Diabetic dilemmas: How to access veterinary info online

DEC 17, 2009

After reading yesterday's comments on Internet sales and information I thought it appropriate to offer this Miami Herald article today. Remember, I only get 400 words to play with!

Q: My cat Aarwen was just diagnosed with diabetes. She’s doing well on the insulin injections I give her twice a day, but I’ve read online about a variety of new treatments that don’t require these frequent shots. My vet says they’re “snake oil” and that I shouldn’t rely on anything I read on the Internet. Where can I go to get more information on diabetes in cats?

A: Your veterinarian is right. You shouldn’t rely on just anything you read online. But there is a way to get credible information from online sources that’ll greatly improve your ability to manage your cat’s diabetes.

Almost any disease or problem our pets can develop is profiled somewhere on the Web in some detail. What your vet may be concerned about, however, is that you’ll take to the Internet as a substitute for his or her services. It’s not that we worry we’ll lose your business, it’s simply that...

1) much of what’s available online isn’t exactly what most vets would consider responsible information, and...

2) too many pet owners seek out veterinary information online thinking they can diagnose and treat their pets without ever seeing a veterinarian.

Sure, the Web will never replace your veterinarian, your accountant or your lawyer. But it can still help you tremendously by offering a solid background on your cat’s disease, reliable groups that you can tap for support, new research on diabetes and clinical trials that may be underway.

The key is to research the Web safely. Consider sites sponsored by major organizations (universities, specialty groups and industry associations). Stay away from sites selling non-regulated products. Look into larger sites with reputations to protect. Blogs and smaller sites may well offer great information but it’s harder to tell if they’re offering the real deal. And don’t forget to ask your veterinarian which sites he or she recommends.

Luckily, South Floridians have two local options for their pet information needs. If you want to support a local business and learn more about diabetes or any other pet disease, PetMD.com and Petplace.com are excellent options to research. Petplace offers encyclopedic information while PetMD’s veterinarian-edited cache of articles and community-centric content is a must-visit site for any pet lover.

For feline diabetes, in particular, look no further than felinediabetes.com. This website is where I send all my diabetic kitty owners. Enjoy!

•••

As an adjunct, I'd like to add some sage advice offered by Dr. Nancy Kay in her recent email newsletter (sign up here). It's more complete and "advanced" than anything I could ever write for the Herald. Here's a mere excerpt on what to look for when researching veterinary information online:

 

#1 Ask your veterinarian for her Web site recommendations.  She might wish to refer you to a specific site that will supplement or reinforce the information she has provided.

#2 Veterinary college Web sites invariably provide reliable information.  Search for them by entering “veterinary college” or “veterinary school” after the name of the disease or symptom you are researching.

#3 Web addresses ending in “.org,” “.edu,” and “.gov,” represent nonprofit organizations, educational institutions, and governmental agencies, respectively.  They will likely be sources of objective and accurate information.

#4 If your dog has a breed-specific disease, pay a visit to the site hosted by that specific breed’s national organization.

#5 Avoid business-sponsored Web sites that stand to make money when you believe and act on what they profess (especially if it involves purchasing something).

#6 Be ever so wary of anecdotal information.  It’s perfectly okay to indulge yourself with remarkable tales (how Max’s skin disease was miraculously cured by a single session of aromatherapy; how global warming is the cause of hip dsyplasia), but view what you are reading as fiction rather than fact.  As fascinating as these National Enquirer type stories may seem, please don’t let them significantly influence the choices you make for your dog.

#7 I really love disease-specific online forums.  Check out those sponsored by Yahoo (http://groups.yahoo.com).  Not only do they provide a wealth of educational information, members can be a wonderful source of emotional support- always a good thing for those of us who share our homes and hearts with an animal.  

If you are considering joining an online forum, I encourage you to look for a group that focuses on a specific disease (kidney failure, diabetes, etc), has lots of members, and has been around for several years.  For example, an excellent Yahoo group K9KidneyDiet (addresses issues pertaining to dogs with kidney failure) has 3,391 members and has been up and running for eight years.  A large group such as this typically has multiple moderators who provide more than one point of view (always a good thing) and greater round-the-clock availability for advice and support.  Look for presentation of cited references (clinical research that supports what is being recommended). Such groups should have a homepage that explains the focus of the group and provides the number of members and posts per month (the more the better). They may have public archives of previous posts that can provide a wealth of information.

 

•••

OK, now it's your turn...

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12 COMMENTS
1
by tripawds.com on 12/17/2009 01:05pm

This is exactly why we focus on creating a community of support for canine cancer survivors and other amputee dogss and their people at tripawds.org. When people ask about various "snake oil" cures, which they often do, we do our best to provide links for further information by researching respected veterinary websites – like this one! Above all, we stress one thing: Buyer Beware.


