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When Should I Call the Vet?
Roberta Dwyer, DVM, MS
I'm a member of an online horse discussion group. Sometimes we ask each other about training or ailments our horses have, and we trade ideas, tips, and advice. Some health conditions sound very serious. How do I know when a problem is serious enough to call the vet?
I also have read some of the postings to these discussion groups, and have read lay people diagnosing rabies and many other diseases after a brief and (usually) incomplete description of the problem. Even veterinarians have to examine an animal--or be very familiar with its medical history--to diagnose or prescribe medications to a client's horse. We are bound by the "veterinarian-client-patient relationship" for the diagnosis and treatment of animals.
There is no way to make an entire list of situations of "when to call the veterinarian" in this short space. However, here are some general guidelines.
The presence of uncontrollable bleeding, foreign objects protruding from the body (do not remove them!), lacerations, injury to the eye or eyelids, abdominal pain or diarrhea, aggressive or unusual behavior, neurologic signs, severe or chronic lameness, mares which are actively in labor for more than 20 minutes without progress, and difficulty in breathing are only some of the obvious times to call your veterinarian. Perhaps the best rule is, when in doubt, call!
All horse owners should know how to take their horse's temperature, pulse, respiration, capillary refill time, and dehydration status. When these basic health parameters are abnormal for an unknown reason, a call to the veterinarian is warranted. When you have observed your animals over a period of time, you should know immediately when something is out of the ordinary, besides obvious clinical signs such as lameness or nasal discharge.
Multiple animals getting sick at once should raise a red flag. Symptoms in several animals could indicate such dangers as infectious diseases or a toxin in the horses' pasture, water, or feed.
A good rule of thumb is, if a child were exhibiting the same symptoms as your horse, would you call the pediatrician? If your child had profuse diarrhea, chances are you're not going let him/her go untreated for a week without seeking a medical opinion. Proper treatment and diagnosis of a sick horse requires a veterinary/patient interaction. This generally is not the case over the Internet. For a lay person to suggest a diagnosis or treatment for a horse is not sound advice.
Part of our training to become veterinary practitioners is to check multiple organ systems, as there are many diseases with complicated symptoms. Someone who has a horse with abnormal behavior might not notice or report over the Internet that the horse has a yellowish color to its gums. To a veterinarian finding this in a physical examination, this would likely lead to blood work to evaluate the condition of the liver. Liver disease can cause the build-up of substances in the bloodstream causing neurologic symptoms. A lay person might suggest treatment for EPM, keying in only on the neurologic nature of the described case.
The Internet is a wonderful tool, but readers must remain critical in their reading, and not believe everything in print. Consider the source. Information made available through the Centers for Disease Control and Prevention (www.cdc.gov), the American Association of Equine Practitioners (www.aaep.com), and many other sites are closely scrutinized for accuracy. If your veterinarian diagnoses Cushing's disease in your horse, and you want to read more information on the disease, do a search at www.thehorse.com, or, for more scientific information, www.medline.com, which searches for scientific papers. Remember, though, that this is general information on the disease, and not advice on how to treat your horse being fed your feed, drinking your creek water, etc. Those decisions need to be discussed with a veterinarian who knows your horse's situation.
On the other hand, you might have Neil from Wyoming providing you advice based on the treatment of his horse for Cushing's disease via the Internet chat room. Neil might not mention that his horse is 20 years older than yours, also has kidney failure, and is on multiple medications for chronic laminitis. Are you really prepared to change your horse's treatment on Neil's say-so?
I'm not saying that chat rooms and advice columns are bad, just that readers should have a qualified veterinarian diagnose and treat their animals. Additional information gleaned from other sources should be closely scrutinized. If you still are not comfortable with your veterinarian's opinion, get a second veterinarian to examine your horse, or ask your veterinarian to consult a university veterinary teaching hospital.
Internet advice for basic training issues is fine. For example, someone might write "How do I ask my horse to pick up a left lead?" In sharp contrast, the person who writes, "My horse has been laying down in the pasture for the past six hours. What do I do now?" should not be on the computer, but on the telephone to his or her veterinarian.
When a diagnosis has been made by a veterinarian, then it is good to get on the Internet and research the disease and treatments. Web research can help owners make intelligent decisions regarding their animals. However, taking medical advice from a total stranger, as in a discussion group, is not advisable.
The saying often fits, "You get what you pay for."
Roberta Dwyer, DVM, MS, is Board Certified by the American College of Veterinary Preventive Medicine. She is an associate professor at the Maxwell H. Gluck Equine Research Center, University of Kentucky, where she is involved in equine preventive medicine, teaching, research, and pre-veterinary advising.
Reprinted with permission from the American Association of Equine Practitioners