Maybe one of the following scenarios sounds familiar: Your horse had a mild but persistent lameness, but you wondered about the diagnostics your veterinarian used. Or perhaps an acute injury has laid your horse up, and you’re wondering if there are different treatment options than the ones offered for your horse’s diagnosis.If treatment is expensive or long-term prognosis is poor, you may want to seek a second vet’s opinion. Photo by Shelley Paulson
In either instance, and in many others like them, seeking a second veterinary opinion can be a wise choice. Let’s explore what it means for you, your horse, and the relationship with your veterinarian.
A second opinion is when a second, independent veterinarian examines your horse after your primary vet has done so. This can be done at any point during a case work-up, from your horse’s initial diagnosis to chronic treatment plan, and is generally requested by the client.
A second opinion is slightly different than a referral, which is the term used when a general practitioner sends a case to a specialist clinic for further diagnostics, surgery, or management. Referrals are almost always requested by the primary veterinarian.
Horse owners seek second opinions for a wide range of reasons, but the most common include situations such as:
◆ When the prognosis for your horse is poor; ◆ When treatment is expensive and/or possibly long-term and prognosis is uncertain; ◆ When management is complicated/difficult; ◆ When end-of-life decisions are being considered; ◆ When you’re frustrated by a lengthy recovery time or a non-responsive recovery; ◆ When you’re confused or unsure of what’s going on with your horse or feel like you’re not being listened to.
For some, seeking a second opinion may feel uncomfortable, like sneaking around behind your vet’s back, especially if you’ve had a long, solid relationship with a specific individual. Keep in mind that vets, as medical professionals, acknowledge that second opinions are warranted and are part of the practice of veterinary medicine.Seeking a second opinion may feel uncomfortable, but keep in mind that medical professionals acknowledge that second opinions are part of the practice of veterinary medicine. Photo by Monkey Business Images/Shutterstock
In fact, a second opinion could technically be considered part of a thorough work-up. We actually do it ourselves sometimes, calling colleagues or specialists when we feel the need for another point of view or a pair of fresh eyes. It’s also helpful in cases where we seek a more creative or innovative option, especially with complicated or chronic cases or when more traditional treatment regimens aren’t working.
If you’re experiencing anxiety over obtaining a second opinion, go through the exercise of asking yourself why you’re doing this in the first place. Identifying why you’re dissatisfied with your current vet’s plan can be a very valuable piece of information.
These can be hard questions to ask yourself, but be honest and try not to judge yourself on your responses. These answers may help you set expectations for the second opinion and help you clearly communicate what you’re looking for. Don’t let your angst or avoidance of a potentially awkward conversation prevent you from seeking the best care for your horse.
As with most things in life, clear communication is the best approach when seeking a second opinion. You don’t have to justify yourself to your current vet, but letting her know your plan is the polite, direct, professional, and potentially mutually beneficial thing to do. If the second opinion unveils a novel treatment or other consideration, your current vet may be glad to know about it for the future.
If you use a multi-vet practice, a second opinion can be as simple as asking to see another vet. However, depending on where you live, sometimes finding another vet that serves your area can be a challenge.If your vet has multiple practitioners in their practice, a second opinion may be as simple as having one of the other vets out. Photo by Dusty Perin
Trailering to a vet school or larger clinic may not be an option for those with limited resources or who live in remote areas. Talking with other horse owners in the area may help you find another vet. Depending on the situation, you could also consider asking your current vet for a recommendation.
Once you’ve established contact with the vet who will give the second opinion, make sure she knows that’s what is happening. If it’s a complex or acute case and there are medical records, make sure the second vet has access to them, preferably before the visit. A complete history of the case is critical to obtaining a useful second opinion.
Some clinics have procedures regarding second opinions and may require that medical records be sent a specified number of days prior to the farm call. For this reason, when scheduling the second opinion, make sure the clinic knows about it ahead of time.
One of two options usually occurs after a second opinion: Either the second vet agrees and therefore confirms the first vet’s diagnosis and plan for your horse, or she offers other suggestions.
Of course, there are numerous shades of gray in between, and now it’s up to you to decide what to do. Here’s where those questions you asked yourself before come in handy: What were you looking for? Were the questions or concerns you had addressed? How do you feel about the situation now?
One scenario to beware of, however, is the one of endless opinions. If you find yourself jumping from vet to vet to vet trying to get an answer that you’re satisfied with, tap the brakes. Some further self-questioning and possible soul-searching is needed at this point.
Is your horse simply no longer ridable and you’re having trouble accepting that? Can you not afford the care offered? Is the care needed beyond your ability or comfort level? Again, try not to judge yourself. Sometimes roping in an independent third party, even a non-horse person, can help sort things out or identify a red flag where you’re unable to.
Do you and your horse a favor; if you decide to seek a true second medical opinion, don’t settle for a shortcut. The main one to avoid is the internet. Social media is full of opinions, that’s for sure, but even well-intentioned individuals online haven’t physically examined your horse. This is a key component of a vet/client/patient relationship.
For this reason, also beware of online ads that read something like this: “Ask a vet online NOW! Free second opinions!”
Although some telemedicine by licensed veterinarians is legal and of high quality, its use depends on the situation and the state. Ultimately, you’ll end up saving time and maybe even money just going straight to a second veterinarian in your area.
In most instances, a vet and horse owner can amicably navigate a second opinion to yield a satisfying result that ultimately benefits the horse. And really, in most people’s opinion, acting in the horse’s best interest should always be the goal.
This article about second opinions for a horse’s diagnosis appeared in the August 2022 issue of Horse Illustrated magazine. Click here to subscribe!
Anna O'Brien, DVM, is a large-animal ambulatory veterinarian in central Maryland. Her practice tackles anything equine in nature, from Miniature Horses to zebras at the local zoo, with a few cows, goats, sheep, pigs, llamas, and alpacas thrown in for good measure.
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