Vetcetera E-vets: Saving pets one email at a time…?

November 6th, 2007  

Add Comment14 Comments

This is a fine line even we e-NON-vets have to straddle. I view my role as the writer of a cat advice column as an educational one, to help cat owners learn about the possible reasons why their cat does X, Y or Z; how to improve their relationship with their cat or between their cat and other animals; or what the common treatment options are when a cat has ailment B--and so on.

I've had a couple of readers I've taken to task for NOT going to the vet when their cat was obviously sick ("My cat's had this ulcer on her eye for a week, and I can't afford a vet, what can I do for home treatment?" type of questions--to which I respond "Nothing. MAKE a way to afford the vet. Your cat needs treatment NOW.") I've also had one or two that I wrote back as soon as I got their e-mails saying "go to the vet, don't wait for me to answer your letter in the column"--who later thanked me for telling them so because their kitty would have died if they hadn't gotten treatment.

So, I dunno. As a pet owner, I'd rather call my vet and pay the extra fee for the emergency call than trust someone I've never met to figure out what's wrong with my cat based on my description.

JaneA November 6th, 2007 09:14:00 AM

I have not had any experience with e-vets, but I can see a usefulness for establishing a standard of care as you mentioned. The doctor whose license was suspended for not properly using pain meds, for example...

He would have had less of an excuse to say he didn't know better, and clients may have gained a better idea of what the current standard pain med protocol was in "the rest of the world" if he was the only practitioner they had access to.

Another area where it would be helpful is helping a client understand that there are reasons for the procedures that you want to do on "Nanook" besides padding the bank account. We recently had a client say they would take their whole kennel club elsewhere because one of our vets was insisiting on pre-dental x-rays before performing a cleaning on their very orally challenged pooch. When the Dr. tried to explain that their appeared to be severe deterioration of the mandible and it was important to the health of the dog to know what we were getting into, the owner said that "so and so animal huckster palace" will do it without the radigraphs.

If these owners were able to actually investigate this on some sort of e-vet site with case histories and examples, they would have realized that by going into this dental blindly, the vet performing this procedure may wind up giving Nanook a mandible that is strangely flexible.

I'm very interested to see whre this goes in the future, since the web is so hard to regulate.

Brian Hewitt November 6th, 2007 09:31:00 AM

Oops, Dr. Khuly, I mistyped above. Even though Nanooks people were only planning on a cleaning, it was very clear that there would be some teeth that needed to come out and it did not look like it would be an easy undertaking at all. It definitely would not have been a routine cleaning that didn't warrant the radiographs.

Brian Hewitt November 6th, 2007 09:36:00 AM

Brian: definitely sounds like Nanook required rads before embarking on any extractions. Though I'd go one further and recommend that *all* extractions be preceded and concluded with x-rays. Not all owners can afford this so often we do without, preferring to remove teeth sans rads when it appears straightforward. In cases where periodontal disease is advanced, though, the vet has to protect himself/herself by drawing a solid line--no rads no extractions! I agree with your hospital's approach.

Dr. Patty Khuly November 6th, 2007 10:17:00 AM

Heh, "e-vet" is also shorthand for "emergency vet", and that's what I thought you meant at first. :)

The closest I get to using an e-vet is posting questions to online communities of pet owners. I recently posted a photo of the underside of Gabe's (cockatiel) feet where they appeared slightly reddened, said that I suspected it was irritation from using a dowel perch primarily, and solicited others' opinions and suggestions. Going to a knowledgeable community for advice is good b/c then I get a variety of opinions, and people generally present their reasons for their opinions and will tell me when I should see a vet in person, if I wasn't sure. I find such resources helpful, and I always know (even if they didn't remind me) that their opinions are exactly that - opinions based upon their experience and the information that I present them, and not based upon medical background and actual interaction with my pet.

zandperl November 6th, 2007 01:03:00 PM

I'm a member of a ferret health list along with vets and other ferret owners. It's good for those "Is this normal," "Does anyone have any info on this condition," or "How can I get my ferret to eat" type of questions. It's also helpful for keeping up with new treatments. I like having the additional information from owners and vets, even when it seems conflicting. Every now and then, though, someone tries to use it as a substitute for in-person veterinary care.

Sydney November 6th, 2007 03:45:00 PM

Hi Dr. Khuly,

We generally do prefer to do radigraphs for all extractions, but we do try to take the finances of the owner and gneral condition of the mouth in question and the animal attached to it into consideration.
Unfortunately our area is within driving distance to some more rural area vets who tend to be a bit more old school that don't think twice about just doing the extraction sans x-rays :(

Brian Hewitt November 6th, 2007 05:05:00 PM

This is an alarming concept and I didn't know it existed.

I guess it's one thing to be in a breed chat room and say "hey, I've got a new puppy and it's making a snorting sound, is this normal or should I go to the vet?" versus "what's wrong with my dog?". The latter being something I would never consider not doing in person. The former being the kind of posts I have made and continue to read on our chat room. 99% of the time, the response on our chat room is "...sounds like [fill in the blank] and you should take fluffy to the vet to be sure".

