Sick pet…surgery…biopsy…what’s next? How long does it take for the faraway pathologist to render a diagnosis?
Some clients call every day—twice, even—hoping to catch the fax as it hits my email inbox.
They’re justifiably on edge, wondering if that scary oral sore is a squamous cell carcinoma, the toe mass a melanoma, the skin mass a grade III mast cell tumor…or something they can finally big a big sigh of relief over.
Three to five business days I tell them. Try to put it out of your mind until then, I urge. Easier said than done, I know.
But last week’s client was not so easily mollified. Angry at what she perceived to be a delay (four and a half days since the biopsy, four days since FedEx took it away to a lab in Oregon), she berated the receptionists mercilessly for our archaic snail’s pace in a 24/7 world.
Hmmm… I couldn’t help but wonder whether this owner had ever undergone any medical treatment for herself.
Lump in breast? Wait two weeks sometimes—up to nine weeks in places with public medicine (Canada, Britain).
Abnormal pap? Took my cervical biopsy three weeks for a final verdict.
Your pet’s tests? Three to five business days, on average. Sometimes within hours if we’ve got an in with a lab and you pay for a stat.
Yes, it’s true that some human hospitals have in-house pathologists to read intra-op slides for surgical procedures, but this isn’t the norm for most people tumors. And sometimes you’ve got to wait months to get scheduled for the procedure in the first place, whereas pets get the benefits of immediate care (if you can afford it, that is).
By most human standards vets are lightning quick—fee-for-service care has its benefits. But you can’t tell a stressed client that. Not while Fluffy languishes with a sore mouth at home…not while the bone under those stitches aches after a punch biopsy.
I know it’s hard…but we’re doing the best we can…really, we are.
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Interesting site from Nova Scotia on wait times:
http://www.gov.ns.ca/health/waittimes/wt_treatment...
dig a little there and they expplain why you have to wait
http://www.gov.ns.ca/health/waittimes/why_waits.ht...
None of that was in Sicko. I wonder what Cuba's wait times are?
Dr. Patty Khuly July 26th, 2008 07:46:00 AM
Have you checked out the health outcomes in developed countries (not Cuba) struggling under the Awful Burden of public medicine? Life expectancy, infant mortality,preventative care, preventable disease, work time lost to illness, survival rates for serious conditions? These are not areas where the US ranks where we'd want it to rank, or where many people assume we rank. Also, "wait times" as measured in the US do not include the substantial portion of the population that has no health coverage at all, and so get only the health care they can pay for out of pocket, or emergency room care with concern about how the bill will be paid deferred till later.
You had a perfectly valid point about wait times for test results in veterinary vs. human medicine, without mucking it up with irrelevant politics.
Lis July 26th, 2008 09:22:00 AM
Lis: No politicizing was intended beyond an indictment of the film Sicko, which was the vilest bit of trivializing polemic I've ever seen on the incredibly complex issue of healthcare. Indeed, I did not mean to interject an opinion on public vs. private medicine, I simply meant to point out a small subset of the issues and their trade-offs.
Dr. Patty Khuly July 26th, 2008 09:31:00 AM
Sorry, still mystified as to what the film Sicko has to do with wait times in veterinary medicine, or how that doesn't constitute politicizing.
It's a mistake to assume that people who share one interest with you, must necessarily regard as "facts" the same political opinions that you do. (Remember the British barbarian in Ceasar and Cleopatra?)
Lis July 26th, 2008 10:39:00 AM
Lis: Last time I checked this was MY blog and what I include here is for you to accept or reject. You're clearly smart enough to make up your own mind. But PLEASE stop your negative lambast of me, my blog, my opinions, my decisions and my profession. I have been very patient with you and have defended your right to showcase your opinions here but I'm beginning to agree with others who have complained that you're abusing your voice. So I know I speak not only for myself when I ask you to take your extreme negativity on the topic of veterinary medicine elsewhere.
Dr. Patty Khuly July 26th, 2008 11:05:00 AM
Dr. Khuly - You go girl! Thank you!
sassy July 26th, 2008 11:36:00 AM
Generally the wait times for Veterinary pathology in Nova Scotia are 5 to 6 business days as it has to go to the Atlantic Veterinary College Lab in PEI. Certainly much better than our human health care wait times. Waiting last January for two pathology reports to come back was certainly nerve racking but I knew that my vet would call with the results when she got them so I didn't call and annoy anyone at the clinic. I think that veterinary wait times are perfectly acceptable and human medicine could take lessons from our Vets. On Thursday afternoon I discovered that one of my labs had what looked to me like an ear infection, and by Friday at noon he had been seen, ear cleaned out and treatment started and I had an apology for having to wait for 30 mins to be seen ( I certainly didn't need an apology, and told her so.) Now had that been my grand daughter in order to be seen by a doctor that fast I would have had to take her to a walk in clinic or out patient department and wait for at least 3 hours and I would not have gotten an apology.
Elizabeth - from Nova Scotia July 26th, 2008 11:55:00 AM
In comparison to human medicine, I do indeed find that biopsy(s) have come back quickly. I used to be a nervous nilly too, waiting to hear. With my changed life circumstances----I now realize that knowing the results quicker aren't going to change a thing. I passed up 2 biopsy(s) on my elderly dog at 14 1/2, because what difference was it going to make and I knew the location and appearance wasn't favorable.
