Wanted: Honest Conversations Between You and Your Veterinarian

When you see a TV report or read an article about pet care, don’t take everything at face value. Ask questions and have a real talk with your veterinarian.

Is your vet trying to up-sell you? By: Pictures by Ann
Build a relationship of trust with your veterinarian. By: Pictures by Ann

Last week, I gave you more than my 2 cents concerning ABC’s 20/20 report about veterinarians and the concept of “up-selling” clients on unnecessary procedures.

The television report accused vets of pushing dental procedures, surgically removing lumps and bumps that didn’t have to be removed, and administering too many vaccines.

Here’s a few more cents on what makes sense to me.

Pardon the pun. It’s been a long winter.

What ABC Didn’t Mention

Offering dental care and educating pet parents about how to take care of pets’ teeth at home is good medicine, plain and simple.

Dentals are often recommended because your pet will benefit from the procedure. If you have a trusting relationship with your veterinarian, you can talk true turkey about the benefit/risk/cost aspects of going forward or not with a dental procedure.

ABC kept its cameras on the oral cavity of a dog with some brown tartar on her teeth. The “good” vet in the 20/20 exposé said the tartar didn’t warrant a dental procedure, and the “bad” vet said the dental was recommended. In my opinion, the dog had some tartar — and I believe most veterinary dentists would have recommended that this dog have her teeth cleaned.

What 20/20 missed discussing, however, was the big honking growth on the dog’s gum. Here they are accusing vets of doing unnecessary dentals, but did anybody address the tumor in the dog’s mouth? I know I wasn’t the only vet in the country watching the report and thinking, “What’s up with that?”

This oral tumor was visible to the naked eye, but I have found other problems during a dental procedure that could never have been found in a regular exam. Only 2 weeks ago, I found a small tumor deep in the throat of a cat during a dental procedure. There is no way I could have seen this growth during a regular exam. The growth turned out to be cancerous, and removing it early has given the cat a good prognosis.

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Anesthesia is often required to do a thorough exam of a pet’s mouth, particularly examining under the tongue, another pesky place where kitty tumors grow. But being old-school, I like to remove huge pieces of tartar from a willing patient’s mouth in the exam room without anesthesia. This helps to show Mrs. Skeptic that her beloved Smelly Mouth could greatly benefit from a thorough dental cleaning.

Of course, it’s nice to get to a lot of these pooches and felines before they become Stinkbreath and Foulmouth. Prevention is the key here.

The Questionable Lumpectomy

The 20/20 report gave lip service to an ex-veterinarian who accused vets of removing unnecessary lumps from pets, claiming that many of these lumps are benign and did not have to be removed.

Many pets develop lumps and bumps as they age. The vast majority of vets, I suspect, are honest with their clients when they examine a growth on a pet. But here’s the kicker: If I stick a little needle into a growth to get a sample (called a fine needle aspirate), I may or may not get a good enough sample of cells to make a diagnosis. Honesty is the best policy here. If my impression is that this is a fatty, benign lump, I can offer that opinion with the disclaimer that the needle sample could be misleading.

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There’s nothing worse than sending a dog home with the diagnosis of a benign lump only to have that dog come back in 6 months later with the lump looking very different indeed. A common skin tumor in the dog, for example, is a mast cell tumor. Basic pathology taught us that these tumors are known as “the Great Masqueraders.”

Why? Because they can look “benign,” whatever that means, and they can even go up and down in size. In other words, just looking at a “lump” and offering a definitive diagnosis is impossible.

After an honest conversation with your vet, if you choose to have a lump removed or do a biopsy, I would hope most pet caretakers would be happy with a benign pathology report or grateful that a cancerous mass was found early and removed.

Unnecessary Vaccinations

Okay, if 20/20 portrayed this segment honestly and found a vet recommending an annual distemper vaccination when the vast majority of vets recommend giving this vaccine every 3 years or less, this is a “gotcha” moment for ABC. This vet is, I believe, in the wrong.

I know some vets who don’t follow the AVMA guidelines and give too many vaccines, and I think it’s a disgrace. Talking about your pet’s lifestyle with your vet is important when discussing vaccines. All pets should not receive the same vaccines.

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Is your pet old as Moses or a sweet young thing? Chipper like a snowboarder or ready for the retirement community? An outdoor kind of woodsy pup or a fluff bucket in a pocketbook? These are all important questions that should be the foundation of a trusting discussion with your vet about vaccines. Vaccines are not like cookies cut out of the same mold, and if you don’t understand what your vet is proposing, ask more questions.

Search for Truth

If you haven’t seen the 20/20 segment, you might as well check it out. Read or see all and everything that interests you about animal care, but don’t take everything at face value. The more you question, the more honest conversations you will have with your vet — and I think that makes all the difference in the world.

When you leave your vet appointment and drive home and snuggle up with Snowball on the couch as the real snow comes down outside, I bet you forgot to ask your vet something. Or maybe something the vet said wasn’t clear to you. Give the office a call back. I bet you’ll learn more than anything a 20/20 report can give you.

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