Waiting is the Hardest Part – on the Pet

The cost and effort involved in fixing a chronically ill pet is many times what it could have been had the condition been caught early on.

April 13, 2012 (published)
Photo by Karen James

It is human nature to avoid or postpone unpleasant things – trips to the dentist, wearing pants, paying taxes, or even taking a pet in for a checkup when there appears to be a need. But when does this natural inclination to postpone certain things evolve into a pathological delay that could have disastrous consequences? I don’t have the answers, but we see the sad result every day when a pet’s illness that, if caught early, could have been cured (or at least its impact lessened) devolves into a life-threatening condition. The cost and effort involved in fixing a chronically ill pet is many times what it could have been had the condition been caught early on. Imagine the suffering the world could have been saved if the guy who first presented the script for Gleaming the Cube or Battlefield Earth had been given a simple “No” instead of “Greenlight! Let’s go with it."

A good example of this phenomenon is the diabetic pet whose owner notes the initial signs of excessive thirst and urination, coupled with weight loss, but for some reason does nothing about it. I have had many owners who bring their pets in to me with advanced stages of diabetes mention that they had noted the signs and symptoms, but had inexplicably not sought out help. I see this as an opportunity missed. Many claim that they thought these signs are just part of the aging process, and I am sure many more are just leading busy lives like the rest of us, and the health of their pet got shuffled to the bottom of the deck. I don’t usually attribute it to malice, just simple human nature. The results can be tragic.

Diabetes is a complex disease usually involving a lack of insulin production when the body’s immune system destroys the pancreas. This is known as type I diabetes. (In some cases, it can be due to resistance to the normal effects of insulin on the tissues, allowing sugar into cells to serve as a source of energy, but this form of diabetes – type II - is more common in humans than in companion animals.)

If caught early and the patient is feeling relatively well, the treatment for uncomplicated type I diabetes is straightforward and involves diet change and starting insulin injections.  Life is usually good for about 75% of these diabetics and they are almost indistinguishable from non-diabetic pets. For those in whom the early signs are missed and the effects of high blood sugar (and, essentially, starvation as the body cannot use sugar for energy) persist, the results are disastrous. These patients are amongst the most desperately ill I have ever treated, and require a complex medical plan and expensive intensive care to restore their health. The level of care, not to mention the cost involved, can be astronomical. While a new diabetic can be started on a regimen with about $50 a month worth of medication and testing, a severely ill diabetic (in a state known as diabetic ketoacidosis, or DKA) can be in the hospital for many days, accruing a bill in the thousands. Many do not survive, for medical or financial reasons.

For some, when faced with the realization that they held the key to preventing a health crisis, their outlet becomes anger directed at the person delivering the bad news – the veterinarian. For a disease that has really dug in its heels and had time to blossom, the treatments and tests needed go way beyond what is required in the early stages.  The bills escalate and the prognosis grows dimmer. All of these factors can end up pushing pet owners over the edge and redirecting their ire at the one person that can help in this situation. I have borne the brunt of it many times, when I have had to deliver the bad news about a patient’s chronic malady; it isn’t fun. It is no fun for the patient or the client, either.

Another coping mechanism that we sometimes see is selective forgetfulness – the early signs may have been noticed, but the report given to the veterinarian is that the patient “just got sick yesterday.” While in many instances this is actually the case, we know that some people play this card to avoid the guilt that comes from waiting too long. One factor that can complicate this particular situation is the natural tendency that companion animals.

In the current economic climate, big medical bills are impossible for many people, and many more animals are getting euthanized for financial reasons than in years past. In the ER, I have noticed a definite trend towards the so-called ‘stop-treatment point’ (the point at which a client will not be able to bear further financial burden and has to elect to euthanize a pet) getting earlier and earlier in the process. If we catch a disease early on, we have a better chance of not burdening clients with huge medical bills and of saving more lives.

There is no disease that benefits from becoming chronic! If we can step in and intervene before a condition can grow roots and take hold, we have a better chance of returning our patients to a life of health and activity.  Your veterinarian has the tools and knowledge to help you and your pet early in the course of a condition – it is up to you to take advantage of the opportunity and act quickly.


August 29, 2012

Excellent post. I'd go a step further and add that this advice applies to humans as well as our pets.

June10, 2012

Tony, I love your articles. Keep writing. As an owner of a copy of Battlefield Earth, simply for the shear badness, I appreciate the reference.

May 1, 2012

Dr. Tony, You are always so helpful. I must say, I am sometimes guilty of waiting until the last minute to take my dogs to the vet. We are what one might call... lazy. The point about "selective forgetfulness" is so true. I think a lot of people do that. Great post, Dr. T! You are a great writer and very convincing! Now, I must go... I have to call my vet and schedule an annual appointment for my dogs. :)

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