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Written by leading veterinarians to provide you with the information you need to care for your pets.

The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Do You Trust Your Veterinarian?

Most animals I see are referred to me by their primary care veterinarian, and since cancer tends to occur in older dogs and cats, many of these pets have been seen by the same doctor from the time of their very first vaccines as a puppy or kitten. Given my inherent lack of a similarly established long-term relationship, I’m continually astonished at the level of trust owners have in my opinion of their pet’s condition.

A further complicating fact is that most owners we see truly identify their pet as a part of their family, and many refer to them as their children (even those who have actual children will do so). I am also typically introducing myself during an emotionally charged time period, which I anticipate would be a set-up for more episodes of skepticism than I typically encounter. Yet, with few exceptions, a bond is established quickly and efficiently; something I’ve yet to take for granted.

Both my husband and I have experienced a few minor health issues ourselves over the past few months, and I can easily compare my trust in the human medical system to that experienced by pet owners. When a person in a white lab coat is telling you something, whether related to your own health, a loved one’s health, or your pet, you will listen. Often this may be ironically compounded when you may not understand every word being uttered or test being recommended.

Medical jargon is scary and foreign, even to those of us trained in its meaning and with an understanding of anatomy and physiology. When you are on the other side of the exam table, I believe it allows you to comprehend this in a different way.

I suppose given some of the limitations on the “bedside” manner aspect of human doctors, I strive for a higher standard and I have contemplated some of the reasons why it is that I’m able to form a connection in such a rapid fashion. I think what’s most astonishing to me as that I feel the majority of the “work” we put into connecting with owners comes during the time after they have left the exam room.

My new appointments are scheduled for one hour, and during that time I will discuss a great deal with owners, generally covering what I describe as, “What we know, what we don’t know, and the things we can do to bridge the gap.” Though owners may arrive prepared with their own research, most are eager to hear the information I present, are attentive to detail, and ask insightful questions about available options.

In the realm of medical appointments, an hour may seem near eternity, yet simultaneously in the larger scale of the relationship between an owner and his or her pet, it’s a mere nanosecond of time. The time I have to establish a connection with owners and their pets isn’t nearly enough time.

Often consults run longer than an hour, and even more frequently my correspondence with an owner is not limited to the face time experienced during our initial meeting. Most owners will call and/or e-mail follow-up questions, or I’m calling them to discuss test results within a day or so after meeting them. This accessibility is one aspect separating specialty veterinarians from our human counterparts.

We also often proactively call owners to check up on patients or to follow up on previous concerns. This is done out of genuine concern for the welfare of our cases; we sincerely worry about our patients when they are not directly under our care. Yet, I am somewhat shocked if my own doctor gives the same service, and cynical in thinking their inquiry is likely more related to making sure my co-pay was delivered.

Sometimes the level of confidence I’m given borders on becoming overwhelming. It’s difficult to remember when an owner calls with a question we might consider somewhat self-evident that they are doing so because they are so dedicated to their pet’s care and because they value our stance on their issue. Some issues are more controversial (e.g., those related to vaccination or what food to feed), while others seem more innocuous (e.g., those related to walking on grass versus concrete or whether it’s OK to continue brushing their teeth). Either way, I’m their “go-to” person for things they likely never afforded much consideration prior to their pet’s life with cancer.

Reciprocally, an owner should realize it places a tremendous amount of pressure on me to have an opinion on something I may not truly have expertise in. I know I am limited in my knowledge of areas such as nutrition and supplements, but this also instills a desire to continue to further the depth and breadth of my own education and truly forces me to keep current on all aspects of veterinary oncology — not just those related to my typical day-to-day activities.

Perhaps I shouldn’t feel so astonished at the faith instilled in me by owners, but rather see it as a sign that my work is valued and appreciated. I feel humbled by their acceptance, yet simultaneously empowered by their sureness. Whether I truly deserve their reliance is another issue altogether, I suppose.

An endeavor I think I’m pretty happy to try and prove.

Dr. Joanne Intile

Image: Thinkstock

Comments  10

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  • Pets With Cancer
    10/02/2013 03:23pm

    My new appointments are scheduled for one hour, and during that time I will discuss a great deal with owners, generally covering what I describe as, “What we know, what we don’t know, and the things we can do to bridge the gap.”

    Really helpful to learn everything we can, I expect my vet to do the same. Thanks for setting the bar :)

  • "bedside manner"
    10/02/2013 08:15pm

    I think this means more to me in evaluating a vet than any other factor. Do they appear to really care about my pet? Are they willing to take time to discuss options, questions, concerns in a way I can understand? It doesn't take me long to evaluate their expertise but I can tell in the first five minutes if they have that elusive caring quality. When I had to take my dog to the oncology specialist at the University of Iowa, just the way she approached, handled and touched him gave me immediate confidence.

