Below I have outlined the sort of information that will help you and your veterinary surgeon on the rare occasions (hopefully) that you will need to take your pet to visit your local Practice. I will assume that this is the first time for seeing the vet at a new practice so I address every angle, but obviously if you’ve already registered and visited the practice in the past, then some of the information will already have been recorded and is known to them. If you see a different/new vet from before, then it will help them and speed up proceedings to tell him/her any history that you think is relevant to the current situation.
I have written this predominantly from a pet/vet visit perspective, but much is equally applicable to when you first call a vet out to your horse/pony or other animals.
Here's a checklist of questions and information a vet is likely to want to know during a Practice registration and consultation:
Your information
Name and address.
Your pet's information
Name, species, breed, age, weight, and sex of the animal.
Get them to note any identifying marks or features in case your cat/dog is brought in as “lost” by a stranger.
Insurance status
If asked, my advice would always be to say “No” and to only reveal it if you are when it comes to making a claim! Otherwise you could find that your vet runs every possible diagnostic test under the sun. Diagnostic tests are useful ONLY when it is necessary to determine which of a number of possible treatment options is appropriate. Remember, the aim is for your pet to receive the most appropriate treatment with the minimum interference and expense that is necessary. It is not an exercise in intellectual satisfaction for your vet for that sake alone! If, for example, a dog is slightly lame having had a boisterous run around with his mates, and on physical examination there are no obvious breaks, ligament ruptures, wounds, or extreme pain etc then rest with short lead-restricted walks for a couple of days and possibly homeopathic Arnica is not an unreasonable first option advice. Remember, a bit of discomfort serves a purpose to let your dog/cat know what they can or cannot do without exacerbating an injury, so absolute pain relief isn’t necessarily entirely helpful or useful, especially if your pet is the sort that is likely to be too energetic if they can’t detect any pain. If it gets worse or persists then that justifies closer investigation, but there’s no need to dive in with X-rays, MRIs and blood tests etc in the first instance.
Over-use of all the advanced diagnostic toys is what has driven up bills and pet insurance premiums, so whilst those of you who are insured haven’t had to pay directly for such investigations in the past, by giving carte blanche permission for your vet to “do whatever tests they think are necessary”, you and everyone else has been paying ever since through the now eye-watering monthly premiums I keep hearing about. Insurance is a purely financial balancing act, and if claim costs keep rising then insurance companies will keep raising premiums across the board to cover all their costs, operating overheads plus their own profit. In my opinion, the veterinary profession has tended to be guilty of slowly strangling the goose that has been laying the golden eggs they’ve been trying to hoard. Whilst running a veterinary practice is also a business as well as a care providing service for animals the pendulum appears to have swung more towards the financial aspect than it should have done, or at least that is the widely held perception.
Many times, I’ve heard that tests are much more carefully selected, and costs reduced when the vet thinks their client is not insured, and yet they sign the insurance claim form to say they’ve only charged their normal fees. They’ll say they’ve reduced costs to be kind to the uninsured, but I strongly suspect that without vet fees insurance, charges would not be quite so high now, and diagnostic tests would be more carefully chosen too.
To be fair to vets, most people in the UK have no idea what it costs to run a veterinary hospital (as they mostly are these days) and provide medical and surgical care because people’s perception of a health service is based on the NHS which is free at the point of service. Those of you in the USA and similar countries where you know how much human health costs will be more understanding. Overheads in terms of business rates, utilities, wages, and mortgages etc have risen as people well know from their own personal expenditure, not to mention the cost of abiding by associated legislation. Having said that, I have little doubt that taking advantage of the insurance situation has occurred too, although maybe not to the degree that people might think given that wages in the veterinary sector are nowhere near in line with the equivalent human medical and dentistry wages. The politics of this are very much more complex than I’ve laid out here too and beyond the scope of this article.
In the corporate practices that have bought up many of the once private practices, the charges have come down from on high and are not set by the vet who you consult with, so it’s not their fault and they shouldn’t be blamed personally. I have heard that they are set financial targets to hit from consultations etc instead of being allowed to make purely clinical decisions without this financial pressure. It isn’t how the veterinary profession was set up when I qualified and I don’t see what has developed as positive progression. The profession is fast losing the good will of the public.
Getting back to what you will be asked when you go to see your local vet…
Medical history
Any past illnesses, allergies, surgeries, or injuries etc.
Current medications or supplements being taken.
Any relevant familial information re parents and/or siblings.
Vaccination history
Core and non-core “routine” vaccinations: Primary course and booster dates and possibly manufacturer/brand.
Others eg Rabies: dates and brand
I have covered the clinical side of vaccination in past articles so won’t repeat that here.
