Posted on May 7, 2017
Don’t Wait Too Long to Get a Second Opinion
By the time I met Lucy, her condition had deteriorated to the point that I was unable to provide her with significant help. Rather than talking about treatment options, her care providers and I were forced to discuss end-of-life decision making. If only I’d been able to get my hands on this darling little Sheltie sooner, the outcome could have been so different.
Lucy was suffering from a disease called hyperparathyroidism , an overproduction of parathyroid hormone resulting in excess calcium within her bloodstream. The treatment of choice for this disease is surgical removal of the overactive parathyroid gland. Such therapy is typically quite straight forward and results in a complete cure.
Poor Lucy. In spite of nine office visits with her family veterinarian over the course of six months because of symptoms caused by her parathyroid disease, appropriate treatment was never recommended and the extra calcium in her bloodstream over such a prolonged period caused irreversible kidney damage. By the time Lucy arrived at my doorstep, she was suffering from profound kidney failure with weakness, loss of appetite, vomiting, and debilitation. There was no going back for this little sweetie.
What gets in the way of a second opinion
There are a few reasons I can come up with as to why veterinarians will watch a patient deteriorate week by week and without a clearcut diagnosis, and yet still not discuss a second opinion. Perhaps they truly believe that there’s nothing more to be offered by someone else. Perhaps they think they “know” that their client would not want to get a second opinion because of cost and/or inconvenience. Maybe the veterinarian has a strong desire to hold onto the case, either because of their own ego or for financial gain.
Why is it so darned difficult for some folks to request a second opinion for their beloved pets? For some, veterinarians represent authority figures and their abilities are not to be questioned. One client told me that she viewed her relationship with her veterinarian to be like her relationship with her pastor- ask no questions! I’ve heard other clients state that requesting a second opinion would imply mistrust which would result in delivery of poorer quality veterinary care in the future. Some hold off on obtaining a second opinion (or they do so secretly) because they don’t want to hurt their veterinarian’s feelings.
My sense of Lucy’s caregivers is that they believed their veterinarian was doing the best job possible. They never thought to question his diagnosis (or lack thereof) and didn’t seem to know that they had the option of a obtaining a second opinion. They ultimately chose to come see me based on the recommendation of a friend who was concerned about Lucy’s decline.
The need to be an effective medical advocate
When I hear such rationalizations from folks who have postponed second opinions for their pets, I’m always tempted to respond with a line from the movie, Moonstruck in which singer/actress Cher slaps Nicholas Cage across the cheek while commanding, “Snap out of it!” Fortunately, the grownup in me manages to intervene with more mature counsel and I encourage the individual to step up to the plate as their pet’s medical advocate. The well being of their pet must be the number one consideration.
Putting total blind faith in any one veterinarian makes no sense, no more so than relying on any one medical doctor to safeguard our health. The veterinarian is only one member of an animal’s health care team, and it is the team captain who needs to call the shots. The team captain is the one who feeds, cares for, loves, and truly knows that animal better than anyone else. When there is no diagnosis in spite of multiple tests, or the animal’s health is declining in spite of therapy, it’s time for the team captain to order up a second opinion.
A situation like Lucy’s is heartbreaking. Don’t let her story happen to one of your family members.
Have you ever obtained a second opinion for one of your pets?
Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
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Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.