What you need to ask your veterinarian

This post is taken from the notes I made in preparation for a presentation on Thursday morning. I am a member of BNI international and each week, a member gets to give a presentation about their business.

I want everyone to think about their veterinarian, specifically, ask yourself if you like your veterinarian. If the answer is no, then this is a short discussion and you have to ask yourself why you still go there. If the answer is yes, or yes, but, then you should ask why you like your veterinarian.

Some people will answer that the doctor is nice, or he/she loves animals. The hospital is pretty, or modern. The facility is clean, and there is no smell. The staff is courteous and helpful. These things are all important, and they are things that you can see and make a judgment on. You certainly don't want to go to an animal hospital that is dirty, or smells bad. You don't want to go where the staff or doctors seem to be unhappy, or don't seem to like animals. But what you can't see, or know, is what goes on once you leave the exam room.

Even in the exam room, you should have a good interaction with the doctor and staff. Do they ask about your pet? Are recommendations made specifically for your pet and it's lifestyle (more about this in a future post), or do the recommendations seem canned and applied to all animals? Do they do a complete physical examination, looking into your pet's eyes, ears, and mouth? Is the chest listened to with a stethoscope and is the abdomen carefully felt for abnormally sized organs or tumors? Are the medical records complete, legible and can you get a copy if you want it? Are all of your questions answered?

While you are asking questions, there are some other things you want to be aware of. If the pet is going to be anesthetized, who will monitor the anesthesia. In NY State, only veterinarians, and Licensed Veterinary Technicians (LVT) can administer medications, anesthesia, and monitor anesthesia. Do they have monitoring equipment? In our hospital, a LVT monitors anesthesia using several machines, keeping an eye on the heart rate, respiration, the oxygen saturation, and body temperature. It looks like a scene from ER, your pet is hooked up to many monitors so that we can do our best to assure a successful outcome.

During anesthesia, do all pets have an IV catheter placed, and do they get fluids to help support them during anesthesia? What types of medications are used and is the pet intubated to maintain a safe airway.

Does the hospital have an in house laboratory for running blood tests. At Crawford Dog and Cat Hospital, we have a complete in house laboratory. This enables us to run blood work the morning of surgery to make sure that everything is OK. It also allows us to get results back for sick pets in under an hour, so that a diagnosis can be obtained and a treatment plan formulated. If your veterinarian does not have an in house laboratory, how long does it take them to get back blood test results? This could be important if your pet is critically ill and time may make a difference in the outcome.

Now I know that everyone assumes that the surgery suite is sterile and clean, but it is important to make sure that the operating room is an operating room and used for nothing else. Here is a picture of ours :
http://www.crawforddogandcathospital.com/site/view/102351_SurgerySuite.pml In addition, ask if a clean sterile pack is used for every procedure. One would think, "of course", but I assure you that this is a place that many low cost clinics keep their overhead down. They re-use packs for multiple surgeries.

The technique for performing surgery is very personal. We use a laser seen here http://www.crawforddogandcathospital.com/site/view/102352_Laser.pml because we feel there is less bleeding, less pain, and a faster return to function. Many practices use scalpels, and this is fine, both are just a way to cut tissue. The important thing is that the surgeon be comfortable with what he/she is doing. It is also important that adequate pain control measures be taken. Yes that's right, surgery hurts dogs and cats just like it hurts people, and all of our pets should have pain medication after surgery.

Speaking of some painful procedures, remember your last visit to the dentist? Now I'm not talking about a simple tooth cleaning, although this needs to be done for our pets regularly. I'm talking about extractions, tumor removals form the gums, or even root canals. Dentistry, including cleanings, cannot be done with the dog or cat awake. It is impossible to safely, and effectively evaluate and treat dental disease above and below the gum line in an awake pet. In addition, dental radiographs should be taken, just like when you go to the dentist. See? http://www.crawforddogandcathospital.com/site/view/102350_Dentistry.pml

Everything that we talked about for surgery and anesthesia holds true for dental procedures as well. Adequate monitoring, good technique, competent, trained staff, appropriate well maintained equipment, and post procedure follow up including pain medication when indicated.

I hope that this little glimpse into the workings of our hospital will give you an idea as to what you need to be aware of when selecting a veterinarian for your pet. Check out our full web site at www.crawforddogandcathospital.com, especially the library page where you can search for articles written by specialists about a variety of topics concerning your pets health. We will be posting on this topic again in the future, so follow this blog for more information. You can also follow me on www.twitter.com/knvet for less detailed postings about our day to day activities here at the office and on the road.

Keith Niesenbaum, VMD
Crawford Dog and Cat Hospital
Garden City Park, NY