Tuesday, March 8, 2011

Veterinary Networking

Veterinary Networking

     Last week a local veterinarian called me to discuss a horse he was treating for metabolic syndrome.  The horse had been treated with a specially designed diet and exercise program for the past 6 months to address a problem of abnormal weight gain, high blood sugar and insulin levels.  She was being re-evaluated and the veterinarian had some questions about interpretation of her latest laboratory values.  He called me because I am a diplomate of the American College of Veterinary Internal Medicine, which means I successfully completed a 3 year clinical large animal residency training program and a rigorous examination process to ensure my advanced knowledge and experience diagnosing and treating internal medicine problems in large animal species.
      I stopped by to visit with Dr. Shane Miller at Comstock Large Animal Hospital yesterday.  Shane is a diplomate of the American College of Veterinary Surgeons.  I had taken some x-rays of a foal with an unusual stifle lameness and had some questions about the abnormalities I had seen on the radiographs.  Shane and I sat down and looked at the films together.  He gave me his opinion on the radiographic changes and some suggestions on treatment options for the foal. 
     This type of congenial exchange of information goes on all the time behind the scenes as a routine part of your animal's care. In addition to consulting with local specialists, there are larger networks we utilize to keep up with the constantly expanding subject matter concerning veterinary medicine.
    I allocate a portion of every day to reading two listserves that I follow on line- one is supported by the American College of Large Animal Veterinary Internal Medicine, the other by the American Association of Equine Practicioners.  These internet based conversation groups provide a wonderful, interactive forum for veterinarians to discuss cases they are treating and get input from colleagues worldwide.
    The variety of problems presented to the ambulatory veterinarian is enormous, and maintaining this network of colleagues is a critical part of my service to you.  After 22 years as a practicing veterinarian, the majority of patients I see exhibit clinical signs with which I am familiar, and diagnostic and treatment plans are relatively routine.  However, when an animal presents with an unusual history or presenting complaint, it is wonderful to have a network of specialists to consult.  Sometimes the initial conversation with a specialist leads to the referral of the patient for advanced diagnostics or treatment.  
Last month I sent a patient to the UC Davis Veterinary Teaching hospital not only for advanced diagnostic services, but also to ensure a level of intensive care treatment and monitoring that could not be provided in the field.  
     Deciding when to consult or refer with a specialist is not always a cut and dry matter - a crucial part of my job is to be sure to keep lines of communication open, and to present all your options to you as a horse owner.  If you ever have unanswered questions about your horse, discuss them with me until you are completely satisfied, and ask for a referral for a second opinion if you feel it is warranted -  I am happy to comply.
    There are 21 specialty colleges of veterinary medicine recognized by the American Veterinary Medical Association. In the greater Reno area we have 2 board certified surgeons practicing on horses, 1 large animal internist, and a board certified ophthalmologist who sees both large and small animal patients.  UC Davis is 3 hours away and offers specialists in most of the large animal disciplines.  To learn more about veterinary specialists, google AVMA specialty organizations.
I believe that education is the key to evolution. I believe that animals are the key to compassion. I believe the learning never stops.


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