Virtual Vets – Any Virtue In It?

I received an invitation to undertake a survey for an online veterinary service last week. I suppose that it was inevitable that someone would set this sort of service up but I have grave doubts about the possible effects.

This particular service was based in Scandinavia. Their website it extremely simple and the “meet some of our vets” section simply has three images of the vets who are listed as being “licensed” but have no biographical details or qualifications accompanying the images. I am not for a moment doubting that they are qualified, but I do wonder how much synergy there is between, for instance, this particular part of Scandinavia and the UK in terms of regulations and practice. Even if there is uniformity of approach in the way that vets are trained, there are inevitable differences in practice, not least because the dog-owning cultures vary widely between rural and urban, for instance, never mind between countries.

As an example, the population of the whole of Sweden is just 2 million more than the population of London for a start, with a population density of 57 inhabitants per square mile as opposed to 3,900 per square mile in London. The estimated total population of dogs in Sweden is just over 800,000: less than on tenth of the population of dogs in the UK. It stands to reason that there is likely to be more homogeneity in the way that dogs are treated and the way that any problems with dogs that arise are dealt with than is possible in the UK. Although neutering in Sweden, is exempt from the legal prohibition on the removal of body parts that has existed since 1988, it is prohibited in Norway unless a vet decrees that an established, specific clinical condition requires it and, in practice, it seems to be largely confined to hypersexual behaviours. Serious behavioural problems may be considered as acceptable grounds, but only on a case by case basis. This is not without controversy but again, with a comparatively small population of animals and people and a fraction of the density that exists in most of the UK. Neutering is just one very obvious example of where different approaches may occur and may lead to unintentional miscommunication and assumptions being made by both parties.

It is not clear, for instance, whether the vets will actually provide a diagnosis or just advice on whether further treatment should be sought. A lot of that process for vets though, is tactile. By the time that an owner feels that something is wrong with their dog, it is usually time to make an appointment anyway, or at least a telephone call. If it is the case that an odd lump or bump is worrying, what is to stop an owner sending a picture to their own vet and then making a telephone call or popping in to see a nurse without paying a consultation fee? Needless to say, the vets will also have no access to the previous history which will have a huge bearing on a diagnosis.

I am concerned that, having spent a fee getting advice online, owners may feel that they have “seen” a vet and not pay for additional help, even if it is advised. Compliance is shockingly poor and can be as low as 36% in some cases. Medications are often not administered or administered incorrectly and owners can delay seeing a vet due to worries about the cost and if their animal dislikes travelling, being in the surgery or being handled. Even when given unequivocal, face-to face advice that an animal needs further treatment, some owners prevaricate and often delay bring in the animal in. It is those owners that I fear may be lulled into a false sense of security by an online “consultation”.

The latest fad, for instance, is for administering cannabinoids to “treat” pain and even seizures. More than 100 cannabinoids have been identified in cannabis. The best known is tetrahydrocannabinol (THC), the psychoactive properties of which provide the “high”. How many owners know the difference between tetrahydrocannabinol (THC) and the cannabidiol (CBD) that is the active ingredient in cannabis oils? An oral dose of 3g/kg of the dog’s bodyweight of THC can be lethal in dogs. An online consultation combined with folk lore about such substances could result in a dead dog. How many owners are going to ensure that over the counter products, often bought online, are what they say they are and administer them in a “safe” dose when we know that compliance under veterinary supervision is often poor? There are no formal studies on the use of CBD in dogs or scientific data supporting beneficial effects of CBD use in dogs.

We would do better to educate owners to make daily checks for parasites, grass seeds etc, abnormalities and changes, in recognising discomfort and pain in their animals and in not administering over the counter human treatments which, in addition to being potentially harmful, is also illegal. It is easy to see that online “consultations” could tempt some owners into doing this to save money or if access to their vet is difficult for whatever reason.

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