A “Gold Standard” is called that because it is considered the best in its category, whatever that may be. But just because it is the best, is it always necessary?
Dr. Richardson has been doing TPLOs and orthopedic and spinal surgeries for years, helping many dogs recover feeling in their back legs and the ability to walk again. The terrifying feeling when your pet starts dragging its feet or has wobbly back legs may put you in front of an emergency clinician with little time to spare. Yes, decisions need to be made quickly as the condition can deteriorate quickly. Unfortunately, the gold standard to diagnose the condition can often prove deadly by not leaving enough finances left over for the actual treatment. So, today’s gold standards for dog spinal surgery — are they really the best for your pet? This guest post by Dr. Richardson explains why they might not be.
Many diagnostic and treatment procedures for pets labeled “Gold Standard” are available in Sacramento, but not in all locations, so they are not always accessible to everyone. Finances are also a key issue for most people seeking veterinary care for their pet, and so the best is not always affordable. But just because you can’t get the best care, a.k.a. the gold standard, it doesn’t mean you can’t get quality care for your pet to deal with the issue at hand.
Say for example that your dog has a ruptured disc in its back. The gold standard for dog spinal surgery diagnostics would be an MRI, which takes quite a bit of effort and expense, and on an urgent basis, it is much less accessible than myelography. To define the two procedures, MRI uses a large magnet to realign the hydrogen atoms of your body to get detailed images of the spine and soft tissues relating to it. Myelography involves the injection of a dye to follow the spinal cord to see where it is pinched. Both MRI and myelography locate the area of the spine that needs surgery; but with myelography, the cost is less so that more money can go towards paying for the actual treatment.
Even before so-called gold standards of care came about, many disorders and diseases were managed and cured by other known, compassionate, workable standards of care. Myelography was once considered the gold standard for spinal imaging. It has been successfully used for over 40 years. It remains the back-up procedure at UC Davis when MRI is not accessible. Some doctors will arrogantly label myelography as archaic, but its ability to diagnose and preserve a pet’s mobility and do so at an affordable price solidifies its usefulness in spinal imaging. It is a foundational tool that should never be regarded as ineffective, dangerous or even life threatening, especially if you are choosing between that or euthanasia for your pet.
My message here is this — if a gold standard procedure is not accessible or affordable to you, don’t let that make you feel inferior if you have to choose a lesser option to save your pet’s life. We have been fortunate to have been consulted on many cases by pet owners after another veterinarian recommended euthanasia; whereas instead, we were able to use myelography as a viable alternative to help heal their pet. We’ve also seen some pet owners who have spent their entire available budget just on the MRI, leaving nothing to afford the actual surgery.
Hence, gold standards can threaten your pet’s life. Keep this in mind as you are making health care decisions for your pet. We believe the goal is always to keep our patients healthy, comfortable and mobile — with diagnostics and treatment options that are accessible and affordable. Compromise may have a bad name in many circumstances, but in this case, it can save a life.
*Pictured above is Keebler in a Walkin’ Wheels dog wheelchair donated to him by Handicapped Pets.