Thursday, February 7, 2013

Ipsa Scientia Potestas Est (Knowledge, Itself, is Power)



Have you ever heard this saying before? If not in the Latin, then most likely you have heard it in the English form. Another form might be “Forewarned is Forearmed.” We all see this in daily life and often make decisions, or change decision based on this premise. A simple traffic report on television or the radio may alter your route to work today. Knowing your friend has had too much to drink would make you take away their keys and get them a cab. The weather forecasts shape our wardrobes, choice of transportation, and our vacation destinations. In essence, the more you know the better choices you can make and the more negative experiences you can avoid.

We see this daily in veterinary medicine as well. The cleaner a pet’s teeth are kept, the fewer kidney, liver, and heart diseases they tend to have. They also have less oral pain when eating, feel generally better, and are less “offensive” to the nose to have around! The more we in the profession can educate owners about dental health issues, the better off the animals are.

Let’s face it. We are all busy. Between our families, our jobs, our hobbies, our pets, our educations, our health, and just daily living we are all stretched very thin. I personally do not have the time, energy, experience, or training to know the best way to fix an electrical problem at the clinic: that is why I pay an electrician to do those things. I am not up to date on all of the changing tax laws: that is why I have a CPA. I cannot fathom all of the nuances of the federal and state laws: this is why I have an attorney. In all of these cases I rely on the knowledge of another in a particular field to help guide certain important decisions in my life.

In our profession, a large part of what we do is education. Part of my philosophy has been that in the end, it is each owner’s decision as to what they do or do not do with their pet. I believe that it is our job to do all we can to make any such decisions about your pet as informed as we possibly can. Part of that education is verbal, but part is diagnostic.

We have an incredible arsenal of diagnostic tools at our disposal in veterinary medicine. We have the basic physical exam which helps us narrow down our choices quite a bit. Then we have x-rays, ECG, ultrasound, blood work, urinalysis, bacterial culture, biopsy, cytology, and in the more advanced cases we have CT and MRI in town!

We routinely recommend testing based on the symptoms found during our exam of your pet; but there are times when testing without symptoms can be invaluable! We often recommend wellness diagnostic testing for just this reason. Some people take advantage of it, some do not. That is their decision of course. I would like to relate a few cases of owners who chose to take advantage of this service. The knowledge obtained gave them the power to better the lives of their pets.

Case 1 is a middle aged small breed dog that was in for routine vaccinations. When presented with the wellness diagnostics, the owner said it sounded like a good idea. The dog was outwardly asymptomatic. The wellness testing revealed he had a life threatening, rapidly progressing condition called immune mediated hemolytic anemia (IMHA). In this condition, the immune system decides one day that the red blood cells are foreign invaders and it starts attacking and destroying them. We were able to stop this in its tracks with the proper medical therapy and avoid a bad negative outcome because we had the knowledge to do so in a timely manner.

Case 2 is a female large breed dog who was less than a year and a half at the time of presentation. Again this one was asymptomatic and the testing was run with the intent to set a baseline for future reference. After the testing, we determined that the dog had a raging bladder infection. But further diagnostics showed that she had bladder stones which had set the environment for the infection. Surgery and antibiotics fixed both issues. But the owner had no idea at the outset that there was a problem.

Case 3 is a large breed male dog who again had routine wellness testing. There appeared to be an issue with the liver, but outwardly one would never know. After basic treatment, there was no improvement in the lab values, but the dog was again outwardly fine. After sending to the specialist for an ultrasound, they determined that the live looked very abnormal. One biopsy later and it is revealed that the dog has severe cirrhosis of the liver and is a lot sicker internally than he appears externally. Although the liver disease cannot be cured and cannot be reversed, it can be slowed and the quality of life improved for a longer quantity of time that if we did not have this information.

Case 4 is an older female dog who, although not in for the full wellness testing, was about to undergo a dental cleaning. The pre-surgical blood work (about 75% as comprehensive as the wellness package) hinted at a leukemia. This was confirmed at the specialists and chemo has been started. The foreknowledge gained by these tests has most likely helped us to extend what might have been 3-6 months of time to 1-2 years of good quality life.

To some people “ignorance is bliss,” but I suspect that to these owners, knowledge is far more valuable and they are much happier for having run the tests. So keep that in mind the next time you are presented with the opportunity to run screening heath tests on your pets, or yourself.