Thursday, March 16, 2017
I have been encountering over the last years more more the use of words that tend to convey to the pet owner a sense of guilt and fear.
The following statement with some variations is used: You have declined diagnostics and treatment at this time, as well as humane euthanasia. It is very likely that your pet will continue to decline without treatment and may die at home.
Wow! What a statement; how frightening.
So, are there cases when a pet is so critical that the above is true? Of course there are. But I have encountered cases—and too often—in which the statement is used to scare and create a feeling of guilt.
A true assessment needs to be done, and if true financial hardships are present, then a less costly venue can and should be pursued. In my practice I explain in detail the possible differentials of the illness, being frank and open. Often, with the understanding and acceptance of the owner, a course of treatment will be ensued, and if feasible, and most time it is, I send the patient home, where they are more comfortable. Usually a follow up visit is set for the next day. I explain that this approach has significant limitations, as at this point we do not have a diagnosis, but we can try and see how we are doing with treatment that addresses the symptoms. Of course some medications cannot be started without diagnosis—as they can do harm in certain situations—but at least we are trying to help the pet and the family.
If the patient improves, then, gradually and judiciously we’ll do tests to further define the illness, continue or modify the treatment, and try and get a prognosis.
The bottom line has to be compassionate veterinary care with good communication with the owner, and a relationship of mutual trust.
Dr. Ehud Sela
The Gentle Vet
© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.
Saturday, January 7, 2017
Chronic Renal disease is a common problem in cats. Blood work can detect it, but once the blood work shows abnormalities changes already were established in the kidneys and often, at that point, the treatment is for control of the disease rather than prevention.
One of the diseases that cats can have is an infection of the kidneys called pyelonephritis. It is often an insidious disease and does not become manifest until late in the disease process.
I am a strong believer in early detection and prevention. In my geriatrics cat patients, I often advise routine urine analysis. It's a simple test and the owner can easily collect the sample at home.
I also routinely perform abdominal ultrasounds and have found pyelonephritis in cats before the kidneys suffer irreversible damage.
These geriatric cats might have nonspecific mild syndromes with slight weight loss, and just seem to the owner that they are not doing right, in a mild nonspecific way early in the disease process.
These cats usually respond nicely to antibiotics and the owner notices an improvement in their general wellbeing.
Dr. Ehud Seal
Gentle Vet Animal Hospital