Should You Get Those Tests?

When I was in general practice, clients asked all the time whether they really needed to order the diagnostic testing that I just recommended. The answer is…it depends. In veterinary school, we’re pretty much trained to do ALL THE TESTS, and it takes time and experience for us to learn which ones are really important, and when. When the situation is life-or-death, you would be well advised to listen to your vet’s advice. Other times, the answer might depend on your resources and priorities for your pet’s well-being and comfort, especially near the end of life.

The Question

It all boils down to this: What are you going to do with the information that is gained? Possible answers:

  • It might tell you what treatments, if any, will be effective, or if the current treatment is working.
  • It might give you an idea of prognosis, or in other words, what is the likely course of this problem?
  • It might simply give you peace of mind to know the answers.

All of the above are valid reasons to say yes to testing. These potential gains must be weighed against other factors:

  • Will paying for the diagnostics cause financial strain for the family?
  • If the answers lead to treatment recommendations, will that be affordable or otherwise realistic for you to pursue?
  • Is the testing process going to be stressful for your pet? This depends on the particular procedure and your pet’s temperament.

A Scenario

Take Millie, who is an eight year old Great Dane who is brought to her regular vet for limping. The veterinarian asks some questions, examines Millie carefully, and tells Millie’s caregivers that she is very worried, based on Millie’s age, breed, and clinical signs, that she might have a very serious bone tumor called an osteosarcoma. She recommends X-Rays, and if they suggest it is an osteosarcoma, to follow up with a bone biopsy.

Millie’s caregivers, Mr. and Mrs. Smith, ask for a few minutes to talk it over. The doctor says to take all the time they need, and she will poke her head in in about 10 minutes to see how they are doing. They already know that they cannot afford an amputation and chemotherapy, the usual recommended treatments for osteosarcoma. Mr. Smith says it’s pointless to do X-Rays if they can’t treat it anyway. He thinks they should just take Millie home and enjoy her for as long as they can.

Mrs. Smith counters that the uncertainty of Millie’s future is causing her anxiety. She wants to know what is wrong so that if it is bad news, she can prepare herself for what is to come. Their vet had also explained how painful bone tumors are, and Mrs. Smith wants to treat Millie’s pain aggressively to ensure she is as comfortable as possible for her remaining time with them.

When the doctor returns, the Smiths say they would like to do the X-Rays, but there is still one problem. Millie is terrified when she is left alone at the clinic. The vet assures the Smiths that they can work out a plan to get the X-Rays without Millie spending time in the kennels, and they can give her anti-anxiety and pain medications for a low-stress and painless experience. As worried as they are, the Smiths feel good about this plan, and that the information they receive will be helpful for both peace of mind and in making future decisions about Millie’s care. Since a biopsy is more expensive and invasive, and will require Millie to be hospitalized for at least a day, they want to discuss that further after the X-Ray results are in.

A different family and dog – say a single professional who has saved up some money and has pet insurance to help defray the cost, and her mellow Labrador Retriever who would be more than happy to hang out at the clinic all day – may make very different decisions when faced with the exact same clinical scenario.

This practical approach may not give you all the answers, but it will help you organize your thoughts and ask your veterinarian the right questions, so that you can make a decision that works for both you and your animal companion. Above all: whatever you decide, if you do your best with what you have, and you do it out of love, then rest assured that you are doing the right thing.

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