When it comes to treating cancer in their dogs, people will try anyithing. We are always sure to stress that any recommendations we do make are solely based on our own experiences, and that we are not veterinarians, and we ask ask our members to do the same.

2
by Pat Madona on 12/17/2009 01:29pm

I have a Westie with Addison's. While I keep in touch with the online forum I found after much advice from persons online that my veterinarians management was best. People online were aggressive attaching his dosage of prednisone as being far too much in their opinion. In the end his recommendation was her perfect formula. We can never learn too much about ours or our pets illnesses and nothing should be taken at face value without research to make ourselves a bit smarter. My experience was my Vet knew best. That was 5 years ago. Having said that the education I received online gave me greater understanding of her disease and therefore gave me insight on how to better care for her. I also met and keep in touch with someone who has a Westie the same age as Molly and we compare notes on Addison's and the aging dog. Just my experience.


Pat Madona

3
by Stefani on 12/17/2009 03:42pm

Dr. K,


I want to both thank and commend you for referring folks to the feline diabetes message board.  It is a wonderful community for diabetic cat owners, where people are available 24 hours a day to help the usually emotionally distraught and overwhelmed, frightened person whose beloved pet has been diagnosed with this frightening but most treatable and manageable disease.


Through the Feline Diabetes Message board owners have access to peers who are "up on" the latest and greatest information on feline diabetes.  This is consistent with what an up-to-date vet will advise (and of course, this knowledge exists mostly because it came from vets who are up to date in the appropriate treatment of diabetes), but it is NOT consistent with what many vets who are NOT up to date on diabetes treatement will advise.   


Sadly, precisely because they are warned that "the internet is full of wackos" peddling "snake oil" pet owners often come to the feline diabetes site and -- when they are given very good advice yet find that that advice conflicts with what their vet told them -- they trust the "in the flesh" DVM and not the internet "wackos peddling snake oil" -- who in this case aren't wackos at all, but basically obsessed feline diabetes geeks who adore their cats and by extension all cats, especially those with diabetes. And have been reading and studying the best most modern veterinary approaches to the disease.


I wish more vets were actually CURRENT with the knowledge of the feline diabetes message board when it comes to diabetes. 


The upside is that the board members actually end up EDUCATING a lot of vets, printing out studies, suggesting they confer with vets who are feline diabetes specialists, etc.  When that fails, and their vet won't listen or says "My way or the highway" THEN many of those people get a recommendation of a BETTER vet off that list and they switch!


Thus, the "better" vets get clients, the open-minded but NOT up to date vets get educated, and those are both good things. 


The sad part is though, that occasionally, before an owner trusts the "list" their backwards vet has already mismanaged their cat's case so badly that its too late and kitty is dead of improperly treated DKA, hypo, or simply had such complications from poorly managed diabetes that he was PTS.


Not that these things don't VERY RARELY and occasionally happen with kitties getting state of the art care, but the risk is much higher if your vet is not up to date and you haven't yet figured that out or don't trust people when they tell you that.

4
by Carol on 12/17/2009 03:51pm

I found that Yahoo groups was a wealth of information.  Discovered a B12 protocol for IBD that has helped my cocker immensely.  Even my vet mentioned recently about how fantastic he's done since he started the protocol.  It could help other pet owners in similar situations.


Keeping an open, yet cautionary, mind is important when getting info from the internet.  The support from other pet owners with similar situations is invaluable however, and is available 24/7.

5
by PJB http://pjboosinger.viviti.com/ on 12/17/2009 04:07pm

Sorry Dr. K, Can't really go there with you today.  "Blogs and smaller sites may well offer great information but it's harder to tell if they're offering the real deal."  Of course it's harder to tell but this is where you find the real talent, the forward thinkers; those who lead even if no one follows for a hundred years.  I want those who are keeping up on and ahead of the game; not those who are 20 years behind, staid and stuck like the .gov tends to be.


The best accountants and attorneys I've known had little or no "formal" training as we would think of those today and the one's we now graduate and license generally do their work pro forma, via a formula.  I've seen all too much of the same in health care, human and animal.


Of course one shouldn't rely on "just anything" but a collective of experienced people not confined by the parameters drilled in school often find truth, facts, and solutions outside those blinders our professional school hammer into place.


"larger sites with reputations to protect"  Well there's a can of wriggly worms.  If their reputation will fall because they admit error, they may well be sufficiently vested to keep trying to hide the facts, science, whatever might damage their reputation.  Having a reputation to protect is not the same as deserving the reputation one has.  Some of those companies now being convicted for Ponzy Schemes had lovely websites and incredible reputations which is indeed why people believed them, to their current horror of living in poverty.

