High-tech link helps Scruffy

If your pet is stricken with a rare condition or complex disease, your veterinarian is no longer limited to help from a colleague around the corner.

In today’s high-tech, high-touch world of veterinary medicine, a solo practitioner in an isolated small town can access a world expert just by picking up the phone or logging onto the computer and utilizing telemedicine.

Scruffy the “schnoodle” (a schnauzer-poodle cross) was in dire straits. He had been the picture of health for 10 years with nary a scratch or sniffle and had never missed a meal.

But everything changed suddenly after his 10th birthday. Almost overnight, Scruffy became very lethargic and refused to eat.

Scruffy’s owners assumed it might be the warmer weather, but when Scruffy started to vomit and his urine became bright orange, his owners knew something was really wrong and took the little dog to see the family veterinarian, whom we’ll call Dr. Jane Allen.

During her complete physical examination, Allen noticed Scruffy had a yellow tint to the whites of the eyes and skin and was experiencing pain in the abdomen. His liver was enlarged, and he was running a slight fever and appeared dehydrated.

According to the previous year’s health records, Scruffy had dropped 2 pounds, which was significant for a 20-pound dog.

Allen was concerned about acute liver disease and suggested blood tests, urinalysis and X-rays be done ASAP. Blood tests would assess if anemia or infection were present and if other body systems were involved. The urinalysis would evaluate kidney function and possible bladder infection. X-rays would evaluate the abdominal organs.

Allen also recommended that Scruffy receive IV fluids for dehydration, anti-emetics to relieve vomiting, and antibiotics to ward off a possible infection.

Scruffy improved somewhat and was sent home. However, the diagnostic tests were inconclusive. Scruffy’s veterinarian wanted to consult with a specialist in internal medicine to assist with the diagnosis. The nearest specialty practice was 300 miles away.

Allen was able to consult with an internal medicine specialist without leaving her practice by using the new leading edge in veterinary practice – telemedicine.

“Telemedicine assists in the diagnosis based on information received via fax, Internet, and/or phone services,” explains Johnny Hoskins, DVM, and diplomat of the American College of Veterinary Internal Medicine who owns his own business as an internal medicine consultant.

“I receive the pet’s name, medical history and laboratory work via fax and the radiographs and/or ultrasound images via the Internet. I review all of this information and prepare a full report suggesting a diagnosis, additional tests if needed, and provide treatment suggestions for the family veterinarian.”

What makes Hoskins’ practice unique is that it’s mobile and travels nearly 10,000 miles a year in a high-tech vehicle. Hoskins can provide services to any family veterinarian with access to the Internet.

In 2005 he traveled to 14 states, spending two to four weeks in each location. His futuristic recreational vehicle is equipped with a satellite dish that makes it possible for him to receive downloads and faxes from veterinarians across the United States, Canada and even Puerto Rico.

“Through my mobile practice, I’m able to enjoy the freedom to work in any state I want and see much more country than I could in a brick and mortar office,” Hoskins said. If advanced hands-on diagnostic tests such as endoscopy or specialized treatments such as orthopedic surgery are required, then there may be a need for travel to the specialist. However in many cases, with telemedicine, family veterinarians can now benefit from the advanced training and expertise of a specialist without having to send the owner and pet elsewhere.

For their part, most specialists are keen on telemedicine since it allows them to do more of what they love to do, while helping more people and pets. For some experts, such as cardiologists who specialize in reading transmitted ECGs, and radiologists, who remotely review X-rays, ultrasound, CT or MRI images, telemedicine allows them to bring state-of-the-art care to the patients of veterinarians in isolated practices.

Hoskins received the transmitted results of Scruffy’s blood tests, urinalysis, X-ray images, and a copy of Scruffy’s medical record. After his review, he became concerned and suggested additional blood testing for leptospirosis, a potentially fatal infectious cause of acute liver and kidney disease.

Hoskins also recommended hospitalizing Scruffy and starting treatment for possible leptospirosis and kidney failure. Three days later, when the tests confirmed leptospirosis, Scruffy was already feeling a bit better.

He was drinking and eating a little on his own without any vomiting. His owner was delighted to see her perky little dog holding his favorite ball in a mouth with gums that had turned from yellow back to a healthy pink.

Scruffy went home 10 days after his first visit to the veterinarian.

Because of the cooperation between Scruffy’s primary veterinarian and the advice Hoskins provided through telemedicine, Scruffy survived a potentially fatal disease.