  • Not so trustworthy
    10/04/2013 04:10am

    I'm happy with my current Vet, but how ironic that this article was written by Joanne Intile, a supposedly "trustworthy" Vet. I'm still red hot angry with her, and with my prior regular Vet, who I sought a referral to her from, even though nearly three years has passed since together they literally prevented my beloved Devon from getting chemo locally, and made us face an over four-hour round trip for treatment, and all the added stress that entailed on top of dealing with lymphoma! It's now been just over a year since Devon lost his battle with the disease, but I still couldn't be angrier with those two! I believe it was nothing but pure bias against Devon, a very large but incredibly loving and lovable pitty mix, that caused my ex-Vet to sabotage my efforts to get Devon into treatment at the emergency and specialists' office where Intile was practicing at the time. And it was plain wrong for her to at first agree to see him, but then cancel our appointment, sight unseen, and refuse to change her mind even after I begged and pointed out the lies my Vet told her about my dog. He had even been at that same office once before, for an emergency visit, and thus she had a record right there proving that he was fine at a Vet visit. Horrible, horrible treatment of an innocent, ill dog and a desperate dog parent!

  • 10/11/2013 07:42pm

    I am so sorry for your lose. It is so hard to loose a pet. Do you know why Dr Intile would not see the dog?

  • 10/11/2013 08:39pm

    Thanks for your empathy rockjdog. As I indicated in my post, she was improperly influenced/biased against him by my ex-Vet. I had been taking Devon to him since puppyhood - it had been nearly 5 years when the lymphoma was diagnosed - but for some reason from the minute the lymphoma was diagnosed he tried to discourage me from getting him treatment. Looking back on it now I realize that as Devon grew larger the Vet seemed to dislike him more and more. But that only became clear to me when Dr. Intile cancelled our appointment; her office manager wouldn't tell me exactly what the referring Vet told them, but it was obvious that he had completely sabotaged my attempt to get Devon in to see Dr. Intile. Devon was a totally sweet and loving dog; he was reactive to other dogs, but as to humans there was not an ounce of reactivity. At the place I eventually took him to for the treatment he needed (but having to go through that arduous, over four-hour trip weekly for months!), everyone loved him, and there were no problems at all. Shame on Dr. Intile, and on Dr. Bryce Hauschildt in Rochester, NY!

  • 10/11/2013 09:02pm

    I am so sorry that you had to go through that alone. We have to be advocates for our pets. It sounds like you were a great protector and advocate for Devon. You still are and that is a great way to honor him in memory.
    I have a very dog reactive dog and I do my best to keep her safe and not let her make bad choices. If she needs help I fight for her tooth and nail. You are not alone! We need great pet owners like you,
    Rest in peace sweet Devon, no more suffering.

  • 10/12/2013 02:30am

    First of all, I am so sorry Yolanda for the loss of Devon. I am happy to hear he did well with treatment and I am also sorry you still harbor so much anger at me and your previous primary care veterinarian for actions from over 3 years ago.

    The tone of your messages depicts me in a negative light to the public and as such I feel it is important to present an additional side to this situation which has been omitted thus far.

    When you called to schedule your initial appointment with me once receiving a diagnosis of lymphoma from Devon's primary care veterinarian, you were not in town and unable to attend an appointment in person for a specified time period.

    You wished for me to see Devon and start treatment immediately, and you did not want to wait until you returned home from being out of town. Therefore you requested I see Devon as a "drop off" appointment with (I believe) your son leaving Devon at our hospital with the intention of me performing a physical exam, assessment of medical records, and then calling you later in the day to go over my recommendations.

    Seeing new appointments who have never been evaluated by the current attending doctor as "drop off" cases is not a policy typically allowed at most veterinary hospitals, however I persuaded our management team to agree to this as I too wanted to help Devon and recognize the urgency when a diagnosis of cancer is incurred.

    After much debate about concerns for liability (even before any question of potential aggression was raised), management allotted me this opportunity and we scheduled Devon as a drop off appointment very soon after your initial phone call.

    When we received the medical records from your veterinarian, there was indication Devon had shown severe aggression towards the veterinarian and staff members. This raised a flag for me as this could potentially represent an unsafe situation for our staff at our hospital since the plan was Devon would be dropped off early in the morning with no human being to be responsible for him while he was here.

    I called your primary care veterinarian and discussed his concerns of Devon's aggression with him. After speaking with him it was indicated Devon had historically shown signs of aggression towards his staff members.

    I discussed this new piece of information with our management team again, and it was decided that we could not see Devon as drop off appointment because of liability issues.

    My coordinator then called you and offered to see Devon as a regular appointment as long as someone (not restricting this to only you - his primary caregiver as is the case for all other patients seen at our hospital) would be available to be with him at all times while in hospital.

    You elected to not pursue this appointment and sought care elsewhere.

    We never had the chance to evaluate Devon and see how he would feel around our staff and if aggression would even be an issue.

    I do not feel as though we were wrong for our decision as we had indication Devon had shown aggression previously and it was simply considered unsafe for him to be left alone in our hospital with no one responsible for him.