Actually, even to get a favorable report on a melanoma & plasmacytoma doesn't guarantee a whole lot anyways. But curiosity gets the best of me and having a sure "diagnosis" influences treatment.
Gosh, having a biopsy (on-site) at a huge hospital can be weeks---and then you need the followup appointment with the surgeon too! And even a brilliant, experienced pathologist often gives 2-3 "possibilities" in order of likelihood as to what it could be or precursor of----interesting!!
Barbara A. Albright/New Hampshire July 26th, 2008 03:41:00 PM
I thought I was the only one that was feeling Lis's negativity.. and it was turning me off..
I appreciate the imformation, Dr. Khuly .. The input, and incite from your readers has been a great help.. I'm not used to negativity, as I tend to defuse things before they get to that level..
I'm pretty low key, considering I'm from NY
Thanks,
Socrates's mom
barri July 26th, 2008 05:01:00 PM
I must be an oddball. I view a blog similar to an email group, reading the paper, or listening to the news. People have different opinions, interpret differently and as such, I agree, disagree, learn something, inspired, maybe become annoyed--but if so, on the latter, I just mentally disregard it and move on or voice my disagreement. Wouldn't it be boring otherwise? And can't one decide what to read, such as the blog only w/o comments? (that is how it shows up on a rss feed). I have yet to contact any on-line moderator to complain about anything!
Barbara A. Albright/New Hampshire July 26th, 2008 07:02:00 PM
I'm laid back too, unless I happen across a bully or a know it all. I have read all the comments here, including many I don't agree with. But I say my two cents worth and go on. I gotta say the back and forth on some issues are interesting, entertaining, and educational. But I think when one disagrees just to disagree, it becomes more like the Jerry Springer Show. We're all here because we are very interested in our pets, and we like to learn a little from an insider. I think it's pretty evident the difference between arguing just to be negative and truly getting across a different point of view. Hope this makes sense.....I'm on midnites and a little fuzzy as it's still early....
agadoresmama July 26th, 2008 10:57:00 PM
In Britain the turn around time for the last few years from finding a breast lump and receiving a diagnosis has been a strict 14 days. That 9 week thing is out of date, for us at least. There waiting list problem in Britain tends to be confined to problems like hip replacements, where the patient is in pain but not in danger from the wait. I'm not saying it's perfect by any means, btw-when Sicko came out there were a lot of hollow laughs in the UK. But surveys have shown that an overwhelming majority of our population prefer our model to that of the US, despite some problems-I haven't seen it asked in a survey but maybe we'd accept a half-way model like Germanys, but definitely not the US model.
Sian July 27th, 2008 07:03:00 AM
My pet's surgery was scheduled for Feb 14, 2008. He had an exploratory surgery for the removal of an obstruction that his attending vets and internists diagnosed. The surgeon found NO OBSTRUCTION but performed a liver biopsy. My companion animal died on Feb 21, 2008, the date the surgeon received the biopsy from the University hospital pathologist. If he (surgeon) had received the biopsy results even one day prior to my pet's death (due to an underlying disease), the vets might have been able to diagnose my pet correctly, administer the RIGHT treatment and spare his life and my mental deterioration.
Fotini July 28th, 2008 09:25:00 PM
My pet's surgery was scheduled for Feb 14, 2008. He had an exploratory surgery for the removal of an obstruction that his attending vets and internists diagnosed. The surgeon found NO OBSTRUCTION but performed a liver biopsy. My companion animal died on Feb 21, 2008, the date the surgeon received the biopsy from the University hospital pathologist. If he (surgeon) had received the biopsy results even one day prior to my pet's death (due to an underlying disease), the vets might have been able to diagnose my pet correctly, administer the RIGHT treatment and spare his life and my mental deterioration.
Fotini July 28th, 2008 09:25:00 PM
Fotini: So sorry for your loss. You speak eloquently of the agony of not knowing and how that can easily translate into no treatment...and death. Only one day...how sad.
Dr. Patty Khuly July 29th, 2008 08:22:00 AM
We live in British Columbia, Canada, on Vancouver Island
My daughter felt a lump in her breast three months ago. She got an immediate medical appointment on a Tuesday and the biopsy was done three days later in a public hospital under our health care system. I think a lot of people in the US don't really understand our system. You can always go to emergency if necessary.
The reason I found your site was a google search for waiting periods for a biopsy on my cat. The possibility of west-coast leprosy and a host of other illnesses was mentioned. The sample was sent six days ago and still no result. I don't want to pester my vet, so that's why I tried to find out for myself. Of course we have to add a day for the samples to get to the lab in Vancouver, so I may have to wait a few more days as two new bumps grow larger.
Thank you for your website.
Jean M July 29th, 2008 10:09:00 PM
Jean M: Wishing you the best.
Dr. Patty Khuly July 30th, 2008 07:58:00 AM
Dr. Khuly:
Thank you for your sympathetic comments. You can read the whole story on my site:
http://alabamavetboardwatch.110mb.com/
Fotini August 1st, 2008 01:10:00 AM
good information
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