Many pet owners unable to spot an out of hours vet emergency
Although the results only reflect behaviour for one out-of-hours service, the authors believe that this tendency could be be replicated across the small animal veterinary sector.
UK veterinary practices are required to provide their clients with access to veterinary care outside of normal working hours. As with human emergency medicine, this system relies on members of the public recognising what an emergency is and identifying the right time to make contact.
Human research also shows that some people use emergency services for the convenience of seeing medical staff at the time of their choosing, but no such research exists for veterinary services.
So a team based at University Centre Hartpury in Gloucester decided to evaluate if veterinary clientele could differentiate between emergencies and non-emergencies to discover if a similar situation to that observed in human medicine exists within the veterinary industry.
They reviewed calls from one out-of-hours service in the West Midlands, offering a dedicated emergency service for small animals across 29 veterinary practices from January to March 2014.
An emergency was defined as a case where without immediate or timely intervention, lasting damage or death of the patient may occur.
A total of 450 emergency calls were reported, of which 45% were categorised as emergencies, while the remaining calls (55%) were non-emergencies. Common reasons for calls included vomiting, breathing difficulties, lethargy, not eating or drinking, diarrhoea, bleeding, lame, restless and "not themselves."
The majority of calls (67%) related to dogs, 27% were cats and 3% related to rabbits. Within dogs, 67% of calls were categorised as non-emergencies compared with 56% in cats and 49% in rabbits.
A large percentage (up to 67%) of the small animal pet owners surveyed could not accurately recognise veterinary emergencies within their pets, say the authors.
They suggest that, like human emergency medicine, some pet owners may be using veterinary emergency services for convenience "especially given the time demands associated with modern living and the emotional investment people have in their pets."
Other possible reasons for the high percentage of non-emergency calls could be that pet owners are unsure whether their pet's condition is an emergency or not, turning to the emergency out-of-hours service for reassurance.
The authors suggest veterinary practices could offer guidance on what conditions require emergency treatment. Further research exploring why clients elect to contact out-of-hours services for non-emergencies and do not engage with traditional working hours appointments is also warranted, they conclude.
In an accompanying editorial, Emily Thomas at the University of Edinburgh's Royal (Dick) School of Veterinary Studies, says this study raises important questions about the most appropriate handling of non-emergency out-of-hours calls.
She discusses scope for an NHS 111 style telephone advice service, saying on the one hand, "it is likely that the patient will receive more cost effective and possibly better care if treatment is delayed until normal working hours." While on the other hand, "there may be pressure from the client to provide immediate care. The vet may also be constrained by practice treatment policies dictated by commercial pressures."
Instead, she suggests all members of the out-of-hours team, including receptionists, "should be trained in telephone triage and should be aware of common clinical signs constituting an immediate emergency."
Editorial: Easing the emergency burden: ethical dilemmas faced by the out-of-hours vet, veterinaryrecord.bmj.com/looku … doi/10.1136/vr.j3420