What to Expect From an Online Vet Visit

It is 6:00 pm and you come home from work to find a house full of dog diarrhea. Your dog will not eat her food, but she otherwise seems happy and normal. Should you worry about her eating? Unfortunately, your veterinarian’s office closed 30 minutes ago, so calling them isn’t an option.

Or perhaps your kitten was recently spayed, and you’re concerned that the surgical wound looks red and maybe infected. The problem is that it’s a Sunday afternoon, and your veterinarian’s office is closed except for emergencies, and you’re not sure if this is an actual emergency. 

Or maybe you just want to know which flea and tick medication is the right one, but it’s not worth scheduling an appointment with your veterinarian to ask a simple question.

What can you do? In all of these situations, there is an increasingly popular option: searching for an online vet to talk to. Just like in human medicine, veterinarians are increasingly available online to answer questions, triage (evaluate urgency), and give health and wellness advice.

But there are also some big differences from human telemedicine in terms of what services online veterinarians can legally provide. Here are some important things to know about online vet services so you can get the most from your chat.

How Online Vet Services Work

Services that provide online veterinary help may be free, or they may be part of a membership or subscription plan, like Chewy’s Connect With a Vet, which is free for Autoship customers.

Depending on the service, you can talk to licensed veterinarians through chat, a phone call, email, or a video call. Online veterinarians are a great resource for certain non-emergency situations and general health questions.

Some of the pros of working with an online veterinarian include:

• More convenient hours and easier access to a veterinarian from home.

• Veterinarians can help determine how urgent your pet’s problem is, give general medical advice, and answer general health or product questions.

• Faster response time.

• May not need to leave home if your pet does not need a physical exam, testing, or treatment.

• Free or low-cost feedback from a licensed veterinarian.

• Generally less stressful for your pet than an in-person visit.

• Allows you to better know what to expect if an in-person visit is needed.

However, to get the most from the experience, there are a few points to keep in mind:

• Online veterinarians legally cannot diagnose or prescribe medications, because a veterinary-client-patient relationship (VCPR) has not been established.

• Technical issues like slow Internet speeds or dropped calls may interrupt or impact your ability to communicate with the veterinarian.

• It may be difficult to communicate what is going on with your pet accurately without an in-person physical exam, so it’s a good idea to be as prepared as possible.

Why Can’t Online Vets Write Prescriptions?

In my time working as an online veterinarian, I can tell you that one common question we hear is whether we can write prescriptions for the pets we see online. While it would be convenient for pet parents, online veterinarians can’t legally write prescriptions. This is because there is no VCPR with an online veterinarian.

The VCPR, or veterinary-client-patient relationship, is a special type of relationship formed between a  veterinarian, a pet parent (the client), and their pet (the patient). Most states require a veterinarian to examine a pet in person to establish a VCPR.

This helps ensure that a veterinarian is familiar enough with your pet’s current and past medical history to diagnose and treat any medical concerns, and that you can ask questions and understand the diagnosis and treatment options recommended by the veterinarian.

What Can You Use an Online Vet Service For?

Even without the ability to prescribe, there are still many benefits to talking with an online vet.

Getting General Pet Health Info

Communicating with an online veterinarian is a convenient way to get general health advice for your pets. You can ask questions about nutrition, health, grooming, parasite prevention, behavior, and more, and you can trust the information you receive from a licensed veterinarian.

For example, as an online telehealth and teletriage veterinarian, I commonly get questions about the best diet for a growing puppy or the most effective heartworm prevention. I love getting questions like this because it shows how much pet parents love their pets, and how much they care about keeping them happy and healthy.

It is great to have the time to discuss the pros and cons of different products, and after the conversation, I can send helpful article and product recommendation links, which makes it much easier for the pet parent to review again later.

Triage: Finding Out When Something Is an Emergency

Triage is another area where online veterinarians can be very helpful. Teletriage involves determining whether a situation is an emergency that needs immediate attention, or if it can wait until it’s more convenient to get help.

For example, questions about vomiting and diarrhea are very common. Vomiting and diarrhea can indicate anything from some mild stomach upset from eating too many treats, to severe illness like parvovirus, kidney failure, or toxicity.

