Specialization in veterinary medicine is definitely growing, as more pet owners are looking for advanced care and more veterinarians are choosing to tackle it: According to the AVMA, almost 40 percent of 2007’s veterinary school graduates enrolled in targeted post-graduate coursework, internships and residencies, up from just 15 percent in 1995. And despite the current economic situation—and the fact that a specialist will almost always cost more than a family veterinarian (generally about twice as much, says Dr. Robbins)—owners are keeping them busy. They can be found throughout the country, at major veterinary teaching hospitals as well as clinics, many of which offer a few different types of specialty care along with 24-hour emergency services.
When to Get a Specialist
Most often, a specialist will see clients who have been referred by their primary veterinarians, although owners also wind up there after bringing their dogs into a specialty hospital for emergency care.
Most general practice veterinarians will readily suggest a specialist in cases that are beyond their area of expertise, says Dr. Khuly. “A few vets might want to do everything in-house, or they might feel that the client wouldn’t want to see a specialist for financial or other reasons, but most routinely make referrals,” she says. The phenomenon is much like the one in human medicine, she says. “The general practitioner is your go-to person for everyday issues, but the specialist is who you see for more complicated problems.”
For example, your family vet might suggest you see a specialist for treatment of a known disease or condition (such as heart rhythm abnormalities or diabetes), says Dr. Kay. You also might be sent to a specialist if your dog isn’t getting better—or is getting worse—despite the treatment he’s currently getting. Dr. Kay also recommends seeking a specialist for a second opinion, or if you just want to feel more certain about your dog’s care or have a “gut feeling” that he might need more than your family vet can provide.
You also might want to consult a specialist if your dog needs diagnostic procedures beyond the run-of-the-mill temperature readings and blood work that your regular vet provides. For example, endoscopy—a nonsurgical method of evaluating a dog’s respiratory, gastrointestinal or urinary tract or removing growths or tissue for biopsy—is generally left to the specialists, says Dr. Kay. “Some general practitioners perform endoscopy procedures, but unless they’ve received extensive training, they won’t have nearly the experience that a specialist in internal medicine does.”
Seeking Out Surgeons
By far the most common reason dog owners seek specialists (and the most common reason that general practice vets make referrals) is for surgery. “Most family veterinarians know that they can’t perform a total hip replacement, and they’re not about to take out a big scary cancer mass,” says Dr. Khuly. “They know that they have limits, and so they’ll refer those cases to a surgeon.”
If your veterinarian recommends taking your dog to a surgeon (or if you think you should see one for a second opinion), do your homework—on both the surgeon and the surgery that your vet has recommended—before the consultation, says Dr. Kay. Find out if he’s board certified, and ask about his experience in cases like your dog’s. Be sure to bring your dog’s medical records, including the latest x-rays, lab results and prescriptions, to the appointment.
When you meet with a surgeon, Dr. Robbins recommends asking the following questions:
•Are there any other options that we could consider? What’s the advantage of surgery over nonsurgical options?
•What can I do to ensure that my dog will be a good candidate for this procedure? Are there additional tests that should be performed (such as “staging” of cancer)?
•What are the risks and possible complications? What is the prognosis for my dog, considering his age and overall health?
•What will the aftercare involve? Will my dog need to remain in the hospital immediately after the surgery (and does your hospital provide 24/7 care)? Do I need to buy special equipment, like an orthopedic bed or baby gates for the stairs? How much post-operative rehabilitation will he need and what will it entail?