Laurie's Blogs.

Veterinary Medicine has progressed and expanded exponentially over the last several decades.  The options available to our pets are astounding, from top of the line surgeries, to cancer treatments, from fancy diagnostics, to a whole host of pharmaceuticals.  But, has the baby been thrown out with the bath water?  Is going bigger, fanciers, (and more expensive) always the best option?  Or are some dogs not being served because a whole host of options aren’t even being presented?

Where am I going with this?  While conversing with a table of veterinarians out here in California, we got onto the topics of “Standards of Care”, and the differences between big city and small town vet medicine, ‘why’ some vets are dissatisfied with general practice, and ‘why’ some vets choose to go into rehab.  All very interesting.  But here’s the points I want to make:  1. There are some good, simple things that are being overlooked, or tossed in the trash in veterinary medicine general practice, 2. ‘Bigger’ isn’t always better, and 3. As an outsider to the veterinary world, I can tell you what your clients are saying.  So, let’s get to it:

Point 1.  Extracapsular repairs (lateral suture technique) are not total garbage!  They still have a place in treating torn ACLs.  It makes me want to cry when I hear that an owner was told, “You can do a TPLO or euthanize.”  (We see a number of Rottweiler rescue dogs, and they have had dogs turned over to them for this reason on several occasions.)  Small dogs can do great with an extracapsular repair, and some medium and larger dogs can do good as well.  It should still be an option.  We have clients ask us about options.  I’m always honest.  For a large or giant breed dog a TPLO will likely be the best option.  But if that is not financially possible, then why not offer an extracapsular repair?  It seems that less and less veterinarians are performing this technique, and chatting with the ‘table of vets’, one vet said that its now almost considered ‘substandard care.’  And that’s a shame.  It ties in with point 2.

Point 2.  Thank goodness for Dr. Google!  I know we all have those instances where we bang our heads against the wall because a client has ‘read on google…’, but honestly, without google, some of our clients might never find us.  So, in the cases where a person doesn’t want to do the TPLO, and they search online and find one of us who might help them with their dog’s knee problem, they are so grateful!  Yes, we can provide an option for non-surgical, conservative care for their dog’s torn ACL.  Am I saying that NO dogs should have surgery or that conservative is better than surgery?  NO!  But I am saying it’s an option.  I have a 12-year-old Golden Retriever patient that I’ve been seeing for various things and maintenance for the last 8 years.  She had an extracapsular repair on one stifle when we first met.  We rehabbed that.  Then she blew out her other stifle, but she was functioning so well with it, that I convinced the owner to just continue with rehab and strengthening.  Now, about 6 years later, you cannot tell which knee is which!  They’re both great!  Which takes us to point 3.

Point 3.  Psst!  Your clients want options.  They want open discussion.  They want you to admit when you don’t know something, but respect when you say you’ll look it up or ask around.  They admire you when you refer something that is outside of your comfort zone or body of knowledge.  They like when you can provide simple solutions as well.  Bottom line, they are not always looking for the bells and whistles.  They want open dialogue, choices, and not to be pushed in any one direction.

So, maybe we need to put the client back into the equation.  Engage them in decision making.   Give them all of the options.  And help them with whatever they choose.

And on that note, I’m going to grab another glass of California Red while I’m out here!

Cheers,

Laurie