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Microsoft word - advances in veterinary medicine hill rag july 2010.doc



Living Longer and Better: Advances in Veterinary Medicine
By Dr. Gary Weitzman

The days of a general practice physician coming to your house to treat everything that ails you
are over. Frankly, so too are the days of a veterinary generalist. Today, there are as many
specialties in veterinary medicine as there are in human medicine and surgery. From cardiology,
to ophthalmology, from dermatology to radiation oncology, veterinary medicine has changed
dramatically. The James Herriot days which lured us veterinarians into this field are over.
Recent advances include stem cell treatments for arthritis, complicated orthopedic repairs that
would have been inconceivable a decade ago, limb prosthetics, and medical protocols so
sophisticated that they take a team of doctors—and at least a few checkbooks—to administer.
Clients, by and large, welcome these changes and even expect veterinary medicine to be equal in
sophistication to human medicine. Yet few will happily pay for it. While we expect and accept
astronomical fees for human health care, many of us still deeply resent the expenses that stem
from providing comprehensive, advanced care for our animals. That's a paradox.
And then there's the convenience factor. Remember the daily heartworm tablets? Now, that was
inconvenient. Or what about the days of dipping your dog or—Horror!—cat in flea dip? Now we
complain because the monthly application of flea medication that is so quickly and easily applied
onto one small spot on our pet's neck may not work the full four weeks. We've become
accustomed to progress and convenience. Fortunately, veterinary medicine is doing its best to
keep up.
But to keep up, we veterinarians have had to learn more, continue longer training under huge
debt, and seek board certification, like our human physician counterparts. Today's veterinary
school graduate is predominantly female, has had at least eight years of post-high school
education, and is in debt well into the six figures for her education. Then, there is the year of
internship and at least three years of residency training, followed by specialty fellowships and
board examinations. That's another half to full decade of training to get through—and pay for.
What that means is, we can do so much more for you and your pet than the previous generation
of general practice veterinarians could. But as in human medicine, these advances affect the very
nature of health care. It's no longer reasonable to expect quick answers from your primary
veterinarian. Or a rapid cure. With the scope of today's diagnostic tools and medicinal options,
treatments may take time. Not everything we try may work, or even work the same way between
one patient and the next. Given today's many advances in veterinary medicine, it should be more
understandable than ever that your vet may not be able to diagnose and treat every disease
quickly and at a minimal cost.
Consider, for a moment, the dental service we offer. These days there are new machines, dental
x-rays, and entire dental suites to aid in keeping our best friends' teeth and gums healthy and


happy. And thank heaven for this. But would you ever, in a hundred years, expect your physician to treat your teeth? Of course not. And that's the point. Stop expecting your veterinarian to be superman (or woman). With all of the detailed knowledge and exacting specialties these days, your vet can no longer be expected to do a perfect, absolutely comprehensive physical exam, analyze blood work, do the cytology, spay or neuter your pet, know every detail about internal medicine, perform complicated surgery to, say, repair a cruciate ligament, and offer flawless advice on animal behavior. Given the knowledge base and advances in our field, this is simply no longer possible. And our patients are also changing: they are living longer, long enough to develop chronic diseases that were never a problem decades ago. Fifty years ago, veterinarians did not treat diseases like cancer, arthritis, immune-mediated illnesses, and allergies. Dogs and cats simply died of what was considered the natural, albeit shorter, course of his or her life. Today, your veterinarian can extend your pet's life and improve its quality through total hip replacements, laser surgeries, cataract laser treatments, kidney transplants (for cats), corneal transplants, open heart surgery, in-depth cancer treatments, and telemedicine. There are now probiotics and nutriceuticals to treat and prevent many aging symptoms or control inflammatory bowel disease and allergies. New vaccines range from the first canine melanoma vaccine to dental vaccines to prevent tartar and gingivitis. There are drugs, like Slentrol®, for canine obesity. (Yes, really!) Laparoscopic surgery can take care of everything from arthroscopic joint surgery to spaying. A curious dog owner can even ask a veterinarian for DNA testing for mixed breed composition, if he or she has enough disposable income for this. And before too long, many medications—everything from tranquilizers to analgesics and thyroid treatments—may be administered through trans-dermal patches. (No more difficult pilling!) And it doesn't stop there. In the past two decades, we've developed numerous behavior-modifying medications for our animals, all of which sound very familiar in human mental health: Elavil, Prozac, Buspar, and Xanax to name a few. We even have drugs specifically labeled for separation anxiety. True, we don't yet offer the couch and analysis, but an entire college of hugely talented veterinary behaviorists can actually save an animal from being surrendered to a shelter, or worse, euthanized. I could keep going, but this list seems to double yearly (or even faster). And that's the best evidence there is of the sort of medical advancement we have come to want and expect for our pets. We're lucky here in Washington; we're surrounded by no fewer than half a dozen advanced, specialty veterinary hospitals housing teams of specialists for everything from surgery and internal medicine to acupuncture and cobalt radiation machines. These days, even our regular, progressive animal hospitals have ultrasounds, digital dental radiographs, and telemedicine. So it's time to see your primary veterinarian differently.Let him or her be your partner in keeping your pet healthy and happy. Vets have more expertise and tools than they have ever had, and


they'll help you seek specialists when you need them. And please don't complain too much about the price. It's expensive out there—it's expensive everywhere. Just bear in mind that veterinarians still offer expert care comparable to what humans receive—and with deep compassion in most cases—for about a fifth of the price a human hospital would charge. Let's hope that practice is one advancement that never changes. Gary Weitzman, DVM, MPH, is the CEO of the Washington Animal Rescue League, located at 71 Oglethorpe Street, NW (202-726-2556 or www.warl.org). The League, an animal rehabilitation and adoption center, also houses a full-service medical center for shelter animals and the pets of low-income guardians. Weitzman can be heard every week on WAMU 88.5 FM's "The Animal House" at 7 a.m. Saturday mornings. He can be reached at gweitzman@warl.org.

Source: http://www.warl.org/images/uploads/Hill_Rag_July_2010.pdf

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