Apples and Oranges

Often veterinarians borrow medical information and techniques from our human counterparts in order to explore, learn and provide better care for your critters.  While how your Fido or Fluffy may respond/react to some drugs are certainly different from humans, basic anatomy and how the body works is very similar, which is why we use many human based drugs and procedures in our care for animals.  I am ultimately convinced that my dogs and cats think they are human!  Along with medical drugs and procedures being borrowed, we also often adopt human medical practices and protocols.  Example:  when I was growing up there weren't a lot of speciality doctors in the veterinary world, most veterinarians were general practitioners like myself, tending to every aspect of an animal veterinary needs.  Even speciality MD's were few.  As technology and medical knowledge advanced, it became more difficult to stay abreast of all the information and the birth of more speciality fields such as cardiology, orthopedics, oncology, etc, became more common place in the MD world and in the DVM world.

HOWEVER-- there are some things I am most glad that I have not mirrored from the human medical field.

My 76 year old mother-in-law has been suffering from digestive pain for several months.  After a period of treating the symptoms for the most common digestive maladies by her general practitioner with no improvement, she was referred to a internal specialist (all very logical).  The internist (keep in mind the speciality clinic is 2 hours from home) could not find room in their schedule for at least 30 days and my mother-in-law (ML) waited and suffered quietly until she could be seen.  Once at the internist,  a variety of diagnostics were repeated (blood work already performed by her GP) and a MRI was scheduled to rule in/out a variety of potentials (ulcers, gallbladder, cancer, etc.) however once again the appointment for the MRI was weeks away.  Another trip to the MRI lab (2 hours away) and another wait for the radiologist to read and report the information to the internist.  Then another repeat trip to the internist to learn what the radiologist reported, which was gallbladder disease.  Are you sitting down?  The internist now refers my ML to a surgeon...another wait for several weeks and another 2 hour trip.  Luckily my ML has a lot of patience and endurance.

Last week, we got a phone call that ML was being sent by ambulance to the hospital because she lost consciousness and was blue!  The consensus from her visit to the ER was that somehow the gallbladder is causing an obstruction blood flow that caused her to pass out.  Hmmm...that had me thinking.  In the mean time they instructed her to eat small meals and avoid fatty meals...(something I hope that her internist had already done).

This week, my husband drove his mother to the surgeon's appointment for the purpose to review her records and perform a physical examination, repeat blood work and they scheduled an appointment with the cardiologist to be sure that she had no special heart needs prior to surgery.  So guess what?  Another trip in a couple of weeks for EKG, etc.  Now...while my ML is being patient....I am starting to get frustrated.  The necessity for heart evaluation in a 76 year old woman, prior to surgery, is certainly not unwarranted.  However, I am thinking....the surgeon or the internist had to have considered her overall health prior to surgery at some point before now.  For convenience, time and expense wouldn't it have made sense to have made her appointments for both the surgeon and the cardiologist on the same day!  Make a full day of it!  Let's get this woman to surgery and fix her problem for Pete's sake!

So...there will be another trip to cardiologist, testing, waiting for results and sharing of information with the surgeon, another appointment with surgeon to discuss results and go over procedure of surgery and to set appointment date for surgery (probably weeks away).

I am thinking....a anorexic, vomiting, diarrhea dog comes into my office.  What would my client do or say if after my initial examine of their pet and preliminary evaluation and ruling out the most common, such as garbage gut, I told them they had to come back next week for x-rays, the following week for an ultrasound (luckily I have one so I wouldn't have to send him to a specialist yet) and finally diagnosed the dog with gallbladder disease and would made them an appointment in a week (or more) for surgical removal.  In the mean time the dog is still miserable, still vomiting and has diarrhea (something that is as much fun for the client as it is the dog).

Frankly, I know what my client would do.  I would be questioned about my abilities as a doctor, I would be told that they would not be back and they would be seeking another veterinarian who could take care of their dog's needs in a more expedient manner.

One of the many things I take pride in at my clinic is our compassion and empathy for our clients and their pets, and our organizational skills in trying to expedite testing, care, treatment therapies to service to save time and expense for us and our clients.  We realize that your time is as valuable as ours.  Thank God I am a VETERINARIAN!