I guess I like the internet for being able to set my neurotic concerns for my dog's health free. But I am saddened that people can actually have their pets diagnosed over the internet. I guess maybe getting a second opinion about an Xray makes sense, but are you saying that e-vets actually respond to an electronic description of an ailment? That seems to cross an intangible line. But, I am also horrified that people can "download" house plans and build their 'dream house' from them. ;(

Amy in Somerville November 6th, 2007 05:34:00 PM

Well, I have received valuable information off the internet - not just from e-vets but also from various forums. However, I don't think the internet can replace a vet. You can get good information and questions to ask your vet so you are better informed. I did do a phone consult with a vet I found over the internet - just getting a different perspective. But again, I did not replace my regular vet with this consult. But it did give me a better feeling about saying I didn't want to use the UTI diet my vet was prescribing - and it turns out my cat didn't need.

Jenny November 6th, 2007 07:05:00 PM

Are we veterinarians in practice really so hard to reach by phone that pet owners have to reach-out to groomers, evets, and breeders for advice? I don't think so. For whatever reason, people look to layfolks for help far too often. And I don't see advice-for-pay taking off anytime soon.

Gerald DVM November 11th, 2007 12:46:00 PM

It goes without saying that an e-vet can never replace a real life veterinary consultation in a clinic. None of them will even make such a claim. However, I think they can play a role. Firstly, these e-vets normally charge <$10 to answer your question (a veterinary consultation is more like $50) so if you are not 100% sure that your problem warrants a trip to the vet, it can be a way of finding out. Secondly, owners might want a second opinion on something, or clarification on what their vet said during that consultation. Thirdly, some websites even have exotic species experts that will answer relevant questions. I know from taking my African Grey to my local vet that usually 'regular' vets will be clueless when it comes to exotic species, in those situations I'd rather have an online dialogue with an avian expert.
Obviously there will be loads of dodgy e-vets out there and you have to find a website you can trust. I had a good experience with one called Why Does My Pet? but this seems to have been discontinued.

Peter Smith November 14th, 2007 04:56:00 AM

I used to look up vet books when a pet was diagnosed with a particular problem, or if I found something and was unsure if a vet was needed (some injuries for example). The Internet seems to have largely replaced books, and has the advantage of being more up to date. Also, the information is all in one place (in a way - no need to travel to libraries, or trawl your own bookshelves and check indexes). But you do have to be wary. Then again, some books are not 100% correct either.

Its also great for behaviour problems - I find it difficult to locate anyone who can tell me what to do about a cat that bites - most vets dont seem to offer that information, or know enough about animal behaviour to give a useful answer.

But it is rarely a substitute for a vet visit. It can give more information than the vet has time to offer, and also information from another angle. When my dog was diagnosed with cataracts (wrongly, it turns out), I was able to read up on the surgery, recovery, costs, and what it all involved, and make a decision based on that. Same for his collapsing trachea - surgery or no? does surgery work? is age a factor? are there other treatments, researched or not?

Some vets give out information leaflets, which to me says "this will save me time explaining it to you in detail, and to the next person who comes in with the same problem".

Email lists offer another source of information that was closed to us not so long back. A group of people who are knowledgeable, and joined by their common interests. They can also offer personal experiences, not always possible from a vet (who wont necessarily own every species they treat, or have experienced directly the effects of an illness or injury in the longer term - ie living with the pet in that condition).

I am not sure I would be willing to pay for that information, since so much is available free anyway. How much more useful would the information be, compared to a reputable vet website?

Robin November 15th, 2007 08:12:00 PM

Never have and never will. It probably is the same cost as a trip to the vet. If my trip to the vet is over my budget, I make payments. It is not worth losing your pet over saving a few dollars. Most times I can call my vet explain the symptoms to them, they call me back and let me know , come in or we have medicine for you to give your pet. Also I have 18 cats 7 which are young kittens, and 10 dogs. So my vet loves me , he also gives me breaks because I rescue orphaned , abondoned , abused and specail needs pets.

Barb November 17th, 2007 07:00:00 PM

Yes I agree for some things you just have to go to the vet, and it's nice to as well if you have a close relationship with your vet, of course they can give your pet a general check over while you're there. I find vet fees can be a bit pricey though. Here in London you pay anything up to £30 ($60) for a consultation. If it's something relatively minor, I don't want to do that. I'd rather ask an online expert and pay £3 ($6). Of course that only applies to minor problems, behavioral stuff etc, and it has to be an extremely reputable site that I trust, preferably with multiple experts that are regulated, rather than one vet who might not themselves know the answer.

I know loads of info online is free, but sometimes I can't be bothered to trawl through it all. And it is easy to go off on a red herring at times. At least the paid advice is tailored to my individual pet, considering the individual medical history and circumstances. I don't see that kind of personalized human attention ever being replaceable.

Peter Smith November 23rd, 2007 12:19:00 PM

Add Commment

Your Name:

CAPTCHA Verification