College Connection | Fall 2023
Contextualized Veterinary Care : It ’ s not black or white and certainly not gold continued from previous page
College Connection | Fall 2023
Contextualized Veterinary Care : It ’ s not black or white and certainly not gold continued from previous page
The veterinary team must also respect the human-animal bond :
• How committed is the owner to the patient ?
• How can the veterinary team preserve and enhance the humananimal bond ?
The veterinary team often grapples with stresses related to these questions surrounding the patient , the owner and the human-animal bond .
These options are even less possible when the veterinary team recognizes the environment in which diagnosis and treatment are provided :
• Does the practice have the necessary resources or ability to refer the patient ?
• Is the client really understanding the pet ’ s medical state when giving informed consent ?
• How much will diagnosis and treatment cost ?
• How does the veterinarian balance access to resources and costs against professional standards ?
• What is the nature of the veterinarian-client-patient relationship ( VCPR ) and how will this particular VCPR affect discussion of diagnosis and treatment ?
• How do living conditions and socio-economic status affect the ability to provide gold standard veterinary medicine ?
• What about implicit bias due to culture and belief systems , racialization and societal norms affect decisions related to offering “ gold standard ” or less preferred diagnosis and treatment options ?
• Is the veterinary team aware of their own implicit biases when explaining all the options to clients ?
These are all difficult questions , and they lead to different diagnostic and treatment discussions . But the contextualized model of veterinary medicine can help the veterinarian and the veterinary team in offering appropriate care for the patient and owner while respecting the humananimal bond and the environmental conditions in which the veterinary care is provided .
Contextualized care allows for discussing a range of treatment options with clients , helping them find the option that works best for their situation without judgement . It protects their dignity and individual wishes , and truly achieves informed consent .
Let ’ s revisit the earlier examples , applying a contextualized care model .
Noah ’ s calves need immediate rehydration and , if they are too weak to nurse or suck from a bottle , support in feeding .
Noah cannot afford hospitalization of his calves , but the veterinarian can use the contextualized model to discuss home options , such as using YouTube videos from a respected source to learn how to place an esophageal tube , emphasizing there are risks and how to mitigate the risks such as
accidental placement of the tube into the trachea .
The veterinarian must ensure a strong bond with his calves because esophageal treatment requires commitment and Noah being physically and emotionally capable of passing an esophageal tube .
Deb is stunned by Bucko ’ s diagnosis and likely suspicious of the veterinarian ’ s diagnosis and treatment advice .
In this case , the veterinarian needs to consider that the VCPR may be strained , and treatment of Bucko ’ s diabetes could start with nutritional management . In this example , followup calls and / or appointments with the RVT can help Deb begin to accept Bucko ’ s diagnosis and learn to use an insulin pen or receive help from a neighbour in administering insulin . If not , at least the model can help the veterinary team to understand how Bucko may not be able to be treated with insulin . continued on next page
Public confidence in veterinary regulation cvo . org 4