By Dr. Cockshutt
Like most health-care fields, veterinary medicine has become multi-tiered. Regular veterinarians, like general practitioners in human medicine, are highly skilled at providing excellent basic health care for pets. They also encounter patients with serious or complex medical problems.
It is not feasible for regular veterinarians to have the expertise to manage every disease or injury, and in such cases they rely on veterinary specialists to provide advanced levels of advice or care.
A specialist is a veterinarian who has pursued formal, advanced study in a specific field.
As a result, specialists tend to have a greater knowledge of unusual, uncommon or rare conditions, and a deeper understanding of common ones. More than 20 specialties are currently recognized by the American Veterinary Medical Association, including internal medicine, surgery, critical care, radiology, neurology, cardiology and ophthalmology.
The goal of these specialty colleges is to ensure a standardized level of skill and expertise. Each specialty college has its own rigorous training, examination and certification process.
These highly selective programs are similar to residency training programs in human medicine.
They typically require three or more years of advanced training beyond the veterinary degree. “Board certified” or “Diplomate” denote successful completion of the college requirements. Only those veterinarians that have earned diplomate status in a specialty are entitled to call themselves specialists.
Specialists are held to a higher standard and are expected to provide superior care to the patients referred to them.
They generally offer advanced medical and surgical procedures including orthopedic or cancer surgery, endoscopy and chemotherapy. Additionally, specialists stay up-to-date on the latest research in their disciplines. The specialty colleges have websites that allow pet owners to search for specialists in their area (www.acvim.org, www.acvs.org, www.acvr.org).
In the past, most specialists were employed by veterinary schools within universities, such as the Ontario Veterinary College at the University of Guelph. In the past 20 years, private specialty practices have appeared in most major cities in North America.
Specialty hospitals are typically equipped to provide advanced, state-of-the-art services, including diagnostic imaging such as ultrasound, CT and MRI. They often have facilities such as intensive care units and some incorporate an out-of-hours emergency hospital.
Specialty practices typically work only with referrals (cases sent by veterinarians), and do not provide basic care such as checkups, spay/neuter or vaccinations.
Instead, they work in partnership with regular veterinarians to provide the highest level of patient care.
Should your pet see a specialist? If you have concerns about your pet’s diagnosis or care, you should discuss those concerns with your family veterinarian. You should ask about the possibility of a referral to a specialist when:
- Your pet’s medical condition is chronic, complex, uncommon or remains undiagnosed after standard testing by your family veterinarian;
- Your pet is not responding well to current treatment or the response is less than was expected;
- Your pet requires a sophisticated test or procedure that is not offered by your regular veterinarian;
- Your pet would benefit from 24-hour monitoring or requires the intensive care provided by many specialty hospitals;
- You want a neutral, informed second opinion of your pet’s condition, with information on treatment options and prognosis.
For many patients, early referral can result in a better outcome and reduced cost. It's important to get a referral from your regular veterinarian, as this ensures accurate transfer of crucial medical information and can avoid duplication of tests such as bloodwork or radiographs.
As well, having your veterinarian involved in the referral permits them to provide appropriate follow-up so that your pet receives the best care.
Dr. Cockshutt is a graduate of the University of Victoria. She received her Doctorate in Veterinary Medicine in 1979 from the Western College of Veterinary Medicine in Saskatoon. After graduation, she moved farther east to Guelph for an internship in small animal medicine and surgery at the Ontario Veterinary College, which was followed by a surgical residency. After attaining an MSc in surgery in 1984, Dr. Cockshutt joined the OVC small animal surgery department faculty and became a Diplomate of the American College of Veterinary Surgeons in 1991. As Assistant, and then Associate Professor at OVC, she was involved in management of referral surgery cases, intern and resident training, and undergraduate teaching, as well as participating in clinical research, for more than 15 years. In 2000, Dr. Cockshutt left OVC to join the team of specialists at Toronto Veterinary Emergency Hospital. Visit us at www.tveh.ca or 416-247-VETS (8387, twitter.com/#!/TorontoVetEmerge.