Parasite Control
Current parasite prevention methods - flea/tick control, heartworm prevention.
Any recent issues with parasites.
Diet and Nutrition
Hopefully, you’re feeding a proper species-appropriate DIY raw meaty bones diet to carnivores and a proper species-appropriate DIY plant diet to herbivores. Vets who do not properly understand nutrition will no doubt admonish you if your pet’s diet doesn’t fit in with what they’ve been brain-washed to believe in terms of ultra-processed diets. They may try to blame everything wrong with your pet (regardless of how tenuously or justifiably linked) on what they consider to be the “dangerous” diet. If they do this, you can either just ignore them or suggest they better educate themselves! It depends what kind of relationship you wish to have with them! Many unfortunately do themselves no favours by coming out with all sorts of ridiculous statements, and some practices have unjustifiable requirements for admitting inpatients now too.
Details that might be useful if the current symptoms are enteric in nature.
Type of food being fed (brand/DIY, wet/dry, cooked/raw and ingredients if DIY).
Frequency and quantity of meals including treats.
Any recent changes in diet.
Have they eaten chocolate, grapes, onions, macadamia nuts, xylitol or other toxic plants?
Exercise and Environment
Daily activity levels and any change in level or tolerance to activity?
Venue: this might be useful if symptoms suggest a contagious infection or something like Alabama Rot where others might have been seen with the same symptoms. Similarly, if this is a regular or new venue which might explain exposure to something novel and never encountered before.
Have they just come back from abroad, or recently rescued from abroad?
Have they had any more ticks than usual recently?
Any encounters with wildlife or other animals. This might not be direct and you should consider if urban foxes etc frequent your garden.
Reproductive history
Is your pet spayed or neutered? If not entire, was it a gonad-sparing procedure or the full ovariohysterectomy or castration? I have covered the clinical aspects of this in a recent article so won’t go into that here.
If an entire female, have you bred from her, and if so, how many times and how long ago was the last litter? Was this her last mating? If not, when was that? When was she last in season and are her cycles otherwise regular and normal?
If an entire male, has he been used at stud and if so when was he last used and was there a problem? Any abnormal discharge? Any change in behaviour around females? Any increase in aggression or other behaviour change?
Current Symptoms
Your vet will want to know a detailed description of the current symptoms, including when they started, how they've been happening and how they’ve progressed, and what, if anything, you have tried before booking in for a consultation.
t is easy to get flustered and forget what could be an important detail, so my advice would be to sit down before you leave your home and write everything down. Ask other members of the family if they’ve noticed anything unusual over the time you think an illness/lameness has been developing. Did anybody notice anything just prior to the current situation that wasn’t thought to be important at the time but on retrospective analysis might now have an important bearing on the situation? Something you previously didn’t know might come to light that now throws a whole different perspective on things, which might make you more or less concerned.
Things you should consider include
Physical changes: Any visible abnormalities like lumps, bumps, or wounds.
Non-physical changes:
behaviour – aggression/lethargy/anxiety,
appetite – increase/decrease, difficulty +/- pain?
thirst – increase/decrease,
urination – increase/decrease and difficulty/loss of control, bloody, odour.
defecation – increase/decrease and difficulty/loss of control, change in faeces consistency – hard/soft/colour, bloody/mucous/watery/odour.
Exposure to other animals or potential toxins: Was there an “event” on a recent walk (or at home) that on retrospect you think might now be important? This might be a trip, a collision whilst playing, a yelp you heard but didn’t see the cause of, he/she ate something you saw/didn’t see what it was. Was a farmer spraying a nearby field near where you live or where you exercised? Anything else out of the ordinary?
When you’re in the consultation, some vets like to use lots of long technical jargon words. If you don’t understand what exactly it is they’re saying, ask them to explain and use simpler language so you do understand. If you don’t understand, how can you make a fully informed decision in your pet’s best interest?
Following on from these basic questions your vet may well want to know more about the following…
Changes in living environment or routine.
Have you redecorated (toxic chemicals), or otherwise changed the physical home environment? This might even be something like rearranging the furniture which might cause anxiety in an elderly dog with vision problems now encountering an obstacle where there wasn’t one before.
Has the family composition changed? For example, has a partner moved in/out, is there a new baby, has a child left for university, has someone got a new job with different leaving and coming home times etc?
Have you got new equipment such as a Wi-Fi booster or other “smart” technology that your pet is sensitive to and could be causing harm to?
Have you installed aircon or changed the thermostat for winter/summer and so materially changed the ambient home temperature that might be exacerbating a problem that was already occurring but more mildly?
