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Finding an IVDD vet

January 2016

Finding a good vet can be tricky. Many vets are wonderful with the routine visits but when it comes to a health problem not commonly seen, they may not have the experience to treat IVDD.

Talk to your friends, co-workers, neighbors, etc and ask them about their vet. Particularly ask if they've ever had to use the vet in an emergency situation or when their dog was ill rather than just for well visits or routine exams. When you hear of one that sounds good call the office and ask them a few questions. You might even set up an appointment for a consultation visit, this isn't all that uncommon these days.

Having a vet familiar with IVDD is important as it is a disease your dog will have for the rest of its life. If a vet is open to learning, consulting with colleagues plus an owner willing to delve into learning about IVDD and discussing the information with to their vet then that works out great. But your vet isn't open to such a situation and isn't treating IVDD properly then it's time to look for a new vet.

Should your dog need surgery look for a board certified specialist to perform this most delicate of surgeries. Look for these letters to indicate the vet is a board certified surgeon:  Neuro (ACVIM) or Ortho (ACVS)

Board-certified surgical specialists can be found at University vet teaching hospitals. You can locate these Veterinary surgeons (ACVS) and neuro surgeons (ACVIM) here: http://find.vetspecialists.com

Search Dodgerslist Members' reported surgical costs and vet recommendations directory.

"Five Red Flag Indicators That It’s Time to Find a New Vet" http://dodgerslist.boards.net/thread/778/red-flag-indicators-time-find

General information on getting your pet's records for the new vet:  http://www.aspca.org/pet-care/dog-care/getting-vet-records   The American Veterinary Medical Association has a summary of state laws that govern the release of patient veterinary records: https://www.avma.org/Advocacy/StateAndLocal/Pages/sr-confidentiality-patient-records.aspx

What is Board Certified?

When looking for a vet or surgeon, patients generally see many alphabet credentials and certifications in a title. Many times these credentials are confusing, and there is little opportunity to weigh the relative value of seemingly similar credentials.

With a four year general practice veterinary DVM degree and a license, a vet may practice any kind of medicine or surgery with or without additional special training.

The American Veterinary Medical Association mandates the use of  “specialist” be reserved only for veterinarians who have completed advanced study to become a “diplomate” , board certified.  Diplomates have completed an additional coursework, approved residency and passed the board’s exam and may rightly then use ACVIM or ACVS in their title.

ACVIM (Neurology) indicates having completed board certification from the American College of Veterinary Internal Medicine. These veterinary surgeons are specialists in neurological diseases such as IVDD.

ACVS indicates having completed board certification from the American College of Veterinary Surgeons. These vets are specialists in orthopedics  (injuries and diseases of the bones, joints, ligaments, tendons, muscles, and nerves)

While many vets who are family practice DVMs (not board certified) might offer neurological surgery, board certification is a good standard by which to measure competence and training.

You can be confident that vets who are board certified (ACVIM or ACVS) have at a minimum the proper training in their specialty and have demonstrated their proficiency through supervision and testing. While there are many non-board certified vets who are highly competent, it is more difficult for a dog owner to assess the level of their training. Naturally, board certification alone does not guarantee competence, but it is a standard that reflects successful completion of an appropriate training program.

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Questions for the general family practice DVM vet
  • How often do you see dogs with IVDD?
  • How do you treat a mild IVDD episode with pain only?  When there are neuro functions loss?
  • What period of crate rest do you recommend? Is that actually in a crate or just keeping the dog quiet?
  • What medications do you use for IVDD and if you use both steroids and NSAID anti-inflammatories how do you choose which to use?
  • How do you feel about pain management?
  • What surgeon would you send me to if my dog needed IVDD surgery?
  • Who are the IVDD friendly ER vets?
  • What is your opinion of alternative and non-traditional treatments for IVDD: supplements & acupuncture, laser light therapy? NOTE: Chiropractic manipulation (VOM) is a red flag for IVDD dogs.
  • Do you have a list of alternative providers that you regularly work with?

Questions to ask your ER DVM vet:

  • What tests or examinations will you perform to determine what my dog has? (neurological exam, x-rays to rule out other things that mimic IVDD, bloodwork for organ health?)
  • If my dog has a disc herniation, does he have deep pain recognition, bladder and bowel control?
  • What treatment options do you offer?
  • Are you staffed to keep him overnight? Technician or lay staff?
  • If you are going to administer drugs, which are they and what are their side effects? Pain meds?
  • Does your facility have a board-certified surgeon or a specialized neurological or orthopedic surgeon? If not, will you refer us to one if surgery is needed?
  • Surgery is not an option for us, will my dog continue treatment with you or will you refer me to another vet? If so, what are the recommendations of that vet? Can you transfer us to my regular daytime vet?
  • What is your final diagnosis and prognosis?
  • Have you ruled out any other diseases? How and what tests were done?
  • Will you write down all the drugs, tests and results of my dog for me to have, and to take to another vet if needed? Can I have a copy of my records and my x-rays to take to my regular vet or the referral surgeon?
  • Referral to a board-certified neurological or orthopedic surgeon
Questions to ask the board certified neuro or ortho SURGEON:
  • Do you use MRI, Myelogram or CT Scan to determine the site of the herniation? What are the risks of each one or the one you use?
  • What are the risks of surgery, length of time on the table?
  • What is your IVDD experience, IVDD case load/month?
  • What techniques do you use? Anesthesia: premeds, IV or gas induction agent, monitors, post operative pain medication; ICU hours? Technicians or lay staff? – ask for explanation in layman’s terms if you don’t understand.
  • Tell me about your specialized surgical equipment (i.e. diamond bit high speed drill to reduce blood, bone rongeur, endoscope to reduce cutting, operating microscope)
  • Do you fenistrate? (operate on adjacent discs to prevent a future herniation). If not, what are you reasons?
  • What symptoms must the dog show for you to perform surgery vs. continuing with conservative treatment? (do they wait until the dog is paralyzed, just in pain, just wobbly, etc).
  • What drugs are usually recommended after surgery? Will you provide an pain med Rx in case at home pain occurs?
  • What post-op protocol do you usually recommend regarding physical therapy and crate rest ?
  • What prognosis of recovery do you give with surgery? I know there are no guarantees, but with my dog’s particular neurological signs, what is the usual prognosis?
  • Is there a technician to show me how to express the bladder and perform exercises?
  • Will you provide me with a list of symptoms that might indicate that something is wrong with my dog’s healing process once he is at home?
  • What is my procedure if something goes wrong during healing at home? (who to call, where to go, what to do).


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Disclaimer:
This information is presented for educational purposes and as a resource for the Dachshund community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.


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