Telemedicine: A Vet’s Perspective on the Future of Pet Care
Boris, a 5-year-old Border Collie and a patient of mine, has been destroying his house every time there is a thunderstorm. The first time I saw Boris, he had cut his paws during a lightning storm when he panicked and decided to jump through a glass window. His owner was so distraught and concerned about how we were going to deal with his behavior. Not only was it stressful for her every time she left the house, but she also worried about the potential for Boris to seriously injure himself.
After trying some simple methods (anti-anxiety medications and a ThunderShirt®, to name a few), we decided we needed a veterinary behaviorist. Unfortunately, due to COVID-19, veterinary practices were limited to essential services only, which did not include behavioral services. They were, however, offering telemedicine appointments, so we decided to book a virtual visit via the PennVet Behavior Platform.
How Telemedicine Works
Through a collaborative effort between myself, the client, and the behavior specialist, we decided on a course of treatment and put it into action. Included was not only pharmaceutical therapy, but also training recommendations, as well as an in-depth behavior analysis of Boris and what may have contributed to his deep-seated anxiety. The client was able to upload videos of Boris’s destructive behavior and the behaviorist dissected it, minute by minute, analyzing body language and cues from Boris to better help the owner and myself understand his routines and habits. It was much more than just the sound of the storm that triggered Boris. Subtle things about the way the owner behaved that she thought helped calm him were actually having the opposite effect!
I have been following up on the case with the team at the University of Pennsylvania Veterinary Hospital and Boris has started to relax during thunderstorms. On recommendation from the behaviorist, we also started crate training Boris and creating a “safe haven” for him. Before this, I thought crate training was just for puppies, but it turns out that a crate is useful for dogs of all ages and really is an important place for a dog to feel safe and secure.
Telemedicine allows general practice veterinarians like myself the opportunity to talk with a specialist and help our clients without ever having to leave our practice. An expert opinion is available online and allows direct communication between the primary care physician and the specialist. I am able to share my medical records with the specialist, voice my concerns, thoughts, and opinions, as well as discuss what methods we have already tried with the client and patient, allowing for a comprehensive and integrative approach.
The Origins of Virtual Pet Care
During this unprecedented time, veterinarians are being forced to consider virtual appointments and triage as a way to continue to provide care safely and effectively. While telemedicine is becoming the standard in “human medicine,” veterinarians are just starting to warm up to this technology. Hands-on care is invaluable in our field, because, unfortunately, our patients cannot tell us how they are feeling. We are not suggesting that telemedicine is equal to a thorough physical exam, but are only proposing that we augment our services, adapting to our circumstances as this pandemic has necessitated.
This isn’t an entirely novel approach, though. For many years, we’ve used the ASPCA Animal Poison Control Center (APCC) to speak directly to veterinarians and toxicologists regarding all the strange and potentially dangerous things our pets may have eaten. Both clients and veterinarians alike can call their number (888-426-4435) and speak with a professional, describing what plant or chemical their pet has ingested, reporting any concerning physical changes they are seeing at home, and receiving recommendations for the APCC on whether or not a veterinarian visit is necessary. It is nearly impossible as a veterinarian to keep abreast of all the potential plant toxicities, let alone the newest essential oil craze, and each accompanying cutting-edge treatment method. Veterinarians have long partnered with the ASPCA Poison Control Center, which has demonstrated that telemedicine does have its proven place in our profession.
Available Telemedicine Platforms
When considering telemedicine options, there are a number of platforms available from different veterinary hospitals. The American Veterinary Medical Association’s (AVMA) telemedicine policy states that the veterinarian needs to have a valid veterinarian-client-patient relationship, or VPCR. This means that in order to be eligible for a consultation with a specialist, your regular veterinarian must be involved in the consult. During the COVID crisis, some states have allowed for a temporary waiver of the in-person VCPR, but this will likely end with the quarantine. Telemedicine is not perfect or without risk, and having poor-quality pictures or delays in response to the evaluation can be life threatening, so discretion is advised with each case.
Every veterinary clinic has had to make adjustments to continue providing quality care for both their staff and clients. At my clinic, we feature curbside admission of pets for their appointments, and offer video chat during appointments so the owner can feel like they are present. Although slightly cumbersome at times compared to our normal workflow, it does serve the purpose of limiting human contact.
The PennVet Behavior Platform is just one of many new innovations on the horizon in our field. Powered by Intellivets, this app was created to provide access to speciality care via telehealth, offering all kinds of specialists at the click of a button.
Pet Care for When You Need It the Most
Does your cat have frustrating dietary requirements? Maybe a history of cystitis and newly-diagnosed irritable bowel disease? Your veterinarian can now consult directly with a board-certified veterinary nutritionist for the best commercial prescription diets available, as well as recipes for viable and well-balanced home-cooked meals.
Was your dog recently diagnosed with a mast cell tumor and you’re not sure if you’re ready to commit to chemotherapy? Your family veterinarian can communicate directly with an oncologist and provide you with all the available treatment plans and statistics regarding your pet’s specific diagnosis. You can have the conversation with your veterinarian at your local clinic about what diagnostics are needed, and have the tough conversation about survival time and potential side effects. If after these conversations you decide to pursue chemotherapy, then you can make the drive to receive speciality care.
From providing quality care during social distancing, to making specialty care accessible no matter where you live, telemedicine is helping grow our profession, improving life for both pet owners and primary care veterinarians.