This past June, my 82 year-old father was diagnosed with a small cancerous tumor in his lung. Within two weeks of diagnosis, my father had thoracic surgery. I wish I could say that everything went well, but it did not. I thought we chose the right surgeon, the right hospital and the best postsurgical care possible for my father but in retrospect maybe my family and I could have done better. Fortunately, despite the mistakes, my father recovered. I would like to share with you what I learned from this experience because I believe it will make you a better health caregiver to your pet.
Ten tips to being a better health caregiver to your pet:
1. Make sure your veterinarian evaluates the entire patient.
Tell your veterinarian all your pet's problems and your concerns. Don't hold back on details. Your veterinarian may be a skilled diagnostician, but your history is integral to a successful diagnosis and treatment plan. Additionally, have your doctor examine the entire pet - from head to tail - to make sure all your concerns are addressed. It would be unfortunate if you brought your pet in to see your veterinarian for coughing but did not address your pet's painful arthritis.
2. Tell your veterinarian what medications, supplements and food you are giving your pet. Just last week, I ran a chemistry profile on an older dog and discovered that the pet's blood calcium level was significantly elevated. I was just about to investigate this problem when I soon discovered that the owner was giving a calcium supplement to her dog that was prescribed by her previous veterinarian.
3. Ask questions and make sure you not only get answers but also understand the answers. At your pet's next appointment, bring a list of questions to ask your veterinarian. During many conversations with my father's medical team, I frequently forgot to ask them important questions because I was so frazzled by my father's poor health. Check your list of questions before you exit the examination room to make sure that all your questions and concerns were addressed to your satisfaction. If you do not understand what your veterinarian is telling you, please speak up and say you don't understand. Ask your veterinarian for written material on your pet's illness that you can read later in a less stressful setting. If your veterinarian cannot immediately answer your question, make sure he/she will get back to you in a timely fashion or direct you to someone who can. Your veterinarian is the best referral source, so take advantage of it.
4. Make sure your veterinarian is capable of thinking outside the box. Yes, the proverbial saying "common things happen commonly" is true. After practicing over 28 years, most illnesses I recognize immediately and know exactly how to proceed. Occasionally, I'll have a medical case that does not follow the textbook and I need to be creative with my diagnostic pursuit. If your current veterinarian is not reaching a diagnosis or formulating a successful treatment plan, seek a second opinion from another veterinarian.
5. Make sure your veterinarian is compassionate and treats you and your pet with respect. Don't let them minimize your concerns and fears. Make sure your veterinarian addresses them head on. Your veterinarian should include you in the decision-making process and not proceed without your consent. Find out when you will receive the test results. Do you call the doctor for test results or will he/she call you? Never assume that if you do not hear from your veterinarian, that the test results are normal because no news is not always good news. A lack of response may mean a test sample was lost, your veterinarian never received laboratory results, or phone messages were not heard. If you do not hear from your veterinarian in a timely matter, do not hesitate to call him/her.
6. Remember no drug or "natural product" is 100% free of side effects. Ask your veterinarian what the side effects are for each drug your pet is prescribed. When my father was in the hospital, he was heavily medicated with a pain medication. Unfortunately, one of the side effects of this pain medication was respiratory depression - a reduced capacity to breathe. The doctors wanted to put my father on a ventilator but I told them, let's wean him off this drug, start him on an anti-inflammatory drug to minimize his discomfort, and give his body a chance to recover. (At this point, they asked me if I was an anesthesiologist. I told them, "No, I'm a veterinarian.") Within 18 hours, he started to breathe more effectively and the need to put him on a ventilator passed. Sometimes, you just have to step back a bit and look at the total picture before making a major decision.
7. Know what the logical or anticipated outcome of your pet's disease is. Although no one has a crystal ball to predict your pet's exact outcome, many other pets have experienced a similar illness and research studies are usually available to tell you the anticipated outcome. I think it is important that every client knows the expected prognosis so they can make the best medical decision for their pet. I recently discovered a large abdominal mass in a 16-year-old cat with chronic kidney disease. The owner asked me what the most probable diagnosis and prognosis were. I told her that it was most likely a malignant tumor and long-term prognosis was grave. She asked me if this were my cat what would I do. I told her that I would proceed with an abdominal ultrasound to see if this mass had spread to other organs and if it could be surgically removed. If overt metastatic disease was present or if inoperable, I would provide supportive care only to my cat. Despite my desire to prolong her life, I would not perform heroic measures to keep her alive. I strongly believe in quality of life, not quantity of life. Just because the science may exist to prolong your pet's life, sometimes it is not justifiable to pursue due to the stress and pain that it may cause in the household and in the ill pet. Please don't be afraid that your veterinarian is silently passing unfavorable judgment on you if you choose a less aggressive diagnostic or treatment plan. Remember, your pet is your loving responsibility and your veterinarian wants you to make the best decision for you and your pet.
8. Get explicit discharge instructions before you leave the hospital and make sure you are capable of doing them. I find it extremely helpful to provide the client with written discharge instructions detailing what and when medications are to be given. Sometimes, I provide a spreadsheet for clients to follow. Ask your veterinarian the following questions:
• Are there any medications that cannot be given together? For instance, never give a probiotic at the same time as an antibiotic.
• Some pets are extremely difficult to medicate. So, before you leave the hospital, ask the veterinary technician to physically show you how to pill your pet. Listen carefully to their helpful pilling tips!
• It is important for you to monitor your pet's progress. Ask your veterinarian what clinical signs you should watch for that indicate that your pet is not improving and may need immediate medical attention.
• Does your pet need a re-evaluation appointment?
• Are there any changes that I need to make in my home before my pet returns there? Do I need to buy floor mats to keep my pet from sliding? Should I change the location of the cat litter box? Do I need to buy a special harness to help my pet walk?
• Do I need to restrict my pet's activity level?
• Is my pet contagious to other pets or people? Are there any precautions I should take when picking up its stools or cleaning out the litter box?
9. Ask for an estimate for today's services as well as the anticipated near future expenses. Are you financially prepared to spend everything possible to help your pet, or is there a set dollar limit? Tell your veterinarian what your limit is. Do not let your veterinarian assume what your financial restraints are.
10. Tell your veterinarian what type of care you want your pet to receive. Are you the pet owner that wants to do every test right away, or are you the client that likes to take one step at a time? Are you interested in keeping your pet alive for as long as possible? Or, on the contrary, are you the pet owner that believes keeping the pet alive is not justifiable given the emotional or/and financial burden it places on you? After hearing your veterinarian's recommendations, tell him/her what you want to do. Let your doctor adjust to your desired style of care. Remember, you are the client, the loving pet owner, and are paying for it.
Being a great pet owner is an enormous responsibility. I hope these 10 tips make caring for your ill pet a little bit easier. Remember, your veterinarian is your partner in your pet's health care.
Dr. Donna Solomon is a veterinarian at Animal Medical Center of Chicago and invites you to email her your questions or future topic ideas to email@example.com.