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How to Find a Veterinary Specialist for Your Dog
When, why and how to find one

If a member of your (human) family got sick or hurt or had a condition that demanded expert care, you’d ask your doctor for a referral to a specialist—someone who could offer treatments beyond what your GP could provide.

And now, if your dog needs care beyond the scope of your regular veterinarian’s practice, you can do the same thing for him.

Specialists can take over where standard veterinary care leaves off because they have specific education and hands-on experience over and above that of most general practice vets, says Nancy Kay, DVM, a board-certified specialist in small animal internal medicine in Rohnert Park, Calif., and author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life (2008). “Veterinary specialists have spent two or more years of in-depth residency training, often receiving one-on-one guidance from clinicians who are experts in their fields,” she says. “That’s where they learn how to deal with challenging cases.”

Veterinary specialists—experts in everything from anesthesia to zoological medicine—were all but unheard of when most of us were young (and romping with the dogs of our childhood). The first specialties were recognized by the American Veterinary Medical Association (AVMA) in the 1950s, when the association established the American Board of Veterinary Specialties (ABVS) to serve as an umbrella organization for all AVMA-recognized specialty groups.

Today, the ABVS represents 39 distinct specialties, which are practiced by members of 20 specialty organizations, some of which encompass several disciplines (for example, the American College of Veterinary Internal Medicine, or ACVIM, covers large and small animal internal medicine, plus oncology, cardiology and neurology). More than 9,000 U.S. veterinarians—roughly 9 percent of all vets in the country—are card-carrying members, or board-certified diplomates, of these organizations. To obtain diplomate status, a vet must complete postgraduate coursework and residency and pass a certification exam. In some cases, that means several years of additional training after vet school.

In addition to the AVMA-recognized specialty groups, a few organizations offer specialized training and certification to vets who have added physical rehabilitation and various types of alternative medicine to their practices. (See sidebar.)

Extra Credit

While the specific requirements for diplomate status vary, virtually all require a veterinarian to take additional coursework and complete an internship (or its equivalent in active veterinary practice).

The expertise demanded of specialty veterinarians is especially important in veterinary medicine, because vets—unlike human doctors—can legally perform any accepted procedure on your dog, says Mitch Robbins, DVM, a diplomate of the American College of Veterinary Surgeons (ACVS) who practices at the Veterinary Specialty Center in Buffalo Grove, Ill. “If you needed surgery, your doctor is required to refer you to a surgeon,” he says. “He can’t just operate on you himself. But if your dog needs surgery, your regular vet can do it himself. The question isn’t whether he can perform the procedure—it’s whether he is the best person to do it.”

Another issue is equipment—high-tech radiology, neurosurgery and diagnostic machines that specialists have (and general practice vets almost never do). Specialists have received training on this equipment and are well versed in the latest therapies and technologies, says Patty Khuly, VMD, a general-practice veterinarian in Miami, Fla. “They’ve invested in the kinds of equipment that I wouldn’t buy for my practice,” she says. “Of course, there are good and not-so-good specialists just like there are good and not-so-good general practitioners, but, generally speaking, specialists are at least four years ahead of everybody else. Veterinary medicine is advancing very quickly, so four years represents an awful lot.”

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Special Interests
Here are some of the more popular specialties, and the conditions that they address.

