Question:  My pet has a chronic medical condition, and I’m getting very frustrated with all the medications and tests.  Should I get a second opinion?

Answer:
The Short Answer: Many times, having another veterinarian evaluate your pet can be helpful, and reassure you that your pet has a correct diagnosis and treatment plan. However, sometimes communication is the issue, and that may or may not be improved by seeing another doctor.

The Long Answer:  I see a lot of pets for second (and third and fourth) opinions, and the primary reason is poor communication between the owner and the veterinarian or veterinary health care team. Yes, there are times when I disagree with a diagnosis or would recommend a different treatment approach, but that is much less common.

For many second opinions, once I’ve taken a meticulous history, evaluated previous medical records, and done a thorough physical exam, I reach the same diagnostic conclusions as the previous DVM.  However, the difference is that because I realize that there may have been communications issues in the past with the case, I am particularly careful to communicate not only my observations and recommendations, but to articulate my thought processes.  Owners (especially those seeking another opinion) need to have an understanding of the diagnostic process—in essence, not only “what’s wrong with my pet?” but also “why do you think this is the problem?", "why do you think these tests and treatments are necessary?” and, very importantly, “how will we assess the effectiveness of treatment and manage the condition?”

If your pet has a frustrating medical condition, make sure you have discussed these questions with your pet’s doctor:
1) What do you think is the correct diagnosis (and why do you think that?)  Are there other things it could be?  If so, how could we find out?
2)  What are the available treatments, and the pros and cons of each?  How can we assess the effectiveness of the treatment?
3) What are the short and long-term management needs? What should we expect as far as improvement or management (best and worst case scenario?)

You may still need another opinion, but at least you can make sure you are communicating effectively and advocating for your pet.

Second Opinions with Specialists
Just like in the human medical field, veterinarians can specialize, so we have veterinary ophthalmologists, surgeons, dentists, dermatologists, etc. Your primary care DVM may suggest a consultation with a specialist, or you may request a referral.  Either way, the above comments on communication still apply.

Not every medical condition can be diagnosed and treated rapidly and effectively.  Medicine has always been an art as well as a science, and a significant fraction of that art is communicating.

--Dr.Angie Lathrop 

Question:  Is it true that certain breeds are at higher risk for certain diseases and even cancers?

Answer: Unfortunately, the answer is yes.  Every veterinarian sees a higher incidence of certain problems in particular breeds of dogs, and sometimes even in particular lines within the breed.

However, this does not mean that all diseases are genetic in origin, or that these problems would be easy to eliminate by simply not breeding affected individuals.  Most diseases are due to a complex interaction of the environment with the genes of the animal, and many problems cannot be easily screened for using existing methods.

The good news is that rapid advances in genetics research are benefiting pets as well as humans.  The Canine Genome Project is using cutting edge technology to investigate the origins of canine genetic diseases, and to ultimately help finds cures or ways to prevent transmission of genetic diseases.

If you are interested in canine genetics in general, or in research being done in a particular breed, here are a few websites to get you started.

American Kennel Club Canine Health Foundation

http://www.akcchf.org/

Orthopedic Foundation for Animals

http://www.offa.org/

Canine Genetics Diseases Network

http://www.caninegeneticdiseases.net/

The NHGRI Dog Genome Project

http://research.nhgri.nih.gov/dog_genome/

This is a long post, but one of the most frequent questions we get is "What should I feed my pet?" Here is our answer to that question.

Pet Foods and Your Pet

Over the past five years, over five thousand new pet foods have been introduced to the market.  If you’ve ever shopped for pet foods and wondered how to choose the best one for your pet, you’ve got reason to be overwhelmed.  Dry or canned? Raw? Homemade? Holistic? Natural? Organic? Is more expensive better?  Should I feed a senior diet?  What about foods that are supposed to help with arthritis/weight control/senility, etc--Do any of those actually work?

How do I know what to feed my pet?

Tips on Selecting a Food for your Pet 

• Look for the AAFCO statement on the label.  Has the food been tested by feeding trials, or has it simply been formulated to meet the nutritional requirements?
• Look for a food that is labeled for your pet’s life stage, not all life stages.  Food that is labeled for all life stages has enough calories, protein, and nutrients for an animal that is growing or is pregnant – that’s too many calories and the wrong balance of nutrients for an adult animal who is not pregnant, or for a senior who has special nutritional needs.
• Things to look for in your pet when evaluating their current diet: glossy, thick hair coat; appropriate stool volume, consistency and odor; lean, muscular body condition. (Not all health conditions can be evaluated externally, however.)
• Be aware that many claims by manufacturers are meaningless (and thought up by very savvy marketing departments) – for example, the words ‘holistic,’ ‘natural,’ and ‘human grade’—all of these terms have no standard definition within the industry.  Pet food labels do have some restrictions, but websites and other marketing materials are not regulated.
• Pets with medical problems or senior animals will very often benefit from special diets. Prescription veterinary diets have made huge strides in disease prevention and treatment in recent years. Consider taking advantage of these very real benefits—these foods incorporate nutrients that can extend lives and treat many medical problems (without you having to give your pet pills!)
• If you have questions about a diet, call the pet food company.  They should be able to give you any information you request, and even have research to back up their claims.  If they don’t, or cannot answer your questions, look elsewhere for your pet’s food.

Our new website has been a while in coming, but hopefully it will be even more informative and easy to navigate. One goal we have is for our veterinary website to provide accurate veterinary and animal care information to our clients and animal owners in general.  Another goal is for the LVH website to be a portal to internet veterinary medical sources -- a good place to start if you'd like to find out more about a particular medical condition or for general pet and animal information.  You've heard it a million times -- be careful about what you read on the internet.  The truth is that there are vast amounts of valuable information mixed with absolutely incorrect drivel, and overwhelming amounts of material that is ambiguous and open to interpretation. The solution -- start at our website.  We'll direct you to reputable sites, and they may have links to other good sources.  Then, as you graze the endless pastures of opinions, facts, studies, and testimonials you'll have a good base to ground you. 

Happy grazing!