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Thursday, February 14, 2008

Pet Advocacy & Treatment Plans

by Grant Madsen
I have recently been asked: Why do we send home a Treatment Plan with clients for services that they did not request?

Let me share a few thoughts that may help the explanation.

Our pets are like small children that either cannot talk yet, or clearly explain their feelings. I have a 4 yr. old daughter that sometimes cries when upset, but I cannot get her to explain whether her sister hit her, her brother teased her, she fell down, her tummy hurts, she just woke from a scary dream, or what. She just screams. My choices are to hug her and send her on her way since she’s not bleeding, stop what I’m doing to hold her until she settles down, or get mad at her for screaming for no apparent reason and send her to her room so I don’t have to listen to her. Many a mother is driven temporarily insane with helpless worry over a baby that fusses and cries at all hours of the day or night for no explicable reason. It may be colic, insecurity, a cold draft, diaper rash, a wet / soiled diaper, constipation, an ear ache, teething pain or something more serious or not serious at all. The bottom line: she just can’t tell. Sometimes a visit to the pediatrician detects a problem that is quickly resolved with simple treatments. Sometimes finding nothing at least provides some peace of mind. But how would you feel if the doctor examined the baby, thanked you for the visit and sent you on your way without explaining a thing? Or, worse, described scenarios with potentially serious consequences and then sent you home without offering any options for further testing or treatment? I have heard many a story of these exact same things happening within our illustrious medical professions.

Now for some evolutionary theory (No, it’s not Darwinism!). Pets, particularly dogs, developed as pack animals with a very defined social order and hierarchy. Cats have packs too, just more loosely defined and harder for us humans to recognize. Just look at a pride of lions: definitely pack animals with social hierarchy. It is not in a pack animal’s best interest to manifest or display behaviors that could put his social standing within the pack at risk. Animals higher up the social ladder, even the pack leaders, will have their positions challenged by younger, stronger, healthier rivals if weakness or illness should make them appear unable to maintain their position and lead the group. If a lesser position animal acts sick, it is often left behind, avoided, pushed out of the pack, or even attacked and killed, to prevent putting the entire pack at risk of attack by other predators or rivals. So, in order to maintain their social standing, animals camouflage their illnesses and symptoms, learning to cope with underlying pain or diseases (that often develop gradually to begin with) until the condition is so far advanced that they cannot compensate any longer.

Although dogs and cats have been domesticated into family settings for millennia, they have retained several traits of their wild ancestry to preserve their position within their modern pack, our family. Do not be mistaken. Dogs do not consider themselves as part of our family, as just another child with fur and four legs. They consider the family members their pack and see themselves somewhere within the social hierarchy with an assumed role. Just ask yourself if the dog obeys certain family members and ignores others. Usually our pets recognize either or both parents as pack leaders, while realizing that certain children (often the younger ones) are not their superiors and do not need to be obeyed, while another child may be idolized and followed regardless of age.

How often have you gone on a trip, even for a couple weeks, and upon return notice how much taller the kids have gotten, or how much the grass has grown, or how dusty the house is. Yet these changes are often not noticed amid our daily activities, even though they are happening right before our eyes! Only, with our pets it is happening at a more rapid rate. You’ve heard the adage that dogs age seven years for every human year. Over the course of a lifetime that is true. Yet, a dog’s first two years are the equivalent of our first 24-30 years, and even more for a cat. Later things slow down, but the fact remains that animals age more rapidly than you and me.

So, you have a pet that cannot speak, aging unnoticeably at an accelerated rate, developing painful and/or degenerative conditions with which they learn to cope without obvious symptoms, in order to instinctively retain their standing in the family. As a veterinarian, I have taken an oath to be your pet’s advocate, recommending those treatments, tests, nutritional changes and services that will maintain optimum health and longevity in the hopes of preserving a long and healthy relationship in your home. So when I detect conditions that could be painful or that indicate the possibility of underlying diseases, or detect a condition that would benefit from a special medication, better nutrition or diagnostic testing, I am duty bound to stand as an advocate for your pet, voicing what I feel would be in their best interest. I always present first the treatments that I consider to be the optimum level of care. Anything less that that is sub-optimum and it would reflect poorly on my reputation if I were to recommend anything less than what I felt would be the best course of action. Sadly many veterinarians subconsciously x-ray a client’s pocket book before recommending treatments, judging whether the client can afford care based on how they dress, the kind of car they drive, where their address is located, or what kind of job they have (if they even know), and often limit their options without even explaining them. My job is to determine what needs to be done and then let you choose whether you want the recommended level of care. Should you elect a lesser or more conservative level of care, whether for financial or emotional reason, it then becomes my duty to assure that you get the most value for your chosen level of investment. But you must first know what would be the best course of action.

If you are personally diagnosed with a joint problem, a dental problem, a chronic illness, or a nutritional imbalance, you can choose to pursue it further or not. You can choose to treat it or not. You can select the food that ends up in your grocery cart. These choices have many influences, including personal finances, health insurance options, family health history, personal fears, and individual lifestyles. The point is, you have a choice: your pet does not. They rely entirely on your goodwill and judgement for everything.

I will do my part in keeping you informed of your options and the best course available given our current understanding and then try to fit that within your personal guidelines. I try not to leave surprises that surface only when it’s time to pay the bill, but endeavor to prepare you for the reality of what good pet care costs ahead of time. So, the next time we present a Treatment Plan for your review, rest assured that we are recommending what we truly feel is best for your pet, but we will respect your decision if you can’t do it all today. We hope you will come to trust our recommendations and trust us enough to tell us where you need to draw the line.