As a pet parent, it is very hard to know how serious these symptoms can be. Veterinarians are trained to evaluate the urgency of a situation. An online veterinarian can interpret your pet’s symptoms and medical history and inform you whether your dog needs to be seen right away by an emergency veterinarian, or whether it can wait until your regular veterinarian’s office is open.

Getting a Second Opinion

Getting a second opinion often brings peace of mind to pet parents who want more information about their pet’s health.

When getting an opinion from an online veterinarian, however, keep in mind that we cannot truly give an educated second opinion without examining the pet, and we don’t have access to the x-rays, test results, and exam details that pertain to your pet’s condition. Additional testing may be needed as well.

Instead, an online veterinarian may be able to give suggestions on other tests or treatments, and can help educate you about the initial diagnosis.

Asking About Follow-Up Concerns

Follow-up is an important part of pet parenting. As veterinarians, we are often asked about next steps for pets that have been treated for an illness or are recovering from surgery. In this circumstance, we can help give you some peace of mind by looking at photos of surgical incisions or healing skin and letting you know whether it looks like it is healing as expected or not.

However, this consultation is not the same as a true follow-up visit with your veterinarian. It does not replace an in-person recheck with the veterinarian that treated the pet, so you should always keep your recheck and follow-up appointments.

I have assured several worried pet parents that their dog’s spay or neuter incisions appear to be healing as expected, but I’ve also counseled pet parents to seek medical attention ASAP if I fear that an incision could be infected.

General Info on Preventative Care

Online veterinarians are excellent resources for advice on preventative care. One common example is discussing flea, tick, and heartworm prevention with pet parents.

There are so many different parasite prevention products out there that it can be very difficult to know which kill adult fleas short-term vs. preventing fleas all month.

Some products, like Simparica Trio, cover multiple types of parasites and may be the only product needed, while others, like Heartgard, are very effective, but do not protect against fleas or ticks, so they must be paired with another product like NexGard or Bravecto for full coverage.

On top of that, it can be difficult to know how to apply certain topical flea and tick medications, as some tubes open by pushing down the cap, and others twist off, etc.

While you should always talk to your veterinarian about which products may be best for your particular pet based on their age, breed, and medical history, online veterinarians can help via education, product suggestions, and online resources.

Online Vet Chat vs. Video Consultation

In recent years, more online veterinary services, including Connect With a Vet, are offering video televisits as well as chat or text-based conversations. Chats are great for pet parents who don’t have access to video conferencing tools, and they can provide a lot of helpful information.

However, a video visit opens more possibilities. Video visits allow you to make a more authentic connection with the veterinarian. 

Being able to see a pet’s respiratory rate, gum color, eyes/ears, hair/coat quality, gait, skin injuries, etc., allows the veterinarian to get a better idea of a patient’s status. Video also allows immediate feedback with both verbal and nonverbal cues, as opposed to having to wait for someone to type a response.

What to Expect in an Online Vet Consultation

To get the most from your online veterinarian, be prepared to offer much more description than you would during an in-person appointment. Because we cannot do a hands-on exam, and our patients can’t tell us what hurts, we rely on you to let us know what has changed. This means the more thorough you can be, including providing pictures, the more helpful we can be.

What questions will the veterinarian ask?

The online veterinarian will likely ask similar questions as your regular veterinarian. You might be asked to describe your concern, whether your cat is acting normally, eating and drinking well, whether there has been recent vomiting or diarrhea, and if she is on any medications or has any known medical conditions.

The veterinarian can then tailor the questions as needed depending on the individual case.

What resources will an online veterinarian give you?

The information and resources given by the veterinarian may depend on the type of service you are using. A service in which you ask a single question, like a forum, and the veterinarian gives a single answer, is more limited, whereas other services enable the veterinarian to share relevant articles, give product recommendations, and even to help find veterinary clinics in a pet parent’s location.

For example, if a dog suffers from severe allergies and chronic skin infections, an online veterinarian might send links to informative articles about common skin conditions in dogs, links to products such as a soothing oatmeal shampoo and omega-3 skin supplements, and information for a local, board-certified veterinary dermatologist, as this dog likely needs specialized care.

