SHOULD
YOU GET A SECOND OPINION?
What
to do when a pet is ill... it's a no-brainer! Still,
every
caretaker has
experienced that moment of indecision and self doubt, when it's unclear
exactly how serious the problem is or exactly how ill a pet is
feeling. Sometimes, deciding
when to make the call or whether or not to visit the emergency
clinic
involves a great deal of deliberation and anxiety.
We don't want to act too soon and earn the reputation of an alarmist
(Maybe
it’s nothing or it will pass by
morning). On the
other hand, there may be danger in
putting that visit off (Maybe this is
serious and I’ll do my pet harm if I wait until
tomorrow).
Err on the side of caution! At worst, you’ll be called an alarmist; at best, you’ll save your pet’s life. If you're unsure, call ahead and describe to your vet or to an emergency clinic vet the clinical signs (symptoms) that you see. Ask them to help you decide whether or not your pet should be examined on an emergency basis and if not, find out what steps you might take to resolve the problem at home. When a diagnosis of cancer is given, your vet may make a recommendation of euthanasia at the time of diagnosis, or deliver a very poor prognosis. Choosing euthanasia or not to treat cancer are both choices with far reaching consequences. A second opinion would be invaluable before making such irrevokable decisions. Euthanasia is a difficult and unnecessary choice to make when a pet is still having good quality of life. Dr. Alice Villalobos of Hermosa Beach CA has developed a progressive program for "Pawspice" as an alternative to early euthanasia, allowing pets the opportunity to pass peacefully at home while ensuring their comfort and freedom from pain. Because
oncology is a very new
field within veterinary medicine, there are still many vets who are not
believers. Some haven't seen first hand the successes that are possible
and others are not believers simply because of their own personal
philosophies about cancer treatment for dogs.
Seek
a
second
opinion at any point when the best next step is unclear or when
the execution of that next step may have long term
effects. Treatment recommendations may be based on the type of
equipment that a veterinarian has access to or is most experienced in
using. Seek a second opinion to either confirm the first one or to
discover a better option. There is often more
than
one logical course of action and another vet may have a different
evaluation of
the
situation, a different diagnosis, a different prognosis and/or a
different
treatment plan.
Specialists
have more
experience and more training in the tests and treatments within their
specialty than do general practice
veterinarians. In the cancer field, this includes board certified
surgeons, oncologists and oncology radiologists. On the other hand,
because there are only 160 veterinary oncologists in the U.S. and
millions of dogs and cats with cancer, many generally practice
veterinarians have become experienced and competent in providing
cancer treatment.
Lumps should generally be diagnosed, via fine needle aspiration (FNA) if possible. The "Let's wait and see" approach is a gamble. At the diagnostic stage for a tumor, when FNA was inconclusive and surgical biopsy is the next step, you or your veterinarian may want to consult an oncologist for guidance before proceeding. When a tumor is removed, the amount of surrounding tissue that is removed with the tumor and the achievement of "clean margins" determine whether or not the cancer will recur. Oncologists and surgeons are generally better equipped for and more experienced in tumor excision. If a specialist is not going to perform surgery on a tumor, the veterinarian should consult an oncologist about exactly how much tissue should be removed and about the follow-up treatment plan. Cryotherapy is sometimes an option. Keep in mind that when an unbiopsied tumor is removed via cryotherapy, information is not attained for diagnosis or prognosis and clean margins are not attained. Cancer cells may remain in the surrounding tissue, ready to grow and multiply. Some types of
cancer
are treated with chemotherapy. The current "best"
chemotherapy protocol for a particular type of cancer is easily
ascertained by any vet and treatment may be given by any vet with
experience. When side effects occur and are not quickly resolved,
however, consult an
oncologist - unmanaged side effects can be terminal or can end
treatment altogether.
Never be embarrassed or shy about asking for a second opinion! Don't worry that your vet will take this as a personal insult. Often there are differences of opinion in what the best treatment plan will be. When you have discovered the various options, you will be better able to decide what's best for you and your pet. |
REMEMBER...
Not
Today and Not Without a Fight!
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