Growth

Our normal vet refuses to see my dog, because we went to the pet ER and they said she had kidney issues and should see a specialist. We can’t afford that. She is over 14 yrs old and I can’t tell if she is comfortable anymore. She has developed a growth on her side that grew what seemed like over night. Mind you she had a growth at one time on her leg (not there anymore just vanished one day) but the vet at that time said ‘old age’ I just don’t know what to do. She has developed this cough (sounds like she is a smoker trying to get something up)

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Hello and thank you for your query.  I am struggling to understand what was said about your dog and why.  In  veterinary medicine, practise vets are very much like GPs in that we see cases when they first present, but while a GP doctor will refer as soon as possible to the right department eg if surgery or specialist medical judgements are required, GP vets also do their own basic surgery (including hysterectomies, splenectomies, lump removals, radiographs, and may also work up their own complex skin cases, neuro cases, internal medicine cases (that includes things like kidneys) and so on.  However, we do still have the option to refer.  I tended to refer for two reasons:  a) if an owner, aware that they could go to - for example, a kidney expert instead of me, the all-rounder - asked me to send them to one.  In this case it makes sense if the owner can afford it because a kidney expert will obviously have much more know-how than I specific to that area.   Or b) if I became aware that own knowledge gaps were making things harder for the animal to get the treatment they needed.  Actually, these are two ways of saying the same thing.   To be continued.....

All that said, I do not understand from the small amount of information that you gave me why your vet refuses to see your dog.   Usually a good reason is required for this; it seems strange and unethical, indeed an RCVS matter, for a vet to refuse to give any care to an animal purely because specialist referral treatment has been offered and declined.  In the human world, someone who does not go for private healthcare can be referred back to the GP or state hospital for treatment and this is the same for animals (albeit animal GPs charge).  I wonder whether there are factors that make the situation more complex than it appears and whether there is any more that you can tell me about it.  A common one would be for a GP to offer a choice between referral (or) euthanasia (or) terminal care if they felt that sustained treatment would not be feasible or within their capabilities.  This can be a heartbreaking situation for everyone concerned  There may be other possibilities that I hadn't heard of. Anyway, it sounds as though your dog still needs care and it sounds as though a phone call to your vet to clarify their situation and their recommended next steps for your dog, given that the referral will not be happening, would be in order.