Human doctors dispensing veterinary advice

[theunraveler]

one of the pet forum i visit alot has this doctor and sometimes when some of the ppl on the forum has a sick pet he/she would dispense medical advice. i have watched this happen for quite awhile. i know vet and human medicine are quite entwined but something tells me there is something wrong with that...

any ideas how i should put it across to that person?

---

Members don't see this ad.

 

[rexosaurus]

is there a moderator of the site? you could let that person know.

 

[theunraveler]

moderator yes but getting them to work no

let me put it this way i want to put it across to him/her that while medicine is similar, there are some important differences between species that may make his/her advice deadly

so i was juz wondering wat shld i tell that person?

 

[Bill59]

Whether or not the person is an MD is irrelevant. Nobody should be giving medical advice without a valid doctor-client-patient relationship. This means taking a history and examining the patient. It would be wrong (ethically and legally) even if they were a veterinarian.

By medical advice I mean specific recommendations regarding diagnosis or treatment of a particular patient. There is nothing wrong with someone, MD or otherwise, providing general information about a particular medical condition. (Some moderators don't understand this distinction IMO).

For example:

Q: "Is it OK to give Tylenol to cats?"
A: "Cats metabolize acetominophen differently than people or dogs and even one regular-strength Tylenol table might be toxic to a cat."

would be fine.

But,

Q:"My cat has a sore foot, can I give him Tylenol or something for pain?"

In that case, any answer other than "See a veterinarian" is on shaky ground.

Of course an MD shouldn't be diagnosing or treating nonhuman animals even if they do examine them.

 

[theunraveler]

in sdn they are quite strict about giving medical advice but other forums not so ...anyway the words of an anoynomous individual on the web is as much weight as the person is willing to give

the case in question is about a dog with renal failure, one of the other members suggested that if the vet has not come up with a diet plan for the pet then it would be advisable to cut down on protein , phosphorus and up the calcium and fluid level...that sounds pretty good

so this dr dude lets called him "MD" says protein restriction is a myth and should give erythropoietin shots ...

so i am at the sideline observing this and i wonder if wat he said is applicable to pets?

 

[Bill59]

Short answer, Dr. Dude is wrong.

Longer answer, Dr. Dude is wrong but it's more complicated. Dogs with glomerular disease need protein restriction. Intersitital disease needs low phosphorous (and maybe restricted protein but the protein part is mostly moot because all protein comes with phosphorous). Restricted protein means around 16% on a DM basis, which is still enough for maintenance.

But focusing only on protein misses the point. What veterinarians recommend is a renal diet, which has restricted protein but a lot of other things as well: phosphorous restriction, alkalinizing, high calorie and with extra potassium, water soluble vitamins, and n3 fatty-acids.

A randomized study has shown that feeding a manufactured renal diet results in a better quality of life and longer life in dogs with renal insufficiency compared a maintenance diet. A renal diet reduces the relative risk of a uremic crisis by over 70%, delays the onset of uremic signs almost 2.5 times longer, and increases survival time over 3 times longer.

Human erythropoietin is effective at treating the anemia associated with chronic renal failure, although dogs often develop antibodies to human EPO. Canine EPO is becoming available soon I think.


Jacob F, et al. Clinical evaluation of dietary modification for treatment of spontaneous chronic renal failure in dogs J Am Vet Med Assoc. April 2002;220(8):1163-70.

 

[WhtsThFrequency]

Agreed, and high protein does not cause kidney disease. But it will exacerbate it if present. IMHO and from what I have learned, a moderate *high-quality* protein diet is best for dogs eith renal problems, but a close eye kept on phosphorous/ash content *shrug - 2 cents*

 

[WhtsThFrequency]

And an MD dispensing veterinary advice is just as bad as a vet dispensing human medical advice. They are not qualified, and it even smacks of malpractice.

 

[RxWildcat]

I have seen MDs write rxs for animals before, they seem embarrassed when they get a phone call asking them if they are a vet as well.

 

[LADoc00]

And an MD dispensing veterinary advice is just as bad as a vet dispensing human medical advice. They are not qualified, and it even smacks of malpractice.

Totally depends on the situation. But in general, a DVM dispensing paid or unpaid professional medical advice about human pathology is jail time in EVERY state in the US. The converse of this isnt jail time but may result in censure/fines but if you have the qualifications to do so (as in combined DVM/MD training but not neccessary DVM licensed) you are fine.

 

[Bill59]

Totally depends on the situation. But in general, a DVM dispensing paid or unpaid professional medical advice about human pathology is jail time in EVERY state in the US.

That's not necessarily true. Just yesterday, I recommended a particular anesthesia resident undergo a medical procedure, specifically removal of a wooden foreign body from his rectum. I don't think he liked it, but I didn't get arrested.