    I am happy you were able to find alternative treatment for Devon and I am sorry you felt you had no other option but to travel 2 hours to Cornell for treatment when we did offer you the option of attending an appointment as is done by every other pet owner we see.

    I do not feel I acted inappropriately in anyway, as we did offer you an alternative option to the initial unconventional option and you declined this option.

    I never refused to see Devon - this is a misconception and/or miscommunication. Furthermore, I do take issue of you representing me falsely to the people who come to this website for information and help in stating I am not trustworthy.

    I have not, nor ever will, refuse to treat any patient based on their behavior, and we treat all dogs with cancer, regardless of whether they show signs of aggression or not. I have treated dozens of aggressive cats and dogs and never once turned away a case based on behavior. We simply asked that someone be present while Devon was in hospital for his appointment and this was not agreed to on your part.

    Again, I am truly very sorry for your loss and sorry you still feel so much anger towards me and your previous veterinarian. However I cannot allow the misrepresentation of the facts of surrounding your concern to be purported in a public forum where I my character and integrity is being questioned.

    Joanne Intile

  • 10/12/2013 03:54am

    Dr. Intile, the truth of the matter is that I would not harbor such anger and strong feelings, especially after so much time has passed, were what you are now saying the truth. Indeed I was sadly far away from home when the diagnosis of lymphoma was confirmed via biopsy, on a trip that had been planned long before I had any idea Devon was ill. However, family members were going to bring him in for the initial appointment, and there was never an issue of him being left unaccompanied as a "drop off" at your office. Most particularly, your office NEVER offered me the option of him being seen, at all, after I was notified you had canceled the originally scheduled appointment. This was even though I called back again after first getting that news and literally begged, in tears, for him to be seen. I was told in no uncertain terms that you reserved the right to choose which patients to see! We were thus literally forced to travel out of town (to Cornell) for his treatment. Family members did in fact take Devon to Cornell for his first appointment (which was delayed much longer than it should have been due to my desperate but failed attempts to have him seem at your office initially). I fully participated in that first appointment, with both video and voice, via Skype and my laptop and my family member's laptop. I could have participated that way had he been seen at your office as well. Then I cut short what had been planned as a longer trip away from home, and took Devon to Cornell for his second appointment, and, of course, for many more months after that. As for his purported aggression, I have already stated that Dr. Hauschildt was unfairly and unjustly biased against my beloved dog, who was never in his life aggressive with people, and I will not belabor my firm conviction that he was for some unfathomable reason simply not telling you the truth about Devon. But now you add insult to injury by also not telling the truth about what happened - you did utterly and definitively refuse to see him, at the very least as explicitly conveyed to me by your office manager!

  • nope dont trust em
    10/09/2013 08:28pm

    No I don't trust my vet. I am not sure if I expect too much or perhaps I just don't understand how complex the animal body is or if I just have bad luck.
    I had one vet do a barium x-ray ( not sure if that's exactly the right phrase) but he declared that my dog had stomach cancer. I got a second opinion and the next vet said it was a tumor of the soft pallet. Went to an emergency hospital and they confirmed it was the soft pallet tumor. Too late because the cancer was too advanced. Soft pallet tumors are hard to detect.
    I have tried other vets in my area but we have an emergency hospital in the area so as soon as any difficulty arises the vet wants us to go to the hospital ( they charge five times what our regular vet does). Here is an example. I tried a vet close to my home. My dog had a couple of bumps, so a biopsy was taken. It came back as cancerous. The vet recommended that we go to the emergency hospital to see the oncologist. So I paid two hundred just to see her ( the oncologist). She told me that she could not diagnose the stage until the bumps had been removed. So I paid two hundred for nothing. Had the bumps removed by our regular vet for 400 and they came back as stage one. Not a big worry and most of the time stage one bumps are resolved by removal. Now one of my dogs bloated so off to the emergency hospital we went. They tacked his stomach after taking care of the bloat. About five months later the same dog had a blood clot removed and two months later he bloated again. They could not get the tube down because his stomach twisted. There was no way it could have twisted if he was tacked. It seems as if my regular vet removed the tacking when he removed the blood clot. I try to learn as much as I can about a disease when my dog is sick but when you try to ask questions or discuss it the vet seems a bit miffed. I know I am not a doctor, I am just trying to advocate the best I can for my pet so the vet wont miss anything. I just dont trust my vet and I wish I did.

  • I Missed This!
    10/23/2013 11:21pm

    Can't believe I missed a post.

    Guess I'm pretty lucky with the vet and specialists I currently use.

    I had one bad experience some years ago and almost lost a kitty (she spent several days in kitty-cat-ICU), but referred myself to the internist and changed regular vets at the same time.

    I may show up at the speciality clinic "armed" with information, but I give a great deal more weight to information from doctors that have personally examined my critter and translated test results themselves.

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