The Number One Factor That Determines Successful Veterinary Medical Outcomes

This post’s featured image kind of gives away the suspense of this article, but it could not be more relevant to veterinarians.  We may have your pet in our exam room for perhaps 30 minutes, in the operating room for perhaps 90 minutes, or in the hospital perhaps for a few days.  However, the treatment and rehabilitation that must occur for a pet for make a full recovery could be weeks or months…meaning, that the pet owner has perhaps as big an influence on the success of treatment than the veterinarian making the treatment recommendations.

Owner compliance deficiencies can stem from patients that may be particularly difficult to treat.  Sometimes it may be the result of forgetting to treat the pet because a pet owner may be particularly busy with work, raising children, or personal emergencies.

That stated, please observe the picture above and take a guess which species poses the biggest challenge to compliance with the veterinarian’s treatment recommendations.  If you picked the human, you are absolutely correct.

I may have outlined some legit challenges an owner may face to proper treatment compliance, however, very often failure to comply is the result of a conscious decision to not comply or an inexplicable failure to follow clear instructions.

Here are a few common examples of compliance failures leading to bad outcomes that I experience on a regular basis:

• A dog has such severe chronic recurring skin allergies that I finally level with the owner that there is no other effective option other than to maintain the dog on a daily maintenance dosing of a skin allergy medication called Apoquel.  Luckily, however, it is a very safe drug for long term use.  I dispense a month’s worth and tell the owner to call us for refills, as the dog will require life long dosing with the medication.  2-3 months later, the owner returns and tells me that Apoquel did not work.  I notice in the record that the owner had not purchased any additional Apoquel since the last visit.  I then ask, “If it did not work, why didn’t you call me sooner?”  The answer is usually something like this: “Well it worked while he was on it but after I ran out his skin gradually got worse”  Right, so what part of “..the dog will require life long dosing with the medication,” was I not clear about?
• This one is a real doozy of a compliance failure and happens at least twice a year.  A dog or cat comes in with severe lower urinary tract signs and on x-rays I discover that there are urinary bladder stones.  I surgically remove the bladder stones and once I get their identity, recommend a prescription urine pH neutralizing diet that will effectively prevent the stones from recurring as long as the pet is fed the diet exclusively long term.  The dog or cat comes back in one year later with the exact same signs and low and behold there are stones in the bladder again.  I ask, have you been feeding the food I recommended?  The answer is usually something like this: “No because that food has grains in it and I do not believe in feeding animals grains.”  Right, so in light of your pet needing surgery for the second time in a year, how do you think the grain free approach is working out for you?
• And last but not least, pet just had a surgery and the owner is advised to keep the e-collar on until suture removal 2 weeks from discharge.  The pet comes back in some time before the 2 week post-operative appointment with its incision opened and infected.  It appears somebody did not follow our advice to leave the e-collar on.

I could go on here, but you get the idea.  I am so commonly bombarded with compliance failures that it makes me want to bring out my inner Jerry McGuire (Tom Cruise), pleading with his high maintenance wide receiver client Rod Tidwell (Cuba Gooding Jr.) and say, “Help me, help you; help me, help you; help me, help you.”

Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms.  In addition to being passionate about integrative veterinary medicine for which he is a globally recognized expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport.  He is president of Maybeck Animal Hospital , general partner of Grant Animal Clinic, and runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care.  Dr. Welton fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.