Pete the Vet: Rule change means I may not be able to give 'telemedicine' advice

Pete the Vet: 'The Veterinary Council of Ireland is currently finalising these new telemedicine guidelines. The proposed rules mean that, from the beginning of 2022, vets in Ireland who have not examined animals will only be able to offer pet owners “triage” or “general non-specific advice”.'

As a pet owner, do you ever read newspaper advice about readers’ pets, written by vets like myself? Do you listen to radio vet slots where questions about a listener’s pet are answered by a vet? And would you ever consider using an online service where you can ask a vet a question about your own pet, such as the “Ask A Vet” service on my website?

In the future, here in Ireland, you may not be allowed to do this any more. This type of advice service is under threat, because it falls under the broad categorisation of “telemedicine”. A new veterinary code of conduct aims to seriously restrict the type of advice vets are allowed to offer on animals that they have not physically examined.

Telemedicine has been widely adopted by the medical profession at a time when GPs have been under particular pressure. Vets are also under pressure (there’s currently a shortage of vets, following the COVID boom in pet ownership), but the profession is far more conservative than doctors about allowing online assistance. Rules are currently being laid down to prevent vets from carrying out the type of video consults that doctors are now doing. However the proposed rules go much further than this: they strictly limit vets in Ireland on what they can do if they don’t carry out a physical hands-on examination. If owners want online advice about their pets, the borderless nature of the internet means that pet owners will find themselves visiting websites from other jurisdictions which are not controlled by Irish rules, and this may not best benefit their animals.

The Veterinary Council of Ireland is currently finalising these new telemedicine guidelines. The proposed rules mean that, from the beginning of 2022, vets in Ireland who have not examined animals will only be able to offer pet owners “triage” or “general non-specific advice”.

Triage is, indeed, very important. This is the process of allocating urgency to a sick animal: deciding whether or not it needs to be seen by a vet, and if so, how promptly. To give an example, someone contacted me via the Petfix website recently on a Saturday night because their pup had eaten a sock. They wondered if they should wait to see if he would pass it naturally. I told them, unequivocally, that they should take the pup to an emergency vet at once. The vet gave an injection which immediately caused the pup to regurgitate the sock. The crisis was quickly and easily solved. If they had not gone to the vet promptly, the sock would have passed beyond the stomach and into the intestines. It’s common for socks to become firmly lodged here, requiring a major operation to surgically remove them. My simple triage advice to “get that pup to a vet without delay” may have saved the little animal’s life. I am very relieved that triage will continue to be permitted.

In contrast, I am deeply concerned that any advice that online vets give, from now on, can only be “general” and “non-specific”. This means that I will not be able to offer anyone “specific” advice if they are worried about their pets. I can recount many situations to date where I have given helpful and reassuring specific advice to people who have asked me about their pets, whether on the radio or television, in print, or via the internet. I won’t be able to do this any more.

Some examples highlight why I think the plan to ban specific advice may damage animal welfare. Last summer, a pet owner who wasn’t a client of my vet clinic phoned me during a real-life crisis: their previously healthy dog had just collapsed, panting, while out on a hill walk. What should they do? It was a hot sunny day, and the dog had been exercising heavily. It was very likely that this dog was suffering from life-threatening heatstroke. I gave them specific advice to take the dog to a nearby pool of water and cool the dog down, and then to take the dog to the vet. Research shows that this method saves more lives of dogs with heatstroke than taking dogs straight to the vet without cooling them down first. In future, I will not be allowed to make a suggestion like this without breaking the new code on telemedicine.

Other examples of questions that pet owners will not be allowed to ask online vets include: My dog has a small lump on her tummy: what might it be? My dog barks in the night: how can I stop her? My 12-year -old Labrador takes a long time to get up in the morning. What could be causing this? The only helpful way to answer such queries is to give specific advice but this will no longer be possible. Vets will have to respond to such queries by saying “I cannot comment on your pet’s issue without examining them”.

I know from experience that people and animals can be helped a great deal without a physical examination. My belief is that the wording of the guidance on telemedicine should be changed from "general, non-specific advice” to just "advice". This may not sound like a big change, but to animals that benefit from being given specific advice, it could be life-changing.

The draft Code of Practice for Vets is open for public consultation until 13th October: to express your opinion, visit the Veterinary Council of Ireland website at https://www.vci.ie/ to answer a short questionnaire. If you agree with me, please add the comment that you believe that advice should not be limited to “non-specific”.