Have you ever wondered about the differences between human and veterinary medicine? A GP or pre-operative consultation will usually involve questions about your symptoms rather than a ‘nose to tail’ examination. Human medics rely on history taking to uncover most maladies. In contrast, vets are presented with a mute, unwell pet.
Table of contents
- The physical examination is vital…
- …but often not enough
- But these tests cost money
- So, how do we find a way forward in this paradoxical situation?
- A common example of tests appearing irrelevant or expensive is seen in treating an arthritic dog or cat with pain relief medication.
- Long term medical conditions need to be carefully managed.
- Cultivate your relationship with your vet so that you can comfortably discuss difficult issues.
- It is often traumatic, disruptive and stressful when your animal is ill.
A thorough history can be taken from an owner, but this still cannot tell us everything. Imagine if your dog has a secretly pilfered fishbone stuck deep in their throat. What would you see? They may seem quiet, preoccupied, and lethargic. Your vet could ask you many questions but none of your answers would point to an offending bone.
The physical examination is vital…
This is the reason that vets carry out a full physical examination on every patient. Domestic pets hide discomfort and pain as they don’t have supportive social structures in the wild and have to look after themselves. Exhibiting pain or weakness puts them in a vulnerable position. Objective parameters like temperature, pulse and heart rate cannot be masked. These parameters give an indication of the health of your pet. Listening to the heart and lungs and palpating the abdomen can also reveal illnesses with few overt signs.
…but often not enough
If we return to our fishbone problem, physical examination will not detect the painful nuisance. Unfortunately, there are many conditions which are completely hidden on examination and too subtle to be noticed by an owner. Early organ disease including diseases of the brain, heart, lungs, gastrointestinal tract, liver, kidneys and uterus or prostate do not exhibit any specific identifying (pathognomic) signs. Similarly, hormonal diseases such as thyroid dysfunction, adrenal gland disease (Cushing’s or Addison’s) and diabetes can be silent.
Many of these diseases will be fatal if untreated. Your vet has a duty of care to you and your animal to diagnose and treat their disease as quickly and effectively to prevent serious illness.
But these tests cost money
As we do not have an NHS for animals, this is where finances become involved. Further tests are often required to diagnose your pet’s illness. Tests are expensive as they require equipment, overheads, staff and laboratory costs to process them. A vet will receive many complaints about these costs each day. They will also receive complaints if they do not promptly diagnose and treat your pet’s illness.
No vet can see a fishbone in a throat without an x-ray or detect early organ disease without blood tests, ultrasound or x-ray. Making assumptions and treating without an accurate diagnosis will often result in expensive delays, financially and in terms of the health of your pet. This is a recipe for medical negligence and pet fatality. Vets are often on the receiving end of clients’ grief and anger if they feel that their pet was not treated appropriately.
So, how do we find a way forward in this paradoxical situation?
Everyone wants the pet to recover as quickly as possible and tests are required to obtain a diagnosis.
It is important to acknowledge that veterinary care is expensive. Private medical care is expensive for humans too. Apart from charity practices with means tested services limited to certain areas, most practices function in the same way as private practice. So, their overheads including staff salaries, building costs, training and equipment need to be paid for. Expensive equipment such as an ultrasound machine, blood testing and x-ray equipment are necessary to diagnose and treat conditions.
Some conditions require MRI and CT scanners for diagnosis. As medicine evolves, investigation and treatment are often more effective and more expensive. Being prepared for these costs provides peace of mind when your animal is ill. We are all inclined to think that pets will never become ill, but they will and they do. Pet insurance will protect you and your pet from being in a situation where their welfare is compromised by financial limits.
Your relationship with your vet is extremely important when considering the expense of tests. You need to trust your vet and comfortable to have difficult conversations with them. Finding a vet who you can communicate with easily pays dividends in these situations. Together you can discuss your financial limits, all the options for investigation and treatment and choose a way forward that is right for you and your pet. In a non-urgent situation, you can ask about the necessity and relevance of every test suggested.
A common example of tests appearing irrelevant or expensive is seen in treating an arthritic dog or cat with pain relief medication.
Initially you are pleased with their response to treatment and accept that blood tests are required to assess their ability to take the medication. After six months, your pet is still comfortable and your vet wants to run monitoring bloods. Everything looks the same to you, your pet is well, they take the medication easily, it is hard to see the reason for more tests. However, the vet knows that if early kidney or liver disease occurs, the medication will make it worse and you will lose your pet far earlier than is necessary. Monitoring certain parameters in their blood may save their lives. No pet should live in pain so the medication is necessary, but monitoring is also essential to prolong life. This applies to other long-term medication and conditions.
Long term medical conditions need to be carefully managed.
For example, poorly controlled diabetes can cause damage to organs such as the eye and brain. Thyroid and adrenal disease similarly need careful management. Chest x-rays, heart ultrasound and abdominal ultrasound can reveal conditions which will cause severe disease and early death if untreated.
Cultivate your relationship with your vet so that you can comfortably discuss difficult issues.
Generally, vets choose their vocation because they love animals and want to help. The financial aspect of their job is difficult and frustrating for them as they often cannot do what is best for the animal. Many practices will discipline a vet who is not charging appropriately as it does cause inequity for other clients and in future consultations. Remember your vet is human too and they are trying to do their best for you and your pet.
It is often traumatic, disruptive and stressful when your animal is ill.
Coping with your feelings and discussing complicated issues can be overwhelming. Having a pet insurance policy for your dog, cat, rabbit, small pet or horse can help to remove financial constraints. Also, take time to discuss and understand how tests will facilitate diagnosis and treatment. Armed with this information you can formulate the best plan with your vet to investigate and treat your pet’s illness.
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