  • Acupuncture. Vets are certified by the International Veterinary Acupuncture Society (IVAS) and can treat arthritis and other musculoskeletal problems, plus skin, respiratory and gastrointestinal problems.
  • Behavior. Diplomates are certified by the American College of Veterinary Behaviorists (ACVB) and treat behavioral issues, such as aggression or anxiety, that are often tied to a dog’s overall health.
  • Canine and Feline Medicine. Diplomates are certified by the American Board of Veterinary Practitioners (ABVP), which offers certification for general practitioners who focus on dogs and cats. (ABVP also certifies equine, dairy, avian and other practices.)
  • Chiropractic. Vets are certified by Animal Chiropractic Certification Commission (ACCC) and treat various types of muscle, nerve and joint pain as well as digestive and other internal medicine problems.
  • Dentistry. Diplomates are certified by the American Veterinary Dental College (AVDC) and treat conditions involving the teeth and mouth.
  • Internal medicine. Diplomates are certified by the American College of Veterinary Internal Medicine (ACVIM) in small or large animal internal medicine, cardiology, oncology or neurology, and treat internal medicine disorders, such as diabetes, heart disease, cancer and neurological problems.
  • Ophthalmology. Diplomates are certified by the American College of Veterinary Ophthalmologists (ACVO) and treat diseases and injuries involving the eye.
  • Radiology. Diplomates are certified by the American College of Veterinary Radiology (ACVR) and provide imaging services or cancer treatment (radiation oncologists).
  • Physical Rehabilitation. Vets are certified by the Canine Rehabilitation Institute and provide physical rehabilitation after accidents or surgery.

Second Opinion Etiquette
Going for a second opinion? Nancy Kay, DVM, Diplomate, ACVIM, and author of Speaking for Spot  tells us how to serve our dogs’ best interests as well as maintain harmony with his health care team.

  • If your primary-care veterinarian didn’t provide the referral, be sure to let her know what you’re doing. (Plus, how else will the specialist have access to your dog’s medical records?) Avoid the impulse to “sneak out” for a second opinion for fear of hurting your vet’s feelings. Unless she’s fresh out of school, this won’t be the first time a client has requested another opinion, and it won’t be the last. Remember, your vet’s foremost concern should be your dog’s health, not her own feelings. This is part of the oath we all take when we enter the profession.
  • Arrive early for the appointment with the specialist. There will be paperwork to complete, which can be a 10- to 15-minute process, or even longer if the receptionist is busy.
  • Have a legible copy of your dog’s recent and relevant medical records, including all laboratory data, imaging studies (x-rays, ultrasound evaluations, CT and MRI scans), ECGs (electrocardiogram tracings) and doctor’s notes. It really helps when this material is arranged in chronological order. Icing on the cake is a legible summary prepared by your family vet. Remember, a stack of invoices is not a substitute for your dog’s medical record.
  • Bring all of your dog’s current and recent medications so the specialist can read the actual prescription labels. Just like human doctors, vets often have lousy handwriting, so details from a printed label are usually more reliable.
  • As tempting as it may be to tell the specialist everything your family vet has told you, hold back and give her a chance to draw her own conclusions by asking her own questions.
This article first appeared in The Bark, Issue 55, Jul/Aug 2009

Martha Schindler Connors writes frequently about health; her work has been published in Prevention, Self and Shape.

CommentsPost a Comment
Submitted by Sarah Katherine Moore on October 8, 2010.

I don't know if it's just the vets in my area but I had a terrible time when another of my four-legged family (horse) needed what my regular vet said was laser surgery to remove a tumor in a sensitive area (ear). BUT because his clinic did not have laser surgical capability he insisted that they do it "the traditional way" and refused to refer me. His way would have meant 2 weeks in the clinic's pet hospital on IV and with a blood transfusion (or two or three) several hours under a general anesthesia and no guarantee of outcome and probable life threatening effects from the GA. I found another vet who COULD do laser surgery on an outpatient basis with little risk to the horse, far less pain, reduced bleeding and vastly better prognosis. Second vet wanted to know who my regular vet was and then proceeded to call that vet and tell him. Regular vet not only immediately called me at work, screaming threats incl how he would (and he has) blacklist me for "going behind his back." He screamed at me on the phone so hard and loud that my boss in the next office heard it through the phone receiver reverberating throughout the office. After that no vet (includingthe laser vet) in a hundred mile radius would even talk to me. The horse's tumor was cancerous and had it been removed he would have a chance to live but because of these vets' antics and being unable to get other local vets to treat him, we lost him. The day he died I lost any faith in veterinarians.

Submitted by groendog on August 18, 2010.

The important thing about Specialists, which we learned the hard way, is not to wait until the last minute for a consult.
Give your Vet a reasonable amount of time to fix the problem, say two weeks, and then head for the Big Guns. If your Vet won't refer you, you need another Vet anyway.

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