6
by Elizabeth - from Nova Scotia on 12/17/2009 05:26pm

I too have a dog with Addison's and I have to say without  the Addisondogs.com website and the Yahoo group AddisonDogs my boy would not be as as well managed as he is today. The key is educating yourself and your vet if necessary, sorry Dr. Khuly no offense meant to you but unfortunately many vets do not know how to properly manage a dog with Addison's once they have been diagnosed. I realize the diagnosis can be tough as it is not called "The Great Pretender" for nothing. Each dog writes their own book when it comes to how much percorten/florinef/prednisone they need and how often. It is not one size fits all.

7
by Barb A./NH on 12/17/2009 05:33pm

I am glad Dr. K suggested more than the routine .org & .edu's to gather information.


If you have a purebred dog, chances are that a particular affliction has been experienced by some breed member, if not many. It is an excellent resource often overlooked. When my Sealyham had non-steroid curable IVDD, I got on the horn with quite a few that had opted for surgery with varying experiences.


Years ago, in '97 I posted a web site about my Scottie with Transitional Cell Carcinoma: what the symptoms were, the road to diagnosis, the treatment, and the success/progression. It NEVER occurred to me to put disclaimers anywhere on my site. I even included the Vitamin C dosage added to the vet-med protocol published. I guess I could have been in big trouble, helping all those lost owners through sad times with their own dogs, via phone, snail & email.


Sometimes as PJB mentioned there is a definite "hold-back" , and whether this is due to possibility of adverse outcomes or what-have-you, it sure isn't helpful. Now am I going to believe holding a bag of herbs over my head will cure my headache, no and I don't think others do either.


SEO, an annoying technology advance in web-based searching, has created a problem also. Particularly those that try to "redirect" to frivolous or false information to obscure the good sites!

8
by Shellie on 12/18/2009 12:41am

I agree that the Yahoo groups have a wealth of information available, but are not a substitute for your own vet. My oldest lab is currently being worked up for laryngeal paralysis. My own vet has made the presumptive diagnosis, and informed me that this is beyond their ability to definitively diagnose, much less correct surgically, and I am in process of looking for a board-certified surgeon in my area who has experience with the condition and the UTB surgery. The first one I spoke with had done "only a few" and so was not for me. The folks on the Yahoo group LP have been very helpful in educating me about what to expect both pre- and post-op, what questions to ask the surgeon, dietary adjustment after surgery (soft meat balls), and the consistent reminder that LP is not a death sentence. So the internet can be extremely valuable as an information tool, but is no substitute for veterinary expertise.

9
by Chicago on 12/18/2009 06:42am

Very interesting, Dr. Khuly. Perhaps you could elaborate on the "snake oil" theme in a future posting. How is it possible for a "treatment aid" to receive  conditional approval from the USDA without extensive testing? And why are some veterinary medicines that are sold in Europe not available here?

10
by Dr. Patty Khuly on 12/18/2009 07:06am

Chicago: It's now on my list. Lots of issues there to discuss––some of which I've addressed in bits and pieces. 

11
by charliebear22 on 12/18/2009 10:06am

The reason I'm here at this site is because of trying to research Hematomas and alternative treatments after (surprise!) the first one failed miserably, and my vet was pushing for another.  If I hadn't of made it to Dolittler, I would have forked out many more dollars for another surgery instead of insisting that my vet investigate drainage and the technique.  (it still cost almost half of surgery, but worked beautifully)  My vet was NOT happy, and we didn't receive proper follow up care, but because of Dolittler, I was able to manage on my own - now 1 year later, and no recurrence.


When I search for information regarding medical conditions (pet or human), I visit many sites.  I have found that often the good information is repeated on many different websites.  I look for "professional" type sites, but love the feedback from people that have experienced the treatments.


There's nothing wrong with educating yourself and going to your provider armed with knowledge.  It offers you the ability to make better, more informed decisions.  Ultimately, you do have to work with your provider, but if you are a researcher like I am, and your provider is a "do it my way" kind of person, then you are not properly matched IMO, and you should be seeking care or other opinions elsewhere.

12
by Connie on 12/18/2009 02:08pm

Just so you know, .org generally means a non profit organization, but that is not the strict rule that .edu is.  ANYONE can register a .org domain, so you should not give as much credit to .org as you do to .edu or .gov which are restricted.  To give a domain credit simply because it is .org is misinforming the public.

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Photo of Patty Khuly

Patty Khuly

VMD, MBA

...is a small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. Apart from her daily blogging here at PetMD's FullyVetted, she authors weekly pet health columns for USA Today and The Miami Herald. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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