Board-certified veterinary internists have a saying, “Cats are not small dogs.” We general practitioners might hear that admonition at any continuing education event.
The point of the proverb is that cats are different from dogs, physically and metabolically.
Do you know what else cats aren’t, that dogs aren’t either?
They are not people.
Don’t get me wrong. Pets are family. The motto of our practice is The Family Practice For Family Pets. No one on earth treats their pets more like family than my wife, Brenda, and me.
The point is that just as cats are different from dogs physically and metabolically, dogs and cats are different from people physically and metabolically.
A couple of events occurred this week to inspire me to make this point in today’s Article.
When Brenda arrived in her Orthopaedic Wing hospital room her first night nurse was Susan. Susan has been terrific: smart, expert, knowledgeable, informed, caring, loving and patient.
She nearly cried when she found out I was a veterinarian, and told me of the recent loss of a sweet puppy to parvovirus disease. We commiserated about the sadness of losing a pet to such a terrible and preventible disease. I told her that it was a shame that the person she got the puppy from had not cared enough about the litter to have them vaccinated before she obtained it.
I went on to say that she needed to wait at least sixty days before she got a new puppy, as parvovirus is notorious for persisting on fomites and in the environment for long periods of time. Food and water bowls and bedding should be discarded immediately and all possible surfaces should be disinfected with a 1:10 solution of bleach and water.
I cringed when Susan said she had already gotten two new puppies. “I hope you had them vaccinated before you took them home,” I offered.
“Oh, I made sure I did that myself. I got the vaccine at the co-op.”
I immediately whipped out my ink pen and wrote down the URL of the MyPetsDoctor.com Article about the pitfalls of co-op vaccines and why the physical examination is the most important part of every pet’s visit.
A different case makes a similar point. Read on.
At our hospital this week I got a call from the client of another doctor who was upset because the doctor had failed to make an “easy diagnosis”. In fact, it was so easy that she, a physical therapist, had made the diagnosis herself after consulting the online version of the Merck Veterinary Manual. After all, it does call itself “the world’s most trusted resource for animal care information.”
And all this time I thought one’s veterinarian was the most trusted resource for animal care information! What was I thinking? Do you mean to say that I could have skipped all of those years of undergraduate study, and four years of 100-plus-hour weeks of learning at Auburn University’s College of Veterinary Medicine? All I had to do was log on to the Internet and read this book?
It’s even easier than that! The physical therapist printed out the list of symptoms she’d based her diagnosis on and, voila! I didn’t have to read the entire book, I had only four pages to read!
The only problem was that she had taken the symptoms out of context and failed to realize that she needed to consider other options. Doctors call it a list of differential diagnoses, all of the possible diseases and disorders that could fit some or all of the abnormal signs a patient displays.
The physical therapist had focused in on one cause of paralysis in her dog. In less than a minute I came up with ten more-likely causes and with a little more time I could expand that list to fill up a legal pad.
There is a reason that doctors spend all of that time in study!Don’t get me wrong! I have an incredible respect for the job that nurses and physical therapists do. I have been amazed as I watched Susan and her nurse colleagues care for Brenda in every way. They take care of her medical needs, her physical needs, they commiserate with her about the pain she is in, they find ways to ease her pain, they find ways to move her and minimize her discomfort. It is truly amazing how well they do everything they do.
There is a reason that, after thirty years of practice I have accumulated 1500 hours of continuing education!
There is a reason doctors are licensed to perform in ways different from the ways nurses and physical therapists do!
A Merck Veterinary Manual is not a doctor, either.
I have had physical therapy for shoulders, knees, wrists, hamstrings and a pelvic injury. Physicians’ preferences and insurance company requirements have necessitated that I sometimes go to different therapists. Every one I’ve been to has impressed me with his detailed knowledge of anatomy and techniques. I literally stand in awe of the physical therapists I’ve been to.
However, as Inspector Harry Callahan said, “A man has got to know his limitations.”
Veterinarians are trained to do our specific jobs on pets.
Yet we are not allowed to practice medicine on people because we are not physicians.
Nurses and physical therapists are trained, highly trained, to do their specific jobs on people.
Yet, they are not allowed to practice medicine on people or pets because they are not doctors.
There is a public radio show with the motto, “Taking the mystery out of medicine.” Let’s go ahead and clear this up right now: You are never going to take the mystery out of medicine; the practice of it or the drugs themselves!
Practicing medicine is complicated. Years of training, experience and continuing education enable us to do it better and better, building on a foundation doctors learn in their first four years in medical school.
Nurses, physical therapists, and the Merck Veterinary Manual simply don’t have the same foundation as doctors. Without that foundation, there are many, many things about practicing medicine that one cannot understand. That lack of understanding leads to mistakes, such as thinking co-op vaccines are all the care a puppy needs and that one diagnosis in a book is all of the possibilities for one’s pet’s ailment.
Your pet needs and deserves a veterinarian.