When Should You Take Your Pet to the See the Veterinarian?

Online veterinarians can do a good job helping ease worry and stress for pet parents who are concerned that something is wrong with their pet. However, there are still many cases when it’s important to seek out in-person veterinarian care, including emergencies.

Below are some of the conditions that should trigger a visit to your veterinarian’s office.

Vomiting/Diarrhea/Not Eating for More Than 24 Hours

After 24 hours of vomiting or having diarrhea, dehydration is a serious concern, and the list of possible causes of these symptoms is a mile long.

It is necessary for your pet to have a physical exam so the veterinarian can check their vital signs, evaluate abdominal pain, and perform diagnostics. With these symptoms, x-rays and lab tests like bloodwork, urinalysis, and fecal analysis may be recommended.

Example: A dog swallowed a sock two days ago and now vomits after eating any food.

This dog may have a foreign body obstruction (the sock is stuck) of its intestine, which is considered an emergency. Waiting can be fatal, and surgery is often necessary.

In a case like this, with known ingestion of foreign material, a veterinarian will likely recommend x-rays of the abdomen to check for evidence of intestinal blockage, and bloodwork to evaluate the dog’s hydration and electrolyte status.

Traumatic Injury

A pet should always be seen in person after a traumatic injury, because internal damage can be much worse than it appears externally. Trauma to the eyes should always be evaluated in person, as vision can be lost abruptly, and eye injuries become serious quickly.

Example: A dog escaped from the backyard for two hours and came home limping and holding up a paw. The dog has road rash, indicating that it may have been hit by a car.

Although this dog doesn’t have any severe external injuries, impact with a car can cause serious internal damage, which may be fatal. It is vital that this dog be evaluated by a veterinarian in person to ensure that they have stable vitals. An x-ray or ultrasound may also be needed to check for internal organ damage and/or bleeding.

Bleeding or Open Wound

Infection and blood loss are both risks for animals with bleeding or open wounds. An online veterinarian cannot disinfect, evaluate, and treat a wound or blood loss through the computer.

Dogs with open wounds will often require antibiotics and pain medication and may require surgery as well. This is something that should be addressed promptly, as at-home care may make it worse.

Neurological Conditions Such as Seizures or Paralysis

Any evidence of seizures, abrupt changes in your pet’s mental activity, inability to move one or multiple limbs, or signs of other neurological issues, like a head tilt and circling, should be treated as an emergency.

A hands-on neurological evaluation of your pet is necessary when it comes to localizing where in the nervous system the issue may be.

Seizures that last longer than a few minutes or occur more than once in a day can lead to permanent neurological damage. Paralysis can indicate serious issues with the spinal cord and can be permanent if not addressed quickly.

Example: A Dachshund jumped off the couch, which the pet does every day, but this time, they yelped and began dragging their back legs.

Dachshunds are very prone to intervertebral disc disease (IVDD), which can result in injury to the spinal cord and paralysis. This should be treated as an emergency, as the ability to walk may be regained with appropriate treatment.

An x-ray with or without other advanced imaging like a CT/MRI may be recommended, and if a herniated disc is identified, surgery may be the next step. These dogs are in a lot of pain, and if seen by a veterinarian promptly, this pain can be managed with injectable medications.

Having Trouble Breathing

Dyspnea, or when a pet has trouble breathing, is serious and should always be addressed immediately.

Signs of dyspnea in a dog include:

• An outstretched neck

• A fast, shallow respiratory rate

• Increased effort from the abdominal muscles to take a breath

• Often, lethargy or collapse

In cats, dyspnea may present as:

• Open-mouth breathing

• Coughing

• A rapid, shallow respiratory rate

This indicates that thepet is not getting enough oxygen.

Example: A cat has known heart disease but has not shown symptoms of congestive heart failure. Today, the cat started breathing with their mouth open and seemed distressed.

This cat may be in congestive heart failure and should be seen by a veterinarian immediately. Cats in respiratory distress can worsen quickly, and it is important that they be seen in person so that the veterinarian can administer oxygen and medications as needed to improve their ability to breathe.

Featured Image: iStock.com/Sviatlana Barchan

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