The Tele-Veterinarian Will See You Now

Amid COVID-19, a request from pet owners Joan and Mike Strauss resulted in a ground-breaking appointment for Cummings Veterinary Medical Center.

The Strausses—clients of the Henry and Lois Foster Hospital for Small Animals—were seeking advice from an internal medicine veterinarian and a veterinary nutritionist about their dog, Teagan, who had kidney disease. And they were hoping to involve their regular veterinarian, who had referred Teagan to Tufts and closely managed her care, in the discussion.

Getting multiple veterinarians, two clients, and a patient in the same room at the same time is nearly impossible under normal circumstances, never mind under COVID-19 restrictions. But it was possible with a telemedicine appointment, said veterinary nutritionist Deborah Linder, V09, GBS16.

Everyone involved in Teagan’s case was able to log into a virtual Zoom meeting where they could see and hear each other on a video conference.

“I just loved it,” said Linder, who heads the Tufts Obesity Clinic for Animals and also chairs Cummings Veterinary Medical Center’s Telehealth Taskforce. “Since we were all in the same virtual room, I got to hear from the client’s regular veterinarian with, ‘Here's what my recommendation would be. What do you think in terms of management for that?’ I also got to hear internal medicine's point of view and what their priorities are, so I can better develop the nutrition plan to address those.”

Linder emphasized that, in accordance with Massachusetts law, telemedicine appointments at the Foster Hospital for Small Animals are only for current clients, which is defined as pets that have been seen in person by Tufts clinicians within the past year. Pet owners can opt for virtual appointments related to behavior, dermatology, nutrition, internal medicine, and even neurology.

Hilary Jones, V14, is the co-founder of TeleTails, a virtual platform for veterinarians that allows them to provide telemedicine services for patients. She said about 25 percent of telemedicine appointments through that platform are for dermatology, with behavior being another common topic.

“It's great that people are home more with their pets during the pandemic, but it does mean that owners are noticing more things about their pets and making more inquiries to their veterinarians,” Jones said. “Telemedicine is really helpful for behavior, because the veterinarian can see the pets in their actual environment, without the other stressors that come into play when the pet comes to a veterinarian’s office.”

Jones said one of TeleTails’ partners has been using telemedicine to check in on litters of new puppies and kittens. The veterinarian can access even more information via video, such as where the crate and food dish are located. “If the veterinarian asks, what food are you feeding? The client might not remember the brand,” she said. “Then the veterinarian could ask, ‘Can you show me?’ And they can just hold it up.”

Jones said that although telemedicine is well-suited for chronic case management and, “Do I need to come in for this?”-type questions, it can’t always provide the answers. Veterinarians, for example, can’t diagnose a heart murmur or do blood or other lab work to rule out possible causes.

Telemedicine is not a replacement for in-person visits; it’s simply a new way for veterinarians and owners to communicate.

“As a veterinarian, if you see a pet on a virtual appointment, and you know they need to be seen in-person, that’s not a failed telemedicine interaction,” said Jones. “You've still had the time to talk to the client, explain your concerns, what you want to do, and why you think they should come in."

Studies show that telemedicine seems to have a positive impact on the veterinarian-client relationship.

In a published study by Rob McCarthy, V83, an associate professor and veterinary surgeon at Cummings School, a survey of about 400 pet owners found that an overwhelming majority said they would use alternative methods of communication, such as virtual appointments, if their veterinarian provided the service. Clients also reported that telemedicine left them feeling better informed about their pet’s health and better able to communicate with their veterinarian.

McCarthy’s study also cited a 2004 study that found that 98 percent of clients were satisfied with telemedicine visits, because virtual appointments made scheduling easier and eliminated travel time.

Telemedicine as a teaching tool

Telemedicine offers benefits not only for clients and veterinarians, but for also for veterinary students at Cummings School of Veterinary Medicine. Some clients give permission for their telemedicine appointments to be recorded and later replayed for veterinary students for educational purposes.

“I think it's a great teaching tool,” said Linder. “We can't have ten students in the room for appointments, but they can all watch it afterward. I incorporated it as part of our new online clinical nutrition elective for students. In a typical week, each student would normally sit in on one appointment. And now all of them can see many appointments.”

She said recorded appointments are especially valuable for topics such as nutrition and weight management, which can be a delicate subject to broach with a pet owner. “One of the things our students struggle with is how to have that conversation and how to bring it up. Students are able to see that conversation happening and how we give them resources or educate them.”

Some clients really enjoy helping her teach students, Linder said. She recalled how, during a recent chat with a long-time client, she asked if he’d be willing to allow a student to join them on a virtual appointment, during which they would discuss weight management for his two cats.

“He said, ‘I love it. I used to teach.’ And I was like, ‘That's great. How many students are you comfortable with?’ And he said, ‘Bring them all,’” she said. “So, we had a Zoom call with 15 students, him, and me.”

The client challenged the students by giving them some information about his pets and withholding other details so students could learn how to ask questions in order to make a recommendation. Both Linder and the client appreciated that he had an active part in helping to teach future veterinarians.

Current clients who are interested in a telehealth appointment should contact the client liaison for the service that saw their pet within the last year and ask if a telehealth appointment is appropriate and available for their pet.

Angela Nelson can be reached at angela.nelson@tufts.edu.