about being offered the best, they may no longer get such offers.
As a pet owner, your job is to decide what you can afford, and what you think is best for your entire family. Your vet should do his best to work within your needs, giving you options and then help you weigh your chances. This partnership works best when clients establish a regular relationship that involves annual pet check-ups, follow agreed-upon treatments to the tee, and appear for scheduled rechecks even when the problem seems cured. This allows the vet to understand your pet better, to modify treatments based on your pet’s response and to further discuss any questions you may have. If you’re still unsure about your pet’s care, keep asking questions, or seek a second opinion from a board certified veterinary specialist. Have your records sent first so that the specialist can get a complete view. But please remember, even specialists don’t graduate with a crystal ball.
For more information on pet diseases check out the following veterinary-sponsored web page: http://www.VeterinaryPartner.com