We have all heard the saying, “What’s good for the goose is good for the gander.” It is a proverb that basically means that one person’s situation should be treated similarly to another person’s situation. We have all tried to use that to our advantage-especially with our parents. “Mom, Joe can stay out past midnight so I should be able to stay out too.” That type of thinking gets ingrained in our habits and in our actions. Unfortunately, it has gotten ingrained in medicine too and we all know that isn’t right. What works for you may not work for your uncle Larry.
Transformative veterinary medicine is a different approach to medicine. Instead of a one-way dialog from the doctor to the patient (or pet owner), it is a unique approach that focuses on the needs of the patient and the family first. What is right for one is not necessarily right for another. This approach becomes invaluable in cases of chronic or even terminal disease states.
Let’s look at an example. I will call it “Transformative Veterinary Medicine and the Case of the Allergic Dog”. Allergies are an example of a disease that generally cannot be cured but rather managed. With traditional medicine, the veterinarian would look at the patient, prescribe medicine for the patient, and move on to the next patient. With transformative medicine, the doctor approaches the case with the desires of the patient first.
For example, Mr. and Mrs. Smith bring in Fluffy for allergies. Fluffy is very itchy and has broken open the skin causing a mild infection. Mr. and Mrs. Smith have a holistic lifestyle. They do not want Fluffy to have any pills unless absolutely necessary. They are willing to do whatever it takes to make Fluffy comfortable. In this case, the veterinarian may prescribe frequent medicated baths along with some topical medications that will provide antimicrobial therapy for the mild infection. The veterinarian may talk about allergy testing and environmental control. All these therapies take a lot of time and effort but will likely result in Fluffy being comfortable and avoiding oral medications.
Next, we have Mrs. Jones and her dog Henry. Henry has allergy problems similar to Fluffy. Mrs. Jones works full time and has 3 kids. She can barely get the kids bathed much less Fluffy. Time is at a premium in her house. Henry’s itching is driving her to distraction and she wants the problem fixed and controlled for the allergy season. In this case, an intensive topical regime is not going to work. The veterinarian may then prescribe an antibiotic for the infection and give Mrs. Jones some options for allergy medications that can be given safely long term to both keep Henry comfortable and to prevent Henry from relapsing during the allergy season.
Finally, we have Mr. Brown and his dog Alice. Alice has cancer and is being treated with many powerful medications. Mr. Brown wants Alice to be comfortable and happy with whatever time she has left. He is concerned about the infection because her immune system is compromised but he’s also concerned about additional medications and side effects. In this case, a transformative approach recognizes the goal of quality of life along with the goal of not causing further immunosuppression with the therapy.
In our three examples, the allergies are controlled but the approach is dictated by what is important to the patient and their family as well as the different life circumstances of each patient. Together the doctor and the patient (or pet owner) engage in mutual investigation and critical reflection to determine the best course of action. They rely not only on their medical interpretation of disease but on their learned and life experiences. This collaborative process requires excellent communication from all parties involved as well as mutual trust and respect in order to be successful.
It is the mission of Whiskers and Paws Animal Hospital to practice transformative veterinary medicine from the routine to the complex with the utmost compassion while supporting the needs of both the patient and their family.
Written by Carrie Lynn Ellis, DVM