 

[JIKJen124]

I know this is off topic, but... How did he get a wooden foreign body in his rectum in the first place?!

 

[david594]

I know this is off topic, but... How did he get a wooden foreign body in his rectum in the first place?!

He told him to take the stick out of his ass.

 

[MickeysPet]

 

[lazyjayn]

wait.. I thought it was always "I slipped and fell on it"....

 

[Hobiecat1642]

"That's not necessarily true. Just yesterday, I recommended a particular anesthesia resident undergo a medical procedure, specifically removal of a wooden foreign body from his rectum. I don't think he liked it, but I didn't get arrested."




That is really funny. And how is he doing post-op? Or did he decline your advice?

 

[chris03333]

 

[Bill59]

And how is he doing post-op? Or did he decline your advice?

Well he quit second guessing how we were managing the case and got the patient asleep, which is what I wanted.

I should point out that I love anesthesiologists. They save my and patients' behinds on a routine basis. This particular individual was just having a bad day and tried to take it out on my resident. It's all good now.

 

[theunraveler]

thx bill59 for clearing this up

vet and human medicine seems very alike and yet at the same time very different. so maybe if i do see him i could tell him that subtle differences in physiology/biochemistry makes the difference between life and death

anyway this leads me to another question, how much is animal and human medicine different from each other?

 

[pathognomonic]

anyway this leads me to another question, how much is animal and human medicine different from each other?

Mmm...more similar than different. Most of the odd idiosyncracies are on the animal side of the house. As a veterinarian currently in medical school, I'm not running into anything I haven't seen before, but I did learn things in vet school/practice that I'm not being exposed to here.

The biggest difference I think is that medical school is more interested in details while veterinary school is more big picture (learn the details in practice). I think this is simply because of the shear volume you must assimilate in veterinary school dealing with different species.

Vet school taught me how to think. Medical school is teaching me how to memorize vast quantities of information. This may also be a function of the philosophies of the veterinary school I attended versus the medical school I am attending.

 

[twelvetigers]

I'd rather know how to think than how to memorize stuff.

Honestly though, I'm curious what drew you to human medicine after going the vet route first? It must have been a big draw, considering the costs of attending two different types of medical schools...

 

[Bill59]

anyway this leads me to another question, how much is animal and human medicine different from each other?

Well, humans are animals. But otherwise, the biggest difference is veterinary patients are nicer and more appreciative.

 

[masterpate]

Take these situations
A: You are a doctor that sees a dog with a cut on its leg that looks infected and needs stitched. You happen to have a needle and thread on you, and a shot of *insert random antibiotic* , now do you sew up that dog and give it the antibiotic or do you not and let it suffer because you are not a veterinary doctor.
B: You are a veterinarian and someone you know has a cut on their hand. Perhaps in your clinic, or perhaps just a friend. Do you have them go to a doctor and spend lots of $$$ to get it sewn up, or do you do it yourself? (I have several relatives that have got this treatment from a local vet actually... but i do live in hicktown, Arkansas)
C. This one happened to my uncle, He dislocated his shoulder in a softball game. THe only 'doctor' around was a veterinarian. The veterinarian walked up to him, felt the arm to be assured it was dislocated, and said, if you don't mind a veterinarian doing it, I can pop this back in for you. Was he wrong to do so?

 

[Bill59]

A: You are a doctor that sees a dog with a cut on its leg that looks infected and needs stitched. You happen to have a needle and thread on you, and a shot of *insert random antibiotic* , now do you sew up that dog and give it the antibiotic or do you not and let it suffer because you are not a veterinary doctor.

You tell them to take the dog to a veterinarian.

B: You are a veterinarian and someone you know has a cut on their hand. Perhaps in your clinic, or perhaps just a friend. Do you have them go to a doctor and spend lots of $$$ to get it sewn up, or do you do it yourself?

You have them go to an MD.

C. This one happened to my uncle, He dislocated his shoulder in a softball game. THe only 'doctor' around was a veterinarian. The veterinarian walked up to him, felt the arm to be assured it was dislocated, and said, if you don't mind a veterinarian doing it, I can pop this back in for you. Was he wrong to do so?

yes

 

[chris03333]

Take these situations
A: You are a doctor that sees a dog with a cut on its leg that looks infected and needs stitched. You happen to have a needle and thread on you, and a shot of *insert random antibiotic* , now do you sew up that dog and give it the antibiotic or do you not and let it suffer because you are not a veterinary doctor.
B: You are a veterinarian and someone you know has a cut on their hand. Perhaps in your clinic, or perhaps just a friend. Do you have them go to a doctor and spend lots of $$$ to get it sewn up, or do you do it yourself? (I have several relatives that have got this treatment from a local vet actually... but i do live in hicktown, Arkansas)
C. This one happened to my uncle, He dislocated his shoulder in a softball game. THe only 'doctor' around was a veterinarian. The veterinarian walked up to him, felt the arm to be assured it was dislocated, and said, if you don't mind a veterinarian doing it, I can pop this back in for you. Was he wrong to do so?