Have you changed brand of cleaner, washing powder, fabric conditioner, air freshener, shake ‘n’ vac or similar? Useful for potential toxicities and allergies.
Any change in house plant that might cause an allergic reaction or toxic if eaten?
Has your pet eaten something they shouldn’t eg human medications, poisonous foods like chocolate, grapes, mouldy food etc?
Previous Veterinary Care
If this is the first time for an older pet at a new Practice , what is the name and contact information of the previous Practice so that the past veterinary medical and treatment history can be obtained, including past tests and lab work.
Financial Considerations
The vet should discuss the diagnostic and treatment options during the first consultation having taken the history and performed a physical examination. He/she should then have a list of potential differential diagnoses which may all require the same treatment approach or may need some tests to decide which one is best. This way you will have an idea what you’re letting yourself in for financially from the start. If you’re not sure that a diagnostic test is really necessary, ask the vet to explain why it is, what the chances are it will reveal useful information, and whether it changes the course of action significantly if that test isn’t carried out.
For example, what is the point of doing a test that you can just as easily guess the outcome?! Don’t be surprised if an elderly individual has slight liver or kidney issues. If they have a broken leg it just needs mending regardless of what a blood test might show, so you can justifiably question what the point of lots of blood tests before is?
It seems that vet students are taught these days not to consider their differential diagnosis list until after they’ve taken bloods etc, but this is the wrong way round in my opinion, and definitely not what I was taught at university. Cases are rarely textbook “classical” presentations and doing diagnostic tests before considering the diagnosis can often confuse the issue and don’t always make things clearer. As my first boss used to say to me “Common things occur commonly!” and whilst it sounds a very obvious truism, it seems to be largely forgotten at times.
Budget constraints for diagnostics and treatment options must be considered. Tests that only give information on unaffordable procedures aren’t helpful. For example, if a dog has a suspected spinal issue and the vet wants to do an MRI with a view to spinal surgery, if the spinal surgery is out of the question whether financially or the risk of success is very low, then what’s the point of doing the MRI which will also be very expensive? In some cases, it is better to try some treatment with less information about what is being treated that at least provides a chance of recovery than use up all the available budget (whether insurance or owner’s) on diagnostics that don’t progress treatment or recovery, but leave nothing left to pay for treatment even if you know it’s treatable. This isn’t uncommon unfortunately and insurance companies should state a maximum % of the overall claim amount that should be used for diagnostics in my opinion. Vets would be very much more careful with the diagnostic budget if there’s a limit as to what is covered by insurance within the overall claim.
Too many times I’ve seen a case where I know I can successfully treat it, but the entirety of the available insurance budget has been used up, and the case is then abandoned before resolution. Unless a philanthropist wishes to sponsor me, I can’t afford to work for nothing. I offer the best I can, but sometimes even this is too much for the owner to afford. If no insurance money was paid out until the case was successfully treated, with the successful vet getting their full invoice paid and the rest of the claim budget divided amongst those who failed to the limit of the claim to cover their costs, then there might be a lot more care taken over what money gets spent on excessive diagnostics and treatment unlikely to be successful.
2nd Opinion
If you’re not entirely convinced with what you’re being told, the cost of what is being suggested and you’re not confident of a good result, don’t be bullied into just going ahead. You have every right to ask for a referral or get a 2nd opinion. Bear in mind that a specialist referral is likely to be very expensive, so cost it out in advance and weigh up the chances of it being money well spent.
I often get consulted where owners are being offered little hope of success, where a more radical intervention than the owner thinks necessary is being recommended, and sometimes with euthanasia being the only other solution available. In many cases I can offer a different, more natural approach, but not in all cases. I always try to give an honest appraisal including what I think are the worst and best outcomes and where I think it’s reasonable within that range to expect. It’s not in anybody’s interest for me to over-promise and under-deliver. I will usually provide treatment options when asked in cases where the chances of success might be slim provided it doesn’t extend any patient suffering.
The aim of course is to minimise vet visits, and if you do the basic animal husbandry correctly, especially diet then you should reduce your vet bills to the bare minimum. The vast majority of vets at the coalface do care for your pets and want to do the best they can. Many of course are restricted by what their employer allows, their belief system as taught by their university course and CPD, which includes having been taught that alternative treatments are unscientific. This is completely untrue so I would urge you to educate yourself and seek out those vets who have done so already and who offer what they’ve learned to the best of their ability.
Hopefully, this article will help you get the most out of your vet interactions and hopefully save you money on consultations, tests and treatments that might be avoidable. Please consider subscribing or buying me a coffee on that basis! TIA.
Many thanks for taking the time to do this.
Thank you again for all you are doing. If I may ask ,what is the best NATURAL prevention for heartworm, please