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Questions to ask vet if dog has sm symptoms

anniemac

anniemac

Well-known member
Karlin has the great symptom sheet to hand vets but I wanted to ask things b/c I learned the hard way & someone could learn.

My vet said he was very familiar with SM & saw it in another state but not here. I would add there is someone on the forum that sees same vet but I have reason to say this. He said sm could be related to location & that is why, anyway obviously no expert.

So asking if they are familiar is not enough, would you suggest asking how many they see?

Not getting into specifics one thing I want to know is allergy testing.

Is there a test they can do? I think he might have said something but he suggested start on food, then another, and so on. Which he said is a long process and if a cavalier has cm/sm psom etc. Time and "wait and see" is not something I like. Time is of essense.

PSOM- would you suggest to ask if they know about this and can they see from examining ears? What to ask?

Vet told me he did not feel ella needed to go to neurologist for MRI, wait and see, which I finally had to cry to partner to send me referral. Seeing neurologisit does not mean automatically having ,MRI.

Talked to ellas neurologist about this and he told me he would need referral but that he would examine and give opinion in regards to next step (MRI). So this is huge and I tell people that but even my vet said it that it was for MRI.

Any suggestions someone going to vet Saturday on things to ask along with bringing document?

I agree its important to rule out other things like allergies, ear mites etc.

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anniemac said:
... My vet said he was very familiar with SM & saw it in another state but not here. I would add there is someone on the forum that sees same vet but I have reason to say this. He said sm could be related to location & that is why, anyway obviously no expert.
Click to expand...

Scary thought. He says he is "very familiar" with SM" but suspects it is related to location. Has he brought up fluoride in the drinking water, yet?

anniemac said:
So asking if they are familiar is not enough, would you suggest asking how many they see?
Click to expand...

That is a good question to ask, but I would not eliminate vets from your list just because they have not examined many SM patients. After all, there are not that many cavaliers around, compared to other breeds. What I would want is a vet willing to learn, even from a cavalier owner, about the disorders either unique or unusually common to our breed.

If the vet acts like he is not interested in what you may have to tell him about SM or MVD or PSOM or episodic falling syndrome, then I would be concerned. If he tells you that he is very familiar with SM and then suggests it may be a geographical location disorder, that would turn me off.

anniemac said:
Not getting into specifics one thing I want to know is allergy testing.

Is there a test they can do? I think he might have said something but he suggested start on food, then another, and so on. Which he said is a long process and if a cavalier has cm/sm psom etc. Time and "wait and see" is not something I like. Time is of essense.
Click to expand...

Yes, there are tests. There are blood tests and there are "intradermal skin tests". The blood tests often are quite expensive and reportedly not always very reliable, due mainly to "false positives". But, they can be helpful. The under-the-skin tests are tedious but reliable. I would have a dermatologist conduct the skin tests.

anniemac said:
PSOM- would you suggest to ask if they know about this and can they see from examining ears? What to ask?
Click to expand...

I would ask. I ask every vet I ever talk to about PSOM. Few seem to know about it, but they are familiar with examining ears and otitis media in general -- just not the progressively enlarging plug variety. PSOM does not necessarily show up from a standard ear exam, using an otoscope, unless the mucus plug is so large as to cause the tympanic membrane to bulge.
 
anniemac said:
Vet told me he did not feel ella needed to go to neurologist for MRI, wait and see, which I finally had to cry to partner to send me referral.
Click to expand...

We had the same problem. Vet acted like we were crazy and didn't think anything was wrong. Pretty much refused the referral. Had to beg and plead to a different vet in the same office to get it. I don't understand why vets are so against giving a referral for a patient to see a neurologist. Is it because it takes the money away from there practice?
 
Reptigirl said:
We had the same problem. Vet acted like we were crazy and didn't think anything was wrong. Pretty much refused the referral. Had to beg and plead to a different vet in the same office to get it. I don't understand why vets are so against giving a referral for a patient to see a neurologist. Is it because it takes the money away from there practice?
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I hate that :( I asked ellas neurologist about vet and he said he has referred several so said if someone doesn't like it to do what you did and see another vet. I don't understand because you pay the neurologist for the visit and HE should determine if an mri is needed. So I don't want pet owners who generally need to see a specialist not go b/c they assume they have to get mri.



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Reptigirl said:
... I don't understand why vets are so against giving a referral for a patient to see a neurologist. Is it because it takes the money away from there practice?
Click to expand...

My guess is a combination of unjustified pride in their own education, experience, and judgment, combined with a sense of contempt for whatever knowledge a cavalier owner may have.

I don't understand why so many specialty practices insist upon referrals before setting appointments. By the time cavalier breeders contact a neurologist or cardiologist, they have exhausted their other options.

When calling a specialist, if your general practice vet will not make the referral, tell the specialist's receptionist that your dog is a cavalier with either symptoms of SM or of MVD, and that you need to see a specialist as soon as possible. Emphasize that the dog is a cavalier and that your vet is ignorant about the disorder, and that the receptionist should go to the vet and ask him to make an exception to the referral policy. Cardiologists and neurologists know about these disorders, and if the information gets to them, they probably would make an exception and allow the appointment to be made.
 
I think GP vets refusing referrals is a, sadly, common problem. The specialist vet should be recommend vets who have referred to them previously, does anyone have experience trying this method?

There must be a simple solution to this absurd problem.
 
It does seem absurd. This is not like with humans where it is an insurance issue that a referral froma PCP is needed.
I do understand that they don't want everybody bringing their pets to a specialist for just run of the mill ailments. However, half the people I tell that I take Jack to a board certified vet neurolgist, say they never knew such existed (and many of these people are human health professionals). So my point being that most people who want to take their pet to a specialist are usually an educated pet owner and should not have to do hurdles just to get their pet the attention he/she needs.
 
Ellas neurologist said they usually want referral from vets for pr reasons between uhs ? And vets? Said people could simply ask for a referral and he would not see why one would refuse

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A person went to vet with a video of symptoms. Good idea and information. Very receptive and b/c of video said definately not allergies however said he would consult neurologist to see if a mri is neccesary?

I find that vets trying to determine this or saying this like mine did is not up to them. Why not have the specialist determine?

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