A: Hope you don't get bit because you tried to sew up a dog who is awake. Hope you don't cause an abscess because you were stupid enough to stitch up an "infected" cut. Hope your antibiotic last long enough so it does not cause a resistant infection, is not an antibiotic which has worse side effects in dogs than the infected cut.
B: I would not touch a human with a 10' pole. ESPECIALLY one I know. What if something goes wrong?
C: YES

 

[ProZackMI]

Take these situations
A: You are a doctor that sees a dog with a cut on its leg that looks infected and needs stitched. You happen to have a needle and thread on you, and a shot of *insert random antibiotic* , now do you sew up that dog and give it the antibiotic or do you not and let it suffer because you are not a veterinary doctor.
B: You are a veterinarian and someone you know has a cut on their hand. Perhaps in your clinic, or perhaps just a friend. Do you have them go to a doctor and spend lots of $$$ to get it sewn up, or do you do it yourself? (I have several relatives that have got this treatment from a local vet actually... but i do live in hicktown, Arkansas)
C. This one happened to my uncle, He dislocated his shoulder in a softball game. THe only 'doctor' around was a veterinarian. The veterinarian walked up to him, felt the arm to be assured it was dislocated, and said, if you don't mind a veterinarian doing it, I can pop this back in for you. Was he wrong to do so?

Hello lawsuit. Good-bye vet license. In an emergency, call 911. Do what you can do apply remedial first aid, but for God's sake, do NOT do anything beyond that. If you're not an EMT, stop and call 911.

I'm an MD and a JD. I have two pets who I love more than people. I love my cats. When my one kitty got her collar (how, I have no idea), wrapped around her armpit, which caused a severe abrasion, bordering on laceration, that became infected before I got home from work, rather than attempt to treat her myself, I captured her, removed the collar, and brought her to an emergency vet service. Could I have treated her? Perhaps, but in reality, even though I knew there was an infection due to the odor and pus formation, I did not know how bad it was or whether it required stitches, etc. Only a vet would be able to tell this.

Likewise, while I'm sure vets know a great deal about "medicine" in general, human and vet, they are not trained to spot signs and sx's in humans nor do they know human pharmacology. There is a reason why there are two separate professional schools for humans and animals.

As an attorney, I can honestly say, in a crisis situation with a human victim, do your best to administer remedial first aid, but call 911 and do not expose yourself to liability. In most places, vets are not protected by Good Samaritan health care provider statutes. Now, if you're a DVM and a licensed EMT, hey...go for it! If you're an MD or DO and an LVT, go for it. Otherwise, stop.

Going back to the OP, it's always easy for an anonymous tool to give medical advice on a forum. This MD has no business dispensing specific medical advice, human or otherwise, an any forum without a physician-patient relationship. Giving general medical advice is okay, but should be limited, general, and always followed by "see a physician" or "see a veterinarian".

 

[theunraveler]

Well, humans are animals. But otherwise, the biggest difference is veterinary patients are nicer and more appreciative.

i mean besides anatomy, how much difference in terms of physiology, biochemistry and cardiology ....etc?

 

[Bill59]

In general, the closer two species are on an evolutionary basis the more similar their anatomy and physiology. There earlier the branching, the larger the difference.

So dogs and human are different. But less different then say, iguanas and dogs. And more different than dogs and cats, or humans and chimps.

But the differences in anatomy, pathophysiology, medicine and surgery are probably much less then other issues, such as the legal standings of human patients compared to veterinary patients and the economic concerns, such as 3rd party payers.

 

[Orthonut]

i mean besides anatomy, how much difference in terms of physiology, biochemistry and cardiology ....etc?

A LOT.
Kid + Fever + Tylenol = happier kid (hopefully)

Cat + Tylenol= death

And whomever said LVTs on scene should go for it-they can and do lose licenses for that. Everything an LVT does is supposed to be done under the supervision of a licensed veterinarian. So unless they're in phone contact (and that's sketcy in most states) with the veterinarian who has a valid veterinarian-patient-client relationship it's illegal.

I've sutured myself but I'd never treat another human. I mean *shudder* what if it goes wrong and they file an MB complaint against you? My dad's a prison guard and I've heard about what goes on there and wholeheartedly wish to stay far away.