Sick pet? Why searching the internet might not help
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Many people turn the internet for answers when they feel sick, even before calling a doctor. Pet owners often do the same for their pets. A wave of websites offering online veterinary advice launched in the past few years to answer questions about pet illnesses, with some promising to put you in touch with a real veterinarian. But is using these websites a good idea?
PetCoach is one of these websites. Users can ask questions free on the site and await answers from one of about 100 veterinarians around the world who work with the PetCoach. A veterinarian responds in about two hours, said Christie Long, chief veterinarian for PetCoach.
Users can pay $4.99 to get an answer within 30 minutes, Long said. They can also pay to speak one-on-one with a veterinarian. Since launching in 2014, PetCoach has fielded nearly 300,000 questions and has 200,000 registered users.
Petco, a pet retailer with more than 1,500 locations in North America, acquired PetCoach in April. The website now fields inquiries from customers in Petco stores and from Petco.com, Long said.
There are a number of studies looking into how veterinary practices incorporate "telemedicine," said Lori Teller, a member of the the American Veterinary Medical Foundation (AVMF) board of directors and a practicing veterinarian in Houston. Telemedicine, the term for doctors treating patients remotely using text, voice or video, is becoming widespread in human and pet medicine.
Ariana Finkelstein, a veterinarian in Florida, said this can be useful for pets with chronic conditions like diabetes. Owners can send her updates on glucose levels, diet and insulin doses and Finkelstein can tell whether they need to adjust insulin levels. Owners can send her post-surgery pictures to see whether a pet is recovering as planned or needs to come into the office.
Patients can text Finkelstein to ask questions when the office is closed. Her practice also gives owners access to their pets' medical charts through a mobile app.
"For already established clients, I think it's great," she said.
While there are pitfalls, accessing veterinary advice digitally could be especially useful for people who live in remote areas, said Stephen Divers, a professor of zoological medicine at the University of Georgia.
Many PetCoach users don't have a local veterinarian, perhaps because they recently moved or just haven't seen one in a while, Long said. Office veterinarians aren't always available immediately. Some people might not be able to afford a veterinarian (pet insurance can help cover unexpected bills).
"Maybe their vet's not available," she said. "Maybe it's the middle of the night or the weekend."
Many people who turn to websites like PetCoach have pets dealing with common problems like fleas, allergies, hair loss or mange. PetCoach has articles on these basic issues, but other problems require more investigation.
While veterinarians are becoming more comfortable with offering advice online, websites like PetCoach are growing because consumers, especially younger pet owners, are used to turning to the web when they need answers, Long said.
Finkelstein believes a veterinarian can tell an owner whether their pet needs immediate attention over the phone, but trying to treat a pet over the phone comes with risks.
Without a physical exam, or a history of physical exams, Finkelstein said she isn't sure a veterinarian can help a sick pet. Telemedicine can work in human medicine because people can talk. If you have pain and you call a nurse over the phone you can tell them exactly where it hurts.
You can call a veterinarian because you can tell your dog is in pain, but you won't know exactly where.
"We can't do a neuro exam over the phone," Finkelstein said. "We can't see it walk over the phone. So how are we going to know, did it hurt its back? Can it actually walk?"
Technology can't replace a veterinarian who can touch a pet, listen to its heart or look in its ears, Divers said.
"It's very difficult for a veterinarian to provide an informed professional opinion based on what a client is telling them and if they can't physically examine the animal," he said.
Most states require veterinarians to have an "established veterinary-client-patient relationship" before they can diagnose or treat a pet, Teller said. Establishing such a relationship has a few requirements, but the most important is that the veterinarian has examined the pet before, in person.
"If the pet owner does not have an established veterinary-client-patient relationship with the veterinarian with whom they're speaking on one of these sites, legally that person can only provide general information and they should not be providing specific diagnostic or treatment information," Teller said.
For example, if your dog is vomiting and has diarrhea, a veterinarian you don't know could tell you generally what causes those symptoms. Recommending specific actions like feeding your dog Pepto-Bismol could get a veterinarian in trouble, and could harm your dog, Teller said. But if you've just taken your dog to a veterinarian and it develops a limp, you can video chat with the vet to figure out what to do because there's an established relationship.
"It's a little easier for me to make appropriate recommendations specific to that pet," Teller said.
Teller advises pet owners to always err on the side of caution if they're weighing whether they need to see a veterinarian. You can call or text the office ahead of time to make sure, but it's usually better to be safe than sorry.
Long, chief veterinarian for PetCoach, said no relationship is required to give advice.
"We're basically telling people what could be going on — what's most likely going on," she said.
The veterinarians on PetCoach mainly perform triage, Long said, with 75% of interactions resulting in users needing to take their pet to a veterinarian. Users are told not to use the site if their pet has certain urgent symptoms, like unconsciousness, bleeding, difficulty urinating or vomiting for more than 24 hours.
Just as when family or friends ask them questions about their pets' medical issues, veterinarians on the website can rattle off a few possible causes based on breed and environment, she said. She acknowledged that most often, pets need a physical exam or further testing for a formal diagnosis. But veterinarians have long been giving general pet advice.
"It's really not that new," Long said. "We've been doing this as long as there have been telephones."
Long believes telemedicine will become even more widespread among veterinarians. She hopes to see states follow the example of Ontario, where regulators in April allowed veterinarians to establish a veterinary-client-patient relationship remotely. She believes remote monitoring devices used in human medicine to track markers like blood pressure or heart health will increasingly make their way to the pet world.
"I think those devices and those types of tests can put the power in the hands of the client," Long said.
For the near-term though, pet owners should still see a veterinarian in person, Teller said.
"But certainly, as technology improves, things can change and the AVMA will be monitoring that and updating our policy as needed," she said.
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