Updated March 23, 2021
I want to tell you about the most under-used diagnostic test in veterinary medicine and why you should ask for it more often. I’ll start with just two examples that highlight the extremes: the worst and best of cases.
The Rare Disease
Some time ago I was talking to an ex-client who had moved away. She told me about the tragic story of her cat, who was euthanased a few months earlier.
As she described the quite unusual and distinctive features of the illness it began to get horribly familiar. Many years earlier (thanks to help from a specialist) I had seen and diagnosed an identical case. Once we had the diagnosis, the cure was a simple surgical procedure and the cat lived a long and happy life.
The problem for this very unlucky cat was that the condition had only been reported once in an obscure journal, and most vets had never seen or heard of it. I was lucky to have done so, but that doesn’t make me special. There are no doubt many other rare diseases I’ll never see or hear of.
All this cat may have needed was a second opinion.
Bella’s Neck Pain
Bella is the Kelpie above who as you can see still loves life, though she’s not as young as she used to be. She’s always been well but recently she started yelping at home and her owner took her to the vet. A neck problem was diagnosed, and she was prescribed anti-inflammatory treatment.
Bella’s owner met one of our clients on the beach, and so on recommendation she came for a second opinion. My examination of Bella found that she did indeed exhibit neck pain, though less than the day before. We also discussed several other findings from the examination.
The advisability of X-rays was discussed, but owing to her improvement, it wasn’t felt to be essential. Due to her age and a recent period of possible ill health, we also took a routine blood test, which was normal.
In summary, our findings substantially agreed with the first vet’s opinion, though our approaches differed. Here are Bella’s owner’s views on the experience.
I believe that part of being a responsible dog owner is to set the bar high and that means questioning everything and not accepting a prognosis on your beloved family pet if a) it doesn’t “feel right” and b) not enough information is forthcoming from the vet. Just as we seek additional medical opinions on health issues for humans, asking for a second, sometimes third opinion is a sensible, practical option for our beloved pet, that brings with it peace of mind.
What Happens At Second Opinions
These two cases represent each end of a vast spectrum. Sometimes, our opinions are the same as the first vets, and the only difference is in our approach. Sometimes, there is a profound difference in outlook. Most of what we see falls in between.
Getting a second opinion is as simple as making an appointment. The only difference will be that the nurses will ask you if we can request a copy of your pet’s history from your vet. This is that hardest part for most people as they usually prefer not to let their vet know.
I can honestly tell you that when my histories get requested by other vets, I only have one of two reactions:
- I know I’ve done my best and I’m sure the client will become more confident in that by seeking another point of view
- I know I haven’t been able to do my best and I hope the second vet sees something that I’ve missed
Second opinions are not offered as a way to gain new clients. In our busy practice they only represent one or two patients a day. They are a genuine service that all vets offer.
Why Get A Second Opinion?
Please note: it’s possible to look better than the first vet in a way that sometimes isn’t fair. The vet doing the second opinion can sometimes get a boost from the work of the first vet. If something was tried, even if it didn’t work, the results will help to plan what to do next. For all we know, the first vet may have planned to do exactly the same.
I’m also not saying I’m better than other vets. I’m not. I’m saying two heads are better than one. It’s a collaboration, not a competition.
Vet Experience Varies
We all have different educations, opinions, practice policies and life experiences that shape our daily work. We can read, study and be as experienced as we can but no vet will ever know all there is about every disease, and some diseases are undocumented.
Sometimes a disease like that of the cat above is best identified by a process known as pattern recognition, but without seeing it before it’s very hard to do. For example, tetanus in dogs is very hard to diagnose but once you’ve recognised one you’ll never miss another.
We’re Not Infallible
Vets are only people, we all make mistakes at times and sometimes an animal’s medical history can blind us to their new problem. If you are worried about your pet and get a second opinion, one of two good things will happen:
- Two vets will agree and you will have the peace of mind that the diagnosis is almost certainly correct.
- Two vets will disagree and you have potentially saved your pet from severe consequences.
You can read about some of my own mistakes here.
Two Vets Never Say Exactly The Same Thing
Even if the vets agree, it’s almost certain that they will differ in their management of the case. You will get to hear two perspectives on how best to treat the problem; orthopaedic surgery is a good example of how no two vets go about it the same way. If possible you will also hear two views on how to prevent the problem happening again.
Read here about literally five ways to treat the same liver problem, for example.
Discussion of Costs
I’ve already talked about how much the cost of veterinary services can vary between clinics. We get a lot of phone calls about this, and unfortunately we usually have to say that without examining the problem, we can’t give an accurate price for its treatment.
No one wants to talk about money, but for many pet owners it’s a real concern. It is your right to seek information on the expected costs of vet treatment for your pet.
Access to Vet Specialists
Did you know these people exist? At any time you can ask for your pet to be referred to a registered veterinary specialist for a second opinion too. I promise we’ll recommend this when we feel it’s best for you and your pet, but it’s OK to ask.
Why Not Get A Second Opinion?
Two big reasons stop people using this service more often.
Fear of Causing Offence
People often have a very good relationship with their vet stretching over many years, and they worry that they will lose their vet’s goodwill.
I can only speak for myself, but I expect most vets share my views. That is: I’m not perfect, I can’t expect others to think I am, and I know how much their pets mean to them. Therefore, I perfectly understand their need to feel more confident about their pets’ care. If you want a second opinion after seeing me, it won’t spoil our relationship; indeed I’ll even suggest it myself at times.
If the fear of causing offence is enough that you don’t feel comfortable for us to request the history, why not ask for another vet in the same practice you currently attend to have a look?
Cost
We get a lot of phone calls from concerned pet owners inquiring about getting a second opinion, but very few will make appointments. It seems like they are discouraged by hearing they will have to pay for another appointment.
I think we can show you why paying the consultation fee to reexamine your pet and go over their case history is money well spent.
When we talk about all our fancy diagnostic tools, whether blood tests, ultrasound, xray, even MRI, we do ourselves a huge injustice. The best instrument for diagnosis and treatment is and always will be the human brain. It’s the same in any job; think about how you bring your unique judgement and skills to your own employment.
For a modest fee you can run your pet’s health through one of the most advanced and complex devices ever made. Why wouldn’t you?
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By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These articles are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story!
