Veterinary client's wishes lead to a holistic headache


What is a veterinarians obligation when a pet owner insists on natural therapies?

Gina Hull exercised every day along with Hans, her German shepherd, and she prided herself on their fitness. Now 7 years old, Hans was slowing down, and it was most noticeable when they jogged. So she paid a visit to Dr. Longo, Hans' longtime veterinarian.

Ms. Hull liked Dr. Longo's philosophy-he used a natural approach to her pet's medical care whenever possible. She did not like preservatives in her food or the unnecessary use of prescription drugs, and she required the same approach to Hans' care and treatment.

Dr. Longo evaluated Hans and took a full set of pelvic and lumbar radiographs. The results revealed fairly advanced bilateral degenerative joint disease of both hips and significant lumbar spinal spondylosis. He explained that this was the reason Hans was lagging behind during jogging and that the dog was probably experiencing significant discomfort.

Photo source: Getty ImagesDr. Longo recommended an all-natural diet with a glucosamine additive incorporated into the food. He also started Hans on a daily dose of glucosamine-chondroitin tablets. In addition, he advised Ms. Hull to pick up some omega-3 fatty acid capsules and scheduled a series of cold laser treatment sessions to help decrease the inflammation and discomfort in Hans' hip joints. Ms. Hull was not happy with Hans' aging issues, but she was happy she could help him.

Five weeks into the new protocol, Hans was still lagging behind while jogging with his owner. Ms. Hull perceived a minor improvement, but she was unhappy with the dog's overall progress. So she made an appointment with a veterinary orthopedist at a nearby specialty facility.

The doctor examined Hans and reviewed his radiographs. She concluded that the holistic care was helpful but could be combined with prescription medication in a complementary approach. After running a general blood profile, she prescribed an NSAID for Hans to use in conjunction with his supplements and laser. She mentioned that these natural therapies were supported by anecdotal endorsements, while the prescription medicine had been proven effective by mainstream testing. Finally, she told Ms. Hull to not worry about negative side effects with her all-natural treatments because she wasn't aware of any risks.

Within four days of adding the NSAID to the holistic protocol, Hans was almost restored to his younger self. Ms. Hull was happy but a bit disillusioned-why hadn't Dr. Longo prescribed this medication as part of Hans' therapy? She contacted Dr. Longo and asked. He said he believed that Hans would respond to holistic therapy and would not suffer from any side effects.

Ms. Hull was upset after considering Han's suffering and his immediate response to the new medication. She filed a complaint against Dr. Longo for mistreating Hans' painful arthritis condition. Dr. Longo retorted that Ms. Hull used his services specifically because he took a natural approach to medication and treatment. He said he was diligent, caring and certainly not negligent.

Do you agree with Dr. Longo, or is Ms. Hull justified?

Rosenberg's response

I agree with the client in this case. Holistic treatment is appropriate only after a full-disclosure discussion with pet owners. They should be advised that non-FDA-approved treatments are not the accepted standard of care. Once pet owners understand these parameters, they can make an informed decision. Dr. Longo knew that Ms. Hull had a naturalistic medical philosophy, but he was still obligated to explain all treatment options. He didn't do this and fell short of his obligation to the patient and client.

Dr. Marc Rosenberg is director of the Voorhees Veterinary Center in Voorhees, N.J. He is a member of the New Jersey Board of Veterinary Medical Examiners. Although many of his scenarios in “The Dilemma” are based on real-life events, the veterinary practices, doctors and employees described are fictional.

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