Last week a veterinarian called me for consultation on a horse he had diagnosed with equine metabolic syndrome. The veterinarian had some questions about the horse’s latest laboratory values, and how to move forward with a treatment plan. I offered my interpretation of the horse’s laboratory results and made some suggestions regarding treatment . The veterinarian called me because I am a diplomate of the American College of Veterinary Internal Medicine, which means that after receiving my veterinary degree I successfully completed a 3 year clinical residency training program and a rigorous examination process to ensure my advanced knowledge and experience diagnosing and treating internal medicine problems.

On the flip side, I stopped by to visit with one of our local surgical specialists for his opinion on some x-rays I had taken of a yearling with an atypical stifle lameness. Dr. Shane Miller is a diplomate of the American College of Veterinary Surgeons. Shane and I sat down and looked at the radiographs together. He gave me his opinion on the radiographic changes and some suggestions on treatment options.

This type of congenial exchange of information goes on, often without your knowledge, as a routine part of your horse’s veterinary care. The variety of problems presented to the ambulatory veterinarian is enormous, and maintaining this network of colleagues is a critical part of our service to you. After 27 years as a practicing veterinarian, the majority of patients I see exhibit clinical signs with which I am familiar, and diagnostic and treatment plans are relatively routine. However, when an animal presents with a complex complaint outside of my expertise, I do not hesitate to seek consultation. Sometimes the initial conversation with a specialist leads to the referral of the patient for advanced diagnostic evaluation.

Deciding when to take the step of refereal to a specialist is not always clear cut –a crucial part of my job is to keep lines of communication open, and to present all your options to you as a horse owner. Following advanced diagnostics and discussion with specialists at a referral center, horses usually return to my care for ongoing treatment and rehabilitation. You should never feel awkward asking for a referral for a second opinion from a specialist – I am happy to comply. When I make the initial contact leading to referral, we insure that any diagnostic information, as well as my clinical notes, will be part of the information that will accompany your horse to their appointment.

There are 21 specialty colleges of veterinary medicine recognized by the American Veterinary Medical Association! In the greater Reno area we have 2 board certified equine surgeons, 1 large animal internist (yours truly!), and a board certified ophthalmologist who sees both large and small animal patients. UC Davis is 3 hours away and offers specialists in most of the large animal disciplines. To learn more about veterinary specialists, google AVMA specialty organizations.

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