Endocrine Testing: Why one test isn't enough
Testing for endocrine disorders can be costly to your clients. Explain the process-and the costs-right away to increase compliance.
When you suspect endocrine disease in a patient, it's time to be up-front with your client, says Veterinary Economics Editorial Advisory Board member Dr. Andy Rollo. Explain right away that one test may not be enough.
It may be easy to recommend an ACTH stimulation test for a dog that's vomiting, severely dehydrated, and has a sodium to potassium ratio of 22, Dr. Rollo says. But if a dog is gaining weight despite being on a restricted calorie diet or beginning to show signs of thinning hair, the client may not feel much urgency to pursue metabolic disease testing. That's where you come in.
Dr. Rollo suggests saying something like this: "If Sophie's weight exceeds 80 pounds at the next visit, I'd recommend a thyroid test. Now, there's a chance our results may end up in the gray zone, and we'll need to follow up in another three to six months. If all values are in the normal range, I recommend performing a low-dose dexamethasone suppression test to investigate Cushing's disease, which could also explain Sophie's symptoms."
Dr. Rollo also suggests giving cost estimates for all possible tests as well as information on each disease on your list of possibilities. "Communication right from the start is key," Dr. Rollo says. "You may be surprised by the compliance on the client's next visit."
Dr. Andrew Rollo is a Veterinary Economics Editorial Advisory Board member and an associate at Madison Veterinary Hospital in Michigan. Send your questions to ve@advanstar.com.
