Clients can get confused, upset, frustrated and even angry when their vet puts all treatment options on the table.
Full disclosure, however, of all medical choices available to you is the ethical thing to do.
Discussing all possibilities and treatment modalities is exactly that — a discussion. Finding out later that you had options that were not revealed puts your pet at risk.
Different Doctors, Different Answers
A recent personal experience on the human medical side reminded me how important it is for me to give people all options. A personal friend was given 2 surgical opinions from 2 local surgeons. When he went to Boston for a third opinion, the Boston surgeon explained that there was a much less risky surgical intervention available.
That less risky procedure was never revealed to him by the first 2 surgeons. A person should not make decisions about their own health or the health of their pet without full knowledge of options.
Picking the Right Treatment
So here’s a hypothetical pet scenario: Say your cat has an undiagnosed vomiting problem, a very common feline ailment.
After some diagnostics and medical attempts that have not solved the vomiting problem, I could recommend the cat undergo exploratory surgery. But I should also tell the person that endoscopy, a less invasive procedure, is available and might save the cat from undergoing a full exploratory surgery.
In the long run, it may be more beneficial to do one procedure over the other based on the case history. But both procedures, what they can or can’t reveal, the pros and cons, and certainly costs involved should be discussed. Then and only then should we come to a decision.
Continual advances in veterinary medicine save more animal lives, enable us to treat things we could never treat before and give pets longer, happier lives. But all these advances complicate things — more diagnostic and treatment options or referrals to specialists are more expensive.
Cost Is a Consideration
Here’s another example: Aggie, the 15-year-old cat, is diagnosed with hyperthyroidism, a very common condition in geriatric kitties.
There is medication and/or diet to help this problem and then there is radioiodine (I-131) therapy, the gold standard, which entails just 1 visit to a specialist who administers the radioiodine and a short hospital stay for Aggie. This procedure carries a very high cure rate and very little risk, but the price tag is hefty: over $1,000.
Aggie’s caregiver might choose the less expensive treatment option. But when Aggie is not responding that quickly, hates taking her pills or is having side effects from the medication, I must mention the RI option again. Aggie’s human may say they just can’t do it financially and get mad.
This is not a time for anger but more discussion. Outlining all options again, with associated costs, is the right thing to do. We can discuss the risks of not treating Aggie at all, an acceptable option in some cases. We can compare the costs of the medications and monitoring (rechecks and blood tests) versus the radioiodine treatment based on a reasonable life expectancy for Aggie.
This may seem coldhearted, but it’s actually warmhearted: If Aggie is in good health right now and lives to be 18 — a reasonable life expectancy — the radioiodine treatment could actually save Aggie’s family money and aggravation, and maybe it can be made affordable. Giving up on difficult discussions too early can be dangerous for your pet and render you unhappy in the long run.
Listen to this vet’s view of communication skills:
These tough discussions can make a person’s head spin. We’re not talking about buying a dishwasher here. We are talking about the life and well-being of your pet, and you are in an emotional state. This is a tough balancing act, and you and your vet are on the tightrope of decisions.
You need to be informed, you must make decisions together and you should not be made to feel guilty, frustrated or angry. You can be sad that your pet is not completely healthy, but now is the time for you to be the best caretaker you can be.
Full disclosure all the time is a great motto to live by. Options should be informative, not frustrating. Having the knowledge you need to move forward with your pet’s health options should help you with your journey.
This pet health content was written by a veterinarian, Dr. Debora Lichtenberg, VMD. It was last reviewed Sept. 20, 2017.
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