Telemedicine and How it Works

What is telemedicine?

Telemedicine is defined as the act of practicing medicine at a distance, using telecommunication. Veterinarians can offer telemedicine in many ways.

Telephone calls, text messaging, online chat, email consultations, and visits conducted through videoconferencing programs are all examples of telemedicine.

Any time a veterinarian diagnoses a condition, recommends a particular treatment, or provides a prescription without the patient in the hospital for an in-person physical examination, that veterinarian is practicing telemedicine.

Is telemedicine done by my regular veterinarian or by a telemedicine veterinarian?

Telemedicine for pets can only be done within the context of an existing veterinarian-client-patient relationship (VCPR). Historically, to develop a VCPR, an in-person examination was required, which meant that veterinarians could only offer telemedicine services to existing clients and to patients who they had previously seen for a physical examination.

The COVID-19 pandemic caused a change in access to care, so some states and provinces have relaxed the legal requirements around the VCPR and telemedicine, making this service available to a wider range of pet owners.

Some veterinary hospitals offer their own telemedicine services. These services may use veterinarians that work within the veterinary hospital or veterinarians contracted from an outside service. 

"Some veterinary hospitals offer their own telemedicine services."

The advantage of this arrangement is that these veterinarians typically have access to your pet’s medical record, meaning the veterinarian will be familiar with your pet’s medical history and your telemedicine visit will be documented in your pet’s medical record.

If your veterinarian does not offer telemedicine services, there are providers that work directly with pet owners. Depending on the laws in your area, you may be able to receive care from these telemedicine providers.

What issues can telemedicine address?

Telemedicine is not appropriate for every concern. For example, a dog that has been hit by a car or has difficulty breathing needs to be seen in-person and hospitalized for diagnostics and treatment.

Several common veterinary complaints can be addressed via telemedicine.

• Chronic recurrent issues, such as flea allergies and behavior problems, can often be addressed through telemedicine.
• Minor concerns, such as a recent acute (sudden) onset of mild limping or a recent onset of mild diarrhea, may also be good candidates for telemedicine.

Although telemedicine does not provide the opportunity for a detailed medical workup, many common conditions can be treated symptomatically through telemedicine (treatment recommendations will be based only on the pet's symptoms and clinical signs).

Telemedicine can also be used for follow-up care or monitoring of existing patients. Post-surgical rechecks and scheduled follow-up visits for pets with chronic medical concerns can typically be conducted through telemedicine. 

"Telemedicine can also be used for follow-up care or monitoring of existing patients."

If your pet is due for an annual examination but does not need any vaccines, a telemedicine visit may be all that is needed to allow you to refill your pet’s flea, tick, and heartworm prevention. Telemedicine may also be used for prescription refills for current patients and for palliative care.

How can a veterinarian diagnose my pet’s problem without an in-person examination?

In a typical veterinary visit, your veterinarian gathers information about your pet through two methods: the medical history and the physical examination.

Medical history can easily be obtained in a telemedicine visit, just as it would be during an in-person visit. Your veterinarian can significantly narrow down the list of possible diagnoses by understanding what signs you see, when these signs started, whether signs have worsened or improved since their initial onset, and other facts about your pet’s history can. In many cases, the medical history is just as important as the physical examination.

The physical examination is more limited in a telemedicine appointment, compared to an in-person visit. Your veterinarian may ask for images or videos of areas of concern. If your dog is limping, your veterinarian may ask for a video of your dog walking and running. If your dog has a mass, the veterinarian may ask to see the mass, either in a photo or via live video. 

Your veterinarian may also ask you to check specific things on your pet. For example, your veterinarian may explain to you how to check your pet’s heart rate and then ask you to do so. Your veterinarian may ask you to lift your pet’s lip to check the color of your pet’s gums.

While it is impossible to perform a complete, comprehensive examination during a telemedicine appointment, in many cases your veterinarian can gather enough information to arrive at a reasonable, presumptive diagnosis and start treatment. Your veterinarian may recommend things you can do for your pet at home or may prescribe medications to treat your pet’s condition.

In what other circumstances is telemedicine beneficial?

Telemedicine is particularly useful (and necessary) in situations where pet owners cannot physically bring their pet to a veterinary hospital. In remote communities, pet owners typically do not have the option to take their pet to a veterinarian when the pet becomes ill or injured. Veterinarians make their best presumptive diagnosis and create a treatment plan based on the information gathered in the telemedicine appointment, combined with their experience.

What if my pet’s problem cannot be treated via telemedicine?

Your veterinarian may determine that your pet requires in-person care, based on the telemedicine appointment. Your veterinarian may not have been able to collect enough information to make a complete and accurate diagnosis and further diagnostic tests may be required to determine the cause of your pet's problem.

For example, your veterinarian may only be able to provide symptomatic relief to a pet that is experiencing pain. To determine the root cause of the pain and treat it appropriately, additional diagnostic tests may be required, such as bloodwork, radiographs (X-rays), or ultrasound. Preliminary advice may still be given via telemedicine to provide your pet with immediate relief and prevent more serious consequences.

Your veterinarian can help you determine when and where your pet should be seen and can give you an idea of what to expect during the in-person veterinary visit.