Building a Veterinary Healthcare Team

In the past few months, I’ve been trying to get to the bottom of some distressing symptoms exhibited by my 14-year-old dog Otto, by using every one of the three veterinarians that make up our veterinary healthcare team.

Yes, three. Following the precepts described 20 years ago by one of our long-time contributors in “Finding a Balance Between Conventional and Holistic Dog Care,” I have assembled a team to meet all my dogs’ veterinary needs. It’s the only way I’ve been able to access the totality of the care I feel like my dog needs!

Our most local vet is more or less Otto’s primary care doctor. Her clinic is located less than two miles from my home, making it most convenient for picking up Otto’s prescriptions and for routine visits. She’s terrific and her clinic is well-equipped. I can usually get an appointment within about two weeks there. But until recently (and this might be changing as we speak), once the pandemic started, she would see patients only in her clinic without the owners present. Having a conversation about your dog over the phone is better than not having a vet to talk to at all, but it’s not always ideal, so if I feel it’s important to be able to see the doctor examine my dog and be able to point out things and discuss things she observes in that moment, I sometimes use veterinarian number two:

This veterinarian practices in a rural clinic, where in this day of COVID she is happy to see patients with their owners outdoors (weather permitting, and in our climate, this is almost always viable). This vet also offers acupuncture, which we’re using in an effort to reduce some of Otto’s arthritis pain. The down side is that she’s farther away and a little less up-to-speed with the latest diagnostic tools. When my dogs need advanced diagnostics, I go to veterinarian number three:

This veterinarian is board-certified in internal medicine (a Diplomate of the American College of Veterinary Internal Medicine or DACVIM), and practices at the gigantic 24-hour clinic about a half-hour’s drive from here. She has good lines of communication with our primary-care doctor, and they share tests results quickly and easily so they both know what the other doctor is thinking. This practice has almost all the bells and whistles, and while care at this clinic is expensive, the insurance provider I use has never balked at any of the bills.

These are our three go-to providers, but we’ve used other specialists, too:

I took Otto to the Veterinary Medical Teaching Hospital at the University of California (Davis) for a dental procedure some years ago. Radiographs taken during a routine dental cleaning found that Otto had two cracked teeth, and the local vet thought they might be candidates for crowns, rather than extractions. Given our good health insurance, I opted for this additional visit to the dental experts at UCD, hoping we could save two of his teeth. Alas, the much more powerful imaging equipment at the university hospital were able to reveal that the damage to the teeth was deeper than previously seen, and the teeth had to be extracted after all.

This experience has led me to conclude that, at least for older dogs with more complicated dental histories, it’s likely best to go to a bigger, better-equipped hospital for even routine dental exams and cleaning; we could have saved Otto from one of those two general anesthesia events had I taken him to UCD for the first of those two exams.

Building a Veterinary Healthcare Team

Otto also had surgery at a specialty veterinary hospital for a lesion found on his liver.

I’ve known so many friends whose big dogs died from hemangiosarcoma (a disease that has a decent prognosis only if detected super early), that I have asked for Otto to receive an abdominal ultrasound examination as part of his annual well-dog visit. About six years ago, while conducting the ultrasound, our DACVIM observed a lesion on Otto’s liver, making these annual ultrasound examinations not just a matter of reducing my paranoia, but medically necessary. About three years ago, with the lesion growing, our vet recommended that Otto receive either exploratory surgery or a CT scan to better visualize the lesion, followed by (if at all possible) immediate surgery to remove it if indicated. She referred us to a specialty clinic about 90 minutes away, where we were able to schedule the CT scan and, potentially, time with a surgeon, in the same time slot, so Otto wouldn’t have to undergo general anesthesia twice again.

As it turned out, the CT scan showed that the lesion was quite possibly problematic, so Otto went right into surgery after the imaging. Fortunately, after the mass was sent out to a pathologist, we learned that it was not malignant. We keep his liver under observation, however, as it’s shown signs of further (though thankfully still minor) abnormalities.

The surgeon at that practice – and really, the whole staff – was amazing. Otto had to spend the night before the surgery at the practice, so, on the day he was admitted, I brought along copies of WDJ and a WDJ calendar to show the staff, so they knew they were caring for a celebrity. When I got to visit him post-operatively, I was thrilled to see that they had hung the magazines and calendar on his kennel door, so every person walking by him could see what a superstar he is. If Otto ever needs surgery again, that’s where we’ll go.

I know I’m incredibly lucky to live in an area where I have access to all these gifted professionals. Otto has a better healthcare team than my husband and I do! But I have to say that it’s largely the fortunate choice I made for Otto’s health insurance (discussed recently here*) that has made it possible for me to provide this level of healthcare for Otto.

* Otto is covered by a plan from Nationwide. This is not a blanket recommendation for that company, though it’s been very beneficial for me. For more information about choosing pet health insurance, see this article.

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