Why did my vet recommend a specialist?

Many of our daily appointments consist of pets that are not feeling well for a variety of reasons. In many instances, we can determine the problem and treat effectively by obtaining a thorough history, performing a comprehensive physical exam, perform in-office diagnostics or send lab work out to a reference laboratory, and dispensing appropriate medications or treatments. However, in some instances, problems may be more complicated or require diagnostics beyond the scope of a general practice, and a veterinary specialist may be recommended.  

Many people are surprised to hear that there are specialists for animals! So, what exactly is a veterinary specialist you may ask? A veterinary specialist is a veterinarian who has gone through at least four additional years of training above and beyond the four-year veterinary school education. This typically consists of a one-year internship program, followed by a three-year residency program focusing on their preferred area of specialty. They then have to sit for their national specialty examination before receiving their board-specialty certification.  

Below are some examples of specialists and why we may refer a pet to them. We’ll discuss other specialities in two weeks with our next post.

Emergency & Critical Care SpecialistLet’s face it, sometimes our pets get so sick that they needs some pretty intensive care! Emergency clinics that have a criticalist on staff have the capacity to do some extremely intensive care, including ventilatory support (i.e. breathing for the patient in an acute lung injury), in-hospital feeding tubes, extensive nursing management and tend to be on the cutting edge with treatment options for some really complicated, really sick cases.

InternistWhen we just can’t seem to find the answer to a pet’s metabolic woes or advanced diagnostics (such as endoscopy or bronchoscopy) are needed — and an internal medicine specialist is often recommended. They excel at complicated case work-ups and are very good at long-term patient and chronic disease management. The types of cases that we often request their assistance with are complicated diabetics, certain respiratory disease, multiple metabolic disease processes occurring at once, and certain infectious, inflammatory and autoimmune diseases. Their wealth of knowledge can be invaluable with making treatment decisions and when changing medications, doses, etc. to find just the right balance for a given patient. Subspecialties within internal medicine include:

Cardiologist: Sometimes we will hear a heart murmur or abnormal heart sound when performing a physical examination. A murmur is turbulent blood flow through the heart, but just listening to the heart doesn’t tell us exactly why the murmur is present. In these cases, we will refer your pet to a veterinary cardiologist to perform an examination and an echocardiogram (an ultrasound of the heart). This will help determine the source of the abnormality. Puppies and kittens may have congenital abnormalities that can be fixed via surgery. Cardiologists also can place pacemakers in certain conditions where the abnormality has to do with the electrical conduction through the heart.

Neurologist: Unfortunately, sometimes our pets go through a variety of neurological disorders. This can include herniated disks in their back, tumors within the brain, congenital abnormalities, seizures, etc. Seeing a veterinary neurologist can help narrow down the cause for some of the signs you are noticing at home and they can also perform MRIs/CT scans on your pets to determine the next best step for treatment. Veterinary neurologists are also trained to perform spinal and brain surgeries.

Oncologist: Many types of cancers in veterinary patients can be surgically removed by your primary care veterinarian, but there are certain types of cancers that do best with surgical removal followed by chemotherapy and/or radiation therapy. These are two types of treatments have to be administered by a veterinary oncologist and may help prolong the quality of life-span of your pet.

SurgeonMost primary care veterinarians can perform routine surgeries, including limb amputations. However, sometimes your pet has injured themselves to the point of needing a veterinary surgeon to repair the damage, or requires a complicated surgery that is beyond the scope of general practice. Examples of this include torn ACL repairs, performing a total hip replacement, complicated tumor removals, surgery entering the chest cavity or around the heart, repairing complicated congenital defects, to name a few.

Veterinary specialists are great resources for your pets when your primary care veterinarian thinks their expertise will be needed to help make your pet feel better, faster! We are fortunate to live in an area with numerous specialty-trained veterinarians to help us provide the best care for our pets.